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PCM Flashcards

1
Q

name the part of medicare: hospital care, limited nursing home & inpatient rehab & hospice

A

PartA

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2
Q

name the part of medicare: outpatient care, medical equipment & ancillary services

A

medicare part B

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3
Q

name this part of medicare: medicare advantage plans, administered through private insurance companies

A

medicare part C

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4
Q

name this part of medicare: prescription meds, doughnut hole

A

part D

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5
Q

the ACA requires employers with greater than ______ employees to provide health insurance

A

50

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6
Q

proportion of pts with the dz who have a finding divided by proportion of pts without the dz who have the finding

A

positive LR

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7
Q

proportion of pts with the dz lacking a finding divided by proportion of pts without the dz also lacking the finding

A

negative LR

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8
Q

what are 4 clinical findings of hepatocellular jaundice that have a high LR+?

A
  1. dilated abdominal veins (LR+ 17.5)
  2. palmar erythema (LR+9.8)
  3. spider angiomas (+LR 4.7)
  4. ascites
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9
Q

can physicians accurately estimate the liver span?

A

clinical assessment of liver span almost always underestimates the actual value

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10
Q

Pathologically speaking, what are the 3 causes of ascites?

A
  1. elevated hydrostatic pressure
  2. decreased osmotic pressure
  3. fluid production exceeding resorptive capacity
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11
Q

A complete evaluation for ascites includes what 2 components?

A
  1. history

2. physical exam

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12
Q

what should be included in the history when evaluating ascites?

A

recent ankle edema, weight gain, or change in abdominal girth
Other: hx of liver dz or CHF

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13
Q

a focused PE for ascites includes what 4 components?

A
  1. inspection for bulging flanks
  2. percussion for flank dullness
  3. a test for shifting dullness
  4. a test for a fluid wave
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14
Q

ascites is unlikely when pts report no _____________ and is very unlikely in male pts who report no history of recent __________________

A

abdominal girth, ankle swelling

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15
Q

how much fluid do you have to have in the peritoneum to detect shifting dullness?

A

500-1100 mL

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16
Q

how could you get a false positive result for shifting dullness?

A

it can happen with accumulation of fluid w/i loops of the colon (e.g. diarrheal illness)

17
Q

which finding has a high LR for splenomegaly?

A

detecting enlarged spleen (in other words if you can palpate the spleen it is most likely enlarged)

18
Q

what are some causes of splenomegaly (4)?

A
  1. hepatic dz (hepatomegaly)
  2. hematologic disorders (LAD, massive)
  3. infectious dz
  4. primary splenic disorders
19
Q

A finding of palpable spleen detecting ________ in returning travelers with fever has a very high LR+

A

malaria

20
Q

what is the gold standard test for ascites?

A

ultrasound

21
Q

What are the purposes of gastric acid?

A
  • provide right environement for activation of proteolytic enzymes
  • solubilizes divalent minerals in the diet
  • prevent conversion of nitrates into nitrites
  • release vitamin B12 from protein binding, for attachment to IF& later absorption
22
Q

bacterial fermentation of carbohydrate breakdown by colonic bacteria result in what 3 products?

A

acetic, propionic, butyric acid

23
Q

BMI of 25-29.9 is considered what?

A

overweight

24
Q

BMI of 30-34.9 is considered what?

A

obese

25
Q

severely obese pts are in what range for BMI?

A

35.0-40.0

26
Q

morbidly obese pts have what kind of BMI?

A

BMI over 40.0

27
Q

Name this model: individ. health behaviors occur w/i multilayered context encompassing interpersonal relationship w/i a community. Significant racial & ethnic disparities in terms of obesity are seen in the US today.

A

social ecological model

28
Q

which 2 races are more likely to be overweight or obese?

A

blacks & hispanics

29
Q

describe the 6 parts of the cycle of violence in domestic abuse?

A

abuse–>guilt–>excuses–>normal behavior–>fantasy–>set-up

30
Q

what are some signs suggestive of child abuse?

A 
cigarette burns
stocking glove burns
multi skull fractures
rib fractures
cerebral edema & retinal hemorrhages (suggest violent shaking)
31
Q

what provides diagnosis for appendecitis?

A

CT & clinical exam

32
Q

what are the findings of appendicitis that have high +LRs?

A

guarding, rebound tenderness, WBCs >17,000

33
Q

how do you diagnose biliary colic?

A

ultrasound

GI (12 decks)

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