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PCM > Interview Basics > Flashcards

Interview Basics Flashcards

1
Q

OLD CAAARTS

A 
Onset
Location
Duration
Characterize
Associated symptoms
Alleviating factors
Aggravating factors
Radiating
Timing
Scale
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2
Q

NURS

A

NAME the patient’s expressed emotions
Make and UNDERSTANDING statement
RESPECT the patient (praise them, acknowledge plight)
Offer SUPPORT

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3
Q

Paralanguage

A 
Speech rate
Pauses
Pause to speech ratio
Tone or voice quality
Pitch
Volume
Articulation
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4
Q

Functions of Pauses

A 
Absolute recall time
Language formation time
Censorship of material
Creating and effect (timing)
Preparing to lie
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5
Q

Word Choice

A

Professional
An atomic terms
Clear
Avoid medicalese

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6
Q

Doctor-Centered Skills

A

Medications (Rx, OTC, herbals, vitamins)
Allergies (to medications) (and effect)
PMH: other active problems (identified by doctor or the patient) problems in the past that have resolved
PSH: operations or invasive procedures in the past

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7
Q

Social History

A 
Demographics and occupational history
Nutrition and diet
Daily activities and exercise
Alcohol, tobacco, and recreational drug use
Spirituality and beliefs
Relationships
Sexual history (sometimes)
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8
Q

Demographics

A 
Age
Gender
Race or ethnic background
Religion/spirituality
Residence
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9
Q

Occupational History

A

Do you work outside your home?
What kind of work do you do?
Tell me what your job is like for you?
What other jobs have you held in the past?
Have you ever had exposure to fumes, chemicals, dust, loud noises, or radiation?
Do you think anything at work or home is affecting your symptoms now?

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10
Q

Nutrition and Diet

A

How would you describe your every day diet?

Patients often give “best case scenarios”
Patients respond differently to different physicians regarding these questions
Food habits are EXTREMELY SENSITIVE topics for many patients

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11
Q

Daily Activities and Exercise

A

CDC recommends adults get 150 min/week of moderate activity (brink walking) and strength training 2 days/week that focuses on all major muscle groups

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12
Q

Tobacco Use

A

Smoking linked to cardiovascular events, cancer, lung disease
Most smokers know they should quit
Most ex-smokers tried to quit 7-8 times before success

Pack years = number of packs smoked per day x number of years smoked

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13
Q

Alcohol Use

A

CAGE questions
Screen patient’s who drink more than one drink daily or who drink a lot on the weekends
If a patient is a daily drinker, can’t say “just quit” - could go through DTs (seizure activity) - need medical support

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14
Q

NIAAA Safe Drinking Limits

A

Men: 14 or fewer drinks/week, no more than 4 drinks/day

Women & those over 65: 7 drinks/week, nor more than 3 drinks/day

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15
Q

CAGE Questions

A

Has anyone ever suggested you CUT BACK?
Are you ever ANNOYED when people talk to you about your drinking?
Do you ever feel GUILTY about your drinking?
Do you ever need a drink in the morning to steady your nerves (an EYE OPENER)?

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16
Q

Recreational Drug Use

A

Truth-telling is an issue
May be tolerate of and/or addicted to prescription pain/anxiety meds
Establishing confidentiality is important
Important to know resources in your communities
Drugs can exacerbate certain health issues
Ask if they have used any prescription or nonprescription or street drug to “get high” in the past 12 months

17
Q

Spirituality and Religion

A

Spirituality does not always mean religion
Spirituality - where do you go to get your strength
Spirituality does not require belief in a higher power

Do you feel supported by any specific faith community?
Is spirituality important to you?

18
Q

Relationships

A

Living environment
Support system
Domestic violence
Partnering

19
Q

Living Environment

A 
Who do you share a home with?
Friends
Children
Spouse or romantic partner
Extended family
20
Q

Support System

A 
Who can you count on to help you if your have a problem?
May be people they share a home with
Co-workers
Church family
Neighbors
Friends
For some, sadly, "nobody"
21
Q

Domestic Violence

A

Be careful when screening for domestic violence
Remember there is emotional warfare, too: words can hurt
SAFE

22
Q

SAFE

A

Stress/Safety
Afraid/Abused
Friends/Family
Emergency Plan

23
Q

Partnering

A

Life patterns can be husbands, wives, girlfriends, boyfriends, or friends
Marriage is not a requirement for people to spend their lives together
Living together is not a requirement for people to spend their lives together
Sexual intercourse is not a requirement for people to spend their lives together

24
Q

Sexual History

A

Open ended first, then get more specific

Remain non-judgmental in choice of words, tone, facial expression, body language

25
Q

Five P’s

A 
Partners
Prevention of Pregnancy
Protection from STDs
Practices
Past History of STDs
26
Q

Partners

A

Do you have sex with men, women, or both?
In the past 2 months, how many partners have you had sex with?
In the past 12 months, how many partners have you had sex with?
Is it possible that any of your sex partners in the past 12 months had sex with someone else while they were still in a sexual relationship with you?

27
Q

Prevention of Pregnancy

A

What are you doing to prevent pregnancy?

28
Q

Protection from STDs

A

What do you do to protect yourself from STDs and HIV?

29
Q

Practices

A

To understand your risk for STDs, I need to understand the kind of sex you have had recently.
Have you had vaginal sex, meaning ‘penis in vagina sex’?
Do you use condoms: never, sometimes, or always?
Have you had anal sex, meaning ‘penis in rectum/anus’ sex?
Do you use condoms: never, sometimes, or always?
Have you had oral sex, meaning ‘mouth on penis/vagina’?
If never: why don’t you use condoms?
If sometimes: in what situations (or with whom) do you not use condoms?

30
Q

Past History of STDs

A

Have you ever had an STD?
Have any of your partners had an STD?

Additional questions to identify HIV and viral hepatitis risk:
Have you or any of your partners ever injected drugs?

31
Q

Review of Systems (ROS)

A

14 body systems
Sort of like “associated symptoms” but questions are more important for ruling in or out other important disease processes (other than the chief complaint)

32
Q

Associated Symptoms vs ROS

A

Associated symptoms are symptoms that may be related to the chief complaint
ROS is about making sure the clinician ins’t missing something ELSE that might do a patient harm

33
Q

Delivering Bad News

A 
The warning shot
No euphemisms
No timelines
Non-anxious presence
Use silence effectively

“I want to make sure you understood, tell me what you heard”

34
Q

Patient-Centered Skills

A

Set the stage for the interview
Obtain the patient’s agenda
Obtain the HPI
Obtain more about the HPI

PCM (26 decks)

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