Vital Signs And Clincal Reasoning

Question 1

Differential diagnosis

Answer 1

Variety of diagnosis that could explain patient’s signs and symptoms

Question 2

Likelihood ratio

Answer 2

Proportion of patients with disease who have a certain test result compared with patients without disease that also got the same test result

Question 3

Shared decision making model

Answer 3

Approach that the clinician and patient are both in agreement w/ plan of care

Question 4

Blood pressure

Answer 4

.Systolic/diastolic
. Cuff occludes artery at certain pressure then opens back up when deflating cuff
. Top number is when you hear Korotkoff sound
. Bottom number is when pulse goes away

Question 5

What level should bp be taken?

Answer 5

Heart level

Question 6

How many measurements need to be taken before labeling someone as having high bp?

Answer 6

Patient relaxed, multiple measurements in both sides

Question 7

Heart rate

Answer 7

.normal 50-90 bpm
. Count for 30 seconds
. Make sure rhythm is regular

Question 8

Respiratory rate

Answer 8

Have hand on wrist to check pulse while counting nu,beer of chest rise and falls ( total is 1 breath)
. Normal rate: 16-20

Question 9

Temperature recording procedure

Answer 9

Record how you took it because they are 1-2 degrees different

Question 10

Pretext probability

Answer 10

Prevalence of disease before application of results of physical exam

Question 11

Sensitivity

Answer 11

Proportion of patients w/ diagnosis who have the physical sign
True positive

Question 12

Specificity

Answer 12

Proportion of patients w/o diagnosis who lack the physical sign
True negative

Question 13

Orthostatis bp

Answer 13

Bp between positions (supine, sitting, standing)

Bp drop 20/10 or HR 10 increase = positive

Question 14

Common errors in bp

Answer 14

. Pressing too hard diaphragm (adding pressure may affect artery collapse)
. Arm not level w/ heart
. Deflating cuff too quickly
. Wrong size cuff

Question 15

How to get accurate bp reading

Answer 15

. Correct cuff size
. Don’t talk
. Empty bladder 
. Supported back/feet
. Uncrossed legs
. Support arm at heart level
. Cuff on bare arm

Question 16

Places to check pulse

Answer 16

Radial, carotid, femoral

Question 17

Average temp. Rectal

Answer 17

36.9 C

Question 18

Avg. temp. Oral

Answer 18

36.5 C

Question 19

Avg. tympanic temp

Answer 19

36.5 C

Question 20

Avg temp. Axillary

Answer 20

36.3 C

Question 21

Time of day with lowest and highest temperatures

Answer 21

Low: 6 AM
High: 6 PM

Question 22

First vital sign to change when a patient is bleeding

Answer 22

HR increases

Question 23

What is gold standard to find pO2?

Answer 23

Arterial blood gas

Question 24

COPD patient oxygen level

Answer 24

88-92%

Question 25

Differential diagnosis VINDICATE

Answer 25

V: vascular
I: inflammatory
N: neoplastic
D: degenerative/deficiency
I: Idiopathic, Intoxication
C: congenial
A: autoimmune/allergic
T: traumatic
E: endocrine