Exam 1

Question 1

It should be written in patient’s own words. Usually not the first complaint mentioned by the patient.

Answer 1

Chief complaint

Question 2

Clear, chronological narrative account of present problem (chief complaint)

Answer 2

History of Present illness

Question 3

What are the things that you should consider in a patient’s persepective?

Answer 3

F-I-F-E

Patient’s Feelings

Patient’s Ideas about the nature and the cause of the problem

The effect of that problem on the patient’s life and Function

the patient’s Expectation of the disease, clinician, or health care

Question 4

This contains the date and time of the examination, as well as the source of history and reliability

Answer 4

general data

Question 4

What do you think is the type of questioning shown here in this sequence?

“Tell me about your chest discomfort.” (pause)

“what else? “(pause)

“Where did you feel it?” (pause)

“show me”. (pause)

“anywhere else?”

Answer 4

Moving from Open-ended to focused questions

Question 5

Type of interview where in you have to follow the patient’s lead

Answer 5

patient-centered

Question 5

What are you going to do if the patient seems to a mutlitude of symptoms?

Answer 5

focus on the context of symptom, emphasizing the patient’s perspective

Question 6

It involves observation of what the patient knows about his/her illness.

Answer 6

History-taking

Question 6

It serves to identify problems the patient has not mentioned so that they are not missed as wells as the symptoms of other diseases that the patient knows or may not know about and symptoms which may be risk factors for present illness

Answer 6

Review of Systems

Question 6

HPN, Heart Disease, DM, cancer, thyroid disease, seizure disorders, psychiatric disorders are reviewed during this part

Answer 6

Family History

Question 7

It is just a simple repetition of the patient’s last words, which encourages the patient to expand on factual details and feelings

Answer 7

echoing

Question 8

What is the most widely used screening questions?

Answer 8

C-A-G-E

Cutting Down

Annoyance when criticized

Guilty-feeelings

Eye-openers

Question 9

What are the 7 attributes of a symptom?

Answer 9

Location

Quality

Quantity/severity

Timing

Setting in which it occurs

Remitting or exacerbating factors

Associated Manifestations

Question 10

Ask about symptoms in the other major body systems NOT mentioned in HPI

Answer 10

Review of Systems

Question 10

A patient with delirium seeks medical help. What do you need to determine first?

Answer 10

Decision-making capacity

Question 12

What is the difference of disease and illness?

Answer 12

1. Disease is the explanation the clinician brings to the symptoms, leads to diagnosis and management plan.
2. Illness is the how the patient experiences the symptoms, shaped by previous experiences, and how it affects daily living, culture, age, and expectations of medical care.

Question 13

This type of questions are more pertinent

Answer 13

Yes or no

Question 14

Encourages patients to express what is most important to them

Answer 14

Patient-centered

Question 15

It consists of facts arranged in a useful manner.

Answer 15

Information

Question 16

the clinician takes charge of the interaction to meet her or his own need to acquire the symptoms

Answer 16

Symptom-focused

Question 17

What are the two type ways a doctor can interview a patient?

Answer 17

1. Patient-centered
2. Symptom Focused

Question 19

What do you need to remember for each symptom?

Answer 19

O-onset of disease

P-precipitating and palliating factors

Q-quality ( including quantity and severity)

R-region/radiations(location), relation to other bodily function/position

S-sysmptoms associated

T-timing

Question 21

This varies with age, socioeconomic status, culture and experiences

Answer 21

History

Question 22

When should you start negotiating a plan with your patient?

Answer 22

After creating a shared understanding of the problem

Question 22

Provides an important framework for organizing the patient's story into various categories pertinent to the patient's present, past and family health

Answer 22

Health history format

Question 23

This contains the identifying data(name, age, sex, ethnicity, civil status, religion, address) and source of referral

Answer 23

General Data

Question 24

How do you respond when you have observed an emotional cue?

Answer 24

use NURes Naming Understanding Respecting

Question 26

it involves fact-finding and investigation about the disease

Answer 26

History-taking

Question 27

Format focuses your attention on the specific kinds of information you need to obtain, facilitates clinical reasoning and clarifies communication of patient concerns and diagnoses

Answer 27

Health history format

Question 29

it involves the present known medical problems current medications, allergies, immunizations, and previous illness/surgery/blood transfusion

Answer 29

Past Medical History

Question 31

Include pertinent POSITIVES and NEGATIVES and may be done during physical examination

Answer 31

Review of Systems

Question 32

Diseases among first or second degree relatives of the patient, listed according to disease, include age at onset and if cause of death

Answer 32

Family History

Question 33

Contains the Seven Attributes of a symptom

Answer 33

History of Present Illness

Question 34

a detailed PROGRESSION or REGRESSION of symptoms is very important.

Answer 34

History of Present illness

Question 35

It is the main reason why the patient seeks medical attention

Answer 35

Chief complaint

Question 36

- relay stories in days before admission - narrate in detail

Answer 36

sequential presentation

Question 37

A normal response to hard work, sustained stress, or grief, elicit the life circumstances in which it occurs.

Answer 37

fatigue

Question 38

It denotes a demonstrable loss of muscle power and will be discussed later with other neurologic symptoms

Answer 38

weakness

Question 39

how do you determine whether the drop in weight is proportional to any change in food intake or whether intake has remained normal or even increased?

Answer 39

Pursue a thorough psychosocial history. Who cooks and shops for the patient? Where does the patient eat? With whom? Are there any prob- lems with obtaining, storing, preparing, or chewing food? Does the patient avoid or restrict certain foods for medical, religious, or other reasons?

Question 40

what is the BMI of an underweight patient?

Answer 40

\<18.5

Question 41

What is the BMI of an extremely obese person?

Answer 41

\>40

Question 42

This begins with the opening moments of the patient encounter,

Answer 42

General Survey

Question 43

If the BMI is 35 or greater, what are you going to do?

Answer 43

measure the patient’s waist circumference just above the hips

Question 44

Width of the inflatable bladder of the cuff should be how many percent in relation to upper arm circumference?

Answer 44

40%

Question 45

a silent interval that may be present between the systolic and the diastolic pressures.

Answer 45

auscultatory gap

Question 46

how do you test for orthostatic hypotension?\>

Answer 46

Measure blood pressure and heart rate in two posi- tions—supine after the patient is resting from 3 to 10 minutes, then within 3 minutes after the patient stands up.

Question 47

How do you assess the heart rate? and what is the normal range of Heart rate?

Answer 47

do a radial pulse. 50-90

Question 48

Pathophysiologic processes result in \_\_\_\_?

Answer 48

specific physical exam findings

Question 49

Skill in physical diagnosis is acquired with \_\_\_\_\_\_??

Answer 49

experience

Question 50

the physical examination should be done when?

Answer 50

as frequently as the clinical situation warrants

Question 51

The results of the examination, like the details of the history, should be recorded when?

Answer 51

right after it's elicited

Question 52

What is the important goal in Physical diagnosis?

Answer 52

An important goal is to minimize the number of times you ask the patient to change position from supine to sitting, or standing to lying supine

Question 53

What are the characteristics of a skillfull clinician?

Answer 53

Thorough without wasting time systematic without being rigid gentle yet not afraid to cause discomfort

Question 54

If the patient cannot stand, what would you examine first? genitalia or rectum?

Answer 54

examine the genitalia first

Question 55

are a set of principles that have been created through reflection and discussion to guide our behavior.

Answer 55

Ethics

Question 56

this guide our professional behavior, are not static, but several principles have guided clinicians throughout the ages.

Answer 56

Medical Ethics

Question 57

What ethical consideration is affected in "Avoiding relevant topics or creating barriers to open communication"

Answer 57

nonmaleficence

Question 58

What ethical consideration: ## Footnote The interests of the patient should prevail over physicians' self- interest or the interests of third parties, such as hospitals or insurers.

Answer 58

Beneficence

Question 59

What ethical consideration: ## Footnote informed patients may refuse recommended interventions and choose among reasonable alternatives.

Answer 59

Autonomy

Question 60

Can the physician withhold a serious diagnosis?

Answer 60

YES

Question 61

This privacy is fundamental to our professional relationships with patients.

Answer 61

confidentiality

Question 62

Ethical Consideration: ## Footnote people should receive what they deserve.

Answer 62

justice

Question 63

forbids discrimination in health care based on race, religion, or gender and supports a moral right to health care, with access based on medical need rather than ability to pay.

Answer 63

Justice