Associated Clinical Sciences Pt 2 (Pt II Boards)

malpractice suit must include

Duty

Dereliction

Damage

Direct causation

4 Ds 1 C

tried according to common law and precedent

standard of care

dr is accountable for average care

affected by advertising, specialization (diplomat, courses, technology changes)

obligated to reasonable diagnose

breech of contract

proving a cure

abandonment (no cover Dr for 7 days)

exceed consent

confidentiality

doctor is held vicariously responsible

tort/tort feasance

wrongful act

societal expectations

criminal charges

adjusting without permission is assault and battery

sexual misconduct

theft

civil suits (MC)

personal damages and duress (emotional, financial)

malpractice

breech of contracts

tort

consent

parental: minor

guardian: alzheimer's, disabled, impaired

informed: risks and options after ROF

implied: accident

experimental or research study needs consent

statute of limitations

period of time to file

7 years - adult

up to 18 years for minors

accounting

1040 ES form: as sole proprietor, estimate and pay taxes quarterly

benefits assignment: patient agrees to have insurance monies sent to dr

state board of examiners/members

selected by governor

protected citizens

binding arbitration

no appeal process

malfeasance

wrong act

res ipsa loquitur

the tings speaks for itself

vicarious liability

dr is responsible for employees actions

direct examination

questioning from the defense (dr attorney)

cross examination

questioning from the plaintiff (patients attorney)

comparative negligence

dr and patient share damage responsibility

voir dire

to speak the truth

primus non nocere

first do no harm

anxiolytic

drugs that are

zine, pine, mine

ram, pam, lam

tranquilizers

tranquilizers

causes falls in the elderly and for normal functional people

haldol

instructional levels anxiolytic

pseudoparkinsonism

schizo

wander

tremor

tardive dyskinesia

blood thinners

avoid vitamin K

"in's in the blood"

heparin

coumadin

aspirin

warfarin

dicumarol

vitamines C and E

muscarine

accidental mushroom poison

sedative and hypnotic drugs

barbiturates (sleeping pills, respiratory depressant, miosis (turning sympathetics off)

posions

SLUD

salivate

lacrimate

urinate

defectate

organophosphates

poisons like insecticides that block cholinesterase

cause runny nose and eyes

atropine

antidote for organophosphates and carbamates

where can you get nitrogen oxide from

cigarettes and plants

where can you get nitrous oxide

anesthetic from dentist

anabolic steroids

causes liver damage and early epiphyseal plate closure in children

carbon tetrachloride and chloroform

causes cause liver failure (even if inhaled)

lead

batteries, paint, solder, pottery glaze, rubber plastic toys, shooting gallery dust

acute lead poisoning

metallic taste, abdominal pain, black stools, Liguria, collapse, coma

chronic lead poisoning

weight loss, fatigue, headaches (encephalopathy), lead lines on gums (blue), anemia, irritable, vomiting, basophilic stippling, nerve tissue damage

lead treatment

EDTA

mercury

crayons, toys, paint

petroleum distillates

ipecac, gasoline, petroleum, lube

long term corticosteroid use

bone loss, DM, infections

ionizide overuse

ANS dysfunction

L-dopa overuse

Parkinsonism

monamine oxide inhibitors (MAO)

prevents breakdown of neurotransmitters increasing availability of synapses for depression

certain foods cause hypertension

takes 6+ months

tricyclics

for depression and takes 6 months to work

prozac

depression

inhibits serotonin uptake

what happens with SSRI

non suicidal turned homicidal

lithium carbonate

manic depressive

NSAIDS

ibuprofen (GI irritant)

acetaminophen is antipyretic and analgesic causing liver damage

overdose treatment for NSAIDS

vomit within 4 hours

n-acetylcysteine antidote

salicylates (aspirin)

for bleeding and inhibits prostaglandin

chronic use of aspirin

tinnitus, GI bleeding, and kidney irritation

overdose treatment for aspirin

vomit within 4 hours, activated charcoal, pump, call poison control

reyes syndrome

post viral influenza in children, acute encephalopathy, fatty infiltrate of viscera, hepatomegaly

headache, vomiting, amnesia, rash seizures, lethargy

Gillian barre

does not have encephalopathy

streptomycin

hearing problems

tetracycline

yellow teeth, avoid diary, avoid sun, binds with calcium

penicillin

anaphylactic shock and rash

amoxicillin

stunts GI neurotransmitters and diminishes brain maturation (autism)

Levaquin

tendon tears and ruptures

acyclovir

herpes

allopurinol

chronic gout for purine metabolism

colchinine

acute gout

Antabuse

disulfiram

turns to aldehyde in the gut when alcohol is ingested

dilantin

taken to decrease seizure activity

propranolol

migraines, heart arrhythmias

ritalin

ADD

tagament

ulcers

lipitor

decreases blood cholesterol

vioxx

cox-2 inhibitor

glucosamine and chondroitin sulfate

disc

MC cause of vision loss

cataracts

MC cause of blindness

macular dageneration

plasmacytoma

multiple myeloma, elevated SED rate, rouleaux formation

hypothyroidism

MC endocrine cause of carpal tunnel

presbyopia

lens elasticity (farsighted)

presbycusis

inability to hear high sounds

macular degeneration

irreversible, painless, central field loss

cerumen

MC cause of conduction loss in elderly

seborrheic keratosis

barnacles of old age

brown and elevated skin

lichenification and leukoplakia

pre-cancerous from things like chew tobacco

osteoporosis

need dexa scan

arterial insufficiency

pale, thin skin, smokers

venous insufficiency

rubor, stasis, dermatitis

part of aging

possible giant cell arteritis or MM

ERS >80 and Pt >50

what decrease in aging

GFR and kidney mass

lean muscle and collagen

lung capacity

extension

bone calcium

H2O and turgor

RBCs

brain and nerves

taste

what stays the same in aging

blood glucose, calcium and WBC

what increases in aging

fat, ESR, IgG, roux formation, residual volume

macule

papule

<1cm

raised and solid

wart

vesicle

<.5cm

raised and serous

herpes

"when you're hiving, hold the wheal or you'll urt the Caria"

pustule

<.5cm

raised and pus

acne

birthmark

flat

Mongolian lesion

nodule

raised and sold

arthritis

bullae

raised and serous

pemphigus lesion

furuncle

raised/pus

boil (carbuncle)

basal cell

MC

waxy, pearly, indurated, rodent ulcer

firm and raised center with depressed center

squamous cell

irregular, flaky (actinic keratosis)

grows out, cracks, bleeds

melanoma

pigmented, multicolor, most invasive skin cancer

grows down

precancerous

actinic keratosis (yellow), leukoplakia (white)

folliculitis

irritated hair follicles (groin and neck)