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Fosforilados > Foundations of Clinical Practice > Flashcards

Foundations of Clinical Practice Flashcards

1
Q

Indication for recombinant zoster vaccine

A

Age ≥50 years or 19-49 years and immunodeficient/immunocompromised

MKSAP 20

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2
Q

What is substituted judgment?

A

Surrogate care decisions based on patient’s previously expressed preferences and values

MKSAP 20

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3
Q

HIV screening frequency for average-risk persons

A

One-time screening

MKSAP 20

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4
Q

Perioperative management of biologic agents for non-SLE rheumatologic disease

A

Withhold preoperatively; perform surgery just after the next dose would have been due

MKSAP 20

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5
Q

USPSTF recommendation for primary prevention of preeclampsia in ASCVD risk I patients

A

Low-dose aspirin

MKSAP 20

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6
Q

Influenza formulation recommended for adults ≥65 years of age

A

Inactivated (standard or high dose) or recombinant influenza vaccine

MKSAP 20

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7
Q

Recommended minimum weekly physical activity

A

150-300 minutes of moderate-intensity or 75 minutes of vigorous-intensity aerobic activity

MKSAP 20

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8
Q

Increase in disease probability with positive LRs of 2, 5, and 10

A

15%, 30%, and 45%

MKSAP 20

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9
Q

What is the responsibility when a colleague is impaired or unable to carry out clinical responsibilities?

A

Report to appropriate authorities and identify appropriate sources of help

MKSAP 20

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10
Q

Perioperative management of aspirin for secondary prevention

A

Continue perioperatively for elective noncardiac surgery

MKSAP 20

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11
Q

Indication for annual influenza vaccination

A

All adults

MKSAP 20

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12
Q

Role of vitamin D supplementation in fall prevention

A

None

MKSAP 20

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13
Q

Initial agent for radiation-induced vomiting

A

Serotonin antagonists (ondansetron, granisetron)

MKSAP 20

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14
Q

Recommendation for enteral/parenteral nutritional support at end of life

A

Avoid

MKSAP 20

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15
Q

Components of patient decision-making capacity

A

Can understand relevant information and communicate choice consistent with information and stated values

MKSAP 20

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16
Q

Intervention when a medical error is discovered

A

Error disclosure with compassion and concern for patient

MKSAP 20

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17
Q

What is the bias that occurs automatically and unintentionally?

A

Implicit bias

MKSAP 20

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18
Q

Number one cause of preventable disease, disability, and death in U.S.

A

Smoking

MKSAP 20

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19
Q

Study type providing the highest level of evidence

A

Systematic review

MKSAP 20

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20
Q

CDC-recommended HIV screening frequency for MSM

A

At least annually

MKSAP 20

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21
Q

Rate of diagnostic error in clinical decision making

A

10%

MKSAP 20

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22
Q

Age indications for HPV vaccination

A

11-12 years or between 13 and 26 years

MKSAP 20

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23
Q

USPSTF criterion for DM screening in patients aged 35-70 years

A

Obesity/overweight

MKSAP 20

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24
Q

Time to delay elective noncardiac surgery after stroke or TIA

A

At least 6 months

MKSAP 20

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25
Q

Prerequisite for genetic testing

A

Genetic counseling

MKSAP 20

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26
Q

Patients who should undergo preoperative screening for OSA

A

All patients

MKSAP 20

OSA stands for Obstructive Sleep Apnea, a condition that can complicate anesthesia and surgery.

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27
Q

Strongest clinical study design

A

Randomized controlled trial

MKSAP 20

This design minimizes bias and allows for the comparison of different interventions.

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28
Q

Perioperative management of untreated subclinical hypothyroidism

A

Proceed to surgery without further testing/treatment

MKSAP 20

Subclinical hypothyroidism generally does not require intervention prior to surgery.

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29
Q

Four-step quality improvement method

A

Plan-Do-Study-Act (PDSA) cycle

MKSAP 20

This method is commonly used for continuous quality improvement in healthcare.

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30
Q

Test’s ability to accurately detect those with the disease

A

Sensitivity

MKSAP 20

Sensitivity measures the proportion of true positives among those with the disease.

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31
Q

Only indication for routine preoperative spirometry

A

Planned lung resection

MKSAP 20

Routine spirometry is not indicated for all patients but is necessary for those undergoing lung surgery.

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32
Q

USPSTF screening criterion for intimate partner violence

A

Women of childbearing age

MKSAP 20

The United States Preventive Services Task Force recommends screening in this demographic due to higher risk.

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33
Q

Contraindication to elective surgery in liver disease

A

MELD score >20

MKSAP 20

MELD stands for Model for End-Stage Liver Disease, and a score above 20 indicates significant liver dysfunction.

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34
Q

Minimum preoperative DAPT duration after bare metal stent placement

A

14-30 days

MKSAP 20

DAPT refers to dual antiplatelet therapy, crucial for preventing stent thrombosis.

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35
Q

Postoperative rigidity, fever, confusion, and autonomic instability in patient with Parkinson disease

A

Parkinsonism-hyperpyrexia syndrome (dopamine agonist withdrawal)

MKSAP 20

This syndrome can occur after abrupt withdrawal of dopaminergic medications.

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36
Q

Typical time to restart DOACs postoperatively after major surgery

A

48-72 hours

MKSAP 20

DOACs are Direct Oral Anticoagulants, and timing for resumption is critical to balance bleeding risk and thromboembolism.

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37
Q

Essential geriatric prescribing principle

A

Frequent review of medication necessity

MKSAP 20

This principle helps to minimize polypharmacy and adverse drug reactions in older adults.

38
Q

Rapid-acting depression treatment useful at end of life

A

Methylphenidate

MKSAP 20

Methylphenidate can provide quick relief of depressive symptoms in terminally ill patients.

39
Q

Prophylactic device for pressure injury

A

Advanced static mattress or mattress overlay

MKSAP 20

These devices help redistribute pressure and prevent pressure ulcers in at-risk patients.

40
Q

Genetic testing before prescribing allopurinol

A

HLA-B*58:01

MKSAP 20

Testing for this allele helps predict the risk of severe hypersensitivity reactions to allopurinol.

41
Q

AHA-recommended number of hours of sleep in adults

A

7

MKSAP 20

The American Heart Association emphasizes adequate sleep for cardiovascular health.

42
Q

Indication for one-time abdominal aortic aneurysm screening

A

Men aged 65-75 years who have ever smoked

MKSAP 20

This population is at increased risk for abdominal aortic aneurysms.

43
Q

Systems factors that contribute to diagnostic error

A

Communication policies and practices, resources, practice structure

MKSAP 20

These systemic issues can lead to failures in diagnosis and patient care.

44
Q

Contributors of suboptimal care transitions

A

Poor communication among team; inadequate information transfer and patient education

MKSAP 20

Effective transitions are critical for continuity and quality of care.

45
Q

Perioperative management of chronic β-blocker therapy

A

Continue β-blocker unless prohibited by hypotension

MKSAP 20

Maintaining β-blockers can help prevent cardiovascular complications during surgery.

46
Q

Likely the greatest indicator of health outcomes

A

Socioeconomic position

MKSAP 20

Socioeconomic factors significantly influence overall health and access to care.

47
Q

Indications for deferral of surgery in patients with hypertension

A

Evidence of end-organ dysfunction or BP >180/110 mm Hg

MKSAP 20

These conditions increase the risk of perioperative complications.

48
Q

Role of preoperative placement of IVC filter in VTE prophylaxis

A

None

MKSAP 20

Current guidelines do not support the routine use of IVC filters for VTE prophylaxis before surgery.

49
Q

Role of adding aspirin for primary prevention of ASCVD in a patient aged >59 years

A

None

MKSAP 20

Aspirin is not recommended for primary prevention in this age group due to risk of bleeding.

50
Q

Nutrition factors predictive of poor surgical outcomes

A

15% weight loss over 6 months, BMI <18.5, serum albumin level <3.0 g/dL (30 g/L)

MKSAP 20

These indicators reflect nutritional status and can influence surgical recovery.

51
Q

Initial preoperative assessment of patients with ≥1% risk for MACE

A

Assessment of functional capacity

MKSAP 20

MACE stands for major adverse cardiac events.

52
Q

Time to stop DOACs preoperatively

A

2-3 days before surgery

MKSAP 20

53
Q

Impact of palliative medicine

A

Improved quality of life, symptoms, mood, and caregiver satisfaction

MKSAP 20

54
Q

Basic principles of medical ethics

A

Beneficence, nonmaleficence, respect for patient autonomy, justice

MKSAP 20

55
Q

Indication for preoperative urinalysis

A

Suspected UTI, planned urologic procedure

MKSAP 20

56
Q

Lead-time bias

A

Survival time appears longer because the screened patient was diagnosed earlier

MKSAP 20

57
Q

Self-reflection and discovery to build honesty and trustworthy relationships

A

Cultural humility

MKSAP 20

58
Q

USPSTF-recommended BP screening frequency in adults aged ≥40 years

A

Annually

MKSAP 20

59
Q

Prevalence of U.S. adults who use vitamins or dietary supplements

A

50%

MKSAP 20

60
Q

USPSTF-recommended means of calculating CV risk

A

Pooled Cohort Equations

MKSAP 20

61
Q

Elderly fall prevention interventions

A

Exercise, discontinuing/decreasing centrally acting medications, modifying home environment

MKSAP 20

62
Q

Most common type of preventable medical error

A

Medication errors (prescribing/transcribing, dispensing, administering/taking, or monitoring)

MKSAP 20

63
Q

Tdap vaccination recommendation for pregnant patients

A

Between 27 and 36 weeks’ gestation for every pregnancy

MKSAP 20

64
Q

Treatment of established pressure injuries

A

Wound care, protein supplements, pressure-reducing surfaces, hydrocolloid and foam dressings

MKSAP 20

65
Q

Postoperative transfusion threshold in orthopedic and cardiac surgery patients

A

Hemoglobin level of 8 g/dL (80 g/L)

MKSAP 20

66
Q

Mnemonic for never events in health care

A

WSPEs (wrong-site, wrong-procedure, wrong-patient errors)

MKSAP 20

67
Q

Indication for one-time screening for hepatitis C

A

All patients aged 18-79 years

MKSAP 20

68
Q

Indication for preoperative echocardiography in patients with valvular disease

A

Moderate to severe valve disease without TTE within last year or change in clinical status

MKSAP 20

69
Q

Population-based screening for carotid artery stenosis

A

USPSTF grade D

MKSAP 20

70
Q

Indications for cardiac catheterization before noncardiac surgery

A

Same as those for patients not undergoing surgery

MKSAP 20

71
Q

Routine preoperative laboratory testing in low-risk surgery (cataract surgery, hernia repair)

A

None

MKSAP 20

72
Q

Length-time bias

A

Survival time appears longer because screening detects indolent disease

MKSAP 20

73
Q

Indication for screening for chlamydia and gonorrhea in women

A

Age ≤24 years and sexually active

MKSAP 20

74
Q

Screening for CAD in low-risk asymptomatic patients

A

None

MKSAP 20

75
Q

Timing of palliative medicine initiation for incurable/advanced disease

A

At time of diagnosis

MKSAP 20

76
Q

Threshold functional capacity for proceeding to surgery without further testing

A

4 METs

MKSAP 20

METs refers to Metabolic Equivalent of Task, a measure of exercise capacity.

77
Q

Structured communication strategies to improve handoffs

A

I-PASS, call-outs, SBAR, check-backs

MKSAP 20

These strategies are designed to enhance communication and reduce errors during patient handoffs.

78
Q

Test’s ability to identify those without the disease

A

Specificity

MKSAP 20

Specificity is a key concept in diagnostic testing, indicating the proportion of true negatives.

79
Q

Ethical distinction between withholding and withdrawing care

A

None

MKSAP 20

This indicates that there is no ethical difference between the two actions in medical practice.

80
Q

Age to begin osteoporosis screening in average-risk women

A

65 years

MKSAP 20

This recommendation is based on guidelines for osteoporosis prevention.

81
Q

Recommended frequency of Td booster in adults

A

Every 10 years

MKSAP 20

Td refers to Tetanus and Diphtheria vaccination.

82
Q

Population appropriate for depression screening

A

All adults, including pregnant and postpartum patients

MKSAP 20

This highlights the importance of mental health screening across various demographics.

83
Q

Minimum preoperative DAPT duration after drug-eluting stent placement

A

3-6 months

MKSAP 20

DAPT refers to Dual Antiplatelet Therapy, crucial for preventing thrombotic events.

84
Q

Indications for perioperative bridging anticoagulation in patients with AF

A

CHA2DS2-VASc ≥7, recent thromboembolic event, mechanical heart valve

MKSAP 20

These criteria help assess the risk of thromboembolism in atrial fibrillation patients.

85
Q

Pneumococcal vaccination for immunocompetent patients aged ≥50 years

A

PCV20 alone, PCV21 alone, or PCV15 followed by PPSV23 ≥1 year later

MKSAP 20

PCV refers to Pneumococcal Conjugate Vaccine, and PPSV23 refers to Pneumococcal Polysaccharide Vaccine.

86
Q

Hospital VTE prophylaxis following hip fracture or total knee/hip arthroplasty

A

Concomitant mechanical and pharmacologic prophylaxis

MKSAP 20

This approach reduces the risk of venous thromboembolism in surgical patients.

87
Q

Effect of behavioral counseling interventions on cardiovascular events

A

20% reduction

MKSAP 20

This statistic reflects the efficacy of counseling in promoting heart health.

88
Q

Calculation for number needed to treat

A

1/absolute risk reduction

MKSAP 20

This formula helps determine the effectiveness of a treatment.

89
Q

Targeted screening in high-risk patients

A

Case finding

MKSAP 20

This strategy focuses on identifying patients who may benefit from screening based on risk factors.

90
Q

Preoperative laboratory testing in patients with CKD

A

Serum electrolyte and creatinine levels

MKSAP 20

CKD refers to Chronic Kidney Disease, making these tests vital for surgical safety.

Fosforilados (16 decks)

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