SM01 Mini 2 Flashcards
(45 cards)
Techniques of a Successful Interview
- appropriate introduction
- non-verbal communication
- use of empathy
- open-ended questions
- active listening
- summarized repetition
- check for understanding
Medical History Sequence
- cheif complaint
- history of present illness (HPI)
- past medical history
- Family Hisotry
- Social History
- review of systems
- assessment of patient
Chief Complaint
CC
problem or concern that prompted patient to seek care
History of Present Illness
HPI
detailed story of the CC
use open-ended questions
duration, frequency, better or worse
Past Medical History
PMH
- childhood illness
- diagnosised medical conditions
- hospitalizations
- surgeries
- OB/GYN
- immunizations
- allergies
- medications (including OTCs & vitamins)
- alternative remedies
Family History
includes pt. parents, siblings, & children
hereditary diseases or predispositions to disease
medical diagnoses &/or cause of death w/age
Social History
- sexual history (5Ps)
- smoking
- alcohol use
- illicit or recreational drug use
- marital status
- employment status
- education status
- diet & exercise
Review of Systems
systematic inquiry to discover symptoms not otherwise revealed
Closing the Encounter
discuss differential/likely diagnosis with patient, next steps toward diagnosis or treatment
auscultation
to listen
auscultory gap
gap in sound between systolic and diastolic bp
not present for everyone
bruit
sound of turbulent blood flow
can be caused by arterial narrowing by plaque narrowing or aneurysm
sometimes palpable by thrill
claudation
pain in the legs caused by arterial obstruction
orthostatic hypotension
differences of systolic bp of 20 or more & differences of diastolic bp of 10 or more, when assessing back to back bp of two of three: supine, sitting, or standing
symptoms: dizziness & lightheaded, usually upon standing from sitting or sitting form laying down
diastolic bp
pressure in arteries during ventricular filling
bottom number on bp reading
systolic bp
pressure in arteries during heart contraction
top number on bp reading
relationship-centered care
- healthcare relationship that includes personhood
- affect & emotion are important components
- all health care relationships occur in context of reciprocal influence
- formation & maintenance of genuine relationships in health care
outcomes of relationship-centered care
affect patient behavior & health outcomes
adherence to physician advise, medical costs, filing of lawsuits/complaints, disenrollment
better recovery
habits of practice associated with positive outcomes
- invest in the beginning
- elicit the patient’s perspective
- demonstrate empathy
- invest in the end
adherence
used instead of compliance (suggests manipulation)
reflects evolving change in the relationship between doctors and patients
PEECE
Positive prognosis
Empath
Empowerment
Connection
Education
palpate
to touch
Bouchard’s nodes
hard bony outgrowth or gelatinous cyts on proximal interphalangeal joints (PIP)
in OA, much more common, caused by calcificed spurs of cartilage
in RA, less common, caused by antibody deposition in synovium
Herberden’s nodes
hard bony outgrowth or gelatinous cyts on distal interphalangeal joints (DIP)
in OA, much more common, caused by calcificed spurs of cartilage
in RA, less common, caused by antibody deposition in synovium
