PCM 2

Question 1

Adult BP

Answer 1

90/60

to 120/80

Question 2

Adult RR

Answer 2

12-18 breaths per min

Question 3

Adult pulse

Answer 3

60-100 bpm

Question 4

Adult temp (range and average)

Answer 4

97.8-99.1F

avg 98.6F

Question 5

how long should you count an infant’s RR?

Answer 5

a full 60 seconds

Question 6

what vitals are expected to increase during fever?

Answer 6

HR
BP
RR

Question 7

does a normal BP in children mean they are stable?

Answer 7

NO! BP is the last to change in a clinically decompensating child. do not assume they arre stable just because their BP is normal

Question 8

what is an extremely ominous sign in a child?

Answer 8

bradycardia

usually the result of hypoxia…act quickly as the child is extremely critical

Question 9

what is HEADSSS?

Answer 9

Home

Education/Employment

Question 10

What is general trend for newborn compared to adult

RR
HR
BP

Answer 10

higher RR and HR

lower BP

Question 11

What is CRAFFT questionnaire

Answer 11

evaluates adolescent risk factors and current habits; 2 or more yes suggests high risk serious substance use problem

• ever ridden in a Car driven by someone high or using drugs/alcohol
• ever use drugs or alcohol to Relax and feel better about yourself
• ever use drugs or alcohol when you are Alone
• ever Forget things you did while using drugs or alcohol
• do your Family/friends ever tell you that you should cut down your drinking or drug use?
• ever gotten into Trouble while using drugs or alchol

Question 12

for what treatments can minors give consent for?

Answer 12

Infectious Disease
Birth control (except sterilization)
Substance abuse
Mental illness

Question 13

what is the 5 A’s model

Answer 13

for facilitating a change

Ask about use
Advise to quit
Assess willingness to quit
Assist attempt to quit
Arrange follow up contact

Question 14

what is the CAGE questionnaire

Answer 14

screening for substance abuse
1 yes is a positive test

ever ...
felt need to Cut down drinking
felt Annoyed by criticism of drinking
had Guilty feelings about drinking
take a morning Eye opener, a drink first thing in the morning to steady your nerves

Question 15

what are two common perceptions patients have about ETOH abuse

Answer 15

beer is not alcohol

most pts do not perceive they need treatment for substance abuse

Question 16

what are the ABCDEs of delivering bad news

Answer 16

Advance prep
Build therapeutic relationship
Communicate well 
Deal with patient and family reactions
Encourage and validate emotions

Question 17

what as RADAR for IPV

Answer 17

Routinely inquire about violence
Ask direct questions
Document findings 
Assess safety
Review options and referrals

Question 18

what group experiences highest rate of IPV

Answer 18

women age 16-24

*underreporting in LGBTQ, males, elders

Question 19

clues of physical violence that you may see on interview and exam?

Answer 19

• abrasion
• avulsion
• bruise, hematoma, petechiae
• puncture/stab
• laceration, cut, or incision

Question 20

providers are bound not to contact law enforcement against will of IPV victim EXCEPT in what 2 cases

Answer 20

• wounds inflicted by knives or firearms
• younger than 18
• older than 60

Question 21

describe and name three tests are for rotator cuff injury?

Answer 21

Neer impingement sign - press on scapula with one hand, raise patient’s arm straight up with the other (compresses greater tuberosity against acromion)
Hawkins impingement - flex shoulder and elbow to 90 degrees, then with one hand on forearm and one on elbow, rotate arm internally
Drop arm sign - fully abduct arms to shoulder level, then lower it slowly

Question 22

what test for AC joint

Answer 22

crossover test

Question 23

describe empty can test and what it tests

Answer 23

supraspinatus rotator cuff tear

elevate arms to shoulder level in front of patient, internally rotate arms with thumbs down as if emptying a can.
ask pt to resist downward pressure

Question 24

name and describe two tests for carpal tunnel

Answer 24

Tinel’s - Tap over median nerve in carpal tunnel (t for tap)
Phalen’s - press backs of hands together to form right angles for 60 seconds (compresses median nerve, positive if numbness and tingling)

Question 25

what are advance directives?

name and describe two types of advance directives

Answer 25

advance directives are formal documents that direct healthcare decisions
if patients lose capacity to speak for themselves

• living will - pt directs types of treatments the want/don’t want if capacity to make decision is lost. only kick in when pt can’t communicate and when circumstances in document occur
• power of attorney - person who pt designates to make decisions on pt’s behalf if they become unable to do so

Question 26

what are 3 causes of holosystolic murmurs?

Answer 26

tricuspid regurg
mitral regurg
VSD

Question 27

mnemonic for systolic murmurs

Answer 27

MR PASS is the MVP

Mitral Regurg (and tricusp)
Mitral Valve Prolapse
Physiologic
Aortic Stenosis (and pulmonic)
Systolic

Question 28

mnemonic for diastolic murmurs

Answer 28

MS ARD

Mitral Stenosis  (and tricusp)
Aortic Regurg (and pulmonic)
Diastolic

Question 29

what is the basis of S3?

when can it be normal?

Answer 29

in acute HF, high LA pressure causes blood to slam into LV in early diastole.

can be normal in “suckers” - athletes, young people, pregnant people -vigorous LV relaxation quickly sucks blood into LV

Question 30

what is the basis of S4?

what is it

Answer 30

atrial kick slamming into a stiffened LV near the end of diastole

Question 31

moderately loud, no thrill

Answer 31

grade 3

Question 32

loud with palpable thrill

Answer 32

grade 4

Question 33

very loud with thrill, heard with stethoscope partly off chest

Answer 33

grade 5

Question 34

very loud with thrill, may be heard with stethoscope completely off chest

Answer 34

grace 6

Question 35

optic disc bulging and blurred margins

Answer 35

papilledema- increased ICP

Question 36

very loud with thrill, may be heard with stethoscope completely off chest

Answer 36

grade 6