Exam 1 Flashcards

1
Q

What are some of the components of effective communication in a patient interview?

A

Active listening, open-ended questions, empathy, being aware of cultural perspectives

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2
Q

What is paralanguage?

A

Speech-patterns
- A warm and soft tone soothes patients
-Your pitch and volume should be low

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3
Q

What are kinesics in patient speech patterns?

A

Their body language
- be aware of facial expressions, eye contact, defensive barriers, etc
- BE CAREFUL w Touch

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4
Q

How should you be starting your interviews?

A

Start with open ended questions and then move towards more focused questions
- DO NOT use accuasatory or leading questions

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5
Q

Symptoms vs signs

A

Symptoms: What the patient feels, subjective
Signs: What the examiner finds, measurable
(Wheezing and pain are both a sign and a symptom)

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6
Q

Can a patient history be subponeaed?

A

Yes

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7
Q

What does the complete history include?

A

CC
HPI
PMH/Psx
SH
ROS

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8
Q

What are some considerations that we should take with geriatric patients?

A
  • ADL’s, nutrition/cognitive/psych assestment, medications, falls
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9
Q

What are some questions we can ask about nutritional status?

A
  • 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)
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10
Q

What does the HPI describe

A

information relevent to the CC
- Every 1st sentence of the HPI should be: “age of patient, gender, pmh, CC”

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11
Q

What is the acronym for Social History?

A

HEADDSSS
- Home, Education, Employment, Activities, Diet, Drugs, Sexuality, Safety, Support

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12
Q

What is the pack years formula?

A

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

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13
Q

What is included in the SOAP note

A

-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

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14
Q

Steps to building rapport

A

eye contact, ask questions about their life, open communcation, mirroring

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15
Q

What is one of the most important things NOT to do when transitioning from history closure to PE

A
  • DO NOT ANCHOR on a diagnosis
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16
Q

How to deliver bad news?

A

Ensure adequate time and privacy
use eye contact
use touch only if appropriate
communicate well, use laymans terms
active listening

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17
Q

Difference between health and wellness

A

Health: State of being (physical, mental, social)
Wellness: State of living a healthy lifestyle (aims to enhance well-being)

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18
Q

What part of the patient interview do the majority of diagnoses come from?

A

The history and physical exam

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19
Q

How do you perform percussion

A

on drums
(Im kidding)

Use middle finger, tap DIP

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20
Q

What do the different sounds indicate during percussion

A

COPD: high pitched sound
Pnumonia: Have a thudding sound (indicates mucus)

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21
Q

What does the state of nutrition include in the inspection

A

Homeless, drug addict, kekectic or obese, small, etc

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22
Q

What are neck and renal bruits

A

constricted arteries, whooshing sounds. Indicate plaque buildup

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23
Q

Normal range for temperature

A

97F (36.1 C) to 99F (37.2C)
Fever is 100.4 (38C)

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24
Q

When do you use a rectal temperature

A

when the patient is hypothermic or in heat stroke and you need an extremely accurate body temperature

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25
Q

What is a fever of unknown origin typically caused by

A

In adults: infections (25-40% of cases) or cancer (25-40% of cases)
In children: Infections (30-50% of cases) and rarely in cancer (5-10% of cases)

Autoimmune disorders contribute to 10-20% for both adults and children

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26
Q

What do you not use to measure a pulse

A

your thumbs (silly gooses)

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27
Q

What are the characteristiscs of a pulse

A

rythym, amplitude (0-4)

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28
Q

What can cause bradychardia

A

Infections, hypothyoridism, beta blockers, inflammatory diseases

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29
Q

What can cause tachychardia

A

High blood pressure, thyroid disease, alcohol use, emotional stress

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30
Q

Charachteristics of respiratory rate

A

Rythym, rate, character

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31
Q

What is apnea?

A

cessation of breathing

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32
Q

What is hyperpena

A

increased depth of breathing, usually associated with metabolic acidosis

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33
Q

What are cheyne-stokes respirations

A

crescendo-decresendo pattern
Caused by stroke/CNS injury/actively dying patients

34
Q

What are kussmal respirations

A

deep, rapid breathing
seen in DKA

35
Q

What one-time measurement of BP indicates treatment?

A

> 160/100

36
Q

What orthostatic measurement is significant when taking BP

A

When the patient goes from sitting to standing, the systolic should not decrease more than 20, and the diastolic should not decrease more than 10, the HR should not increase by 20 or more.

37
Q

What is a short description of general survey

A

WDWN (well developed, well nourished)

38
Q

What is a macule papule

A

macule: <1cm, papule: superficial, raised, <1cm

39
Q

What is the difference between a primary and secondary leasion

A

Primary arises first, secondary arises from the changes to the primary leasion (i.e. scratch itchy mole and it create scales, the scales are secondary)

40
Q

Elevated lesions classifications

A

Plaque: >1cm
Papule: <1cm
Nodule: deeper, solid, >1cm

41
Q

Elevated lesions with fluid classifications

A

Cyst: Fluid filled papule or nodule
Postule: pimple
Vesicles: Superficial, fluid filled, <1cm (herpes virus)
Bullae: >1cm (blister/burn)

42
Q

What is excoriation a fancy word for

A

a scratch

43
Q

What is an ulcer

A

a loss of skin below the dermis

44
Q

What is blanching

A

when you touch a lesion and it turns white

45
Q

What are the 3 red/purple lesions

A

Petechiae- nonblanching, <.5cm
-Pupura- nonblanching, >.5cm
Ecchymosis: Nonblanching, various size

46
Q

What does keratotic mean

A

horny thickening (like warts)

47
Q

What condition appears in a linear-line shape

A

poision ivey, linear postules/bullae

48
Q

What appears in a multiform shape

A

chicken pox

49
Q

What are papulosquamous?

A

Papules or plaques with scaling

50
Q

What appears in a zosteriform arrangement

A

shingels

51
Q

How does chicken pox appear

A

Macular papula rash

52
Q

What is impetigo

A

postules on kids mouth from staph infection

53
Q

What are psoriasis classified as

A

plaques (bigger than 1cm and riased)

54
Q

How does tinea corporis appear

A

anular, accruate, target lesion

55
Q

What are examples of contact dermatitis

A

allergy from rings, eczema

56
Q

Most common type of skin cancer

A

Basal cell carcinoma

57
Q

Presentation of squamous cell cancer

A

non-healing, ulcerated, firm, progressive, crusted

58
Q

Which skin cancer are you at a risk for if you are immunocompromised

A

squamous cell

59
Q
A

Bulla, >1cm, fluid filled, blister/burn

60
Q
A

macule, circular flat, <1cm

61
Q
A

Nodule, circular elevated, solid, >1cm

62
Q
A

Patch, flat, >1cm

63
Q
A

Papule, superficial solid and elevated, <.5cm

64
Q
A

Plaque>1cm

65
Q
A

Vesicle, vesicle containing fluid

66
Q
A

Papule (circular collection of free fluid, <1cm)

67
Q
A

Wheal, plaque, may last a few hours (commonly from injecting anesthetic)

68
Q
A

Scales, flakes or plates

69
Q
A

Fissure - crack or split

70
Q
A

Excoriation (linear erosion)
its literally just a scratch lol

71
Q
A

Erosion (superficial loss of epidermis)

72
Q
A

Dorsal recumbent- good for pts who cannot lie flat due to back pain

73
Q
A

Fowlers- used for pts who have cardio issues/difficulty breathing/NG tube

74
Q
A

Lithotomy
Time for a pap smear!
used for OB/GYN procedures and childbirth

75
Q
A

Left lateral recumbent- take off pressure on vena cava for pregnant women or hypertensive patients

76
Q
A

Proctologic
rectal exams (potentially?)

77
Q
A

Reverse trendelenburg
-venous air embolism, pulmonary asperation prevention

78
Q
A

Sims position
Enemas, perineal exams, comfort during pregnancy

79
Q
A

I fear i do not need to include a description for sitting

80
Q
A

supine
also called recumbent

81
Q
A

Trendelenburg
OBGYN procedures, abdominal surgeries, central line placement

82
Q
A

Here for reference