TERMS AND CONCEPTS

System 1

A doctor recognizes a classic bulls-eye rash and immediately suspects Lyme disease without conscious analysis. Which reasoning system is being used?

Availability heuristic

A resident recently saw a memorable case of pulmonary tuberculosis and now suspects TB in every patient presenting with a chronic cough. Which heuristic is influencing them?

Anchoring

A clinician sticks to an initial diagnosis of viral gastroenteritis even after the patient develops new symptoms of an ectopic pregnancy. Which heuristic involves this stickiness to an initial impression?

Occams Razor

A physician seeks a single unifying diagnosis to explain all of a patients unexplained symptoms. This simplicity heuristic is also known as?

Law of Parsimony

In medicine, the principle of unitarianism or seeking the simplest explanation with the least assumptions is called the?

Pathophysiologic framework

A student organizes a differential diagnosis for fever into categories such as infection, malignancy, and inflammatory conditions. Which framework is being used?

Organ-System framework

A patient presents with fatigue, and the physician organizes causes into cardiovascular, endocrine, pulmonary, and psychiatric systems. Which framework is this?

Anatomic framework

A clinician organizes the causes of a headache into within the cranium, outside the cranium, and connected structures. Which framework is being used?

Prognostic approach

An ER physician orders an ECG for a patient with crushing chest pain to rule out myocardial infarction, even though GERD is more likely. Which prioritization approach is illustrated?

Probabilistic approach

A physician suspects a viral URI in a child because it is the most common and prevalent explanation for the symptoms in the local area. Which approach is being used?

Pragmatic approach

A clinician provides paracetamol for musculoskeletal pain while awaiting further tests because the treatment is safe and may relieve symptoms. Which approach is this?

Possibilistic approach

A doctor treats all known causes of a symptom as equally likely and tests for all of them simultaneously. Which approach, considered not useful in clinical practice, is this?

Cognitive error

A diagnostic error resulting from a clinicians faulty synthesis of data or lack of knowledge regarding a disease is categorized as a?

System-related error

A misdiagnosis occurs because a laboratory machine was improperly calibrated or a communication gap existed in the hospital. This is a?

No fault error

A diagnostic error occurs because a disease has a masked or unusual presentation that does not match the classical picture. This is a?

Defensive medicine

A doctor orders an expensive CT scan for a minor injury primarily to preclude future criticism or protect against potential malpractice claims. What is this practice called?

Capitation

Which physician payment scheme involves a fixed payment per patient per year and encourages global budget management?

Fee-for-service

Which physician payment scheme may encourage the overuse of clinical interventions because doctors who do more get paid more?

Fixed Salary

Which physician payment scheme provides an incentive to see fewer patients because pay remains the same regardless of effort?

Checklists

What tool has been proposed to reduce cognitive errors in high-stakes settings like the operating room or intensive care units?

Subjective

A 35-year-old worker reports job exposure to chemical solvents and aggravating factors for his cough. In which section of the SOAP note is this recorded?

Objective

A doctor documents a patients blood pressure of 140/80 and clear breath sounds found during the physical exam. In which section of the SOAP note is this recorded?

Assessment

A physician writes a problem list including both Biomedical and Psychosocial concerns. Which part of the SOAP note is this?

Active problem

A patient presents with an acute stroke; they also have a history of treated TB from a decade ago. According to Weeds definition, the stroke is classified as an?

Inactive problem

In a patient with a current stroke and a history of successfully treated TB from ten years ago, the TB is classified as an?

Data Base

Which component of the Problem-Oriented Medical Record includes the complete history and physical examination findings?

Problem List

Which component of the POMR serves as a table of contents for the patients active and inactive conditions?

Initial Plans

Which component of the POMR includes the diagnostic work-up, therapeutic interventions, and patient education?

50 to 90 percent

Approximately what percentage of a correct diagnosis is typically contributed by the patients history alone?

Cues

Identifiable physiological or psychosocial changes experienced and reported by the patient are called?

Inferences

Judgments or mini-conclusions made by the physician that go beyond factual data are called?

Framing

Which cognitive shortcut involves developing a concise, few-statement summary of a clinical case using salient features?

Salient features

Pertinent positives and negatives in the history and physical exam used to construct a problem representation are called?

Pre-test probability

The clinicians initial estimate of how likely a patient has a disease before any diagnostic test is performed is the?

Diagnostic test

Any technology or clinical sign that changes a physicians understanding of a patients problem qualifies as a?

Test Threshold

The probability level below which a clinician decides a disease is ruled out and no further testing is needed is the?

Treatment Threshold

The probability level above which a clinician decides to start treatment directly without ordering more tests is the?

Sensitivity

The proportion of patients with a disease, defined by a gold standard, who have a positive test result is?

Specificity

The proportion of patients without a disease who have a negative test result is?

SnNOut

A highly sensitive test for TB PCR returns a negative result, allowing the clinician to rule out the disease. Which mnemonic applies?

SpPIn

A highly specific HbA1c test returns a result of 8.5 percent, allowing the clinician to rule in diabetes. Which mnemonic applies?

True Positive

A patient actually has appendicitis and their Procalcitonin test is positive. This result is categorized as a?

False Negative

A patient actually has appendicitis but their Procalcitonin test is negative. This result is categorized as a?

Positive Likelihood Ratio

Which measure tells you how much a positive test result increases the pre-test odds of a disease?

Negative Likelihood Ratio

Which measure tells you how much a negative test result decreases the pre-test odds of a disease?

LR = 1.0

A diagnostic test result that provides no value and does not change the post-test probability has a Likelihood Ratio of?

Significant change

A diagnostic test result that causes a conclusive change in post-test probability, with an LR plus of 10 or higher, is categorized as what kind of change?

Nomogram

Which clinical tool is used to determine post-test probability by drawing a straight line between the pre-test probability and the likelihood ratio?

Gold Standard

The test that defines the presumably true state of a patients disease is the?

First

Which step of the Rotarys Four-Way Test for lab exams asks, Is this the best test for what I want to know?

Second

Which step of the Rotarys Four-Way Test for lab exams asks, Do I know how to interpret this test?

Third

Which step of the Rotarys Four-Way Test for lab exams asks, Will the management and prognosis change if I do this test?

Fourth

Which step of the Rotarys Four-Way Test for lab exams asks, Can the patient afford this test?

Troponin I

A 60-year-old male presents with acute chest pain. Which immunology test is requested to confirm an Acute Myocardial Infarction?

HbA1c

A clinician needs to monitor a diabetic patients average blood sugar levels over the past 2 to 3 months. Which test is requested?

Creatinine

Which breakdown product of muscle creatinine phosphate is the primary laboratory test for kidney function?

HBsAg

Which part of a Hepatitis profile indicates an active Hepatitis B infection?

Anti-HBs

Which part of a Hepatitis profile indicates immunity to Hepatitis B?

NS1

Which antigen test is typically requested during the early phase of a suspected Dengue infection?

AFP

Which tumor marker is produced by the liver during the fetal period and is used to screen for liver cancer?

PSA

Which tumor marker is produced by both malignant and nonmalignant prostate cells?

CEA

Which fetal protein serves as a tumor marker for colorectal cancer?

CA 19-9

Which antigen is used as a tumor marker for pancreatic cancer?

Urinalysis

Which clinical microscopy test is used to screen for UTI, lithiasis, and chronic kidney disease?

FOBT

A patient needs to be screened for minute amounts of blood in the stool to check for GI malignancies. Which test is ordered?

AFB smear

Which staining method is specifically used to screen for Mycobacterium tuberculosis?

India Ink Preparation

Which microbiology test is used to identify the capsule of Cryptococcus in cerebrospinal fluid?

KOH mount

Which microbiology preparation is used to demonstrate hyphal elements in fungal infections?

Crossmatching

Before a blood transfusion, which test is done to ensure the donor blood is compatible with the recipients blood?

Coomb's DAT

Which blood bank test is used to detect the presence of autoantibodies in plasma, often in transfusion reactions?

ABG

Which pulmonary test assesses acid-base balance and oxygenation status in respiratory failure?

BNP

Which protein produced by the heart is used to evaluate a patient for chronic heart failure?

T1-weighted image

An MRI sequence where fat appears bright and fluid appears dark is categorized as a?

T2-weighted image

An MRI sequence where fluid appears bright and is best for detecting edema is categorized as a?

TR

In MRI settings, the repetition time for protons to align with the main magnetic field is called?

TE

In MRI settings, the time provided for absorbed radio waves to be released and detected is called?

Titanium

Which metal implant material is generally considered safe and compatible with MRI machines?

PI-RADS

Which system is used to assess and characterize mass lesions in the prostate via MRI?

Diffusion-weighted imaging

Which specific MRI sequence is used to detect hyperacute infarcts in a stroke patient?

Transducer

What is the name of the ultrasound instrument that converts electrical energy into sound waves?

Piezoelectric crystals

Which components inside an ultrasound transducer convert energy into sound pulses?

Anechoic

What is the ultrasound term for structures like the bladder or cysts that appear black due to the absence of internal echoes?

High frequency

Which ultrasound sound wave setting is used to visualize superficial structures like the thyroid or breast?

Low frequency

Which ultrasound sound wave setting is used to visualize deep structures like the liver or a fetus?

Bowel gas

What is the primary limitation of ultrasound that creates artifacts and covers structures like the pancreas?

Transvaginal

Which ultrasound approach is preferred during the first trimester of pregnancy to get the probe closer to the embryo?

Crown-rump length

Which measurement is taken during a first-trimester ultrasound to determine the age of gestation?

Target sign

Along with the pseudo-kidney sign, what is the characteristic ultrasound finding for pediatric intussusception?

Sausage-shaped mass

What characteristic abdominal mass might be felt on physical exam in a child with intussusception?

Crow's feet

The appearance of hepatic veins on an ultrasound that indicates you are looking at the superior segments of the liver is called?

Morrison's pouch

What is the clinical name for the hepatorenal space often assessed for free fluid or ascites?

Shadowing

A hyperechoic gallstone blocks sound waves from returning to the transducer, creating a dark area behind it known as?

Dromedary hump

Which normal renal anatomical variant is caused by the spleen pushing on the kidney during development?

Hydronephrosis

A pathologic ultrasound finding of dilated calyces filled with urine is called?

6 hours

What is the ideal time window from the onset of symptoms to surgery for a patient with testicular torsion?

9 to 18 months

At what age does the anterior fontanelle typically close in a healthy infant?

6 to 8 weeks

At what age does the posterior fontanelle typically close?

Superscription

Which part of a written prescription contains the date, patient address, age, and the symbol Rx?

Inscription

Which part of a written prescription contains the name and strength of each drug ingredient?

Subscription

Which part of a written prescription provides directions to the pharmacist, such as Dispense 10 tablets?