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Professional Development > PD 3 Final Exam > Flashcards

PD 3 Final Exam Flashcards

1
Q

______ a human population distinguished as a more or less distinct group by genetically transmitted physical characteristics

A

race

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2
Q

______ a sizable group of people sharing a common and distinctive racial, national, religious, linguistic or cultural heritage

A

ethnicity

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3
Q

_____ the collection of beliefs, customs, traditions, arts, social hierarchies, societal norms, experience, values, attitudes, and material traits of a particular racial, religious, or societal group

A

culture

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4
Q

which of the following terms is behavior based? race, ethnicity or culture

A

culture is behavior based

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5
Q

______ a disproportionate number of health conditions and deaths compared with the general population

A

health disparity

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6
Q

What population group is the most likely to be uninsured?

A

hispanic women of reproductive age, especially if they are living in poverty

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7
Q

T/F: Black adults are more likely when compared to white adults to trust health care workers

A

FALSE! Black adults are LESS likely to trust healthcare workers

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8
Q

T/F: black adults are more likely to perceive discrimination in the US health care system

A

TRUE

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9
Q

_____ are a set of behaviors and attitudes and a culture within the business or operation of a system that respects and takes into account the person’s cultural background, cultural beliefs, and their values and incorporates it into the way healthcare is managed to that individual

A

cultural competency

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10
Q

How do Americans and eastern countries differ in terms of attitudes toward conflict?

A

Americans - face-to-face, direct approach

Eastern countries - open conflict may be seen as demeaning

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11
Q

How do asian and hispanic culture vs european and american cultures approach to completing tasks?

A

Asian and Hispanic - promote relationship development at the beginning of a project, focus on completion at the end

European and American - promote working on the task first and letting relationships develop secondarily

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12
Q

How does American and S. European/Latin American cultures differ in terms of different approaches to decision making?

A

American - Delegation of decisions

S. European, Latin American - Make decisions oneself

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13
Q

T/F: Some cultures consider it inappropriate to be frank about emotions, reasons behind a conflict, personal information

A

true

attitudes towards disclosure are vastly different

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14
Q

What are the 4 basic steps to consider when caring for all patients?

A
  1. Identify the core cross-cultural issues
  2. Explore the meaning of the illness
  3. Determine the social context
  4. Negotiate
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15
Q

What are 2 important questions to ask your patient when trying to find the meaning of the illness?

A

What do you think has caused your problem?

What worries you most about the illness?

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16
Q

_______ Comparative study of how different cultures view disease and how they treat or prevent it

A

ethnomedicine

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17
Q

What is the vision of Healthy People 2030?

A

a society in which all people can achieve their full potential for health and well being across the lifespan

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18
Q

______ is reduction in ability to perform usual activities. Personal care/hygiene, school or work, socialization

A

Activity Limitation

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19
Q

What is the US average life expectancy- “free of activity limitation” ?

A

67.1 years

male: 65.3 years

female: 68.9 years

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20
Q

What are the different versions of healthy life expectancy?

A

Life Expectancy at Birth - Free of Activity Limitation

Life Expectancy at Birth - Free of Disability

Life Expectancy at Birth - In Good or Better Health

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21
Q

______ limited ability to participate in society due to problems with 1+ of the skills below:
Hearing, vision, concentration, remembering/decision making, walking/climbing stairs, dressing/bathing, doing errands alone

A

disability

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22
Q

What is the US average age for “free of disability”?

A

65 years old

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23
Q

______ rating self as being in good or better health for your age in terms of chronic disease, activity level, etc.

A

good or better health

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24
Q

What is the US average life expectancy for “good or better health”?

A

70.1 years

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25
Q

What is the average US life expectancy for both healthy and unhealthy years?

A

78.6 years

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26
Q

What are the 6 determinants of health?

A
  1. Social Determinants
  2. Physical Determinants
  3. Personal Behavior
  4. Health Services
  5. Biology and Genetics
  6. Policies and Laws
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27
Q

What are some examples of social determinants?

A

Availability of resources to meet needs
Education, jobs, wages, food
Social support, norms, attitudes
Exposure to crime, violence, mass media, technology
Quality of schools and education
Access to healthcare
Internet access
General socioeconomic condition

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28
Q

_______ Differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States. What are the MC?

A

health care disparities

CVD, DM and cancer

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29
Q

What is the Hospital Survey and Construction Act (“Hill-Burton Law”)?

A

Only federal legislation in the 20th century that permitted use of federal funds to provide racially exclusionary services

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30
Q

Hospital segregation ended with President Johnson signing into law the _____ on July 9, 1965

A

Medicare bill

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31
Q

What pt population is MC to be uninsured for a year or longer?

A

young, hispanic, poor, sick and living in the south

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32
Q

A _______ is one that experiences health disparities as a direct result of a lack of resources and/or an increased health care risk

A

“vulnerable population”

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33
Q

______ are the #1 vulnerable population from lecture

A

immigrants and refugees

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34
Q

_______ A tendency to believe that some people, ideas, etc., are better than others that usually results in treating some people unfairly

A

bias

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35
Q

What are biases fueled by?

A

Stereotypes
Negative past experiences
Views of family, friends, society

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36
Q

______ include clothing, art, buildings, food, festivals, observable mannerisms

A

external culture

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37
Q

_____ include values, norms, worldviews, expectations, beliefs

A

internal culture

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38
Q

_______ Actively berating a person or community based on cultural background

A

cultural desctructiveness

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39
Q

_______ Willing to support culturally oriented practices yet unable to actually provide support

A

cultural incapacity

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40
Q

______ Attempting to treat everyone the same regardless of culture. Can miss key elements attributable to culture

A

cultural blindness

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41
Q

_______ Recognizes culture is influential
Attempts to make some improvements and adaptations
No continuous improvement plan

A

cultural precompetency

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42
Q

______ Values diversity
Continuously implements and evaluates new ideas to improve culturally related care
Actively educating on or researching cultural care

A

cultural proficiency

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43
Q

_____ True, 100% cultural competency can never be fully achieved!
There is always room for improvement and change

A

cultural competency

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44
Q

______ malfunctioning of physiologic and/or psychological processes in a patient

A

disease

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45
Q

______ psychosocial experience and meaning of perceived disease for patient, family and friends

A

illness

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46
Q

models of communication: __________ Method most providers are taught by and most comfortable with. Attributes symptoms and diseases to pathophysiologic or
etiologic causes

A

western biomedical model

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47
Q

models of communication: __________ 8 questions geared towards evaluating patient beliefs about illness, its etiology, the treatment they want and where they want to go next with their care

A

explanatory model

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48
Q

models of communication: __________ Designed to elicit the psychosocial context of a situation, or life in general. Acts as a rough screening test for anxiety, depression and situational stress.

A

BATHE model

aka good for psych illness

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49
Q

models of communication: __________ Similar to Explanatory Model; adds in explicit opportunity for patient to educate the provider and the opportunity to express empathy in the structure of the interview.

A

BELIEF model

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50
Q

models of communication: __________ Geared towards improving cultural competence in particular; invites discussion of alternative treatments and healers and negotiation of plan of care.

A

ETHNIC model

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51
Q

models of communication: __________ Geared towards improving cultural competence in particular; general framework of visit with multicultural patients including negotiation of treatment.

A

LEARN model

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52
Q

models of communication: __________ A pared-down version of the explanatory model.

A

“4 C’s” model

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53
Q

______ The search for meaning, purpose, and truth in life and the beliefs and values by which an individual lives

A

spirituality

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54
Q

______ Attempts to answer the search and questions posed by spirituality with a specific set of beliefs and practices

A

religion

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55
Q

What are the 3 spiritual models of communication?

A

HOPE
FICA
SPIRIT

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56
Q

Limited English Proficiency (LEP) patients have _____ and ____ with healthcare in general

A

more problems

less satisfaction

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57
Q

T/F: Providers who participate in Medicaid, Medicare or any other federally-funded program are required to provide oral language assistance

A

TRUE!!

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58
Q

What is the order of “best value” in terms of which translators types are preferred in the healthcare setting?

A

1 Bilingual clinician >

#2 in-person interpreter >
#3 remote (video / phone) interpreter >
#4 family/friend

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59
Q

What are the guidelines for choosing an interpreter for a pt?

A

Choose interpreter of same age/gender or older

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60
Q

______ often use natural materials, traditional knowledge passed down by other ______. May include herbalism, acupuncture, massage, religious ceremony, prayer, personal or family counseling, voodoo, spiritual leaders, herbalists, mediums, divination

A

traditional healer

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61
Q

Give two pros of working with traditional healers.

A

Healers often have influence in community and over both patients and family

Patients may feel more comfortable with healers

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62
Q

When considering fusing traditional and alternative medicine, Cases must be handled ____ and with ______
We can’t judge whether the healing helps! Only if it would cause _____

A

individually

great sensitivity

harm

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63
Q

______ medical and health care systems, practices, and products that aren’t part of conventional/allopathic medicine OR have historic origins outside of mainstream medicine. What is the difference between the two?

A

Complementary/Alternative Medicine

Complementary - used TOGETHER with conventional therapies

Alternative - used IN PLACE of conventional therapies

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64
Q

What is integrative medicine?

A

Evidence-based and patient-centered

Strong emphasis on foundational health with a holistic approach: goal is to prevent disease, not just to treat it

Incorporates CAM when clinically indicated, in a way that is safe and synergistic with conventional therapies

65
Q

Who is the typical CAM pt? What organ system is MC?

A

Female
Middle-aged
Higher Educational Level
Multiple Medical Conditions

MSK and used complementary to standard medicine

66
Q

Dissatisfaction with allopathic medicine
was _____ to predict greater CAM use

A

NOT FOUND

67
Q

Health care workers may be (more/less) likely to use CAM than the general population

A

MORE LIKELY to use CAM

68
Q

CAM is more common in patients with (higher/lower) education status

A

higher education status

69
Q

What is the Mind-Body-Spirit Relationship?

A

the health of one part influences the other

70
Q

_______ Behavioral, psychological, social and spiritual approaches to medicine not commonly used. What are some common forms?

A

Mind-Body-Spirit Medicine

Biofeedback
Hypnosis
Meditation
Relaxation techniques
Yoga, Tai Chi, Qi Gong

71
Q

_______ Manipulation of soft tissue and bone. Treatment of wide range of diseases. Primarily musculoskeletal

A

Osteopathic medicine

72
Q

_______ Emphasis on spinal manipulation.
Treat wide range of diseases
Primarily musculoskeletal. How long is the training?

A

chiropractic medicine

5 years of training

73
Q

______ belief the body has powerful means of self-healing. How long is the training? What do they place emphasis on?

A

Naturopathy

4 years education is basic and clinical sciences

Emphasis on relatively low doses of drugs, herbal medications, special diets, exercises

74
Q

What are the requirements for a Naturopathic Physicians (ND, NMD)?

A

4 yr graduate level program at an accredited school

Need bachelor’s degree and standard premed courses

75
Q

What are the generic guidelines for traditional neuropaths?

A

Do not use prescription drugs, x-rays, surgery

Emphasize lifestyle changes and noninvasive tx

Not subject to licensing

Programs often distance learning, not accredited by a unifying body

76
Q

What is functional medicine? What is the focus on?

A

Must already be a licensed practitioner (MD, DO, chiropractor, ND, dentist, NP, PA, RN, dietician, pharmacist, acupuncturist)
AND
must complete a series of training modules

Focus on personalized, pt-centered health with emphasis on poor nutrition, stress, toxic exposures, allergens, genetics, and the microbiome as the root cause of disease

77
Q

______ is the organization that functional medicine providers must be members and maintain certification through

A

Institute for Functional Medicine

78
Q

What are the generic guiding principles of functional medicine practice?

A

Still complete thorough H&P with emphasis on lifestyle, genetics, and environment

Can use labratory testing and diagnostic studies depending on their baseline degree and state laws/regulations

Treat with a combination of lifestyle changes (nutrition, exercise), medication, botanical medications/supplements, detoxification programs, and stress-management techniques

79
Q

_______ Belief that a vital energy, chi, circulates in the body through 12 pathways (meridians). What are the training requirements?

A

acupuncture

Requires training, national exam, licensure
4 yrs of school for non-physicians

80
Q

What are the training requirements for massage therapy?

A

500 hrs of training, exam and licensing

46 states and DC have laws for licensing

81
Q

_______ Based on belief in opposing energies (“yin and yang”), life force energy (“qi”) and energy pathways in the body (“meridians”). Imbalanced energies or blocked flow of qi → illness

What are the training requirements?

A

oriental medicine

Training varies - many have completed masters/doctoral-level training
43 states require certification with the NCCAOM

82
Q

______ “The Doctrine of Similars”
Compounds diluted to 10^60 or more

Accepted less in the US than other countries

A

homeopathy

83
Q

______ used to tx benign prostatic hypertrophy (BPH)

Risks - dizziness, HA, hormonal effects

A

saw palmetto

84
Q

_____ used to tx depression, topical antimicrobial

Risks - numerous DDIs, dizziness, serotonin syndrome

A

St. John’s Wort

85
Q

_____ used to tx menopausal symptoms, PMS

Risks - stimulating hormone sensitive tissue (CA, endometriosis, fibroids)

A

Black Cohosh

86
Q

_____ used to tx anxiety, insomnia

Risks - hepatotoxicity

A

Kava Kava

not sold legally in the US

87
Q

Note: ALL herbal therapies carry the risk of _____, _____, and ______!

A

GI upset, DDIs and contamination/potency issues

88
Q

____ used to tx joint pain/OA

Risks - D/C, drowsiness, warfarin DDI, shellfish allergy

A

Glucosamine and Chondroitin

89
Q

_____ used to tx CHD, HF, HTN, hypertriglyceridemia

Risks - GI, oily stool, burping, bleeding

A

Fish oil

90
Q

_____ used to tx insomnia, jet lag

Risks - fatigue, depression, drowsiness, irritability

A

melatonin

91
Q

____ used to tx HF, HTN, statin-induced myopathy, migraine

Risks - mild heartburn, GI

A

Coenzyme Q10

92
Q

_____ is reported to treat a wide variety of diease.
Good evidence for epilepsy
Mild evidence for insomnia, anxiety, chronic pain
No evidence for more grandiose claims (e.g., cancer, overall wellness)

What is the 2nd MC ingredient?

A

CBD

cannabis

93
Q

______ essential oil can cause gynecomastia

A

lavender

94
Q

________ Often touted as a panacea as well as a “wellness booster” and can be consumed in many ways

A

urine therapy

95
Q

______ Also reported as a panacea - especially targeted at autistic pts, cancer pts and is essentially a bleach solution. life-threatening SE possible

A

“Miracle Mineral Solution”

96
Q

_______ Often touted as a cancer remedy
Typically orally administered - apricot pits/kernels
Highly toxic - basically cyanide

A

Laetrile (“Vitamin B17”, “Amygdalin”)

97
Q

______ Often seen as “natural” because it is based on an essential oil distilled from pine tree sap. Recommended for “Candidal infections,” but multiple benefits claimed. Can cause serious toxicity - as little as 1 tsp fatal in children, 3 tsp in adults

A

Turpentine

98
Q

_______ Compound containing sanguaranine (bloodroot) and/or zinc chloride. Highly corrosive - often touted as a topical tx to “draw out” cancer and spare normal tissue

A

Black salve

99
Q

_______ is the #1 reason CAM was not discussed with health care provider

A

health care provider never asked!

100
Q

What are 5 simple chemistry facts that everyone should understand?

A
  1. Everything is made of chemicals, even that organic vegan spirulina hemp seed coconut milk smoothie.
  2. There is no such thing as a toxic chemical, only toxic doses; “The dose makes the poison.”
  3. There is no difference between “natural” and “synthetic” (lab-created) versions of the same chemical.
  4. “Natural” chemicals are not automatically safe, and “artificial” chemicals are not automatically bad.
  5. A chemical’s properties are determined by the other chemicals that it is bound to.
101
Q

______ Concerned with the health effects of air, climate, water, sanitation, use of chemicals, radiation exposure, and aspects of cities and built environments

A

environmental health

102
Q

What actually kills people?

A

tobacco use
poor diet/lack of exercise
alcohol use
infectious agents
pollutants/toxins

103
Q

T/F: Pollution kills more people in developed countries than in developing countries.

A

FALSE! kills more people in DEVELOPING countries

104
Q

Many pollutants induce signaling pathways that are _____ sensitive

A

oxidative-stress

105
Q

What are some common cancer causes agents?

A

radon, asbestos, benzene, coal, soot and smoke, arsenic, triclosan

106
Q

What chemicals can lead to Obesity/Metabolic Syndrome/Diabetes? By interfering with ______

A

herbicide, triclosan, flame retardants, stain repellents, nonstick compounds, DDT

interfere with thyroid function

107
Q

_____ stored in fat released in blood with wt loss. may undermine further efforts to lose weight

A

xenobiotics

108
Q

____ and ______ increase pancreatic oxidative stress and may contribute to DM

A

arsenic and cadmium

109
Q

______ leads to oxidative stress which has a strong correlation w/development & progression of vascular diseases

A

toxic metals (heavy metals)

110
Q

_______ daily intake of a chemical that appears to be associated with minimal to no risk over lifetime. ____ and ____ regulate it in the US

A

acceptable daily intake

FDA and Dept of Agriculture

111
Q

______ ability of an agent to cause injury

A

hazard

112
Q

_____ frequency of undesirable occurrence after exposure

A

risk

113
Q

______ higher-than-usual prevalence or incidence of a disease in a group of patients with a common exposure

A

disease cluster

114
Q

What are the 3 different routes of exposure?

A

industrial
atmospheric
water/soil

115
Q

What is considered acute duration of exposure? chronic?

A

single or multiple over a brief period (seconds to 1-2 days)

chronic: multiple exposures over a longer period of time

116
Q

______ intake of contaminant > ability to excrete or metabolize. chemicals that accumulate in living organisms

A

bioaccumulation

117
Q

_____ increased concentration of a given contaminant as it goes up food chain

A

biomagnification

118
Q

_____ resist environmental, and often metabolic, breakdown

A

persistence

119
Q

______ rating based on repeated exposures which result in human or environmental adverse outcomes

A

toxicity

120
Q

_______ monitors the air pollutants. What is the score that is considered the national standard

A

Air Quality Index

Score of < 100 is considered the national standard

121
Q

carbon monoxide has ____ the affinity of O2. What are the s/s? What organs are commonly affected?

A

220X

Headaches, nausea, dizziness, LOC

brain and heart the most

122
Q

______ Bluish irritant gas occurring normally in atmosphere → absorbs UV light. What are the s/s?

A

ozone

irritation of mucous membranes

think respiratory inflammation

123
Q

What is the clinical impact of drinking contaminated water?

A

Waterborne infections - cholera, typhoid, amoebic dysentery

Chemicals and metals - arsenic, nitrates (fertilizers), pesticides, lead and other heavy metals

124
Q

Halogenated Aliphatic Hydrocarbons includes _____ which is the best known solvent. Under what scenario is it mainly used? What does it pose a serious problem to?

A

chloroform

dry cleaning and degreasing

persistent water pollutants

125
Q

_____ is an aromatic hydrocarbon. Where is it commonly seen?

A

benzene, toluene, xylene

combustion - volcanoes, forest fires, gasoline, tobacco smoke
common liquids - dyes, detergents, pesticides, cleaning, adhesives, lubricants, pharmaceutical solvent
common solids - plastics, resins, synthetic fibers

126
Q

what are s/s of solvent toxicity?

A

CNS depression and cancer

Toxic to heart, liver, kidneys, bone marrow
Chronic → impaired memory, peripheral neuropathy

127
Q

_____ is a common pesticide and is used to control mosquito populations. What are the s/s?

A

DDT

CNS stimulation: tremor, convulsions, dyspnea, lacrimation, confusion. May see long-term demyelinating neuropathy

128
Q

______ is a chlorophenoxys and is especially associated with _____ and ______

A

agent orange

neurologic disease and cancer

129
Q

______ : reduce to free radicals; have been ______ in humans. What are the s/s?

A

Bipyridyls

fatal

causes severe hemorrhage

130
Q

_______ most widely used herbicide in world. Likely to cause irritation of _____ and ______. What is the tx for toxicity?

A

glyphosate

skin and eye irritant

NO TX!

131
Q

_____ can have major effects at low levels. It is mainly absorbed through the ______. 99% binds to ___ and then transported to _____ then ______.

A

lead

LUNGS (rarely skin)

99% binds to Hb → transported to soft tissues, then bone

132
Q

Can lead cross the placenta?

A

YES!! can cross placenta and affect fetus

133
Q

What are s/s of lead toxicity? What is the tx?

A

neurotoxicity, anemia, fatigue, joint pain, abdominal pain (“lead colic”), HTN, cancer

chelation in acutely high levels, stopping exposure, symptomatic

134
Q

Where are 3 places mercury is found?

A

Elemental - manufacturing; gold mining; dental amalgam (very low risk)

Inorganic Salts - chloralkali (bleach) industry, electroplating, laboratory reagents

Diet - predatory fish (tuna, shark, swordfish, marlin, mackerel)

135
Q

Where is mercury absorbed? What are the s/s?

A

through lungs or GI/skin

nephrotic syndrome and CKD possible with both

136
Q

What are the s/s of elemental mercury toxicity? salts?

A

Elemental - pneumonitis (acute), neurotoxicity (chronic)

Salts - hemorrhagic gastroenteritis (acute), chronic GI irritation

137
Q

What is the tx for mercury toxicity?

A

chelation in acutely high levels, stopping exposure, symptomatic

138
Q

_____ is naturally occurring contaminate in well water, rice, smelting, refining, mining, pesticides (pre-1990s). It is absorbed by the ______

A

arsenic

GI tract

139
Q

What are some s/s of arsenic toxicity?

A

cancer, skin lesions, neurotoxicity, cardiotoxicity

Skin lesions - hyperpigmentation, hyperkeratotic papules

Salts - hemorrhagic gastroenteritis (acute), chronic GI irritation

140
Q

_______ is added to plastics, foam and fabrics. widespread exposure in virtually all pts

A

brominated Flame Retardants (BFR)

141
Q

What are ways to reduce BFR exposure?

A

avoiding torn/exposed foam, vacuuming, HEPA filters

142
Q

____ and ___ are microplastics. ______ make plastic more flexible. _____ makes plastic clear

A

phthalates and phenols

Phthalates

phenols

143
Q

______ are considered “forever chemicals”. Name 2 places these chemical are found

A

PFAs

stain and water resistance in carpets/fabrics

non-stick surfaces

144
Q

____ are at the highest risk of chemical toxicity. ____ filters out lead

A

kids

kidneys

145
Q

_____ and/or _____supplements (IV or oral) are used in functional medicine to help with detox

A

Glutathione and N-acetyl cysteine

146
Q

What does occupational health focus on?

A

primary prevention of hazards

147
Q

What is the goal of OSHA?

A

“Assuring safe and healthful working conditions for working men and women by setting and enforcing standards and by providing training, outreach, education and assistance.

148
Q

What is the role of an Occupational Health Providers?

A

To assess whether the adaptation will occur automatically, or if any accommodations are necessary.

149
Q

What is fitness to work examination?

A

Objective assessment of physical and mental health of employees in relation to requirements and working conditions of specific jobs

150
Q

What are the different determination of fitness to work?

A

Fit to work (they can do the job)
Temporarily fit
Fit, subject to work modifications
Temporarily fit, subject to work modifications
Temporarily unfit
Permanently unfit

151
Q

FtW: ______ Able to perform job without danger to self or others, without reservations or special restrictions

A

fit to work

152
Q

FtW: _______ Able to perform job without danger to self or others, without reservations or special restrictions
Should be reassessed in a given time frame

A

temporarily fit

153
Q

FtW: _______ Employee would be a hazard to self or others if employed in job as described
Would be fit to work without undue risk if certain conditions are modified

A

fit, subject to work modifications

154
Q

FtW: _______ Employee would be a hazard to self or others if employed in job as described, but would be fit to work without undue risk if certain conditions are modified
Should be reassessed in a given time frame OR requirement for work conditions may be lifted if patient’s conditions are improved

A

Temporarily fit, subject to work modifications

155
Q

FtW: ______ Unable to perform job without danger to self or others
Medical condition may improve over time, allowing return to work
Should be reassessed in a given time frame

A

temporarily unfit

156
Q

FtW: _____ Unable to perform job without danger to self or others

A

permanently unfit

157
Q

What are the 4 major categories of workplace hazards?

A

Physical Hazards
Ergonomic Hazards
Chemical Hazards
Biological Hazards

158
Q

When do you need to consider that the disease might be occupational?

A

The disease fails to respond to standard treatment
The disease does not fit typical demographics
The disease is of unknown origin

159
Q
A

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