Term
| In situations of child abuse, which roles/individuals are commonly the abusers? |
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Definition
| Mother or father, especially single parents |
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Term
| What personal history is common among child abusers |
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Definition
| These individuals have commonly been abused themselves as children. |
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Term
| Describe some findings that should make you suspicious that physical abuse is occurring? |
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Definition
Bruises on face or torso, possibly in obvious shapes
Burns
Lacerations to lips/gums etc.
Facial fractures
Bite marks
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Term
Retinal hemorrhage +Nonresponsive pupils
should make you worry about.... |
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Definition
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Term
| Ocular signs of child abuse |
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Definition
Retinal hemorrhage
Retinal folds/retinoschisis
Subconj. hemes
Periorbital edema/bruising
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Term
| Name 4 purposes of laws the require the reporting of child abuse |
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Definition
Prevent abuse
Enhance welfare of abused children
Preserve families
Improve Parental capacity |
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Term
| Necessary steps of an examination on a patient you suspect to be a victim of child abuse |
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Definition
Assess vision
Record very carefully
Check pupils/APD
Dilate pupils and perform BIO
Check for other injuries
Ask child open ended questions
Ask how injuries occurred
REPORT |
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Term
| Describe some information that must be included in a report of child abuse |
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Definition
Name
DOB
Gender
Address
Siblings (#/names)
Name/address of parents/caretakers
nature/extent of abuse
Location of child |
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Term
T/F
It is important to be absolutely certain that abuse is occurring before you report it |
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Definition
False
You do not need to be sure, you just need to be suspicious 'in good faith.'
Will never be charged/sued for a false report |
|
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Term
| Common domestic violence injuries/signs |
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Definition
head/neck
periorbital contusions
traumatic iritis
commotio retinae
subconj hemorrhage
orbital fracture
wounds in different stages of healing
repeat visits for similar trauma |
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Term
| 2 Questions useful for screening for domestic violence |
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Definition
Are you in a relationship where you have been hit or threatened or forced to have sex?
Is there anyone you are afraid of? |
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Term
| Appropriate actions for when domestic violence is disclosed (ABCs....) |
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Definition
ALONE-acknowledge that the pt feels alone
BELIEF-State you believe violence is wrong and is not their fault
CONFIDENTIALITY-Tell them you respect their confidentiality
DOCUMENT-what you have heard/found
EDUCATE-on local resources
SAFETY-assess safety before they leave the office |
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Term
| Name 3 different types of syncope |
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Definition
Reflexive
Orthostatic Hypotension
Cardiac |
|
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Term
| Which of the 3 types of syncope are most common? |
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Definition
| The Reflexive vasovagal neural reponse |
|
|
Term
What are some symptoms of reflexive syncope
|
|
Definition
Tingling
Sweating
Pallor
Blurry vision
light-headedness
dizziness
N&V
myoclonic jerks |
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Term
| 3 possible causes of Orthostatic Hypotension Syncope |
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Definition
Autnomic Failure
Drug Induced
Volume Depletion |
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Term
| Describe the blood pressure changes in orthostatic hypotension syncope |
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Definition
Decrease in Systolic of 20 mmHg
Decrease in Diastolic of 10 mmHg |
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Term
| What is the difference between reflexive of orthostatic hypotension syncope? |
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Definition
| Both have similar symptoms but orthostatic hypotension has blood pressure abnormalities |
|
|
Term
| What are some causes of volume depletion that could result in orthostatic hypotension syncope |
|
Definition
Hemorrhage
Diarrhea
Vomiting |
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|
Term
Name 6 Associations of Orthostatic Hypotension Syncope
|
|
Definition
Prolonged recumbancy
Varicose veins
Old Age
Addisons
Exhaustion
3rd trimester of pregnancy (compression of vena cava) |
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Term
| Name 4 cutaneous symptoms of anaphylaxis |
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Definition
Urticaria
Flushing
Itching
Angioedema |
|
|
Term
| Name 4 respiratory symptoms of anaphylaxis |
|
Definition
Nasal discharge
congestion
Throat closure
Dyspnea |
|
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Term
| Name 4 GI related symptoms of anaphylaxis |
|
Definition
Nausea
Vomiting
Diarrhea
Cramps |
|
|
Term
| Name 4 Cardiac-related symptoms of anaphylaxis |
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Definition
Dizziness
Tachycardia
Hypotension
Collapse |
|
|
Term
| What are the most common anaphylaxis triggers for children? |
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Definition
|
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Term
| What are the most common anaphylasix triggers for adults |
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Definition
| Medication and Insect Stings |
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Term
| Describe the position you should try to place your patient in when they are experiencing anaphylaxis and are not dyspneic or vomiting |
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Definition
| Supine with legs elevated |
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Term
| What position should to try to place your patient in if they are experiencing anaphylactic shock and are dyspneic or vomiting? |
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Definition
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Term
| Pt in anaphylactic state, what oral medication may be given in addition to intramuscular epinephrine? |
|
Definition
|
|
Term
| Name 3 Pitfalls of anaphylaxis |
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Definition
Reluctance to recognize since it doesn't always present as shock
Confusion with an asthmatic exacerbation
Assume skin symptoms are always present |
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Term
| 2 Major risk factors of fatal asthma |
|
Definition
Recent history of poorly controlled asthma
prior history of near-fatal asthma |
|
|
Term
T/F
Fatal asthma is usually a sudden, severe attack |
|
Definition
False
80% of fatal asthma cases are of slow onset
The symptoms can be present anywhere from 12 hours to 3 weeks prior to incident. |
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Term
| 4 signs of acute respiratory distress |
|
Definition
Guns N Roses make me breath fast
G-grunting (sense of suffocation)
N-nasal flaring
R-Retraction of accessory breathing muscles
Breath fast=tachypnea, >60 breaths per min |
|
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Term
| 3 Actions to take when responding to an asthmatic exacerbation |
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Definition
1. Administer Short-acting Beta agonist
2. Start systemic glucocorticoids of no response to SABA
3. Call PCP or 911 |
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Term
| Name the typical cause of Cardiac Arrest |
|
Definition
| Sustained Ventricular Tachycardia/ Ventricular Fibrillation |
|
|
Term
2 Signs of Cardiac Arrest
|
|
Definition
Loss of consciousness
Pulselessness |
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Term
| When ventricular fibrillation results in cardiac arrest, what is commonly the cause of the ventricular fibrillation? |
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Definition
| Structural damage to the heart due to coronary heart disease |
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Term
| Name 4 Risk factors for cardiac arrest |
|
Definition
Smoking
Excess alcohol
Exercise (transient risk)
Family history
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Term
| Management of Cardiac Arrest |
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Definition
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Term
| Key presenting features of a myocardial infarction |
|
Definition
Angina/Chest pain
Pallor
diaphoresis
tachycardia
palpitations |
|
|
Term
Management of Myocardial infarction
|
|
Definition
911
Chew 325mg aspirin
Nitroglycerin if pt has
Oxygen mask
Have defibrillator ready |
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Term
| Who is most at risk of hypoglycemia in terms of diabetic patients? |
|
Definition
Type 1 is most common
Type 2 if on insulin secretogogue/insulins
Elderly |
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Term
| What are some common causes of hypoglycemia in non-diabetic patients |
|
Definition
Drugs like alcohol
Critical illness
Sepsis
Malnourishment
Cortisol deficiency |
|
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Term
| Name some catecholamine-mediated neurogenic symptoms of hypoglycemic |
|
Definition
Tremor
Palpitations
Anxiety/arousal |
|
|
Term
| Name some acetylcholine mediated neurogenic symptoms of hypoglycemia |
|
Definition
Sweating
Hunger
Paresthesis |
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Term
| Name some neuroglycopenic symptoms of hypoglycemic |
|
Definition
Cognitive impairment
behaviour changes
psychomotor abnormalities
lower plasma glucose levels
seizures
coma |
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Term
| Short term management of hypoglycemia |
|
Definition
Give them a fast acting carb
Followed by a long acting carb |
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Term
How do you manage severe hypoglycemia?
Severe meaning unconcious or unable to ingest. |
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Definition
|
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Term
| Give 3 examples of fast acting carbs |
|
Definition
Glucose tablets
hard candy
sweetened fruit juice |
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Term
| How do you deal with hypoglycemia with a patient taking insulin or insulin secretagogue? |
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Definition
| Only pure glucose (dextrose) should be given, it will be the most effective |
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Term
| What substance greatly improves prognosis of a stroke if given within 1 hour? |
|
Definition
|
|
Term
| 4 aspects of managing a stroke in your office |
|
Definition
Call 911
Oxygen
Check vitals
Administer t-PA |
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