The Interview

Front 1

An increase in heart rate is a ____________ (sign/symptom), which is a(n) ____________ (objective/subjective) observation.

Back 1

An increase in heart rate is a sign which is an objective observation.

Front 2

Being unable to sleep at night is is a ____________ (sign/symptom), which is a(n) ____________ (objective/subjective) observation.

Back 2

Being unable to sleep at night is a symptom (we are not directly observing or testing this), which makes it a subjective observation.

Front 3

Explain when a patient complaint may be both a sign and a symptom.

Back 3

When an objective sign may have additional subjective characteristics (ie. a cough)

Front 4

You ask your patient how many packs of cigarettes they smoke in a day. They tell you that they have smoked approximately half a pack daily for the past eleven years. What is their pack.year value? Can we assume that their lungs have undergone chronic changes with this value?

Back 4

To get pack.year values, calculate:

# packs a day x number of years smoked

0.5 packs x 11 years smoked

= 5.5 pack.year

The reference value we use to assume chronic changes to the lung is 8 pack.year. Therefore, we would say that chronic changes have not yet taken place, since this patient's pack.year value falls short at 5.5 pack.year.

Front 5

What is the formula that we use to calculate recreational smoking?

Back 5

There is none. LOLZZZZZ

Front 6

Hemoptysis is a term that refers to ___________ which suggests ___________

Back 6

Hemoptysis is a term that refers to blood in the sputum which suggests bleeding in the lungs, lung disease, or cancers.

Front 7

Your patient complains about the presence of yellow sputum following bouts of coughing. What does this symptom suggest?

Back 7

Yellow sputum suggests inflammation.

Front 8

Your patient complains about the presence of frothy pink sputum following bouts of coughing. What does this symptom suggest? What physiological events cause the appearance of the sputum?

Back 8

Frothy pink sputum suggests heart failure.

The sputum is pink coming from the heart, and becomes frothy due to pressure.

Front 9

Your patient complains about the presence of green sputum following bouts of coughing. What does this symptom suggest?

Back 9

Green sputum suggests infections.

Front 10

Your patient complains about the presence of brown sputum following bouts of coughing. What does this symptom suggest?

Back 10

Brown sputum suggests the presence of old blood in the lungs.

Front 11

Your patient complains about the presence of frank red sputum following bouts of coughing. What does this symptom suggest?

Back 11

Frank (bright) red sputum suggests the presence of blood in the lungs.

Front 12

Dyspnea is a term that refers to:

Back 12

Shortness of breath.

Front 13

Paroxysmal nocturnal dyspnea refers to:

Back 13

Shortness of breath that awakens the patient during the night.

Front 14

Your patient comes to you with complaints of waking up in the middle of the night with shortness of breath. You express immediate concern because these symptoms are usually indicative of __________.

Back 14

Heart failure.

Front 15

Your patient arrives at your clinic with puffiness in his hands and feet. What is this sign called, and what is it indicative of?

Back 15

Peripheral edema

Indicative of cardiac weakness, poor circulation, or hydration issues.

Front 16

What is the term for the pathology on the right? What does it indicate?

Back 16

Peripheral edema

Indicates heart weakness/issues, poor circulation, or hydration issues.

Front 17

What is the term used for this pathology? What does it indicate?

Back 17

Clubbing

Indicates low oxygen levels (body compensates with increased blood flow) due to conditions such as lung disease, COPD, or cystic fibrosis.

Front 18

What is the term used for this pathology? What does it indicate?

Back 18

Cyanosis

Indicates low oxygen levels in the blood (hypoexmia), specifically a reduction of at least 5g Hb/dl.

Front 19

What is the purpose of a medical chart review?

Back 19

To extract information on a patient in order to build a database on them, which assist the PT in assessing and the development of a treatment plan.

Front 20

In what conditions might a medical chart review be especially important?

Back 20

- If the patient is unconscious

- If you cannot interview the patient (ie. if they are a child)

- If the patient is undergoing cognitive changes

Front 21

What is pulmonary history? What things might you want to ask about or keep in mind of while taking this history (12)?

Back 21

History relating to respiration.

History of CR disease, occupation, smoking, social history, physical capacity, cough/sputum production, hemoptysis, dyspnea evaluation, pain, fever, peripheral edema, loss of appetite/weight loss.

Front 22

What are the three scales used to measure dyspnea?

Back 22

1. Visual Analogue Scale

2. Graphic Rating Scale

3. Borg Scale/Modified Borg Scale

Front 23

What is this scale called? What does it measure?

Back 23

This scale is called the Visual Analogue Scale.

This example in particular quantifies dyspnea (shortness of breath).

Front 24

What is this scale called? What does it measure?

Back 24

The Borg Scale, which measures perceived exertion.

We can tell because it measures perceived exertion on a scale of 6-20.

Front 25

This is an example of the __________ Scale, which can be used to measure __________.

Back 25

This is an example of the Verbal Descriptor Scale, which can be used to measure pain.

Front 26

List the different scales that may be used pain intensity.

Back 26

1. Verbal Descriptor Scale

2. Visual Analogue Scale

3. Numeric Rating Scale

4. Faces-Pain Scale Revised

Front 27

Draw a Visual Analogue Scale that might be used to measure pain intensity.

Back 27

This is so friggen small wtf

Front 28

Describe the criteria used for clubbing (4).

Back 28

- Increased bulk of terminal tuft

- Change in angle between skin and nail (>180)

- Sponginess of nail

- Increased nail curvature

All must be present, or at least one to a severe degree.

Front 29

How might the reliability of cyanosis be compromised?

Back 29

Cyanosis differs between people with different skin pigmentation. We are less likely to see it in people with darker tones, impacting its reliability.

Front 30

What is important to remember during a patient interview?

Back 30

Privacy/Space

Empathy

Time

Trust

Acceptance

Attention

(PETTAA... kinda like Petar LOOOOOL)

Front 31

What are professional boundaries? Who is responsible for setting them?

Back 31

Physical and emotional limits that are appropriate to maintain; ie. maintaining a balance between providing professional health care and friendly interactions.

Set by the physical therapist.