Associated Clinical Science (ACS) part 2 Flashcards
In a malpractice suit, what must be included?
Duty Dereliction (act average) Damage Direct Causation (or just causation) You are tried according to common law and precedent
What is a standard of care?
doctor is accountable for “average care”
affected by advertising, specialization (diplomat, courses, technology changes)
obligated to diagnose, reasonable
What is a breech of contract?
promising a cure (not cured)
abandonment (no “cover” dr.)
exceed consent
confidentiality (telephone, waiting room)
doctor is help vicariously responsible (unless you script them)
What is a tort/tort feasance?
wrongful act
societal expectations
What are some criminal charges seen with chiropractors (RARE)?
adjusting without permission is assault and battery
sexual misconduct
theft
What are most common civil suits seen with chiropractors?
personal damages and duress (emotional, financial, etc.)
malpractice
breech of contracts
tort
With a minor, who needs to give consent?
parental figures
For a patient with alzheimer’s, disabled, impaired, who needs to give consent?
A gaurdian
When do you give informed consent?
risks and options after ROF
Who gets implied consent?
those in an accident
Does an experimental or research study need consent?
YES
What is a statute of limitations?
period of time to file (7 years- adult) up to age of 18 years for minors
in a 1040 ES form as sole proprietor, how often do you estimate and pay taxes?
quarterly
In a benefits assignment, a patient agrees to what?
patent agrees to have insurance monies sent to doctor
What do state board of examiners/members do?
protect citizens and are selected by a governor
What is binding arbitration?
no appeal process
What is malfeasance?
wrong act
What is res ipsa loquitur?
the things speaks for itself
What is vicarious liability?
doctor is responsible for employee’s action
What is direction examination?
questioning from the defense (doctor’s attorney)
What is cross examination?
questioning from the plaintiff (patients attorney)
What is comparative negligence?
doctor and patient share damage responsibility
What is Voir Dire?
to speak the truth (for prospective juror impartiality)
What is premium Non Nocere?
first do no harm
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)
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)
What is a common sedative or hypnotic drugs?
barbituates- sleeping pills, respiratory depressant, miosis
What are common mushrooms?
psilocybin- hallucinogenic (ex. PCP)
muscarine- poison
What is carbon monoxide gas commonly from?
motors, cigarettes and cars
What is nitrogen oxide gas commonly from?
cigarette and plants
What is nitrous oxide gas commonly from?
anesthetic (laughing type gas; got everyone slightly high in the office…haha)
What does organophosphate poisoning do?
- its an insecticide
- blocks cholinesterase
- causes runny eyes and nose
What are the SLUD poisonings?
Salivate
Lacrimate
Urinate
Defecate
What is an atropine poison?
- antidote for organophosphates and carbamates
- too much causes dry eyes, nose and mouth
What do anabolic steroids do to the body?
causes liver damage and early epiphyseal plate closure in children
What does carbon tetrachloride and chloroform do to the body?
causes acute liver failure (even if inhaled)
What products are commonly seen to have lead in them?
batteries, paint, solder, pottery glaze, rubber, plastic toys, jewelry and dust in shooting galleries
What can lead affect?
CNS and PNS
What are symptoms of acute lead poisoning?
metallic taste, abdominal pain, black stools, oliguria, collapse, and coma
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
What are treatments for chronic lead poisoning?
EDTA
Where is mercury seen?
in crayons, toys, paint
Petroleum distillates are seen in what?
vaseline or sex lubes
Ipecac (can vomit up)
What does monamine oxide inhibitors do?
- for depression
- prevents breakdown of neurotransmitters
- increases the availability of synapses, certain foods causes hypertension
What are tricyclic drugs used for?
For depression (6 months)
What is a prozac drug for?
for depression
inhibits serotonin uptake (days to weeks)
What is the lithium carbonate drug used for?
for manic depressive disorders
What happens when you have long term corticosteroid use?
Cushings disease (adrenals)
What does overuse do to your body?
causes bone loss
DM
infections
What happens with overuse of Ionizide?
ANS dysfunction
What happens with overuse of L-Dopa?
parkinsonism
What are Common NSAIDS?
ibuprofen (GI irritation)
acetaminophen (tylenol)
What does acetaminophen do?
Antipyretic and analgesic (liver damage)
does not irritate mucosal linings
What is the overdose treatment of NSAIDS?
vomit within 4 hours
use an N-acetylcysteine antidote
(can get ulcers or GERD)
What are Salicylates (aspirin)?
inhibits prostaglandins
can cause bleeding
What can chronic use of aspirin (salicylates) cause?
Tinnitus (ear ringing), GI BLEEDING and kidney irritation
What is the overdose treatment for aspirin?
vomit within 4 hours, activated charcoal, pump, call poison control
What is Reye’s Syndrome (for aspirin)?
post viral/influenza in children (less than 18 yo), ACUTE ENCEPHALOPATHY, fatty infiltration of viscera, hepatomegaly,
What are the signs and symptoms for Reye’s Syndrome?
HEADACHE, vomiting, amnesia, rash, seizures, lethargy (fatigue)
Explain Guillain barre syndrome…
ascending paralysis due to viral exposure
What is the streptomycin antibiotic used for?
Hearing problems
What is the tetracycline antibiotic used for?
yellow teeth, avoid air, avoid sun
binds with calcium
What is the penicillin antibiotic used for?
anaphylactic shock, rash
What is the amoxicillin antibiotic used for?
student Gi neurotransmitters and diminishes brain maturation (autism)
What does the levaquin antibiotic used for?
tendon tears and ruptures (spontaneous)
To retain natural flora, what should be encouraged?
pro-biotics (like lactobacillus and acidophilus)
What drug is used for herpes?
acyclovir (lysine and valtrex)
What drug is used for chronic gout?
allopurinol
What drug is used for acute gout?
colchicine (purine metabolism like organ meats, wine, and cheese)
What is Antabuse used for?
disulfiram (turns to aldehyde in the gut when alcohol is ingested)
What drug is used to decrease seizure activity?
Dilatin
What is digitalis used for?
this drug is used to strengthen heart contractions
What is propranolol used for?
this drug is taken for migraines, heart arrhythmias, etc..
“ol”=beta blocker
What is Ritalin used for?
this drug is taken ADD
What is tagamet used for?
this drug is taken for ulcers
What drug decreases blood cholesterol?
lipitor
What does Vioxx/Celebrex drug do?
the drug is a Cox-2 inhibitor
What drug is used to help with discs?
glucosamine and chondroitin sulfate
What is the most common cause of endocrine cause of Carpal Tunnel?
Hypothyroidism (upper extremity)
What is Presbyopia?
lens elasticity (farsighted)
What is Presbycusis?
high tones (men; sensorineural)
What is macular degeneration?
irreversible, painless, central field loss
What is the most common visual loss?
cataracts
What is the most common blindness?
macular degeneration
What is the most common cause of conduction loss in elderly?
Cerumen
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
What happens with a stroke?
tear of intima
F (face), A (arm), S (speech), T (time)
What is Seborrheic Keratosis?
The “barnacles of old age”
insignificant
What happens with lichenfication and leukoplakia?
pre-cancerous (chew tobacco)
Actinic Keratosis
Constipation is due to a _______ in fiber and fluid?
decrease (in fiber and fluid)
What scans should be done with osteoporosis?
DEXA
Bone density
What test is used for prostate cancer?
a prostate specific antigen (NOT SPECIFIC)
What is seen with arterial insufficiency?
pale, thin skin, smokers
Vitamin C