Exam 4

Front 1

Amniocentesis

Back 1

A test whereby the physician withdraws a sample of amniotic fluid (the fluid surrounding the developing fetus inside the mother’s womb) from the uterus of a pregnant woman. The fluid is then tested for genetic or other conditions that may lead to abnormal development of the fetus.

Front 2

Artificial Insemination

Back 2

The mechanical injection of viable semen in the vagina.

Front 3

Chromosome

Back 3

A microscopic structure found within the nucleus of all living cells that carries genes responsible for the organism’s characteristics.

Front 4

Clone

Back 4

An organism produced asexually, usually from a single cell of the parent.

Front 5

Cloning

Back 5

The process by which organisms are created asexually, usually from a single cell of the parent organism.

Front 6

DNA (deoxyribonucleic acid)

Back 6

The combination of proteins, called nucleotides, that is arranged to make up an organism’s chromosomes.

Front 7

Emancipated minor

Back 7

Individuals in their mid- to late teens who legally live outside parents’ or guardians’ control.

Front 8

Gene

Back 8

A tiny segment of DNA found on a chromosome within a cell’s nucleus. Each gene holds the formula for making a specific enzyme or protein.

Front 9

Gene therapy

Back 9

Treating harmful genetic diseases or traits by eliminating or modifying the harmful gene.

Front 10

Genetic counselor

Back 10

An expert in human genetics who is qualified to counsel individuals who may have inherited genes for certain diseases or conditions.

Front 11

Genetic discrimination

Back 11

Differential treatment of individuals based on their actual or presumed genetic differences.

Front 12

Genetic engineering

Back 12

Manipulation of DNA within the cells of plants, animals, and other organisms through synthesis, alteration, or repair to ensure that certain harmful traits will be eliminated in offspring and that desirable traits will appear and be passed on.

Front 13

Genetics

Back 13

The science that accounts for natural differences and resemblances among organisms related by descent.

Front 14

Genome

Back 14

All the DNA in an organism, including its genes.

Front 15

Heredity

Back 15

The process by which organisms pass genetic traits on to their offspring.

Front 16

Heterologous artificial insemination

Back 16

The process in which donor sperm is mechanically injected into a woman’s vagina to fertilize her eggs.

Front 17

Homologous artificial insemination

Back 17

The process in which a husband’s sperm is mechanically injected into his wife’s vagina to fertilize her eggs.

Front 18

Human Genome Project

Back 18

A scientific project funded by the U.S. government, begun in 1990 and successfully completed in 2000, for the purpose of mapping all of a human’s genes.

Front 19

Infertility

Back 19

The failure to conceive for a period of 12 months or longer due to a deviation from or interruption of the normal structure or function of any reproductive part, organ, or system.

Front 20

In vitro fertilization (IVF)

Back 20

Fertilization that takes place outside a woman’s body, literally “in glass”, as in a test tube.

Front 21

Mature minors

Back 21

Individuals in their mid- to late teens who, for health care purposes, are considered mature enough to comprehend a physician’s recommendations and give informed consent.

Front 22

Multipotent stem cells

Back 22

Stem cells that can become a limited number of types of tissues and cells in the body.

Front 23

Mutation

Back 23

A permanent change in DNA.

Front 24

Parens patriae

Back 24

A legal document that gives the state the authority to act in a child’s best interest.

Front 25

Pluripotent stem cells

Back 25

Stem cells that can become almost all types of tissues and cells in the body.

Front 26

Safe haven laws

Back 26

State laws that allow mothers to abandon newborns to designated safe facilities without penalty.

Front 27

Stem cells

Back 27

Cells that have the potential to become any type of body cells.

Front 28

Surrogate mother

Back 28

A woman who becomes pregnant, usually by artificial insemination or surgical implantation of a fertilized egg, and bears a child for another woman.

Front 29

Xenotransplantation

Back 29

Transplantation of animal tissues and organs into humans.

Front 30

Active euthanasia

Back 30

A conscious medical act that results in the death of a dying person.

Front 31

Brain death

Back 31

Final cessation of bodily activity, used to determine when death actually occurs; circulatory and respiratory functions have irreversibly ceased, and the entire brain (including the brain stem) has irreversibly ceased to function.

Front 32

Coma

Back 32

A condition of deep stupor from which the patient cannot be roused by external stimuli.

Front 33

Curative care

Back 33

Treatment directed toward curing a patient’s disease.

Front 34

Do-not-resuscitate (DNR) order –

Back 34

Orders written at the request of patients or their authorized representatives that cardiopulmonary resuscitation not be used to sustain life in a medical crisis.

Front 35

Durable power of attorney –

Back 35

An advance directive that confers upon a designee the authority to make a variety of legal decisions on behalf of the grantor, usually including health care decisions.

Front 36

Health care proxy –

Back 36

A durable power of attorney issued for purposes of health care decisions only.

Front 37

Hospice

Back 37

A facility or program (often carried out in a patient’s home) in which teams of health care practitioners and volunteers provide a continuing environment that focuses on the physical, emotional, and psychological needs of the dying patient.

Front 38

Involuntary euthanasia

Back 38

The act of ending a terminally ill patient’s life by medical means without his or her permission.

Front 39

Living will

Back 39

An advance directive that specifies an individual’s end-of-life wishes.

Front 40

National Organ Transplant Act –

Back 40

Passed in 1984, a statute that provides grants to qualified organ procurement organizations and established an Organ Procurement and Transplantation Network.

Front 41

Palliative care

Back 41

Treatment of a terminally ill patient’s symptoms to make dying more comfortable; also called comfort care.

Front 42

Passive euthanasia

Back 42

The act of allowing a dying patient to die naturally, without medical interference.

Front 43

Patient Self-Determination Act

Back 43

A federal law passed in 1990 that requires hospitals and other health care providers to provide written information to patients regarding their rights under state law to make medical decisions and execute advance directives.

Front 44

Persistent vegetative state (PVS)

Back 44

Severe mental impairment characterized by irreversible cessation of the higher functions of the brain, most often caused by damage to the cerebral cortex.

Front 45

Terminally ill

Back 45

Referring to patients who are expected to die within six months.

Front 46

Thanatology

Back 46

The study of death and of the psychological methods of coping with it.

Front 47

Uniform Anatomical Gift Act –

Back 47

A recommendation of the National Conference of Commissioners on Uniform State Laws, that all states accepted, allowing individuals to donate their bodies or body parts, after death, for use in transplant surgery, tissue banks, or medical research or education.

Front 48

Uniform Determination of Death Act

Back 48

A proposal that established uniform guidelines for determining when death has occurred.

Front 49

Uniform Rights of the Terminally Ill Act

Back 49

A 1989 recommendation of the National Conference of Commissioners on Uniform State Laws that all states construct laws to address advance directives.

Front 50

Voluntary euthanasia

Back 50

The act of ending a dying patient’s life by medical means with his or her permission.

Front 51

Access

Back 51

The availability of health care and the means to purchase health care services.

Front 52

Agency for Healthcare Research and Quality (AHRQ)

Back 52

The lead federal agency responsible for tracking and improving the quality, safety, efficiency, and effectiveness of health care for Americans.

Front 53

Baby boom generation

Back 53

Those individuals born between 1946 and 1964.

Front 54

Cost

Back 54

The amount individuals, employers, state and federal governments, HMOs, and insurers spend on health care in the United States.

Front 55

Epigenetics

Back 55

The study of changes in gene activity that do not involve alterations to the genetic code, but are still passed down to at least one successive generation.

Front 56

Genometrics

Back 56

The science of determining how genes cause the expression of certain traits in individuals.

Front 57

Gross domestic product (GDP)

Back 57

The total value of goods produced and services provided in a country during one year.

Front 58

Life expectancy

Back 58

The number of years an individual can expect to live, calculated from his or her birth.

Front 59

Life span

Back 59

The number of years an individual actually lives.

Front 60

Medical management

Back 60

The management of patient care and populations.

Front 61

Personalized medicine

Back 61

The products and services that leverage the science of genomics and proteomics and capitalize on the trends toward wellness and consumerism to enable tailored approaches to prevention and care.

Front 62

Pharmacogenomics

Back 62

The science that defines how individuals are genetically programmed to respond to drugs.

Front 63

Proteomics

Back 63

The study of the proteins that genes create or “express.”

Front 64

Quality

Back 64

The degree of excellence of health care services offered.

Front 65

Stakeholders

Back 65

Those who have a vested interest in the health care industry in the United States, and in any efforts to reform the industry.

Front 66

State Children’s Health Initiative Program (SCHIP)

Back 66

A program enacted by the Balanced Budget Act of 1997 to help low-income children under 19 who are not covered by Medicaid.

Front 67

Define: IVF

Back 67

FLIP

- In vitro fertilization= fertilization that takes place outside a woman’s body, literally “in glass”, as in a test tube.

Front 68

Discuss “stem cell research”: What stage of cellular development is best for the process?

Back 68

FLIP

- Early-stage human embryos, called blastocysts, consist of about 20 cells and are considered valuable for research because they are composed of stem cells. These early embryonic cells have the potential to become any type of body cell. Interest in this type of research, the therapeutic use of stem cells, remains intense because stem cells have shown promise for treating patients with a wide variety of medical problems.

Front 69

What are the ethical implications of a physician withholding care for a newborn? In what circumstances might it be permissible under the law?

Back 69

FLIP

Physicians may legally withhold treatment, including food and water, from infants who are chronically and irreversibly comatose, will most certainly die and for whom treatment is considered futile, would suffer inhumanely if treatment were provided. Ethical implications= should the federal government intrude into physicians’ and parents’ decisions with imposed regulations? Is it ever in an infant’s best decision to die, or should medical treatment be administered regardless of the probable outcome? Is quality of life an issue that can ethically be considered?

Front 70

Define: DNA

Back 70

FLIP

DNA= deoxyribonucleic acid) = the combination of proteins, called nucleotides, that is arranged to make up an organism’s chromosomes.

Front 71

Discuss the federal laws surrounding the protection from genetic discrimination:

Back 71

FLIP

HIPAA prevents health insurers from denying coverage based on genetic information, but only applies to individuals moving between health insurance plans. The American’s with Disabilities Act offers some protection against genetic discrimination in the workplace. Protects those who have a genetic condition or disease, or is regarded as having a disability, against discrimination. Applies to anyone who is discriminated against on the basis of genetic info relating to illness, disease, conditions, or other disorders. A person with disability cannot be denied insurance or be subject to different terms or conditions of insurance based on disability alone, if the disability does not pose an increased risk.

Front 72

Define: amniocentesis:When is it performed?

Back 72

FLIP

Amniocentesis= a test whereby the physician withdraws a sample of amniotic fluid (the fluid surrounding the developing fetus inside the mother’s womb) from the uterus of a pregnant woman. The fluid is then tested for genetic or other conditions that may lead to abnormal development of the fetus. It is performed between 16 to 18 weeks into pregnancy (early stage of second trimester)

Front 73

Discuss the ethical issues of genetic testing:

Back 73

FLIP

The use of test results, for example expecting mother finds out baby has Down syndrome, should they consider aborting the fetus? Young man finds out he has Huntington, should he not have kids to not pass on the gene? And the issue of privacy, for instance, should employers and health and life insurance companies have access to genetic test results?

Front 74

Define the process of cloning :

Back 74

FLIP

Produced asexually, an organism is grown from a single cell of the parent, so it is genetically identical to the parent. Scientist use a process called nuclear transfer to clone the subject from the parent cell.

Front 75

List the goals of the Human Genome Project :

Back 75

FLIP

Goals of the human genome project= to locate and map the location of each gene on all 46 chromosomes and to create a data bank of the info that would be available to all scientist or physicians who could use it.

Front 76

List the goals of genetic engineering:

Back 76

FLIP

- Goals of genetic engineering= to manipulate DNA within the cells of plants, animals, and other organisms to ensure that certain advantageous traits will appear and be passed on, or that certain harmful traits are eliminated.

Front 77

Define xenotransplantation:

Back 77

FLIP

Xenotransplantation= transplantation of animal tissues and organs into humans.

Front 78

Define: parens patriae:

Back 78

FLIP

Parens patriae= a legal doctrine that gives the state the authority to act in a child’s best interest.

Front 79

Discuss the federal laws that affect some aspect of adoption:

Back 79

FLIP

Generally adoption is more regulated by state law but these are federal regulations that affect it as well = The Adoption Assistance and Child Welfare Act of 1980, the Child Abuse Prevention and Treatment and Adoption Reform Act, and the Indian Child Welfare Act all contain certain provisions that pertain to adoptive parents and their children. Adoptions of Native American children, however are governed by the Indian Child Welfare Act, and the act’s provisions outline specific rules and procedures that must be followed if the adoption of a native American child is to be approved.

Front 80

Discuss stems cells and how they are used in genetic engineering:

Back 80

FLIP

Since the stem cells can become any type of body cell, they are used to treat patients with a variety of medical problems. For example, skin tissues grown from stem cells could replace burned tissue, and cultivated cardiac tissue might help damaged arteries and hearts.

Front 81

Define: brain death:

Back 81

FLIP

Final cessation of bodily activity, used to determine when death actually occurs; circulatory and respiratory functions have irreversibly ceased, and the entire brain (including the brain stem) has irreversibly ceased to function.

Front 82

List and understands the stages of grieving as defined by Kubler-Ross:

Back 82

FLIP

Stage 1=denial and isolation. Stage 2= anger. Stage 3=bargaining. Stage 4= depression. Stage 5=acceptance.

Hint 82

Front 83

Understand the acts and decisions surrounding the right to refuse medical tx:

Back 83

FLIP

It’s part of the patients’ rights to be able to refuse medical treatment.

Front 84

Discuss the Patient Self-Determination Act:

Back 84

FLIP

Patient self-determination act was passed in 1990 and took effect in December 1, 1991. The act requires hospitals and other health care providers to provide written information to patients regarding their rights under state law to make medical decisions and execute advance directives.

Front 85

Discuss the philosophy of hospice care:

Back 85

FLIP

Hospice care focuses on relieving pain, controlling symptoms, and meeting emotional needs and personal values of the terminally ill, instead of targeting the underlying disease process. The hospice philosophy also recognizes the family members and other caregivers deserve care and support, continuing after death of the patient. Hospice programs ease dying; they do not support active euthanasia or assisted suicide.

Front 86

Discuss the Uniform Determination of Death Act:

Back 86

FLIP

Uniform determination of death act= a proposal that established uniform guidelines for determining when death has occurred.

Front 87

Define “thanatology”:

Back 87

FLIP

Thanatology= the study of death and of the psychological methods of coping with it.

Front 88

What is the physician’s responsibility in the release of confidential information with or without the patient’s consent?

Back 88

FLIP

Responsible to make sure the patients private information is safe from unauthorized parties and to inform the patient if their information was released without their consent whether due to mistake or on purpose, for example subpoenaed.

Front 89

Define: “stakeholders” in the American health care system; who are they?

Back 89

FLIP

Stakeholders= those who have a vested interest in the health care industry in the united states, and in any efforts to reform the industry. Include, but are not limited to: the public, employers, health care facilities and practitioners, federal state and local governments, managed care organizations, private insurers, voluntary facilities and agencies that provide health care or influence health care policies, health care practitioner training institutions, professional associations and other health care industry organizations, medical biotechnological pharmaceutical and other health care companies.

Front 90

Compare Medicare with Medicaid; why were they set in place?

Back 90

FLIP

Medicare was in place to provide help with health care costs for seniors, and Medicaid provided aid for lower-income and unemployed individuals.

Front 91

Define “surrogacy” and distinguish between the two main types:

Back 91

FLIP

Surrogacy= a woman who cannot carry an embryo to term employs a surrogate mother, which is a woman who becomes pregnant, usually by artificial insemination or surgical implantation of a fertilized egg, and bears a child for that woman. Two types are gestational surrogacy (if the surrogate is not genetically related to the embryo) and traditional surrogacy ( if surrogate contributes eggs to produce the embryo or is related to either husband or wife)

Front 92

Define “euthanasia” – distinguish between the various types:

Back 92

Front 93

Define Durable Power of Attorney. Why and when is it used?

Back 93

FLIP

It confers upon a designee the authority to make a variety of legal decisions on behalf of the grantor. It takes effect when the grantor loses the capacity to make decisions, through either unconsciousness or mental incompetence.

Front 94

Discuss health care forecasts mentioned in this text in regards to cost, assess and quality.

Back 94

Pg 395, 402, 403, 404, 405

Front 95

Name the four (4) major provisions of the Anatomical Gift Act.

Back 95

FLIP

Hint 95