Exam 1 Flashcards
What are some of the components of effective communication in a patient interview?
Active listening, open-ended questions, empathy, being aware of cultural perspectives
What is paralanguage?
Speech-patterns
- A warm and soft tone soothes patients
-Your pitch and volume should be low
What are kinesics in patient speech patterns?
Their body language
- be aware of facial expressions, eye contact, defensive barriers, etc
- BE CAREFUL w Touch
How should you be starting your interviews?
Start with open ended questions and then move towards more focused questions
- DO NOT use accuasatory or leading questions
Symptoms vs signs
Symptoms: What the patient feels, subjective
Signs: What the examiner finds, measurable
(Wheezing and pain are both a sign and a symptom)
Can a patient history be subponeaed?
Yes
What does the complete history include?
CC
HPI
PMH/Psx
SH
ROS
What are some considerations that we should take with geriatric patients?
- ADL’s, nutrition/cognitive/psych assestment, medications, falls
What are some questions we can ask about nutritional status?
- Eating throughout the day (what/how often)
- Weight change (loss or gain, intentional or not)
-Diets
-Deficiencies (Vitamin C deficiency=scurvey, alcoholism leads to folate deficiency, Vitamin B- Pellagra)
What does the HPI describe
information relevent to the CC
- Every 1st sentence of the HPI should be: “age of patient, gender, pmh, CC”
What is the acronym for Social History?
HEADDSSS
- Home, Education, Employment, Activities, Diet, Drugs, Sexuality, Safety, Support
What is the pack years formula?
PPD x years
i.e. 1/2 a pack per day over 20 years is 10 pack years
1 pack per day over 20 years is 20 pack years
What is included in the SOAP note
-Problem focused, short
S: Subjective (CC, HPI, PMH and ROS, meds/allergies)
O: Vital signs, PE findings, lab data, imaging results
A: Diagnosis and differential diagnosis
P: Further testing, therapy, referrals, pt education
Steps to building rapport
eye contact, ask questions about their life, open communcation, mirroring
What is one of the most important things NOT to do when transitioning from history closure to PE
- DO NOT ANCHOR on a diagnosis
How to deliver bad news?
Ensure adequate time and privacy
use eye contact
use touch only if appropriate
communicate well, use laymans terms
active listening
Difference between health and wellness
Health: State of being (physical, mental, social)
Wellness: State of living a healthy lifestyle (aims to enhance well-being)
What part of the patient interview do the majority of diagnoses come from?
The history and physical exam
How do you perform percussion
on drums
(Im kidding)
Use middle finger, tap DIP
What do the different sounds indicate during percussion
COPD: high pitched sound
Pnumonia: Have a thudding sound (indicates mucus)
What does the state of nutrition include in the inspection
Homeless, drug addict, kekectic or obese, small, etc
What are neck and renal bruits
constricted arteries, whooshing sounds. Indicate plaque buildup
Normal range for temperature
97F (36.1 C) to 99F (37.2C)
Fever is 100.4 (38C)
When do you use a rectal temperature
when the patient is hypothermic or in heat stroke and you need an extremely accurate body temperature
