Public Health 2.0, Renal, Heme Flashcards
Medical Insurance Plan Restricted to limited panel, except emergencies
Exclusive Provider Organization
Medical Insurance Plan Restricted to limited panel, except emergencies Deny for any service that does not meet established evidence-based guidelines
Health Maintenance Organization
Medical Insurance Plan Patient can see providers outside network I need a referral Higher copays and deductible for out of network services
Point of Service
Medical Insurance Plan Patient can see providers outside network I do not need a referral Higher copays and deductibles for all services
Preferred Provider Organization
Medical Insurance Plan Providers voluntarily enroll Medicare
Accountable Care Organization
Disease prevention, what type is this? Prevent disease before it occurs
Primary Disease Prevention
Disease prevention, what type is this? Screen early for and manage existing but asymptomatic disease (Pap Smear)
Secondary Disease Prevention
Disease prevention, what type is this? Treatment to reduce complications from disease that is ongoing or has long term effects
Tertiary Disease Prevention
Disease prevention, what type is this? Identifying patients at risk of unnecessary treatment, protecting from the harm of new interventions?
Quaternary Disease Prevention
Healthcare Payment Models Healthcare organization receives a set amount per service, regardless of ultimate cost, to be divided among all providers and facilities involved
Bundled Payment
Healthcare Payment Models Physicians receive a set amount per patient assigned to them per period of time, regardless of how much the patient uses the healthcare system, used by HMO
Capitation
Healthcare Payment Models Patient Pays for each individual service at a discounted rate predetermined by providers and payers
Discounted Fee for Service
Healthcare Payment Models Patient pays for each individual service
Fee-for-Service
Healthcare Payment Models Patient pays for all expenses associated with a single incident of care with a single payment. Most commonly used during elective surgeries, as it covers the cost of surgery as well as the necessary pre and postoperative visits
Global Payment
Who uses…. Medicare? Medicaid?
Medicare is Elderly Medicaid is Destitute
Medicare parts, which one is? Hospital Insurance, home hospice care
Part A
Medicare parts, which one is? Basic medical Bills, doctor’s fee, and diagnostic testing
Part B
Medicare parts, which one is? Combo of hospital insurance, home hospice care, and basic medical bills
Part C
Medicare parts, which one is? Prescription Drugs
Part D
PDSA Cycle, what does it stand for? Plan? Do?
Plan-define a problem Do-test a new process
PDSA Cycle, what does it stand for? Study? Act?
Study: Measure and analyze data Act: Integrate new process into workflow
What quality measure looks at Physical Equipment, resources, facilities?
Structural
What quality measure looks at Performance of system as planned?
Process
What quality measure looks at Impact on Patients
Outcome
What quality measure looks at Impact on other systems/outcomes
Balancing
What health care model focuses on systems and conditions rather than an individuals’s error?
Swiss cheese model
What type of medical error occurs at level of frontline operator, has an immediate impact?
Active Error
What type of medical error occurs in processes indirect from operator put impacts patient care, considered an “accident waiting to happen”?
Latent error
Medical Care analysis Retrospective approach, applied after failure event to prevent recurrence?
Root Cause Analysis
Medical Care Analysis Forward looking approach. Applied before process implementation to prevent failure occurrence?
Failure Mode and Effects Analysis
What equation is for the urine anion gap?
What equation is for the plasma anion gap?
Urine Anion Gap = Na + K - Cl
Plasma Anion Gap = Na - Cl - HCO3-
When there is a metabolic acidosis, what happens to the urine anion gap? Why
Urine anion gap is negative The equation Na+K-Cl = UAG is used. The increase in acid secretion will increase the Cl indirectly due to an increase in NH4+. Therefore, the UAG is negative
When there is a RTA type 1, what is a hallmark sign on xray and the UAG?
UAG is positive, cannot secrete H+, therefore, there wont be an increase in Cl, therefore, the UAG will be positive There will be bilateral calcium renal stones, usually an autoimmune disease with hypokalemia DDX RTA type IV has hyperkalemia
What drug can cause an increase or ensue a Type 1 RTA, think sketchy?
Amophotericin B, lose K, Mg via the drug, there is one test tube in the sketchy video too
What drug blocks the release of glutamate and norepi? This is used in fibromylagia
pregabalin
What class of drugs are used in Cardio, no effect on AP or ERP, therefore? Not to mention they are not allowed for structurally abnormal hearts What drug of this class is not in first aid?
Class 1c Morioizine
What does milrinone decrease?
afterload and preload
What drug inhibits late sodium currents, reducing diastolic wall tension and O2 consumption?
Ranolazine
What drug, cousin of heparin, can be given in order to not measure PTT?
Low Molecular Weight Heparin
What drug only acts on factor Xa, via antithrombin III?
Fondaparinux
what does cilostazol inhibit in the treatment of claudication?
Cyclic AMP phospodiesterase III
lost the ball in baseball sketchy video right hand side
What is the MOA for dipyridamole?
inhibit cyclic GMP phosphosdiesterase
What goes through the opening of T8?
What goes through the opening of T10?
Vena Cava
Oesophagus
What goes through the opening of T12?
name 3
Aortic hiatus
thoracic duct
azygos vein
What is a normal A-a gradient that has hypoxemia?
(Think Respiratory)
High altitude, hypoventilation
What drug can be given for granulocyte colony stimulating factor? This treats neutropenia and neutropenic fever
Filgrastim
What does metformin decrease?
What organ are we worried about with metformin?
gluconeogenesis
kidney
What does Sargramostim do?
GM-CSF, increase monocyte and granulocytes
What does Oprelevekin (IL-11) and Romiplostim do?
Increases thrombopoietin, increase platlet production