CCMA advanced eclinical exam

scope of practice

Scope of practice refers to the duties and tasks that a MA can perform based on their education, training and certification

HMO

HMO's often use the PCP as the "gatekeeper". A patient receives all primary andpreventative care from the PCP. Any care needs outside the PCP's scope of practice would be referred out and coordinated by the PCP. Any care, other than emergency care, not coordinated through the PCP would not be covered by the HMO.

4 types of HMO's

- group model

-individual practice association

-network model

-staff model

PPO

preferred provider organization: : A program in which contracts are established with providers of medical care. the benefit contract provides significantly better benefits for services received from preferred providers, thusencouraging members to use these providers

POS

point of service plan: n: A type of health plan allowing the covered person to choose to receive a service from a participating or a nonparticipatingprovider, with different benefit levels associated with the use of participating providers. Members usually pay substantially higher costs in terms of increasedpremiums, deductibles, and coinsurance

PCMH

the patient centered medical home: an approach to delivering high-quality, cost-effective primary care. Using a patient-centered,culturally appropriate, and team-based approach, the PCMH model coordinates patient care across the health system. The PCMH model has been associated witheffective chronic disease management, increased patient and provider satisfaction, cost savings, improved quality of care, and increased preventive care.

ACO

accountable care organizations: groups of hospitals, physicians, and other providers who agree to coordinate care for patients anddeliver the right care at the right time, while avoiding unnecessary utilization of services and medical errors. ACO participants also agree to take onresponsibility for the total costs of care for their patients. ACOs that reduce the total costs of care for their patient populations can share in the savingswith the payer.

hospice

Hospice care is a special kind of care that focuses on the quality of life for people who are experiencing an advanced, life-limiting illness andtheir caregivers. Hospice care provides compassionate care for people in the last phases of incurable disease so that they may live as fully andcomfortably as possible.

Collaborative care model

The collaborative care model offers one approach to integration in which primary care providers, care managers, andpsychiatric consultants work together to provide care and monitor patients' progress.

Pay for performance

also known as "value-based purchasing", is a payment model that offers financial incentives to physicians, hospitals,medicalgroups, and other healthcare providers for meeting certain performance measures.

General practitioner

a physician who treats acuteand chronic illnesses and provides preventive care and health education topatients of all ages. Their duties are not confined to specific fields of medicine,and they have skills in treating people with multiple health issues

family practitioners

Family medicine is a medical specialty within primary carethat provides continuing and comprehensive health care for the individual andfamily across all ages

Internists

They're doctors who specialize in the internal organs and systems ofthe body, but they are not limited to those areas. They can also give preventivecare and treat anything from skin rashes to ear infections. They only treat adults

allergist/immunologist

They treat immune system disorders such as asthma, eczema, food allergies, insect sting allergies, and some autoimmunediseases.

anesthesiologists

These doctors give you drugs to numb your pain or to put you under during surgery, childbirth, or other procedures. Theymonitor your vital signs while you're under anesthesia

cardiologists

They're experts on the heart and blood vessels. You might see them for heart failure, a heart attack, high blood pressure, or anirregular heartbeat

dermatologists

Have problems with your skin, hair, nails? Do you have moles, scars, acne, or skin allergies

endocrinologists

These are experts on hormones and metabolism. They can treat conditions like diabetes, thyroid problems, infertility, and calciumand bone disorders

Gastroenterologists

They're specialists in digestive organs, including the stomach, bowels, pancreas, liver, and gallbladder. You might see them forabdominal pain, ulcers, diarrhea, jaundice, or cancers in your digestive organs. They also do a colonoscopy and other tests for colon cancer

hematologist

These are specialists in diseases of the blood, spleen, and lymph glands, like sickle cell disease, anemia, hemophilia, and leukemia.

Infectious Disease Specialists

-They diagnose and treat infections in any part of your body, like fevers, Lyme disease, pneumonia,tuberculosis, and HIV and AIDS. Some of them specialize in preventive medicine or travel medicine

nephrologists

They treat kidney diseases as well as high blood pressure and fluid and mineral imbalances linked to kidney disease

neurologists

These are specialists in the nervous system, which includes the brain, spinal cord, and nerves. They treat strokes, brain andspinal tumors, epilepsy, Parkinson's disease, and Alzheimer's disease

OBGYN

these doctors focus on women's health, including pregnancy and childbirth. TheydoPap smears, pelvic exams, and pregnancy checkups. OB/GYNs are trained in both areas. But some of them may focus on women'sreproductive health (gynecologists), and others specialize in caring for pregnant women (obstetricians

oncologists

These internists are cancer specialists. They do chemotherapy treatments and often work with radiation oncologists andsurgeons to care for someone with cancer.

ophthalmologists

You call them eye doctors. They can prescribe glasses or contact lenses and diagnose and treat diseases like glaucoma.Unlike optometrists, they're medical doctors who can treat every kind of eye condition as well as operate on the eyes

pathologists

These lab doctors identify the causes of diseases by examining body tissues and fluids under microscopes.

pediatrician

They care for children from birth to young adulthood. Somepediatricians specialize in pre-teens and teens, child abuse, or children'sdevelopmental issues

podiatrists

They care for problems in your ankles and feet. That can includeinjuries from accidents or sports or from ongoing health conditions likediabetes. Some podiatrists have advanced training in other subspecialties ofthe foot.

plastic surgeons

-You might call them cosmetic surgeons. They rebuild orrepair your skin, face, hands, breasts, or body. That can happen after aninjury or disease or for cosmetic reasons

urologists

These are surgeons who care for men and women for problemsin the urinary tract, like a leaky bladder. They also treat male infertility anddo prostate exams.

managed care plan

An umbrella term for all healthcare plans that provide healthcare in return for preset monthly payments and coordinated care through a defined network of primary care physicians and hospitals

medicare

A federally sponsored health insurance program for those over age 65 and for individuals under age 65 who are disabled

medicaid

Medicaid is a joint federal and state program that, provides health coverage to qualifying children, pregnant women, parents, seniors, and individuals with disabilities. Medicaid is the single largest source of health coverage in the United States. To participate in Medicaid, federal law requires states to cover certain groups of individuals. Low-income families, qualified pregnant women and children, and individuals receiving Supplemental Security Income (SSI) are examples of mandatory groups. States have additional options for coverage and may choose to cover other groups, such as individuals receiving home and community-based services and children in foster care who are not otherwise eligible

TRICARE

A government-sponsored program under which authorized dependents of military personnel receive medical care. Originally called CHAMPUS

workers comp.

A system of laws that protects employees against the loss of wages and the cost of medical care resulting from an occupational accident, disease, or death, unless the employee is proven negligent

CHAMPVA

Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) A comprehensive health care program in which the VA pays the cost of covered health care services and supplies for eligiblebeneficiaries; to be eligible, the individual cannot be eligible for TRICARE, but can be the spouse or child of a disabled veteran, as well as the surviving spouse or child of a veteran who died from a service-connected disability;a veteran who died while suffering a service disability; or a military member who died in the line of duty.

private health insurance

-Privatehealth insurance is individual health insurance available to an individual or family through either the federal health insurance marketplace (Affordable Care Act plans) or directlyfrom private insurance companies.

Advanced beneficiary notice

helps Medicare Fee-for-Service (FFS) beneficiaries make informed decisionsabout items and services Medicare usually covers but may not cover in specific situations

allowed charge

(allowable amount) The maximum amount of money that many third-party payers allowfor a specific procedure or service

co-insurance

-A policy provision frequently found in medical insurance whereby the policyholder and theinsurance company share the cost of covered losses in a specified ratio (e.g., 80/20 means that 80% iscovered by the insurer and 20% by the insured

Copay

A sum of money that is paid at the time of medical service; a form of co-insurance.

deductible

Specific amounts of money a patient must pay out of pocket before the insurance carrierbegins paying. Usually, this amount ranges from $100 to $500. This deductible amount is met on a yearlyor per-incident basis

explanation of benefits

A letter or statement from the insurance carrier describing what was paid,denied, or reduced in payment. It also contains information about amounts applied to the deductible, thepatient's co-insurance, and the allowed amounts

participating provider

A physician or other healthcare provider who enters into a contract with aspecific insurance company or program and by doing so agrees to abide by certain rules and regulations setforth by that third-party payer.

superior (cranial)

toward the head or upper part of the body; above

inferior (caudal)

away from the head or toward the lower part of the body, below

ventral (anterior)

toward or at the front of the body; in front of

Dorsal (posterior)

toward the back of the body; behind

medial

toward the midline of the body

lateral

away from the midline of the body

intermediate

between a medial and lateral position

proximal

closer to the origin of the body part or point of attachment of a limb to the body trunk

distal

away from. the origin of a body part or point of attachment of a limb to the body trunk

superficial (external)

toward or at the body surface

deep (internal

away from the body surface

saggital plane

a vertical plane that divides the body into left and right parts

oral administration

Pills, capsules, syrups, elixirs, and lozenges are all examples of oral medications. However, not all medications given orally are absorbed by the digestive tract. Medications for mucosal absorption may be given sublingually or in the buccal mucosa as well

inhalation medical administration

Metered dose inhalers, dry powder inhalers, nebulizers, as well as oxygen by nasal cannula or mask are all examples of inhaled medications. Because the medication is delivered right to the site of action, these medications work very quickly

topical medical administration

Creams, ointments, gels, are all forms of topical medication. These are applied directly to the skin for absorption. Keep in mind that occluding a topical medication with clothing or bandages may enhance its systemic absorption

instillation medical administration

Instillation is the term used for delivery of a medication by drops. Instillation can be used for the eyes, the ears, or the nose. Examples include eye drops for allergies or infection11ear drops for pain or infection and nasal drops for congestion or infection. Installation requires proper patient positioning

transdermal medical administration

Transdermal patches deliver medication topically, but usually do so slowly overtime. Examples include Fentanyl patches for pain and estrogen patches for hormone replacement therapy.

vaginal medical administration

Medications delivered vaginally typically come in the form of suppositories, pills, or creams. The vaginal ring may also be used as a form of contraception. These all deliver their effect via mucosal absorption of the vagina

rectal medical administration

The rectum provides a mucosal surface for drug absorption that typically produces a rapid effect using smaller medication doses. This is because medications given by this route bypass metabolism in the liver. Nausea, anti-seizure, and narcotic and non-narcotic pain medications are frequently given in this manner

subcutaneous injection

The medication is injected into the subcutaneous fat. An example of a drug that is delivered SQ is insulin

intramuscular injection

The medication is injected into the muscle belly itself. An example of an IM drug is corticosteroid, such as dexamethasone

intradermal injection

The medication is injected very superficially into the dermis, or second layer of skin. The most common use of ID injection is for delivery of PPD, known as the Mantoux test for tuberculosis

schedule I

Schedule I drugs, substances, or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse. Some examples of Schedule I drugs are: heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), 3,4-methylenedioxymethamphetamine (ecstasy), methaqualone, and peyote

schedule II

Schedule II drugs, substances, or chemicals are defined as drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence. These drugs are also considered dangerous. Some examples of Schedule II drugs are: combination products with less than 15 milligrams of hydrocodone per dosage unit (Vicodin), cocaine, methamphetamine, methadone, hydromorphone (Dilaudid), meperidine (Demerol), oxycodone (OxyContin), fentanyl, Dexedrine, Adderall, and Ritalin

Schedule III

Schedule III drugs, substances, or chemicals are defined as drugs with a moderate to low potential for physical and psychological dependence. Schedule III drugs abuse potential is less than Schedule I and Schedule II drugs but more than Schedule IV. Some examples of Schedule III drugs are: products containing less than 90 milligrams of codeine per dosage unit (Tylenol with codeine), ketamine, anabolic steroids, testosterone

schedule IV

Schedule IV drugs, substances, or chemicals are defined as drugs with a low potential for abuse and low risk of dependence. Some examples of Schedule IV drugs are: Xanax, Soma, Darvon, Darvocet, Valium, Ativan, Talwin, Ambien, Tramadol

schedule V

Schedule V drugs, substances, or chemicals are defined as drugs with lower potential for abuse than Schedule IV and consist of preparations containing limited quantities of certain narcotics. Schedule V drugs are generally used for antidiarrheal, antitussive, and analgesic purposes. Some examples of Schedule V drugs are: cough preparations with less than 200 milligrams of codeine or per 100 milliliters (Robitussin AC), Lomotil, Motofen, Lyrica, Parepectolin

pharmacokinetics

Study of drug absorption, distribution, metabolism, and excretion.

cc to mL

1:1

tsp to cc

1:5

tbsp to cc

1:15

rights of medication administration

-right patient

-right drug

-right route

-right time

-right dose

right doccumentation

right doccumentaion

Always immediately and completely document all details regarding the administration of the medication in the patient's medical record, including how the drug was tolerated.

anorexia nervosa

is a potentially life-threatening eating disorder characterized by an abnormally low body weight, intense fear of gaining weight, and a distorted perception of weight or shape

bullimia nervosa

is a serious, potentially life-threatening eating disorder. When you have bulimia, you have episodes of bingeing and purging that involve feeling a lack of control over your eating

binge eating disorder

When you have binge-eating disorder, you regularly eat too much food (binge) and feel a lack of control over your eating. You may eat quickly or eat more food than intended, even when you're not hungry, and you may continue eating even long after you're uncomfortably full.

Ericksons stages of psychosocial development

Stage 1: Trust vs. Mistrust (Infancy from birth to 18 months)

Stage 2: Autonomy vs. Shame and Doubt (Toddler years from 18 months to three years)

Stage 3: Initiative vs. Guilt (Preschool years from three to five)

Stage 4: Industry vs. Inferiority (Middle school years from six to 11)

Stage 5: Identity vs. Confusion (Teen years from 12 to 18)

Stage 6: Intimacy vs. Isolation (Young adult years from 18 to 40)

Stage 7: Generativity vs. Stagnation (Middle age from 40 to 65)

Stage 8: Integrity vs. Despair (Older adulthood from 65 to death

maslov's hierarchy of needs

Biological and physiological needs - air, food, drink, shelter, warmth, sex, sleep.

Safety needs - protection from elements, security, order, law, stability, freedom from fear• Love and belongingness needs - friendship, intimacy, trust, and acceptance, receiving and giving affection and love. Affiliating, being part of a group (family, friends, work)

Esteem needs - which Maslow classified into two categories:

1. esteem for oneself (dignity, achievement, mastery, independence)

2. the need to be accepted and valued by others (e.g., status, prestige).

Self-actualization needs - realizing personal potential, self-fulfillment, seeking personal growth and peak experiences. A desire "to become everything one is capable of becoming"

stages of grief

Denial- Avoidance, confusion, Shock, Fear

Anger- Frustration, Irritation, Anxiety

Bargaining- Struggling to find meaning, reaching out to others trying to find meaning

Depression- overwhelmed. Helplessness, hostility

Acceptance- exploring options, moving forward

frontal plane

Also known as coronal, the frontal plane faces forward and divides the body into anterior and posterior (or ventral and dorsal) portions.

saggital

Also known as lateral, the sagittal plane runs perpendicular to the ground and divides the body into left and right portions. Note that a midsagittal or median plane would pass directly through the spine and navel. All other lateral plans are considered parasagittal.

transverse

Also known as horizontal, the transverse plane runs parallel to the ground and divides the body into superior and inferior (or cranial and caudal) portions

abdominal cavity

contains the stomach, intestines, liver, spleen, gallbladder, pancreas, ureters, and kidneys

cranial cavity

the cavity inside the skull, or the cranium, contains the brain

pelvic cavity

contains the urinary bladder, urethra, part of the large intestine, and the rectum, uterus, and vagina in the female, and prostate in the male.

spinal cavity

consists of the spinal column connecting to the cranial cavity.

thoracic

contains the esophagus, trachea, lungs, heart, and aorta. This cavity can be divided into two smaller areas. The pleuralcavity surrounds the lungs.

mediastinum

is the area between the lungs. It contains the heart, aorta, trachea, esophagus, and thymus gland.

cells

The smallest unit of all life is the cell. Cells are primarily responsible for storing genetic information and carrying out microscopic processes such as metabolism and protein synthesis. However, human cells are specialized to perform specific tasks, so their structure and function varies greatly

tissues

A group of cells with the same structure and function make up tissue. Tissues are typically arranged in layers and also differ based on their operation and location in the body. The most general tissue categories include epithelial, connective, muscle, and nervous tissues, but each division includes more precise types (such as cardiac, smooth, and skeletal)

organs

More than one tissue arranged together into a differentiated structure is called an organ. Organs are specialized and each is responsible for a specific, vital function in the body. They can be hollow or solid but are typically self-contained. Examples of organs include the heart, lungs, brain, and liver

organ system

An arrangement of organs working together to achieve a unified bodily objective(such as respiration, blood circulation, or digestion) is an organ system. There are at least 11 unique organ systems, but sometimes systems are referred to in a combined fashion based on their close interaction (such as muscular and skeletal into "musculoskeletal")

skeletal system functions

mechanical support, movement, protection, blood cell production, calcium storage and endocrine regulation.

axial skeleton

consists of the bones of the head and trunk.

appendicular skeleton

consists of the bones within the limbs, as well as supporting pectoral and pelvic girdles.