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36 Cards in this Set
- Front
- Back
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how do you prep for the exam
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reflect on your approach
know tasks before entering the room wash hands IN FRONT of the pt adjust for noise and lighting |
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describe proper draping
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only expose necessary part and recover when finished
allow pt to control the gown and hseet avoid words like pull down slip in and feel-- try find place locate remove or lower |
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what is the typical sequence of manuevers
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inspect
palpate percuss auscultation |
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give an overview of sequencing
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order of manuevers
head to toe regional systems patient centered-- least to most uncomfortable and batch tools |
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what is the rule of 1/3
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applies to older adults
1/3 disease 1/3 age 1/3 disuse |
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what are some "hidden illnesses" to discuss with older patients
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depression
hearing loss dental nutrition sexual dysfunction |
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list 4tests of congnititon you can use
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MMSE mini mental status exam
clock drawing animal fluency SLUMs mental status |
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compare and dementia and delirium
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delirium- acute, with varying levels of consciousness, abrupt onet, disoriented, short attention span, agitation, medical emergency
dementia-- gradual onset, multiple cognitive probs, consciousness ok, disorientation later, not agitated, NOT a medical emergency |
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describe the MMSE
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orientation-- what day is it?
registration-- 3 unrelated object attention/calculation-- count back from 100 by 7s, spell world backwards recall-- three words from before |
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how many points do you need to pass MMSE
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24
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define decision making capacity
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patient understands relevant info, consequences, and can communicate their choice
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when do you use power of attorney
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formally documented medical decision used when patient can't make own decisions
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define surrogate judgement
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decisions made based knowledge of what they would want for themselves
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define substituted judgement
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decisions based on goa's and values used
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when do you use substituted judgement
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when there is no knowledge of what the patient would ahve watned in a given situation
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what is the four box model
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medical indications
patient preferences quality of life context |
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what are the tactics of abuse
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isolation
inteimidation emotial abuse minimize, lie, blame kids eocnomics coercision and threats societal oppression and privilege cultural abuse spritual abse |
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try to name the eight things on the power and control physical and sexual violence rule
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economics
kids emotions privilege coercsion intimidation minimizing, deny, blame |
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what are some general barriers to leaving abusive relationship
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doesn't recognize it as abuse
embarassed or ashames it's her ault financial down't think anyone will beleive her marriage vows religious reasons hope fear of retaliation staying for kids earlier futiele attemps loves him just wants abuse to stop believes he will change unaware of resources social stigma |
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what are other barriers that further marginilze abuse victims
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women of color
rural lgbtq rural disability |
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how many times on average do you have to ask an abuse victim before she discloses
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6 to 8 times
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what is IPV
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intimate partner violence
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what is the golden rule of asking about abuse
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only ask if the pt is alone
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what four things do you need to do when the pt discloses abuse
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listen
believe affirm offer help! |
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define adolescence
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secondary sex char to end of growth
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legally the parent is responsible until the teen is ___ years
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18
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HEADSS
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home
education activities drugs sex suicide |
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what is CAGE
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cut down?
annoyed by criticism by others? guilty about drugs or alcohol? eye- opener? |
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CRAFFT-- how many for positive screen?
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ridden in CAR?
alone? forget? friends think you need to cut back? trouble? two yes = positive screen |
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at what age do you teach self breast exam? testicular exam?
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18
16 |
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what is the AMA's definition of physician impairment
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inability to practice medicine with reasonable skill and safety to pts by reason of physial r mental illness including problems with drugs or alcohol
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what is the prevelance of drugs and alcohol among physicians
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same as general public
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what is the prevelance of benzos and weaker opiods in physicians
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higher because of access
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what specialties are at greatest risk
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rural
psych anesthesia |
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define substance abuse
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use + consequences + repeat
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define substance dependence
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use + neuroadaptation
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