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Interview Questions for the Physician Candidate

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601. Chronic Obstructive Pulmonary Disease (Follow-up)

both pharmacologic and non-pharmacologic modalities, and will likely require multiple attempts to maintain success. The transition from smoking to not smoking occurs in the following 5 stages: Precontemplation Contemplation Preparation Action Maintenance Smoking intervention programs include self-help, group, health care provider delivered, workplace, and community programs. Setting a quit date may be helpful. Physicians and other health care providers should participate in setting the target date (...) is invasive and requires special training for the physician, the patient, and the caregiver. The procedure has risks as well as medical benefits but has limited application. NIPPV for hypercapneic respiratory failure Noninvasive positive-pressure ventilation (NIPPV), as the name suggests, allows the delivery of positive-pressure ventilation without the use of an endotracheal tube. In place of the tube is a tight-fitting nasal or facial mask that is attached to a continuous positive airway pressure (CPAP

2014 eMedicine.com

602. Cancer and Rehabilitation (Follow-up)

provide services to patients throughout the course of illness, during all stages. Treatment plans must be individualized to meet each patient's unique and specific needs. Physicians Professional clinicians composing the interdisciplinary team include physicians from several specialties. Primary care physicians, surgeons, radiation oncologists, and medical oncologists make active and concurrent contributions to rehabilitation efforts to manage the disease process. The physiatrist, a specialist in PM&R (...) of the disease are simultaneous. Cancer rehabilitation is an emerging field within PM&R and it has many unique characteristics that may require specialized fellowship training. Fellowship training programs teach physicians to evaluate the functional needs of cancer patients during treatment and follow-up. Cancer rehabilitation is a challenging and rewarding field since it combines many aspects of medicine, such as inpatient and outpatient care, patient continuity of care, clinical assessment, diagnostic

2014 eMedicine.com

603. Hysterectomy (Follow-up)

Procedures Procedures 2002 1839938-overview Procedures Procedures 2002 1839957-overview Procedures Procedures 2002 270723-overview Procedures Procedures Need a Curbside Consult? Share cases and questions with Physicians on Medscape consult. (...) ; injury to the bowel, bladder, or ureter; nerve damage; and urinary tract infection. Candidates for this surgery include those who have fibroids, abnormal or heavy bleeding, chronic pelvic pain, endometriosis, adenomyosis (endometrial tissue that has infiltrated the myometrium), uterine prolapse, cancer of the reproductive organs, or pelvic inflammatory disease. Vaginal hysterectomy In a vaginal hysterectomy, the uterus is removed through the vaginal introitus. Prior to surgery, the patient is given

2014 eMedicine.com

604. Sudden Unexpected Death in Epilepsy (Follow-up)

-overview Diseases & Conditions Diseases & Conditions 2002 1181649-overview Diseases & Conditions Diseases & Conditions 2002 1138154-overview Diseases & Conditions Diseases & Conditions 2002 1140724-overview Diseases & Conditions Diseases & Conditions Need a Curbside Consult? Share cases and questions with Physicians on Medscape consult. (...) vulnerability to cardiac arrhythmia. [ ] Seizure threshold also might diminish, leading to rebound effect and increase in seizure frequency. Patients on multiple antiepileptic drugs had a significantly higher rate of SUDEP than patients with epilepsy who were not on multiple antiepileptic drugs. Also, a questionable role has been attributed to recent sudden changes in medication regimen of patients. Genetic predisposition The following genes have been studied in SUDEP autopsy cases: KCNQ1 , SCN1A , LQTS

2014 eMedicine.com

605. Sudden Unexpected Death in Epilepsy (Overview)

-overview Diseases & Conditions Diseases & Conditions 2002 1181649-overview Diseases & Conditions Diseases & Conditions 2002 1138154-overview Diseases & Conditions Diseases & Conditions 2002 1140724-overview Diseases & Conditions Diseases & Conditions Need a Curbside Consult? Share cases and questions with Physicians on Medscape consult. (...) vulnerability to cardiac arrhythmia. [ ] Seizure threshold also might diminish, leading to rebound effect and increase in seizure frequency. Patients on multiple antiepileptic drugs had a significantly higher rate of SUDEP than patients with epilepsy who were not on multiple antiepileptic drugs. Also, a questionable role has been attributed to recent sudden changes in medication regimen of patients. Genetic predisposition The following genes have been studied in SUDEP autopsy cases: KCNQ1 , SCN1A , LQTS

2014 eMedicine.com

606. Body Dysmorphic Disorder (Follow-up)

Disorder What to Read Next on Medscape Related Conditions and Diseases Medscape Consult News & Perspective Tools Slideshow Most Popular Articles According to Psychiatrists Recommended 2002 286227-overview Diseases & Conditions Diseases & Conditions 2002 916933-overview Diseases & Conditions Diseases & Conditions 2002 290955-overview Diseases & Conditions Diseases & Conditions 2001 http://www.medscape.com/resource/anxiety-disorders Need a Curbside Consult? Share cases and questions with Physicians (...) the effectiveness of escitalopram vs placebo with regards to relapse prevention. Escitalopram delayed time to relapse and fewer escitalopram-treated subjects relapsed than did placebo-treated subjects. In addition, body dysmorphic disorder severity significantly improved during the additional six months of escitalopram treatment following acute response, and more than one-third of escitalopram-treated subjects experienced further improvement. [ ] Use of SSRIs in pediatric patients Physicians are advised

2014 eMedicine.com

607. Lung Cancer, Non-Small Cell (Follow-up)

chemotherapy. [ ] Patients with stage IIIB and IV NSCLC are usually offered chemotherapy with the option of surgery. Molecular-targeted therapy plays an increasingly important role in the treatment of advanced NSCLC. Radiation is a reasonable option for treatment in patients who are not candidates for surgery. The role of adjuvant radiation therapy after resection of the primary tumor remains controversial. See the table below, as well as . Because most NSCLC cannot be cured with currently available (...) group also had less depressive symptoms, and fewer patients in this group received aggressive end-of-life care. [ ] Emergency Treatment All patients thought to have lung cancer should be encouraged to obtain follow-up care with their primary care physician. In almost all cases, document the possible diagnosis and discuss it with the patient. Definitive treatment of the underlying cancer is not the purview of the emergency department (ED). Emergency treatment is based on symptoms. In cases of upper

2014 eMedicine.com

608. Gonococcus (Follow-up)

patients, seeking specialist help (in the form of specialist nurses or physicians) to interview and collect specimens (if necessary) for testing is prudent. Careful documentation of physical findings, even if apparently normal, is crucial for medicolegal reasons. Notification of child-protective services is required if abuse is suspected. Previous Next: Monitoring Per the 2015 CDC Sexually Transmitted Diseases Treatment Guidelines, a test-of-cure is no longer needed for patients with uncomplicated (...) & Perspective Tools Slideshow Most Popular Articles According to Infectious Disease Physicians Recommended 2002 218059-overview Diseases & Conditions Diseases & Conditions 2002 782913-overview Diseases & Conditions Diseases & Conditions 2001 /viewarticle/895833 News News 2001 /viewarticle/895915 Journal Article Journal Article Need a Curbside Consult? Share cases and questions with Physicians on Medscape consult.

2014 eMedicine.com

609. Gonococcemia (Follow-up)

patients, seeking specialist help (in the form of specialist nurses or physicians) to interview and collect specimens (if necessary) for testing is prudent. Careful documentation of physical findings, even if apparently normal, is crucial for medicolegal reasons. Notification of child-protective services is required if abuse is suspected. Previous Next: Monitoring Per the 2015 CDC Sexually Transmitted Diseases Treatment Guidelines, a test-of-cure is no longer needed for patients with uncomplicated (...) & Perspective Tools Slideshow Most Popular Articles According to Infectious Disease Physicians Recommended 2002 218059-overview Diseases & Conditions Diseases & Conditions 2002 782913-overview Diseases & Conditions Diseases & Conditions 2001 /viewarticle/895833 News News 2001 /viewarticle/895915 Journal Article Journal Article Need a Curbside Consult? Share cases and questions with Physicians on Medscape consult.

2014 eMedicine.com

610. Gonococcal Infections (Follow-up)

patients, seeking specialist help (in the form of specialist nurses or physicians) to interview and collect specimens (if necessary) for testing is prudent. Careful documentation of physical findings, even if apparently normal, is crucial for medicolegal reasons. Notification of child-protective services is required if abuse is suspected. Previous Next: Monitoring Per the 2015 CDC Sexually Transmitted Diseases Treatment Guidelines, a test-of-cure is no longer needed for patients with uncomplicated (...) & Perspective Tools Slideshow Most Popular Articles According to Infectious Disease Physicians Recommended 2002 218059-overview Diseases & Conditions Diseases & Conditions 2002 782913-overview Diseases & Conditions Diseases & Conditions 2001 /viewarticle/895833 News News 2001 /viewarticle/895915 Journal Article Journal Article Need a Curbside Consult? Share cases and questions with Physicians on Medscape consult.

2014 eMedicine.com

611. Cancer and Rehabilitation (Treatment)

provide services to patients throughout the course of illness, during all stages. Treatment plans must be individualized to meet each patient's unique and specific needs. Physicians Professional clinicians composing the interdisciplinary team include physicians from several specialties. Primary care physicians, surgeons, radiation oncologists, and medical oncologists make active and concurrent contributions to rehabilitation efforts to manage the disease process. The physiatrist, a specialist in PM&R (...) of the disease are simultaneous. Cancer rehabilitation is an emerging field within PM&R and it has many unique characteristics that may require specialized fellowship training. Fellowship training programs teach physicians to evaluate the functional needs of cancer patients during treatment and follow-up. Cancer rehabilitation is a challenging and rewarding field since it combines many aspects of medicine, such as inpatient and outpatient care, patient continuity of care, clinical assessment, diagnostic

2014 eMedicine.com

612. Chronic Obstructive Pulmonary Disease (Treatment)

both pharmacologic and non-pharmacologic modalities, and will likely require multiple attempts to maintain success. The transition from smoking to not smoking occurs in the following 5 stages: Precontemplation Contemplation Preparation Action Maintenance Smoking intervention programs include self-help, group, health care provider delivered, workplace, and community programs. Setting a quit date may be helpful. Physicians and other health care providers should participate in setting the target date (...) is invasive and requires special training for the physician, the patient, and the caregiver. The procedure has risks as well as medical benefits but has limited application. NIPPV for hypercapneic respiratory failure Noninvasive positive-pressure ventilation (NIPPV), as the name suggests, allows the delivery of positive-pressure ventilation without the use of an endotracheal tube. In place of the tube is a tight-fitting nasal or facial mask that is attached to a continuous positive airway pressure (CPAP

2014 eMedicine.com

613. Drug-Induced Hepatotoxicity (Treatment)

drug reactions result in or death. Drug-induced hepatic injury is the most common reason cited for withdrawal of an approved drug. Physicians must be vigilant in identifying drug-related liver injury because early detection can decrease the severity of hepatotoxicity if the drug is discontinued. The manifestations of drug-induced hepatotoxicity are highly variable, ranging from asymptomatic elevation of liver enzymes to fulminant hepatic failure. Knowledge of the commonly implicated agents (...) is not familiar with the drug or if any question remains about the safety of continuing a drug, consultation with a hepatologist should be considered. Elevated aminotransferase levels with acute hepatocellular injury Drug-induced liver injury is designated hepatocellular if the ALT levels are increased to more than twice the upper limit of the reference range, with alkaline phosphatase levels that are within the reference range or are minimally elevated. Elevation of aspartate aminotransferase (AST) greater

2014 eMedicine.com

614. Gonococcus (Treatment)

patients, seeking specialist help (in the form of specialist nurses or physicians) to interview and collect specimens (if necessary) for testing is prudent. Careful documentation of physical findings, even if apparently normal, is crucial for medicolegal reasons. Notification of child-protective services is required if abuse is suspected. Previous Next: Monitoring Per the 2015 CDC Sexually Transmitted Diseases Treatment Guidelines, a test-of-cure is no longer needed for patients with uncomplicated (...) & Perspective Tools Slideshow Most Popular Articles According to Infectious Disease Physicians Recommended 2002 218059-overview Diseases & Conditions Diseases & Conditions 2002 782913-overview Diseases & Conditions Diseases & Conditions 2001 /viewarticle/895833 News News 2001 /viewarticle/895915 Journal Article Journal Article Need a Curbside Consult? Share cases and questions with Physicians on Medscape consult.

2014 eMedicine.com

615. Gonococcemia (Treatment)

patients, seeking specialist help (in the form of specialist nurses or physicians) to interview and collect specimens (if necessary) for testing is prudent. Careful documentation of physical findings, even if apparently normal, is crucial for medicolegal reasons. Notification of child-protective services is required if abuse is suspected. Previous Next: Monitoring Per the 2015 CDC Sexually Transmitted Diseases Treatment Guidelines, a test-of-cure is no longer needed for patients with uncomplicated (...) & Perspective Tools Slideshow Most Popular Articles According to Infectious Disease Physicians Recommended 2002 218059-overview Diseases & Conditions Diseases & Conditions 2002 782913-overview Diseases & Conditions Diseases & Conditions 2001 /viewarticle/895833 News News 2001 /viewarticle/895915 Journal Article Journal Article Need a Curbside Consult? Share cases and questions with Physicians on Medscape consult.

2014 eMedicine.com

616. Gonococcal Infections (Treatment)

patients, seeking specialist help (in the form of specialist nurses or physicians) to interview and collect specimens (if necessary) for testing is prudent. Careful documentation of physical findings, even if apparently normal, is crucial for medicolegal reasons. Notification of child-protective services is required if abuse is suspected. Previous Next: Monitoring Per the 2015 CDC Sexually Transmitted Diseases Treatment Guidelines, a test-of-cure is no longer needed for patients with uncomplicated (...) & Perspective Tools Slideshow Most Popular Articles According to Infectious Disease Physicians Recommended 2002 218059-overview Diseases & Conditions Diseases & Conditions 2002 782913-overview Diseases & Conditions Diseases & Conditions 2001 /viewarticle/895833 News News 2001 /viewarticle/895915 Journal Article Journal Article Need a Curbside Consult? Share cases and questions with Physicians on Medscape consult.

2014 eMedicine.com

617. Coccidioidomycosis (Treatment)

because of respiratory tract or systemic manifestations. Management in symptomatic patients varies with the clinical syndrome. Because most Coccidioides infections resolve without specific therapy, few clinical trials have assessed outcomes in less-severe disease. Most treatment recommendations represent consensus guidelines based on the Mycosis Study Group trials and the experience of many investigators. Even physicians in endemic regions disagree on who should be treated, the length of treatment (...) , and what agent should be used. [ , ] However, the Infectious Diseases Society of America has published . [ ] Three questions should be asked before a case of coccidioidomycosis is treated. Is intervention necessary? If antifungal therapy would be beneficial, which agents are appropriate? Is a surgical procedure necessary for debridement and reconstruction of destructive lesions? In the decision-making process, significant weight is given to the severity of infection, risk factors for dissemination (eg

2014 eMedicine.com

618. Coccidioidomycosis (Infectious Diseases) (Treatment)

because of respiratory tract or systemic manifestations. Management in symptomatic patients varies with the clinical syndrome. Because most Coccidioides infections resolve without specific therapy, few clinical trials have assessed outcomes in less-severe disease. Most treatment recommendations represent consensus guidelines based on the Mycosis Study Group trials and the experience of many investigators. Even physicians in endemic regions disagree on who should be treated, the length of treatment (...) , and what agent should be used. [ , ] However, the Infectious Diseases Society of America has published . [ ] Three questions should be asked before a case of coccidioidomycosis is treated. Is intervention necessary? If antifungal therapy would be beneficial, which agents are appropriate? Is a surgical procedure necessary for debridement and reconstruction of destructive lesions? In the decision-making process, significant weight is given to the severity of infection, risk factors for dissemination (eg

2014 eMedicine.com

619. Conversion Disorders (Treatment)

Diseases & Conditions 2002 917864-overview Diseases & Conditions Diseases & Conditions 2002 805361-overview Diseases & Conditions Diseases & Conditions 2010 lamictal-lamotrigine-343012 Drugs Drugs Need a Curbside Consult? Share cases and questions with Physicians on Medscape consult. (...) for those with motor or gait symptoms. [ ] Psychiatrist: This is generally indicated when the symptoms persist. This can aid in identification of psychologic stressors symbolically linked to the symptoms and other risk factors for conversion disorder. The patient must be informed about the consultation before the psychiatrist does the interview. Psychiatric treatments that have demonstrated effectiveness include the following: Insight Oriented Supportive therapy: Offers the client support and helps

2014 eMedicine.com

620. Pervasive Developmental Disorder: Autism (Overview)

-by-case basis. (See Treatment.) Practice guidelines The American Academy of Child and Adolescent Psychiatry's practice guidelines for the assessment and treatment of children and adolescents with ASD include the following recommendations: [ , ] Questions about core symptoms of ASD should be a routine part of psychiatric and developmental assessments of young children. If screening reveals significant ASD symptomatology, a thorough evaluation should be performed and possible comorbid diagnoses should (...) with an ongoing seizure disorder requires treatment because maternal seizures can result in serious morbidity and mortality for the mother and the fetus. To stop anticonvulsant therapy when a woman with a seizure disorder becomes pregnant to avoid teratologic effects may precipitate uncontrolled seizures that may be fatal to the mother and the fetus. Therefore physicians treating women with child-bearing potential can appropriately initiate frank conversations about future pregnancies. Juvenile myoclonic

2014 eMedicine Pediatrics

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