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PCM III Exam 1 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Describe non analytical clinical reasoning

A

Involves pattern recognition; fast & implicit

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2
Q

Describe analytical clinical reasoning

A

Evidence based; slow, deliberate and rational

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3
Q

Equation for sensitivity

A

sens = a/(a+c)

a = true + (finding present in disease pts)
c = false - (finding absent in disease pts)

a+c = n1 (total disease pts)

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4
Q

A ______ sensitivity rules _____ disease

A

NEGATIVE sensitivity rules OUT disease

“SnOUT”

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5
Q

Equation for specificity

A

Spec =d/(b+d)

b = false + (patient without dz WITH finding)
d = true - (patient without dz WITHOUT finding)

n2 = b + d (total patients without dz)h

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6
Q

Equation for positive likelihood ratio

A

+LR = sens/(1-spec)

A high +LR means a high likelihood of dz

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7
Q

A positive LR value of 2 means ___%of having dz

A

+15% of dz

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8
Q

A positive LR value of 5 means ___%of having dz

A

+30% of dz

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9
Q

A positive LR value of 10 means ___%of having dz

A

+45% of dz

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10
Q

Equation for negative likelihood ratio

A
  • LR = (1-sens)/spec

A smaller negative LR means less like hood of having dz

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11
Q

A negative LR value of 0.5 means ___%of having dz

A

-15% chance of having dz

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12
Q

A negative LR value of 0.2 means ___%of having dz

A

-30% chance of having dz

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13
Q

A negative LR value of 0.1 means ___%of having dz

A

-45% chance of having dz

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14
Q

A ____ specificity rules _____ dz

A

POSITIVE specificity rules IN disease

“SpIN”

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15
Q

Migraines vs tension headaches have a…

A

Migraine headaches will have prodrome 48 hours before onset (irritability, yawning, hunger)

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16
Q

Strep pharyngitis vs viral pharyngitis will have a….

A

Strep pharyngitis has a very high grade fever (up to 104), whereas viral will have a very low grade fever (if any)

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17
Q

Who’s the cutest

A

You

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18
Q

Before performing a urea breath test for H pylori gastritis, make sure the patient is not using ______ to avoid ______

A

Not using PPI to avoid FALSE NEGATIVE

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19
Q

Behavioral modification for gastritis

A

Stop using causative agent (NSAID, alcohol, smoking)

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20
Q

Metabolic/energetic/immune therapy for gastritis

A

Triple therapy for H pylori

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21
Q

Resp/circulatory therapy for gastritis

A

FOB (fecal occult blood test)

Treat lymphatics

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22
Q

Chapman point for gastritis (stomach)

A

Left 5th and 6th intercostal space parasternal

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23
Q

Sympathetic innervation for stomach (gastritis)

A

T5-10

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24
Q

Parasympathetic innervation for stomach (gastritis)

A

OA/AA

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25
Red flags in GERD (and PUD)
Dysphagia (only GERD) Weight loss Anemia + FOB
26
If red flags are present in GERD ( and PUD), do a....
EGD
27
Behavioral therapy in GERD
lifestyle mod - elevate head on bed; avoid alcohol/smoking, coffee, chocolate, carbs and fats Weight loss for fat patients
28
Metabolic/energetic therapy for GERD (3 total)
PPI and H2 antagonists | Metaclopramide to stimulate gastric emptying
29
Respiratory/circulatory therapy for GERD
Check for complications: asthma, hoarseness, dental carried
30
Sympathetic innervation of esophagus (GERD)
T5-10
31
Parasympathetic innervation for esophagus (GERD)
OA/AA
32
Ulcers in patients 30-55yo are more likely... (duodenal or gastric?)
Duodenal
33
Ulcers in patients 55-70 are more likely... (duodenal or gastric?)
Gastric
34
When does pain occur in duodenal PUD
1.5-3 hours after eating
35
Are patients with duodenal or gastric ulcers more likely be woken out of sleep?
Duodenal
36
Behavioral therapy for PUD
Balance meals at regular intervals Stop smoking g *NO justification for bland meals*
37
Metabolic/energetic/immune therapy for PUD
PPI | Abx
38
Respiratory/circulatory therapy for PUD
FOB CBC Address lymphatics
39
Chapman’s point for stomach (yes, second time I’m asking this.... just for completeness)
Left 5th and 6th intercostal space parasternal
40
What demographic is most likely affected by biliary dz
Fat middle aged wome
41
Imaging for biliary disease
Transabdominal ultrasound after 6 HOURS FASTING | *if negative, do a HIDA scan with CCK
42
Which imaging is not sensitive for detecting gallstones
CT
43
Behavioral therapy for biliary dz
Anything that helps you lose weight lmao (exercise, healthy diet)
44
Metabolic/energetic/immune therapy for biliary disease
Ursodiol (for patients who are not candidates for cholecystectomy)
45
Chapman’s point for biliary dz
Right 6th intercostal space parasternal
46
Respiratory/circulatory therapy for biliary dz
Treat lymphatics
47
Biomechanical therapy for biliary dz
Cholecystectomy
48
Ur still here bro?
Up ur nic pussy
49
Best imaging for pancreatitis
MRI with contrast
50
Behavioral therapy for pancreatitis
Stop alcohol Cholesterol lowering diet Oral pancreatic enzymes? Idk why tbh
51
Metabolic/energetic/immune therapy for pancreatitis
``` Parenteral nutrition (saline or Ringers lactate) Opioids ```
52
Respiratory/circulatory therapy for pancreatitis
Watch for complications: 1 splanchnic venous thrombosis 2 pseuaneurysm
53
Anterior Chapman’s point for pancreas
7th intercostal space
54
Posterior Chapman’s point for pancreas
Transverse process of T7and T8
55
Sympathetic innervation for pancreas
T5-10
56
Parasympathetic innervation for pancreas
OA/AA
57
Biomechanical therapy for pancreatitis
check for SD and then treat with MFR, MET, counter strain
58
Behavioral therapy for acute hepatitis
Stop drinking | Stop NSAIDs
59
Metabolic/energetic/immune therapy for acute hepatitis
Test enzymes | Ultrasound
60
Respiratory/circulatory therapy for acute hepatitis
O2 Prophylaxis for DVT Lymphatics once stable
61
Chapman’s point for liver
Right 5th and 6th intercostal space at costrochondral joint
62
Biomechanical therapy for acute pancreatitis
Once stable, find SD and treat with indirect techniques, CS, FPR, articulation
63
Imaging for diverticulitis
CT with IV and oral contrast
64
Behavior therapy for diverticulitis
Increase fiber
65
Respiratory/circulatory therapy for diverticulitis
IV fluids | DVT prophylaxis
66
Metabolic/energetic/immune therapy for diverticulitis
CBC and enzymes
67
Sympathetic innervation for descending colon and sigmoid
T12-L2
68
Sympathetic innervation for ascending and transverse colon
T10-L2
69
Parasympathetic innervation for upper GI all the way to transverse colon
OA/AA
70
Parasympathetic innervation for descending and sigmoid colon
S2-4
71
Appendectomy is protective against _____ (IBD)
Ulcerative colitis
72
Metabolic/energetic/immune therapy for IBD
B9, B12, Vit D supplement Monitor for anemia Address lymphatics
73
Respiratory/circulatory therapy for IBD
CT - thickening of bowel wall
74
Biomechanical therapy for IBD
Once stable, Identify SD and use indirect techniques, CS, FPR, articulation

PCM III Exam 1 (1 decks)

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