CDM Review Presented by Ethics Club. DISCLAIMER The following practice questions were written by several medical students throughout the years. They are.

CDM Review Presented by Ethics Club

DISCLAIMER The following practice questions were written by several medical students throughout the years. They are designed to help you assess what you do and do not know. Since CDM I changes throughout the years, the questions may not necessarily be a good representation of the concepts covered on your exam. It is advised that you use your best judgment when preparing for this exam.

Are you Here? 1.Yes 2.No Countdown 10

Asking your patient, “can you tell me about your chest pain?” is an example of: 1.a focused question 2.validating 3.an open-ended question 4.a closed question

Asking your patient, “can you tell me about your chest pain?” is an example of: a)a focused question- asks about a particular subject b)validating- communicates acceptance of the patient’s emotional response c)an open-ended question d)a closed question- range of possible answers is restricted

According to Bates, which of the following is NOT one of the 7 attributes of a symptom (abbreviated “sx”)? 1.The setting in which the sx occurs 2.The quality of the sx 3.The location of the sx 4.The severity of the sx 5.The timing—including onset, duration, and frequency—of the sx 6.A family history of the sx 7.Exacerbating or remitting factors of the sx 8.Other factors associated with the sx

According to Bates, which of the following is NOT one of the 7 attributes of a symptom (abbreviated “sx”)? 1.The setting in which the sx occurs 2.The quality of the sx 3.The location of the sx 4.The severity of the sx 5.The timing—including onset, duration, and frequency—of the sx 6.A family history of the sx 7.Exacerbating or remitting factors of the sx 8.Other factors associated with the sx Explanation: It is important to get the family history of a sx. If a patient presents with chest pain, then it would be wise to ask about a family history of heart and lung disease. However, Bates does not define this as one of the 7 attributes of a symptom. All other answers are one of the 7 attributes of a sx. These are important to know.

An African American woman with diabetes and renal failure has not been placed on the wait-list for a kidney transplant. A white woman with the exact same history and disease progression has received a transplant. These differences are called: 1.discrimination 2.disparities 3.favoritism 4.prejudice

Which of the following is true regarding interpersonal violence? 1.women who are victims of violence often don’t know their attacker 2.women between the ages of 60-65 are at the greatest risk for intimate partner violence 3.more men than women are stalked in their lifetime 4.children who witness violence in the home are more likely to beat their own children

Which of the following is true regarding interpersonal violence? 1.women who are victims of violence often don’t know their attacker- females are most often victimized by someone they know 2.women between the ages of 60-65 are at the greatest risk for intimate partner violence- women aged 20-24 are at the greatest risk 3.more men than women are stalked in their lifetime- women are more likely to be stalked 4.children who witness violence in the home are more likely to beat their own children

Disease differs from illness in that: 1.illness is acute, while disease is chronic 2.disease is chronic, while illness is acute 3.illness is the physician’s way of explaining the patient’s problems using organs and systems, whereas disease is the patient’s personal experience of ill health 4.disease is the physician’s way of explaining the patient’s problems using organs and systems, whereas illness is the patient’s personal experience of ill health

In an interview of a patient suffering from PTSD due to a car accident, the internist says the following: “Being in that accident must have been very scary. Car accidents are always unsettling because they remind us of our vulnerability and morality. That could explain why you still feel upset.” The previous statement is an example of… 1.Non-verbal communication 2.Validation 3.Reassurance 4.Partnering 5.Summarization

In an interview of a patient suffering from PTSD due to a car accident, the internist says the following: “Being in that accident must have been very scary. Car accidents are always unsettling because they remind us of our vulnerability and morality. That could explain why you still feel upset.” The previous statement is an example of… 1.Non-verbal communication – this can’t be non-verbal because the doctor is talking 2.Validation – validation is acknowledging the legitimacy of the patient’s experience. The dialog is the exact example used on page 73 in bates for validation 3.Reassurance – reassuring refers to encouraging a patient that everythign will be alright. The physician is not doing this 4.Partnering – a physician is partnering when she makes an explicit desire to work with the patient in an ongoing way. The physician is not partnering in this case 5.Summarization – summarizing refers to reviewing the pertinent details of the patient’s story out loud during the interview. This statement is more specific than summarizing

The CAGE questions are used in which special interviewing topic? 1.interpersonal violence 2.alcohol abuse 3.depression 4.tobacco abuse

The CAGE questions are used in which special interviewing topic? a)interpersonal violence b)alcohol abuse C = cut down A = annoyed G = guilty E = eye opener a)depression b)tobacco abuse

Which of the following would NOT make a patient feel vulnerable? 1.unfamiliar surroundings 2.dependence of the physician 3.being a minority 4.all of the above can make a patient feel vulnerable

Question 5: Which of the following would NOT make a patient feel vulnerable? a)unfamiliar surroundings b)dependence of the physician c)being a minority d)all of the above can make a patient feel vulnerable

What is the name of the law that prohibits group health insurance plans and issuers of coverage from basing eligibility or adjusting premiums on the basis of genetic information? 1.Nondiscrimination Information Act 2.Genetic Nondiscrimination Act 3.Discrimination Prevention Act 4.Don’t Ask, Don’t Tell

A 95-year-old woman in a nursing home has had advanced vascular dementia, severe dysphagia, and a 9-kg (20-lb) weight loss over the past 2 months. Her four children are divided regarding the decision to provide artificial feeding through a gastrostomy tube. There is no living will. The oldest son approaches the physician after a family meeting and says, "You should simply decide what is best for her and tell the others that's what we should do." Assuming the physician proceeds in this manner, which of the following best describes the physician's action? 1.Paternalism 2.Preserving fairness in use of resources 3.Protecting patient autonomy 4.Rationing care 5.Truth-telling

A 95-year-old woman in a nursing home has had advanced vascular dementia, severe dysphagia, and a 9-kg (20-lb) weight loss over the past 2 months. Her four children are divided regarding the decision to provide artificial feeding through a gastrostomy tube. There is no living will. The oldest son approaches the physician after a family meeting and says, "You should simply decide what is best for her and tell the others that's what we should do." Assuming the physician proceeds in this manner, which of the following best describes the physician's action? 1.Paternalism 2.Preserving fairness in use of resources 3.Protecting patient autonomy 4.Rationing care 5.Truth-telling Explanation: This example was taken from one of the practice exams that the USMLE publishes. Most of the step 1 questions will be in the form of clinical vignettes. http://www.usmle.or g/examinations/s tep1/2011Step1. pdf

Cultural competence: 1.moves us toward ethnocentricity 2.occurs naturally in all first year med students 3.is the passive application of awareness and knowledge used to support recovery 4.requires extensive knowledge of different cultures 5.none of the above are true

Cultural competence: a)moves us toward ethnocentricity b)occurs naturally in all first year med students c)is the passive application of awareness and knowledge used to support recovery d)requires extensive knowledge of different cultures e)none of the above are true Explanation: Cultural competence does not occur naturally and therefore requires the active application of awareness and knowledge. However, this knowledge does not need to be extensive for each culture; a simple understanding of different cultures is sufficient. Cultural competence also moves us away from ethnocentricity, which is defined as using our own cultural rules to make judgments about people who are different.

In diagnosing depression, either depressed mood or this symptom must be present: 1.feelings of worthlessness or guilt 2.fatigue or loss of energy 3.anhedonia 4.Impaired concentration

In diagnosing depression, either depressed mood or this symptom must be present: 1.feelings of worthlessness or guilt 2.fatigue or loss of energy 3.anhedonia 4.Impaired concentration Explanation: Anhedonia is diminished interest or pleasure in all activities. To diagnose depression, 5 total symptoms must be present, and one must be either depressed mood or anhedonia.

What is the proper way to correct an error in a SOAP note? 1.scribbling out the error, dating, timing, and signing 2.white out the error, dating, timing, and signing 3.crossing out the error with a single line, dating, timing, and signing 4.highlighting the error, dating, timing, and signing

What is the proper way to correct an error in a SOAP note? a)scribbling out the error, dating, timing, and signing b)white out the error, dating, timing, and signing c)crossing out the error with a single line, dating, timing, and signing d)highlighting the error, dating, timing, and signing

Medical paternalism can be defined as: 1.patients and physicians working together to make medical decisions 2.physicians making decisions for their patients based on what they believe is in the patients’ best interest 3.physicians making decisions for their patients based on their own (the physician’s own) beliefs 4.none of the above define paternalism

Medical paternalism can be defined as: a)patients and physicians working together to make medical decisions b)physicians making decisions for their patients based on what they believe is in the patients’ best interest c)physicians making decisions for their patients based on their own (the physician’s own) beliefs d)none of the above define paternalism

Question 10: Which of the following is NOT an ethical argument against genetic testing? 1.genetic testing may enable the correlation of disease to genes 2.genetic testing provides information about relatives as well as the proband 3.genetic information might lead to stigma and discrimination 4.patients might overestimate the impact of genes on disease or behavior

Question 10: Which of the following is NOT an ethical argument against genetic testing? a)genetic testing may enable the correlation of disease to genes- this is a good thing! b)genetic testing provides information about relatives as well as the proband c)genetic information might lead to stigma and discrimination d)patients might overestimate the impact of genes on disease or behavior

Question 20: Trying to announce T-shirt tiiiime, The Situation walks in on Snooki smushing with Vinny. Upset, Vinny throws Snooki at The Situation, but misses and hits J-Woww who falls and hits her head. Using the bioethical principle of _________, J-Woww refuses to go to the ER. The roommates, worried about J-Woww’s health and considering what they learned in CDM, think that their bioethical principle of ________ overrules J-Woww, and they call an ambulance. 1.justice, beneficence 2.autonomy, beneficence 3.autonomy, non-maleficence 4.beneficence, beneficence

Question 20: Trying to announce T-shirt tiiiime, The Situation walks in on Snooki smushing with Vinny. Upset, Vinny throws Snooki at The Situation, but misses and hits J-Woww who falls and hits her head. Using the bioethical principle of _________, J-Woww refuses to go to the ER. The roommates, worried about J-Woww’s health and considering what they learned in CDM, think that their bioethical principle of ________ overrules J-Woww, and they call an ambulance. a)justice, beneficence b)autonomy, beneficence- J-Woww has the right to make her own health care decisions, but the roommates know that she’s probably drunk (or concussed) and not thinking clearly, and just want to help her c)autonomy, non-maleficence d)beneficence, beneficence

1.Chief complaint, focused question, and open question 2.Open question, continuer, and closed question 3.Open question, focused question, and open question 4.Open question, focused question, and closed question 5.Open question, continuer, and focused question In terms of patient interviewing/communication, Dr. Z’s 1 st /2 nd /3 rd statements/questions are examples of ____, _____, and _____,respectively: In the following dialogue: Dr. Z: what brings you in to see me today? Patient: I’ve been having a lot of chest pain Dr. Z: Uh-huh… Patient: Well it started yesterday, and it’s been hurting real bad Dr. Z: Can you tell me more about the pain?

The next MOST appropriate statement/question/action from Dr. Z would be _______ and this represents an example of a(n) ___________: In the following dialogue: Dr. Z: what brings you in to see me today? Patient: I’ve been having a lot of chest pain Dr. Z: Uh-huh… Patient: Well it started yesterday, and it’s been hurting real bad Dr. Z: Can you tell me more about the pain? a) Well we will do all we can to help you out/Validation b) Can you tell me about the location of the chest pain?/Transition c) Can you tell me about the location of the chest pain?/Closed question d) On a scale of 1-10 how would you rate this pain?/Focused question e) On a scale of 1-10, how would you rate this pain?/Closed question

Which of the following is NOT one of the “5 P’s” of sexual history (i.e. which “P” is not asked when obtaining a sexual history)? 1.penis problems 2.protection from STDs 3.practices 4.partners 5.prevention of pregnancy 6.past STDs

Which of the following is NOT one of the “5 P’s” of sexual history (i.e. which “P” is not asked when obtaining a sexual history)? 1.penis problems- probably important to know, but is not one of the 5 P’s 2.protection from STDs 3.practices 4.partners 5.prevention of pregnancy 6.past STDs

Sighing is an example of: 1.reassuring 2.non-verbal communication 3.confronting 4.verbal communication

Sighing is an example of: 1.reassuring- puts the patient at ease 2.non-verbal communication 3.confronting- draws attention to something the patient is unconsciously doing or is purposely trying to avoid 4.verbal communication- this requires words

Ensuring that a patient’s decision on treatment is free from coercion is an example of which of the following bioethical principles? 1.beneficence 2.non-maleficence 3.autonomy 4.justice

Ensuring that a patient’s decision on treatment is free from coercion is an example of which of the following bioethical principles? a)beneficence- doing what’s in the patient’s best interest b)non-maleficence- do no harm c)autonomy- free from interference and control of others d)justice- they never gave us a good definition of this last year, but we were asked to define it on the test….good luck with that

Which of the following is NOT a conflict of interest? 1.physicians who do research on their patients 2.an alcoholic physician 3.product sales in the physician’s office 4.a cardiologist with a heart defect

Which of the following is NOT a conflict of interest? a)physicians who do research on their patients- dual role of physician and investigator b)an alcoholic physician- colleagues may be torn between helping the physician and allowing the physician to help his/her own patients c)product sales in the physician’s office- patients might think these products are more legit d)a cardiologist with a heart defect- that’s just ironic (unless of course it’s interfering with his/her ability to work)

Mr. R is a 34 y.o. hispanic male w/ a Hx of hypertension and hypercholesterolemia who presents to the UTMC ER (which receives federal funding) with a chief complaint of a fever and a severe headache. Accompanying Mr. R. is his family including his son, daughter, and his wife, Mrs. R., who states that her husband’s primary language is not English and as such he has little understanding of the language. Please note that UTMC does have bilingual staff and staff- interpreters available. Based on this information, the the BEST course of action for the physician is to: 1.Ask the patient’s son or daughter to facilitate by translating the oral dialogue 2.Inform the patient and his wife, as best he can, that he can provide language access services, but because of rising costs and the Health Information Act, the patient will need to pay for it 3.Obtain assistance from one of the UTMC staff interpreters, taking care to speak directly with the interpreter during the interaction to prevent misinterpretation 4.Obtain assistance from one of the UTMC staff interpreters, making sure to put the interpreter in the background 5.Choices A, B, and D are correct 6.Choices A, B, and C are correct 7.Choices B and D are correct

Regarding family and interpersonal violence (IPV), which of the following is/are true? 1.As a physician, if suspect abuse, even if the individual is not a minor, you should immediately call the police 2.One of the biggest reasons physicians don’t ask about IPV is because they don’t have time 3.Most cases of IPV are eventually reported to the police 4.Because of the drastic consequences of IPV, when asking about it, physician should be very aggressive and probing to ensure the patient is telling the truth 5.More than one of the above choices is correct 6.None of the above choices are correct

Question 12: List each step of the LEARN model. L- E- A- R- N-

Question 12: List each step of the LEARN model. L- Listen E- Explain A- Acknowledge R- Recommend N- Negotiate

Question 18: Define justice.

Justice is generally used to mean fairness. In medicine, this means treating similar patients similarly. It can also refer to the allocation of health care resources. For a question like this, they’ll probably give a point for the first sentence, and a point for the second.

When obtaining the HPI, what question do each of the letters in the mnemonic FAR COLDER ask? F- A- R- C- O- L- D- E- R-

When obtaining the HPI, what question do each of the letters in the mnemonic FAR COLDER ask? F- Frequency A- Associated Symptoms R- Radiation C- Character O- Onset L- Location D- Duration E- Exacerbating Factors R- Remitting Factors

Good Luck! 2010 Exam 1: avg=87.09; med=87.68 2010 CDM1 final grades: – Count=172 – Minimum Value=80.00 – Maximum Value=97.00 – Range=17.00 – Average=89.88 – Median=90.00 – Standard Deviation=3.38 – Variance=11.4 – 90 – 100  102 – 80 - 89  70 – 70 - 79  0 – 60 - 69  0

CDM Review Presented by Ethics Club. DISCLAIMER The following practice questions were written by several medical students throughout the years. They are.

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CDM Review Presented by Ethics Club. DISCLAIMER The following practice questions were written by several medical students throughout the years. They are.

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