Exam #5: Putting It All Together

Question 1

What are the four C’s of communication?

Answer 1

1) Courtesy
2) Comfort
3) Connection
4) Confirmation

Question 2

What are some of the common ways that a good doctor-patient relationship is hindered?

Answer 2

• Keeping the patient waiting without an explanation
• Being in a furry
• Belittling the patient’s concerns or emotions
• Ignoring their life stresses*

Question 3

What should you keep in mind when dealing with a difficult patient?

Answer 3

1) Understand the needs & insecurities of the patient
2) Never disrespect
3) Use supportive resources

Question 4

What are some things that can be done to effectively deliver bad news?

Answer 4

• Turn off pager/ phone
• Involve family, significant other, &/or clergy
• Be specific in details
• Adjust flow of information to patients needs
• Avoid jargon
• Inform patient ASAP

Question 5

When would you take a comprehensive history?

Answer 5

• New patient
• Annual physical
• Pre-operative physical
• Hospitalized patient

Question 6

When would you take a problem oriented or focused history?

Answer 6

• Typical progress note
• Sick visit
• Acute problem
• Life threatening problem

*Anything requiring immediate attention

Question 7

What is the difference between a basic physical exam and an expanded physical exam?

Answer 7

Basic= tests major function of the system

• Heart
• Lungs
• Do a basic exam of these on ALL patients

Expanded= in depth examination of a system; done for

• System of chief complaint
• In follow-up to a new problem
• Abnormality found in basic examination

Question 8

What are the parts of the basic examination of the heart?

Answer 8

• Inspect
• Palpate PMI
• Auscultate

Question 9

What are the parts of a basic examination of the lungs?

Answer 9

• Inspect
• Auscultate
• AP diameter

Question 10

How should you orally present a patient?

Answer 10

This is a brief presentation of all pertinent positives & negatives–the shorter the better

Question 11

Aside from history, what else should be given in an oral presentation to a mentor/ colleague?

Answer 11

• Pertinent exam findings
• Assessment including pertinent labs, imaging, other diagnostic procedures
• Differential diagnosis
• Proposed plan