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PCM-1 > Intro to Physical Exam and Instruments > Flashcards

Intro to Physical Exam and Instruments Flashcards

1
Q

What is a fundoscopic exam?

A

eye exam looking at retina

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2
Q

When do you use the medium light on your ophthalmoscope?

A

in a dark, non-dilated pupil

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3
Q

what must you include when documenting an allergy?

A

The reaction

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4
Q

What is a useful mnemonic for spirituality and religion questions?

A

FICA

faith and belief

importance

community

address in care

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5
Q

How long should you scrub your hands when washing them?

A

at least 20 seconds

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6
Q

What is low-risk drinking for men?

A

no more than 4 drinks on a single day and no more than 14 drinks per week

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7
Q

What are the CAGE questions?

A

Has anyone ever suggested you Cut back?

Are you ever Annoyed when people talk about your drinking?

Do you ever feel Guilty about your drinking?

Do you ever need a drink in the morning to steady your nerves (an Eye opener)?

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8
Q

When checking the ear of a child > 12 months or an adult, how do you pull the ear back?

A

hold otoscope in same hand as ear you are viewing and use free hand to pull ear up and back

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9
Q

For women and those over 65, what is low-risk drinking?

A

no more than 3 drinks on any single day and no more than 7 drinks per week

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10
Q

What is the CAGE questionnaire useful for?

A

to screen pts who drink more than one drink daily OR who drink a lot on the weekends

can open door to conversation about getting help

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11
Q

How should you angle the tip of the otoscope when performing an exam?

When should you stop?

A

slightly toward the pt’s nose to follow ear canal

Stop at any sign of increased pain

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12
Q

In a child <12 months, how do you pull the ear back during an ear exam?

A

down and back

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13
Q

How long do you measure a regular pulse?

How long do you measure an irregular pulse?

A

30 seconds –> multiply number by 2

full 60 seconds

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14
Q

What are the 5 ways you can measure temperature?

A

orally

rectally (0.5-0.7 degrees higher than mouth)

axillary (usually 0.3-0.4 degrees lower than mouth)

ear

skin

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15
Q

How is bp written?

A

systolic/diastolic

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16
Q

What are the 3 types of sphygmomanometers used to measure bp?

What is the gold standard of reading bp?

A

mercury, aneroid, and digital

gold std = auscultation

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17
Q

If bp is elevated, what should you do?

A

measure 2 additional times, waiting a few minutes btw measurements

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18
Q

What do you ask a pt to do when examining their eyes with an ophthalmoscope? Where do you put your hand?

A

look over your shoulder - pick a spot Put your hand on pt’s forehead

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19
Q

What can cause falsely high bp?

A

brachial artery below heart

cuff too small/narrow

cuff too large/wide on a large arm

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20
Q

What is the 5 step approach to pt-centered interviewing?

A
  1. Set the stage for the interview
  2. Elicit chief complaint and set agenda for visit
  3. Open the HPI
  4. Continue pt-centered HPI
  5. Transition to the clinician-centered process
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21
Q

When do you use the bell of a stethoscope?

A

low pitched sounds (bruits)

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22
Q

What are the 5 parts of a physical exam?

A

inspection auscultation palpation olfaction percussion

23
Q

What do you set the lens selector to on your ophthalmoscope?

A

“o”

24
Q

For men that have ever smoked at least 100 cigarettes in lifetime, what is recommended?

A

One-time screening for abdominal aortic aneurysm

25
Q

What are the AUDIT-C questions and scoring?

A

How often do you have a drink containing alcohol?

How many drinks containing alcohol do you have on a typical day when you are drinking?

How often do you have six or more drinks on one occasion?

Score: max is 12, greater than or equal to 4 = above recommended levels for men; above 2 = above recommended levels for women

26
Q

When do you use the diaphragm of a stethoscope?

A

for high-pitched sounds (breath sounds and hear tones)

27
Q

Where is the arm supposed to be when measuring bp?

A

at heart level

28
Q

In what case is lung cancer screening recommended?

A

annual screening w/ low-dose computed tomography in adults aged 55-80 who have 30 pack-year smoking history and currently smoke or have quit within the past 15 yrs

29
Q

What is the accronym to remember social history?

A

FEDTACOS

food

exercise

drugs

tobacco

alcohol

caffeine

occupation

spirituality and sexual relationships

30
Q

Among the 7% of women who reported same-sex sexual relationship, what percent still identify as heterosexual?

A

50%

31
Q

What is the gold standard technique for hand hygiene? When is the other technique preferred?

A

hand rubbing with an alcohol-based hand rub washing with soap and water - when visibly dirty; after using toilet; when exposed to potential spore-forming pathogens is suspected

32
Q

What is the metal part of the stethoscope attached to the eartips called?

A

biaural spring

33
Q

What is the ausculatory gap?

What is its clinical significance?

A

period of diminished/ absent korotkoff sounds during measurement of bp

can get confused by this and underestimate systolic or overestimate diastolic

34
Q

What are the 5Ps of the sexual history?

A

Partners

Practices

Prevention of Pregnancy

Protection from STIs

Past History of STIs

35
Q

What is an ophthalmoscope used for?

A

to visualize inner aspect of eye - retina, vascular supply, optic nerve, etc.

36
Q

What percentage of women who report same-sex sexual behavior have had/still have male sex partners?

A

50-97%

37
Q

when do you use the half light on your ophthalmoscope?

A

if pupil is partially obstructed (cataracts) half circle can be used to pass light through only the clear portion to avoid reflection

38
Q

What is the AUDIT questionairre useful for?

A

better sensitivity that CAGE

more questions, somewhat difficult to score

39
Q

If you are looking at a pt’s right eye, which of your eyes do you use to look through the ophthalmoscope?

A

your right eye - use the same eye to examine the pt’s eye

40
Q

Who and what should you include in family history?

A

first degree relatives

things that run in the family

41
Q

When should you wear gloves?

A

if there is obvious blood or body fluid (wash hands before and after wearing gloves)

42
Q

According to the KCU SOAP note template, how do you start your note?

A

with the chief complaint

43
Q

What is normal temperature?

A

97.8-99 degrees F

44
Q

What is the pneumoic on how to be empathetic in a pt encounter?

A

NURSE:

name

understand

respect

support

explore

45
Q

When do you use the small light on your ophthalmoscope?

A

when the pupil is very constricted; well-lit room w/ no dilator used

46
Q

How many times do people try to quit smoking before success?

A

7-8 times

47
Q

When do you use the large light on your ophthalmoscope?

A

when you use mydriatic eye drops to dilate

48
Q

What is percussion?

A

taping over an area to differentiate air, fluid or solid underneath surface

49
Q

What are the 7 key active listening skills?

A
  1. be attentive
  2. ask open-ended questions
  3. Ask probing questions
  4. Request clarification
  5. Paraphrase
  6. Be attuned to and reflect feelings
  7. Summarize
50
Q

What can cause falsely low bp

A

brachial artery above heart

cuff too large/wide on a small arm

51
Q

How high should you inflate the bp cuff?

A

180 mmHg or roughly 30 higher than estimated systolic pressure

52
Q

According to the Joint Commission, what % of accidental deaths and injuries and linked to communication failures?

A

70%

53
Q

what percentage of patients walk out of a doctor’s office not knowing what they were told or what they are supposed to do?

A

50%

PCM-1 (11 decks)

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