Comlex Ethics

• * If a patient is dismissed from a physician’s practice for forging prescriptions, physician is required to * provide any letters of documentation of treatment • * Physician is also required to send termination letter including the reason of termination within 30 day. *Termination -> treatment noncompliance, FUP noncompliance, verbal abuse, violent behavior and nonpayment • Delay of termination may be needed if patient is in a cute phase of treatment, if the physician is the only source of medical care within a reasonable driving distance • If a patient is denied care by another provider due to Sex/Age/Race/HIV, find patient another physician and report the discriminatory physician to the ethics committeee • Patients are allowed to refuse prophylaxis, but present risk and benefits in addition to document in chart • If a patient keeps on flirting with a physician, explain the ethics, document encounters and state that if it continues they must see another physician/discharge charge/give reccomendations • Health department is only notified if a patient has a confirmation of an infectious disease • Patients with limited english profiency, use a certified medical interpreter • EMTALA requires screening and stabilization of patient prior to any transfers • Confusd patient, who cannot make his own decisions, family is in strong disagreement about the best course of action —-> Call ethics committee • Squirrels, hamsters, guinea pigs, rats, mice, gerbils, chipmunks, rabbits -> small rodents do not require rabius prophylaxis • 5-49 —-> Intranasal influenza vaccine • A physician in private practice - if aren’t accepting any new patients - no obligation to provide a list • Only referall to another doctor if they are an established patient • Statin induced myopathy -> appropriate first step is discontinue simvastatin and begin therapy with another statin once symptoms resolve • 2 years old —> forward facing car seafety seat in the rear career seats with harness • Belt-positioning booster seats in read seat -> 8-12 and have not reached 4’9 • Level 3 evidence - case-control studies • Level 1 - randomized, controlled, double blind • Level 4 - case reports and case series • Level 2 - cohort, metanalysis (prospective) • 3 - retrospective cohort, case-control • 5 - expert, opinions • Know immunizations • Lap and shoulder seat belts in the rear seats of the vehicle —-> if 12 + 4’9 and weight more than 120 • Volunteer protection act - level of liability protection for volunteers are of large, organized volunteer efforts • Stafford act - disaster relief - state must respond to disaster and have an emergency plan • Public health service act —-> shall all federal public health and medical responses • Children less than 2 years of age should ride in a rear-facing car safety seat until they reach the limits of their height and weight • National Practitioner Data bank provides information about malpractice payments • Healthcare integrity and protection data bank is to combat fraud and abuse • Joint Comission on Accreditation of Healthcare organizations - operates accreditation programs to —— any hospital that meets Joint commission accfreditation can meeet Medicare • National comittee for quality assurance improve healthcare quality • Standard of care - all patients regardless of pyament should be treated for their medical problems with the same diagnostic and therapeutic rigor • Breach of duty describe a failure to maintain the duty that the physician owes to the patient —-> does not provide standard of care

Resident physician leaves prior to transferring care to another health care professional - abandonment Physicians are legally protected to reveal a patient’s HIV status if the physician feels that a third party’s life is being put in danger Good Samaritan act does not protect health care professionals from abandonment and gross neglience even though he was performing an off-duty service Never leave the scene of an accident until EMS personal have arrived if you have begin care otherwise considered abandonment and negligience • Elder abuse does not have to be reported if there is no evidence and the patient has documented mental illness or dementia • Duty only applies if a relationship between victim and physiican was established • Vitreous hemorrhage seen in shaken baby syndrome • Hospitals are liable for negligence on behalf of employees - vicarious liability • Medical student involvement can improve patient care by serving as navigator to aid communication between the patient and healthcare team • There is minimal to no risk to a fetus that has been exposed to a lumbar radiograph • Ionizing radiation should be avoided in patients who are pregnant • IGUR, spontaneous abortion, teratogenic effects, malformation, IUGR - radiation effects • HMO requires referall from PCP • Healthcare provider related injuries -> stop whatever ur doing, leave OR, wash wound and go to employee health office • The most common cause of Death in children aged 1-4 is unintentional injury - drowning, accidents, burn/fires • Bismurth subsalicylate is the non-antibiotic prophylactic agent for traveler’s diarhea • Saw Palmetto can cause headaches, nausea, dizziness, hypertension • Red yeast rice can cause myalgias, liver enzyme changes • Ginkgo biloba can cause allergic reactions • Smoking increases incidence and prevalence • If last booster was more than 5 years ago and it’s dirty -> Tdap or TD • If booster was 5-10 years and clean > give nothing • Fewer than 5 years since previous dose, all wounds > give nothing • More than 10 years since previous dose, all wound > give tetatnus vaccine booster • Fewer than 3 doses/uncertain vaccination history + clean > give tetanus booster • Fwever than 3 doses/uncertain, dirty > give IVIG and Tetanus vaccine • Gingko can cause serious bleeding