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Part II Boards > Associated Clinical Science (ACS) part 2 > Flashcards

Associated Clinical Science (ACS) part 2 Flashcards

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
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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

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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)

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4
Q

What is a tort/tort feasance?

A

wrongful act

societal expectations

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5
Q

What are some criminal charges seen with chiropractors (RARE)?

A

adjusting without permission is assault and battery
sexual misconduct
theft

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6
Q

What are most common civil suits seen with chiropractors?

A

personal damages and duress (emotional, financial, etc.)
malpractice
breech of contracts
tort

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7
Q

With a minor, who needs to give consent?

A

parental figures

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8
Q

For a patient with alzheimer’s, disabled, impaired, who needs to give consent?

A

A gaurdian

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9
Q

When do you give informed consent?

A

risks and options after ROF

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10
Q

Who gets implied consent?

A

those in an accident

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11
Q

Does an experimental or research study need consent?

A

YES

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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

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13
Q

in a 1040 ES form as sole proprietor, how often do you estimate and pay taxes?

A

quarterly

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14
Q

In a benefits assignment, a patient agrees to what?

A

patent agrees to have insurance monies sent to doctor

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15
Q

What do state board of examiners/members do?

A

protect citizens and are selected by a governor

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16
Q

What is binding arbitration?

A

no appeal process

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17
Q

What is malfeasance?

A

wrong act

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18
Q

What is res ipsa loquitur?

A

the things speaks for itself

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19
Q

What is vicarious liability?

A

doctor is responsible for employee’s action

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20
Q

What is direction examination?

A

questioning from the defense (doctor’s attorney)

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21
Q

What is cross examination?

A

questioning from the plaintiff (patients attorney)

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22
Q

What is comparative negligence?

A

doctor and patient share damage responsibility

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23
Q

What is Voir Dire?

A

to speak the truth (for prospective juror impartiality)

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24
Q

What is premium Non Nocere?

A

first do no harm

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25
Q

What are anxiolytic drugs?

A
  • thorazine, chlorpromazine, benzodiazepine, clomipramine (“zine-pine-mine”)
  • lorazepam, alprazolam, citalopram (“ram-pam-lam”)
  • Haldol (anti anxiety drug)
  • Tranquilizers (librium and valium)
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26
Q

What are different types of blood thinners?

A 
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)
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27
Q

What is a common sedative or hypnotic drugs?

A

barbituates- sleeping pills, respiratory depressant, miosis

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28
Q

What are common mushrooms?

A

psilocybin- hallucinogenic (ex. PCP)

muscarine- poison

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29
Q

What is carbon monoxide gas commonly from?

A

motors, cigarettes and cars

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30
Q

What is nitrogen oxide gas commonly from?

A

cigarette and plants

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31
Q

What is nitrous oxide gas commonly from?

A

anesthetic (laughing type gas; got everyone slightly high in the office…haha)

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32
Q

What does organophosphate poisoning do?

A
  • its an insecticide
  • blocks cholinesterase
  • causes runny eyes and nose
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33
Q

What are the SLUD poisonings?

A

Salivate
Lacrimate
Urinate
Defecate

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34
Q

What is an atropine poison?

A
  • antidote for organophosphates and carbamates

- too much causes dry eyes, nose and mouth

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35
Q

What do anabolic steroids do to the body?

A

causes liver damage and early epiphyseal plate closure in children

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36
Q

What does carbon tetrachloride and chloroform do to the body?

A

causes acute liver failure (even if inhaled)

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37
Q

What products are commonly seen to have lead in them?

A

batteries, paint, solder, pottery glaze, rubber, plastic toys, jewelry and dust in shooting galleries

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38
Q

What can lead affect?

A

CNS and PNS

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39
Q

What are symptoms of acute lead poisoning?

A

metallic taste, abdominal pain, black stools, oliguria, collapse, and coma

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40
Q

What are symptoms of chronic lead poisoning?

A

weight loss, fatigue, headache (encephalopathy), lead lines on gums (blue), anemia, irritable, vomiting, basophilic stippling, nerve tissue damage

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41
Q

What are treatments for chronic lead poisoning?

A

EDTA

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42
Q

Where is mercury seen?

A

in crayons, toys, paint

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43
Q

Petroleum distillates are seen in what?

A

vaseline or sex lubes

Ipecac (can vomit up)

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44
Q

What does monamine oxide inhibitors do?

A
  • for depression
  • prevents breakdown of neurotransmitters
  • increases the availability of synapses, certain foods causes hypertension
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45
Q

What are tricyclic drugs used for?

A

For depression (6 months)

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46
Q

What is a prozac drug for?

A

for depression

inhibits serotonin uptake (days to weeks)

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47
Q

What is the lithium carbonate drug used for?

A

for manic depressive disorders

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48
Q

What happens when you have long term corticosteroid use?

A

Cushings disease (adrenals)

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49
Q

What does overuse do to your body?

A

causes bone loss
DM
infections

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50
Q

What happens with overuse of Ionizide?

A

ANS dysfunction

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51
Q

What happens with overuse of L-Dopa?

A

parkinsonism

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52
Q

What are Common NSAIDS?

A

ibuprofen (GI irritation)

acetaminophen (tylenol)

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53
Q

What does acetaminophen do?

A

Antipyretic and analgesic (liver damage)

does not irritate mucosal linings

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54
Q

What is the overdose treatment of NSAIDS?

A

vomit within 4 hours
use an N-acetylcysteine antidote
(can get ulcers or GERD)

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55
Q

What are Salicylates (aspirin)?

A

inhibits prostaglandins

can cause bleeding

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56
Q

What can chronic use of aspirin (salicylates) cause?

A

Tinnitus (ear ringing), GI BLEEDING and kidney irritation

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57
Q

What is the overdose treatment for aspirin?

A

vomit within 4 hours, activated charcoal, pump, call poison control

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58
Q

What is Reye’s Syndrome (for aspirin)?

A

post viral/influenza in children (less than 18 yo), ACUTE ENCEPHALOPATHY, fatty infiltration of viscera, hepatomegaly,

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59
Q

What are the signs and symptoms for Reye’s Syndrome?

A

HEADACHE, vomiting, amnesia, rash, seizures, lethargy (fatigue)

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60
Q

Explain Guillain barre syndrome…

A

ascending paralysis due to viral exposure

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61
Q

What is the streptomycin antibiotic used for?

A

Hearing problems

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62
Q

What is the tetracycline antibiotic used for?

A

yellow teeth, avoid air, avoid sun

binds with calcium

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63
Q

What is the penicillin antibiotic used for?

A

anaphylactic shock, rash

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64
Q

What is the amoxicillin antibiotic used for?

A

student Gi neurotransmitters and diminishes brain maturation (autism)

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65
Q

What does the levaquin antibiotic used for?

A

tendon tears and ruptures (spontaneous)

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66
Q

To retain natural flora, what should be encouraged?

A

pro-biotics (like lactobacillus and acidophilus)

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67
Q

What drug is used for herpes?

A

acyclovir (lysine and valtrex)

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68
Q

What drug is used for chronic gout?

A

allopurinol

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69
Q

What drug is used for acute gout?

A

colchicine (purine metabolism like organ meats, wine, and cheese)

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70
Q

What is Antabuse used for?

A

disulfiram (turns to aldehyde in the gut when alcohol is ingested)

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71
Q

What drug is used to decrease seizure activity?

A

Dilatin

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72
Q

What is digitalis used for?

A

this drug is used to strengthen heart contractions

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73
Q

What is propranolol used for?

A

this drug is taken for migraines, heart arrhythmias, etc..

“ol”=beta blocker

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74
Q

What is Ritalin used for?

A

this drug is taken ADD

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75
Q

What is tagamet used for?

A

this drug is taken for ulcers

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76
Q

What drug decreases blood cholesterol?

A

lipitor

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77
Q

What does Vioxx/Celebrex drug do?

A

the drug is a Cox-2 inhibitor

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78
Q

What drug is used to help with discs?

A

glucosamine and chondroitin sulfate

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79
Q

What is the most common cause of endocrine cause of Carpal Tunnel?

A

Hypothyroidism (upper extremity)

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80
Q

What is Presbyopia?

A

lens elasticity (farsighted)

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81
Q

What is Presbycusis?

A

high tones (men; sensorineural)

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82
Q

What is macular degeneration?

A

irreversible, painless, central field loss

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83
Q

What is the most common visual loss?

A

cataracts

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84
Q

What is the most common blindness?

A

macular degeneration

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85
Q

What is the most common cause of conduction loss in elderly?

A

Cerumen

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86
Q

What are the most common fractures in the elderly

A

Traumatic- fall down in the winter and break their wrist

Spontaneous- break their hips and fall down

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87
Q

What happens with a stroke?

A

tear of intima

F (face), A (arm), S (speech), T (time)

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88
Q

What is Seborrheic Keratosis?

A

The “barnacles of old age”

insignificant

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89
Q

What happens with lichenfication and leukoplakia?

A

pre-cancerous (chew tobacco)

Actinic Keratosis

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90
Q

Constipation is due to a _______ in fiber and fluid?

A

decrease (in fiber and fluid)

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91
Q

What scans should be done with osteoporosis?

A

DEXA

Bone density

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92
Q

What test is used for prostate cancer?

A

a prostate specific antigen (NOT SPECIFIC)

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93
Q

What is seen with arterial insufficiency?

A

pale, thin skin, smokers

Vitamin C

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94
Q

What is seen with venous insufficiency?

A

rubor, stasis dermatitis

lower extremity

95
Q

With age many things decrease, but what stays the same in your body?

A

Blood glucose
Blood calcium
WBCs

96
Q

With age many things decrease, but what increases in the body?

A

Fat
ESR (multiple myeloma or giant cell arteritis)
Residual Volume

97
Q

When you have a rouleaux complex, are over 50 and have a sed rate over 80, what is a possibility?

A

multiple myeloma

98
Q

What occurs when you are over 50 and have a sed rate over 80, what a possibility?

A

giant cell arteritis

99
Q

Describe a Macule.

A

flat
a freckle
(

100
Q

Describe a Birthmark.

A

flat and a mongolian

large

101
Q

Describe a Papule.

A

raised/solid
warts (wide based)
(

102
Q

Describe a Nodule.

A

raised/solid
Arthritis
(large)

103
Q

Describe a Vesicle.

A

raised/serous
hives, wheats and urticaria
Herpes
(

104
Q

Describe a Bullae.

A

raised/serous
pemphigus
(large)

105
Q

Describe a Pustule.

A

raised/pus
acne
(

106
Q

Describe a Furuncle

A

raised/pus
boil
(large)

107
Q

A boil can lead to a _________. this is just a supersize furuncle.

108
Q

What is the most common skin cancer?

A

basal cell cancer

109
Q

What is basal cell cancer?

A

a waxy, pearly, indurated, firm, rodent ulcer

it has raised borders with a depressed center

110
Q

What is a Squamous cell cancer?

A

an irregular, flaky (actinic keratosis)

111
Q

What is a melanoma?

A

pigmented, multicolor, MOST invasive skin cancer

112
Q

What is pre-cancerous and is yellow in nature (skin cancers section)?

A

actinic keratosis

113
Q

What is white and precancerous (skin cancers section)?

A

Leukoplakia

114
Q

What is the most dangerous skin cancer?

115
Q

What is folliculitis?

A

irritated hair follicles (in the groin or neck region primarily)

116
Q

What is psoriasis (use the jingle from NBS)?

A

silver scales (psoriatic plaques)
pitted nails
occurs on extensors (primarily elbow region)
15% joint involvement, hyperuricemia

117
Q

What is the most significant feature seen with psoriasis?

A

psoriatic plaques (silver scales)

118
Q

What is eczema?

A

a contact dermatitis seen on extensors
can commonly occur from a reaction to something
remove agent

119
Q

What is pediculosis?

A

lice (nits-baby eggs)

120
Q

What are scabies?

A

“they furrow and burrow in with all their mites (at night)”

121
Q

What is tinea capitis?

A

ringworm (tinea means fungus)

122
Q

What is lyme disease?

A

a spirochete carried by ticks

123
Q

What is erysipelas?

A

strep
shiny red vesicles
fever
red patches

124
Q

What is pityriasis Rosea?

A 
herald (mother) patch
10-30 year old
fatigued, post viral
comes on fast
recedes slowly
125
Q

Where is pityriasis rosea commonly seen on the body?

A

on the torso- this is called satellite lesions

“its a PITY to have a HERALD patch”

126
Q

What is seborrheic dermatitis?

A

scaly, oily, itchy, erythema
painful (skinalgia)
binds hair (cradle cap)
blepharitis

127
Q

What is the treatment for seborrheic dermatitis?

A

shampoo (sulfur and aspirin)
steroid cream
(Dandruff on roids)

128
Q

What is Dermatomyositis?

A

Rash (heliotrope)

seen on the eyelids and knuckles

129
Q

What rash is seen with SLE?

A

a butterfly or malar rash

130
Q

What age is acne seen in?

A

the younger population

131
Q

What is Rosacea?

A

“NOSEY ROSEY”

rhinoplasty

132
Q

What is impetigo?

A

staph or strep infection
Primary has a vesicle and bulla
Secondary is crusty (around mouth commonly)

133
Q

What is tinea versicolor?

A

subcutaneous fungus causing white patches (summer; under the skin)

134
Q

What is vitiligo?

A

patchy absence of melanin (darker skinned individuals can see this more commonly)

135
Q

What is lichenification?

A

thickened epidermis induced by scratching (washboard)

136
Q

What is an Epidermal Nevus?

A

a group of hamartomas
brown
flat
warty

137
Q

What is a hemangioma?

A

a red, elevated birth mark

138
Q

What is a mongolian mark?

A

a flat, dark region

139
Q

What are cafe au lait spots seen in?

A 
fibrous dysplasia (coast of maine; a bone)
neurofibromatosis (coast of california); aka von recklinghausens disease
140
Q

What is seen in the skin section on the Purpler List?

A

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
Q

What is another name for mouth lesions?

A

stomatitis

142
Q

What color are fordyce spots?

143
Q

What color is aphthous stomatitis?

A

yellow, center red halo (canker sore or cold sore)

144
Q

What color is acrodyna?

A

mercury poisoning (commonly seen in children)

145
Q

What is a mechanical mouth lesion?

A

dentures, moth appliances

146
Q

What is Leukoplakia?

A

white (CAN NOT peel it off)

147
Q

What is hairy leukoplakia?

A

white (CAN peel off)

148
Q

What is thrush?

A

White (can peel off)

149
Q

What is Diphtheria?

A 
a pseudomembrane (in throat)
exotoxin (difficult to swallow)
150
Q

What is a known sign for scarlet fever?

A

beefy red tongue

151
Q

What is seen with herpes?

A

vesicles, prodrome (itchy before breakout)

152
Q

What are koplik spots?

A

white spots on erythematous base

153
Q

What is cleft palate?

A

anomaly of soft, hard, or both palates

154
Q

What usually shows a sign with clubbing of the nails?

A

COPD, cancer and RA

155
Q

What is onychocryptosis?

A

and ingrown toenail

156
Q

what are pitted nails seen with?

157
Q

What are transverse groove seen with?

A

a systemic illness (seen on all nails; beau lines)

158
Q

What is pachyonychia?

A

thickened nailbeds

159
Q

What is paronychia and onychia?

A

inflammation around nail bed

160
Q

What is leukoychia?

A

white nail bed with a red moon

161
Q

What are splinter hemorrhages seen with?

A

SBE (subacute bacterial endocarditis)

painful osier’s nodes on tips of digits

162
Q

What is kilonychia?

A

iron deficiency and fungus (lifting up nail beds; crud inside)

163
Q

What is your nail bed is lifting up, but there is no crud underneath?

A

B vitamin deficiency

164
Q

What is onychomycosis?

A

fungal infection (common in geriatrics)

165
Q

Where are skene glands located in the female?

A

paraurethral

166
Q

Where are bartholin glands located in the female?

A

vulvovaginal

167
Q

What does prolactin do in the female?

A

milk production

168
Q

What does oxytocin do in the female?

A

uterine contraction and milk “let down”

169
Q

What occurs in mono phase (female)?

A

no ovulation, progesterone

170
Q

Corpus Luteum?

A

estrogen and progesterone (organize)

171
Q

Corpus albicans?

A

fibrosis of corpus luteum

172
Q

Corpus Atretica?

173
Q

What is placenta prevue?

A

low lying placenta (painless)

174
Q

What is placenta abruptio?

A

detached placenta (painful)

175
Q

What is placenta accreta?

A

Retained placenta

176
Q

What is placenta increta?

A

in uterine muscle

177
Q

What is placenta percreta?

A

through uterine muscle (perimetric)

178
Q

What is seen in the endometrium?

A

estrogen => food

179
Q

What is seen in the myometrium?

A

contract uterus => oxytocin (relaxes the breasts)

180
Q

What is a cystocele?

A

weakness of anterior vaginal well (causing a bulge) from bladder tissue

181
Q

What is a rectocele?

A

herniation of rectum into the posterior wall of the vagina

182
Q

What is the cerivcal pre-pregnancy shape?

A

round, oval

183
Q

What is the cervical post-pregnancy shape?

184
Q

What are some common cervical conditions?

A

warts, polyps, cysts, cervicitis (discharge) and cancer

185
Q

What contributes to Pelvic Inflammatory Disease (PID)?

A

multiple agent causes from poor hygiene and STDs (salpingitis)

186
Q

What can cause a ruptured tubal pregnancy?

A

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
Q

What are the symptoms of ovarian cysts and tumors?

A

often asymptomatic until rather large.

Alternate monthly adnexal pain

188
Q

What is mastitis?

A
  • red streaks (on breast) caused by staph
  • GO TO ER
  • “red, spread, dead”
189
Q

What is fibrocystic disease?

A

multiple tender nodules that regress after each menstrual cycle

190
Q

What is seen with breast cancer?

A
  • bleeding from the nipple (paget’s- nipple cancer)

- retraction or dimpling of the skin (peau d’orange)

191
Q

What is mittelschmerz?

A

ovulation pain, middle of the cycle

192
Q

What is dysmenorrhea?

A

difficult menses

193
Q

What is dyspareunia?

A

difficult intercourse

194
Q

What is dystocia?

A

difficult delivery

195
Q

What is procidentia?

A 
prolapse uterus (overflow incontinence)
Multiparus
196
Q

What is endometriosis?

A

an ectopic endometrium, progressive dysmenorrhea, late period (can lead to eventual infertility)

197
Q

When does the toxemia of pregnancy occur?

A

during the 3rd trimester

198
Q

Toxemia of pregnancy has dependent edema and pre-eclampsia. what is seen with this?

A

Hypertension, Edema and Proteinuria (“HEP me”)

+UA

199
Q

Toxemia of pregnancy has dependent edema and eclampsia. What is seen with this?

A

Hypertension, Edema and Proteinuria + CONVULSIONS

200
Q

The baby is high is which trimesters?

A

1st trimester and 3rd trimester?

201
Q

The baby is low in which trimesters?

A

2nd trimester

202
Q

2 weeks before the baby is due, where are they located?

A

it drops from the high position

203
Q

What is seen with involution melancholia?

A 
menopause (shrinkage) (atropic vaginitis/vulvitis)
hot flashes (progesterone)
204
Q

What is seen with a good increase in HCG?

205
Q

What is seen with a bad increase in HCG?

A

hydatidiform mole- benign problem

206
Q

What is seen with a REALLY bad increase in HCG?

A

choriocarcinoma- caner problem

207
Q

What is checked in a female bimanual exam?

A 
tenderness
tumor
fetus position
ovary, tubes
uterus
208
Q

What is checked in a female speculum exam?

A

discharge
vagina
cervix

209
Q

What infection is seen with toxic shock?

210
Q

What is HRT?

A

clots and bleeding

211
Q

What is cryptomennorhea?

A

imperforate hymen

212
Q

What is Nagel’s rule?

A

Last menstrual period +7 days + 9 months

this gives you the estimated day of confinement

213
Q

Where do you measure the pelvic birth canal?

A

pubis to sacrum

conjugate

214
Q

Where does fertilization occur?

A

in the ampulla

215
Q

When does implantation occur?

A

within 7-10 days (journey through the cilia)

216
Q

What does HCG do?

A

causes persistence of corpus luteum and prevents menstruation, chorion, trophoblast, seminoma (men)

217
Q

Chadwick’s?

A

“bluish congested vagina” (first sign)

218
Q

Chadlin’s?

A

soften cervix

219
Q

What occurs in the 1st stage of labor?

A

1st contraction => full dilation (10cm; longest stage)

220
Q

What occurs in the 2nd stage of labor?

A

dilation => delivery of the fetus (vertex presentation)

221
Q

What occurs in the 3rd stage of labor?

A

this is when delivery of the fetus => expel the placenta

222
Q

How long does puerperium period go for?

A

4-6 weeks post part, usually takes 3 months (goes up to 6 months to get back to nonpregnant condition)

223
Q

After delivery the mother is vulnerable to _(1)____ and ___(2)___

A
  1. hemorrhage (placental tearing/separation)

2. infection

224
Q

If mom gets an infection after delivery, what occurs?

A

puerperal sepsis (high grade fever, abdominal tenderness)

225
Q

Lochia is a discharge that occurs after birth and lasts 1-2 weeks. What are the 3 different phases?

A 
lochia rubra (red)
lochia serosa (yellow)
lochia alba (clear)
226
Q

What is chloasma (aka melanoma)?

A

facial mask (pigmentation)

227
Q

What is the linea nigra?

A

belly pigmentation

228
Q

What are braxton hick’s contractions?

A

false contractions after 3 months

229
Q

What is quickening when mom is pregnant?

A

when mom feels baby move

230
Q

During labor, what is station?

A

fetal descent during labor, ischial spine (zero)

231
Q

when does lightening occur in pregnancy?

A

descent 2 weeks before delivery

232
Q

What does the cervical plug consist of?

A

mucous plug aka operculum

233
Q

What is effacement (pregnancy)?

A

thinning of the cervix

234
Q

When does a cesarean occur?

A

active vagninal infection

Part II Boards (4 decks)

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