Block 1

Question 1

3 things an illness script includes

Answer 1

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

Question 2

After accumulating illness scripts, next step is

Answer 2

Hypothesis-driven data gathering

Question 3

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

Answer 3

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

Question 4

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

Answer 4

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

Question 5

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

Answer 5

DOCCLARAPPP

Question 6

what does DOCCLARAPPP stand for

Answer 6

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

Question 7

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

Answer 7

comprehensive physical examination

Question 8

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

Answer 8

VINDICATE and CARD

Question 9

VINDICATE stands for

Answer 9

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

Question 10

CARD stands for

Answer 10

Common
Atypical presentation
Rare
Dont miss

Question 11

semantic qualifiers-

Answer 11

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

Question 12

analytic reasoning-

Answer 12

hypothesis driven

Question 13

non-analytic reasoning-

Answer 13

pattern recognition

Question 14

how long should you listen to a patient

Answer 14

as long as you need to

Question 15

6 key items in the therapeutic relationship with patient

Answer 15

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

Question 16

Full history done for (3)

Answer 16

initial visits, well visits, and formal assignments

Question 17

focused history done for (4)

Answer 17

sick visits, hospital visits, structured exams, and DXR

Question 18

Components of medical history (6)

Answer 18

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

Question 19

3 particularly difficult styles of patients:

Answer 19

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

Question 20

the preferred doctor patient relationship model

Answer 20

shared decision-making model

Question 21

4 general rules of the physical exam

Answer 21

Inspect, palpate, percuss, and ascultate

Question 22

Never forget to do vital signs! (6)

Answer 22

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

Question 23

graphesthesia-

Answer 23

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

Question 24

stereognosis-

Answer 24

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

Question 25

Tanner staging-

Answer 25

sexual maturity rating with adolecents

Question 26

With your history, youre looking for _______ | With physical exam, youre looking for ______

Answer 26

symptoms | signs

Question 27

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

Answer 27

do a thorough patient history and a head to toe exam

Question 28

when did formal modern medical ethics begin?

Answer 28

1960's-70's

Question 29

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

Answer 29

Health care must always be more than a business | Law is the ethical minimum

Question 30

most important of the 4 principles of medicine

Answer 30

non-maleficence

Question 31

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

Answer 31

reasoned assesment

Question 32

what is the cornerstone of our healthcare system?

Answer 32

that health care must always be more than a business

Question 33

the centerpiece of autonomy is

Answer 33

legal written informed consent

Question 34

what distinguishes an ethical dilemma from an ethical problem?

Answer 34

an ethical dilemma has more than 1 right and wrong choice

Question 35

consequential theory-

Answer 35

weighs right and wrong by consequences

Question 36

utilitarian theory-

Answer 36

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

Question 37

casuistry-

Answer 37

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

Question 38

ethics of caring-

Answer 38

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

Question 39

virtue ethics-

Answer 39

emphasizes the physicians character

Question 40

fiduciary-

Answer 40

holds something in trust for another

Question 41

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

Answer 41

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

Question 42

3 reasons to intervene with impaired/incompetent colleagues

Answer 42

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

Question 43

what are Personal Health Records?

Answer 43

patient controlled health records

Question 44

% of people who will experience back pain in lifetime

Answer 44

60-70%

Question 45

musculoskeletal problems make up ___% of back pain cases

Answer 45

97%

Question 46

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

Answer 46

visceral disease in abdomino-pelvic region and systemic disease

Question 47

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

Answer 47

- aneurysm in abdominal vessel - vague abdominal pain that can radiate to back - usually older people, especially smokers and drinkers

Question 48

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

Answer 48

- 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

Question 49

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

Answer 49

- 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

Question 50

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

Answer 50

- kidney infection - anyone - back pain in costal vertebral angle

Question 51

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

Answer 51

- kidney stones - anyone - acute pain

Question 52

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

Answer 52

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

Question 53

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

Answer 53

nah, not if isnt life threatening