Fcm Orientation/overview

Front 1

three functions of the medical interview

Back 1

1) Gather data
2) Build rapport
3) Patient education and negotiation of treatment plans

Front 2

Components of a standard complete medical history (adult)

Back 2

1) Identifying data
2) Source and reliability of history
3) Chief complaint
4) History of present illness (HPI)
5) Past medical history (PMH)
6) Family history
7) Social history
8) Review of Systems

Front 3

Components of a standard complete medical history (geriatric)

Back 3

1) Identifying data
2) Source and reliability of history
3) Chief complaint
4) HPI
5) PMH
6) FH
7) SH
8) Functional assessment
9) Review of systems
10) Mental Status exam in physical exam

Front 4

Components of a standard complete medical history (pediatric)

Back 4

1) Identifying data
2) Source and reliability of history
3) Chief complaint
4) History of present illness (HPI)
5) Past medical history (PMH)
6) <b> Developmental history</b>
7) <b> Nutrition history </b>
8) Family History
9) SH
10) Review of Systems

Front 5

What is the most important tool a clinician uses to dx and tx patients?

Back 5

the medical interview

Front 6

What are the three functions of the physical exam?

Back 6

1) Ascertain causes of illness and follow progression of disease
2) Screen for asymptomatic disease
3) Reassure the patient and support a therapeutic pt-doctor relationship

Front 7

What are ways to enhance patient comfort during the physical exam?

Back 7

1) Privacy while undressing and dressing
2) Appropriate draping
3) Explanations and clear instructions during the exam process
4) Choosing appropriate sequence for examination.

Front 8

How can a physician optimize the exam room environment for improved physical
exam accuracy and efficiency?

Back 8

1) Adequate lighting, quiet environment
2) Appropriate positioning and exposure of patient
3) Proper and readily available equipment
4) Positioning oneself in relation to patient

Front 9

How might the order and content of the physical exam vary based upon the age
of the patient?

Back 9

Adults: usually systematic "head-to-toe" with examiner on right side of exam table

Geriatric: Traditional medical interview plus functional assessment and mental status exam. In PE pay special attn. to gait, mobility, and balance.

Peds: Least distressing aspects of exam are done first and most done last.

Front 10

What do we mean when we talk about standard or universal precautions?

Back 10

All patients could potentially have a communicable disease. Standard precautions are standard for everyone.

Front 11

What are 4 diseases spread by hand?

Back 11

1) Impetigo (skin infection)
2) Viral diseases (cold, flu)
3) Conjunctivitis (eye infection)
4) Hepatitis A (fecal-oral transmission)

Front 12

What is the best way to prevent transmitting diseases spread by hand to yourself
or another person?

Back 12

WASH HANDS. 15-20 seconds with soap and water.

Front 13

What diseases are spread by exposure to blood or body fluids?

Back 13

Hep B & C, HIV, Syphilis, among others

Front 14

What precautions should you take to avoid exposing yourself to a disease spread
by blood or body fluids?

Back 14

-Use gloves with examiner has any open hand wounds and when examiner could be in contact with patient's body fluids/open wounds. Use additional eye/mouth precautions when in situations posing risk for spraying blood.

Discard medical waste in proper containers.

Front 15

Other than blood, what are body fluids?

Back 15

1) Semen
2) Earwax (cerumen)
3) Tears
4) Sweat
5) Saliva
6) Urine
7) Stool
8) Vaginal secretions

Front 16

What disease is spread by airborne particles? How do you avoid exposure to airborne particles?

Back 16

Tuberculosis.

Avoid exposure by wearing masks in presence of anyone suspected of it.

Front 17

What do you do if you are accidentally exposed to a patient’s blood or body
fluids?

Back 17

Wash site with soap/water for 3-5 minutes. Report injury. Community preceptors are responsible for obtaining blood specimens and medical history on the source patient. Get this lab work: HIV, Hep B and C antibody, Baseline AST, ALT.

Student should contact Student Health or come directly to Student Health.

If injury is severe (deep or from a known HIV+ patient), medications are recommended and should be started within 1-2 hours of exposure. Has to go through PEP team and get them from MCV hospital pharmacy.