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LaRose Test 1
Steve from book
38
Health Care
Professional
10/04/2012
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Term
1.       The word diagnosis is derived from the Greek words “dia” meaning _____, and through “gnosis” meaning _____.
 Definition
APART; KNOWING
Term
2.       Dorland’s medical dictionary defines _____ as the art of distinguishing one disease from another, while Taber’s medical dictionary defines it as the use of scientific methods to establish the cause and nature of a person’s illness.
 Definition
DIAGNOSIS
Term
3.       The purpose of a diagnosis is to determine the level of _____.
 Definition
INTERVENTION
Term
4.       The art of diagnosis is subtle and governed by these 2 laws.
 Definition
1) OCCAM’S RAZOR, 2) SUTTON’S LAW
Term
5.       This law which governs the art of diagnosis is the law of parsimony.
 Definition
OCCAM’S RAZOR
Term
6.       This law which governs the art of diagnosis is the law of odds.
 Definition
SUTTON’S LAW
Term
7.       _____ was a fourteenth century English philosopher who claimed that “multiples should not be posited without necessity.” When applied to clinical diagnosis the rule of thumb suggests that when a patient presents with several problems, one should look for a single solution or diagnosis. That being said, sometimes patients presenting with multiple problems may have more than one diagnosis.
 Definition
WILLIAM OF OCCAM
Term
8.       When applied to clinical problem solving, this law suggests that one should use the one symptom/sign/test that is most likely to confirm your diagnosis. This would involve knowing the sensitivity and specificity of specific symptoms, signs or tests.
 Definition
SUTTON’S LAW
Term
9.       The science of diagnosis involves the calculation of the _____ of a particular patient having a specific disease.
 Definition
ODDS
Term
10.   One needs to be able to understand the difference between _____ and _____ of tests and how these can be used to predict whether a patient with a particular symptom or sign may have a specific disease.
 Definition
SPECIFICITY AND SENSITIVITY
Term
11.   _____ is calculated by taking the number of patients with a true positive, and dividing it by the total number of patients with the disease.
 Definition
SENSITIVITY
Term
12.   A highly _____ test is good at excluding the diagnosis.
 Definition
SENSITIVE
Term
13.   Sensitive tests are useful in screening _____ disease, therefore is the test is negative then the patient does not have the disease.
 Definition
OUT (SnOUT)
Term
14.   _____ is calculated by taking the number of patients with a true negative divided by the total number of patients without the disease.
 Definition
SPECIFICITY
Term
15.   A highly _____ test is good at confirming the presence of the disease. Therefore if the test is positive, then the person has the disease.
 Definition
SPECIFIC (SpIN)
Term
16.   _____ is calculated by dividing the sensitivity by the value of 100 minus the specificity.
 Definition
LIKELIHOOD RATIO-POSITIVE
Term
17.   _____ is calculated by dividing the true positive by the sum of the true positive plus the false positives, and express the final answer in percent’s.
 Definition
POSITIVE PREDICTIVE VALUE
Term
18.   4 different approaches that can be used in problem solving.
 Definition
1) ALGORITHMIC APPROACH, 2) HYPOTHETICO-DEDUCTIVE APPROACH, 3) PATTERN RECOGNITION MODEL, 4) TRADITIONAL MODEL
Term
19.   The _____ approach of problem solving consists of following the logical steps laid out in the approach. It is based on a combination of epidemiology, probability, and selectivity created by experts in the field. Its detractors state that it is to mechanical and void of thinking.
 Definition
ALGORITHMIC APPROACH
Term
20.   The _____ approach of problem solving starts off with the chief complaint as the initial cue. One main hypothesis is formed based on the circumstances of the chief complaint, namely the age, sex and duration of the chief complaint. Once the hypothesis is formed, then a concerted effort is made to search for additional cues that would support the hypothesis. If such cues are found then the most appropriate confirmatory test is ordered, and if positive then the diagnosis is made. A management plan is implemented and the patient is reviewed at an appropriate time to see if there is improvement. Should the test be negative, then revise the hypothesis. If the search came up with nothing, revise the hypothesis. If the review does not show any significant improvement, then revision of the hypothesis is recommended.
 Definition
HYPOTHETICO-DEDUCTIVE MODEL
Term
21.   The _____ approach of problem solving is a time-honored method which relies on patients presenting with classic findings and the student learning to recognize the classic findings of hundreds of diseases. This model is commonly used by primary care physicians when diagnosing commonly occurring conditions.
 Definition
PATTERN RECOGNITION
Term
22.   The _____ approach of problem solving involves gathering every possible piece of data through a detailed history, a through physical examination followed by tests that confirm or exclude various diagnoses. This model is appropriate for the novice practitioner and for unusual presentations of diseases when other decision-making strategies have failed.
 Definition
TRADITIONAL METHOD
Term
23.   In the traditional method of problem solving, once the doctor takes a detailed history, he or she should come up with a list of _____.
 Definition
DIFFERENTIAL DIAGNOSES
Term
24.   Generating a list of _____ is a process that involved the formation, validation and confirmation of a variety of hypotheses. Sometimes it may also involve intuition.
 Definition
DIFFERENTIAL DIAGNOSES
Term
25.   5 important principles related to the art of differential diagnosis.
 Definition
1) BE VERY BROAD IN THE BEGINNING STRTING WITH POSSIBILITIES AND WORKING TOWARDS PROBABILITIES, 2) USE EVERY BIT OF DATA COLLECTED FROM THE HISTORY AND PHYSICAL, 3) REMEMBER TO ASK ALL THE IMPORTANT QUESTIONS, 4) DO NOT TRY TO FORCE A SQUARE PEG INTO A ROUND HOLE, 5) USE YOUR DIFFERENTIAL LIST TO BE SELECTIVE IN YOUR CHOICE OF LAB AND IMAGING STUDIES
Term
26.   _____ is a clinical approach that is used to specifically address spinal pain.
 Definition
MURPHY’S APPROACH
Term
27.   Murphy’s approach recommends that the chiropractor asks him or herself these following 3 questions.
 Definition
1) ARE THERE ANY RED FLAGS, 2) WHAT IS T HE SOURCE OF THE PAIN, 3) ARE THERE ANY PERPETUATING FACTORS
Term
28.   Although Murphy confines his search for perpetuating factors such as fear, passive coping strategies, catastrophizing, depression, or segmental instability it is important to think beyond these factors. I would be very helpful if the chiropractor remembers DD Palmer’s postulate that _____, _____ and _____ may be involved in the causation of disease.
 Definition
TRAUMA, TOXINS AND THOTS
Term
29.   Regardless of the problem solving approach, a _____ is an essential component of the examination.
 Definition
DETAILED HISTORY
Term
30.   4 important components of a detailed medical history.
 Definition
1) PATIENT PROFILE, 2) HISTORY OF THE PRESENTING COMPLAINT, 3) PAST MEDICAL, FAMILY AND SOCIAL HISTORY, 4) PROBLEM ORIENTED REVIEW OF SYSTEMS
Term
31.   When taking care of a patient, it is imperative from the perspective of patient satisfaction of address the _____.
 Definition
PATIENT’S AGENDA
Term
32.   A patients agenda addresses these 5 issues.
 Definition
1) CONCERNS, 2) REASONS FOR THE VISIT, 3) IDEAS ABOUT THE CAUSE, 4) MEANING OF THE ILLNESS, 5) EXPECTATIONS OF THE PATIENT
Term
33.   The physical examination must include the _____, and should focus on the systems most likely to be affected.
 Definition
VITAL SIGNS
Term
34.   It is estimated that in approximately 80% of patients, a diagnosis can be made from just the _____ alone.
 Definition
HISTORY
Term
35.   10% of patients diagnoses can be made from both _____ and _____.
 Definition
HISTORY AND PHYSICAL EXAM
Term
36.   In 5% of patients, the diagnosis will only be made after _____.
 Definition
LAB TESTS
Term
37.   When ordering lab tests, you should consider these 4 things.
 Definition
1) IS THIS THE BEST TEST, 2) HOW MUCH WILL IT COST, 3) WHAT DISCOMFORT IS THERE TO THE PATIENT, 4) WHAT ARE POSSIBLE COMPLICAITONS OF THE TEST
Term
38.   It is important to remember that the diagnostic process does not end with the diagnosis. It must be followed by implementation of a _____ and _____ assess the outcome of the intervention.
 Definition
TREATMENT PLAN AND FOLLOW UP
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