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subjective means - Correct Answer ✅interview objective means - Correct Answer ✅physical exam an HPI is a - Correct Answer ✅problem focused history and physical exam For each problem let the patient describe using - Correct Answer ✅oldcart OLDCART - Correct Answer ✅onset, location, duration, characteristics, associated sxs (ROS), relieving and aggravating factors, treatment pertinent negatives - Correct Answer ✅what they don't have (important to rule out to form hypothesis / diagnosis ID (identifying data) - Correct Answer ✅date/time of appointment, name, DOB, referral, source of reliability
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CC (chief compliant) - Correct Answer ✅quote patients own words Present illness HPI - Correct Answer ✅use old cart, also ask about medications, allergies, tobacco, alcohol, and drugs, risk of pregnancy for women of childbearing ages Past history - Correct Answer ✅childhood, adult, surgical, ob/gyn, psychiatric, health maintenance (immunizations/screenings) Personal/social history - Correct Answer ✅Education, employment , family unit, stress, social support, sleep , exercise, diet, safety, lifestyle habits ROS (review of systems include) - Correct Answer ✅general, skin, heent, neck, breasts, respiratory, cardiovascular, gastro, unirtnay, and peripheral vascular, muscoloskeltal, genital, psychiatric, neurologic, hematologic, endocrine
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Kwashiorker in child is a condition caused by - Correct Answer ✅protein deficiency Determine your nutritional health - Correct Answer ✅D- diease E- eating poorly T-tooth loss/mouth pain E-Economic hardship R- Reduced social contact M- multiple medications I- Involuntary Weight loss/gain N- Needs assistance in self gain E- Elder years above age 80 BMI overweight - Correct Answer ✅25-29. risk factor for body weight - Correct Answer ✅20% over or under ideal levels
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percussion notes and characteristics - Correct Answer ✅flatness - high pitch, short duration, example of location is the thigh Dullness- medium pitch, medium duration, example of location is the liver resonance- low pitch, long duration, example of location is healthy air filled lung Hyperresonance- lower pitch, longer duration, could be from COPD Tympany- high pitch, N/A duration, gastric air bubble or puffed out cheek General appearance (objective data) - Correct Answer ✅Height/weight, general state of health, posture, motor activity, gait, dress, grooming, personal hygiene, odors of body or breath, facial expressions, manner affect, speech vital signs are - Correct Answer ✅blood pressure, heart rate and rhythm, respiratory rate and rhythm, temperature, oxygen saturation, pain
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population groups, health conditions or coexsitising diagnoses, where the hypertension recommendations may be indicated include - Correct Answer ✅cardiovascular disaese, diabetes mellitus (type 2) , or obesity the general survey is a study of a - Correct Answer ✅whole person, covers general health state and any obvious physical charactisistcs 4 areas of general survey - Correct Answer ✅physical appearance, body structure, mobility, and behavior objective data for physical appearance - Correct Answer ✅age, sex, level of consciousness, and skin color, facial features, no signs of acute distress present objective data body structure - Correct Answer ✅stature, nutrition, symmetery, posture
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mobility - Correct Answer ✅gait normally, base is as wide as shoulder width behavior - Correct Answer ✅facial expression, mood and affect, speech,dress, personal hygiene, measurement - Correct Answer ✅weight, height, vital signs - Correct Answer ✅tempature mean of 37.2 (99F) normal oral temprature in a resting person is - Correct Answer ✅37 C, (98.6F) with a range of 35.8C to 37.3 C (96.4F to 99.1F) pulse - stroke volume - Correct Answer ✅amount of blood every heart beat pumps into aorta, about 70 ml for adult respirations count for ______seconds if you suspect and _________________ - Correct Answer ✅30; abnormality
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level of consciousness - Correct Answer ✅how aware the person is of his environment attention: - Correct Answer ✅ability to focus or concentrate Alert; - Correct Answer ✅patient is awake and aware lethargic - Correct Answer ✅you must speak to the patient in a loud forceful manner to get response obtunded - Correct Answer ✅shake patient to get response stuporous - Correct Answer ✅patient is unarousable except by painful stimuli short term memory - Correct Answer ✅memories or events occuring minutes or days before
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long term memory covers events or memories that occrured - Correct Answer ✅months to years before moods : the sustained emotion of the pateint - Correct Answer ✅euthymic : normal Dysthymic : Depressed Manic: elated Mental status exam consists of the following components - Correct Answer ✅Appearance / behavior, speech and language, mood, thoughts and perceptions, cognitive function appearance / behavior : - Correct Answer ✅assess the level of consciousness, if patent doesn't respond, speak to the patient by name and in loud voice, shake patent, posture and motor behavior, assess patients dress, grooming, hygiene, facial expressions
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Paraphasias - Correct Answer ✅words are malformed when assessing mood : - Correct Answer ✅use open ended questions abnormalities in thought process - Correct Answer ✅Cirumstantiality- speech characterized by indirection and delay due to patients excessive use of details that have no connection to the point Derailment : speech in which a person shifts topics with no apparent relation between topics Flights of ideas: accelerated change of topics in a very fast but coherent manner Neologisms: invented or distorted words abnormalities in thought content - Correct Answer ✅compulsions: repetitive behaviors that a person feels driven to perform to prevent or produce some future state of affairs obsessions : recurrent, uncontrollable thoughts, images, or impulses that a patient considers unacceptable
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Phobias: persistent fear of a stimuli Anixeity: apprehension or fear that may be focused or free floating abnormalities of perception - Correct Answer ✅illuisons, hallucisionations 3 parts of ear - Correct Answer ✅external, middle , inner tympanic cavity is in the - Correct Answer ✅middle ear Tympanic membrane landmarks - Correct Answer ✅Incus, handle of malleus, stapes, cone of light middle ear infection is called - Correct Answer ✅otitis media acute otisis media is often associated with an - Correct Answer ✅upper respiratory infection or cold
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concerning symptoms of eyes - Correct Answer ✅visual disturbances, spots, flashing lights, use of corrective lenses, pain, redness, excessive tearing , double vision (diplopia ) concerning symptoms of ears - Correct Answer ✅hearing loss, ringing (tinntitus), vertigo, pain, discharge concerning symptoms of nose - Correct Answer ✅drainage (rhinorrhea), congestion, sneezing, nose bleeds (epistaxis) concerning symptoms of oropharynx - Correct Answer ✅sore throat, gum bleeding, hoarseness concerning symptoms of neck - Correct Answer ✅swollen glands or goiter head and neck techniques of exam - Correct Answer ✅inspect and palpate
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inspect for head and neck - Correct Answer ✅hair distribution, scalp - scaling, skull-size, contour, face- expression, contours, skin- color, pigmentation, hair distribution, lesions palpate for head and neck - Correct Answer ✅hair texture, skull- lumps, face- sinuses, skin- texture, temp eyes - Correct Answer ✅inspect and palpate, vision acuity, fields, external structures internal structures of eye - Correct Answer ✅pupils, EOMs, Ophthalmoscope eyelids - Correct Answer ✅width of palperbral fissures, edema, color, lesions, condition and direction of eyelashes, adequacy of closed eyelids iris - Correct Answer ✅markings clealy defined
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auditory acuity - Correct Answer ✅test one ear at a time , whisper test, standing 1-2 feet behind patent softly say nine four, baseball Air and bone conduction - Correct Answer ✅weber and rinne weber - Correct Answer ✅lateralization of sound to impaired ear, suspect unilateral conductive hearing loss rinne - Correct Answer ✅compare time of air vs bone conduction, if bone conduction is equal or greater than air conduction , then suspect conductive loss external nose exams - Correct Answer ✅inspect for asymmetry or deformity inside of nose - Correct Answer ✅mucosa - color , swelling, bleeding, exudate, ulcers, or polyps septum- deviation, inflammation, or perfornation
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turbinates- view middle and inferior turbinates palpation of sinuses - Correct Answer ✅frontal and maxillary mouth exam - Correct Answer ✅inspect lips, note color, palpate any nodules or irregularities pharynx exam - Correct Answer ✅soft palate, anterior and posterior pillars, uvula, tonsils, and pharynx, note color symmetry, presence of exudate, swelling, ulceration, or tonsillar enlargement what do you inspect for for an neck exam? - Correct Answer ✅symmetry, masses, scars, enlarged glands or lymph nodes, trachea potation and alignment, thyroid gland, symmetry What do you for the neck? - Correct Answer ✅nodes and thryroid. Lymph nodes the size shape, delimitation, mobility, consistency, tenderness
