Medical Interview

Question 1

What are the 4 objectives of the medical interview

Answer 1

1. gather info
2. establish rapport
3. educate
4. support & motivate

Question 2

Discuss the steps to start a patient encounter

Answer 2

1. smile
2. greet
3. state your name
4. state your role/reason you are there
5. ask permission
6. you may also ask how the patient would like to be addressed

Question 3

When introducing yourself as a PA student (or PA) what are the top key points to mention?

Answer 3

1. you are part of a TEAM
2. you work in collaboration with the physician(s), nurses and other clinic staff
3. you may mention your education - OHSU med school, grad level
4. if you are a student emphasize that the MD or practicing PA will be in to see them
5. you may elaborate on your scope or role - you are a medical provider (or one in training)

Question 4

If a patient reports they are having nausea is this subjective or objective?

Answer 4

SUBJECTIVE

Question 5

If you determine that a patient has low calcium from their recent blood work is this subjective or objective?

Answer 5

OBJECTIVE

Question 6

Symptoms are: subjective or objective

Answer 6

SUBJECTIVE

Question 7

Signs are: subjective or objective

Answer 7

OBJECTIVE

Question 8

The information you gather from a physical exam is: subjective or objective

Answer 8

OBJECTIVE

Question 9

What % does physical exam add to determining the diagnosis?

Answer 9

10%

Question 10

What are the seven components of the COMPLETE MEDICAL HISTORY?

Answer 10

Chief Complaint (CC)
History of Present Illness (HPI)
Past Medical History
Past Surgical History
Family History
Social History
Review of Systems

Question 11

True or False: The Chief Complaint is the patient’s first description or answer to why they are attending the visit.

Answer 11

False - it is not always the first words that they say, sometimes you have to dig deeper……..example: the first response is “I feel like crap and hate the world”, but if you inquire further you might find out that they have had a headache for 2 days straight, then it becomes “pounding headache for 2 days straight”

Question 12

When interviewing for the chief complaint what additional piece must you also determine?

Answer 12

Inquire why they are seeking evaluation at this time - has there been a change or something significant to prompt the particular visit at that time?

Question 13

What is the HPI?

Answer 13

History of present illness: description of the patient’s chief complaint starting from the last time the patient felt well.

Question 14

What are the SEVEN DOMAINS of a COMPLAINT

Answer 14

1. location
2. quality
3. severity
4. timing
5. context
6. modifying factors
7. associated signs and symptoms

Question 15

When considering HOW the chief complaint has IMPACTED the patient’s life you should consider the following areas (name 4)

Answer 15

interpersonal relationships
work/school
sexual relationships
emotional stability

Question 16

Name seven ways to facilitate COMMUNICATION

Answer 16

facilitation: posture, words/actions
reflection: repeat the patient’s own words
clarification: ask questions about areas that are unclear
empathetic response: show understanding of feelings
confrontation: point out contradictory statements based on observation (you say you don’t care, but why are you crying)
interpretation: based on inference (what you are “sensing”), not what you observe
summation: provide a recap or summary