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63 Cards in this Set
- Front
- Back
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Tanner stage 1
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childhood
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Tanner stage 2
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pubic hair begins to develop (adrenarche), increase size of testes, breast tissue elevation
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Tanner stage 3
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increase pubic hair, darkens, becomes curly, increase penis size/length
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Tanner stage 4
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increase penis width, darker scrotal skin, development of glans, raised areolae
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Tanner stage 5
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adult, areolae no longer raise
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Stages of grief
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Denial
Anger Bargaining Grieving Acceptance |
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Grief
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normal bereavement- shock, denial guilt, somatic symptoms
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pathologic grief
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excessively intense, prolonged, delayed, inhibited, denied
- may be depressed, delusions, hallucinations |
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Apgar score
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Appearance
Pulse Grimace Activity Respiration 10 pt scale measured at 1 & 5 minutes |
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low birth weight
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<2500 g
increased risk of physical & emotional problems complications: infections, infant RDS, necrotizing enterocolitis, intraventricular hemorrhage, persistent fetal circulation |
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Autonomy
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respect patients as individuals and their preferences
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beneficience
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act in patients best interest, as long as patients can make informed decision they have right to decide
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nommaleficience
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do no harm (surgery exception)
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justice
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treat persons fairly
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medicare
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elderly
A:hospital B: bills |
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medicaid
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poor
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reportable diseases
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Hep A
Hep B Hep C HIV Salmonella Shigella Syphilis Measles Mumps AIDS Rubella TB Chicken pox Gonorrhea |
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Leading causes of death: infants
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congenital anomalies, short gestation/low birth weight, sudden infant death syndrome, maternal complications of pregnancy, respiratory distress sydrome
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Leading causes of death: 1-14
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injuries, cancer, congenital anomalies, homicide, heart disease
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Leading causes of death: 15-24
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injuries, homicide, suicide, cancer, heart disease
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Autonomy
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respect patients as individuals and their preferences
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beneficience
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act in patients best interest, as long as patients can make informed decision they have right to decide
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nommaleficience
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do no harm (surgery exception)
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justice
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treat persons fairly
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medicare
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elderly
A:hospital B: doctor bills |
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medicaid
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poor
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reportable diseases
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Hep A
Hep B Hep C HIV Salmonella Shigella Syphilis Measles Mumps AIDS Rubella TB Chicken pox Gonorrhea |
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Leading causes of death: infants
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congenital anomalies, short gestation/low birth weight, sudden infant death syndrome, maternal complications of pregnancy, respiratory distress sydrome
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Leading causes of death: 1-14
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injuries, cancer, congenital anomalies, homicide, heart disease
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Leading causes of death: 15-24
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injuries, homicide, suicide, cancer, heart disease
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Leading causes of death: 25-64
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cancer, heart disease, injuries, suicide, stroke
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Leading causes of death: 65+
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heart disease, cancer, stroke, COPD, pneumonia, influenza
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Informed consent
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discuss pertinent info, patients agreement to plan, freedom from coercion
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consent for minors
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parent consent needed unless married or emancipated
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exceptions to informed consent
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patient lacks ability/legally incompetent, implied in emergency, therapeutic privilege (withhold info bc disclosure would cause sever harm), waiver
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Changes in elderly- sexual
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Men- slower erection/ejac, longer refractory period
women- vaginal shortening, thinning and dryness no decrease in sexual interest |
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changes in elderly- sleep
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decrease REM, slow wave
increase: latency, # awakenings per night |
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Elderly- common medical conditions
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arthritis, HT, heart disease, osteoporosis
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Elderly- psych disorders
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lower prevalence among healthy elderly than any other life stage
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Elderly- suicide
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increase rate in males 65-74
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Elderly- other changes
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decreased vision, hearing, immune response, bladder, renal/pulmonary/gi fx
decreased muscle mass, increased fat |
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stress effects
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induces production of FFA, 17 OH corticosteroids, lipids, cholesterol, catecholamines; affect water absorption, muscular tonicity, gastrocolic reflex, mucosal circulation
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sexual dysfx
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Differential dx:
1. drugs (antiHT, neuroleptics, SSRI's, ethanol) 2. diseases (depression, diabetes) 3. psychological (performance anxiety) |
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BMI
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weight (kg)/ [height(m)* height(m)]
<18.5 = underweight 18.5-25 = normal 25-30 = overweight >30 = obese |
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Narcolepsy
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sleep/wake cycle disorder
hynogoic/hypnapompic hallucinations start off with REM sleep NO OREXIN cataplexy- loss of muscle tone following strong emotional stimulus strong genetic component give stimulants |
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Sleep stages- EEG findings
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awake: beta
eyes closed: alpha NREM: 1:theta 2:spindles & K complexes 3-4: delta REM: beta (high freq low amplitude) |
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Sleep stages- Description
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1- Light sleep
2- deeper sleep 3:4- slow wave sleep, deepest NREM sleep, sleepwalking, night terrors, bed wetting REM: loss of motor tone, memory processing fx, erections, increase brains use of oxygen |
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REM sleep
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increase/variable pulse & bp, penile/clitoral tumescence,
every 90 minutes increases during night ACH principle NT ("REM ON") decreases with age |
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Sleep Stages- general info
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1. 5HT of raphe nucleus key to sleep initiation (?)
2. NE reduces REM sleep 3. Extraocular movements during REM due to PPRF 4. REM has same EEG as awake- "paradoxical sleep" 5. Benzo's shorten stage 4- useful for night terrors 6. Imipramine (TCA) treats enuresis by decreasing stage 4 as well |
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Toddler- motor milestones/cognitive social milestones
18-24 mos: |
stacks 6 blocks/ rapprochement
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Toddler- motor milestones/cognitive social milestones
12-24mo: |
climbs stairs, stacks 3 blocks/
object permanence, 200 words, '2 word sentences at age 2' |
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Infant- motor milestone/cognitive social milestone
Birth-3mo: |
rooting reflex
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Infant- motor milestone/cognitive social milestone
3mo: |
holds head up, moro reflex disappears/ social smile
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Infant- motor milestone/cognitive social milestone
4-5mo: |
rolls to back, sits when propped/ recognizes people
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Infant- motor milestone/cognitive social milestone
7-9mo: |
sits alone, crawls/ stranger anxiety, orients to voice
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Infant- motor milestone/cognitive social milestone
15 mo: |
walks/ few words, separation anxiety
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Toddler- cognitive social milestones
24-48 mos: |
parallel play
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Toddler-cognitive social milestones
24-36mos: |
core gender identity
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Preschool motor milestone/cognitive social milestone
30-36 mos: |
stacks 9 blocks (number of blocks stacked = age in years x 3)
toilet trained ("pee at 3") |
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Preschool motor/ cognitive social milestones
3yrs |
rides tricycle (rides 3 cycle at age 3); copries line or circle drawings
900 words and complete sentences |
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Preschool motor/ cognitive social milestones
4yrs |
simple drawings (stick figure), hops on 1 foot
cooperative play, imaginary friends, grooms self, brushes teeth |
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School Age
6-11 |
Reads, understands death
development of conscience (superego), same sex friends, id with same-sex parent |
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Adolescence (puberty)
11 girls 13 boys |
abstract reasoning (formal operations), formation of personality
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