Medical Ethics — Flashcards

Flashcard 1: beneficience (bioethics)

Answer: duty to act in the best interest of the patient

Flashcard 2: respect for patient autonomy (bioethics)

Answer: obligation to respect patient preferences in medical care

Flashcard 3: Give examples of four common situations in which breaching patient confidentiality may be justified or required (state specific).

Answer: 1. Reportable disease 2. Child/elder abuse 3. Suicidal/homidical patients 4. Intoxicated driver (Breach may be justified when patient plans to commit any dangerous crime not explicitly listed above.)

Flashcard 4: Patient has difficulty taking medications.

Answer: Provide written instructions, simplify treatment regimen, use teach-back

Flashcard 5: A drug company offers a "referral fee" for every patient a physician enrolls in the study.

Answer: Eligible patients who may benefit may be enrolled, but it is never acceptable to receive compensation from a drug company. Patients should be informed that a referral fee was offered.

Flashcard 6: You order an invasive test for the wrong patient.

Answer: No matter how serious or trivial, a physician is obligated to inform a patient that an error has been made.

Flashcard 7: Give three factors, that together, might justify a breach of patient confidentiality.

Answer: 1. patient may harm self or others 2. by breaching confidentiality, harm may be prevented or mitigated 3. no alternate means exist to warn or protect those at risk

Flashcard 8: surrogate decision maker (medical law)

Answer: one or more individuals acting on behalf of an incompetent patient who had not prepared an advanced directive

Flashcard 9: justice (bioethics)

Answer: duty to treat individuals fairly

Flashcard 10: nonmaleficence (bioethics)

Answer: the concept of "do no harm"

Flashcard 11: What are the four core ethical principles of medicine?

Answer: patient autonomy, beneficience, nonmaleficence, justice

Flashcard 12: procedure bias

Answer: unequal procedures for different groups (e.g. more follow-up for treatment group promoting greater adherence than control group)

Flashcard 13: A(n) _____ is defined as injury to a patient due to failure to follow evidence based best practice guidelines

Answer: preventable adverse event

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Flashcard 14: Examples of the beers criteria include drugs that increase the risk of _____ infections (PPIs)

Answer: C. difficile

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Flashcard 15: Treatment of friends should be limited to emergency situations when _____

Answer: no other physician is available

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Flashcard 16: If there are risks to a medical action, can the principle of nonmalificence still be intact? _____

Answer: Yes

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Flashcard 17: Examples of the beers criteria include drugs that increase the risk of _____ (alpha blockers)

Answer: hypotension

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Flashcard 18: A(n) _____ is an unexpected occurrence involving death or serious physical / psychological injury that requires immediate investigation

Answer: sentinel event

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Flashcard 19: Red flags for physical abuse include _____ medical care

Answer: delayed

Extra: Watch associated Bootcamp video [https://app.bootcamp.com/med-school/psychiatry/videos/developmental-disorders?index=12] https://onlinemeded.org/spa/pediatrics/child-abuse/acquire?ref=anki 

Flashcard 20: Clostridioides difficile is a nosocomial infection that commonly follows _____ use

Answer: antibiotic (e.g. ampicillin, clindamycin)

Extra:  Watch Clostridium difficile [https://dashboard.sketchy.com/study/medical/courses/medical-microbiology/units/medical-microbiology-bacteria/videos/medical-microbiology-bacteria-gram-positive-bacilli-clostridioides-difficile?utm_source=anki&utm_medium=partnership&utm_campaign=february_update&utm_content=medical] https://onlinemeded.org/spa/infectious-disease?ref=anki 

Flashcard 21: Patients with Clostridioides difficile infections require extra contact precautions, in that hand washing must be done with _____

Answer: soap and water

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Flashcard 22: Treating patients affected by microbial infections that can be aerosolized and remain suspended in air for extended periods requires a(n) _____

Answer: respirator

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Flashcard 23: Examples of the beers criteria include drugs that increase the risk of anti-_____ activity (antihistamines, GI antispasmodics)

Answer: cholinergic

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Flashcard 24: Which type of medical error analysis involves a forward-looking approach to prevent failure occurrence? _____

Answer: Failure mode and effects analysis

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Flashcard 25: Examples of the beers criteria include drugs that increase the risk of _____ (benzodiazepines, opioids)

Answer: falls

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Flashcard 26: Two of the most likely methods to prevent intravascular catheter related infections include: - maximal _____ during the procedure - hand hygiene prior to beginning the procedure

Answer: barrier precautions

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Flashcard 27: If there is suspicion for child abuse, what should be your next step? _____

Answer: Ask permission to interview the child alone

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Flashcard 28: A(n) _____ is a medical outcome that should never occur

Answer: "never event"

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Flashcard 29: Which type of medical error analysis involves a retrospective approach, applied after failure to prevent recurrence? _____

Answer: Root cause analysis

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Flashcard 30: A(n) _____ is a medical error that is recognized before any harm is done to the patient

Answer: near miss

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Flashcard 31: Two easy ways of preventing medication errors are instructing physicians to avoid the use of unsafe _____ and trailing zeros

Answer: abbreviations

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Flashcard 32: A(n) _____ is a human factor design to improve quality/safety that prevents undesirable actions

Answer: forcing function

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Flashcard 33: Risk of wrong-site surgery can be reduced by: - _____ the operative site - requiring "dual identifiers" - performing a surgical time out before the procedure

Answer: marking

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Flashcard 34: In patients with traumatic spinal cord injury, _____ placement can assess for urinary retention and prevent acute bladder distention/damage

Answer: urinary catheter

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Flashcard 35: If a physician suspects child abuse, what is the first action that should be taken? _____

Answer: Contact child protective services (CPS)

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Flashcard 36: For patients leaving against medical advice, physicians should offer to _____ care

Answer: resume

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Flashcard 37: For spousal abuse, ensure the patient has a(n) _____

Answer: safe place to go during emergency

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Flashcard 38: Friable perineal laceration and postmenstrual bleeding in an 80 year-old nursing home resident is suggestive of _____

Answer: elder sexual abuse

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Flashcard 39: The health care proxy is in effect only if _____

Answer: the patient is deemed to have insufficient capacity

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Flashcard 40: For patients leaving against medical advice, physicians should offer to assist with care in the _____ setting

Answer: outpatient

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Flashcard 41: Leakage of CSF after epidural placement may result in postural headaches, which are worse with _____ and better with _____

Answer: sitting up

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Flashcard 42: _____ is practicing below the standard of care

Answer: Negligence

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Flashcard 43: Nasogastric tube feeding is associated with _____ risk for aspiration pneumonia

Answer: increased

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Flashcard 44: Treatment for compression ulcers? _____

Answer: Roll (prophylaxis)

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Flashcard 45: If a malpractice case is successful, the patient can receive _____ and _____

Answer: compensatory damages

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Flashcard 46: What are the recommendations to reduce the risk of ventilator-associated pneumonia for intubated patients? (3) _____

Answer: Elevate head of bed at 30-45 degrees Suction of subglottic secretions Minimize patient transport Limited use of gastric acid inhibitors

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Flashcard 47: What are the true contraindications to vaccinations? _____

Answer: Anaphylaxis to previous vaccination Very sick

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Flashcard 48: Staph food poisoning (e.g. potato salad) is usually caused by inadequate _____

Answer: refrigeration

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Flashcard 49: What is the good samaritan law? _____

Answer: Protect from legal liability in non-medical settings

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Flashcard 50: Only nonmonetary gifts that are of minimal value and that directly benefit the _____ should be accepted

Answer: patient

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Flashcard 51: If someone comes in with an acute onset of wheezing and dyspnea, what is the first step? _____

Answer: SKIP the diagnosis and move directly to treatment

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Flashcard 52: USPSTF recommends clinicians screen for _____ in women of reproductive age

Answer: intimate partner violence

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Flashcard 53: How should physicians respond to patients leaving against medical advice (3)? _____

Answer: Offer alternative treatment; offer to resume care if patient reconsiders; offer assistance with outpatient/follow-up care

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Flashcard 54: _____ is Deviation (neglect) from Duty that was the Direct cause of Damage

Answer: Malpractice

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Flashcard 55: Can MRI be performed on a patient with cochlear implants? _____

Answer: No

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Flashcard 56: Medical errors often occur due to _____ failure during hand-off, which can be remedied by using _____

Answer: communication

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Flashcard 57: Atelectasis is usually managed/prevented with _____

Answer: incentive spirometry

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Flashcard 58: What type of catheterization is recommended for patients with neurogenic bladder to reduce the risk of catheter-associated UTI? _____

Answer: Clean intermittent catheterization

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Flashcard 59: What steps are most likely to reduce the risk of long-term prescription opioid misuse? (3) _____

Answer: Review state's prescription drug-monitoring program data Random urine drug screens Regular follow-up visits

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Flashcard 60: Should addiction history affect pain management? _____

Answer: No

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Flashcard 61: Which type of medical error analysis involves a forward-looking approach to prevent failure occurrence?_____

Answer: Failure mode and effects analysis

Flashcard 62: Children < _____ years old should not ride in a seat with a front facing airbag

Answer: 12

Flashcard 63: What type of disease prevention is identifying patients at risk of unnecessary treatment?_____

Answer: Quaternary

Flashcard 64: Patients undergoing splenectomy should be vaccinated against _____ organisms

Answer: encapsulated

Flashcard 65: What type of vaccine should be avoided in patients with SCID?_____

Answer: Live vaccines

Flashcard 66: Which type of medical error analysis involves a retrospective approach, applied after failure to prevent recurrence?_____

Answer: Root cause analysis

Flashcard 67: The Beers criteria are used to reduce potential inappropriate prescribing and harmful polypharmacy in the _____ population

Answer: geriatric

Flashcard 68: A _____ is a medical outcome that should never occur

Answer: "never event"

Flashcard 69: Examples of the beers criteria include drugs that increase the risk of _____ (benzodiazepines, opioids)

Answer: falls

Flashcard 70: What must be used in all patients treated with cisplatin?_____

Answer: IV saline