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29 Cards in this Set

  • Front
  • Back
1. Mature Minor doctrine/rule (judicial Bypass)?
a. A minor may consent to receive medical care w/o the consent of the parents or guardian if deemed “mature” by the judicial system.
2. 4 moral principles of ethics?
i. Autonomy
ii. Beneficence
iii. Nonmaleficence
iv. Justice
3. Justice?
a. Just implies the fair and nonbiased treatment of the patient regardless of age, sex, or ethnicity.
b. Consequently, adolescent patients should be given the same level of care as adults without having the fear of disclosure, when they are mentally capable of receiving care.
1. Anaemia definition for men and women according to the WHO?
a. Haemoglobin of:
1. Women: <12
2. Men: <13
2. Symptoms, commonly reported by elderly people with anemia?
a. Fatigue
b. Weakness
c. Dyspnea
3. Note: anaemia may result in worsening the symptoms of other underlying conditions for example, the reduced oxygen-carrying capacity of the blood of the consequences anaemia may exacerbate dyspnea associated with CHF.
3. Note: anaemia may result in worsening the symptoms of other underlying conditions for example, the reduced oxygen-carrying capacity of the blood of the consequences anaemia may exacerbate dyspnea associated with CHF.
4. What is considered a reliable sign of anaemia in the elderly?
a. Conjunctival pallor
5. Signs of B12 deficiency anaemia?
a. Glossitis
b. Decreased vibratory and positional senses
c. Ataxia
d. Parasthesia
e. Confusion
f. Dementia
g. Pearly grey hair at an early age
6. What type of anaemia may produce Koilonychias?
a. Fe-Deficient.
7. Other clinical manifestations of anaemia?
a. Jaundice- May be a clue that haemolysis is a contributing factor.
b. Splenomegaly- Can indicate that a thalassemia or neoplasm may be present.
8. What can be used to confirm B12 deficiency?
a. Elevated Methylmalonic Acid (MMA) level.
9. In whom is folate deficiency anaemia most commonly seen?
a. Alcoholics
10. Most common cause of a normocytic anaemia in the elderly?
a. Anaemia of chronic inflammation (formerly anaemia of chronic disease).
11. Pathphys of anaemia of chronic inflammation?
a. The body’s iron stores are normal, but the capability of using the stored iron in the reticuloendothelial system becomes decreased.
12. Clues to anaemia of chronic inflammation?
a. A lack of improvement in symptoms and hemoglobin w/iron supplementation.
13. RBC size w/ anaemia of chronic inflammation?
a. Microcytic or normocytic.
14. Other causes of normocytic anaemia?
a. Renal insufficiency due to decreased erythropoietin production.
15. Gold standard for differentiating between iron-deficiency anaemia and anaemia of chronic inflammation?
a. Bone marrow iron stores
b. Although, simple serum testing is still used to diagnose and differentiate these two types of anaemia.
16. Serum Iron, TIBC, Transferrin saturation, and serum ferritin in Iron deficiency anaemia?
a. Serum Iron: low
b. TIBC: high
c. Transferrin saturation: low
d. Serum ferritin: low
17. Serum Iron, TIBC, Transferrin saturation, and serum ferritin in Anaemia of Chronic Inflammation?
a. Serum Iron: Low or normal
b. TIBC: Low
c. Transferrin saturation: Low or normal
d. Serum ferritin: Normal or high.
18. Commonly used threshold for transfusion?
a. Anaemia of <7, however may be indicated at a higher level if the person has comorbid conditions such CAD.
19. Typical tx of iron-deficient anaemia?
a. Ferrous sulfate 325 tid.

b. Parenteral iron preparations are available for those w/poor iron absorption and high iron replacement needs.
20. Tx of B12 deficiency?
a. IM B12 1000 ug IM daily for 7 days,
b. Then weekly for 4 weeks,
c. Then monthly for the rest of the patient’s life.
d. Newer research shows that many pts can be successfully treated w/oral B12 therapy using 1000-2000 ug po in a similar fashion.
21. Tx folate deficiency anaemia?
a. 1 mg daily until the deficiency is corrected.
22. Tx of anaemia of chronic inflammation?
a. Primarily managed by tx of the underlying condition.
23. Indication for anaemia workup in elderly pt on physical exam?
a. Conjunctival pallor.
b. Clinical findings of anaemia require investigation for underlying causes.
24. What is mandated by findings of GI bleeding (ie + guaiac) in elderly pts?
a. GI workup- EGD and colonoscopy.
25. Note: Investigating for B12 and folate deficiency is of high importance in a pt w/a hx of heavy EtOH intake and/or abuse.
25. Note: Investigating for B12 and folate deficiency is of high importance in a pt w/a hx of heavy EtOH intake and/or abuse.
26. Complete
26. Complete