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Revision type questions, with answer and each document will have 30 questions

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cd /tmp/workspace && mkdir -p pptx_extract && python3 << 'EOF' from pptx import Presentation import os files = { "History Taking": "/tmp/workspace/attachments/e5a937bb-6755-4a6a-81ba-31fba7d62cf6/1. History Taking.pptx", "Ethics and Professionalism": "/tmp/workspace/attachments/e5a937bb-6755-4a6a-81ba-31fba7d62cf6/2. Ethics and Professionalism.pptx", "Informed Consent": "/tmp/workspace/attachments/e5a937bb-6755-4a6a-81ba-31fba7d62cf6/3. Informed Consent.pptx", } for name, path in files.items(): out_path = f"/tmp/workspace/pptx_extract/{name.replace(' ','_')}.txt" prs = Presentation(path) lines = [] for i, slide in enumerate(prs.slides, 1): lines.append(f"\n--- Slide {i} ---") for shape in slide.shapes: if shape.has_text_frame and shape.text_frame.text.strip(): lines.append(shape.text_frame.text) if shape.has_table: for row in shape.table.rows: cells = [c.text for c in row.cells] lines.append(" | ".join(cells)) if slide.has_notes_slide: notes = slide.notes_slide.notes_text_frame.text if notes.strip(): lines.append(f"[NOTES]: {notes}") with open(out_path, "w") as f: f.write("\n".join(lines)) print(name, "->", len(prs.slides.__iter__.__self__._sldIdLst), "slides, saved to", out_path) EOF

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Revision Questions with Answers

Based on the three PPTX files provided, here are 30 revision questions with answers for each topic.

1. History Taking (30 Questions)

Q1. What is the WHO definition of health? A: A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity.
Q2. Differentiate between "illness" and "disease." A: Illness is the patient's subjective experience of feeling unwell (symptoms like pain, fatigue, nausea); disease is a pathological condition diagnosed via clinical, laboratory, or imaging findings.
Q3. Can a patient have an illness without a disease? Give the concept. A: Yes - a patient may report symptoms (illness) even if no objective abnormality (disease) is found.
Q4. Define anamnesis. A: The process of gathering a patient's medical history and relevant details (past/current health, family history, lifestyle) to build a comprehensive understanding of their health and needs.
Q5. What is the difference between a comprehensive and a focused assessment? A: A comprehensive assessment covers the patient's full health history and all systems; a focused assessment targets a specific complaint or problem area.
Q6. Define subjective data and give two examples. A: Subjective data is what the patient tells you; examples include symptoms, chief complaint, medical history, review of systems.
Q7. Define objective data and give two examples. A: Objective data is what you observe or measure; examples include signs, physical exam findings, lab results, vital signs, imaging results.
Q8. What three things should be documented under "Initial Information" in a health history? A: Date and time of history, identifying data (age, gender, marital status, occupation, source of history/referral), and reliability of the patient.
Q9. Why is documenting the time of history important, especially in urgent/emergent settings? A: It provides an accurate timeline of the patient's condition and evaluation, important for urgent, emergent, or hospital-based care and medico-legal records.
Q10. When should the reliability of a patient's history be judged? A: At the end of the interview, noting whether the information given was clear or vague.
Q11. List the sequence of collecting anamnesis (7 steps). A: Introduction to the patient, Chief complaint, History of present illness, Past medical history, Family history, Social history, Review of systems.
Q12. What five things should happen during the "Introduction" phase of history taking? A: Greet the patient (build rapport/trust), introduce yourself and your role, ensure confidentiality, ask for consent, and set the tone to encourage sharing.
Q13. Define "chief complaint." A: The primary reason the patient is seeking medical care, expressed directly in the patient's own words.
Q14. Why should leading questions be avoided when eliciting the chief complaint? A: They bias the patient's response and can distort the true nature of the complaint (e.g., asking "Do you have chest pain?" instead of "What brought you in today?").
Q15. Expand the mnemonic SOCRATES used for History of Present Illness. A: S - Site, O - Onset, C - Character, R - Radiation, A - Association, T - Time course, E - Exacerbating/Relieving factors, S - Severity.
Q16. In SOCRATES, what does "Radiation" refer to? A: Whether the symptom (e.g., pain) spreads or moves to another location.
Q17. In SOCRATES, what does "Character" ask about? A: How the patient would describe the symptom (e.g., sharp, dull, burning, crushing).
Q18. What six categories are covered under Past Medical History? A: Chronic illnesses, past acute illnesses/hospitalizations, surgical history, medications/drug history, allergies/adverse drug reactions, and immunization history.
Q19. Why is family history important in anamnesis? A: It helps detect early hereditary/genetic diseases and assess risk based on relatives' conditions.
Q20. What relatives should be asked about in family history, and what else should be noted? A: First-degree and second-degree relatives, genetic conditions, and age of onset/cause of death (if applicable).
Q21. How should family history questioning begin? A: With an open-ended question, e.g., "Do any medical conditions run in your family?"
Q22. List the components of Social History. A: Smoking, alcohol and drugs; occupation and work environment; living conditions; diet and exercise; sexual history; travel history; social support.
Q23. What is covered under "General Symptoms" in the Review of Systems? A: Weight loss/gain, fatigue, fever, night sweats.
Q24. What is asked about in the HEENT review of systems? A: Headache, tinnitus, runny nose, nosebleed, difficulty swallowing, bleeding gums, mouth ulcers.
Q25. What symptoms fall under the cardiovascular system in ROS? A: Chest pain, palpitations, racing heart.
Q26. What symptoms fall under the endocrine system in ROS? A: Frequent urination, increased thirst, weight changes.
Q27. What is asked in the hematologic review of systems? A: History of anemia, past transfusions, transfusion reactions.
Q28. A patient says, "I have a stabbing pain in my chest that spreads to my left arm, started 2 hours ago, worse with exertion." Which SOCRATES elements have been covered? A: Site (chest), Character (stabbing), Radiation (left arm), Onset (2 hours ago), and Exacerbating factor (exertion). Missing: Association, Time course, Severity.
Q29. Why is it important to quote the patient's own words for the chief complaint rather than paraphrasing? A: It preserves the patient's original meaning and context and avoids the clinician's bias or misinterpretation influencing the documented complaint.
Q30. What is the key tip emphasized regarding listening during the chief complaint discussion? A: Listen attentively - the patient may reveal additional information crucial to understanding their condition beyond the initial complaint.

2. Ethics and Professionalism (30 Questions)

Q1. List the skilled interviewing techniques mentioned in the lecture. A: Active listening, empathic responses, guided questioning, nonverbal communication, reassurance, partnering, summarization, transition, empowering the patient.
Q2. List the techniques of guided questioning. A: Moving from open-ended to focused questions, using questions that elicit a graded response, asking one question at a time, offering multiple-choice answers, clarifying what the patient means, encouraging with continuers, and using echoing.
Q3. What is "echoing" in patient interviewing? Give an example. A: Repeating a patient's own word/phrase to encourage elaboration. Example: Patient says pain "spread"; clinician responds "Spread?" prompting the patient to explain further.
Q4. List the techniques for sharing power with the patient. A: Evoke the patient's perspective, convey interest in the person (not just the problem), follow the patient's leads, elicit and validate emotional content, share information at transition points, make clinical reasoning transparent, and reveal the limits of your knowledge.
Q5. What four things should a clinician do to prepare for an interview? A: Review the clinical record, set goals for the interview, review your own clinical behavior/appearance, and adjust the environment.
Q6. List the sequence of a clinical interview. A: Greeting the patient and establishing rapport, taking notes, establishing the agenda, exploring the patient's perspective, identifying/responding to emotional cues, expanding and clarifying the patient's story, generating and testing diagnostic hypotheses, sharing the treatment plan.
Q7. Expand the FIFE mnemonic used to explore the patient's perspective. A: F - Feelings (emotions about illness), I - Ideas (what patient thinks is causing it), F - Function (effect on daily life), E - Expectations (what patient hopes to gain from the visit).
Q8. Expand the NURSE mnemonic for responding to patient emotion. A: N - Name the emotion, U - Understand/accept it, R - Respect and validate the feeling, S - Support (offer help/reassurance), E - Explore (encourage elaboration).
Q9. What happens during "generating and testing diagnostic hypotheses"? A: The clinician considers possible causes for the patient's symptoms based on information gathered so far.
Q10. List the three steps in "Sharing the Treatment Plan." A: 1) Present options and explore preferences, 2) Move toward a decision, 3) Confirm readiness and support.
Q11. Define cultural humility. A: An approach to patient care emphasizing the clinician's willingness to learn from the patient about their cultural background, values, and beliefs, rather than assuming cultural competence.
Q12. Why is cultural humility important? (3 reasons) A: It respects patient autonomy and beliefs, builds trust and better communication, and reduces bias and stereotyping.
Q13. List the three dimensions of cultural humility. A: Self-awareness (recognizing your own biases), respectful communication (avoiding assumptions of "normal," learning from patients), and collaborative partnerships (building relationships on respect and mutual plans).
Q14. In the Ghanaian taxi driver scenario, what was the patient's main complaint about his care? A: That the clinician did not give him chloroquine, reflecting his cultural expectation for treating fever, and highlighting a mismatch between his health beliefs and the U.S. clinical approach (extensive testing, blood draw refusal).
Q15. In the 16-year-old menstrual cramps scenario, what ethical/communication failures occurred? A: The clinician ignored her main concern (cramps), failed to explore her perspective (FIFE), made assumptions based on appearance (bias/stereotyping about sexual activity), used poor rapport-building communication, and missed shared decision-making by pressuring her into unwanted birth control.
Q16. List types of "challenging patients" discussed. A: The silent patient, the confusing patient, the patient with altered cognition, the talkative patient, the crying patient, the angry/disruptive patient, the patient with a language barrier, the patient with hearing loss, the patient with impaired vision.
Q17. Differentiate between capacity and competence. A: Capacity is a clinical judgment (made by a doctor/clinician) about a patient's ability to make a specific medical decision at a given time; competence is a legal status (determined by a court/judge) about whether a person can make decisions for themselves generally.
Q18. Give an example that illustrates the difference between capacity and competence. A: A patient may be too sick today to consent but capable later (capacity, fluctuating); a patient with advanced dementia may be legally incompetent (fixed until changed by law).
Q19. List four key signs that a patient may lack capacity. A: Doesn't understand medical information, cannot weigh options (risks vs. benefits), cannot reason through choices logically, cannot communicate a choice, and/or has fluctuating or impaired consciousness/cognition.
Q20. In the 88-year-old fall/hyponatremia scenario, why might the patient lack capacity to refuse rehab? A: Due to hyponatremia and possible cognitive changes she may not understand the risks of going home; she cannot weigh the risk of falling versus benefit of rehab, and her decision (to go home despite severe weakness/inability to ambulate) is inconsistent with her safety needs, even though she can communicate a choice.
Q21. Define "advance directive" and name its two main types. A: A legal document stating a person's wishes about medical care if they become unable to decide for themselves. Types: Living Will (instructions on treatments, especially end-of-life care) and Health Care Power of Attorney (appoints an agent/proxy to decide on your behalf).
Q22. List the sensitive topics that require careful, respectful history-taking. A: Sexual history, mental health history, alcohol and drug use, domestic violence.
Q23. Expand the CAGE questionnaire used for alcohol screening. A: C - Cut down (felt you should cut down on drinking), A - Annoyed (others annoyed by criticism of your drinking), G - Guilty (felt guilty about drinking), E - Eye-opener (needed a drink first thing in the morning).
Q24. Name the four principles of medical ethics. A: Autonomy, Beneficence, Non-maleficence, and Justice.
Q25. Define autonomy in medical ethics. A: The patient's right to make their own informed decisions about their medical care, free from coercion.
Q26. Define beneficence and non-maleficence. A: Beneficence is the duty to act in the patient's best interest/benefit; non-maleficence is the duty to avoid causing harm ("do no harm").
Q27. Define justice as an ethical principle. A: Fair and equitable distribution of healthcare resources, benefits, and risks among patients/society.
Q28. In the student clinical rotation scenario (exhausted patient at night), what ethical issue is raised? A: Whether it's appropriate to perform a lengthy history/physical purely for the student's education when the patient is exhausted, and the need to ask permission and consider the patient's welfare over educational goals.
Q29. In the Ms. Robbins biopsy scenario, what is the core ethical conflict? A: A conflict between honesty/patient autonomy (the patient wants to know her results and has expressed a preference for full disclosure) and respecting the attending physician's authority/instruction to withhold results until Monday - raising issues of truth-telling, non-maleficence (avoiding unnecessary anxiety), and the chain of command.
Q30. In the advanced lung cancer scenario, whose wishes should prevail regarding the ventilator - the patient's or the family's, and why? A: The patient's wishes prevail, since he is conscious, has capacity, and has clearly and consistently expressed his wish not to be placed on a ventilator - this reflects respect for patient autonomy over family preference.

3. Informed Consent (30 Questions)

Q1. Define informed consent. A: An ethical and legal process where a patient or research participant voluntarily agrees to a medical intervention or study after understanding its risks, benefits, alternatives, and costs.
Q2. In the colonoscopy scenario, why is the patient's signature NOT valid informed consent? A: Because the doctor minimized the risks ("do not worry"), did not explain the procedure's risks, benefits, or alternatives, and did not confirm the patient's understanding - signing a form alone does not equal informed consent without adequate disclosure and comprehension.
Q3. List the three types of informed consent. A: Implied consent (agreement shown through actions), verbal consent (agreement expressed orally), and written consent (agreement documented with a signature).
Q4. Give an example of implied consent. A: A patient rolling up their sleeve for a blood draw or extending their arm for a blood pressure check.
Q5. List the components that must be included in informed consent. A: Description of the procedure, explanation of risks vs. benefits, alternatives (including their risks/benefits), and assessment of the patient's understanding.
Q6. List the five requirements for valid informed consent. A: Capacity/competence, voluntariness, adequate disclosure, understanding, and authorization/consent itself.
Q7. What does "voluntariness" mean in the context of informed consent? A: The patient's decision must be made freely, without coercion, pressure, or undue influence from the clinician, family, or institution.
Q8. What does "adequate disclosure" require? A: The clinician must provide sufficient information about the procedure, risks, benefits, and alternatives for the patient to make an informed decision.
Q9. Why is "assessment of the patient's understanding" a necessary component, not just disclosure? A: Because giving information is not enough - the clinician must confirm the patient actually comprehends it, since consent based on misunderstanding is not valid.
Q10. In the coronary angiography scenario, can the team proceed just because the patient signed the form 2 hours earlier? A: No. Consent can be withdrawn at any time before the procedure. Since the patient is awake, oriented, hemodynamically stable, and clearly withdrawing consent, her refusal must be respected regardless of a prior signature.
Q11. What principle does the angiography scenario illustrate? A: That informed consent is an ongoing process, not a one-time signature, and can be withdrawn at any point prior to (or during) the intervention.
Q12. In the cesarean section scenario, what is the correct course of action if the pregnant woman has capacity and voluntarily refuses surgery, despite fetal risk? A: Respect the woman's refusal, since she has capacity and is refusing voluntarily - a competent patient's autonomous refusal must be honored even if it carries risk to the fetus, and it cannot be overridden by the partner's wishes.
Q13. Can a partner/spouse override a competent patient's decision regarding their own treatment? A: No. Only the patient (if she has capacity) can authorize or refuse her own treatment; a partner cannot consent or refuse on her behalf when she is capable of doing so herself.
Q14. List the special circumstances of informed consent discussed. A: Emergency/unconscious patient, patients lacking capacity or competence, children and adolescents, language or communication barriers, refusal of treatment, use of surrogate/substitute decision-makers, withdrawal of consent, and research/teaching involvement.
Q15. How is consent typically handled for an unconscious patient in an emergency? A: Under the emergency exception/doctrine, treatment can proceed without explicit consent if delay would cause serious harm or death, and no surrogate is immediately available.
Q16. What is a surrogate/substitute decision-maker? A: A person (e.g., family member, legal guardian, or designated proxy) authorized to make medical decisions on behalf of a patient who lacks capacity to decide for themselves.
Q17. Define informed assent. A: The affirmative agreement of a person (typically a minor or cognitively impaired individual) to participate in research or a clinical procedure; while they lack legal capacity for informed consent, their willingness is still sought as an ethical "dual procedure" alongside parental/guardian consent.
Q18. Why is informed assent from a minor still ethically important even though it isn't legally binding? A: It respects the child's developing autonomy and involvement in decisions about their own body/care, even though final legal authorization rests with the parent/guardian.
Q19. What should be done if a patient has a language or communication barrier during the consent process? A: Use a professional interpreter (not an untrained family member when possible) to ensure the patient truly understands the information before consenting.
Q20. Can a patient withdraw consent after already signing a written consent form? A: Yes - consent can be withdrawn at any time, even after signing, and must be respected as long as the patient retains capacity and is voluntarily choosing to withdraw.
Q21. What must be verified before accepting a patient's refusal of treatment as valid? A: That the patient has decision-making capacity and is refusing voluntarily (without coercion), and that they have been adequately informed of the consequences of refusal.
Q22. Why can't a signed consent form alone substitute for the full informed consent process? A: Because true informed consent requires disclosure, comprehension, and voluntary authorization - a signature only documents that a form was signed, not that these substantive requirements were actually met.
Q23. What ethical principle is primarily protected by requiring informed consent? A: Patient autonomy - the right of a competent patient to make decisions about their own body and care.
Q24. In research or teaching settings, why does informed consent require special attention? A: Because participants must clearly understand that the intervention is for research/education (which may not directly benefit them), understand risks involved, and consent voluntarily without coercion from the fact that a clinician is also their care provider.
Q25. What distinguishes verbal consent from written consent in terms of use? A: Verbal consent is typically used for lower-risk or routine procedures; written consent is generally required for higher-risk, invasive, or significant procedures/interventions to provide documented evidence of the discussion.
Q26. If a patient lacks capacity and has no advance directive or designated proxy, who typically makes decisions? A: The closest available surrogate (e.g., next of kin) is usually asked, following legal/institutional hierarchy for substitute decision-makers, or the treating team may proceed using the emergency doctrine/best-interest standard if urgent.
Q27. Why should a clinician avoid words like "It's just routine, don't worry" when obtaining consent (as in the colonoscopy case)? A: Because minimizing risks or dismissing patient concerns undermines adequate disclosure and true understanding, both of which are required elements of valid consent.
Q28. What is the difference between capacity/competence as it relates to the "requirements of valid consent" versus the earlier ethics topic of capacity vs. competence? A: They refer to the same underlying concept - capacity is the specific, clinician-assessed ability to understand and decide about a particular treatment at a given time, and it is one of the five prerequisites (along with voluntariness, disclosure, understanding, authorization) needed for consent to be legally and ethically valid.
Q29. Give an example of a situation requiring a surrogate decision-maker. A: A patient in a coma after a car accident with no advance directive - a legally recognized family member or court-appointed guardian would act as the surrogate decision-maker.
Q30. Summarize why the cesarean and angiography scenarios both emphasize the same core lesson about informed consent. A: Both illustrate that informed consent is dynamic and can be withdrawn or refused at any time, and that a patient's autonomous, voluntary decision (when they have capacity) must be respected even under time pressure, high stakes, or objections from others (family/partner) - consent is not a fixed, permanent authorization once given.
That covers all 90 questions (30 per document) with answers drawn directly from the slide content of each presentation. Let me know if you'd like these compiled into a downloadable Word or PDF document, or converted into a quiz/flashcard format instead.
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