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Patient Interview Flashcards

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1
Q

Steps for interviewing (5)

A
  1. Read chart (research pt)
  2. Plan interview
  3. Request interview (waiting room)
  4. Conduct interview privately
  5. Sensitively topics -> respect
  6. Do NOT diagnose/give diagnostic opinions
  7. Form general picture in mind before presenting to attending
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2
Q

What are the six tasks during the patient interview (not steps)? (6)

A
  1. Establish relationship w/ patient
  2. Eliciting info for diagnosis (interview) + medical history (SUBJECTIVE info)
  3. Consulting w/ preceptor
  4. Assessment + plan (diagnostic impression) -> short term soln.
  5. Exposition phase -> inform and counsel
  6. Recording
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3
Q

What are the 4 sensitive topics?

A
  1. Sexual history
  2. Alcohol + drug use
  3. Family violence
  4. Death
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4
Q

What is an open-ended/non-direct question?

A

Leaves things open, vague.

“What brings you here today?”

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5
Q

What is a closed-ended question?

A

Yes/No question

Found in past medical history section

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6
Q

What are direct/focused questions?

A

Used for further clarification, allow you to control the interview

Always end in a question mark

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7
Q

What are indirect questions?

A

Statement like and used to soften the tone of the interview

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8
Q

What is facilitation?

A

Head nodding, mhmm, hand motions

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9
Q

How do you transition from open-ended questions to focused questions?

A
  • Asking a series of questions one at a time
  • Multiple choices for an answer
  • Using echoing
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10
Q

What are the 3 types of questions to avoid?

A
  • Suggestive questions (seeing a lump and immediately asking if family history of cancer)
  • Accusative questions
  • Multiple compound questions
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11
Q

What is the first data you should establish? What KIND of information is this?

A

Chief complaint and history of present illness

SUBJECTIVE

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12
Q

What is the abbreviation for identifying the history of present illness? What do the letters stand for?

A

NLDOCAT

Nature
Location
Duration
Onset
Course
Aggravating factors
Treatment
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13
Q

What is the difference between hyperhidrosis and bromhidrosis?

A

Hyperhidrosis -> increased moisture to skin

Bromhidrosis-> foot stank

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14
Q

What is
Interdigital tinea pedis
Moccasion tinea pedis
Vesicular tinea pedis

A

Interdigital ->web of toes
Moccasin-> scaling plantar surface
Vesicular -> vesicles on arch of foot

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15
Q

What is hyperkeratotic lesion?

A

Corns/calluses

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16
Q

What is a heloma dura? What is a heloma mole?

A

CORNS (so dorsum of foot)
Dura-> durable -> HARD ON PIPJ

MOLE-> M looks like webs of toes -> soft on interdigital

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17
Q

Where are calluses found?

A

Plantar surface of foot

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18
Q

What are diabetic ulcers a result of?

A

Pressure

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19
Q

What are venous ulcers a result of?

A

Impaired venous return -> leads to EDEMA

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20
Q

What is onychocryptosis?

A

Ingrown toenail

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21
Q

What is paronychia?

A

Inflammation of nail fold?

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22
Q

What is hallux adbuctor valgus?

A

Bunion deformity

Lateral devio w/o medial or dorsal prominence of 1st metatarsal head

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23
Q

What is hallux limitus?

A

ROM of 1st MTPJ limited

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24
Q

What is hallux ridigus?

A

Loss of motion at MTPJ

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25
What is tailors bunion?
Adbuction of 5th metatarsal/enlargement of 5th
26
What happens to hammertoes at PIP, DIP, MTP?
PIP -Plantar flex DIP- neutral/hyperextend MTP- dorsiflex
27
What is ethics vs ethical?
Ethics -body of moral principles that govern an individuals interactions w/ others Ethical- behavior consistent w/ body of morals
28
What are morals?
Right/good, ethics is a critical reflection about morality
29
What is a profession?
Occupation requiring training
30
What is professionalism?
Behavior exemplifying professional character, spirit and methods
31
What are bioethics?
Moral issues refer to moral issues as a result of modern medicine *Usually life or death issues
32
What is an ethical dilemma?
Value conflicts w/ no clear consensus of right and wrong
33
What is consequentialism?
Actions determined and justified by the consequence of an act
34
What do consequentialists do?
Consider all the consequences prior to doing
35
What is utilitarian ethics?
Considers greatest good for largest number of people
36
What is intuitionism?
Resolves ethical dilemmas by appealing to one's intuition, moral faculty
37
What is autonomy?
The right to participate in and decide on a course of action w/o undue influence
38
What is self-domination?
The freedom to act independently
39
What is veracity?
The duty to tell the truth
40
What is beneficence/nonmaleficence?
The principal of doing good and avoiding harm
41
What is fidelity?
Strict observance of promises/duties
42
What is comparative vs noncomparative justice?
Comparative: deciding who gets a kidney based on age Noncomparative: lottery system for kidney
43
What sound does a flat diaphragm pick up?
High pitched sounds
44
What sounds does a bell shaped diaphragm pick up?
Low pitched sounds
45
What is the order of assessment techniques?
Inspect- palpation - percussion - auscultation *IPPA) Abd-> Inspect - auscultation - percuss - palpate (IAPP)
46
What are vital signs?
PBRT Pulse, BP, Resp. Temp
47
What is the most common cause of an abnormal pulse?
Atrial fibrillation (AF)
48
What can a faster than average pulse indicate?
Infection, dehydration, stress, anemia, heart conditions
49
What can a lower than average pulse indicate?
A sign of a heart condition
50
What areas should you check the pulse?
Radial -> weak go to brachial Posterior tibial + dorsalis pedis -> weak go to the popliteal and femoral pulse
51
What does 0 - 3+ mean for grading pulses?
0- absent 1+ - weak 2+ normal 3+ increased
52
What is hypertensive emergency?
180 systolic or 120 diastolic
53
What spaces is the chest divided into?
Mediastinum between lungs | Right/left pleural cavities
54
What are the divisions of the tracheobronchial tree?
Bronchi -> bronchus -> branches -> bronchioles -> respiratory bronchioles -> acini
55
What is pectus excavatum?
Depression pushing heart to the side (CAVE)
56
What is precuts carinatum?
Caved out chest
57
What is tactile fremitus?
Vibrations felt w/ hands during vocal fremitus
58
What does resonance, hyper-resonance and dullness indicate in percussion?
Resonance- normal hyper-resonance - hyperinflation dullness - pleural effusion/lobar pneumonia
59
What is whispered pectoriloquy?
An increased loudness of whispering noted during auscultation
60
What does "e to a" transition indicate?
Pneumonia
61
What heart sounds are the most distinct, what sounds are the most difficult?
S1/S2 the most distinct S3/S4 are the most difficult
62
What is the basic unit of contraction?
Myofibril
63
What surrounds the myofibrils?
Endomysium
64
What binds to fibers to compose a fascicle?
Perimysium
65
What binds to fascicles to form a muscle?
Epimysium
66
What is a type 1 muscle fiber?
Slow twitch, red, aerobic oxidation | endurance
67
What is type 2 muscle fiber?
fast twitch, white fiber, anarobic strength activity lactic acid
68
What is isotonic?
Contraction of muscle length will shorten, movement takes place
69
What is isometric?
Contraction in which the muscle shortens, no movement takes place ANTAGONIST + AGONISTS work against each other
70
What is isokinetic?
Contraction performed where the muscle shortens and movement takes place BUT the speed of contraction remains the same the entire range of motion
71
What are tendons composed of? What type of collagen?
Fibro blasts-> type 1 collagen
72
What is an axis?
Theoretical line in space around which motion occurs
73
What is motion?
Change in position of any part over any segment
74
What is ante version?
Rotation in a forward direction
75
What s retro version?
Rotation in a backward direction
76
What is recurvatum?
Eversion beyond 180 degrees
77
What are the components of pronation?
Dorsiflexion, abduction, eversion
78
What are the components of supination?
Plantarflexion, adduction, inversion
79
What is active movement AROM?
Movement available for the patient
80
What is passive movement PROM?
movement available by the examiner
81
What is hyper mobility?
increase in ROM beyond normal
82
What is crepitus?
Grating, crackling or popping sounds
83
What is lordosis?
Natural arch to the lower back
84
What is kyphosis?
Abnormal excessive convex curvature of spine
85
What is a goniometer?
An instrument for precise measurement of angles
86
What is the basal ganglia role?
Abnormal movements, disorders of tone NOT myotonia
87
What is extrapyramidal?
Akinesia/bradykinesia Postural changes TREMORS-> PARKINSON
88
What is pyramidal?
Upper motor syndrome/LMS Extraspinal - descending signs/symptoms Intraspinal - ascending
89
Where may a lower motor neuron unit be found?
Central or peripheral
90
What is upper motor manifestation?
Hyperreflexia + fatigue, possible clonus Rigidity/spasticity/tonic paralysis Decreased superficial reflexes EXCEPT BABINSKI
91
Why would you have upgoing extensor-plantar reflex?
Upper motor manifestation
92
What is lower motor manifestation?
Decreased superficial reflexes Fasciulations Hypotonia Muscle atrophy IPSILATERAL TO LESION
93
Why would you have mute extensor-plantar reflexes?
Lower motor manifestation
94
What does posterior column/medial lemniscus receive?
Conscious proprioception, light touch, vibratory sensation
95
What does spinocerebellar receive?
Unconscious proprioception, IPSLATERAL to lesion
96
What does spinothalamic receive?
Light touch, temperature, pain
97
What are the grading of DTRs?
0- no visible reaction 2- Normal 4- hyperactive

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