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PCM > Spring Semester Exam 2 > Flashcards

Spring Semester Exam 2 Flashcards

1
Q

What are the leading causes of mortality in the US?

A

Modifiable risk factors

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2
Q

The most common causes of disease, disability, premature death, and healthcare burden can be attributed to what 4 health behaviors?

A
  1. Smoking
  2. Poor diet
  3. Physical inactivity
  4. Alcohol consumption
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3
Q

What is the USPSTF recommendation/grade for behavior change counseling regarding smoking?

A
  1. Ask all adults about tobacco use, advise them to stop, provide intervention/cessation information (A)
  2. Ask all pregnant women… (A)
  3. Ask all school-aged children and adolescents (B)
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4
Q

What is the USPSTF recommendation/grade for behavior change counseling regarding alcohol misuse?

A

Screen adults aged 18+ for alcohol misuse, provide counseling (B)

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5
Q

What is acceptable alcohol use for men and women daily?

A

Men: no more than 2 drinks per day
Women: no more than 1 drink per day

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6
Q

What is considered heavy drinking for men and women daily?

A

Men: more than 2 drinks per day on average
Women: more than 1 drink per day on average

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7
Q

Define binge drinking for men and women.

A

Men: 5 or more drinks in one sitting
Women: 4 or more drinks in one sitting

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8
Q

What is the USPSTF recommendation/grade for behavior change counseling regarding healthy diet and physical activity for cardiovascular disease prevention?

A

Offer adults who are overweight or obese and have additional cardiovascular disease risk factors counseling interventions (B)

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9
Q

What are the 5 A’s for behavior change counseling?

A
  1. Assess health risks and patient’s stage of readiness for change
  2. Advise health risks and behaviors that contribute to them
  3. Agree to identify a target behavior, barriers/benefits of change
  4. Assist by offering resources, strategies, support; create an action plan
  5. Arrange for monitoring and follow-up
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10
Q

Describe the stages of change model.

A
  1. Pre-contemplation
  2. Contemplation
  3. Preparation
  4. Action
  5. Maintenance –> Stable Behavior
  6. Relapse
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11
Q

What is the goal when a patient is in the pre-contemplation stage?

A

Patient will begin thinking about change

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12
Q

What is the goal when a patient is in the contemplation stage?

A

Patient will examine benefits and barriers

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13
Q

What is the goal when a patient is in the preparation stage?

A

Patient will discover the elements necessary for decisive action

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14
Q

What is the goal when a patient is in the action stage?

A

Patient will take decisive action

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15
Q

What is the goal when a patient is in the maintenance stage?

A

Patient will incorporate change into daily lifestyle

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16
Q

What is the goal when a patient is in the relapse stage?

A

Learn from temporary success and re-engage in the change process

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17
Q

When is motivational interviewing most appropriate?

A

When patients are in the pre-contemplative and contemplative stages

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18
Q

What are the 4 principles of MI?

A
  1. Express empathy
  2. Develop discrepancy
  3. Roll with resistance
  4. Support self-efficacy in the patient
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19
Q

What is the OARS model of MI?

A
  1. Open-ended questions
  2. Affirmations
  3. Reflective listening
  4. Summaries
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20
Q

What is a person’s confidence that she/he can carry out a behavior necessary to reach a desired goal?

A

Self-efficacy

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21
Q

When are physicians less likely to detect alcohol problems?

A
  1. When screening tools are not used universally

2. In patients who they do not “expect” to have alcohol problems (women, higher SES, white)

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22
Q

What is SBIRT?

A
  1. Screening - universal screening for quickly assessing use and severity of alcohol, illicit drugs, and prescription drug use/misuse/abuse
  2. Brief Intervention - brief MI given to risky or problematic substance users
  3. Referral to Treatment - referrals to specialty care for patients with substance use disorders
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23
Q

The primary goal of SBIRT is to identify and effectively intervene with those who are a ___ risk for psychosocial or health care problems related to their substance use.

A

Moderate or high

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24
Q

How much is one drink (wine, beer, spirits)?

A

5 oz glass of wine
12 oz glass of beer
1.5 oz spirits (80 proof)

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25
Q

What are some brief and valid pre-screening tools?

A

NIAAA Single-Question Screen, NIDA Single-Question Drug Screen, US AUDIT-C

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26
Q

What are some tools that should be used if a person screens positively in pre-screening?

A

AUDIT (Alcohol Use Disorders Identification Test), DAST (Drug Abuse Screening Test)

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27
Q

How is the AUDIT Scored?

A
  1. Low Risk (0-7): Zone I, Screening and Feedback
  2. At-Risk (8-15): Zone II, Brief Intervention
  3. Harmful Use (16-19): Zone III, Monitoring and Possible Brief Outpatient Treatment
  4. Dependent Use (20+): Zone IV, Referral for Evaluation and Treatment
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28
Q

How is the DAST 10 Scored?

A

1 point for each Yes

0: No Problems Reported, No Action
1-2: Low Level, Monitor, reassess at a later date
3-5: Moderate level, further investigation
6-8: Substantial level, intensive assessment

29
Q

What are the 4 steps in the brief negotiated interview?

A
  1. Build rapport (raise the subject, explore pros and cons)
  2. Provide feedback (ask permission, give information, elicit reactions)
  3. Build readiness to change (1-10 scale)
  4. Negotiate a plan
30
Q

What is the single largest preventable cause of morbidity and mortality in the US?

A

Tobacco use

31
Q

Nearly ___% of adults smokes.

A

20

32
Q

What are the three major aspects of HIPAA?

A
  1. Allows employees to change jobs without a gap in health insurance coverage
  2. Standardizes electronic health care transactions
  3. Regulates the privacy and security of health information
33
Q

HIPAA pre-empts state law unless the state law…

A

…provides greater privacy protections to a patient’s information or affords greater access to information rights to a patient

34
Q

What is a one major federal law governing human subject research?

A

Common Rule

35
Q

What are the four elements to be proven in a malpractice suit?

A
  1. Duty
  2. Breach of duty
  3. Causation
  4. Damages
36
Q

Who has the burden of proof in a malpractice suit?

A

Plaintiff

37
Q

What is that which a reasonably careful physician would do under the same or similar circumstances?

A

Duty

38
Q

What is a deviation from the standard of care and what are the two ways it may occur?

A

Breach of duty via omission or commission

39
Q

Causation requires a reasonable degree of ___.

A

Medical certainty

40
Q

What are the three ways a physician may be involved in the legal system?

A
  1. Defendant
  2. Treating physician
  3. Expert witness
41
Q

What type of discussion involves dealing with the actual question directly or meeting the patient’s style of resistance by remaining focused on the facts?

A

Content discussion (often effective, authoritarian, may lead to debates or impasses)

42
Q

What type of discussion involves commenting or asking about the underlying emotion or frustration and empathizing?

A

Process discussion (leads to better compliance)

43
Q

What is a group of diverse medical and health care systems, practices, and products that are not presently considered part of conventional medicine?

A

Complementary and alternative medicine

44
Q

___ medicine is used together with conventional medicine. ___ medicine is used in place of conventional medicine.

A

Complementary; alternative

45
Q

What type of medicine combines mainstream medical therapies and CAM therapies and demonstrates some high-quality scientific evidence of safety and effectiveness?

A

Integrative medicine

46
Q

What are the 5 domains of CAM?

A
  1. Alternative medical systems
  2. Mind-body interventions
  3. Biological-based therapies
  4. Manipulative and body-based methods
  5. Energy therapies
47
Q

What are the four classifications for evaluating CAM therapies?

A
  1. Unsafe/prove
  2. Safe/proven*
  3. Unsafe/unproven
  4. Safe/unproven*
48
Q

The main principle of ___ is: in a relaxed state, one can access the unconscious for self-control.

A

Hypnosis

49
Q

What is the provision of materials in the form of food to organisms for the purpose of supporting life?

A

Nutrition

50
Q

What is defined as the set of foods that an individual ingests?

A

Diet

51
Q

What are characteristics of successful weight losers?

A

Regimented program low in fat (24%) and kcal (1400), exercised vigorously almost daily to expend about 350 kcal

52
Q

A healthy eating pattern limits what 4 things?

A

Saturated fats, trans fats, added sugar, sodium

53
Q

What are the USDA quantitative recommendations regarding added sugars, saturated fats, sodium, and alcohol?

A

<10% of calories from added sugars
<10% of calories from saturated fates
2,300 mg/day of sodium
Moderation for alcohol

54
Q

For substantial health benefits, engage in moderate-vigorous aerobic exercise for ___minutes/week.

A

150

55
Q

How does one determine if a patient is safe to exercise?

A

Treadmill stress test or clinically

56
Q

Define high risk for exercise.

A

Known or equivalent cardiovascular, pulmonary, or metabolic disease

57
Q

Define moderate risk for exercise.

A

2+ CAD risk factors

58
Q

Define low risk for exercise.

A

Asymptomatic with no known CAD; men <45, women <55; no more than 1 risk factor

59
Q

What are exercise risk factors?

A
  1. Age
  2. Family history
  3. Cigarette smoking
  4. Sedentary lifestyle
  5. Obesity
  6. Hypertension
  7. Hypercholesterolemia
  8. Impaired fasting glucose
  9. NEGATIVE RISK FACTOR: HDL 60
60
Q

Moderate risk requires clearance prior to starting a ___ exercise program. High risk requires clearance prior to starting a ___ exercise program.

A

Vigorous; moderate

61
Q

What are the 4 components of an exercise prescription?

A
  1. Frequency (at least 5 days weekly)
  2. Intensity (Borg scale)
  3. Time (150 min/week for low-moderate intensity, 75 for vigorous)
  4. Types
62
Q

What are the 4 components of a complete nutrition assessment?

A
  1. Anthropometric data
  2. Biochemical evaluation
  3. Dietary history
  4. Clinical observation - nutrition physical examination
63
Q

What are the aspects of anthropometric data?

A

Height, weight, BMI

64
Q

How is BMI calculated?

A

Weight (kg)/Height (m^2) or Weight (lbs)/Height (in) * 703

65
Q

What are the BMI statuses?

A
  1. Underweight: <18.5
  2. Normal: 18.5-24.9
  3. Overweight: 25.0-29.9
  4. Obese: 30.0+
66
Q

What is a common measure used to assess abdominal fat content?

A

Waist circumference (men >40 in, women >35 in at risk)

67
Q

What are the aspects of biochemical evaluation?

A
  1. Glucose levels

2. Serum lipid data

68
Q

What is the difference between broad and focused questions?

A

Broad/background: topic overview for foundational learning

Focused/foreground: discrete questions about a broader topic

69
Q

What are the CRAAP criteria for evaluating information resources?

A
  1. Currency (timeliness)
  2. Relevance
  3. Authority (source)
  4. Accuracy
  5. Purpose (the reason the information exists)

PCM (3 decks)

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