Week 2- Patient Interview Flashcards
PART 1: OSPRO
PART 1: OSPRO
What does OSPRO stand for?
Optimal Screening for Prediction of Referral and Outcome (OSPRO)
OSPRO-ROS:
- What is the purpose of the OSPRO-ROS?
- What areas of the body can it be applied to?
- ___-item screening tool identified 94.7% of red flag responders.
- ___-item screening tool identified 100% of red flag responders.
- Used in order to identify red flags. (systemic pathology)
- Neck, shoulder, low back, and knee
- 10-item
- 23-item
OSPRO-YF:
- What is the purpose of the OSPRO-YF?
- What areas of the body can it be applied to?
- What (3) main categories were looked at with the OSPRO-YF study?
- ___-item tool includes items representing all validated outcomes.
- Different from other multimodal assessments because of the inclusion of ___________/________ constructs.
- Used to assess for yellow flags. (psychosocial aspects)
- Neck, shoulder, low back, and knee
- Negative Mood, Fear Avoidance, Positive Affect/Coping
- 17-item
- positive affect/coping
- OSPRO-ROS = ____ flag
- OSPRO-YF = ______ flag
- red flag
- yellow flag
- OSPRO-YF predictive of _____ and ________ outcomes.
- OSPRO-ROS predictive of ______ and ________.
- pain and disability
- QOL and comorbidity
PART 2: INTERVIEW
PART 2: INTERVIEW
What is the single most important tool in screening for medical disease, includes 80% of info needed to identify cause of symptoms, and guides the exam?
INTERVIEW
- Do we want to use open-ended questions or closed-ended questions more often? Why?
- What can help the patient know that we are listening?
- Open-ended so as to not guide the patients answers.
- Paraphrase what the patient states.
Give some examples of open-ended questions.
- Tell me how I can help you?
- Tell me why you are here today?
- Tell me about your injury?
- What do you think is causing your problem/pain?
What are (4) DON’TS during the interviewing process?
- DON’T jump to conclusions based on answers from 1-2 questions.
- DON’T destroy open-ended questions with follow-up closed-ended questions.
- DON’T overreact to information gathered.
- DON’T use leading questions.
- During the subjective examination we want to make note of and have follow-up questions related to __________.
- Single red flags can be of concern, what is one that is of concern for cardiac issues?
- red flags
- SOB while lying down
What do we want to do at the ending of an interview?
Recap findings with patient and answer all of their questions.
PART 3: SCREENING
PART 3: SCREENING
List of things to screen for. (8)
- Depression
- Eating Disorder
- Substance Abuse
- Falls
- Domestic Abuse
- Elder Abuse
- Adverse drug events
- Work/Environmental
(SQ)
What (2) questions are essential to ask every patient in order to screen for depression?
- ) During the past month have you been feeling down, depressed, or hopeless?
- ) During the past month have you been bothered by having little interest or pleasure in doing things?
What are some common risk factors for Eating Disorders? (6)
- Female
- Caucasian
- Perfectionist personality traits
- Personal/family Hx of obesity and/or eating disorders.
- Sports/athletic involvement
- Hx of sexual abuse or other trauma
Consider the impact of anorexia on ______.
BMD
S/Sx of Eating Disorder. (13)
- Discolored/stained teeth from stomach acid.***
- Broken blood vessels in eyes from vomiting.***
- Dry skin and hair; brittle nails; hair loss/growth (lanugo).***
- Tooth marks, scratches, scars or calluses on back of hands from induced vomiting. (Russell’s sign)***
- Weight loss/gain.***
- Irregular/absent menstrual periods
- Inability to tolerate cold.
- Heartburn, abdominal bloating/gas, constipation or diarrhea
- Bradycardia or low BP
- Enlarged parotid glands from repeated contact with vomit
- Skeletal myopathy and weakness
- Chronic fatigue
- Dehydration or rebound water retention (pitting edema)
What is Lanugo? What is it a sign of?
- Lanugo is soft, feathery hair that can grow all over the body, most often on the back and shoulders.
- Sign of anorexia.
Behavioral S/Sx of Eating Disorder. (7)
- Preoccupation with weight, food, calories, fat grams, dieting clothing size, body shape.
- Mood swings.
- Frequent overweight comments despite looking very thin.
- Excessive exercise to burn off calories.
- Use of diuretics, laxatives, enemas, other drugs to induce urination, bowel movements or vomiting.
- Binging and purging.
- Food restriction.
Populations at Risk for Substance Abuse:
- Teens/adults with _____/______.
- History of _______.
- Individual with ________ disorders.
- Individuals with ________/________ disorders.
- ADD/ADHD
- PTSD
- sleep disorders
- depression/anxiety disorders
What are some red flag patterns in Substance Abuse patients? (5)
- Consistently missed appointments
- Noncompliance with HEP and poor self-care
- Shifting mood patterns
- Excessive daytime sleepiness or unusual excessive energy
- Deterioration of appearance/hygiene
- Tobacco use causes vaso________ and delayed _____ ________.
- Smoking has been linked with disc _________/________.
- vasoconstriction and delayed wound healing
- degeneration/herniation