wellness exam
T or F? The subjective portion of a wellness exam includes past medical history and a review of symptoms.
True, Subjective contains PMH and ROS
T or F? Routine screening can be used during a wellness exam.
True, depends on sex, age, type of prevention
What is the main purpose of the USPSTF?
US preventive services task force provides evidence-based recommendations for screening for different age groups
What are the goals of a comprehensive and focused physical examination?
maximize PT's comfort avoid unnecessary changes in position enhance clinical efficiency
Which portion of the wellness exam should cardinal techniques (i.e. palpation, auscultation, etc) be used?
objective
Explain the differences between primary, secondary and tertiary prevention.
primary - disease does not exist, prevent disease before it occurs secondary - targets those who have an undetected, asymptomatic disease tertiary - known diseases exists in PT, prevent further complication
what are some routine screenings you would perform on the average male over 50 years of age?
prostate cancer (55-69) colorectal cancer (50-75) Abdominal Aortic Aneurysm (65-75)
What is the last task of a complete physical exam?
rectal and genital examination
The USPSTF uses a grading scale to rate recommendations for specific screens. What are they?
A - recommended B - recommended C - recommendation depends on the patients situation D - not recommended E - not enough evidence to make a recommendation
Which of the following abnormal postures can be caused by pregnancy? A. Sway back B. Anterior Pelvic Tilt C. Forward Head D. thoracic kyphosis
A. Sway back
Which of the following abnormal postures can be caused by spondylolisthesis? A. Sway back B. Anterior Pelvic Tilt C. Forward Head D. thoracic kyphosis
A. Sway back
A review of symptoms should go: A. head to toe B. toe to head
A. head to toe
Which of the following abnormal postures can be caused by studying? A. Sway back B. Anterior Pelvic Tilt C. Forward Head D. thoracic kyphosis
C. Forward Head
Which of the following vertebrae cannot rotate? A. C5 B. T11 C. L2 D. C1
C. L2 Lumbars cannot rotate
Which of the following is NOT included in a comprehensive exam? A. establishment of doctor-patient relationship B. baseline for future exams/follow ups C. application of relevant exam methods D. preventative screening
C. application of relevant exam methods this is part of a focused exam. Remember, focused is pertaining to one CC.
Who of the following should not receive a wellness exam? A. A 68 year old man with emphysema B. A 3 year old with a milk alergy C. A BCOM student who recently enrolled in medicare D. A 22 year old college student with type I diabetes
D. A 22 year old college student with type I diabetes The following will receive wellness exams: 1. pediatric patients 2. new people on medicare "welcome to medicare exam" 3. elderly
Which of the following abnormal postures can be caused by compression fractures due to osteoporosis? A. Sway back B. Anterior Pelvic Tilt C. Forward Head D. thoracic kyphosis
D. thoracic kyphosis
Which of the following is true? A. all adults should be seen for a wellness exam every year B. all non-symptomatic adults should be seen for a wellness exam every year C. adults who have symptoms should be seen for a wellness exam D. adults whose insurance companies require yearly wellness exams should be seen each year E. there is no standard recommendation for how often healthy adults should be seen for wellness exams
E. there is no standard recommendation for how often healthy adults should be seen for wellness exams
T or F? The screening osteopathic structural exam should be conducted "head to toe"
False, conducted "foot to head"
T or F? A wellness exam can be focused on a particular complaint.
False, it is a comprehensive exam focused on maintenance of good health, or discovery of a disease process.
T or F? All asymmetry should be noted in a screening ostephathic structural exam.
False, some asymmetry is ok, only note what is abnormal
T or F? Vital signs should be the first task completed in a physical examination.
False; the first task completed is a general survey of the patient's health
What is included in the Plan on a wellness exam as compared to a focused exam?
Focused Plan 1. Symptomatic care (mom advise) 2. Lab tests/xrays 3. return for OMT Wellness Plan 1. Continue Meds (if any) 2. Screenings 3. Follow ups
what are some of the routine screenings you would perform on an average 18-39 year old male?
HIV HTN Hyperlipidemia Tobacco use Alcohol misuse Obesity Type II Diabetes Depression
What are the cardinal techniques of examination?
Inspection Palpation Percussion Auscultation
T or F? Routine screening dictated by health insurance companies should be done in a wellness exam.
True
T or F? A complete wellness exam follows the same general guidelines that are established by a proper SOAP note
True Subjective Objective Assessment Plan
T or F? A left-handed medical student is encouraged to adopt right-sided positioning when performing a physical exam. (i.e. the medical student should stand to the right of the patient)
True Examining from the Patient's Right Side. This book recommends examining the patient from the patient's right side, moving to the opposite side or foot of the bed or examining table as necessary. This is the standard position for the physical examination and has several advantages compared with the left side: Esti- mates of jugular venous pressure are more reliable, the palpating hand rests more comfortably on the apical impulse, the right kidney is more frequently palpable than the left, and examining tables are frequently positioned to accommodate a right-handed approach (Bickley 20)
What is the usual age range for a pediatric PT?
birth to 18 years old, depending on the state
What are the activities of daily living that physicians use to assess elderly medicare PT's?
eating bathing dressing transferring (bed to rocking chair) toileting Walking or moving around
What is included in the assessment on a wellness exam as compared to a focused exam?
focused assessment 1. re-state CC 2. list differential 3. Somatic Dysfunction Wellness Assessment 1. Active Problems 2. Chronic Problems
Where can you find routine screening standards? What organizations?
uspstf CDC American Academy of Pediatrics
What is included in the objective portion of a wellness exam?
vital signs and findings from a physical exam