quickster2008's version from 2015-11-16 12:11

Section 1

Question Answer
risk stratification appropriate follow up0-yearly, 1-semi 2-quarterly 3-monthly
risk stratification risk profile0-normal 1-peripheraly neuropathy 2-neuropathy,PAD, 3 previous ulcer or amputation
According to the risk stratification when does a pt need diabetic shoes or insoles2 or greater, neuropathy and/or PAD 3-previous ulcer or amputation
# of NEW cases of a dz that occur during a specified period of time in a population at risk for developing the dzincidence
measures currently occurring cases of a dz or condition in a specific populationprevalence
measure of riskincidence
measure of of burden of dz in a communityprevalence
dz.'s found in some PLACES but not othersendemic
dz.'s found in some TIMES but not othersepidemic
habitual presence of a dz with a given geographic areaendemic
occurrence in a community or region of a group of illnesses of similar nature, clearly in excess of normal expectancyepidemic
worldwide epidemicpandemic
prevention of dz or injury itself, generally though reducing exposure or reducing levelsprimary prevention
attempts to ID and control dz processes in their early stages, aka early case finding secondary preveion
preemptive txsecondary prevention
seeks to prevent disability after damage is donetertiary prevention
our current health system is focused on what level of preventiontertiary
screening diabetic foot ulcer level of preventionprimary
regular "high risk" care level of preventionsecondary
care for a diabetic pt who already has an ulcer, level of preventionteritary
our current health care system focuses on what level of care2nd and tertiary
level of care that focuses on basic needs of familiesprimary
level of care that is specialized care done at physicians officessecondary
level of care that is referral care requiring highly specialized facilitiesteritary
level of care that provides 80% of necessary careprimary
level of care that provides 20% of necessary caresecondary
3 leading causes of death today1. heart dz 2. cancer 3. stroke
trends in health care delivery over the past centuryhealthcare is now a hugh business, 3rd largest industry in US
who makes up the largest portion of the healthcare systemnurses
True or false, our current system does not have as many PCP as it use totrue
poor countries need what level of prevention (clean water)primary
leading cause of death in past. pneumonia, influenza, TB, enteritis, diarrhea
the US gov principal agency for protection the health of americans and providing essential human services, especially for those who are least able to help themselvesthe department of health and human services
what is the EMR trying to push foroutcomes based reimbursement rather than procedure reimbursement
HHS represents ?% of federal budget25
T or F the department of health and human services administers more grant dollars than all other federal agencies combinedT
nation's largest health insurermedicare
medicare and medicaid together provide health care insurance for MORE THAN ? ratio americans1/4
CMS stands forcenters for medicare and medicaid
administers simplification standards for HIPAA, quality standards in long term care facilities and clinical lab quality standardsCMS center for medicare and medicaid services
HIPAA stands forhealth insurance portability and accountability act
medicare covers americans 65 and older and ? and ?certain disabled americans under 65 and people of any age with permanent kidney failure
medicare is administered byCMS center fo rmedicare and medicaid services
Medicare part A A "hospital insurance" pays for hospitalizations, skilled nursing facilities home health care and hospice care
Medicare part B"medical insurance" a voluntary supplemental program, pays for doctors services and outpt care, some physical and occupational therapy and home health
what medicare is paid thr. payroll taxes when person is workingpart A
T or F medicare part A and B together provide comprehensive coveragefalse.
is medacaid paid for by the state or federal governmentboth, each contributes roughly half of founds
T of F podiatry is a mandated service under medicare and medicaidT
podiatry became a mandated service for medicaid on oct 1 of what year2014
CDC stands forcenters for disease control and prevention
OIG stands foroffice of the inspector general
DoD stands fordepartment of defense
VHA stands forveterans health administration
federal focal point for health research 􏰁 steward of medical and behavioral research NIH National Institute of Health
surveillance to monitor and prevent disease outbreaks, and maintains national health statisticsCDC Centers for Disease Control and Prevention
maintains national health statisticsCDC Centers for Disease Control and Prevention
protect the integrity of the HHS programs, as well as the health and welfare of the beneficiaries of those programsOIG Office of the Inspector General
podiatrists can be involved in all 3 levels of prevention T or FT

Section 2

Question Answer
requirements for therapeutic shoes in DM pts1. documentation in medical record that pt has DM 2. certification that pt is being tx under a comprehensive plane of care f/diabetes and that the pt needs DM shoes
Documentation in pts record that the pt has 1 or > of the following conditions in order to get DM shoesperipheral neuropathy with evidence of callus formation, hx of pre ulcer calluses, hx of prev ulcer, foot deformity, prev amputation of foot or part of foot, poor circulation
people getting DM shoes if they have what level of risk stratification2 or greater
highest risk for ulcer(top 3)1. loss of sensation 2. hx of amputation 3. plantar pressure >65
incidence density ratio also calledrates ratio
difference measure used oto compare the incidence rates of events occurring at any given pt in timerates ratio
A common application for this measure in analytic epidemiologic studies is in the search for a causal association between a certain risk factor and an outcome.rates ratio
ratio of the rates corresponding to the conditions described by two levels of an EXPLANATORY variable.hazards ratio
what does it mean to have a hazards ratio of 2 vs a .52=twice as likely to pass exam, .5=jerr has a relative risk of 0.5 compared to abdul in passing the examJerry is twice as unlikely to pass the exam >1=more risk,1=no difference, .5=less of a risk
relative risk of 3.0 and 95% confidence interval crosses 1. What is risk?no risk
risk for falls(better bones)fam hx of fracture, small framed, start menstruation after age 15, estrogen deficiency, menopause before 45, glucocorticoids

Section 3

Question Answer
Pt scored >4 on stay independent brochure and is worried about falling. You evaluate their gait, strength, and balance but performing the timed up and go, 30 sec chair stand, and 4 stage balance test. No gait, strength or balance problems were shown. What do you do?educate pt, refer to community exercise, balance, fitness or fall prevention program
Behavior modification, place stages of change in order preparation, action, contemplation maintenance, pre-contemplationpre-contemplation, comtemplation, preparation, action, maintenance
pre-contemplation, comtemplation, preparation, action, maintenance which one is getting ready? not ready? readypre-contemplation-not ready, contemplation-getting ready,
Taking action in the next month, planning their action.preparation
Taking action in the past six monthsaction
Intend to change in the next six monthscontemplation
biggest risk factor for fallingincrased heel height
most important question to ask pt for assessing pt's risk for fallinghave you fallen in the past yr
5 things podiatrists do to reduce falls1. get pts in right shoes 2/ encourage shoe use in home 3. stretch 4. relieve pain 5. vit D 700-1000
when can a minor give consent1. prego 2.married. 3. parent 4.emancipated(specifically allowed by court 5. tx for sex abuse 6. tx for addict or who has a family member who abuses drugs 7. contact with STD 8. tx for psychotherapy or admission to mental hospital 8. referred by physician f/birth control
in the state of illinois who can give consentthe patient someone who is 1. competent and 2. has the capacity to make a decision
what constitutes human subject research1. interaction with a person 2. ID private into
federal policy for the protection of human subjects(common rule)states that an IRB(Institutional review board) is needed for any institution that receives NIH funding
An advance directive is a written statement you prepare about how you want your medical decisions to be made in the future, if you are no longer able to make them for yourself.”advance directive
advance directiveAn advance directive is a written statement you prepare about how you want your medical decisions to be made in the future, if you are no longer able to make them for yourself.”
Illinois law allows for the following 3 types of advance directives 1. health care power of attorny, 2. living will 3. mental health tx preference declaration 4. family member agreement1. health care power of attorny, 2. living will 3. mental health tx preference declaration no family
what constitutes human subject research1. interaction w/ the indiv 2. ID private info
HEALTH CARE SURROGATE ACTlaw creates hierarchial list of potential surrogate decision-makers for pts who lack 1) advance directive and 2) decisional capacity

Section 4

Question Answer
The pt has the right to refuse or choose their tx‐ informed consent, pt respect/advocacy is an ex of ?Autonomy
The idea that the burdens and benefits of new or experimental treatments must be distributed equally among all groups in society-rich, poor, black, white, etcjustice
A practitioner should act in best interest of pt‐ professional judgement, physician health responsibilitiesBeneficence
Requires that the procedure be provided with the intent of doing good for the patient involved.Beneficence
Demands that health care providers develop and maintain skills and knowledge, continually update training, consider individual circumstances of all patients, and strive for net benefit.Beneficence
First do no harmNon‐maleficence
Requires that a procedure does not harm the patient involved or others in society.Non‐maleficence
Infertility specialists operate under the assumption that they are doing no harm or at least minimizing harm by pursuing the greater good. However, because assistive reproductive technologies have limited success rates uncertain overall outcomes, the emotional state of the patient may be impacted negatively. In some cases, it is difficult for doctors to successfully apply the do no harm principle T or FT Non‐maleficence
decision‐making process must be free of coercion or coaxing.Autonomy
In order for a patient to make a fully informed decision, she/he must understand all risks and benefits of the procedure and the likelihood of success. Because ARTs are highly technical and may involve high emotions, it is difficult to expect patients to be operating under fully‐informed consent. T or FT Autonomy
what does the APMA code of ethics contain?preamble explain our responsibility as podiatrist to hold ourselves to the highest standards, medical, business, association ethics
scope of practice. biggest issues we deal withankle privileges, physician status
under medicare or medicaid are pods defined as physiciansmedicare, not medicaid
can pods supervise a mid level provider, e.g. PAs?varies by state
how many states can perform on the ankle? which ones can't?45, SC, kansas, missouri, massachusets, alabama
Can pods do an H&P and clear a pt for surgery?yes
DPM = full license to prescribe, but limited medical practice license true or falsetrue, only country that allows pods to prescribe meds

Section 5

Question Answer
what are blood born pathogensviruses, bacteria, parasites, fungi
primary workplace pathogensHIV, HBV, HCV
T or F, HIV antibody test is the only way to know for sure that a pt has HIVT
what pathogen can survive outside the bodyHBV
patient has jaundice, fatigue, abdominal painhep B
patient has flu like symptoms, juandice, dark urine, years laterhep C
? appears in 70% of pts infected by hep Cliver dz
flue symptoms, swollen LNHIV
ECPexposure control plan identifies jobs and tasks for potential exposure

Section 6

Question Answer
medical malpracticeany deviation from standard of care
standard of careWhat a reasonably careful DPM would do or not do under similar circumstances
negligencefailure to provide reasonably qualify procedures that are SHOWN BY EVIDENCE
the only way in which you may decide whether a defendant possessed and applied the knowledge and used the skill which the law required if from expert testimony or evidence of professional standards
standard of evidence
failure to do something that a reasonably careful podiatrist would do or the doing of something that a reasonably careful pod would not donegligence
proving malpractice, a plaintiff must show1. duty 2.standard of care 3. breach negligence fault d. proximate causation e. damages
what a reasonably careful pod would do or not do under similar circumstancesstandard of care
any cause that in the ordinary course of events, produces the injury complained ofcausation
more probably true than not trueburden of proof
if incident happened more than ? yrs ago, cannot take to court4
depositionsolely f/opponent benefit
ACFASevidence of standards
Top 3 situations to most likely result in lawsuits bc they bring the most money1. ampuation 2. RSD(CRPS) 3. hallux deformities

Section 7