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Question 1

guide interview by redirecting the patient

Answer 1

redirecting

Question 2

communicate and compare
clarify
fill in any gaps in info

Answer 2

summarizing

Question 3

background through which HPI develops

Answer 3

general context of symptoms

Question 4

the patient’s views strategies

Answer 4

active listening
open & closed questions
clarify
redirect
summarize
summay+general context
time of onset
quality home
severity
duration + frequency

Question 5

topics to be discussed in order to reach an agreement

Answer 5

nature of problem
roles of doctor and patient
goals of treatment

Question 6

four key elements of communication

Answer 6

clear info
questions from patient
readiness to discuss
agreement

Question 7

clinician makes decisions on behalf of patient without including them

Answer 7

paternalistic model

Question 8

the clinician makes decisions on behalf of patient based on what they know about patient’s preferences

Answer 8

professional as agent paradigm

Question 9

clinician provides info and patient decides independently

Answer 9

informed consumer model

Question 10

clinician and patient share info and discuss treatment plan

Answer 10

collaborative model

Question 11

corner stone in reaching agreement

Answer 11

collaborative patient-clinician relationship

Question 12

ASK to assess patients needs by asking about (6)

Answer 12

privacy
physical + emotional needs
knowledge + understanding
attitudes + motivation
informational needs
literacy

Question 13

TELL components (6)

Answer 13

1-tell info briefly
2-personalize info
3-systematic approach
4-simple non alarming words
5-appreciate patient prior successes
6-advice patient w/ supplementary resources

Question 14

ASK about patients understanding , emotions barriers (3)

Answer 14

check for:
1-patient’s understanding
2-emotional responses (respond accordingly)
3-barriers

Question 15

systematic approach template

Answer 15

name problem
discuss what’s expected
discuss what’s to be done

Question 16

common pitfalls in valuing the patient’s views (5)

Answer 16

1-narrowing focus prematurely thru closed-questions
2-controlling convo
3-restricting info
4-failing to clarify/reopen inquiry
5-failure to elicit

Question 17

clarification is done thru

Answer 17

open & closed questions

Question 18

drawing conclusions helps

Answer 18

decrease likelihood of late arising /hidden complaints
+
helps increase diagnostic accuracy

Question 19

non verbal warmth & attentiveness is done thru (5)

Answer 19

1-eye contact
2-posture
3-tone
4-pace
5-attentive silence

Question 20

greeting
explaining the situation
summarizing
stating: patient’s concerns are my 1ry focus
respond to emotions right away
encourage participation

….demonstrate

Answer 20

verbal warmth & attentiveness

Question 21

outcomes of a positive doctor patient relationship (6)

Answer 21

1-trust
2-no hidden concerns
3-better diagnosis
4-better physical-emotional outcome
5-better coping
6-satisfaction

Question 22

skills needed to build postivie relationship (4)

Answer 22

1-competent doctor
2-warmth, attentiveness, empathy
3-support+reassurance
4-partnership

Question 23

a complex process that begins by identifying the nature of the problem, defining preferred roles and involvement in decision making, and agreeing on goals

Answer 23

reaching agreement

Question 24

common pitfalls in reaching an agreement (6)

Answer 24

1-making prior assumtpions about patient’s preferences
2-failure to discuss all aspects of problem
3-failure to agree on goals of TTT
4-prescribing plans w/o reaching agreement
5-failure to re-evaluate goals over course of illness
6-intepreting patient’s failure to implement plans as non compliance instead of identifying barriers

Question 25

leading and matching are ____behaviors

Answer 25

unconscious

Question 26

first impressions are based on

Answer 26

nonverbal communication

Question 27

nonverbal structure of empathy positive connection with your patient

Answer 27

rapport

Question 28

behavior that accurately reflects real,internal feeling of person

Answer 28

nonverbal

Question 29

facial expressions eye gaze gestures body position

Answer 29

kinesics

Question 30

space b/w interacting individuals

Answer 30

proxemics

Question 31

qualities of voice: tone, rate, rhythm, volume, emphasis

Answer 31

paralanguage

Question 32

involuntary nonverbal signs that reflect person's internal state & emotional statys

Answer 32

autonomic changes

Question 33

general patterns of nonverbal response

Answer 33

safe fight flight conversation-withdrawal

Question 34

relaxed body, facial muscles arms & legs uncrossed body in open bosture neutral facial color

Answer 34

safe pattern

Question 35

increased body tension leaning forward w clenched fists narrowed eyebrows flaring of nostrils tensing of mouth breath deepens

Answer 35

fight pattern

Question 36

increased body tension + disengagement person pulls back head turned avoiding eye contact arms & legs crossed faster, shallower breathing

Answer 36

flight pattern

Question 37

relative immobility sagging of face and limbs voice is very soft hesitant speech neutral facial color

Answer 37

conversation-withdrawal

Question 38

imitating patient's behavior helps build safety & trust

Answer 38

matching

Question 39

synchronization achieved by matching process

Answer 39

leading

Question 40

non-verbal connection that leads patient from feeling unsafe to safe

Answer 40

leading

Question 41

non-verbal connection that shows your patient that you understand their emotions & relate to them

Answer 41

matching

Question 42

reinforces feeling of power and control

Answer 42

vertical height difference

Question 43

best angles of facing? used when?

Answer 43

side-side presenting lab reports/documents

Question 44

best approach when dealing w cultural differences

Answer 44

patient centered approach

Question 45

skills needed to deal w cultural differences

Answer 45

curiosity empathy respect

Question 46

skills needed to deal w cultural differences

Answer 46

curiosity empathy respect

Question 47

common pitfalls in dealing w cultural differences

Answer 47

1-too much details=uncomfortable, confusing conversation 2-patient's response is frustrating 3-avoid attacking patient+control your emotions

Question 48

crucial points in diagnosis of anxiety disorders

Answer 48

detailed history respect & analysis of symptoms

Question 49

anxiety should be suspected in

Answer 49

-pain, fatigue, neurological symptoms -recent exacerbation of illness -major life problems & stress -showing nervousness (verbally/nonverbally) -illnesses that lead to anxiety

Question 50

anxiety disorders detected by

Answer 50

GAD-7

Question 51

response to patient w/ anxiety

Answer 51

empathy appreciation interest support

Question 52

red flags in substance abuse

Answer 52

-physical findings -mental symptoms -social problems -education& employment history -legal problems -family history

Question 53

diagnostic criteria in drug abuse

Answer 53

DSM-IV-TR (12)

Question 54

failure to fulfill obligations use despite hazardous situations use depsite problems caused by substance legal problems

Answer 54

substance abuse

Question 55

-tolerance -withdrawal symptoms -substances taken in larger amounts/longer periods of time -excessive time spent on acquiring substance -obligations unfulfilled -substance use despite problems caused by substance

Answer 55

substance dependence

Question 56

accurate diagnosis of substance abuse depends on

Answer 56

careful non biased interview

Question 57

questionnaire used to assess substance abuse

Answer 57

CAGE

Question 58

dealing w alcoholics requires

Answer 58

experienced knowledge

Question 59

NIAA safe limits

Answer 59

MEN: 4 drinks/day WOMEN: 3 drinks/day

Question 60

best approach in dealing w alcoholics

Answer 60

patient-centered approach

Question 61

if an alcoholic patient is uninterested

Answer 61

throw light on need for future quitting

Question 62

if alcoholic patient is uncertain

Answer 62

motivate them

Question 63

if an alcoholic patient is ready for change

Answer 63

augment their confidence

Question 64

alarming signs of alcohol abuse

Answer 64

alcohol in breath DUI family history

Question 65

steps of breaking bad news

Answer 65

1-getting started 2-what the patient already knows 3-how much do they need to know 4-sharing the info 5-responding to feeling 6-planning follow up

Question 66

treatment plan of MUS (4)

Answer 66

antidepressant 2-substituting addicting medications 3-physical therapy 4-involving family member