Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Unit 1 > Unit 1 DOCS > Flashcards

Unit 1 DOCS Flashcards

1
Q

Justify the value of gathering medical history.

A

Gathering medical history allows you to have a conversation with the pt to build a foundation of trust and rapport while obtaining data framing chief complaint and allowing pt to be heard

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define pt-centered approach

A

An approach to care that respects and values the individual pt’s preferences, needs, and values. It involves giving a voice to the pt and including the pt in their care and treatment decisions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Outline the steps for setting the stage of an interview.

A

Greet pt, introduce yourself, obtain permission - “Good morning Mr/Mrs. ______, I’m Student Doctor ___________. I’m part of Dr. _________’s team today and I’ll be getting some information from you if that’s okay with you.”

Ensure pt readiness and privacy - ask if they want family to stay in the room, close door/curtain

Address barriers to communication, ensure comfort - sit down, get interpreter, make small talk

Indicate time availability and set agenda - “Well I’ve got about ___ mins with you today, can you tell me what’s brought you in?”

Summarize and prioritize - “So we’ve got A, B, C, D, E, and F written down here. So we don’t risk the quality of care you receive, let’s focus on A, B, and C today, and we’ll get you scheduled to come back so we have more time to take care of D, E, and F.”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the elements of a comprehensive medical exam?

A

Identifying Information
Chief Complaint (CC)
History of Present Illness (HPI)
Medications and Allergies
Past Medical History (PMH)
Family Hx (FMH)
Social Hx (SH)
Review of Systems (ROS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Identify and give examples of subjective vs objective information on exams

A

Subjective - what the patient tells you, symptoms
“My chest hurts” “It’s been going on for one week” “I feel depressed”

Objective - what can be measured, signs
Tests, labs, weekly logs, physical exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Explain the value in using open-ended questions, describe the different tactics, and give an example.

A

Encourage the patient to continue giving information, makes pt feel heard

“What brought you in today?”, “Can you tell me more about that?”

Silence: staying silent after a pause to see if pt will continue
Nonverbal encouragement: silence with body language (sympathetic facial expression)
Continuers: brief, noncommittal statements (“uh-huh” “Go on”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Explain the value in using open-ended focused questions, describe the different tactics, and give an example.

A

Helps pt develop their narrative, expands on what’s been put on the table

“Can you describe that?” “How did that make you feel?” “Tell me more about…”

Echoing: provides encouragement to focus by repeating words or phrases
Open-ended requests: asking for more information
Summarizing: shows pt that clinician was listening, following story and is ready for more info

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Explain the value in using closed-ended questions, describe the different tactics, and give an example.

A

Useful for clarifying information toward the middle/end of the interview

“So you mentioned you fell, did you break skin?” “Did you fall on your right knee or left?”

Yes/no questions
Brief answer
Multiple choice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Explain the value in using leading questions and give an example.

A

No value. Do not use.

“You don’t smoke, right?” “I’m sure you don’t but I have to ask…”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Define palpation

A

The application of variable manual pressure to the surface of the body for the purpose of determining the shape, size, consistency, position, inherent motility, and health of the tissues beneath

Light placement of the hands or fingers on the pt’s body to discover abnormal changes of the soft tissue, bones, organs, or skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the layers of palpation?

A

Observation - lesions, wounds, etc
Temperature - felt with wrist or back of hand
Skin topography/texture - feeling drag, moisture, turgor, etc
Superficial fascia - gentle pressing; should slide with ease
Muscle - moderate pressing; more difficult to slide, more dense
Tendons - traced in periphery to bony attachments
Ligaments -
Bone - deep palpation; should once again slide with ease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Explain FIFE and it’s use in exploring the patient’s perspective of their illness

A

Feelings - asking the pt how they are perceiving what’s happening
Ideas - what do they think may have caused it?
Effect on Function - how it is affecting their daily lives?
Expectations - what do they expect from the physician, the appointment, the illness, etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Explain NURSE and it’s use in building empathy during a medical interview

A

Name - give a name to what they’re experiencing “That sounds scary” “I see you’re upset”
Understand - validate their concerns/feelings
Respect - “You’re brave/strong to admit this”
Support - Collaborate with pt, ensure you’ll work together
Explore - “How else are you feeling about it?”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the four qualities of empathy?

A

Perspective-taking
Staying out of judgement
Recognizing emotion in other people
Communicating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe the elements of a SOAP note

_________ guides the __________ -> __________ and __________ give rise to the __________ -> __________ leads to the __________.

A

Subjective information (what the pt says)
Objective information (what you observe, examine, etc)
Assessment (what you think it is)
Plan (next steps)

Subjective guides the Objective -> Subjective and Objective give rise to the Assessment -> Assessment leads to the Plan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

OPPQQRRST

A

Onset
Position
Precipitating factors
Quality
Quantification
Radiation
Related symptoms
Setting
Transformation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe the anatomic position

A

Standing upright
Head, gaze and toes pointed anteriorly
Arms adjacent to sides w/ palms facing anteriorly
Lower limbs together w/ feet parallel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the 5 places to listen to the heart?

A

URSB - Upper right sternal border
ULSB - upper left sternal border
LMSB - lower medial sternal border
LLSB - lower left sternal border
Apex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

OLDCARTS

A

Onset: When did CC begin?
Location: Where is the CC located?
Duration: How long has the CC been going on for?
Characterization: How does the patient describe the CC?
Alleviating/Aggravating factors: What makes the CC better? Worse?
Radiation: Does the CC move or stay in one location?
Temporal factor: Is the CC worse (or better) at a certain time of day?
Severity: On a scale of 1-10, 10 being the worst, how does the patient rate the CC?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

OPQRST

A

Onset
Precipitating factors
Quality
Radiation
Severity
Timing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

TART examination sequence

A

Observation
Temperature
Skin topography/texture
Fascia
Muscle
Tendons/ligaments
Erythema friction rub

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

General Spinal Examination Sequence

A

Inspection
Palpation
Range of Motion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Active testing does/does not involve the patient moving themselves

Passive testing does/does not involve the patient moving themselves

A

does - the patient is active

does not - the patient is not actively moving

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Normal ROM for thoracic spine

A

Flexion - 45 degrees
Extension - 0 degrees
Side bending - 45 degrees
Rotation - 30 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Normal ROM for lumbar spine

A

Flexion - 40-60 degrees
Extension - 20-35 degrees
Side bending - 15-30 degrees
Rotation - 3-18 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

You are performing a hip drop test on a patient. When the pt drops the right hip (puts all their weight on their left leg), you notice limited movement and a lack of sacral curve. What does that mean?

A

The pt has a restriction on the right side of the lumbar spine.

27
Q

Myotomes of the Lumbar and Sacral spines used for strength testing

A

L2: Hip flexion
L3: Knee extension
L4: Ankle dorsiflexion
L5: Great toe extension
S1: Ankle plantarflexion, eversion, hip extension
S2: Knee flexion

28
Q

Dermatomes of Lumbar and Sacral spines used for sensation testing

A

L1: groin
L2: inner thigh
L3: medial knee
L4: medial ankle
L5: top of foot
S1: lateral ankle
S2: lateral knee

29
Q

Reflexes of Lumbar and Sacral Spine (L3-L4, and S1-S2)

A

L3-4: Patellar
S1-2: Achilles

30
Q

Movement in a transverse plane about a vertical axis

A

Rotation

31
Q

Movement in a coronal plane about an anterior-posterior axis

A

Sidebending

32
Q

Anterior movement in a sagittal plane about a transverse axis

A

Flexion

33
Q

Posterior movement in a sagittal plane about a transverse axis

A

Extension

34
Q

Landmarks for scoliosis screening

A

Occipital plane
Shoulder plane
Scapular planer
Iliac crest plane
PSIS plane
Greater trochanter plane

35
Q

Soft tissue treatment is only considered a(n) ________ technique

A

direct

36
Q

3 categories of lower back pain

A

with radiculopathy
without radiculopathy
associated with systemic disease, organ system or other cause (referred pain)

37
Q

The hallmark “Grocery Cart Sign” associated with lower back pain typically leads to what diagnosis?

A

Lumbar stenosis

38
Q

Lower back pain with bowel/bladder dysfunction and “Saddle Anesthesia” is typically…

A

Cauda Equina Syndrome

39
Q

Lower back pain associated with stiffness, gets better with movement, does not respond to treatment, symptoms gradually getting worse. Sacroiliitis seen on Xray later on in disease progression

A

Axial spondyloarthropathy - type of inflammatory arthritis

40
Q

Spinal Landmarks

A

C7 - C7 prominins
T3 - spine of scapula
T7SP/T8TP - inferior border of scapula
L4 - superior border of iliac crest
S2 - most inferior PSIS
Sacral apex - upper greater trochanter

41
Q

PO

A

by mouth

42
Q

BID/TID/QID

A

twice/thrice/four times daily

43
Q

qhs/qAM

A

at bedtime/ in the morning

44
Q

PRN

A

as needed

45
Q

What to ask for medication hx

A

Formulation - pill, liquid, tablet?
Dose - strength and amount
Route of admin - oral, nasal, IM?
Frequency of dosing - how often are you supposed to take it?
Adherence - how often do you actually take it?
Duration of treatment - how long have you taken it?
Adverse effects - any noticed?
Indication - why are you taking it?

46
Q

You (as a physician) call child protective services in the case of suspected child abuse. What type of advocacy is this? Why?

A

Clinical Advocacy - providing care that integrates the full spectrum of the patient’s needs.

47
Q

You (as a physician) meet with hospital leadership to discuss starting a student-run free clinic for patients with limited funds. What type of advocacy is this? Why?

A

Institutional advocacy - making changes in your institution

48
Q

You (as a physician) vote to expand state Medicaid coverage. What type of advocacy is this? Why?

A

Health Care Advocacy - targeting health care policies or laws

49
Q

You (as a physician) write a letter to your congressman supporting prison reform. What type of advocacy is this? Why?

A

Community-based Advocacy - affecting the broader population beyond the patients seen in a typical healthcare setting

50
Q

What goes into a PMHx?

A

Active medical problems (not CC)
Childhood illnesses
Adult illnesses
Preventative Health
Allergies

51
Q

What does into a PSHx?

A

Surgeries, procedures

When, why, complications, anesthesia type

52
Q

What does into a FHx?

A

Common familial illnesses
Illnesses specific to one generation up/down

Relationship-age-disease

53
Q

How is somatic dysfunction disgnosed?

A

Screening exams - posture, gait
Regional exams - inspection, AROM/PROM, TART
Segmental exams - palpation, motion testing, Fryette’s principles

54
Q

List the classification, indications and contraindications of soft tissue technique.

A

Classification: Direct, Passive

Indication: Myofascial soft tissue disorder

Absolute contraindications: consent, no SD

Relative contraindications: Open wounds, fractured vertebrae, pain, contagious skin rash/disorder

55
Q

List the classification, indications and contraindications of muscle energy technique.

A

Classification: Direct, Active

Indication: Arthrodial, myofascial SD

Absolute contraindications: consent, no SD

Relative contraindications: Open wounds, fractured vertebrae, pain, contagious skin rash/disorder, neurological or vascular compromise, malignancy, muscle strain

56
Q

Give an example of an external motivator of Self-Determination Theory

A

Some type of reward

-Doing it because they want something out of it

57
Q

Give an example of an introjected motivator of Self-Determination Theory

A

Self-critical, shaming, pressure to impress

-Doing it because they want to avoid guilt

58
Q

Give an example of an identified motivator of Self-Determination Theory

A

Understanding the feeling of needing to perform/accomplish

  • Doing it because they value the goal
59
Q

Give an example of an integrated motivator of Self-Determination Theory

A

Congruence, awareness, synthesis with self and core love

  • Doing it because it’s important to their self-worth
60
Q

Give an example of an intrinsic motivator of Self-Determination Theory

A

Interest, enjoyment, satisfaction

  • Doing it because they really want to.
61
Q

What are the stages of change?

A

Precontemplation
Contemplation
Preparation
Maintainence
Relapse

62
Q

Differentiate between Deontology, Utilitarianism, and Virtue Ethics.

A

Deontology is rule-based; the right/moral thing to do is that which honors the rule.

Utilitarianism is outcome-based; the right/moral thing to do is that which maximizes collective goodness.

Virtue Ethics identifies a virtuous role model; the right/moral thing to do is emulate what our virtuous model would do in this situation.

63
Q

What are the Four Quadrants approach to Clinical Ethics?

A

Medical Indications
Patients Preferences
Quality of Life
Contextual features

Unit 1 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions