Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

0. Step Ia > FA - Behavioral science - everything else > Flashcards

FA - Behavioral science - everything else Flashcards

1
Q

patient autonomy

A
  • respect patient as individuals (truth-telling, confidentiality)
  • allow for autonomous choice (informed consent)
  • honor their preference in accepting/not accepting medical caer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

beneficence definition

A

ethical (fiduciary) duty to act in the patient’s best interest.
-May conflict with autonomy (an informed patient has the right to decide) or what is best for society (traditionally, patient interest supersedes societal interest)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Nonmaleficence definition

A

“Do no harm”

Balance against beneficence; if benefits > risks, patient may make an informed decision to proceed (most surgeries and meds fall into this category).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is this an example of?

stopping a treatment that has shown to be harmful to the patient

A

Nonmaleficence - “Do no harm”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is this an example of?

encouraging a patient to lose weight and stop smoking

A

beneficence - ethical (fiduciary) duty to act in the patient’s best interest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is this an example of? refusing to provide treatment that has not been shown to be effective

A

Nonmaleficence - “Do no harm”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is this an example of? educating the community about STDs

A

beneficence - ethical (fiduciary) duty to act in the patient’s best interest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is this an example of?

resuscitating a drowning patient

A

beneficence - ethical (fiduciary) duty to act in the patient’s best interest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is this an example of?

providing vaccination to the community

A

beneficence - ethical (fiduciary) duty to act in the patient’s best interest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

informed consent involves

A

disclosure
understanding
mental capacity
voluntariness (freedom from coercion and manipulation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

exceptions to informed consent

A

patient is incompetent
emergency (ie ectopic pregnancy)
therapeutic privledge
waiver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is therapeutic priviledge

A

withholding information when disclosure would severely harm the patient or undermine informed decision-making capacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is a waiver?

A

patient explicitly waives the right of informed consent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When is consent required for minors?

A

DEPENDENTS less than 18yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When is consent NOT required for minors?

A

1) minor is legally emancipated (married, self-supported, or is in the military)
2) getting treatment for
- Sex (contraception, STDs, pregnancy)
- Drugs (addiction)
- Rock and roll (emergency/trauma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What must a physician do when involved in decision-making capacity

A

determine whether the patient is psychologically and legally capable of making a particular health care decision.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is an advance directive?

What are the 3 types?

A

Instructions given by a patient in anticipation of the need for a medical decision

  • Oral advance directive
  • Living Will (written advance directive)
  • Medical Power of Attorney
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is an oral advance directive? Problems with this?

A

Incapacitated patient’s prior oral statements commonly used as guide.

Problem: differences in interpretation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a written advanced directive?

A

aka Living Will.

Describes treatments the patient wishes to receive or not receive if he/she loses decision-making capacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a medical power of attorney?

A

Agent/person designated to make medical decisions in the event that one loses decision-making capacity.

Can be revoked anytime patient wishes (REGARDLESS OF COMPETENCE); more flexible than a living will

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Surrogate decision maker

priority of surrogates?

A

individuals (surrogates) who know the patient determines what the patient would have done if he/she were competent; usually done in the case where there is no advance directive prepared

spouse
adult children
parents
adult siblings
other relatives
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

exceptions to confidentiality? 4

A

1) physical harm to SELF or OTHERS others is serious and imminent - Tarasoff decision
2) reportable diseases
3) child/elder abuse
4) impaired drivers (ie one with epilepsy)

23
Q

Patient is not adherent.

A

dentify the reason for nonadherence and determine his/her willingness to change

do NOT

  • coerce the patient into adhering
  • refer him/her to another physician
24
Q

Patient desires an unnecessary procedure (or does not want a necessary treatment)

A

understand why the patient wants or does not want the procedure and address underlying concerns.

do NOT

  • refuse to see the patient
  • refer him/her to another physician
  • avoid performing unnecessary procedures
25
Q

Patient has difficulty taking medications.

A

KISS - keep it simple, stupid

  • provide written instructions
  • simplify treatment regimens
  • use teach-back method to ensure patient comprehension.
26
Q

Family members ask for information about patient’s prognosis.

A

Avoid discussing issues with relatives w/p patient permission

27
Q

patient’s family member asks you not to disclose the results of a test if the prognosis is poor because the patient will be “unable to handle it.”

A

Explain that as long as the patient has decision-making capacity and does not indicate otherwise, communication of information concerning his/her care will NOT be withheld

28
Q

A child wishes to know more about his/her illness.

A

Ask what the parents have told the child. Parents of a child decide what information can be relayed about the illness.

29
Q

A 17-year-old girl is pregnant and requests an abortion.

A

get parental notification or consent for minors

Unless she is at medical risk, do NOT
- advise a patient to have an abortion regardless of her age or the condition of the fetus

30
Q

15-year-old girl is pregnant and wants to keep the child. Her parents want you to tell her to give the child up for adoption.

A

patient retains the right to make decisions regarding her child, even if her parents disagree

DO

  • provide info about the practical issues of caring for a baby
  • discuss the options, if requested
  • encourage discussion between the teenager and her parents to reach the best decision.
31
Q

A terminally ill patient requests physician assistance in ending own life.

A

refuse involvement in any form of physician- assisted suicide.
May prescribe medically appropriate analgesics that coincidentally shorten lifespan

32
Q

Patient is suicidal.

A

Assess the seriousness and if it is serious, hospitalize patient voluntarily or involuntarily

33
Q

Patient states that he/she finds you attractive.

A

Ask direct, closed-ended questions and use a chaperone if necessary.

Never say: “There can be no relationship while you are a patient,” - implies that a relationship may be possible if the individual is no longer a patient

34
Q

A woman who had a mastectomy says she now feels “ugly.”

A

Find out why the patient feels this way.

do NOT offer falsely reassuring statements (e.g., “You still look good.”).

35
Q

Patient is angry about the amount of time he/she spent in the waiting room.

A

Acknowledge the patient’s anger and Apologize for any inconvenience

Avoid explaining the delay.

36
Q

Patient is upset with the way he/she was treated by another doctor, or staff.

A

Doctor: suggest that the patient speak directly to that physician regarding his/her concerns.

Staff: tell the patient you will speak to that person.

37
Q

A drug company offers a “referral fee” for every patient a physician enrolls in a study.

A

Eligible patients who may benefit from the study may be enrolled - however, it is never acceptable for a physician to receive compensation from a drug company.
Patients must be told about the existence of a referral fee.

38
Q

A physician orders an invasive test for the wrong patient.

A

regardless of how serious or trivial the error, ethically obligated to inform a patient that a mistake has been made.

39
Q

A patient requires a treatment not covered by his/her insurance.

A

Never limit or deny care because of the expense in time or money. Discuss all treatment options with patients, even if some are not covered by their insurance companies.

40
Q

Apgar score of >7

A

good

41
Q

Apgar score of >4-6

A

assist and stimulate

42
Q

Apgar score of <4-6

A

resuscitate

If it remains < 4 at later time points, there is increased risk of long-term neurological damage.

43
Q

low birth weight is defined as:

causes?

associations

A

<2500 g

prematurity or intrauterine growth retardation (IUGR)

SIDs + increased overall mortality

44
Q

Of the three types of Advance Directives, which is the most specific? Which is the most flexible? Which is the most sketchy?

A

(Jen’s interpretation to help her remember)

  • Most specific seems to be the Living Will (written advance directive). written by patient and says what to do in various situations if she loses decision-making ability.
  • Most flexible seems to be the Medical Power of Attorney. Can be revoked at any time regardless of patient competence.
  • “Oral advance directive” kinda sounds like everyone’s best guess.
45
Q

APGAR stands for what?

A 
Appearance
Pulse
Grimace
Activity
Respiration
46
Q

moro reflex disappears at

A

3 mo

47
Q

rooting reflex disappears at

A

4 mo

48
Q

palmar reflex disappears at

A

6 mo

49
Q

babinski reflex disappears at

A

12 mo

50
Q

social smile?
stranger anxiety?
separation anxiety?

A

social smile = 2 mo
stranger anxiety = 6 mo
separation anxiety = 9 mo

51
Q

separation anxiety from mom
rapprochement (moves away from and returns to mom)
comfortably spends part of day away from mom

A

separation anxiety from mom = 9 mo
rapprochement (moves away from/returns to mom) = up to 2.9 mo
comfortably spends part of day away from mom = 3yo and on

52
Q

when does children do parallel play (play side by side)? cooperative play (play together)?

A 
parallel play (play side by side) =  1.0 - 2.9 yo
cooperative play (play together) = 3.0 - 5 yo
53
Q

how do developing countries differ in terms of overall disease morbidity compared to developed countries?

A

developing countries = younger population

developed countries = older population

54
Q

how does REM and slow wave sleep change in the elderly?

A

decrease

0. Step Ia (28 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions