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Physical Diagnosis ( IM ) > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

It should be written in patient’s own words. Usually not the first complaint mentioned by the patient.

A

Chief complaint

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2
Q

Clear, chronological narrative account of present problem (chief complaint)

A

History of Present illness

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3
Q

What are the things that you should consider in a patient’s persepective?

A

F-I-F-E

Patient’s Feelings

Patient’s Ideas about the nature and the cause of the problem

The effect of that problem on the patient’s life and Function

the patient’s Expectation of the disease, clinician, or health care

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4
Q

This contains the date and time of the examination, as well as the source of history and reliability

A

general data

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4
Q

What do you think is the type of questioning shown here in this sequence?

“Tell me about your chest discomfort.” (pause)

“what else? “(pause)

“Where did you feel it?” (pause)

“show me”. (pause)

“anywhere else?”

A

Moving from Open-ended to focused questions

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5
Q

Type of interview where in you have to follow the patient’s lead

A

patient-centered

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5
Q

What are you going to do if the patient seems to a mutlitude of symptoms?

A

focus on the context of symptom, emphasizing the patient’s perspective

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6
Q

It involves observation of what the patient knows about his/her illness.

A

History-taking

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6
Q

It serves to identify problems the patient has not mentioned so that they are not missed as wells as the symptoms of other diseases that the patient knows or may not know about and symptoms which may be risk factors for present illness

A

Review of Systems

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6
Q

HPN, Heart Disease, DM, cancer, thyroid disease, seizure disorders, psychiatric disorders are reviewed during this part

A

Family History

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7
Q

It is just a simple repetition of the patient’s last words, which encourages the patient to expand on factual details and feelings

A

echoing

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8
Q

What is the most widely used screening questions?

A

C-A-G-E

Cutting Down

Annoyance when criticized

Guilty-feeelings

Eye-openers

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9
Q

What are the 7 attributes of a symptom?

A

Location

Quality

Quantity/severity

Timing

Setting in which it occurs

Remitting or exacerbating factors

Associated Manifestations

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10
Q

Ask about symptoms in the other major body systems NOT mentioned in HPI

A

Review of Systems

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10
Q

A patient with delirium seeks medical help. What do you need to determine first?

A

Decision-making capacity

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12
Q

What is the difference of disease and illness?

A
  1. Disease is the explanation the clinician brings to the symptoms, leads to diagnosis and management plan.
  2. Illness is the how the patient experiences the symptoms, shaped by previous experiences, and how it affects daily living, culture, age, and expectations of medical care.
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13
Q

This type of questions are more pertinent

A

Yes or no

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14
Q

Encourages patients to express what is most important to them

A

Patient-centered

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15
Q

It consists of facts arranged in a useful manner.

A

Information

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16
Q

the clinician takes charge of the interaction to meet her or his own need to acquire the symptoms

A

Symptom-focused

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17
Q

What are the two type ways a doctor can interview a patient?

A
  1. Patient-centered
  2. Symptom Focused
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19
Q

What do you need to remember for each symptom?

A

O-onset of disease

P-precipitating and palliating factors

Q-quality ( including quantity and severity)

R-region/radiations(location), relation to other bodily function/position

S-sysmptoms associated

T-timing

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21
Q

This varies with age, socioeconomic status, culture and experiences

A

History

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22
Q

When should you start negotiating a plan with your patient?

A

After creating a shared understanding of the problem

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22
Q

Provides an important framework for organizing the patient’s story into various categories pertinent to the patient’s present, past and family health

A

Health history format

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23
Q

This contains the identifying data(name, age, sex, ethnicity, civil status, religion, address) and source of referral

A

General Data

24
Q

How do you respond when you have observed an emotional cue?

A

use NURes

Naming

Understanding

Respecting

26
Q

it involves fact-finding and investigation about the disease

A

History-taking

27
Q

Format focuses your attention on the specific kinds of information you need to obtain, facilitates clinical reasoning and clarifies communication of patient concerns and diagnoses

A

Health history format

29
Q

it involves the present known medical problems

current medications, allergies, immunizations, and previous illness/surgery/blood transfusion

A

Past Medical History

31
Q

Include pertinent POSITIVES and NEGATIVES

and may be done during physical examination

A

Review of Systems

32
Q

Diseases among first or second degree relatives of the patient, listed according to disease, include age at onset and if cause of death

A

Family History

33
Q

Contains the Seven Attributes of a symptom

A

History of Present Illness

34
Q

a detailed PROGRESSION or REGRESSION of symptoms is very important.

A

History of Present illness

35
Q

It is the main reason why the patient seeks medical attention

A

Chief complaint

36
Q
  • relay stories in days before admission
  • narrate in detail
A

sequential presentation

37
Q

A normal response to hard work, sustained stress, or grief, elicit the life circumstances in which it occurs.

A

fatigue

38
Q

It denotes a demonstrable loss of muscle power and will be discussed later with other neurologic symptoms

A

weakness

39
Q

how do you determine whether the drop in weight is proportional to any change in food intake or whether intake has remained normal or even increased?

A

Pursue a thorough psychosocial history. Who cooks and shops for the patient? Where does the patient eat? With whom? Are there any prob- lems with obtaining, storing, preparing, or chewing food? Does the patient avoid or restrict certain foods for medical, religious, or other reasons?

40
Q

what is the BMI of an underweight patient?

A

<18.5

41
Q

What is the BMI of an extremely obese person?

A

>40

42
Q

This begins with the opening moments of the patient encounter,

A

General Survey

43
Q

If the BMI is 35 or greater, what are you going to do?

A

measure the patient’s waist circumference just above the hips

44
Q

Width of the inflatable bladder of the cuff should be how many percent in relation to upper arm circumference?

A

40%

45
Q

a silent interval that may be present between the systolic and the diastolic pressures.

A

auscultatory gap

46
Q

how do you test for orthostatic hypotension?>

A

Measure blood pressure and heart rate in two posi- tions—supine after the patient is resting from 3 to 10 minutes, then within 3 minutes after the patient stands up.

47
Q

How do you assess the heart rate? and what is the normal range of Heart rate?

A

do a radial pulse. 50-90

48
Q

Pathophysiologic processes result in ____?

A

specific physical exam findings

49
Q

Skill in physical diagnosis is acquired with ______??

A

experience

50
Q

the physical examination should be done when?

A

as frequently as the clinical situation warrants

51
Q

The results of the examination, like the details of the history, should be recorded when?

A

right after it’s elicited

52
Q

What is the important goal in Physical diagnosis?

A

An important goal is to minimize the number of times you ask the patient to change position from supine to sitting, or standing to lying supine

53
Q

What are the characteristics of a skillfull clinician?

A

Thorough without wasting time

systematic without being rigid

gentle yet not afraid to cause discomfort

54
Q

If the patient cannot stand, what would you examine first? genitalia or rectum?

A

examine the genitalia first

55
Q

are a set of principles that have been created through reflection and discussion to guide our behavior.

A

Ethics

56
Q

this guide our professional behavior, are not static, but several principles have guided clinicians throughout the ages.

A

Medical Ethics

57
Q

What ethical consideration is affected in “Avoiding relevant topics or creating barriers to open communication”

A

nonmaleficence

58
Q

What ethical consideration:

The interests of the patient should prevail over physicians’ self- interest or the interests of third parties, such as hospitals or insurers.

A

Beneficence

59
Q

What ethical consideration:

informed patients may refuse recommended interventions and choose among reasonable alternatives.

A

Autonomy

60
Q

Can the physician withhold a serious diagnosis?

A

YES

61
Q

This privacy is fundamental to our professional relationships with patients.

A

confidentiality

62
Q

Ethical Consideration:

people should receive what they deserve.

A

justice

63
Q

forbids discrimination in health care based on race, religion, or gender and supports a moral right to health care, with access based on medical need rather than ability to pay.

A

Justice

64
Q
A

Physical Diagnosis ( IM ) (1 decks)

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