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PCM III Exam 1 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Describe non analytical clinical reasoning

A

Involves pattern recognition; fast & implicit

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2
Q

Describe analytical clinical reasoning

A

Evidence based; slow, deliberate and rational

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3
Q

Equation for sensitivity

A

sens = a/(a+c)

a = true + (finding present in disease pts)
c = false - (finding absent in disease pts)

a+c = n1 (total disease pts)

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4
Q

A ______ sensitivity rules _____ disease

A

NEGATIVE sensitivity rules OUT disease

“SnOUT”

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5
Q

Equation for specificity

A

Spec =d/(b+d)

b = false + (patient without dz WITH finding)
d = true - (patient without dz WITHOUT finding)

n2 = b + d (total patients without dz)h

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6
Q

Equation for positive likelihood ratio

A

+LR = sens/(1-spec)

A high +LR means a high likelihood of dz

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7
Q

A positive LR value of 2 means ___%of having dz

A

+15% of dz

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8
Q

A positive LR value of 5 means ___%of having dz

A

+30% of dz

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9
Q

A positive LR value of 10 means ___%of having dz

A

+45% of dz

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10
Q

Equation for negative likelihood ratio

A
  • LR = (1-sens)/spec

A smaller negative LR means less like hood of having dz

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11
Q

A negative LR value of 0.5 means ___%of having dz

A

-15% chance of having dz

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12
Q

A negative LR value of 0.2 means ___%of having dz

A

-30% chance of having dz

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13
Q

A negative LR value of 0.1 means ___%of having dz

A

-45% chance of having dz

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14
Q

A ____ specificity rules _____ dz

A

POSITIVE specificity rules IN disease

“SpIN”

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15
Q

Migraines vs tension headaches have a…

A

Migraine headaches will have prodrome 48 hours before onset (irritability, yawning, hunger)

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16
Q

Strep pharyngitis vs viral pharyngitis will have a….

A

Strep pharyngitis has a very high grade fever (up to 104), whereas viral will have a very low grade fever (if any)

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17
Q

Who’s the cutest

A

You

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18
Q

Before performing a urea breath test for H pylori gastritis, make sure the patient is not using ______ to avoid ______

A

Not using PPI to avoid FALSE NEGATIVE

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19
Q

Behavioral modification for gastritis

A

Stop using causative agent (NSAID, alcohol, smoking)

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20
Q

Metabolic/energetic/immune therapy for gastritis

A

Triple therapy for H pylori

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21
Q

Resp/circulatory therapy for gastritis

A

FOB (fecal occult blood test)

Treat lymphatics

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22
Q

Chapman point for gastritis (stomach)

A

Left 5th and 6th intercostal space parasternal

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23
Q

Sympathetic innervation for stomach (gastritis)

A

T5-10

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24
Q

Parasympathetic innervation for stomach (gastritis)

A

OA/AA

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25
Q

Red flags in GERD (and PUD)

A

Dysphagia (only GERD)
Weight loss
Anemia
+ FOB

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26
Q

If red flags are present in GERD ( and PUD), do a….

A

EGD

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27
Q

Behavioral therapy in GERD

A

lifestyle mod - elevate head on bed; avoid alcohol/smoking, coffee, chocolate, carbs and fats

Weight loss for fat patients

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28
Q

Metabolic/energetic therapy for GERD (3 total)

A

PPI and H2 antagonists

Metaclopramide to stimulate gastric emptying

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29
Q

Respiratory/circulatory therapy for GERD

A

Check for complications: asthma, hoarseness, dental carried

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30
Q

Sympathetic innervation of esophagus (GERD)

A

T5-10

31
Q

Parasympathetic innervation for esophagus (GERD)

A

OA/AA

32
Q

Ulcers in patients 30-55yo are more likely… (duodenal or gastric?)

A

Duodenal

33
Q

Ulcers in patients 55-70 are more likely… (duodenal or gastric?)

A

Gastric

34
Q

When does pain occur in duodenal PUD

A

1.5-3 hours after eating

35
Q

Are patients with duodenal or gastric ulcers more likely be woken out of sleep?

A

Duodenal

36
Q

Behavioral therapy for PUD

A

Balance meals at regular intervals
Stop smoking g

NO justification for bland meals

37
Q

Metabolic/energetic/immune therapy for PUD

A

PPI

Abx

38
Q

Respiratory/circulatory therapy for PUD

A

FOB
CBC
Address lymphatics

39
Q

Chapman’s point for stomach (yes, second time I’m asking this…. just for completeness)

A

Left 5th and 6th intercostal space parasternal

40
Q

What demographic is most likely affected by biliary dz

A

Fat middle aged wome

41
Q

Imaging for biliary disease

A

Transabdominal ultrasound after 6 HOURS FASTING

*if negative, do a HIDA scan with CCK

42
Q

Which imaging is not sensitive for detecting gallstones

A

CT

43
Q

Behavioral therapy for biliary dz

A

Anything that helps you lose weight lmao (exercise, healthy diet)

44
Q

Metabolic/energetic/immune therapy for biliary disease

A

Ursodiol (for patients who are not candidates for cholecystectomy)

45
Q

Chapman’s point for biliary dz

A

Right 6th intercostal space parasternal

46
Q

Respiratory/circulatory therapy for biliary dz

A

Treat lymphatics

47
Q

Biomechanical therapy for biliary dz

A

Cholecystectomy

48
Q

Ur still here bro?

A

Up ur nic pussy

49
Q

Best imaging for pancreatitis

A

MRI with contrast

50
Q

Behavioral therapy for pancreatitis

A

Stop alcohol
Cholesterol lowering diet
Oral pancreatic enzymes? Idk why tbh

51
Q

Metabolic/energetic/immune therapy for pancreatitis

A 
Parenteral nutrition (saline or Ringers lactate)
Opioids
52
Q

Respiratory/circulatory therapy for pancreatitis

A

Watch for complications:
1 splanchnic venous thrombosis
2 pseuaneurysm

53
Q

Anterior Chapman’s point for pancreas

A

7th intercostal space

54
Q

Posterior Chapman’s point for pancreas

A

Transverse process of T7and T8

55
Q

Sympathetic innervation for pancreas

A

T5-10

56
Q

Parasympathetic innervation for pancreas

A

OA/AA

57
Q

Biomechanical therapy for pancreatitis

A

check for SD and then treat with MFR, MET, counter strain

58
Q

Behavioral therapy for acute hepatitis

A

Stop drinking

Stop NSAIDs

59
Q

Metabolic/energetic/immune therapy for acute hepatitis

A

Test enzymes

Ultrasound

60
Q

Respiratory/circulatory therapy for acute hepatitis

A

O2
Prophylaxis for DVT
Lymphatics once stable

61
Q

Chapman’s point for liver

A

Right 5th and 6th intercostal space at costrochondral joint

62
Q

Biomechanical therapy for acute pancreatitis

A

Once stable, find SD and treat with indirect techniques, CS, FPR, articulation

63
Q

Imaging for diverticulitis

A

CT with IV and oral contrast

64
Q

Behavior therapy for diverticulitis

A

Increase fiber

65
Q

Respiratory/circulatory therapy for diverticulitis

A

IV fluids

DVT prophylaxis

66
Q

Metabolic/energetic/immune therapy for diverticulitis

A

CBC and enzymes

67
Q

Sympathetic innervation for descending colon and sigmoid

A

T12-L2

68
Q

Sympathetic innervation for ascending and transverse colon

A

T10-L2

69
Q

Parasympathetic innervation for upper GI all the way to transverse colon

A

OA/AA

70
Q

Parasympathetic innervation for descending and sigmoid colon

A

S2-4

71
Q

Appendectomy is protective against _____ (IBD)

A

Ulcerative colitis

72
Q

Metabolic/energetic/immune therapy for IBD

A

B9, B12, Vit D supplement
Monitor for anemia
Address lymphatics

73
Q

Respiratory/circulatory therapy for IBD

A

CT - thickening of bowel wall

74
Q

Biomechanical therapy for IBD

A

Once stable, Identify SD and use indirect techniques, CS, FPR, articulation

PCM III Exam 1 (1 decks)

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