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Patient Interview Flashcards

1
Q

Steps for interviewing (5)

A
  1. Read chart (research pt)
  2. Plan interview
  3. Request interview (waiting room)
  4. Conduct interview privately
  5. Sensitively topics -> respect
  6. Do NOT diagnose/give diagnostic opinions
  7. Form general picture in mind before presenting to attending
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2
Q

What are the six tasks during the patient interview (not steps)? (6)

A
  1. Establish relationship w/ patient
  2. Eliciting info for diagnosis (interview) + medical history (SUBJECTIVE info)
  3. Consulting w/ preceptor
  4. Assessment + plan (diagnostic impression) -> short term soln.
  5. Exposition phase -> inform and counsel
  6. Recording
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3
Q

What are the 4 sensitive topics?

A
  1. Sexual history
  2. Alcohol + drug use
  3. Family violence
  4. Death
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4
Q

What is an open-ended/non-direct question?

A

Leaves things open, vague.

“What brings you here today?”

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5
Q

What is a closed-ended question?

A

Yes/No question

Found in past medical history section

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6
Q

What are direct/focused questions?

A

Used for further clarification, allow you to control the interview

Always end in a question mark

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7
Q

What are indirect questions?

A

Statement like and used to soften the tone of the interview

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8
Q

What is facilitation?

A

Head nodding, mhmm, hand motions

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9
Q

How do you transition from open-ended questions to focused questions?

A
  • Asking a series of questions one at a time
  • Multiple choices for an answer
  • Using echoing
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10
Q

What are the 3 types of questions to avoid?

A
  • Suggestive questions (seeing a lump and immediately asking if family history of cancer)
  • Accusative questions
  • Multiple compound questions
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11
Q

What is the first data you should establish? What KIND of information is this?

A

Chief complaint and history of present illness

SUBJECTIVE

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12
Q

What is the abbreviation for identifying the history of present illness? What do the letters stand for?

A

NLDOCAT

Nature
Location
Duration
Onset
Course
Aggravating factors
Treatment
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13
Q

What is the difference between hyperhidrosis and bromhidrosis?

A

Hyperhidrosis -> increased moisture to skin

Bromhidrosis-> foot stank

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14
Q

What is
Interdigital tinea pedis
Moccasion tinea pedis
Vesicular tinea pedis

A

Interdigital ->web of toes
Moccasin-> scaling plantar surface
Vesicular -> vesicles on arch of foot

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15
Q

What is hyperkeratotic lesion?

A

Corns/calluses

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16
Q

What is a heloma dura? What is a heloma mole?

A

CORNS (so dorsum of foot)
Dura-> durable -> HARD ON PIPJ

MOLE-> M looks like webs of toes -> soft on interdigital

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17
Q

Where are calluses found?

A

Plantar surface of foot

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18
Q

What are diabetic ulcers a result of?

A

Pressure

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19
Q

What are venous ulcers a result of?

A

Impaired venous return -> leads to EDEMA

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20
Q

What is onychocryptosis?

A

Ingrown toenail

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21
Q

What is paronychia?

A

Inflammation of nail fold?

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22
Q

What is hallux adbuctor valgus?

A

Bunion deformity

Lateral devio w/o medial or dorsal prominence of 1st metatarsal head

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23
Q

What is hallux limitus?

A

ROM of 1st MTPJ limited

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24
Q

What is hallux ridigus?

A

Loss of motion at MTPJ

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25
Q

What is tailors bunion?

A

Adbuction of 5th metatarsal/enlargement of 5th

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26
Q

What happens to hammertoes at PIP, DIP, MTP?

A

PIP -Plantar flex
DIP- neutral/hyperextend
MTP- dorsiflex

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27
Q

What is ethics vs ethical?

A

Ethics -body of moral principles that govern an individuals interactions w/ others

Ethical- behavior consistent w/ body of morals

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28
Q

What are morals?

A

Right/good, ethics is a critical reflection about morality

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29
Q

What is a profession?

A

Occupation requiring training

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30
Q

What is professionalism?

A

Behavior exemplifying professional character, spirit and methods

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31
Q

What are bioethics?

A

Moral issues refer to moral issues as a result of modern medicine

*Usually life or death issues

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32
Q

What is an ethical dilemma?

A

Value conflicts w/ no clear consensus of right and wrong

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33
Q

What is consequentialism?

A

Actions determined and justified by the consequence of an act

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34
Q

What do consequentialists do?

A

Consider all the consequences prior to doing

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35
Q

What is utilitarian ethics?

A

Considers greatest good for largest number of people

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36
Q

What is intuitionism?

A

Resolves ethical dilemmas by appealing to one’s intuition, moral faculty

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37
Q

What is autonomy?

A

The right to participate in and decide on a course of action w/o undue influence

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38
Q

What is self-domination?

A

The freedom to act independently

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39
Q

What is veracity?

A

The duty to tell the truth

40
Q

What is beneficence/nonmaleficence?

A

The principal of doing good and avoiding harm

41
Q

What is fidelity?

A

Strict observance of promises/duties

42
Q

What is comparative vs noncomparative justice?

A

Comparative: deciding who gets a kidney based on age

Noncomparative: lottery system for kidney

43
Q

What sound does a flat diaphragm pick up?

A

High pitched sounds

44
Q

What sounds does a bell shaped diaphragm pick up?

A

Low pitched sounds

45
Q

What is the order of assessment techniques?

A

Inspect- palpation - percussion - auscultation *IPPA)

Abd-> Inspect - auscultation - percuss - palpate (IAPP)

46
Q

What are vital signs?

A

PBRT

Pulse, BP, Resp. Temp

47
Q

What is the most common cause of an abnormal pulse?

A

Atrial fibrillation (AF)

48
Q

What can a faster than average pulse indicate?

A

Infection, dehydration, stress, anemia, heart conditions

49
Q

What can a lower than average pulse indicate?

A

A sign of a heart condition

50
Q

What areas should you check the pulse?

A

Radial -> weak go to brachial

Posterior tibial + dorsalis pedis -> weak go to the popliteal and femoral pulse

51
Q

What does 0 - 3+ mean for grading pulses?

A

0- absent
1+ - weak
2+ normal
3+ increased

52
Q

What is hypertensive emergency?

A

180 systolic or 120 diastolic

53
Q

What spaces is the chest divided into?

A

Mediastinum between lungs

Right/left pleural cavities

54
Q

What are the divisions of the tracheobronchial tree?

A

Bronchi -> bronchus -> branches -> bronchioles -> respiratory bronchioles -> acini

55
Q

What is pectus excavatum?

A

Depression pushing heart to the side (CAVE)

56
Q

What is precuts carinatum?

A

Caved out chest

57
Q

What is tactile fremitus?

A

Vibrations felt w/ hands during vocal fremitus

58
Q

What does resonance, hyper-resonance and dullness indicate in percussion?

A

Resonance- normal

hyper-resonance - hyperinflation

dullness - pleural effusion/lobar pneumonia

59
Q

What is whispered pectoriloquy?

A

An increased loudness of whispering noted during auscultation

60
Q

What does “e to a” transition indicate?

61
Q

What heart sounds are the most distinct, what sounds are the most difficult?

A

S1/S2 the most distinct

S3/S4 are the most difficult

62
Q

What is the basic unit of contraction?

63
Q

What surrounds the myofibrils?

A

Endomysium

64
Q

What binds to fibers to compose a fascicle?

A

Perimysium

65
Q

What binds to fascicles to form a muscle?

66
Q

What is a type 1 muscle fiber?

A

Slow twitch, red, aerobic oxidation

endurance

67
Q

What is type 2 muscle fiber?

A

fast twitch, white fiber, anarobic
strength activity

lactic acid

68
Q

What is isotonic?

A

Contraction of muscle length will shorten, movement takes place

69
Q

What is isometric?

A

Contraction in which the muscle shortens, no movement takes place

ANTAGONIST + AGONISTS work against each other

70
Q

What is isokinetic?

A

Contraction performed where the muscle shortens and movement takes place BUT the speed of contraction remains the same the entire range of motion

71
Q

What are tendons composed of? What type of collagen?

A

Fibro blasts-> type 1 collagen

72
Q

What is an axis?

A

Theoretical line in space around which motion occurs

73
Q

What is motion?

A

Change in position of any part over any segment

74
Q

What is ante version?

A

Rotation in a forward direction

75
Q

What s retro version?

A

Rotation in a backward direction

76
Q

What is recurvatum?

A

Eversion beyond 180 degrees

77
Q

What are the components of pronation?

A

Dorsiflexion, abduction, eversion

78
Q

What are the components of supination?

A

Plantarflexion, adduction, inversion

79
Q

What is active movement AROM?

A

Movement available for the patient

80
Q

What is passive movement PROM?

A

movement available by the examiner

81
Q

What is hyper mobility?

A

increase in ROM beyond normal

82
Q

What is crepitus?

A

Grating, crackling or popping sounds

83
Q

What is lordosis?

A

Natural arch to the lower back

84
Q

What is kyphosis?

A

Abnormal excessive convex curvature of spine

85
Q

What is a goniometer?

A

An instrument for precise measurement of angles

86
Q

What is the basal ganglia role?

A

Abnormal movements, disorders of tone

NOT myotonia

87
Q

What is extrapyramidal?

A

Akinesia/bradykinesia
Postural changes

TREMORS-> PARKINSON

88
Q

What is pyramidal?

A

Upper motor syndrome/LMS

Extraspinal - descending signs/symptoms
Intraspinal - ascending

89
Q

Where may a lower motor neuron unit be found?

A

Central or peripheral

90
Q

What is upper motor manifestation?

A

Hyperreflexia + fatigue, possible clonus

Rigidity/spasticity/tonic paralysis

Decreased superficial reflexes EXCEPT BABINSKI

91
Q

Why would you have upgoing extensor-plantar reflex?

A

Upper motor manifestation

92
Q

What is lower motor manifestation?

A

Decreased superficial reflexes

Fasciulations
Hypotonia
Muscle atrophy

IPSILATERAL TO LESION

93
Q

Why would you have mute extensor-plantar reflexes?

A

Lower motor manifestation

94
Q

What does posterior column/medial lemniscus receive?

A

Conscious proprioception, light touch, vibratory sensation

95
Q

What does spinocerebellar receive?

A

Unconscious proprioception, IPSLATERAL to lesion

96
Q

What does spinothalamic receive?

A

Light touch, temperature, pain

97
Q

What are the grading of DTRs?

A

0- no visible reaction
2- Normal
4- hyperactive

FPP1 (1 decks)

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