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PT Fundamentals > PT Fundamentals - Exam 1, Week 3 > Flashcards

PT Fundamentals - Exam 1, Week 3 Flashcards

1
Q

Subjective exam steps:

A
  1. Review baseline info/chart review (decide if pt intervention is appropriate course of action)
  2. est. rapport w/ pt
  3. gather general info
  4. analyze that info/dev. hypothesis
  5. gather specific info
  6. plan objective exam
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2
Q

Details concerning step 1 (baseline info/chart review)

A
  • medical screening form, body chart
  • I.D. red/yellow flags
  • “Does this pt even belong in my clinic?”
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3
Q

What are red/yellow flags?

A

red: warning signs that suggest that physician referral may be warranted (vomiting, fever, unexplained weight loss, etc.); may suggest serious pathology
yellow: inc. risk of poor prognosis; other factors like depression, anxiety, fear avoidant behavior, pain catatrophizing

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4
Q

Intheinitialphaseofdifferentialdiagnosis,whichofthe
followingdoesthePTneedtoanswer?
A. Doespatienthaveinsurancetocovermedicalcosts?
B.Whendidsymptomsstart?
C.Doespatientbelonginmyclinic/care?
D.Alloftheabove.

A

C.Doespatientbelonginmyclinic/care?

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5
Q

Key Characteristics of Pain on Body Chart:

A
  • location of symptoms
  • quality/type of symptoms
  • depth
  • frequency
  • rel. b/t areas of symptoms
  • clear relevant areas
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6
Q

Youaremeetingwithapatientforaninitialevaluation.
Whichofthebelowisnottypicallydocumentedonabodychart?
A. Qualityandmagnitudeofsymptoms
B.Hypothesisofcauseofpain
C.Relationshipbetweenpaininspineandextremities
D.Patient’sreportoftypeofpain

A

B.Hypothesisofcauseofpain

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7
Q

Bestdefinitionofchiefcomplaint?
A. PT’sunderstandingofproblem
B.Assigneddiagnosis,incorrectmedicalterminology
C.Representationonbodychart,withnotations
D.Patient’sproblemintheirlayterminology

A

D.Patient’sproblemintheirlayterminology

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8
Q

Details concerning step 2, est. rapport w/ pt

A
  • communication is key:
  • verbal: open- vs. close-ended questions
  • nonverbal: PT always observant of pt/vice versa
  • written: critical that record is accurate
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9
Q

Whichoneiscorrect,regardingwhenpatientsare
interruptedwhenprovidingtheirinformationinthesubjectiveexam?
A.MostarenotasPTwaitsuntiltheyhavecompletedtheiranswer.
B.Afterapproximately5minutes,duetolimitonevaluationtime.
C.Usuallywithin1‐2minutesofstartingtoanswerPT’sfirstquestion.
D.At18‐23secondsintotheinterview

A

D.At18‐23secondsintotheinterview.

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10
Q

Whichofthefollowinghasbeenshowntooccurwhenthe
PTdevelopsagoodrapportwiththepatient?
A. Increasedpatientdependencyontherapist.
B.Decreasedchangeofbeingsuedformalpractice.
C.Decreasedtreatmentplansduetofasterrecoverytime.
D.Extendedtreatmentplansduetosocialaspect.

A

B.Decreasedchangeofbeingsuedformalpractice.

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11
Q

Estimatedthat____%oftheinformation
neededtodeterminemakeadiagnosis
iscontainedinthesubjectiveexam!

A

80%

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12
Q

Regarding step 4, hypothesis dev. is a _____ process

A

continuous, dynamic

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13
Q

Details concerning step 5 (gather specific info)

A
  • date onset
  • mode of onset, method of injury (MOI)
  • symptoms better/worse?
  • any treatment to date? effect?
  • disability/functional status (Oswestry Index–Assesses symptoms and severity of low back pain and the degree to which pain impacts functional activities)
  • aggravating/easing factors
  • quantify pain (visual analog scale)
  • 24-hr beh. of symptoms
  • current activities that have stopped due to symptoms?
  • goals?
  • general health
  • weight change
  • medications
  • diagnostic tests
  • PSHx
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14
Q

In step 5, gathering specific info, you finish by conducting a systems review of what 4 systems?

A
  • cardiopulmonary
  • integumentary
  • musculoskeletal
  • neuromuscular
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15
Q

“The Four Habits Model”

A
  • invest in the beginning
  • elicit pt’s perspective
  • demonstrate empathy
  • invest in the end
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16
Q

Describe each letter in SINSS

A

S: severity; intensity
non-severe: 0-3/10, minimal pain
moderate: 4-7/10, 40-70% reduction in act.; some pain/guarding
severe: 8-10/10, stop act., definite pain/guarding
I: irritability; provocation of pain; time from onset-subside
non-irritable: tolerates pain/con’t act., *pain eases quickly
moderate: tolerate brief/light act. <10 min, eases in ~ same timeframe
severe: avoid act., pain is limiting, takes long to ease
N: nature; type of pain; descriptors (tissue type)
bone pain: deep, localized, nagging
vascular: diffuse/radiates, throbbing, aching
muscle: dull, aching, cramping, MOI
nerve: sharp, bright, lightning-like
S: stage; time since onset of symptoms
acute: 0-6 wks
subacute: 6-12 wks, later stages of healing
chronic=>3 mos., usually past expected recovery time
S: stability; symptom progression
get better
get worse
stay same

17
Q

Whywoulditbeimportanttoestablishtheirritabilityofa
patient’sconditionduringthesubjectiveexamination,withcontinual
reassessmentthroughouttheevaluation?
A. Decideifpatient’sgoalsareappropriate.
B.Determine how constantlythe symptoms present.
C. Assesswhattheappropriatevigoroftheobjectiveexamshouldbe.
D. Predictpatient’sabilitytodoadvancedskills.

A

C. Assesswhattheappropriatevigoroftheobjectiveexamshouldbe.

18
Q

Yourpatientestimatesthattheirkneepainisabout
a2/10.Itdoesbother them but theyhavebeenabletocontinuetheirjob
asacashier.Whatistheseverityinthiscase?
A. Moderatelysevere
B.Non‐severe
C.Chronic
D. Moderatelyirritable

A

B.Non‐severe

19
Q

Truckdriverpresentingwithcervicalpain,statingthatthe
paincangetashighasa7/10whenturning head to clear blind spot. Shenotes
that pain subsideswhengazereturnsforwardandshehasneverhadtostop
driving.Whatdo you rate the irritabilitylevel?
A. Non‐irritable
B.Moderatelyirritable
C.Severeirritability
D. Chronic,aggravated

A

A. Non‐irritable

20
Q

Highschooltennisplayerinjuredtheirkneeduringa
tournamentovertheweekend.Youareabouttoseethemforyour9amappointment
onMondaymorning.Inreviewingtheirmedicalhistoryform,youseethattheyhave
injuredthatsameLEpreviously.Theappropriatestagefortheirinjuryis:
A. Chronic
B.Exacerbation
C.Sub‐acute
D. Acute

A

D. Acute

21
Q

Which aspects of SINSS could limit your exam? What won’t limit your exam?

A

S/I: severity/irritability
if severe/irritable, don’t want to exacerbate symptoms
*Non-irritable: no limit to exam, can try to reproduce symptoms

22
Q

PT Roles as Communicator

A
  • historian
  • pt/family educator
  • motivator
  • confidant/counselor
  • role model
  • leader/supervisor
23
Q

Reasons to medical screen:

A
  • sicker pt; more comorbidities
  • shorter stay in hospital
  • medical specialization
  • disease progression
  • presence of red/yellow flags

PT Fundamentals (3 decks)

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