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PCM Exams OMS-1 Fall > Midterm > Flashcards

Midterm Flashcards

1
Q

Four marks of a profession?

A
  1. ) Acquisition and application of a body of knowledge
  2. ) Regulate themselves
  3. ) Fiduciary duty
  4. ) A shared commitment
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2
Q

What are the six guiding principles of the student and the doctor?

A
  1. ) Altruism
  2. ) Accountability
  3. ) Excellence
  4. ) Duty
  5. ) Honor and integrity
  6. ) Respect for others
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3
Q

What are the four ethics in medicine?

A

Autonomy
Justice
Beneficence
Non-maleficence

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4
Q

How can stress impact you physically?

A

A 15 second episode of stress can cause hormonal changes that last 6 hours

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5
Q

Physical signs of stress?

A

Stooped posture
Sweaty palms
Chronic fatigue
Weight gain or loss

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6
Q

What percent of patients leave the office without understanding what their doctor is telling them?

A

50%

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7
Q

How long before a doctor interrupts a patient?

A

18 seconds

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8
Q

What percent of medical students have symptoms of depression?

A

20% (12% major depression)

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9
Q

What percent of medical students report suicidal ideations?

A

9%

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10
Q

What percent of medical students positive for at risk drinking? Illicit drugs?

A

10-15%

33.4%

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11
Q

Which doctors have the highest rate of substance use?

A

Psychiatrists and anesthesiologists

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12
Q

What are three symptoms of burn out?

A

Emotional exhaustion
Depersonalization (cynicism)
Diminished sense of personal accomplishment

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13
Q

What percent of physicians and medical students experience burn out?

A

40%

50%

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14
Q

What are the three stages of burnout?

A

Stress arousal
Energy conservation
Exhaustion

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15
Q

What percent of patients fully understand what their doctors tell them?

A

15%

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16
Q

What is the average time for a patient to tell you why they are there?

A

120-150

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17
Q

What are the three components of communication?

A

What we say
How we say it (pitch, tone, volume)
Non-verbal body language

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18
Q

What does the doctor patient relationship depend on?

A

Empathy (putting yourself in their shoes)

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19
Q

What is important to listen to when speaking with a patient?

A

Emotion

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20
Q

How many questions does a female ask versus a male in an average 15 minute appointment?

A

6-0

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21
Q

What is verbal communication primarily based on?

A

Culturally based

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22
Q

What is non-verbal communication primarily based on?

A

Biological behavior (ubiquitous across cultures)

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23
Q

What percent of our meaning is derived from non-verbal communication?

A

90%

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24
Q

What is the single most effective diagnostic tool?

A

A good medical interview

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25
Q

What are the three functions of the medical interview?

A
  1. ) Gathering data
  2. ) Establishing a therapeutic rapport
  3. ) Educating the patient
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26
Q

What are the two types of interviewing techniques?

A

Clinician-centered

Patient-centered

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27
Q

What is a clinician-centered interview?

A

The physician takes charge of the entire interaction to acquire details of the patient’s symptoms and data to help with disease ID

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28
Q

What is a patient centered interview?

A

Encourages patients to express what most important to them (recognizes the importance the patient’s expression of personal concerns, feelings, and emotions)

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29
Q

What two categories of information does the medical interview provide?

A

What the patient says about the illness

How the information is told

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30
Q

What are the objectives of the medical interview?

A
  1. ) Establish a supportive environment and initial rapport
  2. ) Develop an awareness for the patient’s emotional state
  3. ) ID all of the problems or issues that the patient has come to discuss
  4. ) Develop a partnership with the patient. Enable the patient to become a part of the collaborative process
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31
Q

What are the two basic categories of medical interviews?

A 
Problem oriented (specific problem)
Health promotion (baseline or past)
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32
Q

What is an important type of question to ask patients?

A

Open ending questions

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33
Q

What is wrong with using leading questions?

A

They direct the patient to answer as they feel the doctor wants to hear; leads to misinformation and or misunderstanding

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34
Q

What is the difference between a “why” and a “what “ question?

A

“Why” may make the patient feel as if they need to defend themselves

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35
Q

What are four interviewing techniques?

A

Facilitation
Reflection
Clarification
Confrontation

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36
Q

What is a facilitation technique?

A

Encouragement and guidance for the patient to tell their story without specifying the kind of information you are seeking

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37
Q

What is a reflection technique?

A

Mirror what the patient just said in a way that encourages more detail

38
Q

What is a clarification technique?

A

Ask for clarification of anything you do not understand, but wait for the proper moment

39
Q

What is a confrontation technique?

A

Bringing attention to something the patient says or how they act that they may not be aware of. Draw attention to the patients verbal or non-verbal responses

40
Q

What are the two types of support?

A

Empathy

Reassurance

41
Q

How is empathy used to show support?

A

Telling the patient that you understand what they are going through. Validates the patient’s feelings without criticism

42
Q

How is reassurance used to show support?

A

A statement given to the patient or family to help them feel better. It must be based on fact.

43
Q

What are the four steps to closing an interview?

A
  1. ) Summarize the important issues discussed
  2. ) Opportunity for questions
  3. ) Offer reassurance if appropriate
  4. ) Guide as to what is next
44
Q

What does S.O.A.P. stand for?

A

Subjective
Objective
Assessment
Plan

45
Q

What is the difference between signs and symptoms?

A

Symptoms are what the patient experiences (Subjective)

Sign is what is observable and palpable (Objective)

46
Q

Where is the chief complaint written?

A

Under the subjective portion (stated in the patients own words)

47
Q

What is the proper way to start the HPI section?

A

Age, Sex, Racial profile of the patient

48
Q

When is it appropriate to take a comprehensive history and physical?

A

New patient evaluation
Annual health examination
Pre-operative examination
Admission for a hospitalization

49
Q

What does the subjective portion include?

A

PMH, PSH, Meds, Allergies, Social History, Family History, ROS

50
Q

Why is it important to ask a patient what happens when they encounter a substance they are “allergic” to?

A

They may give symptoms that are intolerance not true allergies

51
Q

What is important to note about medications?

A

Name, dosage, route, frequency and reason for use

52
Q

What is asked about in allergies?

A

Drug reactions, foods, and environmental agents

53
Q

What does the Objective portion contain?

A

Facts about the patient’s physical exam

54
Q

What are the vital signs?

A

Temp., BP, Pulse, Respiratory rate, Height, Weight

55
Q

What is in the assessment portion?

A

The physician’s medical diagnoses and impressions for the medical visit on the given date of the visit

56
Q

What is the plan portion?

A

What the physician will do to treat or further workup the patient’s problem or concern

57
Q

What are the four cardinal vital signs?

A

Pulse, Respiratory rate, body temp, blood pressure

58
Q

What is the difference between spot and continuous vital signs?

A

Spot: taken periodically (not as accurate)
Continuous: taken continuously (big picture; more accurate)

59
Q

Difference between heart rate and pulse?

A

Heart rate is the number of times a heart beats per minute whereas pulse is the palpable amount of times it beats per minute

60
Q

Where is the first place you attempt to measure a pulse on an adult?

A

Radial artery

61
Q

Where do you take a pulse in an older child?

A

Carotid artery

62
Q

Where do you take a pulse in an infant?

A

Brachial artery

63
Q

What is the average respiratory rate in adults?

A

12 to 16 per minute

64
Q

Normal adult heart rate?

A

60-100 BPM

65
Q

What is a Korotkoff sound?

A

Sounds created by pulsatile blood flow through the compressed artery (non-laminar flow)

66
Q

What is a pre-hypertensive blood pressure?

A

120-139

80-89

67
Q

What is hypotensive blood pressure?

A

Less than 90/60

68
Q

What is mean arterial pressure (MAP)?

A

The average blood pressure in a person

69
Q

What is a normal value for MAP?

A

70-110

70
Q

What MAP value is needed for basic organ perfusion?

A

MAP>60mmHg

71
Q

What is the red thermometer used for??

A

Rectal temperature

72
Q

What is the average body temperature when taken orally?

A

98.6 F/ 37C

73
Q

What is the average body temperature when taken rectally?

A

100.4F/38C

74
Q

What is the most accurate way to obtain a temperature in an infant?

A

Rectal route

75
Q

What are three other “5th” vital signs?

A

Blood sugar
Pulse Ox
End tidal CO2

76
Q

Where are the vital signs and general appearance documented?

A

In the first two lines of the physical exam

77
Q

What happens to a blood pressure reading if you use a cuff too small?

A

Inaccurately high

78
Q

What happens to a blood pressure reading if you use a cuff too large?

A

Inaccurately low

79
Q

What is the most effective method of radiation protection?

A

Distance

80
Q

What angle of X ray is superior?

A

PA

81
Q

What are the factors that affect X ray image quality?

A

Fog (improper development; exposure)
Motion
Artifacts
Focal spot size

82
Q

What is a safe distance in modern x ray units?

A

6 feet

83
Q

What does the ALARA concept mean?

A

Keeping radiation As Low As Reasonably Achievable

84
Q

What are the properties of T1 MRI?

A

Anatomic, short TR and TE

Bright signal if there is fat, acute blood, or high proteinaceous material

85
Q

What are the properties of T2 MRI?

A

Water sensitive, long TR and TE

Bright tissue has high fluid content such as cyst, bladder, spinal fluid

86
Q

What are X-rays best used for?

A

Bone scans

87
Q

What are CT scans best used for?

A

Internal damage of soft tissues and bone; 3D reconstruction

88
Q

What are MRIs best used for?

A

Soft tissue damage 3D

89
Q

Where does golfer’s elbow occur?

A

Medial epicondyle

90
Q

Where does tennis elbow occur?

A

Lateral epicondyle

PCM Exams OMS-1 Fall (3 decks)

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