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Primary Care > Week 1 > Flashcards

Week 1 Flashcards

1
Q

starting in ____ U.S. military health care system included PTs as an entry point

A

1970s

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2
Q

the IOM defines primary care as ____, ____, ____, and ___ care delivered by accountable providers of personal health services.

A

accessible
comprehensive
coordinated
continual

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3
Q

by ___, all 50 states had some form of direct access

A

2015

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4
Q

WHAT IS THE 1ST QUESTION THAT SHOULD BE ANSWERED PRIOR TO ANY OTHERS?

A

Do you belong?
Are they appropriate and safe to begin and/or continue PT?

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5
Q

what 9 conditions are on the do not miss list (refer pt out)?

A

major depression
suicide risk
femoral head and neck fx
cauda equina syndrome
cervical myelopathy
abdominal aortic aneurysm
deep vein thrombosis
pulmonary embolism
atypical myocardial infarction

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6
Q

what is the 2 questions to screen for depression?

A

1) over the past 2 weeks have you felt down, depressed, or hopeless?
2) had little interest or pleasure in doing things?

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7
Q

_____% of PTs formally screen for depression

A

18%

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8
Q

what is the 2nd leading cause of death in ages 10-14 and 20-34?

A

suicide

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9
Q

which test should be conducted first to test for femoral head or neck fx?

A

patellar-pubic percussion test

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10
Q

urinary retention is most frequently noted in what condition?

A

cauda equina syndrome

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11
Q

what condition is suspected when a pt says their legs feel heavy and weak?

A

cauda equina syndrome

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12
Q

what is the most common cause of non-traumatic paraparesis and quadriparesis?

A

cervical myelopathy

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13
Q

what is suspected: UMN signs, impaired hand dexterity, and proximal LE weakness

A

cervical myelopathy

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14
Q

T/F: most patients with an AAA are asymptomatic.

A

T

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15
Q

if a patients reports hot, searing, ripping or tearing pain, what should be done?

A

STOP all activity d/t possible AAA

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16
Q

DVT has a ___ edema

A

pitting

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17
Q

___% of pts with DVTs are asymptomatic in early stages

A

50%

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18
Q

a score of >/= ____ on the DVT clinical decision rules indicates DVT likely

A

2

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19
Q

criteria for clinical decision rule for DVT

A
  1. active cancer
  2. paralysis, paresis, or recent plaster immobilization of LE
  3. recently bedridden 3 days or longer, or major surgery in past 12 weeks requiring general anesthesia
  4. localized tender along distribution of deep venous system
  5. entire leg swollen
  6. calf swollen >3cm more than asymptomatic side
  7. pitting edema
  8. collateral superficial veins (non-varicose)
  9. previously documented DVT
  10. alternative dx at least as likely as DTV (-)
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20
Q

what comprises about 70% of PEs?

A

proximal LE DVTs

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21
Q

> ___% of death related to PE are potentially preventable if dx earlier

A

> 50%

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22
Q

a Well’s Criteria of _____ is moderate risk for a PE

A

2-6 points

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23
Q

a Well’s Criteria of _____ is high risk for a PE

A

> 6

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24
Q

Well’s Criteria for PE

A
  1. clinical signs of DVT
  2. heart rate >100 bpm
  3. immobilized >/= 3 days, or surgery in previous 4 weeks
  4. hemoptysis
  5. cancer receiving treatment, treatment stopped in past 6 months, or palliative care
  6. alternative dx less likely than PE
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25
Q

what is the leading cause of death in women of ALL AGES?

A

cardiac death
(ex: atypical myocardial infarction)

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26
Q

women aged ____ and men aged ____ are at an increased risk of atypical myocardial infarction

A

F: >55
M: >45

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27
Q

what is reliability?

A

does the tool/test measure what it claims to measure

28
Q

what is validity?

A

the test/tool is free of error

29
Q

what is a gold standard?

A

the test that other tests are compared to

30
Q

what is a true positive?

A

test is positive and condition is present

31
Q

what is a true negative?

A

test is negative and the condition is absent

32
Q

what is a false negative?

A

test is negative but condition is present

33
Q

what is a false positive?

A

test is positive but condition is absent

34
Q

what factor rules out? in?

A

sensitivity - out (snOUT)
specificity - in (spIN)

35
Q

formula for sensitivity

A

a / (a+c)
a = true positive
c = false negative

36
Q

formula for specificity

A

d / (b+d)
d = true negative
b = false positive

37
Q

sensitivity or specificity? given that the individual has the condition, probability that the test will be positive

A

sensitivity

38
Q

sensitivity or specificity? given that the individual does NOT have the condition, probability that the test will be negative

A

specificity

39
Q

a test with high ___ helps rule out a condition when negative

A

sensitivity

40
Q

a test with high ____ helps rule in a condition when positive

A

specificity

41
Q

a good diagnostic test has a high

A

specificity

42
Q

a good screening test has a high

A

sensitivity

43
Q

predictive values depend on

A

condition prevalence

44
Q

what are predictive values?

A

of true negatives / # of all negatives

of true positives / # of all positives

45
Q

____ combines sensitivity and specificity values

A

likelihood ratios

46
Q

useful tests should produce _____ in probability given a certain test result

A

large shifts

47
Q

what is the most powerful tool for quantifying the importance of a particular test?

A

likelihood ratios

48
Q

which should be higher MCID or MCD?

A

MCID

49
Q

equation for positive likelihood ratio

A

LR+ = sensitivity / (1-specificity)

50
Q

equation for negative likelihood ratio

A

LR- = (1-sensitivity) / specificity

51
Q

which likelihood ratio is desirable to be small?

A

negative LR

52
Q

what is a stat used to represent the amount of change needed to exceed measured error of a test?

A

minimal detectable chance (MDC)

53
Q

what stat is the smallest difference detected that represents an important improvement from the perspective of individuals with the condition?

A

minimal clinical important change (MCID)

54
Q

increased reliability of a test _____ the MCD value in that population

A

decreases

55
Q

subjective data can tell what about a disease

A

severity
irritability
nature
stage
stability
(SINSS)

56
Q

red flag for cauda equina syndrome

A

saddle anesthesia
B/B dysfunction
LE neurological deficit

57
Q

how long can a pt see a PT in TX without a physician’s order?

A

10-15 days

58
Q

which subjective data describes the clinician’s assessment of intensity of pt’s symptoms as they relate to a functional activity?

A

severity

59
Q

which subjective data describes clinician’s assessment of ease with which symptoms can be provoked or stirred up?

A

irritability

60
Q

which subjective data describes the amount of activity needed to trigger pt’s symptoms?

A

irritability

61
Q

which subjective data describes the severity of the symptoms provoked?

A

irritability

62
Q

which subjective data describes what activity and amount of time before pt’s symptoms subside?

A

irritability

63
Q

what does the nature of the complaint describe?

A
  • hypotheses of structures, syndrome, classification, or pathoanatomic structure
  • anything that warrants caution with physical exam
  • character of presenting pt or problem
    (ex: psychological, personality)
64
Q

which subjective data describes the clinician’s assessment of a condition being in acute, subacute, or chronic?

A

stage

65
Q

which subjective data describes the progression of pt’s symptoms over time?

A

stability

Primary Care (7 decks)

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