Patient Care & Clinical Skills Flashcards
7 cards from real ECFMG practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Patient Care & Clinical Skills flashcards as text
A 35-year-old man presents with three weeks of productive cough, night sweats, and a 10-lb weight loss. He emigrated from Southeast Asia two years ago. Which diagnostic test is most important?
Answer: Sputum acid-fast bacilli smear and culture
The clinical picture strongly suggests pulmonary tuberculosis; sputum AFB smear and culture are essential for diagnosis and to guide infection control.
An 8-year-old child is brought in by her mother for a routine visit. During the exam, you notice multiple bruises in various stages of healing on the child's back and buttocks. The mother states the child 'falls a lot.' What is the most appropriate next step?
Answer: Report suspicion of child abuse to child protective services
Patterned bruises in unusual locations at different healing stages are sentinel signs of abuse; mandatory reporting to child protective services is required by law.
A patient taking warfarin for atrial fibrillation presents with a supratherapeutic INR of 8.5 and active GI bleeding. Which treatment is most urgently indicated?
Answer: Give 4-factor prothrombin complex concentrate (4F-PCC) plus IV vitamin K
Life-threatening bleeding with supratherapeutic INR requires immediate reversal with 4F-PCC (rapid onset) plus IV vitamin K (sustained reversal).
A 60-year-old woman presents with crushing substernal chest pain radiating to her left arm, diaphoresis, and nausea for 45 minutes. ECG shows ST elevation in leads II, III, and aVF. What is the target time for reperfusion?
Answer: Within 90 minutes (door-to-balloon time)
Current ACC/AHA guidelines recommend primary PCI with a door-to-balloon time of ≤90 minutes for STEMI.
A physician notices that a patient's electronic health record contains a billing code that does not match the services actually rendered. The physician suspects insurance fraud by a colleague. What is the most appropriate action?
Answer: Report the concern through appropriate institutional channels or compliance office
Suspected fraud must be reported through proper institutional compliance channels to protect patients, the institution, and the integrity of the health care system.
A 50-year-old man presents after being found unconscious. His blood glucose is 35 mg/dL and he has no IV access. What is the most appropriate immediate treatment?
Answer: Give glucagon 1 mg intramuscularly
In an unconscious hypoglycemic patient without IV access, IM glucagon rapidly raises blood glucose by stimulating hepatic glycogenolysis.
A 25-year-old medical student on her third clinical rotation asks you to sign off on a procedure she has not yet performed. She says she has 'watched it many times.' What should you do?
Answer: Decline and explain that documentation must accurately reflect actual performance
Falsifying medical records or competency documentation is a serious ethical and legal violation; the physician must decline and explain why accurate documentation is mandatory.