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79 Cards in this Set

  • Front
  • Back
what type of prevention is preventing disease occurence
primary disease prevention
what type of prevention is early detection of disease
secondary disease prevention
what type of prevention prevents disablity of disease
tertiary disease prevention
important prevention measures for diabetes
eye, foot exam, urine test
important prevention for drug use
hepatitis immunizations, HIV, TB tests
important prevention for alcohlism
influenza, pneumococcal immunizations, TB test
important prevention for overweight
blood sugar test for diabetes
important immunization for homeless, recent immigrant, inmate
TB test
high-risk sexual behavior prevention tests
HIV, heaptitis B, syphilis, gonorrhea, chlamydia test
name the reportable infectious diseases (12)
hep A, hep B, gonorrhea, syphilis, AIDS, chickenpox, measles, mumps, rubella, TB, salmonella, shigella
is HIV infection reportable?
depends on the state
leading cause of death in infants
congenital abnormalities, SIDS, respiratory distress syndrome
leading cause of death age 1-14
accidents, cancer, congenital abnormalities, homicide
leading cause of death 15-24
accidents, homicides, suicides
leading cause of death 25-64
cancer, heart disease, accidents, injuries
leading cause of death 65+
heart disease, cancer, stroke
medicare part A
medicare part B
doctor's bills
obligation to respect patient and to honor their preferences in medical care
oral advance directive
prior oral statements used as guide - difficulties in interpretation
what makes oral advance directive more valid?
patient was informed, directive is specific, patient made a choice, decision was repeated over time
define living will
patient directs physician to withdraw life-sustaining treatment if develops terminal disease or is in persistent vegitative state
define durable power of attorny
patients designates surrogate to make medical decisions if loses decision-making capacity. surrogate has power until revoked by patient.
what has precedence: living will or durable power of attorny
durable power of attorney
do no harm. but if benefits > risks, patient can make informed consent decsion
physician has obligation to act in patients best interest but patient has right to decide
exceptions to confidentiality (5)
potnetial harm to others, potential harm to self, no alternative measures exist to warn those at risk, child/elder abuse, impaired automobile driver
confidentiality in infectious disease
warn public officials and people at risk
what is the tarasoff decision
law requiring physicians to directly inform and protect those from harm
3 D's of malpractice
dereliction, damage, direct (breach of duty caused harm)
what is the most common factor leading to litigation?
poor patient-physician relationship
situation: patient is noncompliant
work to improve patient-physician relationship
situation: patient has difficulty taking meds
provide written instructions, attempt to simplify regimen
situatoin: family members ask for prognosis
do not give without permission of patient
situation: 17 year old girl wants abortion
need to get parental consent
situation: terminally ill patient wants physician assisted suicide
illegal but physiican can give indirectly give painkillers that patient can use to kill themselves
patient finds you attractive
direct, close-ended questions, chaperone. never appropriate
patient refuses necessary procedure
attempt to understand, address concerns
patient wants unnecssary procedure
avoid doing unnecssary procedures
patient is angry about time in waiting room
apologzie but don't give explanation
patient is upset about way he was treated by another doctor
tell him to directly talk to other doctor, if staff: say will talk to staff personally
child wishes to know more about illness
ask child what parent told him. parents decide how much information is given.
patient continues to smoke
ask how patient feels about smoking, offer advice only if patient wants to quit
APGAR score components
appearance, pulses, grimace, activity, respiration
low birth weight definition
<2500 grams, greater incidence physicial and emotional problems, prematurity or intrauterine growth retardation
what are complications of low birth weight (5)
infections, respiratory distress syndrome, necrotizing enterocolitis, intraventircular hemorrhage, persistent fetal circulation
how long until infant deprivation leads to irreversible changes
>6 months
7 consequences of infant deprivation of affection
decrease muscle tone, poor language skills, poor socialization, poor trust, anaclitic depression, weight loss, physical illness
define anaclitic depression
failure to thrive, withdrawn, unresponsive
when do children display regression behavior?
when udner stress: physical illness, punishment, birth of new sibling, tiredness
child abuse evidence
healed fractures, cigarette burns, subdural hematomas, multiple bruises, retinal hemorrhage/detachment
who primarily causes child abuse
primary caretaker (female)
who primarily causes sexual abuse of children?
male who knows victim
what are 3 signs of sexual abuse of children
uti, std, genital/anal trauma
age when infant holds head up, moro reflex disappears, social smile
3 months
age when infant rolls front to back, sits when propped, recognizes people
4-5 months
age when infant sits alone, crawls, stranger anxiety, orients to voice
7-9 months
age when babinski disappears
12-14 months
age when child walks, says few words, separation anxiety
15 months
age when infant climbs stairs, stacks 3 blocks, object permanence
12-24 months
age when child stacks 6 blocks and rapprochement
18-24 months
age when child has parallel play
24-48 months
age when child has core gender identity
24-36 months
age when child stacks 9 blocks, toilet trains
30-36 months
age when child rides tricycle, copies line/circle, group play
3 years
age when child makes simple drawings, hops on one foot, cooperative play, imaginary friends
4 years
age when child reads, understands death, develops conscience, same-sex friends, ID w/ same-sex parents
6-11 years old
age of puberty in boys and girl
13, 11
milestones in puberty
abstract reasoning, formation of personality
does sexual interest decrease in elderly?
what are some sexual changes in elderly men?
slower erection/ejaculation, longer refractory period
what are some sexual changes in elderly women?
vaginal shortening, thinning, dryness
what are some changes in sleep patterns in elderly?
decrease REM sleep, decrease slow-wave sleep, increase sleep latency, increase awakenings at night
what are some common elderly medical problems
hypertension, arthritis, heart disease, osteoporosis
describe psychiatric conditions in elderly
more prevalent, more suicides
does intelligence decrease in elderly?
how long does normal grief last
6 months to 1 years
what is the normal grief response
shock, denial, guilt, somatic symptoms, illusions
define pathologic grief
excessively intense or prolonged grief or grief that is delayed/denied/inhibited. may have depression, delusions, hallucinations