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SPM > Block 1 > Flashcards

Block 1 Flashcards

1
Q

3 things an illness script includes

A

what is it, who gets it, and what does it look like

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2
Q

After accumulating illness scripts, next step is

A

Hypothesis-driven data gathering

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3
Q

After you do HPI and illness scripts, complete a thorough history which includes what 4 categories

A

past medical history, family history, social history, and review of systems

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4
Q

Past medical history questions: what does MASS I AM stand for?

A

medical problems, accients/injuries, surgeries/gynecologic, screening procedures, immunizations, allergies, medications

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5
Q

If you cant think of illness scripts you should use _____________ to gather more data

A

DOCCLARAPPP

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6
Q

what does DOCCLARAPPP stand for

A 
Duration
Onset
Course
Characterization
Location
Associated features
Relieving factors
Aggravating factors
Pertinent risk factors
Patient concerns
Previous evaluation
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7
Q

when you are taking the data first, hypothesis later approach, what will follow DOCCLARAPPP?

A

comprehensive physical examination

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8
Q

when doing data first, hypothesis later: following DOCCLARAPPP and physical, the helpful frameworks for developing a differential are:

A

VINDICATE and CARD

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9
Q

VINDICATE stands for

A 
Vascular
Infectious/inflammatory
Neoplastic
Degenerative
Iatrogenic/idiopathic
Congenital
Autoimmune/allergic
Toxin/trauma
Endocrine/metabolic
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10
Q

CARD stands for

A

Common
Atypical presentation
Rare
Dont miss

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11
Q

semantic qualifiers-

A

dichotomous terms used to translate what your patient says into what makes sense to you

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12
Q

analytic reasoning-

A

hypothesis driven

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13
Q

non-analytic reasoning-

A

pattern recognition

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14
Q

how long should you listen to a patient

A

as long as you need to

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15
Q

6 key items in the therapeutic relationship with patient

A

Introduction, Body language, Listening skills, Lack of interruption, Respect, Empathy, an Genuineness

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16
Q

Full history done for (3)

A

initial visits, well visits, and formal assignments

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17
Q

focused history done for (4)

A

sick visits, hospital visits, structured exams, and DXR

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18
Q

Components of medical history (6)

A

Chief Complaint, HPI, Past medical history, family history, social history, and review of systems

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19
Q

3 particularly difficult styles of patients:

A

too quiet, too talkative, and says yes to all your questions

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20
Q

the preferred doctor patient relationship model

A

shared decision-making model

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21
Q

4 general rules of the physical exam

A

Inspect, palpate, percuss, and ascultate

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22
Q

Never forget to do vital signs! (6)

A

heart rate, respiratory rate, blood pressure, temperature, pulse oximetry, and pain scale

23
Q

graphesthesia-

A

when youre not looking and someone draws on your skin you can tell what letter they drew

24
Q

stereognosis-

A

youre holding something and know what it is just based on the feel

25
Q

Tanner staging-

A

sexual maturity rating with adolecents

26
Q

With your history, youre looking for _______

With physical exam, youre looking for ______

A

symptoms

signs

27
Q

what to do when you cant come up with an illness script

A

do a thorough patient history and a head to toe exam

28
Q

when did formal modern medical ethics begin?

A

1960’s-70’s

29
Q

besides the 4 classical founding principles of the practice of medicine, there are 2 additional ethical principles:

A

Health care must always be more than a business

Law is the ethical minimum

30
Q

most important of the 4 principles of medicine

A

non-maleficence

31
Q

medicine used to be care at any cost, but today we operate more on ____________

A

reasoned assesment

32
Q

what is the cornerstone of our healthcare system?

A

that health care must always be more than a business

33
Q

the centerpiece of autonomy is

A

legal written informed consent

34
Q

what distinguishes an ethical dilemma from an ethical problem?

A

an ethical dilemma has more than 1 right and wrong choice

35
Q

consequential theory-

A

weighs right and wrong by consequences

36
Q

utilitarian theory-

A

weighs the overall benefits of all interested parties against the overall harm

37
Q

casuistry-

A

looks at how closely a particular case resembles an earlier precedent case, and how or whether the same principles apply to the present facts

38
Q

ethics of caring-

A

teaches that responding to needs of individuals is more important than applying abstract principles

39
Q

virtue ethics-

A

emphasizes the physicians character

40
Q

fiduciary-

A

holds something in trust for another

41
Q

physician can satisfy ethical principles of beneficence and autonomy and better reach an agreement with their patient through these 5 steps

A
  1. understand patients perspective
  2. address misunderstandings and concerns
  3. try to persuade patient
  4. negotiate a mutually acceptable plan of care
  5. but ultimately let patient decide
42
Q

3 reasons to intervene with impaired/incompetent colleagues

A
  1. to prevent harm to patients
  2. to carry out professional self regulation
  3. to help impaired colleagues
43
Q

what are Personal Health Records?

A

patient controlled health records

44
Q

% of people who will experience back pain in lifetime

A

60-70%

45
Q

musculoskeletal problems make up ___% of back pain cases

A

97%

46
Q

the other 3% of back pain cases are the cant miss diagnoses that fall into what 2 categories?

A

visceral disease in abdomino-pelvic region and systemic disease

47
Q

Abdomial aortic aneurysm:
what is it-
what does it look like-
who gets it-

A
  • aneurysm in abdominal vessel
  • vague abdominal pain that can radiate to back
  • usually older people, especially smokers and drinkers
48
Q

peptic ulcer disease-
what is it-
who gets it-
what does it look like-

A
  • ulcers in stomach or small intestine
  • anyone
  • abdominal pain that can radiate to back, along with epigastric pain and sometimes nausea, vomiting, blood in stool
49
Q

pancreatitis-
what is it-
who gets it-
what does it look like-

A
  • inflamed pancreas
  • anyone
  • epigastric or LUQ pain. Can be associated with nausea, vomiting, and increased pain when eating. alcoholism and galls stones are associated risk factors
50
Q

pyelonephritis-
what is it-
who gets it-
what does it look like-

A
  • kidney infection
  • anyone
  • back pain in costal vertebral angle
51
Q

nephrolithiasis-
what is it-
who gets it-
what does it look like-

A
  • kidney stones
  • anyone
  • acute pain
52
Q

When you think back pain is musculoskeletal what should you look for in physical?

A

motor strength in lower extremity, sensory sensation in foot and leg, gait, straight leg test

53
Q

if patient has had back pain for 1 week, should you do a CT?

A

nah, not if isnt life threatening

SPM (2 decks)

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