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clinical medicine > exam 1 material > Flashcards

exam 1 material Flashcards

1
Q

What are the 4 C’s to improve communication?

A

Call, Cause, Concern, and Cope

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2
Q

What are the 4 C’s to improve communication?

A

Call, Cause, Concern, and Cope

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3
Q

Acronym to check for depression

A 
SIG-E-CAPS
Sleep changes
Interest
Guilt
Energy
Cognition/concentration
Appetite
Psychomotor
Suicide
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4
Q

Alcohol thresholds

A

Men: 14/week, 4/day, 5 drinks/2hr binge
Women: 7/week, 3/day, 4 drinks/2hr binge
>65yrs: 1/day

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5
Q

Alcohol acronyms

A 
Concern                    Take (how many to feel buzzed)
Annoyed                   Annoyed (by criticism)
Guilty                         Cut (feel you should?)
Eye-opener               Eye-Opener (need drink in morning?)
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6
Q

Domestic violence acronym

A

Hurt physically
Insult
Threaten
Scream at you?

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7
Q

Types of notes/exams

A

Comprehensive: new pt, expanded, ~45 min
Focused: problem-oriented, based, ~10-15 min

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8
Q

words to avoid

A

normal, within normal limits, poor, good

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9
Q

CODIERS

A 
Chronology
Onset
Description
Intensity
Exacerbating factors
Remitting factors
Symptoms associated
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10
Q

OLDCARTS

A 
Onset
Location
Duration
Character
Aggravating/alleviating factors
Radiation
Timing
Severity
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11
Q

Info about Medications

A

name, dose, number of tablets, route, frequency, last taken

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12
Q

Info about Allergies

A

drugs, food, meds. type of rxn (side effect vs allergy)

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13
Q

PMH acronym

A 
THE CHADS
Thyroid
Hypertension
Emphysema
Cancer
Heart Disease
Asthma
Diabetes
Stroke
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14
Q

Info about surgery

A

type, reasons, date, hospital, complications

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15
Q

General survey at beginning of exam

A

appearance, LOC, nutritional status, comparison to state age, distress, position of comfort, skin color, hygeine, dress

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16
Q

Vital signs

A

temp, pulse, respirations, BP, pain level

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17
Q

Standard temperatures

A

Oral: 37 C, 98.6 F
Axillary: lower than oral by 0.6 C, 1 F
Rectal (elderly and children: higher than oral by 0.4-0.5 C, 0.7-0.9 F
Tympanic: higher than oral by 0.8 C, 1.4 F

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18
Q

Afebrile

A

97-100.4 F rectal (36-38 C)

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19
Q

febrile

A

> 100.4F, 38 C

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20
Q

fever or pyrexia

A

elevated body temp

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21
Q

hyperpyrexia

A

extreme elevation

>106 F, 41 C rectal

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22
Q

hypothermia

A
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23
Q

what temp to worry at for kids

A

> 103-104 F

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24
Q

What temp to worry at for elderly

A

> 100-101 F

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25
Q

Standard resting pulse

A

60-100 bpm

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26
Q

Bradycardia

A
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27
Q

Tachycardia

A

> 100bpm

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28
Q

Pulse scale

A

4+ bounding, aneurysmal: fever, fear, exercise, cocaine, thyroid issues
3+ full, increased: caffeine, fear, anxiety
2+ expected
1+ diminished, barely palpable: stenosis, hypervolemia, anemia, dehydration, shock, left ventricular failure
0 absent, not palpable: asystole, occlusion, thrombosis

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29
Q

Use doppler blood flow for

A

BP, fetal heart sounds, locate blood vessels, weak pulses, vessel patency

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30
Q

Standard respirations

A

12-20 breaths/min

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31
Q

Bradpnea

A
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32
Q

tachypnea

A

> 20 bpm

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33
Q

Diaphragm of stethescope

A

larger, for high-pitched sounds (S1, S2), abdomen, lung, some heart

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34
Q

Bell of stethescope

A

open side, for low-pitched sounds (S3, S4), arteries, bad heart sounds in large vessels

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35
Q

JNC 8 standard BP

A
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36
Q

JNC 8 >60 y/o

A

systolic

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37
Q

JNC 8 >18 y/o with chronic kidney disease or diabetes

A

systolic

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38
Q

JNC 7 prehypertension

A

120-139/80-89

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39
Q

JNC 7 stage 1

A

140-159/90-99

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40
Q

JNC 7 stage 2

A

> 160/>100

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41
Q

Orthostatic BP: When and how

A

if pt has lost fluids/anemic/hypovolemic

sitting to standing, laying down

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42
Q

orthostatus BP changes

A

systolic drop 20 mmHg
diastolic drop 10 mmHg
pulse increase 15 beats

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43
Q

How to take an ideal BP

A

pt rests for 5 min, no nicotine or caffeine for 30 min prior, no clothing, palpate artery, keep arm at heart level, estimate systolic, wait 15-30 sec, use bell

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44
Q

Head circum. used

A

birth-24 months

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45
Q

Universal precautions from CDC

A

used for blood, fluids, excretions, oral mucosa

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46
Q

supine

A

on back

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47
Q

prone

A

on stomach

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48
Q

dorsal recumbent

A

supine knees bent and feet on table

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49
Q

lateral recumbent

A

On side, legs extended or flexed

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50
Q

lithotomy

A

dorsal recumbent with legs in stirrups

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51
Q

sims

A

lateral recumbent with top leg flexed at hip and knee

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52
Q

Examination techniques

A

Inspection
palpation
percussion
auscultation

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53
Q

female athlete triad

A

disordered eating, amenorrhea, osteoporosis

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54
Q

Autonomy

A

the pt’s need for self-determination

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55
Q

beneficence

A

the ethical principle that means ‘do good’ for the pt

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56
Q

chief complaint

A

a brief statement telling why the pt is seeking care

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57
Q

HPI

A

step by step evaluation surrounding the pt’s reason for seeking care

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58
Q

nonmaleficence

A

the ethical principle that means ‘do no harm’ to the pt

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59
Q

PMH

A

a statement of the pt’s overall health prior to the onset of the present complaint

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60
Q

family Hx

A

information about the health of family members to identify a possible health risk for the pt: this should include ages (ages at death) and causes of death

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61
Q

social Hx

A

work, relationship status, diet, exercise, sexual and military experiences, use of tobacco, alcohol, illicit drugs

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62
Q

review of systems

A

identifies the presence or absence fo health-related issues in each body system

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63
Q

utilitarianism

A

a theory that defines the appropriate use of resources as that which results in the greatest good for the greatest number

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64
Q

values

A

the ideals, customs, institutions, and behaviors regarded by a specific group

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65
Q

O in OPQRSTAE

A

onset

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66
Q

Ps in OPQRSTAE

A

provoke (what makes them worse)
palliate (what makes them better)
progression (have they changed)
prior episodes

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67
Q

Q in OPQRSTAE

A

quality, quantity (description)

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68
Q

R in OPQRSTAE

A

region, radiation (where is it, does it spread)

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69
Q

S in OPQRSTAE

A

severity (rate 1-10)

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70
Q

T in OPQRSTAE

A

timing (when does it occur, how long does it last, constant or intermittent)
treatment

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71
Q

A in OPQRSTAE

A

Associated symptoms (ROS)

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72
Q

E in OPQRSTAE

A

environment (anyone else with similar symptoms)

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73
Q

substance abuse screening acronym for adolescents

A 
Car
Relax
Alone
Forget
Family or Friend (asked to cut down)
Trouble
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74
Q

darkened skin on neck

A

acanthosis nigricans

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75
Q

raised and red skin, scar tissue

A

keloid

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76
Q

tool used to examine eye

A

ophthalmoscope

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77
Q

tool used to measure oxygenated Hb

A

pulse oximeter

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78
Q

tests the membrane and bones in ear

A

tympanometer

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79
Q

splotchy sores, sometimes open

A

hidradenitis suppurativa

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80
Q

line of hair during pregnancy

A

linea nigra

81
Q

tool used to examine ear

A

otoscope

82
Q

stretch marks

A

striae

83
Q

splotchy dark spots

A

Kaposi’s sarcoma

84
Q

raised, round spots

A

neurofibromatosis

85
Q

straight line across palm, Down syndrome

A

palmer crease

86
Q

allergic salute

A

transverse crease

87
Q

Acronym to check for depression

A 
SIG-E-CAPS
Sleep changes
Interest
Guilt
Energy
Cognition/concentration
Appetite
Psychomotor
Suicide
88
Q

Alcohol thresholds

A

Men: 14/week, 4/day, 5 drinks/2hr binge
Women: 7/week, 3/day, 4 drinks/2hr binge
>65yrs: 1/day

89
Q

Alcohol acronyms

A 
Concern                    Take (how many to feel buzzed)
Annoyed                   Annoyed (by criticism)
Guilty                         Cut (feel you should?)
Eye-opener               Eye-Opener (need drink in morning?)
90
Q

Domestic violence acronym

A

Hurt physically
Insult
Threaten
Scream at you?

91
Q

Types of notes/exams

A

Comprehensive: new pt, expanded, ~45 min
Focused: problem-oriented, based, ~10-15 min

92
Q

words to avoid

A

normal, within normal limits, poor, good

93
Q

CODIERS

A 
Chronology
Onset
Description
Intensity
Exacerbating factors
Remitting factors
Symptoms associated
94
Q

OLDCARTS

A 
Onset
Location
Duration
Character
Aggravating/alleviating factors
Radiation
Timing
Severity
95
Q

Info about Medications

A

name, dose, number of tablets, route, frequency, last taken

96
Q

Info about Allergies

A

drugs, food, meds. type of rxn (side effect vs allergy)

97
Q

PMH acronym

A 
THE CHADS
Thyroid
Hypertension
Emphysema
Cancer
Heart Disease
Asthma
Diabetes
Stroke
98
Q

Info about surgery

A

type, reasons, date, hospital, complications

99
Q

General survey at beginning of exam

A

appearance, LOC, nutritional status, comparison to state age, distress, position of comfort, skin color, hygeine, dress

100
Q

Vital signs

A

temp, pulse, respirations, BP, pain level

101
Q

Standard temperatures

A

Oral: 37 C, 98.6 F
Axillary: lower than oral by 0.6 C, 1 F
Rectal (elderly and children: higher than oral by 0.4-0.5 C, 0.7-0.9 F
Tympanic: higher than oral by 0.8 C, 1.4 F

102
Q

Afebrile

A

97-100.4 F rectal (36-38 C)

103
Q

febrile

A

> 100.4F, 38 C

104
Q

fever or pyrexia

A

elevated body temp

105
Q

hyperpyrexia

A

extreme elevation

>106 F, 41 C rectal

106
Q

hypothermia

A
107
Q

what temp to worry at for kids

A

> 103-104 F

108
Q

What temp to worry at for elderly

A

> 100-101 F

109
Q

Standard resting pulse

A

60-100 bpm

110
Q

Bradycardia

A
111
Q

Tachycardia

A

> 100bpm

112
Q

Pulse scale

A

4+ bounding, aneurysmal: fever, fear, exercise, cocaine, thyroid issues
3+ full, increased: caffeine, fear, anxiety
2+ expected
1+ diminished, barely palpable: stenosis, hypervolemia, anemia, dehydration, shock, left ventricular failure
0 absent, not palpable: asystole, occlusion, thrombosis

113
Q

Use doppler blood flow for

A

BP, fetal heart sounds, locate blood vessels, weak pulses, vessel patency

114
Q

Standard respirations

A

12-20 breaths/min

115
Q

Bradpnea

A
116
Q

tachypnea

A

> 20 bpm

117
Q

Diaphragm of stethescope

A

larger, for high-pitched sounds (S1, S2), abdomen, lung, some heart

118
Q

Bell of stethescope

A

open side, for low-pitched sounds (S3, S4), arteries, bad heart sounds in large vessels

119
Q

JNC 8 standard BP

A
120
Q

JNC 8 >60 y/o

A

systolic

121
Q

JNC 8 >18 y/o with chronic kidney disease or diabetes

A

systolic

122
Q

JNC 7 prehypertension

A

120-139/80-89

123
Q

JNC 7 stage 1

A

140-159/90-99

124
Q

JNC 7 stage 2

A

> 160/>100

125
Q

Orthostatic BP: When and how

A

if pt has lost fluids/anemic/hypovolemic

sitting to standing, laying down

126
Q

orthostatus BP changes

A

systolic drop 20 mmHg
diastolic drop 10 mmHg
pulse increase 15 beats

127
Q

How to take an ideal BP

A

pt rests for 5 min, no nicotine or caffeine for 30 min prior, no clothing, palpate artery, keep arm at heart level, estimate systolic, wait 15-30 sec, use bell

128
Q

Head circum. used

A

birth-24 months

129
Q

Universal precautions from CDC

A

used for blood, fluids, excretions, oral mucosa

130
Q

supine

A

on back

131
Q

prone

A

on stomach

132
Q

dorsal recumbent

A

supine knees bent and feet on table

133
Q

lateral recumbent

A

On side, legs extended or flexed

134
Q

lithotomy

A

dorsal recumbent with legs in stirrups

135
Q

sims

A

lateral recumbent with top leg flexed at hip and knee

136
Q

Examination techniques

A

Inspection
palpation
percussion
auscultation

137
Q

female athlete triad

A

disordered eating, amenorrhea, osteoporosis

138
Q

Autonomy

A

the pt’s need for self-determination

139
Q

beneficence

A

the ethical principle that means ‘do good’ for the pt

140
Q

chief complaint

A

a brief statement telling why the pt is seeking care

141
Q

HPI

A

step by step evaluation surrounding the pt’s reason for seeking care

142
Q

nonmaleficence

A

the ethical principle that means ‘do no harm’ to the pt

143
Q

PMH

A

a statement of the pt’s overall health prior to the onset of the present complaint

144
Q

family Hx

A

information about the health of family members to identify a possible health risk for the pt: this should include ages (ages at death) and causes of death

145
Q

social Hx

A

work, relationship status, diet, exercise, sexual and military experiences, use of tobacco, alcohol, illicit drugs

146
Q

review of systems

A

identifies the presence or absence fo health-related issues in each body system

147
Q

utilitarianism

A

a theory that defines the appropriate use of resources as that which results in the greatest good for the greatest number

148
Q

values

A

the ideals, customs, institutions, and behaviors regarded by a specific group

149
Q

O in OPQRSTAE

A

onset

150
Q

Ps in OPQRSTAE

A

provoke (what makes them worse)
palliate (what makes them better)
progression (have they changed)
prior episodes

151
Q

Q in OPQRSTAE

A

quality, quantity (description)

152
Q

R in OPQRSTAE

A

region, radiation (where is it, does it spread)

153
Q

S in OPQRSTAE

A

severity (rate 1-10)

154
Q

T in OPQRSTAE

A

timing (when does it occur, how long does it last, constant or intermittent)
treatment

155
Q

A in OPQRSTAE

A

Associated symptoms (ROS)

156
Q

E in OPQRSTAE

A

environment (anyone else with similar symptoms)

157
Q

substance abuse screening acronym for adolescents

A 
Car
Relax
Alone
Forget
Family or Friend (asked to cut down)
Trouble
158
Q

darkened skin on neck

A

acanthosis nigricans

159
Q

raised and red skin, scar tissue

A

keloid

160
Q

tool used to examine eye

A

ophthalmoscope

161
Q

tool used to measure oxygenated Hb

A

pulse oximeter

162
Q

tests the membrane and bones in ear

A

tympanometer

163
Q

splotchy sores, sometimes open

A

hidradenitis suppurativa

164
Q

line of hair during pregnancy

A

linea nigra

165
Q

tool used to examine ear

A

otoscope

166
Q

stretch marks

A

striae

167
Q

splotchy dark spots

A

Kaposi’s sarcoma

168
Q

raised, round spots

A

neurofibromatosis

169
Q

straight line across palm, Down syndrome

A

palmer crease

170
Q

allergic salute

A

transverse crease

171
Q

The best probe for image density while sacrificing depth is

A

linear array

172
Q

You need to image in great detail a superficial structure so you choose a probe in

A

linear array

173
Q

When studying a distant structure, one would select a probe that uses

A

longer wavelength

174
Q

You are interested in a structure that is at a distance from the skin. you select a probe that

A

uses a longer wavelength

175
Q

When ultrasounding a structure, a more complete picture can be obtained by moving the probe. To create a new image in a plane that is parallel to the current plane, you would

A

Sweep

176
Q

You visualize a circular structure with an anechoic center. You theorize it is a blood vessel so you want to insert a needle. you would like to see the needle from when it enters the skin to when it comes to rest within what you theorize is the lumen. you maneuver the probe by

A

rotation

177
Q

To differentiate structures using Doppler effect, one

A

must angle the probe pointing the beam toward the heart

178
Q

when using the doppler setting on the ultrasound machine, one must

A

select the image showing the structure in cross section

179
Q 
Ultrasound waves are attenuated differently by different tissues. Select the tissues that most highly attenuates ultrasound:
air
bone
water
muscle
fat
A

air

180
Q 
Obtaining a good image by ultrasound requires the wave energy from the probe be carried through tissues. Which structure or pathology will most poorly propagate the sound wave?
abscess collection
fractured bone
blood in abdomen
pneumonia
ruptured lung
A

ruptured lung

181
Q

Leading edge

A

side with marker, usually pointed toward pt’s head or right

182
Q

higher frequency, lower wavelength

A

better resolution

183
Q

lower frequency, higher wavelength

A

better penetration

184
Q

focused US exam

A

physician acquired and interpreted

185
Q

comprehensive US exam

A

technician acquired, radiologist interpreted

186
Q

sweep

A

perpendicular to plane of leading edge, large motion

187
Q

slide

A

in plane of leading edge, large motion

188
Q

rock

A

in plane of leading edge, pivoting on point, small motion

189
Q

fan

A

like sweep, pivoting on point, small motion

190
Q

rotate

A

used to switch from short to long axis

191
Q

anechoic

A

black, fluids (blood, bile, urine)

192
Q

hypoachoic

A

gray, soft tissue and solid organs (lung, liver, spleen, muscle)

193
Q

hyperachoic

A

white, air (pericardium, periosteum, diaphragm)

194
Q

anisotropy

A

color of a tissue can change with changing the angle of insonation

195
Q

curved/convex probe

A

medium resolution, medium penetration, abdominal, OB/GYN

196
Q

phased array

A

low resolution, high penetration, cardiac, abdominal, OB

197
Q

linear array

A

high resolution, low penetration, vascular, musculoskeletal, superficial

198
Q

Does ultrasound travel faster through air or tissues?

A

soft tissues

clinical medicine (1 decks)

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