week six kickoff

physical examination

first step in the diagnosis or treatment based on signs and symptoms

signs

objective information detected by the physician

symptoms

subjective information supplied by the patient

what is the role of a clinical medical assistant in the general physical exam?

• interview (chief complaint/subjective)

• obtain histories (subjective)

• determine vital signs (objective)

• measure weight and height (objective)

• ensure instruments and supplies are available

• help into position, ensuring patient comfort

• observe for signs of distress or need for assistance

• educate patients on self-examinations

• perform injections, EKG, phlebotomy

what are the different positions used for a physical exam?

inspection

visual exam

auscultation

listening to body sounds

palpation

touch

percussion

tapping or striking the body to hear sounds or feel vibrations

mensuration

process of measuring

manipulation

• moving of a patient’s body parts

• range of motion of joints

which exam method is the physician using when observing the range of motion of joints?

• mensuration

• palpation

• manipulation

• inspection

manipulation

which position has the patient lying on the left side, left leg slightly flexed, with the right leg flexed at 90º angle?

• lithotomy

• prone

• jack-knife

• sim’s

sim’s

gynecologic exam

overview of a woman’s health and cancer-screening exams and tests

breast exam

examination of breasts and underarm areas to check for abnormal lumps

what is the medical assistant’s role in th gynecologic exam?

• have patient empty bladder and obtain urine specimen if needed

• provide a gown and interview patient

• discuss gynecologic and general health

• review of factors that may indicate cancer or STIs

• ask questions about the patient’s menstrual cycle

• check vital signs

• determine the 1st day of her last menstrual period

• gather supplies and assist physician

pregnancy tests

detect presence of hormone HCG

STI tests

may require bacterial and tissue cultures, examining lesions, blood tests, and patient history

ultrasound

assess organs and structures and produce pictures of a baby

hysterosalpingography

x-ray procedure used to view the inside of the uterus and fallopian tubes

hysterosalpingo-oophorectomy

removal of the uterus, fallopian tubes, and ovaries

assisting in urology

• patient chief complaint and history: check for any changes in urination

• the physical exam

  • palpation of the kidneys and bladder and visual inspection of the external genitalia

  • inspection and palpation of the penis and scrotum

  • the groin is examined for a hernia

    • in men over 40, the prostate gland is examined by digital insertion into the rectum

• MA is responsible for teaching the patient to perform a regular testicular self-exam (TSE)

urinalysis

most commonly ordered test

blood testing

monitor for dysfunctions of the prostate gland and certain STIs

semen analysis

determine fertility and evaluate success of vasectomy

smears

diagnose infections

cystometry

measure bladder capacity and pressure

ectopic pregnancy

fertilized egg unable to move out of fallopian tube into uterus for implanation

fibrocystic breast disease

benign, fluid-filled cysts or nodules in breast

ovarian cysts

• sacs of fluid or semisolid material

• usually benign

menstrual disturbances

• amenorrhea - absence of menstruation

• dysmenorrhea - painful menstrual periods

• menorrhagia - heavy or prolong menstrual bleeding

• metrorrhagia - abnormal bleeding

kidney stones

• chemical substances in the urine form crystals in the kidney, ureter, or bladder

• renal calculi, nephrolithiasis, or urolithiasis

what type of organism is chlamydia?

bacteria

what type of organism is gonorrhea?

bacteria

what type of organism is syphilis?

bacteria

what type of organism is trichomoniasis?

protozoa

what type of organism is HSV (herpes simplex virus)?

virus

what type of organism is HPV (human papilloma virus)?

virus

can chlamydia be cured?

yes

can gonorrhea be cured?

yes

can syphilis be cured?

yes

can trichomoniasis be cured?

yes

can HSV (herpes simplex virus) be cured?

no, but can be managed

can HPV (human papilloma virus) be cured?

no, but can be managed

how is chlamydia transmitted?

fluids

how is gonorrhea transmitted?

fluids

how is syphilis transmitted?

skin to skin

how is trichomoniasis transmitted?

fluids

how is HSV (herpes simplex virus) transmitted?

skin to skin

how is HSV (human papilloma virus) transmitted?

skin to skin

the MA is asked to give a patient education on a procedure for nephrolithiasis. what will the MA explain to the patient about the diagnosis?

• sexual dysfunction

• ovarian cyst

• kidney stones

• excessive bleeding from the uterus

kidney stones

which STI is not caused by a bacteria?

• chlamydia

• gonorrhea

• syphilis

• herpes simplex

herpes simplex

pediatrician

• specialist for children

• up to the age of 18 or 21

• monitors development

• immuunization schedules

• parent education

• development milestones for each stage

developmental stages

encompasses changes in physiological, emotional, mental, social, interactive, spiritual, and physical

erikson’s 8 stages of psychosocial development

• guidelines for identifying psychosocial challenges

• can have a positive or negative outcome for personality development

pediatric examinations

• height (length), weight, head and chest circumference (up to 36 months)

• temperature

  • use tympanic, temporal, rectal, axillary

  • no oral temperature in children less than five years old

• pulse (apical for infants)

• ear exams

• blood pressure (over age 3)

  • use correct cuff size

  • do not use palpatory method

• review family health history, existing conditions, current health conditions

• observe child for any abnormalities that may indicate an underlying health concern

• monitor growth charts, record measurements, height and weight

immunizations

• check published immunization schedules found at cdc.gov

• check for contraindications

• ensure scope of practice when administering immunizations

informed consent for immunizations

• explain the side effects of immunizations

• review with the parent the vaccine information statement (VIS)

• advise parents of immunity

• obtain informed consent for the child’s immunization

what are common disease and disorders in pediatrics?

• common cold and influenza

• ear infections (otitis media/middle ear infection)

• bronchitis - airways in the lungs swell and produce mucus in the lungs (viral)

• respiratory syncytial virus (RSV) - mild cold-like symptoms including fever, coughing, and sneezing

• hand, foot, and mouth disease (HMFD) - very contagious; symptoms include skin rash and fever

• conjunctivitis - “pink eye” (redness, discharge, itchiness, and swelling in on or both eyes)

• gastroenteritis - stomach flu, viral (nausea, vomiting, and diarrhea)

• sinusitis - sinus infection

which of the following types of patients would be measured in length?

• neonate (< 28 days)

• preschool (3-5 y)

• school age (6-9 y)

• preadolescent (10-11 y)

neonate (< 28 days)

which is not taken on a child until the age of 3?

• weight

• pulse

• height

• blood pressure

blood pressure

what are the changes that occur in the integumentary system with age?

• thinning and wrinkling skin

• decreased collagen

what are the changes that occur in the musculoskeletal system with age?

osteoporosis

what are the changes that occur in the nervous system with age?

decreased blood flow to the brain due to arteriosclerosis

what are the changes that occur in the special sense with age?

impaired vision (presbyopia)

what are the changes that occur in the respiratory system with age?

increased shortness of breath

what are the changes that occur in the cardiovascular system with age?

• atherosclerosis

• hypertension

• hypotension

assisting in geriatrics

• observe for physical limitations

• communicate effectively (written instructions, speak clearly with low tones)

• patient may have denial or confusion

• educate patient on the importance of preventative measures

• ensure patient compliance with medications

which physical change happens in the elderly patient’s special senses?

• presbyopia

• osteoporosis

• arteriosclerosis

• kyphosis

presbyopia

at which age is a patient considered geriatric?

• 60

• 65

• 70

• 75

65