Medical Assisting Study Guide

Managed Health Care

  • Managed healthcare systems integrate healthcare delivery functions to improve efficiency.
  • They determine service prices and reimbursements.
  • They function as insurance, creating contract plans between clients and providers.

Types of Care

  • Acute care: For short-term illnesses or injuries.

  • Long-term care: For patients with severe trauma, medical conditions, or those unable to care for themselves.

  • Custodial care: Basic in-home care.

  • Intermediate care: Higher level than custodial care, requiring nursing supervision.

  • Subacute care: Includes wound care, continuous IV therapy in stable patients needing care.

  • Transitional Hospitals: Serve patients medically stable but needing complex care at a lower cost than traditional hospitals.

    • Areas covered: Burn and wound care, IV therapies.

Prefixes and Root Words

Prefixes

  • a-, an-, ar-: without
  • ab-: away from
  • ad-: toward
  • aer-: air
  • angio-: vessel
  • ante-: before, in front of
  • anti-, contra-: against
  • arteri-: artery
  • auto-: self
  • bi-: two
  • brady-: slow
  • cardi-: heart
  • chron-: time, long time
  • con-: together
  • cubit-: elbow
  • de-: without
  • dia-: thorough, completely
  • dys-: abnormal, difficult, or painful
  • endo-: inside, within
  • epi-: on, over, upon
  • erythr-: red
  • eti-: cause
  • equi-: equal
  • ex-, ec(t)-: out of, outside
  • gluc-/glyc-: sugar/glucose
  • hemat-: blood
  • hemi-: half (one side)
  • hepat-: liver
  • homo-: same
  • hyper-: too much, too high
  • hypo-: low, under
  • inter-: between
  • leuk-: white
  • macro-: large
  • mal-: bad
  • melan-: black or dark
  • micro-: small
  • mono-, uni-: one
  • neo-: new
  • phleb-: vein
  • poly-: many
  • ren-: kidney
  • thromb-: clot
  • ven-: vein
  • peri-: around
  • poly-: many
  • post-: after
  • pre-, pro-, ante-: before
  • pseudo-: false or deceptive
  • re-: again
  • retro-: behind or backward
  • semi-: half
  • supra-: above
  • tachy-: rapid, fast
  • trans-: across
  • tri-: three
  • quad(ri)-: four

Root Words

  • angi: blood vessels
  • aort: aorta
  • he, sangu: blood
  • arteri: arteries
  • hemat/o: pertaining to the blood
  • my/o: related to muscle
  • bar: pressure
  • sclerosis: hard or hardening
  • cardi/o: related to the heart
  • stasis: slowing or stopping the flow of bodily fluid
  • chem: drug
  • therm/o: indicates heat
  • derm/a/o, dermat/o: pertaining to the skin
  • ven, phleb: veins

Suffixes

  • -ac, -ar(y), -(e/i)al, -ic(al), -ior, -ory, -ous, -tic: pertaining to
  • -algia: pain
  • -ase: enzyme
  • -ation: indicates a process
  • -centesis: surgical puncture to remove fluid
  • -cyte: cell
  • -emia: blood condition
  • -genic: causing
  • -gram: recording, writing
  • -ia, -ism, -sis, -y: condition
  • -ian, -ist: specialist
  • -iatry, -iatrics, -ics: specialty
  • -itis: inflammation
  • -lysis: breakdown, destruction, or decomposition
  • -logy: the study of
  • -oma: tumor
  • -osis: condition or disease
  • -pathy: disease or disease process
  • -penia: deficiency
  • -poiesis: formation
  • -rrhag(e/i a): excessive flow
  • -stasis: stopping, controlling, or standing
  • -ula, -ulum, -ulus: small, little
  • -um: structure

Anatomical Terms

  • Anterior (or ventral): Front.
  • Posterior (or dorsal): Back.
  • Superior (or cranial): Towards the head.
  • Inferior (or caudal): Away from the head.
  • Medial: Towards the midline of the body.
  • Lateral: Away from the midline of the body.
  • Proximal: Closer to the point of attachment or origin.
  • Distal: Farther from the point of attachment or origin.
  • Planes:
    • Sagittal (or longitudinal) plane: Divides the body into right and left sections.
    • Median plane: Divides the body into equal right and left halves.
    • Parasagittal plane: Divides the body into unequal right and left sections.
    • Coronal (or frontal) plane: Divides the body into anterior and posterior sections.
    • Horizontal, axial, or transverse plane: Divides the body into superior and inferior sections.

Cell Functions and Structure

  • Metabolism: Chemical reactions for processing molecules.
  • Respiration: Use oxygen to release energy from food.
  • Reproduction: Cell division to create new cells.
  • Cell membrane: Controls what enters and leaves the cell.
  • Nucleus: Contains DNA.
  • Cytoplasm: Substance in which most cell activities occur.
  • Mitochondria: Cell’s powerhouse, energy producer.
  • Ribosomes: Protein builders.
  • Endoplasmic reticulum: Material transport.
  • Golgi apparatus: Packages and distributes materials.
  • Lysosomes: Break down waste and digest it.

Cardiovascular System

  • Blood flow through the heart:
    1. Right atrium receives blood from the superior vena cava (head, neck, arms, and chest) and the inferior vena cava (trunk and legs).
    2. Blood passes through the right atrioventricular (tricuspid) valve into the right ventricle.
    3. Deoxygenated blood enters the pulmonary circuit to the right and left pulmonary arteries.
    4. Gas exchange occurs in smaller arterioles and capillaries.
    5. Blood flows from respiratory capillaries into the left and right pulmonary veins into the left atrium.
    6. Blood flows through the mitral valve into the left ventricle, the aortic semilunar valve, and the ascending aorta to the systemic circuit.
  • Systemic circuit: Carries oxygenated blood to the body's tissues.

Blood Vessels

  • Capillaries: Tiny vessels between arteries and veins.
Structure of Blood Vessels
  • Arteries and veins have three layers; veins have thinner walls due to lower pressure.
  • Veins have venous valves to support blood flow to the heart.
    • Tunica intima (interna): Simple squamous epithelium.
    • Tunica media: Smooth muscle.
    • Tunica adventitia (externa): Connective tissue, elastic and collagenous fibers.
  • Capillaries:
    • Endothelial cells: Control flow of blood, nutrients, and gases.
    • Epithelial cells: Provide protection.

Digestive System

  • Mouth and salivary glands: Amylase breaks down starch.
  • Stomach: Food mixes with hydrochloric acid to make chyme. Esophageal and pyloric sphincters control the stomach.
  • Small intestine: Duodenum, jejunum, and ileum. Bile (from liver) and amylase/insulin (from pancreas) digest fats and starches.
  • Large intestine: Absorption of water and salts.

Endocrine System

  • Hypothalamus: Links pituitary gland and endocrine system, controlling temperature, hunger, thirst, fatigue, and sleep.
  • Pituitary gland: Influences bone growth, milk production, childbirth, and menstruation.
  • Pineal gland: Regulates sleep.
  • Thyroid: Influences metabolism and protein synthesis.
  • Parathyroid glands: Regulate calcium.
  • Adrenal glands: Release adrenaline, aldosterone, and cortisol.
  • Pancreas: Produces insulin and glucagon.
  • Ovaries: Produce eggs, estrogen, and progesterone.
  • Testes: Produce sperm and testosterone.

Urinary System

  • Kidneys: Filter blood and produce urine.
  • Ureters: Carry urine to the bladder.
  • Bladder: Stores urine.

Female Reproductive System

  • Ovaries: Produce ova, estrogen, and progesterone.
  • Fallopian tubes: Carry ova to the uterus.
  • Uterus: Egg implants into the uterine wall if fertilized.
  • Cervix: Connects the uterus to the vagina.
  • Vagina: Muscular tube from cervix to exterior.

Male Reproductive System

  • Epididymis: Stores maturing sperm.
  • Vas deferens: Moves sperm to ejaculatory duct.
  • Seminal vesicles: Secretes alkaline fluid into ejaculatory duct.
  • Prostate gland: Secretes proteinaceous fluid into semen.
  • Bulbourethral gland: Secretes neutralizing fluid into urethra.

Nervous System

  • Brain: Cerebrum, brainstem, and cerebellum.

    • Cerebrum: Frontal, temporal, parietal, and occipital lobes.
    • Cerebellum: Anterior and posterior lobes.
    • Brainstem: Midbrain, pons, and medulla oblongata.
    • Cranial nerves: Twelve cranial nerves from the brainstem.

  • Spinal Cord: Transmits nerve signals between the brain and the body.

  • Nerves: Transmit signals throughout the CNS and PNS. Composed of a cell body, dendrites, and axons.

Skin

  • Epidermis, dermis, and hypodermis.
  • Functions: Temperature regulation, protection from fluid loss, vitamin D metabolism, melanin production, waste excretion.

Lymphatic System

  • Lymph vessels, nodes, and lymphoid organs.

  • Lymphoid organs: Thymus, bone marrow, spleen, and tonsils.

  • Lymph nodes perform cleaning.

  • Lymphatic vessels carry lymph.

Respiratory System

  • Nasal cavity: Warms and humidifies air, traps dust and debris.
  • Pharynx: Opens to respiratory and digestive systems.
  • Larynx: Composed of cartilages, muscles and ligaments.
  • Epiglottis: Prevents food and fluid from entering the trachea during swallowing.
  • Trachea: Cartilage sides and smooth muscle. Esophagus is posterior to the trachea.
  • Bronchi: Passages to the lungs.
  • Lungs: Primary organs of respiration. Right lung has three lobes, left has two lobes.

Nutrition

Vitamins

  • Vitamin A:

    • Deficiency Symptoms: Dry eyes and skin, increased infections, vision problems
    • Nutrition Source: Beef liver and other organ meats, salmon, leafy green vegetables, orange and yellow vegetables

  • Vitamin B1 (thiamine):

    • Deficiency Symptoms: Fatigue, beriberi
    • Nutrition Source: Whole grains, meat, fish, legumes, seeds, nuts

  • Vitamin B2 (riboflavin):

    • Deficiency Symptoms: Cracks in corners of mouth
    • Nutrition Source: Cheese, almonds, beef and lamb, eggs, pork, mushrooms

  • Vitamin B3 (niacin):

    • Deficiency Symptoms: Mental confusion and dementia, muscle weakness, diarrhea
    • Nutrition Source: Dairy, eggs, fish, lean meat, fortified cereals, beef, milk

  • Vitamin B5:

    • Deficiency Symptoms: Seizures, scaly rash, red tongue, paresthesias
    • Nutrition Source: Avocado, broccoli, kale, cabbage, eggs, legumes, milk

  • Vitamin B12:

    • Deficiency Symptoms: Fatigue, anemia, weakness, confusion, dementia
    • Nutrition Source: Clams, liver, fortified cereals, trout, salmon, tuna, beef, milk

  • Folate:

    • Deficiency Symptoms: Fatigue, anemia, shortness of breath, red and sore tongue, reduced sense of taste
    • Nutrition Source: Beans, lentils, spinach, asparagus, avocado, broccoli, mango, oranges

  • Vitamin C:

    • Deficiency Symptoms: Bleeding gums, infection, gingivitis, nosebleeds
    • Nutrition Source: Citrus fruits, peppers, guava, kale, broccoli, tomatoes, peas

  • Vitamin D:

    • Deficiency Symptoms: Weak and brittle bones, bone pain, muscle weakness
    • Nutrition Source: Cod liver oil, swordfish, salmon, tuna, orange juice, milk, sardines, liver, eggs

Special Diets

  • Diabetes: Three meals a day with two snacks, limited in carbohydrate intake, with increased fiber and lean meats.
  • Hypertension: DASH (Dietary Approaches to Stop Hypertension) diet focused on vegetables, fruits, and nuts with limited fats and meats. Rich in potassium, calcium, and magnesium.
  • Gluten-free: Limits gluten in grains, pasta, bread, soy sauce, and salad dressings.

Eating Disorders

  • Common in young adult females, but males are not exempt.
  • Treatment: Cognitive therapy, family therapy, and nutritional support.
  • Anorexia nervosa: Fear of weight gain leads to calorie restriction, abuse of laxatives and diuretics, causing electrolyte disturbances and kidney and bowel dysfunction.
  • Bulimia nervosa: Cycle of binge eating and vomiting, use of laxatives, enemas, and diuretics. Frequent vomiting can damage the esophagus and teeth.

Psychology

  • Medical assistants may be the first person the patient encounters.
  • Developmental Stages:
    • Infancy: birth to 1 year
    • Early childhood: 1 - 6 years
    • Late childhood: 6 - 12 years
    • Adolescence: 12 - 20 years
    • Early adulthood: 20 - 40 years
    • Middle adulthood: 40 - 60 years
    • Late adulthood: 65+ years

Psychosocial Assessments

  • Cognitive Assessment: For memory loss, dementia, or delirium. Mini-mental status exam is common.
  • Confusion Assessment: Evaluates progression of delirium.
  • Hamilton Anxiety Scale: Assesses anxiety in adults and children. Evaluates somatic and psychic anxiety and effectiveness of medication.
  • Beck Depression Inventory: Assesses the degree of depression. Values are
    • 0-9: no signs of depression,
    • 10-18: mild depression,
    • 19-29: moderate depression,
    • 30-63: severe depression.
  • Alcohol Use: CIWA (Clinical Instrument for Withdrawal of Alcohol) and CAGE tool. CIWA assesses the physical and mental effects of alcohol withdrawal, and CAGE identifies alcohol problems.

End of Life and Stages of Grief

  • Grief is a normal response to loss.
  • Elizabeth Kubler-Ross's five stages of grief:
    • Denial: Avoidance of the diagnosis or discussion.
    • Anger: Frustration and anger towards family members or healthcare practitioners.
    • Bargaining: Attempt to strike a bargain to achieve the desired result.
    • Depression: Anticipating the loss.
    • Acceptance: Acknowledgment of the end may cause self-isolation.