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Read e-book online Braton's Family Medicine PDF

By Board Review R. Bratton

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Risk factors for falls in the elderly include increasing age, arthritis, medication use (more than four medications, including tricyclic antidepressants, neuroleptics, benzodiazepines, and type IA antiarrythmics), cognitive impairment (dementia and depression), and sensory deficits. Outpatient evaluation of a patient who has fallen includes a focused history with an emphasis on medications, a directed physical examination, and tests of postural control and overall physical function. Treatment is directed at the underlying cause of the fall, with the goal to return the patient to baseline function.

Privacy is the patient's right over the use and disclosure of his or her own personal health information. Privacy includes the right to determine when, how, and to what extent personal information is shared with others. The HIPAA privacy rules grant new rights to patients to gain access to and control the use and disclosure of their personal health information. Security is the specific measures a health-care provider must take to protect personal health information from unauthorized breaches of privacy, as in situations where information is stolen or sent to the wrong person in error.

Examination confirms a mildly enlarged prostate without nodules. Appropriate management at this time includes A) further evaluation to exclude malignancy B) observation and reassurance C) use of alpha blockers to improve urinary flow D) use of a 5-alpha reductase inhibitor Answer and Discussion Prostate cancer screening should be performed at the age of 50 years in those who wish to undergo evaluation and at normal risk for development of disease. Annual examinations can then be considered. In patients with PSA values between 4 and 10 ng/mL, the PSA velocity and percentage of free PSA can be used in making clinical decisions.

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