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Questions and Answers
Which of the following techniques is considered a focusing technique in patient-centered communication?
Which of the following techniques is considered a focusing technique in patient-centered communication?
In the context of medical documentation, what does SOAP stand for?
In the context of medical documentation, what does SOAP stand for?
Which symptom is commonly associated with Cushing's syndrome based on physical examination findings?
Which symptom is commonly associated with Cushing's syndrome based on physical examination findings?
In terms of vital sign assessment, what heart rate range indicates tachycardia?
In terms of vital sign assessment, what heart rate range indicates tachycardia?
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Which waist circumference measurement indicates an increased risk for diabetes and hypertension in women?
Which waist circumference measurement indicates an increased risk for diabetes and hypertension in women?
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What does mydriasis refer to?
What does mydriasis refer to?
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Which condition is characterized by the eye turning inward?
Which condition is characterized by the eye turning inward?
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What does a Rinne test primarily assess?
What does a Rinne test primarily assess?
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What signifies a potential malignancy in lymph nodes?
What signifies a potential malignancy in lymph nodes?
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Which of the following best describes sensorineural hearing loss?
Which of the following best describes sensorineural hearing loss?
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What is the significance of a thready pulse volume?
What is the significance of a thready pulse volume?
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What is the normal respiratory rate (RR) for adults?
What is the normal respiratory rate (RR) for adults?
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What will happen if the blood pressure cuff is too small?
What will happen if the blood pressure cuff is too small?
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What is the first indicator of systolic blood pressure when measuring?
What is the first indicator of systolic blood pressure when measuring?
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What temperature is considered fever in adults?
What temperature is considered fever in adults?
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What skin condition is characterized by symmetric bilateral raised erythematous patches?
What skin condition is characterized by symmetric bilateral raised erythematous patches?
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Which of the following findings should prompt further investigation for endocarditis?
Which of the following findings should prompt further investigation for endocarditis?
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What is the correct placement of the blood pressure cuff relative to the antecubital crease?
What is the correct placement of the blood pressure cuff relative to the antecubital crease?
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What is the primary characteristic of basal cell carcinoma?
What is the primary characteristic of basal cell carcinoma?
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Which of the following is a red flag for back pain?
Which of the following is a red flag for back pain?
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What does the acronym ABCDE stand for in melanoma assessment?
What does the acronym ABCDE stand for in melanoma assessment?
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What percentage of skin cancers are squamous cell carcinomas?
What percentage of skin cancers are squamous cell carcinomas?
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Which node is associated with the distal interphalangeal joint?
Which node is associated with the distal interphalangeal joint?
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What is the common symptom of carpal tunnel syndrome?
What is the common symptom of carpal tunnel syndrome?
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What is the typical size of a mole associated with an increased risk of melanoma?
What is the typical size of a mole associated with an increased risk of melanoma?
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What is the medical term for a runny nose?
What is the medical term for a runny nose?
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What does a larger A wave in atrial filling typically indicate?
What does a larger A wave in atrial filling typically indicate?
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How is central venous pressure (CVP) normally measured?
How is central venous pressure (CVP) normally measured?
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What is indicated by an enlarged left ventricle (LV) apex inferolaterally displaced?
What is indicated by an enlarged left ventricle (LV) apex inferolaterally displaced?
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What characterizes the fremitus felt during a lung examination?
What characterizes the fremitus felt during a lung examination?
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What type of breath sounds are commonly associated with fluid in the alveoli?
What type of breath sounds are commonly associated with fluid in the alveoli?
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What describes visceral pain?
What describes visceral pain?
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When is peritoneal inflammation suggested during an abdominal examination?
When is peritoneal inflammation suggested during an abdominal examination?
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What condition is suggested by the presence of black stool (melena)?
What condition is suggested by the presence of black stool (melena)?
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What is the significance of a distended abdomen with fluid accumulation (ascites)?
What is the significance of a distended abdomen with fluid accumulation (ascites)?
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What auscultation finding is noted in vascular occlusion disease?
What auscultation finding is noted in vascular occlusion disease?
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What is considered a proper depth for chest compressions in adults during CPR?
What is considered a proper depth for chest compressions in adults during CPR?
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Which abnormal sound would indicate air under the pleura during percussion?
Which abnormal sound would indicate air under the pleura during percussion?
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What symptom is falsely associated with cold sweat (diaphoresis)?
What symptom is falsely associated with cold sweat (diaphoresis)?
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Study Notes
Patient Centered Communication
- Nonfocusing communication includes silence, nonverbal encouragement, and neutral utterances.
- Focusing communication involves echoing, open-ended requests, and summaries.
- A symptom is a phenomenon experienced by the affected individual.
- A sign is a phenomenon detected by someone other than the affected individual.
Medical Documentation
- A complete history and physical exam (H&P) is documented during the initial office visit or admission.
- A focused H&P, using the SOAP format (subjective, objective, assessment, and plan), is also important.
- Problem-focused notes provide daily medical updates.
- Task-focused notes are used for operative procedures, labor and delivery, and other specific tasks.
Physical Exam
- General appearance includes facial features like rounded facies in Cushing's syndrome, prominent jaw in acromegaly, and bulging eyes in hyperthyroidism.
- Other aspects to note include overall body condition (frail, cachectic, emaciated, or weak).
- Generalized fat distribution in simple obesity often shows truncal fat with relatively thin limbs (e.g., Cushing's syndrome, metabolic syndrome).
Weight and Obesity
- BMI (body mass index) is a measure for body weight, and different categories exist.
- Underweight is a BMI <18.5
- A normal BMI is within the range of 18.5-24.9
- Overweight BMI is 25–29.9
- Obesity is categorized as 30-39.9
- Morbid obesity is >40.
- Waist circumference measurements are used to assess risk factors such as diabetes, hypertension, and cardio-risk.
- The ratio of waist-to-hip circumference (W-H ratio) also represents risk factors for women and men.
Vitals
- Vital signs (BP, HR, RR, temperature, and pulse oximetry) are crucial for assessment.
- Heart rate (HR) should be within the normal range of 60-100 bpm. Tachycardia is above 100 bpm and bradycardia is below 60 bpm.
- The rhythm can vary with systolic heart failure if irregular.
- Respirations (RR) should typically be between 12 and 20 breaths/minute.
- Blood pressure (BP) is a crucial vital sign. Normal BP is 120/80 mmHg
Derm Exam
- Pruritus (itching) is a common skin symptom.
- The atopic triad includes eczema, allergies, and asthma.
- Vesicles are small, fluid-filled blisters with erythematous (red) bases.
- Herpes zoster, often called shingles, is caused by varicella-zoster virus reactivation.
- It presents with a painful rash.
- Psoriasis is characterized by symmetric bilateral, erythematous, and scaly plaques.
- Annular lesions indicate ringworm or tinea infections.
- Nail clubbing suggests pulmonary/inflammatory bowel disease.
- Melanoma risk factors include personal/family history, tanning, and indoor tanning.
- Basal cell carcinoma is a common type of skin cancer, appearing as pearly or reddish sores.
MSK Exam
- Acute signs of inflammation last up to 6 weeks whereas chronic inflammation lasts for over 12 weeks.
- Back pain red flags include saddle anesthesia and bowel/bladder dysfunction.
- Appendicitis can present with right lower quadrant pain and rebound tenderness.
- Assessment for different conditions such as Carpal tunnel, and joint issues is done using specific methods of palpation and inspection.
HEENT Exam
- Double vision is diplopia.
- Ear ringing is tinnitus.
- Room spinning is vertigo.
- Nosebleed is epistaxis.
- Runny nose is rhinorrhea.
- Sore throat is pharyngitis.
- Pupils are equal, round, and reactive to light (PERRLA).
Cardio Exam
- Bradycardia is slow heart rate.
- Tachycardia is a fast heart rate.
- Jugular venous pulses are assessed for signs like atrial contraction and filling.
- Precordial impulses, a heart examination, are evaluated.
- Auscultation is a crucial step in a heart assessment.
Pulmonary Exam
- S1 is the first heart sound, S2 is the second heart sound, S3 is an early diastolic sound, and S4 is an end diastolic sound.
- Increased or decreased preload can affect these sounds.
- Lung assessment includes checking for increased or decreased sounds, breath sounds, and other signs.
Abdominal Exam
- Visceral pain is a dull, poorly localized experience arising from distension, inflammation, or ischemia.
- Parietal pain is a more severe, sharp, localized experience often caused by inflammation of the peritoneum.
- Referred pain is a sensation felt in a different area of the body than the actual source, indicative of related innervation, and possible pathology.
Laboratory and Diagnostic Tests
- Annual fecal occult blood tests (FIT) and colonoscopies at regular intervals are crucial preventive health checks.
General Anesthesia
- General anesthesia is used for a variety of surgical procedures.
- Contraindications to general anesthesia include facial trauma, certain eye injuries, and foreign bodies in the mouth.
- Specialized equipment (22-mm orifice connectors, bag reservoirs) for general anesthesia is important.
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Description
This quiz covers essential aspects of patient-centered communication, including types of communication and the importance of documentation in medical practice. You will also explore the physical exam and how to recognize symptoms and signs in patients. Test your knowledge on these crucial topics related to effective healthcare delivery.
