Which one of the following is true regarding abuse of the elderly?
Correct Answer B:
Accurate information on elder abuse is difficult to obtain, but it is estimated that it occurs up to five times more often than it is reported. There are seven different kinds of elder abuse: physical abuse, sexual abuse, psychological abuse, financial abuse, neglect, abandonment, and self-neglect. The most common form of abuse substantiated by Adult Protective Services is neglect, with sexual abuse being the least common. Another study listed physical abuse as the most prevalent, followed by verbal aggression and neglect.
Women are most often the victims of elder abuse. Approximately 90% of abusers are related to the victim, with the adult children being the most likely perpetrators. As abusers, an equal number of men and women are guilty of neglect, but other forms of abuse are predominantly committed by men. If the spouse is the perpetrator, there is likely a previous history of violence in the relationship. Abusers are often alcohol or drug abusers and many times are dependent on the victim for money and housing.
A pregnant woman tells you that she plans to go to Cambodia to care for her mother.
Which of the following is the most appropriate advice?
Correct Answer C:
When traveling to Cambodia, malaria prophylaxis is recommended. Chloroquine is pregnancy category C and risk and benefits must be weighed before giving this drug to a pregnant woman.
The safety of hepatitis A vaccination during pregnancy has not been determined; however, because hepatitis A vaccine is produced from inactivated hepatitis A virus, the theoretical risk to the developing fetus is expected to be low. The risk associated with vaccination should be weighed against the risk for hepatitis A in pregnant women who may be at high risk for exposure to hepatitis A virus.
Pregnancy is not a contraindication for use of Tdap.
Measles-mumps-rubella (MMR) vaccine and its component vaccines should not be administered to women known to be pregnant.
A 15-year-old girl comes to your office and is asking for oral contraceptive pills (OCP’s).
What is the appropriate action?
Correct Answer A:
According to Canadian law, there is no minimum age to prescribe contraception, and youth are under no legal obligation to inform their parents that they are being prescribed or are using contraception. Clinical staff is also under no legal obligation to report contraceptive use to parents. In fact, reporting contraceptive use would breach patient confidentiality.
A 16-year-old girl comes to the emergency department because, she says, "something is sticking out of my bottom since I had a bowel movement this morning." She denies previous episodes, although for more than one year she has had occasional difficulty passing stools. In response to your questions, she tells you that she moved away from home more than a year ago and her parents contribute nothing to her support. She has a 6-month-old child, a part time job and lives with a 28-year-old female cousin. In order to follow the correct procedure for treating a minor, which of the following is the most appropriate step prior to evaluating this patient's rectal problem?
A small number of minors, particularly at older ages such as 16 or 17, may be considered 'emancipated' or freed of the need to have parental consent for any medical care. The criteria are that the minor is married, self-supporting and living independently, in the military, or the parent of a child that they themselves support. The criteria for being an emancipated minor relate to being no longer dependent on one's parents for support.
An emancipated minor is free to make health care decisions in all areas, not only just STDs, prenatal care, contraception, or substance abuse.
A new screening test for a type of cancer is carried out on 10,000 subjects. One hundred and sixty have a positive result, of whom eight are determined to actually have the disease. These eight subjects survived longer than other persons suffering from the same type of cancer diagnosed by other means.
Which one of the following statements is correct?
Correct Answer D:
The above graphic illustrates how to calculate various epidemiological values. If we use the information in the question we obtain the following table:
The positive predictive value (PPV) = 8/160 = 5%
Click to expand