1. What are some reasons people pay attention to lecutres?
    • Interesting subject
    • Interesting colors (colors, images, graphs, streamlined)
    • Dynamics of the speaker
    • Voice movment and preparation skills
  2. What are some reasons people attend lectures?
    • to gain knowledge
    • update knowlege of new treatments/therapies
    • identify the best practice
    • tips for managing challenging cases
    • research/trends
    • objectives
    • take home points
  3. 4 things you should consider when creating a presentation
    • Who is your audience?
    • What is your venue
    • Time how long is it?
    • What should you put on your slides
  4. With font/words you should follow the ___ ___ rule
    44 (title) 36 (text rule)
  5. The 44 (title) 36 (text) rule states what?
    that you should use a size 44 font for the title of the slide and a size 36 text for the body of the slide
  6. Should you use a fancy font in a presentation?
    No use one that is clear and ledgible
  7. What does the Carriage Return Rule of presentations state?
    • relates the number of words/line per slide
    • 5-8 lines per slide with 8 being the max lines per slide
    • also that if you are typing a line and it automatically carries onto the next line it is too long.
  8. What are some things you should do when deciding your slide design for a presentation?
    • keep it clear and simple
    • stick to a single color or pattern for the background
    • avoide intense or bright colors for the font or background
    • cool color backgrounds
    • use textures
    • be consistent
  9. Is it OK to use personal images in a presentation
    No, but maybe if they are relevant
  10. What is Susan's favorite font?
    Tahoma Calibri
  11. When should you use animations or transitions?
    When they are appropriate to the flow of the lecture and highlitght important information
  12. What is prime time slot to give a lecture at a conference?
    10 am the second day
  13. What some things you have to consider about audio/videotaping during a lecture?
    • is it permissible in the venue
    • are you ok with being recorded
    • is there a specific location that you need in order to stand so that you don't wander out of the camera view?
  14. The following best describes how Susan approaches humor in presentations

  15. What is an "Endering hook"
    something that "hooks" the audience and that stays with them after the lecture is a personal story or slightly off topic story that you use to personally touch the audience

    (these never work for me btw, just a personal opinion...)
  16. When should you deliever an "endering hook" in a presentation
    in the beginning as the first 30 seconds of an intro and again at the end as a part of the wrap up.
  17. What should you be mindful of when useing images in a presentation?
    • Copyright
    • always site images
    • document your own images as yours
    • document patient permission if using pt images
    • consider removing/obscuring images from hard copy or posted copies prior to release
    • possible disclaimer at the end
  18. The most critical portion of a presentation is...
    the first 30 seconds
  19. What was the 3 top causes of death in 2007?
    • diseases of the heart
    • malignant neoplasm
    • cerebrovascular stroke
  20. what were the top 3 causes of infant mortality in 2007?
    • congenital malformations
    • disorders of low birth weight
    • SIDS
  21. Where do most americans want to die?
  22. Where do most Americans die?
  23. Using every intervention possible to see if it might help or prolong survival a few weeks is called what?
    Exhaustion medicine
  24. What are the 3 goals of Medical care?
    • Cure
    • Stabilization and maximization of function
    • Preparation for a comfortable death
  25. What are some benifits of palliative care?
    • better QOL
    • Less depressive symptoms
    • longer median survival in patients recieving early palliative care
  26. What is Autonomy?
    "self rule" or "self determination" the ability of the patient to make their own informed decisions if they are of sound mind
  27. Which of the following DOES NOT fall under the principle of autonomy?

  28. When a medical care provider acts in the best benifit of the patient to prevent or remove harm and to act to improve the patient situation it is called....
  29. Primum non nocere is the principle of ____
  30. A health care worker avoiding providing ineffective treatmetns or acting with malice towards a patient is acting under the principle of _____
  31. ______ is a legal term that states that competent adults have the right to make their own medical treatment decisions
    informed consent
  32. Patients have the right to make ___s which will make decision in the future if the person becomes incapacitated or unable to make their own decisions
    advanced directives
  33. In case of mental incapacity the right to give or withold informed consent typically passes to the person's...
    • legal representative
    • close family member, agent, attorney, court apointed guardian
  34. The right to be informed of medical donditiona nd progronis, the risks and benifits of a recommended proceedure and an explaination of the alternative procedures and treatments is required due to need for ___ consent
  35. A legal document which designates a trusted relative or firend to make health care decisions for you in the event you are unable to communicate your wishes is a ....
    Health care proxy
  36. A legal document which appoints a proxy (dosent have to be related or friend) to make decisions (not just medical but usually also financial) if the person is to become unconcious, mentally incompetent or unble to make decisions is called a _____
    Power of attourney
  37. What does it mean if a power of attourney is "durable"
    it continues even if the person is to become mentally incompetent
  38. an appointee in a power of attourney is called what?
    a "attourney in fact" or an "agent"
  39. Are living wills recognized in MA?
  40. A document that designates treatment wishes. (document specifying desired life saving and life sustaining care in the event th eperson becomes both incapacitated and terminally ill) (not a DNR)
    Living will
  41. a NON legal document that provides a way for a person to express thier wishes beliefs and preferences reguarding healthcare to others
    Values History
  42. What are some things that a values history may include?
    • Overall attitude of life and health
    • Personal Relationships
    • Thoughts about independence and self sufficency
    • Living environment
    • Religious background and beliefs
    • relationships with doctors and other health
    • care givers
    • thoguhs about illness, death and dying
    • finances
    • funeral plans
    • optional questions
    • legal documents
  43. What is the MA death with dignitiy act?
    • legislation that is proposed that may allow a physician to write a lethal dose of medication for a terminally ill patient.
    • Two people one of whom is not a fiamily member and who would not share the estate have to withness the signing of the request and attest that the patien is capable of acting voluntarily
    • the terminally ill patient has to repeat the request twice verbally at an interval of at least 15days
    • he would be counseled about alternatives like hospice care and pain control
    • the lethal dose would not be administered by a physician rther the patient would have to self administer it
  44. A legal document signifying an order to helth care professionals not to perform CPR. Declines treatment in the event of cardiac arrest.
    DNR do not resuscitate
  45. T or F a DNR is easily revoked
  46. T or F a DNR can be signed by a MD, PA, NP or CNA
    False it can only be signed by an MD, PA or NP
  47. What does MOLST stand for?
    Massachusettes Medical Orders for Life Sustainging Treatment
  48. What does AND stand for?
    Allow Natural Death
  49. What are some factors you should consider when assessing a patients dying process and how to approach them?
    • Trajectory of the illnees
    • persons perosnal cirumstances and values
    • economic and social status
    • ethinic and religous background
    • presences of family and friends
  50. What are some comfort measures that go into effect in the care of a patient when they enter a palliative cares stage?
    • Comfort measures (fmialy memories, religious, enironment)
    • Lifiting restrictions on diet
    • Pain managment (oral methadone, SL morphine sulfate, patches, fentanyl, controlled anesthesia, morphine etc)
    • Agitation/Anxiety managment (lorazapam, midazolam)
    • Secretion managment (hycosyamine, scopolamine)
  51. The non-accidental commision of any act by a caretaker upon a child under age 18 which causes or creates a substantial risk of physical or emotional injury
  52. T or F addiction to drug or drugs at birth is physical abuse
  53. An act that constitutes a sexual offence under the laws of the commonwealth, or any sexual contact between a caretaker and a child under the care of that individual. (can occur in any setting in or out of the home)
    Sexual Abuse
  54. Failure by a caretaker, either deliberatly or through negligence or inability to take actions nessisary to provide a child with minimally adequate food, clothing, shelter, medical care, supervision, emotional stability, or other essential care.
  55. an impairment to or disorder of the intellectual or psychological capacity of a child as evidenced by observable and substantial reduciton in teh childs ability to function within a normal range of performance and behaivor
    Emotional Injury
  56. Abandonment is considered ___ in many states
  57. A child is considered abandoned when:
    • parients identity or whearabouts is unknown
    • the child has been left alone in circumstances where the child suffers serious harm
    • the parent failed to maintain contact with the child or provide reasonable support for a specified period of time
  58. T or F it is considered abandonment when the parent is using a controlled substance that impairs the ability of the caregive to give adequate care for the child
  59. What are some risk factors for abuse?
    young parents with low educational attainment, past psychiatric history, history of child abuse, poverty, mother unemployed, poor social networks, high parity, single mother, reported domestic violence, re-ordered family, unintended pregnancy, low birth weight, fussy child
  60. Would a bruise on the knees and shins of a child who plays soccer be considered signs of abuse?
  61. Would buises on the torso, neck, buttocks or thighs of a child who is reported to be clumsy be signs of abuse?
  62. Name some signs of abuse in children
    • Bruising welds or burns that cant be explained
    • withdrawn fearful or extreame behavior
    • clusters of bruises welts or burns
    • ear contusions
    • blunt force trauma
    • scalding
    • injuries where children don't usually get injured.
  63. What are some signs of sexual abuse in children?
    • difficulty walking/sitting
    • pain or itching in the genital area
    • Torn, stained or bloody underclothing
    • frequent headaches or stomach aches
    • venereal disease
    • bruises or bleeding in external genitalia
    • feeling threatened by physical contact
    • inappropriate sex play or premature understanding of sex
    • frequent urinary or yeast infections
    • child freqently wants to go to the nurse
  64. What are some signs of emotional injury?
    • sleeping problems
    • antisocial behavior
    • behavioral extreames
    • delays in emotional and intellecutal growth
    • speech disorders
    • inability to play as most of a cohort
  65. Signs of Neglect
    • lack of medical or dental care
    • chronically dirty or unbathed
    • lack or adequate school attendance
    • lack of supervision
    • lack of proper nutrition
    • lack of adequate shealter
    • self destructive feelins or behavior
    • alcohol or drug abuse
  66. what are 3 elements of substance abuse that are considered child abuse or neglect in the US
    • prenatal exposure of a child to harm due to the mothers use of an illegal drug or other substance
    • manufacture of methamphetamine in the presence of a child
    • selling, distributing or giving illegal drugs or alcohol to a child
  67. What are some conditions that mimic abuse?
    mongolian spots, HSP, Photodermatitis, Cupping, Impetigo, Coining, Spooning, Mixibustion
  68. Coining
    • Coining, or cao gio
    • (pronounced phonetically gow yaw), is an alternative form of medicine most commonly
    • practiced in Southeast Asia. The practice of coining involves rubbing
    • heated oil on the skin, most commonly the chest, back,
    • or shoulders, and then vigorously rubbing a coin over the area in a linear
    • fashion until a red mark is seen.
    • Coining is believed to allow a path by which a "bad wind" can be released from the body.
    • This "wind" is believed to be the cause of the patient's illness. Advocates use this method to treat a
    • variety of minor ailments including fever, chills, headache, colds, and cough.
  69. Cupping
    • Cupping refers to an ancient Chinese practice in which a cup is
    • applied to the skin and the pressure in the cup is reduced (by using change in
    • heat or by suctioning out air), so that the skin and superficial muscle layer
    • is drawn into and held in the cup. In
    • some cases, the cup may be moved while the suction of skin is active, causing a
    • regional pulling of the skin and muscle (the technique is called gliding
    • cupping).
  70. Moxibustion
    • Moxibustion is a form of fire heat treatment that stimulates
    • specific acupuncture points of the body. The term is derived from the
    • Japanese "mogusa" meaning herb (mugwort) and the Latin "bustion" meaning
    • burning.
  71. Photodermatitis
    • Photodermatitis, sometimes referred to as "sun poisoning" or photoallergy is a form of allergic contact dermatitis in which the allergen
    • must be activated by light to sensitize the allergic response, and to
    • cause a rash or other systemic effects on subsequent exposure. The
    • second and subsequent exposures produce photoallergic skin conditions
    • which are often eczematous.
    • Resembles burns of child abuse
  72. Salting
    • application of salt to the skin or packing skin in salt
    • old turkish custom goal to improve the helath of the newborns skin
    • SEs epidermolysis and hypernatreamia
  73. Caida de mollera
    • Mollera caida
    • (or caida de la mollera) is another folk illness which affects infants.
    • Mollera caida is the term for a
    • sunken fontanelle on a baby’s skull, from the Spanish
    • words mollera (head or
    • crown, but sometimes used to describe the fontanelle) and caida (fallen).
    • It is believed to be caused by a sudden bump or fall, or by the infant’s sudden
    • withdrawal from the breast during breastfeeding. Infants with mollera
    • caida may be fussy, not feed well, or have diarrhea. In Western medicine,
    • a sunken fontanelle has been identified as a sign of dehydration, which is
    • usually caused by diarrhea, poor feeding, or other conditions.

    • In some Hispanic cultures, a common treatment for mollera caida is pushing up on the inside of
    • the palate, on the roof of the infant’s mouth. Other treatments include
    • holding the baby upside down, sucking on the top of the fontanelle with one's
    • mouth, or applying raw egg or oil to the fontanelle. While the folk
    • treatments listed here are probably not harmful if done gently, they don’t do anything to treat the underlying
    • dehydration. In Western medicine, infants with sunken fontanelles should
    • be treated with fluid and electrolyte replacement, starting with oral
    • rehydration but progressing to IV rehydration if needed.
  74. Treatments for "bolita" include
    • putting herbs, raw egg or soap over the fontanel
    • shaving the head over the fontanel
    • oral suction over the fontanel by a folk healer
    • pressure on teh hard palate
    • immerion of the top of the head in water
    • slapping the soles of teh feet or shaking the infant vertically while holding him or her upsidown
  75. What testing should be included in a child whom you suspect is abused?
    • Labs for (hematology, chemistries for neglect, cultures for venerial disease)
    • Skeletal Survey (bodywide x ray for trauma or fractures, and fractures in various states of healing)
  76. What are two types of fractures that are pathopneumonic for abuse?
    posterior rib fractures and metaphyseal fractures
  77. Fragmentation of the distal end of one or both femurs appearing at the
    bone margins as a crescent-shaped osseous density paralleling the
    metaphysis, which is seen on x-rays when the growth plate is
    oblique to the radiographic beam;
    Bucket handel fracture
  78. Classic metaphyseal lesions, rib fractures especially posteior, scapular fractures, spinous process fractures, sternal fractures are all

  79. multiple fractures especially bilaterally, fracture of different ages, epiphyseal separtions, vertebral body fracture and subluxations, digital fractures and complex skull fractures are

  80. subperosteal new bone formation, clavicular fractures, long bone shaft fractures, and linear skull fractures are...

  81. Condition that may mimic fractures seen in child abuse
    • Ostiogenesis imperfecta
    • or Birthing fractures
  82. ___ is the imaging method of choice when imaging suspected inflicted head trauma
    CT unenhanced
  83. What is an opthalmologic sign of abuse you may see in children?
    retinal hemorrhages
  84. How should possibly incriminating statments made by an abusive parent be documented?
  85. T or F in MA you need permission to photograph injuries or lesions that are believed to be abusive in nature
    False, you DO NOT need permission to photograph injuries for abuse documentation
Card Set
Child abuse, Presentations, Palliative Care