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PCM Exams OMS-1 Fall > Midterm > Flashcards

Midterm Flashcards

1
Q

Four marks of a profession?

A
  1. ) Acquisition and application of a body of knowledge
  2. ) Regulate themselves
  3. ) Fiduciary duty
  4. ) A shared commitment
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2
Q

What are the six guiding principles of the student and the doctor?

A
  1. ) Altruism
  2. ) Accountability
  3. ) Excellence
  4. ) Duty
  5. ) Honor and integrity
  6. ) Respect for others
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3
Q

What are the four ethics in medicine?

A

Autonomy
Justice
Beneficence
Non-maleficence

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4
Q

How can stress impact you physically?

A

A 15 second episode of stress can cause hormonal changes that last 6 hours

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5
Q

Physical signs of stress?

A

Stooped posture
Sweaty palms
Chronic fatigue
Weight gain or loss

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6
Q

What percent of patients leave the office without understanding what their doctor is telling them?

A

50%

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7
Q

How long before a doctor interrupts a patient?

A

18 seconds

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8
Q

What percent of medical students have symptoms of depression?

A

20% (12% major depression)

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9
Q

What percent of medical students report suicidal ideations?

A

9%

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10
Q

What percent of medical students positive for at risk drinking? Illicit drugs?

A

10-15%

33.4%

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11
Q

Which doctors have the highest rate of substance use?

A

Psychiatrists and anesthesiologists

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12
Q

What are three symptoms of burn out?

A

Emotional exhaustion
Depersonalization (cynicism)
Diminished sense of personal accomplishment

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13
Q

What percent of physicians and medical students experience burn out?

A

40%

50%

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14
Q

What are the three stages of burnout?

A

Stress arousal
Energy conservation
Exhaustion

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15
Q

What percent of patients fully understand what their doctors tell them?

A

15%

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16
Q

What is the average time for a patient to tell you why they are there?

A

120-150

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17
Q

What are the three components of communication?

A

What we say
How we say it (pitch, tone, volume)
Non-verbal body language

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18
Q

What does the doctor patient relationship depend on?

A

Empathy (putting yourself in their shoes)

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19
Q

What is important to listen to when speaking with a patient?

A

Emotion

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20
Q

How many questions does a female ask versus a male in an average 15 minute appointment?

A

6-0

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21
Q

What is verbal communication primarily based on?

A

Culturally based

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22
Q

What is non-verbal communication primarily based on?

A

Biological behavior (ubiquitous across cultures)

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23
Q

What percent of our meaning is derived from non-verbal communication?

A

90%

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24
Q

What is the single most effective diagnostic tool?

A

A good medical interview

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25
What are the three functions of the medical interview?
1. ) Gathering data 2. ) Establishing a therapeutic rapport 3. ) Educating the patient
26
What are the two types of interviewing techniques?
Clinician-centered | Patient-centered
27
What is a clinician-centered interview?
The physician takes charge of the entire interaction to acquire details of the patient's symptoms and data to help with disease ID
28
What is a patient centered interview?
Encourages patients to express what most important to them (recognizes the importance the patient's expression of personal concerns, feelings, and emotions)
29
What two categories of information does the medical interview provide?
What the patient says about the illness | How the information is told
30
What are the objectives of the medical interview?
1. ) Establish a supportive environment and initial rapport 2. ) Develop an awareness for the patient's emotional state 3. ) ID all of the problems or issues that the patient has come to discuss 4. ) Develop a partnership with the patient. Enable the patient to become a part of the collaborative process
31
What are the two basic categories of medical interviews?
``` Problem oriented (specific problem) Health promotion (baseline or past) ```
32
What is an important type of question to ask patients?
Open ending questions
33
What is wrong with using leading questions?
They direct the patient to answer as they feel the doctor wants to hear; leads to misinformation and or misunderstanding
34
What is the difference between a "why" and a "what " question?
"Why" may make the patient feel as if they need to defend themselves
35
What are four interviewing techniques?
Facilitation Reflection Clarification Confrontation
36
What is a facilitation technique?
Encouragement and guidance for the patient to tell their story without specifying the kind of information you are seeking
37
What is a reflection technique?
Mirror what the patient just said in a way that encourages more detail
38
What is a clarification technique?
Ask for clarification of anything you do not understand, but wait for the proper moment
39
What is a confrontation technique?
Bringing attention to something the patient says or how they act that they may not be aware of. Draw attention to the patients verbal or non-verbal responses
40
What are the two types of support?
Empathy | Reassurance
41
How is empathy used to show support?
Telling the patient that you understand what they are going through. Validates the patient's feelings without criticism
42
How is reassurance used to show support?
A statement given to the patient or family to help them feel better. It must be based on fact.
43
What are the four steps to closing an interview?
1. ) Summarize the important issues discussed 2. ) Opportunity for questions 3. ) Offer reassurance if appropriate 4. ) Guide as to what is next
44
What does S.O.A.P. stand for?
Subjective Objective Assessment Plan
45
What is the difference between signs and symptoms?
Symptoms are what the patient experiences (Subjective) | Sign is what is observable and palpable (Objective)
46
Where is the chief complaint written?
Under the subjective portion (stated in the patients own words)
47
What is the proper way to start the HPI section?
Age, Sex, Racial profile of the patient
48
When is it appropriate to take a comprehensive history and physical?
New patient evaluation Annual health examination Pre-operative examination Admission for a hospitalization
49
What does the subjective portion include?
PMH, PSH, Meds, Allergies, Social History, Family History, ROS
50
Why is it important to ask a patient what happens when they encounter a substance they are "allergic" to?
They may give symptoms that are intolerance not true allergies
51
What is important to note about medications?
Name, dosage, route, frequency and reason for use
52
What is asked about in allergies?
Drug reactions, foods, and environmental agents
53
What does the Objective portion contain?
Facts about the patient's physical exam
54
What are the vital signs?
Temp., BP, Pulse, Respiratory rate, Height, Weight
55
What is in the assessment portion?
The physician's medical diagnoses and impressions for the medical visit on the given date of the visit
56
What is the plan portion?
What the physician will do to treat or further workup the patient's problem or concern
57
What are the four cardinal vital signs?
Pulse, Respiratory rate, body temp, blood pressure
58
What is the difference between spot and continuous vital signs?
Spot: taken periodically (not as accurate) Continuous: taken continuously (big picture; more accurate)
59
Difference between heart rate and pulse?
Heart rate is the number of times a heart beats per minute whereas pulse is the palpable amount of times it beats per minute
60
Where is the first place you attempt to measure a pulse on an adult?
Radial artery
61
Where do you take a pulse in an older child?
Carotid artery
62
Where do you take a pulse in an infant?
Brachial artery
63
What is the average respiratory rate in adults?
12 to 16 per minute
64
Normal adult heart rate?
60-100 BPM
65
What is a Korotkoff sound?
Sounds created by pulsatile blood flow through the compressed artery (non-laminar flow)
66
What is a pre-hypertensive blood pressure?
120-139 | 80-89
67
What is hypotensive blood pressure?
Less than 90/60
68
What is mean arterial pressure (MAP)?
The average blood pressure in a person
69
What is a normal value for MAP?
70-110
70
What MAP value is needed for basic organ perfusion?
MAP>60mmHg
71
What is the red thermometer used for??
Rectal temperature
72
What is the average body temperature when taken orally?
98.6 F/ 37C
73
What is the average body temperature when taken rectally?
100.4F/38C
74
What is the most accurate way to obtain a temperature in an infant?
Rectal route
75
What are three other "5th" vital signs?
Blood sugar Pulse Ox End tidal CO2
76
Where are the vital signs and general appearance documented?
In the first two lines of the physical exam
77
What happens to a blood pressure reading if you use a cuff too small?
Inaccurately high
78
What happens to a blood pressure reading if you use a cuff too large?
Inaccurately low
79
What is the most effective method of radiation protection?
Distance
80
What angle of X ray is superior?
PA
81
What are the factors that affect X ray image quality?
Fog (improper development; exposure) Motion Artifacts Focal spot size
82
What is a safe distance in modern x ray units?
6 feet
83
What does the ALARA concept mean?
Keeping radiation As Low As Reasonably Achievable
84
What are the properties of T1 MRI?
Anatomic, short TR and TE | Bright signal if there is fat, acute blood, or high proteinaceous material
85
What are the properties of T2 MRI?
Water sensitive, long TR and TE | Bright tissue has high fluid content such as cyst, bladder, spinal fluid
86
What are X-rays best used for?
Bone scans
87
What are CT scans best used for?
Internal damage of soft tissues and bone; 3D reconstruction
88
What are MRIs best used for?
Soft tissue damage 3D
89
Where does golfer's elbow occur?
Medial epicondyle
90
Where does tennis elbow occur?
Lateral epicondyle

PCM Exams OMS-1 Fall (3 decks)

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