PCS Final Fall 2024

what is OSCE

practice and demonstrate clinical skills in a health care scenario

SBAR means

way to understand a situation and provide an accurate recommendation

situation

background

assessment

recommendation

what is the nemonic for pain and what does it stand for

Onset

Palliating or provoking factors

Quality

Radiation

Severity

Timing

Using the SBAR tool, which section does the following statement align with?Patient presents to the clinic for a follow-up for hypertension after starting lisinopril 5 mg daily, 2 weeks ago. BP today is 150/94.

a. Situation

b. Background

c. Assessment

d. Recommendation

b. background

Which part of the OPQRST does this question correspond to?"Tell me what the pain feels like. Is it sharp or dull?"

a. Onset

b. Quality

c. Severity

d. Timing

b. quality

Which part of the OPQRST does this question correspond to?"On a scale of 0-10 how much pain are you experiencing?"

a. Onset

b. Quality

c. Severity

d. Timing

c. severity

EOMI

extraocular movements intact

PERRLA

pupils equal, round, reactive to light and accommodation

WNL

within normal limits

TM

transverse myelitis

LOC

level of consciousness

NCAT

no cervical adenopathy or tenderness

mydriatic agent

drug that dilates the pupil

hordeolum

stye

diplopia

double vision

ptosis

drooping eyelid

symptoms of phenytoin toxicity

rapid uncontrolled eye movement

loss of muscle control

difficulty to pronounce and form words

dizziness, syncope

what is the conc of oral phenytoin suspension

125/5

pulse grading

4 = bounding

3 = full or increased

2 = normal

1 = decreased, thready, barely palpable

0 = absent

ataxia

loss of coordination

what ototoxic drug can cause vestibular effects

aminoglycoside antibiotics- gentamicin, tobramycin, amikacin

what is the only oral form of documentation

SBAR

what do SOAP notes need to be

concise, comprehensive, and consistent

subjective data

CC or reason for visit, based on the interview to gather information

Which of the following statements is subjective

a. chest pain is a sharp, stabbing pain that occurs in the center of his chest

b. smokes 1 PPD

c. does not take medication

d. all of the above

d. all of the above

objective data

measurable data usually collected at the visit

which of the following taken from the H& P is considered objective

a. review of systems

b. physical exam

c. family history

d. all of the above

b. physical exam

assessment

the analysis and interpretation of subjective and objective information

plan

make sure the patient is aware of the plan going forward, new medications/ changes, educational points, and follow up information

type 1 error

false positive

type 2 error

false negative

If 95% CI crosses 1, the result is:

not statistically significant

If 95% CI does not cross 1, the result is:

statistically significant

If 95% CI crosses 0, the result is: continuous data

no statistically significant

If 95% CI does not cross 0, the result is: continuous data

statistically significant

relative risk

(% experimental) / (% control)

RR=1

implies NO DIFFERENCE in risk of the outcome between the groups

RR>1

Implies GREATER RISK of the outcome

RR<1

Implies lower risk (reduced risk) of the outcome

relative risk reduction/ increase

(RR) - 1, convert to percentage

absolute risk reduction/ increase

(% experimental) - (% control)

number needed to treat

100/ARI always round up

number needed to harm

100/ARR always round down

List instances in which the power of the study increases

If the sample size, study duration, and effect size/effect rate increase

Which of the following describes a clinical situation consistent with Type II error?

a. A patient is diagnosed with cancer, but does not really have cancer

b. A patient is diagnosed as cancer free, but really does have cancer

c. A patient is diagnosed with cancer and really does have cancer

d. A patient is diagnosed as cancer free and does not really have cancer

b. A patient is diagnosed as cancer free, but really does have cancer

Which of the following describes a clinical situation consistent with Type I error?

a. A patient is diagnosed with cancer, but does not really have cancer

b. A patient is diagnosed as cancer free, but really does have cancer

c. A patient is diagnosed with cancer and really does have cancer

d. A patient is diagnosed as cancer free and does not really have cancer

a. A patient is diagnosed with cancer, but does not really have cancer

Hazard ratios <1 mean that the intervention __________ the risk of the endpoint versus the control.

reduced

Hazard ratios >1 mean that the intervention __________ the risk of the endpoint versus the control.

increased

Hazard ratios =1 mean the incidence of the primary endpoint was __________ between 2 groups.

equal

Which data can only be calculated on dichotomous endpoints?

ARR, NNT, RRR

dichotomous endpoints

nominal data with only two options

continuous endpoints

Usually reported as mean +/- SD (or median +/- interquartile range)

what is the definition of a transgender individual

a. gender identity matches birth assigned sex

b. someone experiencing gender incongruence

c. sexual orientation reflects attraction to someone of the same gender

d. sexual attraction is towards individuals of any gender

b. someone experiencing gender incongruence

what is the definition of a gender diverse individual

a. anyone whose gender identity role or expression differs from culture norms

b. someone who is transgender and also from another minority group

c. someone who is both cisgender and transgender

d. i have no idea

a. anyone whose gender identity role or expression differs from culture norms

what is minority stress

a. stress related to having a child who is gender diverse

b. stress that occurs in gender diverse individuals who also have chronic diseases

c. stress due to factors such as discrimination, harassment, and heathcare barriers

d. stress due to being cisgender

c. stress due to factors such as discrimination, harassment, and heathcare barriers

what is a set of practices that aim to help all individuals fell welcome and supported

inclusiveness

a group of individuals social and political identities result in combinations of discrimination and or privilege

intersectionality of identities

the process of transgender individuals living in accordance with their gender identity

transition

pharmacotherapy for transgender women

antiandrogen

gonadotropin agonist

estrogens

antiandrogen

spironolactone 100-200mg daily minimize male features

GnRh agonists

leuprolide (lupron), gosserelin (zoladex)

suppress testosterone but no feminizing effects not estrogenic

what is used to delay puberty to prevent voice deepening and facial hair growth

histarelin implants (vantas)

estradiol (estrace)

oral increase risk of increased TG and thrombosis

estradiol patch

multiple patches needed apply to lower stomach or butt

what will last longer estradiol valerate/ cypionate

cypionate

goal of testosterone MTF

55

risks and complications of estrogen treatment

thrombosis, liver impairment, weight gain, elevated TG, hyperprolacitnemia, migraines, breast cancer, osteoporosis

testosterone enanthate, cypionate

weekly dose into thigh

every 2 week dose into butt

testosterone undecanoate

butt, BBW pulmonary oil microembolism reaction anaphylaxis

goal testosterone levels FTM

350-700

risks of testosterone

polycythemia, weight gain, acne, alopecia, liver impairment, slight LDL elevation

0-28 days

neonate

1 month- 1 year

infant

1 year- 12 years

child

12years- (18-23)

adolescent

born before 37 weeks of gestation

premature

born between 37- 42 weeks of gestation

full term

born after 42 weeks of gestation

post term

post natal age

time from birth

post menstrual age

gestational development age + postnatal age

what does the APGAR test do

make sure baby is breathing and ready for life outside of the uterus

failure to thrive

inadequate weight gain for age

0-2 weeks estimate renal function

24 hour urine collection

2 weeks- < 18 years estimate renal function

modified schwartz equation

>18 years estimate renal function

CrCl calculation

heart rate starts high or low at birth

high

blood pressure starts high or low at birth

low

respiratory rate starts high or low at birth

high

what is considered a fever rectally

>100.4