CDM Review

1. CDM Review Presented by Ethics Club

2. DISCLAIMER • The following questions and review may in no way reflect the actual CDM written exam • Ethics Club is not responsible for any incorrect information presented in this review • Ethics Club shall not be responsible if this review does not help you on the exam

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

4. Question 1:Asking your patient, “can you tell me about your chest pain?” is an example of: • a focused question- asks about a particular subject • validating- communicates acceptance of the patient’s emotional response • an open-ended question • a closed question- range of possible answers is restricted

5. Question 2:Disease differs from illness in that: • illness is acute, while disease is chronic • disease is chronic, while illness is acute • 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 • 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

6. Question 2:Disease differs from illness in that: • illness is acute, while disease is chronic • disease is chronic, while illness is acute • 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 • 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

7. Question 3: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-

8. Question 3: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

9. Question 4:The CAGE questions are used in which special interviewing topic? • interpersonal violence • alcohol abuse • depression • tobacco abuse

10. Question 4:The CAGE questions are used in which special interviewing topic? • interpersonal violence • alcohol abuse C = cut down A = annoyed G = guilty E = eye opener • depression • tobacco abuse

11. Question 5:Which of the following would NOT make a patient feel vulnerable? • unfamiliar surroundings • dependence of the physician • being a minority • all of the above can make a patient feel vulnerable

12. Question 5:Which of the following would NOT make a patient feel vulnerable? • unfamiliar surroundings • dependence of the physician • being a minority • all of the above can make a patient feel vulnerable

13. Question 6: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? • Nondiscrimination Information Act • Genetic Nondiscrimination Act • Discrimination Prevention Act • Don’t Ask, Don’t Tell

14. Question 6: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? • Nondiscrimination Information Act • Genetic Nondiscrimination Act • Discrimination Prevention Act • Don’t Ask, Don’t Tell

15. Question 7:Cultural competence: • moves us toward ethnocentricity • occurs naturally in all first year med students • is the passive application of awareness and knowledge used to support recovery • requires extensive knowledge of different cultures • none of the above are true

16. Question 7:Cultural competence: • moves us toward ethnocentricity • occurs naturally in all first year med students • is the passive application of awareness and knowledge used to support recovery • requires extensive knowledge of different cultures • 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.

17. Question 8:What is the proper way to correct an error in a SOAP note? • scribbling out the error, dating, timing, and signing • white out the error, dating, timing, and signing • crossing out the error with a single line, dating, timing, and signing • highlighting the error, dating, timing, and signing

18. Question 8:What is the proper way to correct an error in a SOAP note? • scribbling out the error, dating, timing, and signing • white out the error, dating, timing, and signing • crossing out the error with a single line, dating, timing, and signing • highlighting the error, dating, timing, and signing

19. Question 9:Medical paternalism can be defined as: • patients and physicians working together to make medical decisions • physicians making decisions for their patients based on what they believe is in the patients’ best interest • physicians making decisions for their patients based on their own (the physician’s own) beliefs • none of the above define paternalism

20. Question 9:Medical paternalism can be defined as: • patients and physicians working together to make medical decisions • physicians making decisions for their patients based on what they believe is in the patients’ best interest • physicians making decisions for their patients based on their own (the physician’s own) beliefs • none of the above define paternalism

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

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

23. Question 11:Which of the following is true regarding interpersonal violence? • women who are victims of violence often don’t know their attacker • women between the ages of 60-65 are at the greatest risk for intimate partner violence • more men than women are stalked in their lifetime • children who witness violence in the home are more likely to beat their own children

24. Question 11:Which of the following is true regarding interpersonal violence? • women who are victims of violence often don’t know their attacker- females are most often victimized by someone they know • 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 • more men than women are stalked in their lifetime- women are more likely to be stalked • children who witness violence in the home are more likely to beat their own children

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

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

27. Question 13:Ensuring that a patient’s decision on treatment is free from coercion is an example of which of the following bioethical principles? • beneficence • non-maleficence • autonomy • justice

28. Question 13:Ensuring that a patient’s decision on treatment is free from coercion is an example of which of the following bioethical principles? • beneficence- doing what’s in the patient’s best interest • non-maleficence- do no harm • autonomy- free from interference and control of others • 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

29. Question 14:Which of the following is NOT a conflict of interest? • physicians who do research on their patients • an alcoholic physician • product sales in the physician’s office • a cardiologist with a heart defect

30. Question 14:Which of the following is NOT a conflict of interest? • physicians who do research on their patients- dual role of physician and investigator • an alcoholic physician- colleagues may be torn between helping the physician and allowing the physician to help his/her own patients • product sales in the physician’s office- patients might think these products are more legit • a cardiologist with a heart defect- that’s just ironic (unless of course it’s interfering with his/her ability to work)

31. Question 15: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: • discrimination • disparities • favoritism • prejudice

32. Question 15: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: • discrimination • disparities • favoritism • prejudice

33. Question 16: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)? • penis problems • protection from STDs • practices • partners • prevention of pregnancy • past STDs

34. Question 16: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)? • penis problems- probably important to know, but is not one of the 5 P’s • protection from STDs • practices • partners • prevention of pregnancy • past STDs

35. Question 17:Sighing is an example of: • reassuring • non-verbal communication • confronting • verbal communication

36. Question 17:Sighing is an example of: • reassuring- puts the patient at ease • non-verbal communication • confronting- draws attention to something the patient is unconsciously doing or is purposely trying to avoid • verbal communication- this requires words

37. Question 18:Define justice.

38. 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.

39. Question 19:In diagnosing depression, either depressed mood or this symptom must be present: • feelings of worthlessness or guilt • fatigue or loss of energy • anhedonia • Impaired concentration

40. Question 19:In diagnosing depression, either depressed mood or this symptom must be present: • feelings of worthlessness or guilt • fatigue or loss of energy • anhedonia • 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.

41. Question 20:Trying to announce T-shirt tiiiime, The Situation walks in on Snookismushing with Vinny. Upset, Vinny throws Snooki at The Situation, but misses and hits J-Wowwwho 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. • justice, beneficence • autonomy, beneficence • autonomy, non-maleficence • beneficence, beneficence

42. Question 20:Trying to announce T-shirt tiiiime, The Situation walks in on Snookismushing with Vinny. Upset, Vinny throws Snooki at The Situation, but misses and hits J-Wowwwho 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. • justice, beneficence • 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 • autonomy, non-maleficence • beneficence, beneficence

43. Other Stuff • Statistics • Lecture on locating professional resources? • Questions? • Equipment sale in the lobby! • AMA Halloween Party tonight