Ambulatory Care Exam 2- Special Populations

What agency compiles detailed descriptions of what constitutes a “rural” area, population density of <35 people per square mile

HRSA

HRSA estimates that what percent of the US population classifies are rural?

20%

Cholesterol, exercise, blood pressure, diet, weight, smoking, stress. 

Would this classify as modifiable, non modifiable, or modifiable but social? 

Modifiable 

Age, family history, sex 

Would this classify as modifiable, non modifiable, or modifiable but social? 

Non modifiable 

Income, diabetes, social support, insurance status

Would this classify as modifiable, non modifiable, or modifiable but social? 

Modifiable, but social

2 leading causes of death in rural areas?

Stroke and Unintentional injuries

What environmental exposures are connected to animals?

Lyme Disease and Rabies

How soon after a stroke can spontaneous motor recovery take place? 

3-6 months 

Condition caused by bite of tick infected with spirochete bacterium called…

Borrelia burgdorferi

Lyme disease results in

Chronic inflammatory process and multisystem disease

How long must ticks be attached to skin?

36 to 48 hours

Bulls eye rash around tick bite (seen 1-2 weeks after bite), a headache, neck stiffness, muscle pain, fever and chills are signs and symptoms of what? 

Symptoms of Lyme Disease 

Cardiac symptoms of untreated bacterium barrelia burgdorferi?

Dysrhythmias and heart block

Neurologic symptoms of barrelia burgdorferi?

Parasthesia, meningitis, encephalitis

MSK symptoms of barrelia burgdorferi?

Joint errosion

Oral antibiotics when treating lyme disease should take place for how long?

14-21 days 

What medication is most common for treating lyme disease? 

Doxycycline

Bullseye Rash Scientific name?

Erythema Migrans 

What repellant should you wear to prevent Lyme Disease?

DEET repellant or permethrin sprayed on clothes

What is considered a zoonotic disease?

Rabies

ELISA test or a western blood clot test is used for?

Diagnosing Lyme disease

When a person gets bitten and is exposed to rabies, a dose of human rabies immunoglobulin is injected around the wound. A vaccine dose is then given where?

Separate arms 

Rabies causes paoinful laryngeal spasms when the patient attempts to swallow liquids. This fear and avoidance of water is called what?

hydrophobia

Foaming of the mouth is called hyper salivation. Why does this happen?

Inability to swallow saliva

Herbicide used to clear dense forests in Vietnam for warfare?

Agent orange

For veterans under 45 what is the second most leading cause of death? 

Suicide 

For veterans what is the most leading cause of death?

Heart disease

After a patient gets an amputation, a stump shrinker is used for what?

Reduce edema

Maintaining this care is very important to prevent rigidity in the joints for patients with amputations

Contractures

How should patients avoid contractures?

Leg rest or board to keep leg extended 

The sensation of pain in a limb that has been amputated, and it is thought to be caused by the brain's attempt to find the missing limb

Phantom pain

How would you treat phantom pain?

Mirror, massage, acupuncture or opiods

Methadone, Naltrexone, buprenorphine

Reduces opioid use and cravings

Opiod receptor agonist 

Methadone 

Opioid receptor partial agonist

Buprenorphine

Opiod receptor antagonist

Naltrexone