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Details

Clinical Exam Test 1 -A
History taking, patient interviewing, vital signs and peripheral vasculature.
50
Health Care
Professional
09/27/2010

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Cards

Term
ISOCHIP
Definition
injuries, surgeries, OB/GYN, childhood, hospitalizations, immunizations, psychiatric
Term
How long should the stethoscope be?
Definition
30 cm/12" - 38 cm/15"
Term
Why should you assess the neck from the right?
Definition
More reliable JVP
Term
What is different about the right and left kidneys?
Definition
Right is frequently more palpable than the left
Term
What are the terms for the fingers in percussion?
Definition
Striking/plexor finger and pleximeter finger
Term
What are the frequencies of the tuning forks?
Definition
128 Hz and 512 Hz
Term
What should be done specially for the ophthalmoscopic exam?
Definition
Darken the room.
Term
In what position(s) should you inspect the breasts?
Definition
Arms relaxed, elevated and with hands on hips.
Term
Where should the head of the bed be when assessing carotids?
Definition
Elevated to 30 degrees.
Term
Pt should be in what position to listen for apex and mitral stenosis?
Definition
Left side
Term
Pt should be in what position to listen for murmurs of aortic regurg?
Definition
Leaned forward and exhaled.
Term
If you suspect kidney infection, where should you percuss?
Definition
Posteriorly on costovertebral angle.
Term
What are the 3 basic types of clinical reasoning?
Definition
Pattern recognition, schemas and application of relevant basic or clinical science.
Term
When developing hypotheses regarding a pt's illness, you should give special attention to what?
Definition
Potentially life-threatening and treatable conditions.
Term
What should you consider when trying to cluster data into single vs. multiple problems?
Definition
Age, timing and involvement of different body systems.
Term
What is intraobserver reliability?
Definition
One observer finds the same results time after time.
Term
What is interobserver reliability?
Definition
Multiple observers find the same result.
Term
What is validity?
Definition
How well the measurement agrees with the true state or best possible measure of reality.
Term
Sensitivity is...
Definition
Proportion of people who test positive among those with the disease - "true positives"
Term
Specificity is...
Definition
Proportion of people who test negative among those without the disease - "true negatives"
Term
A good test has specificity and sensitivity above...
Definition
90%
Term
What does predictive value tell you?
Definition
How well a given test detects the presence or absence of a disorder.
Term
Predictive value depends heavily on...
Definition
Prevalence
Term
What is PPV?
Definition
Proportion of people who really have the disease among those who tested positive.
Term
What is NPV?
Definition
Proportion of those who really don't have the disease among those who tested negative.
Term
When prevalence increases, what will happen to PPV (assuming a constant specificity and sensitivity)?
Definition
It will increase.
Term
What does LR tell you?
Definition
The odds that a finding occurs in a pt with the condition compared to a pt without the condition.
Term
What is the equation for a positive LR?
Definition
Sensitivity/(1-specificity)
Term
What is the equation for a negative LR?
Definition
Specificity/(1-Sensitivity)
Term
Kappa measures what?
Definition
Interobserver agreement, or degree of precision of clinical finding compared to chance alone.
Term
For Kappa measurement, expected agreement is what?
Definition
59%
Term
What is the equation for k?
Definition
Actual agreement beyond chance / remaining potential agreement beyond chance
Term
What are the ranges for K measurement?
Definition
0-0.2 slight agreement
0.2-0.4 fair
0.4 - 0.6 moderate
0.6-0.8 moderately high
0.8-1.0 substantial
Term
When discussing sensitive topics, what should you do with your notes?
Definition
Put down the pen or keyboard.
Term
You should understand the patient's perspective to the illness. What does this consist of?
Definition
FIFE - Fears, ideas, functional effects, expectations
Term
Before discussing a pt's history or health care with anyone, even colleagues, you should consider what?
Definition
The law - especially HIPAA (1996)
Term
Those not fluent in English are less likely to do what?
Definition
Have regular/preventative care and report problems with their care.
Term
What is CAGE for?
Definition
Determining likelihood of alcohol abuse.
Term
Two "yes" responses to CAGE has what sensitivity and specificity?
Definition
sensitivity 43-94%, specificity 70-96%
Term
What are the 4 main principles of ethics?
Definition
Nonmaleficence, beneficence, autonomy, confidentiality
Term
What is weakness, and what does it suggest?
Definition
Loss of muscle power, myopathy or neuropathy
Term
Fatigue is a normal response to what?
Definition
Hard work, stress and grief
Term
Chills indicate what?
Definition
Rising temperature.
Term
Feeling hot and sweaty indicates what?
Definition
Falling temperature.
Term
Shaking chill with shivering throughout entire body indicates what?
Definition
Extreme temperature swings, possibly bacteremia.
Term
Approx how many people in the US have persistent or intermittent pain?
Definition
70 mil.
Term
What proportion of Americans have a healthy weight?
Definition
Fewer than half
Term
What percent of adults in the US are overweight?
Definition
More than 60%
Term
What percentage of children in the US are overweight?
Definition
Approx 14%
Term
What percentage of black women in the US are overweight?
Definition
Approx 69%
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