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PCMI - Midterm (Lectures) Flashcards

1
Q

According to the medical model, the patient’s role is ______________

A

Passive

  • Patient is quiet
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2
Q

According to the patient-centered model, the patient’s role is __________

A

Active

  • Patient asks questions
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3
Q

According to the medical model, the patient is the ______________ of treatment

A

Recipient

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4
Q

According to the patient-centered model, the patient is a __________ in the treatment plan

A

Partner

  • Patient asks about options
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5
Q

According to the medical model, the physician _____________ the conversation

A

Dominates

  • Doesnt offer options
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6
Q

According to the patient-centered model, the physician ______________ with the patient

A

Collaborates

  • Offers options; discusses pros and cons
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7
Q

According to the medical model, care is ____________-centered

A

Disease

  • Disease is the focus of daily activities
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8
Q

According to the patient-centered model, care is ___________________-center

A

quality-of-life

  • The patient focuses on family and other activities
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9
Q

According to the medical model, the ____________ does most of the talking

A

Physician

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10
Q

According to the patient-centered model, the _____________ listens more and talks less

A

Physician

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11
Q

According to the medical model, does the patient adhere to the treatment plan?

A

May or may not

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12
Q

According to the patient-centered model, does the patient adhere to the treatment plan?

A

They are more likely to than in the medical model

  • Treatment accommodates patient’s cultures and values
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13
Q

What do the letters of SOAP mean in soap note?

A 
S = subjective 
O= Objective 
A = Assessment 
P = Plan
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14
Q

What goes in the subjective section of a soap note?

A

What you learn by taking the patient’s history

  • Chief complain, HPI, PMH, PSH, Meds, allergies, social history, family history and ROS
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15
Q

What does in the objective portion of a soap note?

A

Exam including structural findings, labs and radiology data

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16
Q

What goes in the assessment portion of a soap note?

A

What you think is going on what the patient

  • Not always a diagnosis! A basic description of the problem.
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17
Q

What goes in the plan portion of a soap note?

A

What you and the patient agree to do about the problem, including OMT performed

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18
Q

When do past operations count for past surgical history?

A

Anytime the patient had an operation in a hospital

  • most dental surgeries don’t count unless in a hospital and sutures for minor injuries dont count either
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19
Q

What goes under demographics?

A
  • Age
  • Gender
  • Race or ethnic background
  • Religion/spirituality
  • Residence
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20
Q

What do you discuss regarding habits?

A
  • Diet/nutrition
  • Daily activity and exercise
  • Alcohol, tobacco and drug use
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21
Q

What are the NIAAA safe drinking limits for men?

A

14 or fewer drinks per week, no more than 4 drinks in a day

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22
Q

What are the NIAAA drinking limits for women?

A

Women and those over 64: 7 per week and no more than 3 in a day

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23
Q

What does the mnemonic SAFE stand for in regards to domestic violence?

A

Stress/safety
Afraid/abused
Friends/family
Emergency plan

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24
Q

What are the 5 P’s for obtaining a sexual history?

A 
Partners 
Prevention of pregnancy
Protection from STIs
Practices 
Past History of STIs
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25
Q

What system does weight change fall under?

A

General

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26
Q

What ROS does nausea and vomiting go under?

A

GI

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27
Q

What ROS does leg edema and claudication go under?

A

Vascular

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28
Q

What ROS does loss of sensation/numbness and tingling go under?

A

Neurologic

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29
Q

What ROS does tremors and weakness go under?

A

Neurologic

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30
Q

What ROS does easy bruising/bleeding go under?

A

Hematologic

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31
Q

What ROS does heat/cold intolerance go under?

32
Q

What ROS does mood, anxiety and depression go under?

A

Psychiatric

33
Q

What ROS does memory go under?

A

Psychiatric

34
Q

What ROS does fever, chills and night sweats go under?

35
Q

What ROS does fatigue go under?

36
Q

What types of symptoms do you put under skin ROS?

A

Skin/hair/nail changes, itching, rashes, sores, lumps and moles

37
Q

What types of symptoms do you put under head ROS?

A

Trauma, headache location/frequency/association with nausea, vomiting or visual loss

38
Q

What types of symptoms do you put under eye ROS?

A

Vision correction, bluriness, tearing, tching, acute visual loss

39
Q

What kinds of symptosm do you put under ear ROS?

A

Hearing loss, tinnitus, discharge and earache

40
Q

What types of symptoms would you put under mouth, throat, neck ROS?

A

Bleeding gums, hoarseness, sore throat, swollen neck

41
Q

What types of symptoms would you put under breast ROS?

A

Skin changes, masses/lumps, pain, discharge, self exams

42
Q

What ROS would you put jaundice and hepatitis under?

43
Q

What ROS would you but abdominal pain and change of appetite in?

44
Q

What ROS would you put hernias, birth control, menopause, hot flashes/sweats and period regularity under?

45
Q

What ROS would you put blackouts and fainting under?

A

Neurologic

46
Q

What are the 2 different types of ear infections?

A

Acute otitis media (AOM)

Acute otitis externa (AOE)

47
Q

What are signs and symptoms of a bacterial infection resulting in acute rhinosinusitis?

A 
Persistent and not improving
Severe
Worsening or double-sickening
Purulent mucus from nose
Fever
Maxillary tooth pain
48
Q

Dizziness can lead to different differentials affecting ent, cardiovascular, respiratory or neurology. What type of issues are associated with ENT?

A

BPPV
Labyrinthitis
Meniere’s disease

49
Q

Dizziness can lead to different differentials affecting ent, cardiovascular, respiratory or neurology. What type of issues are considered cardiovascular?

A

Dysrhythmia

Hypotension

50
Q

Dizziness can lead to different differentials affecting ent, cardiovascular, respiratory or neurology. What type of issues are considered respiratory?

A

Hyperventilation

51
Q

Dizziness can lead to different differentials affecting ent, cardiovascular, respiratory or neurology. What type of issues are considered neurological?

A

Parkinsonism

52
Q

What is the Dix-Hallpike maneuver used for?

A

A way to evaluate for BPPV (Benign paroxysmal positional vertigo)

53
Q

What is the epley maneuver used for?

A

To treat BPPV (Benign Paroxysmal Positional Vertigo)

  • Used to dislodge the otolith
54
Q

What signs of strep throat when looking at the back of someone’s throat?

A
  • Beefy red soft palate and uvula
  • Enlarged red tonsils
  • White or yellow patches on tonsils
  • Tiny red hemorrhages on the soft palate
55
Q

What is a very good indicator of strep and if seen you should go ahead and prescribe an antibiotic even without test results?

A

Pre-palatine patichii -> red hemorrhages on roof of mouth toward back of throat (soft palate)

56
Q

Why might nausea be reported by patients with strep throat?

A

The pharynx is right nexxt to intra-abdominal organs on the homunculus

57
Q

What is cobblestoning?

A

Bumps on the back of the throat usually from postnasal drip (typically due to allergies)

58
Q

What are tonsiloliths?

A

Tonsil stones -> mucus and food that gets trapped n the crypts of the tonsils, smelly and nasty but not a big deal

59
Q

What are the three main causes of earaches?

A

Acute otitis media (AOM)
Otitis media with effusion
Otitis externa

60
Q

What should the tympanic membrane look like in a pt with acute otitis media?

A

Often appears to be bulging

  • It also has reduced mobility when pneumatic otoscope is used (puff of air)
61
Q

What is a Pneumatic otoscope?

A

Has a mannual pump on it so you can puff air on the tympanic membrane of a person suspected to have acute otitis media. A healthy TM should move with the air -> when someone is positive for acute otitis media the TM will have reduced mobility

62
Q

What is found during PE of a pt with otitis media with effusion (serous otitis media)?

A

Fluid behind ear drum

  • Can affect hearing
63
Q

Otits media with effusion (aka serous otitis media) can follow what condition?

A

Acute otitis media

  • Can last 3 months, if persists its called chronic otitis media with effusion
64
Q

What is otosclerosis?

A

Abnormal bone growth around the stapes bone

65
Q

Does otosclerosis affect males or females more?

A

Females -> affects about 10% of caucasions

66
Q

What is otosclerosis associated with?

A

Progressive hearing loss beginning as early as young 20’s, marked in middle aged

67
Q

What ear condition can be caused by bacteria entering a small break in the skin of the canal?

A

Otitis externa

68
Q

What are associated symptoms with otitis externa?

A
  • Pts may report drainage from the ear

- usually associated with pain upon touching the external ear structures

69
Q

What spinal nerves are responsible for the sympathetic viscerosomatic reflex?

70
Q

What cranial nerve is responsible for the parasympathetic viscerosomatic reflex?

A

Vagus nerve

71
Q

What is gender identity disorder now called?

A

Gender dysphoria (DSM V)

72
Q

What does the NIAAA classify as “a drink” in regards to beer, wine, and liquor?

A 
Beer = 12 ounces
Wine = 5 ounces
Liquor = 1 ounce
73
Q

What are the pros and cons of using CAGE questions when screening for alcohol use?

A

Pros = useful to screen for pts who drink more than one drink daily or who drink a lot on the weekends, can open door to conversation about getting help

Cons = lots of false positives

74
Q

What are the pros and cons of using AUDIT questions to screen for alcohol use?

A 
Pro = Better sensitivity
Con = More questions for physicians to remember, somewhat difficult to score
75
Q

CDC recommends that children and adolescents 6 years and older can achieve important health benefits by getting _____ minutes or more of daily physical activity

76
Q

The CDC recommends adults get _____ minutes per week of moderate activity (brisk walking) and strength training ____ days of the week that focuses on all major muscle groups.

77
Q

Where in your SOAP note would you put seasonal/food allergies?

A

Could put them in PMH, especially if they are recurrent and cause the pt issues

COM: PCMI (15 decks)

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