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LECOM OPP/H&P (2022-2024) > H&P Final Study Guide > Flashcards

H&P Final Study Guide Flashcards

1
Q

What does CBC stand for?

A

Complete blood count

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2
Q

What does WBC stand for?

A

White blood cell count
Includes: neutrophils, lymphocytes

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3
Q

What does RBC stand for? What does it include?

A

Indices: MHC, MCHC, MCV Hemoglobin
Hematocrit
Platelets
RDW

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4
Q

What does BMP stand for? What are examples?

A

Basic Metabolic Panel
Renal -> BUN, Creatinine
Electrolytes -> Calcium, CO2, Chloride, Glucose, Potassium, Sodium

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5
Q

What does CMP stand for?

A

Complete Metabolic Panel

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6
Q

What does BMP with Liver Tests include?

A

Function Indicators -> PROTEIN
Albumin
Damage Indicators -> ENZYMES
Alkaline Phosphatase, ALT, AST, Bilirubin

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7
Q

What does PO stand for?

A

Taken orally

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8
Q

What does PR stand for?

A

Taken rectally

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9
Q

What does IV stand for?

A

Intravenous

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10
Q

What does IVP stand for?

A

Intravenous push

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11
Q

What does Q day stand for?

A

Once a day

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12
Q

What does Bid, tid, qid indicate?

A

2, 3, 4 times a day

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13
Q

What does Q 6 hrs mean?

A

Every 6 hours

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14
Q

What does Gtts, dppr stand for?

A

Drops, dropperfuls

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15
Q

What does Prn stand for?

A

As needed

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16
Q

What is the importance of open-ended questions?

A

Open-ended questions require that the physician appears relaxed and ready to listen regardless of the amount of pressure from other patients or other duties
Most useful in the beginning of the interview
Allows patient to tell story spontaneously

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17
Q

What can open ended questions not be answered with?

A

Yes and no

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18
Q

What do we need to explain the use of the computer for?

A

EMR

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19
Q

Specific questions require…

A

Specific answers, and rarely anything more and are of more value in dealing with the verbose or rambling patient

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20
Q

What are examples of open ended questions?

A

How are you feeling today, what brought you in today, tell me about your pain, etc.

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21
Q

After open-ended Q’s, interviewers move onto…

A

Direct questions

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22
Q

What are the importance of direct questions?

A

Clarifies and adds detail.
Leaves little room for explanation.
Can usually be answered in one word or with a brief response.

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23
Q

What are examples of open-ended questions?

A

Where does it hurt? When do you get the pain? Which side is the pain?

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24
Q

Should an interviewer stand or sit?

A

Seated at least the same level as patient; patient can be slightly elevated

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25
Q

How far should an interviewer sit?

A

It is generally preferred that the interviewer sit at a distance of about 3 – 4 feet from the patient.
Distance > 5 feet = impersonal
Distance < 3 feet = interferes with “Private space”.

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26
Q

What does tense indicate?

A

Erect with a fairly rigid posture

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27
Q

What does moderately relaxed indicate?

A

Forward 20 or side 10 degrees

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28
Q

What does very relaxed indicate?

A

Back 20 or side 10 degrees

29
Q

What will allow for higher patient satisfaction?

A

Higher patient satisfaction - forward body lean and rotation of the torso toward the patient

30
Q

What will cause a better response from physician?

A

Better response to physicians who support their head with hands on their chin versus physicians who elevate their chin without support

31
Q

What are the goals of a patient encounter?

A

Establish a relationship with the patient
Gather information
Develop a diagnosis and treatment plan
Relate information to the patient

32
Q

What is the principle organ of expression?

A

Eyes

33
Q

What is best expressed with eyes?

A

Sincerity

34
Q

What is the best method for sincerity?

A

Frequent eye contact

35
Q

Patient are most comfortable…

A

when the physician looks at them approximately 50% of the time

36
Q

When is a patient uncomfortable?

A

Eye contact is avoided

37
Q

What is eye contact most accurate for? What is it least accurate for?

A

Most accurate -> fear
Least accurate -> anger or disgust

38
Q

What is a micro-expression valuable for?

A

Indicator of masking or deception

39
Q

Most facial expressions last…

A

More than 1 second

40
Q

What is a micro-expression?

A

Very brief facial expressions, lasting only a fraction of a second. They occur when a person either deliberately or unconsciously conceals a feeling.

41
Q

What is a macro-expression?

A

Normal expressions usually last between 1⁄2-second and 4 seconds. They often repeat, and fit with what is said and the sound of the person’s voice.

42
Q

When do micro-expressions occur?

A

Micro-expressions occur when the patient begins to show a true facial expression, senses this and immediately neutralizes or masks the expression (lasting only a fraction of a second)

43
Q

What must be done before entering the room?

A

Knock

44
Q

What do we use to greet the patient?

A

Last name

45
Q

How do we introduce ourselves?

A

“Good morning, Mrs. Smith, I’m student doctor Bob Jones”
“Good morning, Mrs. Todd, I’m Jim Smith, a third-year medical student and how are you today?”

46
Q

What must be asked early in the interview?

A

Ask the patient what they would prefer to be called. Studies have shown that 90% plus of patients prefer to be addressed by their first names

47
Q

When can summarization be done?

A

While typing soap note

48
Q

What is the importance of summarization?

A

Summarization assures that both parties are using the same definitions and minimizes inappropriate assumptions
“Let me see if I have understood you correctly”
“Am I understanding this correctly?”

49
Q

What are some important points about the conclusion?

A

30-40%, forget to mention to the physician all of their medical concerns.
In order to avoid leaving gaps in the history or allowing patient concerns to go unattended, conclude each interview with:
“Is there anything else bothering you today that we haven’t discussed?” “Is there anything else you would like to mention?”
“Is there anything else that we have not discussed?”
“Did we touch on everything today?”

50
Q

What is the importance of the cuff size?

A

The most common mistake is to use a cuff that is too small, which will result in an overestimation of the pressure

51
Q

What is the proper positioning of blood pressure?

A

Is vital in obtaining accurate blood pressure readings
In general, blood pressure should be measured while you are seated comfortably
The arm being used should be relaxed, uncovered, and supported at the level of the heart

52
Q

What are the importances of technique for BP?

A

Cuff directly over the skin
Position cuff 2.5 cm (1 inch) above antecubital
Center bladder of cuff over brachial artery
DEFLATE THE CUFF SLOWLY @ a rate of 2-3 mmHg/sec

53
Q

The first Kartokoff’s sound is…

A

Systolic pressure

54
Q

What is the point of which the last sound is heard?

A

Diastolic pressure

55
Q

What are the 5 Kartokoff’s sounds?

A

1st: rhythmic tapping which gradually increases in intensity
2nd: soft, swishing sound (turbulent flow)
3rd: sharp crisper sound
4th: muffled, soft
5th: silence

56
Q

What is palpated for pulse?

A

Radial artery

57
Q

What should we not use for pulse?

A

Thumb

58
Q

How do we calculate pulse?

A

RATE: Count number of pulses for 15 seconds and multiply by 4. Normal: 60-100 bpm
Bradycardia: Slow Heart <60 bpm
Tachycardia: Swift Heart > 100 bpm

59
Q

When do we find respiration?

A

After taking pulse

60
Q

What should we not tell patient during respirations?

A

That you are taking respirations

61
Q

What is the technique for respirations?

A

Respirations: Count the number of breaths for 30 seconds and multiply by 2
Normal - Adults at rest 12 - 20

62
Q

What are the three questions for BP?

A

Ask if patient has been seated for 5 minutes
* Inquire about nicotine and caffeine use in the last 30 minutes
* Inquire about restrictions in taking blood pressures in either arm
– NOT preferences

63
Q

Stethoscope binaurals should be positioned…

A

Forward

64
Q

What is eupnea?

A

Normal breathing
12 to 20 bpm

65
Q

What is bradypnea?

A

Slow breathing
< 12 bpm

66
Q

What is tachypnea?

A

Rapid breathing
> 20 bpm

67
Q

What is the most common temperature assessment?

A

Oral

68
Q

What are the 4 components of SOAP note?

A

SUBJECTIVE: Chief Complaint
OBJECTIVE: What health provider observes or
measures.
ASSESSMENT: Possible etiologies of patients
problems (differential diagnosis)
Plan: What will health provider do for patients
problems.

LECOM OPP/H&P (2022-2024) (6 decks)

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