Scribe U Final Questions and Answers Already Passed

New patients - ANSWER-Never been seen at clinic or was seen greater than 3 years ago; no previous records; longer visit; detailed chart Established patient - ANSWER-has been seen at clinic within last 3 years diagnostic visit - ANSWER-new problem, CC: new symptom, goal is to determine cause of problem and treatment health management visit - ANSWER-Check-up, Chief Complaint: Routine physical or management of chronic problem(s), and Goal is preventative care and/or assessing progress of ongoing medical problems "neck arteries cleaned" procedure - ANSWER-carotid endarterectomy leg amputated? - ANSWER-AKA or BKA joint repair - ANSWER-arthroplasty 2 causes for higher genetic risk - ANSWER-family member onset under age 55 or if multiple blood-family members suffer from same disease 5 elements of social history - ANSWER-1. tobacco use/vaping (PPD) 2. Alcohol Use 3. Occupation 4. Living Circumstances 5. Drug Use (substance, route of admin, date used last, how often) Chronic diseases are illnesses that last longer than? - ANSWER-3 months __% of deaths are caused by chronic illnesses in US - ANSWER-70% Comorbitiies - ANSWER-simultaneous presence of 2 or more chronic diseases in Pt; increases complexity and health risk 4 ways comorbidity makes patient care more complex - ANSWER--The treatment of one disease may affect or contradict the treatment of the second -Adverse drug interactions -Compounding symptoms may lead to poor compliance with treatment plan (mo' drugs, mo' problems) -If both illnesses affect a specific organ system, the patient is at increased risk of organ failure HTN etiology - ANSWER-increase in BP causes excess force against arterial walls, damaging arteries 5 Risk factors of HTN - ANSWER-1. FHx 2. obesity 3. high Na+ diet 4. smoking 5. ETOH symptoms of HTN - ANSWER-asymptomatic; if there are symptoms, it's often headaches how is HTN diagnosed? - ANSWER-BP reading; takes several high readings to confirm HTN 4 Non Pharm Management of HTN - ANSWER-1. low Na diet 2. exercise 3. smoking and ETOH cessation (vasoconstrictors!) 4. BP log at home Pharm Management of HTN - ANSWER-1. ACE Inhibitors 2. Ca channel blockers 3. diuretics 4. ARBs what do ace inhibitors do? - ANSWER-relax arteries and block reabsorption of water by kidneys What do Ca channel blockers do? - ANSWER-Dilate the arteries and reduce the force of the heart's contractions What do diuretics do? - ANSWER-reduce the volume of fluid in the blood vessels by urinating excess fluid What do ARBs do? - ANSWER-dilate arteries 2 examples of ACE inhibitors - ANSWER-Lisinopril (Zestril) Lotensin (benazepril) 2 examples of Ca Channel blockers - ANSWER-1. Norvasc (amlodipine) 2. Cardizem (diltiazem) 1 ex of diuretic - ANSWER-hydrochlorothiazide (HCTZ) 2 ex of ARBs - ANSWER-1. Cozaar (losartan) 2. Benicar (olmesartan) HTN leads to what other 5 chronic illnesses - ANSWER-1. Impaired vision 2. Kidney failure 3. CVA 4. CAD/MI 5. CHF Explain Type 1 DM: how many DM patients have it, etiology, etc - ANSWER-insulin insufficiency; pancreas cannot produce insulin; 5% of DM pts have; diagnosed early in life; strong FHx; ALWAYS treated with insulin Explain TYPE 2 DM - ANSWER-high blood glucose levels cause cells to become resistant to insulin; 95% of DM patients; can be treated both non-pharm or insulin; FHx & SHx factors Type 2 DM risk factors - ANSWER-FHx fo DM, obesity, high carb diet, lack of exercise TYPE 2 DM symptoms - ANSWER-unusual weight gain or loss, polyuria, polydipsia, blurred vision, N/V TYPE 2 DM diagnosis - ANSWER-fasting blood glucose, Hb A1c DM can lead to what other 5 chronic diseases - ANSWER-1. Diabetic retinopathy 2. renal failure 3. cardiac diseases 4. PVD 5. neuropathy 4 types of non pharm management of DM - ANSWER-1. low carb diet 2. exercise 3. weight loss 4. blood glucose log at home 3 kinds of insulin for pharm treatment of DM - ANSWER-1. humalog 2. lantus 3. sliding scale Humalog - ANSWER-rapid acting, injected after meals Lantus - ANSWER-long acting, injected once daily sliding scale - ANSWER-dosage based on curren