Associated Clinical Science (ACS) part 2 Flashcards
(234 cards)
1
Q
In a malpractice suit, what must be included?
A
Duty Dereliction (act average) Damage Direct Causation (or just causation) You are tried according to common law and precedent
2
Q
What is a standard of care?
A
doctor is accountable for “average care”
affected by advertising, specialization (diplomat, courses, technology changes)
obligated to diagnose, reasonable
3
Q
What is a breech of contract?
A
promising a cure (not cured)
abandonment (no “cover” dr.)
exceed consent
confidentiality (telephone, waiting room)
doctor is help vicariously responsible (unless you script them)
4
Q
What is a tort/tort feasance?
A
wrongful act
societal expectations
5
Q
What are some criminal charges seen with chiropractors (RARE)?
A
adjusting without permission is assault and battery
sexual misconduct
theft
6
Q
What are most common civil suits seen with chiropractors?
A
personal damages and duress (emotional, financial, etc.)
malpractice
breech of contracts
tort
7
Q
With a minor, who needs to give consent?
A
parental figures
8
Q
For a patient with alzheimer’s, disabled, impaired, who needs to give consent?
A
A gaurdian
9
Q
When do you give informed consent?
A
risks and options after ROF
10
Q
Who gets implied consent?
A
those in an accident
11
Q
Does an experimental or research study need consent?
A
YES
12
Q
What is a statute of limitations?
A
period of time to file (7 years- adult) up to age of 18 years for minors
13
Q
in a 1040 ES form as sole proprietor, how often do you estimate and pay taxes?
A
quarterly
14
Q
In a benefits assignment, a patient agrees to what?
A
patent agrees to have insurance monies sent to doctor
15
Q
What do state board of examiners/members do?
A
protect citizens and are selected by a governor
16
Q
What is binding arbitration?
A
no appeal process
17
Q
What is malfeasance?
A
wrong act
18
Q
What is res ipsa loquitur?
A
the things speaks for itself
19
Q
What is vicarious liability?
A
doctor is responsible for employee’s action
20
Q
What is direction examination?
A
questioning from the defense (doctor’s attorney)
21
Q
What is cross examination?
A
questioning from the plaintiff (patients attorney)
22
Q
What is comparative negligence?
A
doctor and patient share damage responsibility
23
Q
What is Voir Dire?
A
to speak the truth (for prospective juror impartiality)
24
Q
What is premium Non Nocere?
A
first do no harm
25
What are anxiolytic drugs?
- thorazine, chlorpromazine, benzodiazepine, clomipramine ("zine-pine-mine")
- lorazepam, alprazolam, citalopram ("ram-pam-lam")
- Haldol (anti anxiety drug)
- Tranquilizers (librium and valium)
26
What are different types of blood thinners?
```
Heparin
Coumadin
Vitamins C & E
Warfarin
Aspirin
Dicoumarol
"In's thins the blood"
(internal hemorrhage is potential concern, avoid vitamins K because it helps you clot)
```
27
What is a common sedative or hypnotic drugs?
barbituates- sleeping pills, respiratory depressant, miosis
28
What are common mushrooms?
psilocybin- hallucinogenic (ex. PCP)
| muscarine- poison
29
What is carbon monoxide gas commonly from?
motors, cigarettes and cars
30
What is nitrogen oxide gas commonly from?
cigarette and plants
31
What is nitrous oxide gas commonly from?
anesthetic (laughing type gas; got everyone slightly high in the office...haha)
32
What does organophosphate poisoning do?
- its an insecticide
- blocks cholinesterase
- causes runny eyes and nose
33
What are the SLUD poisonings?
Salivate
Lacrimate
Urinate
Defecate
34
What is an atropine poison?
- antidote for organophosphates and carbamates
| - too much causes dry eyes, nose and mouth
35
What do anabolic steroids do to the body?
causes liver damage and early epiphyseal plate closure in children
36
What does carbon tetrachloride and chloroform do to the body?
causes acute liver failure (even if inhaled)
37
What products are commonly seen to have lead in them?
batteries, paint, solder, pottery glaze, rubber, plastic toys, jewelry and dust in shooting galleries
38
What can lead affect?
CNS and PNS
39
What are symptoms of acute lead poisoning?
metallic taste, abdominal pain, black stools, oliguria, collapse, and coma
40
What are symptoms of chronic lead poisoning?
weight loss, fatigue, headache (encephalopathy), lead lines on gums (blue), anemia, irritable, vomiting, basophilic stippling, nerve tissue damage
41
What are treatments for chronic lead poisoning?
EDTA
42
Where is mercury seen?
in crayons, toys, paint
43
Petroleum distillates are seen in what?
vaseline or sex lubes
| Ipecac (can vomit up)
44
What does monamine oxide inhibitors do?
- for depression
- prevents breakdown of neurotransmitters
- increases the availability of synapses, certain foods causes hypertension
45
What are tricyclic drugs used for?
For depression (6 months)
46
What is a prozac drug for?
for depression
| inhibits serotonin uptake (days to weeks)
47
What is the lithium carbonate drug used for?
for manic depressive disorders
48
What happens when you have long term corticosteroid use?
Cushings disease (adrenals)
49
What does overuse do to your body?
causes bone loss
DM
infections
50
What happens with overuse of Ionizide?
ANS dysfunction
51
What happens with overuse of L-Dopa?
parkinsonism
52
What are Common NSAIDS?
ibuprofen (GI irritation)
| acetaminophen (tylenol)
53
What does acetaminophen do?
Antipyretic and analgesic (liver damage)
| does not irritate mucosal linings
54
What is the overdose treatment of NSAIDS?
vomit within 4 hours
use an N-acetylcysteine antidote
(can get ulcers or GERD)
55
What are Salicylates (aspirin)?
inhibits prostaglandins
| can cause bleeding
56
What can chronic use of aspirin (salicylates) cause?
Tinnitus (ear ringing), GI BLEEDING and kidney irritation
57
What is the overdose treatment for aspirin?
vomit within 4 hours, activated charcoal, pump, call poison control
58
What is Reye's Syndrome (for aspirin)?
post viral/influenza in children (less than 18 yo), ACUTE ENCEPHALOPATHY, fatty infiltration of viscera, hepatomegaly,
59
What are the signs and symptoms for Reye's Syndrome?
HEADACHE, vomiting, amnesia, rash, seizures, lethargy (fatigue)
60
Explain Guillain barre syndrome...
ascending paralysis due to viral exposure
61
What is the streptomycin antibiotic used for?
Hearing problems
62
What is the tetracycline antibiotic used for?
yellow teeth, avoid air, avoid sun
| binds with calcium
63
What is the penicillin antibiotic used for?
anaphylactic shock, rash
64
What is the amoxicillin antibiotic used for?
student Gi neurotransmitters and diminishes brain maturation (autism)
65
What does the levaquin antibiotic used for?
tendon tears and ruptures (spontaneous)
66
To retain natural flora, what should be encouraged?
pro-biotics (like lactobacillus and acidophilus)
67
What drug is used for herpes?
acyclovir (lysine and valtrex)
68
What drug is used for chronic gout?
allopurinol
69
What drug is used for acute gout?
colchicine (purine metabolism like organ meats, wine, and cheese)
70
What is Antabuse used for?
disulfiram (turns to aldehyde in the gut when alcohol is ingested)
71
What drug is used to decrease seizure activity?
Dilatin
72
What is digitalis used for?
this drug is used to strengthen heart contractions
73
What is propranolol used for?
this drug is taken for migraines, heart arrhythmias, etc..
| "ol"=beta blocker
74
What is Ritalin used for?
this drug is taken ADD
75
What is tagamet used for?
this drug is taken for ulcers
76
What drug decreases blood cholesterol?
lipitor
77
What does Vioxx/Celebrex drug do?
the drug is a Cox-2 inhibitor
78
What drug is used to help with discs?
glucosamine and chondroitin sulfate
79
What is the most common cause of endocrine cause of Carpal Tunnel?
Hypothyroidism (upper extremity)
80
What is Presbyopia?
lens elasticity (farsighted)
81
What is Presbycusis?
high tones (men; sensorineural)
82
What is macular degeneration?
irreversible, painless, central field loss
83
What is the most common visual loss?
cataracts
84
What is the most common blindness?
macular degeneration
85
What is the most common cause of conduction loss in elderly?
Cerumen
86
What are the most common fractures in the elderly
Traumatic- fall down in the winter and break their wrist
| Spontaneous- break their hips and fall down
87
What happens with a stroke?
tear of intima
| F (face), A (arm), S (speech), T (time)
88
What is Seborrheic Keratosis?
The "barnacles of old age"
| insignificant
89
What happens with lichenfication and leukoplakia?
pre-cancerous (chew tobacco)
| Actinic Keratosis
90
Constipation is due to a _______ in fiber and fluid?
decrease (in fiber and fluid)
91
What scans should be done with osteoporosis?
DEXA
| Bone density
92
What test is used for prostate cancer?
a prostate specific antigen (NOT SPECIFIC)
93
What is seen with arterial insufficiency?
pale, thin skin, smokers
| Vitamin C
94
What is seen with venous insufficiency?
rubor, stasis dermatitis
| lower extremity
95
With age many things decrease, but what stays the same in your body?
Blood glucose
Blood calcium
WBCs
96
With age many things decrease, but what increases in the body?
Fat
ESR (multiple myeloma or giant cell arteritis)
Residual Volume
97
When you have a rouleaux complex, are over 50 and have a sed rate over 80, what is a possibility?
multiple myeloma
98
What occurs when you are over 50 and have a sed rate over 80, what a possibility?
giant cell arteritis
99
Describe a Macule.
flat
a freckle
(
100
Describe a Birthmark.
flat and a mongolian
| large
101
Describe a Papule.
raised/solid
warts (wide based)
(
102
Describe a Nodule.
raised/solid
Arthritis
(large)
103
Describe a Vesicle.
raised/serous
hives, wheats and urticaria
Herpes
(
104
Describe a Bullae.
raised/serous
pemphigus
(large)
105
Describe a Pustule.
raised/pus
acne
(
106
Describe a Furuncle
raised/pus
boil
(large)
107
A boil can lead to a _________. this is just a supersize furuncle.
Carbuncle
108
What is the most common skin cancer?
basal cell cancer
109
What is basal cell cancer?
a waxy, pearly, indurated, firm, rodent ulcer
| it has raised borders with a depressed center
110
What is a Squamous cell cancer?
an irregular, flaky (actinic keratosis)
111
What is a melanoma?
pigmented, multicolor, MOST invasive skin cancer
112
What is pre-cancerous and is yellow in nature (skin cancers section)?
actinic keratosis
113
What is white and precancerous (skin cancers section)?
Leukoplakia
114
What is the most dangerous skin cancer?
melanoma
115
What is folliculitis?
irritated hair follicles (in the groin or neck region primarily)
116
What is psoriasis (use the jingle from NBS)?
silver scales (psoriatic plaques)
pitted nails
occurs on extensors (primarily elbow region)
15% joint involvement, hyperuricemia
117
What is the most significant feature seen with psoriasis?
psoriatic plaques (silver scales)
118
What is eczema?
a contact dermatitis seen on extensors
can commonly occur from a reaction to something
remove agent
119
What is pediculosis?
lice (nits-baby eggs)
120
What are scabies?
"they furrow and burrow in with all their mites (at night)"
121
What is tinea capitis?
ringworm (tinea means fungus)
122
What is lyme disease?
a spirochete carried by ticks
123
What is erysipelas?
strep
shiny red vesicles
fever
red patches
124
What is pityriasis Rosea?
```
herald (mother) patch
10-30 year old
fatigued, post viral
comes on fast
recedes slowly
```
125
Where is pityriasis rosea commonly seen on the body?
on the torso- this is called satellite lesions
| "its a PITY to have a HERALD patch"
126
What is seborrheic dermatitis?
scaly, oily, itchy, erythema
painful (skinalgia)
binds hair (cradle cap)
blepharitis
127
What is the treatment for seborrheic dermatitis?
shampoo (sulfur and aspirin)
steroid cream
(Dandruff on roids)
128
What is Dermatomyositis?
Rash (heliotrope)
| seen on the eyelids and knuckles
129
What rash is seen with SLE?
a butterfly or malar rash
130
What age is acne seen in?
the younger population
131
What is Rosacea?
"NOSEY ROSEY"
| rhinoplasty
132
What is impetigo?
staph or strep infection
Primary has a vesicle and bulla
Secondary is crusty (around mouth commonly)
133
What is tinea versicolor?
subcutaneous fungus causing white patches (summer; under the skin)
134
What is vitiligo?
patchy absence of melanin (darker skinned individuals can see this more commonly)
135
What is lichenification?
thickened epidermis induced by scratching (washboard)
136
What is an Epidermal Nevus?
a group of hamartomas
brown
flat
warty
137
What is a hemangioma?
a red, elevated birth mark
138
What is a mongolian mark?
a flat, dark region
139
What are cafe au lait spots seen in?
```
fibrous dysplasia (coast of maine; a bone)
neurofibromatosis (coast of california); aka von recklinghausens disease
```
140
What is seen in the skin section on the Purpler List?
Kaposi's sarcoma: vessel cancer, violaceous (purple) or black
Erysipelas (red): strep
Lichen Planus: oral (white, glossitis), nail (ridges), purple skin (in wrist and ankles), purple papules
141
What is another name for mouth lesions?
stomatitis
142
What color are fordyce spots?
yellow
143
What color is aphthous stomatitis?
yellow, center red halo (canker sore or cold sore)
144
What color is acrodyna?
mercury poisoning (commonly seen in children)
145
What is a mechanical mouth lesion?
dentures, moth appliances
146
What is Leukoplakia?
white (CAN NOT peel it off)
147
What is hairy leukoplakia?
white (CAN peel off)
148
What is thrush?
White (can peel off)
149
What is Diphtheria?
```
a pseudomembrane (in throat)
exotoxin (difficult to swallow)
```
150
What is a known sign for scarlet fever?
beefy red tongue
151
What is seen with herpes?
vesicles, prodrome (itchy before breakout)
152
What are koplik spots?
white spots on erythematous base
153
What is cleft palate?
anomaly of soft, hard, or both palates
154
What usually shows a sign with clubbing of the nails?
COPD, cancer and RA
155
What is onychocryptosis?
and ingrown toenail
156
what are pitted nails seen with?
psoriasis
157
What are transverse groove seen with?
a systemic illness (seen on all nails; beau lines)
158
What is pachyonychia?
thickened nailbeds
159
What is paronychia and onychia?
inflammation around nail bed
160
What is leukoychia?
white nail bed with a red moon
161
What are splinter hemorrhages seen with?
SBE (subacute bacterial endocarditis)
| painful osier's nodes on tips of digits
162
What is kilonychia?
iron deficiency and fungus (lifting up nail beds; crud inside)
163
What is your nail bed is lifting up, but there is no crud underneath?
B vitamin deficiency
164
What is onychomycosis?
fungal infection (common in geriatrics)
165
Where are skene glands located in the female?
paraurethral
166
Where are bartholin glands located in the female?
vulvovaginal
167
What does prolactin do in the female?
milk production
168
What does oxytocin do in the female?
uterine contraction and milk "let down"
169
What occurs in mono phase (female)?
no ovulation, progesterone
170
Corpus Luteum?
estrogen and progesterone (organize)
171
Corpus albicans?
fibrosis of corpus luteum
172
Corpus Atretica?
shrink
173
What is placenta prevue?
low lying placenta (painless)
174
What is placenta abruptio?
detached placenta (painful)
175
What is placenta accreta?
Retained placenta
176
What is placenta increta?
in uterine muscle
177
What is placenta percreta?
through uterine muscle (perimetric)
178
What is seen in the endometrium?
estrogen => food
179
What is seen in the myometrium?
contract uterus => oxytocin (relaxes the breasts)
180
What is a cystocele?
weakness of anterior vaginal well (causing a bulge) from bladder tissue
181
What is a rectocele?
herniation of rectum into the posterior wall of the vagina
182
What is the cerivcal pre-pregnancy shape?
round, oval
183
What is the cervical post-pregnancy shape?
slit-like
184
What are some common cervical conditions?
warts, polyps, cysts, cervicitis (discharge) and cancer
185
What contributes to Pelvic Inflammatory Disease (PID)?
multiple agent causes from poor hygiene and STDs (salpingitis)
186
What can cause a ruptured tubal pregnancy?
usually caused by previous infection and scarring of cola in the fallopian tubes accompanied with unilateral adnexal pain and tenderness
(usual signs of pregnancy, absent or low HCG)
187
What are the symptoms of ovarian cysts and tumors?
often asymptomatic until rather large.
| Alternate monthly adnexal pain
188
What is mastitis?
- red streaks (on breast) caused by staph
- GO TO ER
- "red, spread, dead"
189
What is fibrocystic disease?
multiple tender nodules that regress after each menstrual cycle
190
What is seen with breast cancer?
- bleeding from the nipple (paget's- nipple cancer)
| - retraction or dimpling of the skin (peau d'orange)
191
What is mittelschmerz?
ovulation pain, middle of the cycle
192
What is dysmenorrhea?
difficult menses
193
What is dyspareunia?
difficult intercourse
194
What is dystocia?
difficult delivery
195
What is procidentia?
```
prolapse uterus (overflow incontinence)
Multiparus
```
196
What is endometriosis?
an ectopic endometrium, progressive dysmenorrhea, late period (can lead to eventual infertility)
197
When does the toxemia of pregnancy occur?
during the 3rd trimester
198
Toxemia of pregnancy has dependent edema and pre-eclampsia. what is seen with this?
Hypertension, Edema and Proteinuria ("HEP me")
| +UA
199
Toxemia of pregnancy has dependent edema and eclampsia. What is seen with this?
Hypertension, Edema and Proteinuria + CONVULSIONS
200
The baby is high is which trimesters?
1st trimester and 3rd trimester?
201
The baby is low in which trimesters?
2nd trimester
202
2 weeks before the baby is due, where are they located?
it drops from the high position
203
What is seen with involution melancholia?
```
menopause (shrinkage) (atropic vaginitis/vulvitis)
hot flashes (progesterone)
```
204
What is seen with a good increase in HCG?
TWINS!
205
What is seen with a bad increase in HCG?
hydatidiform mole- benign problem
206
What is seen with a REALLY bad increase in HCG?
choriocarcinoma- caner problem
207
What is checked in a female bimanual exam?
```
tenderness
tumor
fetus position
ovary, tubes
uterus
```
208
What is checked in a female speculum exam?
discharge
vagina
cervix
209
What infection is seen with toxic shock?
Staph
210
What is HRT?
clots and bleeding
211
What is cryptomennorhea?
imperforate hymen
212
What is Nagel's rule?
Last menstrual period +7 days + 9 months
| this gives you the estimated day of confinement
213
Where do you measure the pelvic birth canal?
pubis to sacrum
| conjugate
214
Where does fertilization occur?
in the ampulla
215
When does implantation occur?
within 7-10 days (journey through the cilia)
216
What does HCG do?
causes persistence of corpus luteum and prevents menstruation, chorion, trophoblast, seminoma (men)
217
Chadwick's?
"bluish congested vagina" (first sign)
218
Chadlin's?
soften cervix
219
What occurs in the 1st stage of labor?
1st contraction => full dilation (10cm; longest stage)
220
What occurs in the 2nd stage of labor?
dilation => delivery of the fetus (vertex presentation)
221
What occurs in the 3rd stage of labor?
this is when delivery of the fetus => expel the placenta
222
How long does puerperium period go for?
4-6 weeks post part, usually takes 3 months (goes up to 6 months to get back to nonpregnant condition)
223
After delivery the mother is vulnerable to _(1)____ and ___(2)___
1. hemorrhage (placental tearing/separation)
| 2. infection
224
If mom gets an infection after delivery, what occurs?
puerperal sepsis (high grade fever, abdominal tenderness)
225
Lochia is a discharge that occurs after birth and lasts 1-2 weeks. What are the 3 different phases?
```
lochia rubra (red)
lochia serosa (yellow)
lochia alba (clear)
```
226
What is chloasma (aka melanoma)?
facial mask (pigmentation)
227
What is the linea nigra?
belly pigmentation
228
What are braxton hick's contractions?
false contractions after 3 months
229
What is quickening when mom is pregnant?
when mom feels baby move
230
During labor, what is station?
fetal descent during labor, ischial spine (zero)
231
when does lightening occur in pregnancy?
descent 2 weeks before delivery
232
What does the cervical plug consist of?
mucous plug aka operculum
233
What is effacement (pregnancy)?
thinning of the cervix
234
When does a cesarean occur?
active vagninal infection
