Exam II

Question 1

Six I’s of Suspected Abuse

Answer 1

Irritability
Inability
Inaccessibility: tardiness, absence
Irresponsibility
Isolation
Incidentals: appearance, complaints

Question 2

Goals of Medicine

Answer 2

Prevention of disease and injury and the promotion and maintenance of health
Relief of pain and suffering caused by maladies
Care and cure of those with a malady, and the care of those who cannot be cured
Avoidance of premature death and the pursuit of a peaceful death

Question 3

Means of Medicine

Answer 3

Technical competence
Avoidance of fraud and misrepresentation
Avoid patient harm disproportionate to expected benefit, and minimize indignity and invasion of privacy
Maintain fidelity to interests of patient

Question 4

quantatative v qualitative medical futility

Answer 4

Qualitative: not improving quality of life; Person lacks conscious awareness so argument is that it does not benefit the patient
Quantitative – statistically will not benefit pt

Question 5

Substance Use

Answer 5

Occasional use of a chemical substance without developing a tolerance or withdrawal symptom when not in use

Question 6

Substance Abuse

Answer 6

The use of illegal drugs or the inappropriate use of legal drugs. The repeated use of drugs to produce pleasure, to alleviate stress, or to alter or avoid reality (or all three)

Question 7

Substance Addiction

Answer 7

Drug addiction is a complex brain disease. It is characterized by drug craving, seeking, and use that can persist even in the face of extremely negative consequences

Question 8

Informed Consent

Answer 8

1. Full disclosure (risks/benefits/alternatives);
2. Voluntary;
3. Competence;
4. Understanding;
5. Signed informed consent

Question 9

“Presumed consent”

Answer 9

Policy of some nations regarding organ donation including Spain, France, Austria, Italy, Norway, and Singapore.
Organs are harvested upon death unless a person specifically requests NOT to donate while living (opt-out)

Question 10

coma dépassé

Answer 10

Brain Death
Often used as the official definition of death in the United States
Whole brain death (US): Includes cerebral hemispheres and the brain stem
Higher brain death: Cerebral hemispheres only (does not include brain stem)

Question 11

Classic bedside physical signs of death*

Answer 11

Unresponsiveness
Fixed and dilated pupils
Absence of pulse and respiration

Question 12

Rigor mortis*

Answer 12

stiffness in death

Question 13

Algor mortis*

Answer 13

the chill of death

Question 14

Livor mortis*

Answer 14

pooling of blood causing discoloration

Question 15

Classic Dx of death*

Answer 15

physical signs
rigor/algor/livor mortis
putrefaction
advanced decomposition

Question 16

“Irreversible Coma”

Answer 16

Unreceptivity and unresponsivity
No spontaneous movements or breathing
No reflexes
confirmed by two electroencephalograms (EEGs), at least 24 hours apart: absence of cortical electrical activity above baseline
Necessary to exclude the presence of any metabolic state, hypothermia, or drug intoxication

Question 17

Vegetative State

Answer 17

Severely impaired consciousness, although eyes may open spontaneously.
Eye opening may give the impression of consciousness, but there is no awareness of the environment.

Question 18

Minimally conscious state

Answer 18

Severe alteration in consciousness, with intermittent, but inconsistent, behaviors suggesting awareness.
may occasionally have purposeful movements, and they may track motions with their eyes or speak.

Question 19

Persistent vegetative state (PVS)

Answer 19

After four weeks in a vegetative state (VS)

state of partial arousal rather than true awareness

Question 20

Coma

Answer 20

State of eyes-closed, depressed consciousness from which patient cannot be aroused by stimulus.
presence of brain stem responses, spontaneous breathing (sometimes) or non-purposeful motor responses.

Question 21

The distinguishing feature of the vegetative state is*

Answer 21

an irregular but cyclic state of circadian sleeping and waking*** unaccompanied by any behaviorally detectable expression of self-awareness

Question 22

Durable power of attorney for health care

Answer 22

An advance directive that names someone to make medical decisions for a person if in the future he/she can’t make his/her own medical decisions

Question 23

Living will

Answer 23

An advance directive that tells what medical treatment a person does or doesn’t want if he/she is not able to make his/her wishes known

Question 24

What are the limitations of living will?

Answer 24

Cannot cover all conceivable end-of-life decisions

Another potential limitation is possible change in the patient’s preferences over time or circumstance

Question 25

Health Care Surrogate

Answer 25

Any competent adult expressly designated by a principal to make health care decisions upon the principal’s incapacity
Designation signed before 2 witnesses
Surrogate cannot witness

Question 26

Proxy

Answer 26

Competent adult not expressly designated to make health care decisions for principal but authorized to do so by statute

Question 27

best choice of treatment for couples that are infertile due to sperm disorders

Answer 27

artificial insemination, can be done with sperm donors

Question 28

Gestational Carrier

Answer 28

woman agrees to carry to term a fetus for another person

Question 29

Surrogacy

Answer 29

the carrier has a genetic connection to the embryo