• * 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