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COM: PCMI > PCMI - Midterm (Lectures) > Flashcards

PCMI - Midterm (Lectures) Flashcards

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1
Q

According to the medical model, the patient’s role is ______________

A

Passive

  • Patient is quiet
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2
Q

According to the patient-centered model, the patient’s role is __________

A

Active

  • Patient asks questions
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3
Q

According to the medical model, the patient is the ______________ of treatment

A

Recipient

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4
Q

According to the patient-centered model, the patient is a __________ in the treatment plan

A

Partner

  • Patient asks about options
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5
Q

According to the medical model, the physician _____________ the conversation

A

Dominates

  • Doesnt offer options
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6
Q

According to the patient-centered model, the physician ______________ with the patient

A

Collaborates

  • Offers options; discusses pros and cons
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7
Q

According to the medical model, care is ____________-centered

A

Disease

  • Disease is the focus of daily activities
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8
Q

According to the patient-centered model, care is ___________________-center

A

quality-of-life

  • The patient focuses on family and other activities
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9
Q

According to the medical model, the ____________ does most of the talking

A

Physician

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10
Q

According to the patient-centered model, the _____________ listens more and talks less

A

Physician

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11
Q

According to the medical model, does the patient adhere to the treatment plan?

A

May or may not

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12
Q

According to the patient-centered model, does the patient adhere to the treatment plan?

A

They are more likely to than in the medical model

  • Treatment accommodates patient’s cultures and values
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13
Q

What do the letters of SOAP mean in soap note?

A 
S = subjective 
O= Objective 
A = Assessment 
P = Plan
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14
Q

What goes in the subjective section of a soap note?

A

What you learn by taking the patient’s history

  • Chief complain, HPI, PMH, PSH, Meds, allergies, social history, family history and ROS
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15
Q

What does in the objective portion of a soap note?

A

Exam including structural findings, labs and radiology data

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16
Q

What goes in the assessment portion of a soap note?

A

What you think is going on what the patient

  • Not always a diagnosis! A basic description of the problem.
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17
Q

What goes in the plan portion of a soap note?

A

What you and the patient agree to do about the problem, including OMT performed

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18
Q

When do past operations count for past surgical history?

A

Anytime the patient had an operation in a hospital

  • most dental surgeries don’t count unless in a hospital and sutures for minor injuries dont count either
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19
Q

What goes under demographics?

A
  • Age
  • Gender
  • Race or ethnic background
  • Religion/spirituality
  • Residence
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20
Q

What do you discuss regarding habits?

A
  • Diet/nutrition
  • Daily activity and exercise
  • Alcohol, tobacco and drug use
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21
Q

What are the NIAAA safe drinking limits for men?

A

14 or fewer drinks per week, no more than 4 drinks in a day

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22
Q

What are the NIAAA drinking limits for women?

A

Women and those over 64: 7 per week and no more than 3 in a day

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23
Q

What does the mnemonic SAFE stand for in regards to domestic violence?

A

Stress/safety
Afraid/abused
Friends/family
Emergency plan

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24
Q

What are the 5 P’s for obtaining a sexual history?

A 
Partners 
Prevention of pregnancy
Protection from STIs
Practices 
Past History of STIs
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25
What system does weight change fall under?
General
26
What ROS does nausea and vomiting go under?
GI
27
What ROS does leg edema and claudication go under?
Vascular
28
What ROS does loss of sensation/numbness and tingling go under?
Neurologic
29
What ROS does tremors and weakness go under?
Neurologic
30
What ROS does easy bruising/bleeding go under?
Hematologic
31
What ROS does heat/cold intolerance go under?
Endocrine
32
What ROS does mood, anxiety and depression go under?
Psychiatric
33
What ROS does memory go under?
Psychiatric
34
What ROS does fever, chills and night sweats go under?
General
35
What ROS does fatigue go under?
General
36
What types of symptoms do you put under skin ROS?
Skin/hair/nail changes, itching, rashes, sores, lumps and moles
37
What types of symptoms do you put under head ROS?
Trauma, headache location/frequency/association with nausea, vomiting or visual loss
38
What types of symptoms do you put under eye ROS?
Vision correction, bluriness, tearing, tching, acute visual loss
39
What kinds of symptosm do you put under ear ROS?
Hearing loss, tinnitus, discharge and earache
40
What types of symptoms would you put under mouth, throat, neck ROS?
Bleeding gums, hoarseness, sore throat, swollen neck
41
What types of symptoms would you put under breast ROS?
Skin changes, masses/lumps, pain, discharge, self exams
42
What ROS would you put jaundice and hepatitis under?
GI
43
What ROS would you but abdominal pain and change of appetite in?
GI
44
What ROS would you put hernias, birth control, menopause, hot flashes/sweats and period regularity under?
Genital
45
What ROS would you put blackouts and fainting under?
Neurologic
46
What are the 2 different types of ear infections?
Acute otitis media (AOM) | Acute otitis externa (AOE)
47
What are signs and symptoms of a bacterial infection resulting in acute rhinosinusitis?
``` Persistent and not improving Severe Worsening or double-sickening Purulent mucus from nose Fever Maxillary tooth pain ```
48
Dizziness can lead to different differentials affecting ent, cardiovascular, respiratory or neurology. What type of issues are associated with ENT?
BPPV Labyrinthitis Meniere's disease
49
Dizziness can lead to different differentials affecting ent, cardiovascular, respiratory or neurology. What type of issues are considered cardiovascular?
Dysrhythmia | Hypotension
50
Dizziness can lead to different differentials affecting ent, cardiovascular, respiratory or neurology. What type of issues are considered respiratory?
Hyperventilation
51
Dizziness can lead to different differentials affecting ent, cardiovascular, respiratory or neurology. What type of issues are considered neurological?
Parkinsonism
52
What is the Dix-Hallpike maneuver used for?
A way to evaluate for BPPV (Benign paroxysmal positional vertigo)
53
What is the epley maneuver used for?
To treat BPPV (Benign Paroxysmal Positional Vertigo) - Used to dislodge the otolith
54
What signs of strep throat when looking at the back of someone's throat?
- Beefy red soft palate and uvula - Enlarged red tonsils - White or yellow patches on tonsils - Tiny red hemorrhages on the soft palate
55
What is a very good indicator of strep and if seen you should go ahead and prescribe an antibiotic even without test results?
Pre-palatine patichii -> red hemorrhages on roof of mouth toward back of throat (soft palate)
56
Why might nausea be reported by patients with strep throat?
The pharynx is right nexxt to intra-abdominal organs on the homunculus
57
What is cobblestoning?
Bumps on the back of the throat usually from postnasal drip (typically due to allergies)
58
What are tonsiloliths?
Tonsil stones -> mucus and food that gets trapped n the crypts of the tonsils, smelly and nasty but not a big deal
59
What are the three main causes of earaches?
Acute otitis media (AOM) Otitis media with effusion Otitis externa
60
What should the tympanic membrane look like in a pt with acute otitis media?
Often appears to be bulging - It also has reduced mobility when pneumatic otoscope is used (puff of air)
61
What is a Pneumatic otoscope?
Has a mannual pump on it so you can puff air on the tympanic membrane of a person suspected to have acute otitis media. A healthy TM should move with the air -> when someone is positive for acute otitis media the TM will have reduced mobility
62
What is found during PE of a pt with otitis media with effusion (serous otitis media)?
Fluid behind ear drum - Can affect hearing
63
Otits media with effusion (aka serous otitis media) can follow what condition?
Acute otitis media - Can last 3 months, if persists its called chronic otitis media with effusion
64
What is otosclerosis?
Abnormal bone growth around the stapes bone
65
Does otosclerosis affect males or females more?
Females -> affects about 10% of caucasions
66
What is otosclerosis associated with?
Progressive hearing loss beginning as early as young 20's, marked in middle aged
67
What ear condition can be caused by bacteria entering a small break in the skin of the canal?
Otitis externa
68
What are associated symptoms with otitis externa?
- Pts may report drainage from the ear | - usually associated with pain upon touching the external ear structures
69
What spinal nerves are responsible for the sympathetic viscerosomatic reflex?
T1-T4
70
What cranial nerve is responsible for the parasympathetic viscerosomatic reflex?
Vagus nerve
71
What is gender identity disorder now called?
Gender dysphoria (DSM V)
72
What does the NIAAA classify as “a drink” in regards to beer, wine, and liquor?
``` Beer = 12 ounces Wine = 5 ounces Liquor = 1 ounce ```
73
What are the pros and cons of using CAGE questions when screening for alcohol use?
Pros = useful to screen for pts who drink more than one drink daily or who drink a lot on the weekends, can open door to conversation about getting help Cons = lots of false positives
74
What are the pros and cons of using AUDIT questions to screen for alcohol use?
``` Pro = Better sensitivity Con = More questions for physicians to remember, somewhat difficult to score ```
75
CDC recommends that children and adolescents 6 years and older can achieve important health benefits by getting _____ minutes or more of daily physical activity
60
76
The CDC recommends adults get _____ minutes per week of moderate activity (brisk walking) and strength training ____ days of the week that focuses on all major muscle groups.
150; 2
77
Where in your SOAP note would you put seasonal/food allergies?
Could put them in PMH, especially if they are recurrent and cause the pt issues

COM: PCMI (15 decks)

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