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What are the 2 most imporant and effective strategies of saving lives?
Prevention and early screening.
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Define Sign
an objective finding as perceived by the EXAMINER
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Define symptom
subjective indication of a disease or a change in condition as perceived by the PATIENT.
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Define syndrome
set of signs or symptoms arising from common cause.
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Define diagnosis
identification of a disease or condition
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When the patient first sees the doc what happens?
The Interview which is the most powerful diagnostic tool of the physician.
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What is the most powerful tool of the physician?
The interview
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What happens during an interview?
- The doc learns the chronological events and symtoms of patient
- Doc determines patient's chief complaints and current status
- Doc establishes the physician patient relationship
- Verbal and nonverbal cues are assessed. (what the patient says or doesnt say)
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Who do the medical records technically belong to?
The hospital NOT the patient.
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How can a patient obtain medical records?
by subpoena to a court of law
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Define Inspection
the use of sight to observe like color of skin, lesions, asymmetry on the surface of skin.
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Define Palpation
use of touch to acquire info. like feeling the axiallry lymphnodes
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Define Percussion
act of striking or tapping patient gently. Like looking for kidney infections or where the lungs and abdomen begin.
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Define Auscultation
act of listening to sounds in the body. LIke using the stethoscope to listen to the heart or lungs, etc.
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Define Vital Signs
temperature, blood pressure, pulse, and respirations
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Define Rhythm
regularity of breathing. see if patient is slow or rapid breathing.
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What are the 4 things important when testing?
- prevalence
- incidence
- sensitivity
- specificity
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Define prevalence
Probability of the disease in the entire poplulation at one time.
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Define Incidence
- probability that a patient without disease develops the disease during an interval
- examples
- 1 in 8 women develops breat cancer and 1 in 8 men develops prostate cancer.
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Define Sensitivity
Probability of a positive test among patients with disease.
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Define Specificity
Probability of a negative test among patients without disease.
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Yearly mammograms start at age
40
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Clinical breast exams start
- every 3 years for 20-30 year olds and
- every year for 40 and up
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Self breast exams should start at age
20
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When is screening with an MRI recommended?
when a woman has a strong family history.
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Beginning at age 50 men and women should have 1 of the following done
FOBT or FIT every year
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What is FOBT
fecal occult blood test
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What is FIT
fecal immunochemical test
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What age should men and women have a FSIG every 5 years
50
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What is FSIG
flexible sigmoidoscopy
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What age should men and women have annual FOBT, FIT, and a FSIG every 5 years
50
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What age should men and women have a double contrast BE every 5 years
50
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At what age should men and women have a colonoscopy every 10 years?
50
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Starting at age 50 men should have what test done annually by a physician?
PSA test and DRE
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What is a PSA
a blood test for the prostate. Prostate Specific Antigen
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What is DRE
digital rectal exam
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Who should start having the PSA and DRE at age 45?
African American men or men with a strong family history.
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What screening should begin 3 years after a women begins vaginal intercourse but no later than 21?
Cervial screening.
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Note:
Cervial screening should be done annually until age 30 and then can be dropped to every 2-3 years if multiple negative tests have resulted.
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After menopause there should be no vaginal bleeding, if there is a women needs to report right away because it could be
endometrial cancer.
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What is Nuclear Imaging
This is like a stress test or a PET scan. The patient is injected with a radioactive material.
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What is a CT scan
Computed Tomography is where the patient is put through a doughnut type tube and a camera goes 360 around them taking pictures. These are great for bone or a mass in the lungs.
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What is a MRI
Magnetic resonance imaging and is magnetic so it has no radiation and is better for the brains scans or tissue scans
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What is an ultrasound
This gives off no radiation and just works off waves. This is one we do not use too much
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