H&P Final

I know it probably won't be terrible, but I figured I would make a deck from all of the slides just in case

CODIERS

Mnemonic used to remember all the elements of Hx of present illness

Symptoms associated

questions about other body systems that need to be asked that may be related to the chief complaint

MASHFML

The mnemonic used to remember all the elements of a patient’s past medical history

FEDTACOS

The mnemonic we use to remember all the elements of a social history

Review of systems

those questions that may not be related to the chief complaint but need to be addressed

VINDICATEM

Mnemonic used to work through the differential diagnoses (will be emphasized more second year)

7 C’s of communication

conciseness, completeness, concreteness, courtesy, correctness, clarity, consideration

50

People are most comfortable when you look them in the eyes __% of the time

Macro expressions

Facial expressions that last more than 1 second

micro expressions

occur when the person begins to show a true facial expression, senses this and immediately neutralizes or masks the expression

Introduction stage

Review patient’s chart, knock on door, wait for response, introduce self, HAND HYGIENE, ask about chief complaint, empathize, ASK FOR PERMISSION TO TAKE NOTES

Hand on the door moment

the moment when you are about to walk out the door and the patient brings up issues they never mentioned, so ask if there is anything we haven’t discussed yet

Cognitive empathy

having the ability to recognize other peoples’ feelings

emotional or affective empathy

cognitive and emotional reactions to the observed experiences of another person

C5

What myotome is tested by elbow flexion?

C6

What myotome is tested by wrist extension?

C7

What myotome is tested by elbow extension?

C8

What myotome is tested by finger flexion?

T1

What myotome is tested by finger ab/adduction?

L2

What myotome is tested by hip flexion?

L3

What myotome is tested by knee extension?

L4

What myotome is tested by dorsiflexion?

L5

What myotome is tested by great toe extension?

S1

What myotome is tested by plantar flexion?

C5

What nerve root controls the muscle stretch reflex for the biceps tendon?

C6

What nerve root controls the muscle stretch reflex for the brachioradialis tendon?

C7

What nerve root controls the muscle stretch reflex for the triceps tendon?

L4

What nerve root controls the muscle stretch reflex for the patellar tendon?

S1

What nerve root controls the muscle stretch reflex for the achilles tendon?

Diaphragm

What part of the stethoscope is the larger, flat part of the chest piece that is designed to detect high-frequency sounds, making it ideal for listening to lung, heart, and bowel sounds?

Bell

What part of the stethoscope is the smaller, concave part of the chest piece, designed to detect low frequency sounds such as the third (S3) and fourth (S4) heart sounds and vascular sounds?

Systole

S1 (M1T1), mitral and tricuspid closure

Diastole

S2 (A2P2), aortic and pulmonic closure

CN I (olfactory)

Which cranial nerve is tested by having the patient lose their eyes and bringing a noxious smell to the patient’s nose (vanilla, coffee grounds, cloves)

CN II (optic)

Which cranial nerve is tested by shining a light source directly into the patient’s eye to see if the pupil constricts? OR have the patient cover their eye and move into their peripheral vision? OR color test

CN III (oculomotor)

Which cranial nerve is tested by eyelid elevation?

CN IV (trochlear)

Which cranial nerve is tested by having the patient move their eyes inward and downward?

CN VI (abducens)

Which cranial nerve is tested by the patient moving their eye laterally?

H-pattern

Which cranial nerve test tests for CN III, IV, and VI at once?

CN V (trigeminal)

Which cranial nerve is tested by lightly touching the forehead on bilateral sides of the face to compare the sensation, then middle of face then mandible? For motor strength, have the patient open/close jaw and palpate the TMJ

CN VII (facial)

Which cranial nerve is tested by clenching eyes shut and physician trying to open them? Or smiling or puffing out cheeks?

CN VIII (vestibulocochlear)

Which cranial nerve is tested by standing behind the patient and whispering to them/rubbing fingers/hair together next to the ear?

Weber test

Which hearing test is done by placing a tuning fork on the patient’s forehead or top of the head, if normal the patient should hear on both sides equally

Rinne test

Which hearing test is done by placing a vibrating tuning fork on the mastoid process. When no longer hears the vibration there, bring to front of ear-should be louder in front of ear

CN IX (glossopharyngeal) and X (vagus)

Which cranial nerves are tested by making the patient gag?

CN XI (spinal accessory)

Which cranial nerve is tested by having the patient rotate their head against resistance/shrug?

CN XII (hypoglossal nerve)

Which cranial nerve is tested by having the patient stick out their tongue?

Price

Why would we recommend an uninsured patient get a basic metabolic profile over a comprehensive metabolic profile?

Comprehensive metabolic profile

this test gets all of the information from a BMP + glomerular filtration rate, Bun/Cr ratio, calcium, alkaline phosphatase, LDH, AST, ALT, albumin, protein, globulin, bilirubin

Hemoglobin A1C

This test measures the amount of glucose attached to RBC’s by chromatography. Average glucose over the previous 90 days, helps the physician know how controlled a patient’s diabetes is

Xray

This visualization technique captures the whole picture of the body part examined, a 2D picture (posterior-anterior, anterior-posterior, lateral), small amount of radiation, inexpensive, used to screen for bone fractures/dislocations/small objects

CT Scan

This visualization technique is a 3D image (axial, sagittal, and coronal planes), some radiation, captures images by taking slices through each plane, gives more details about bone, soft tissues, and blood vessels

Ultrasound

This visualization technique is safe, noninvasive, less expensive, no radiation, fast, multiple planes for pultiple views, good for OB/fetal anatomy, female pelvic exam, fluid consolidation in chest, and abdomen. Not great for lung and bone

MRI

This visualization technique uses magnetic and radiofrequency waves to detect small changes within soft tissue. Can get slices in coronal and sagtital views. Good for looking at soft tissue, ligaments and solid body organs. Takes more time than CT, patients may get claustrophobic, contraindicated in patients with electronic devices and certain metallic implants