COMMEDRecon_Evals7

COMMED EVALS 7 (December 16, 2010)

COMMED EVALS 7 (December 16, 2010)

Topics Covered: Topics Covered:

 Traditional, Complementary and Alternative Medicine  Dr. CarnateTraditional, Complementary and Alternative Medicine  Dr. Carnate

 Violence Against Women and Elder Abuse  Dr. CarnatViolence Against Women and Elder Abuse  Dr. Carnat ee

 HH_{ealth Emergency Management  Dr. Gonzagaealth Emergency Management  Dr. Gonzaga}  HH_{ospice and Palliative Care  Dr.ospice and Palliative Care  Dr.} HH_ipolipol

1.

1. The Traditional Medicine Program of the Philippines was replaced in 1997 by the:The Traditional Medicine Program of the Philippines was replaced in 1997 by the: A.

A. Philippine Institute of Traditional and Alternative Philippine Institute of Traditional and Alternative MedicineMedicine B.

B. Philippine Center for Traditional and Alternative MedicinePhilippine Center for Traditional and Alternative Medicine C.

C. Philippine Institute for Traditional and AlternativePhilippine Institute for Traditional and Alternative HH_{ealth Careealth Care} D

D.. Philippine Institute for Traditional, Alternative and Complementary HealthPhilippine Institute for Traditional, Alternative and Complementary Health

2.

2. The traditional and alternative modalities currently accepted in the Philippines include the following, except:The traditional and alternative modalities currently accepted in the Philippines include the following, except: A.

A. AcupunctureAcupuncture

B

B_{.. ChiropracticChiropractic}

C.

C. Folk medicineFolk medicine D

D.. Herbal medicineHerbal medicine E.

E. MassageMassage 3.

3. One of the objectives of the PhilOne of the objectives of the Philippine program for traditional medicine is to protect these from exippine program for traditional medicine is to protect these from ex ploitation andploitation and patenting:

patenting: A.

A. Traditional healersTraditional healers B.

B. Indigenous health resourcesIndigenous health resources C.

C. Consumers of traditional medicine modalitiesConsumers of traditional medicine modalities D.

D. All of the aboveAll of the above 4.

4. This is one of the characteristics that differentiates alternative medicine from traditional medicine:This is one of the characteristics that differentiates alternative medicine from traditional medicine: A.

A. Holistic health careHolistic health care

B

B_.. HH_{anded down from another cultureanded down from another culture}

C.

C. Not included in biomedicineNot included in biomedicine D

D.. Based on history, heritage and consciousnessBased on history, heritage and consciousness E.

E. None of the aboveNone of the above Traditional Medicine

Traditional Medicine

The sum total of knowledge, skills and practices on

The sum total of knowledge, skills and practices on holistic health careholistic health care which iswhich is recognized and accepted by the community recognized and accepted by the community  forfor its role in maintenance of health and treatment of diseases. It is based on the theory, belief and experiences that are its role in maintenance of health and treatment of diseases. It is based on the theory, belief and experiences that are indigenous to the different cultures

indigenous to the different cultures, and that is, and that is developed and handed down from generation to generationdeveloped and handed down from generation to generation ..

Traditional and Alternative

Traditional and AlternativeHH_{ealth Care (TAealth Care (TA}HH_C)C)

The sum total of knowledge, skills and practices on health care a

The sum total of knowledge, skills and practices on health care and other than those embodied in biomedicine, used in nd other than those embodied in biomedicine, used in thethe prevention, diag

prevention, diagnonosis and elimination of physical or mental disorders.sis and elimination of physical or mental disorders. TRADITIONAL Medicine

TRADITIONAL Medicine

The sum total of knowledge, skills and practices on health care

The sum total of knowledge, skills and practices on health care not necessarily explicable in the context of modern,not necessarily explicable in the context of modern, scientific framework,

scientific framework, but recognized by the people to help maintain and improve health towards the wholeness of but recognized by the people to help maintain and improve health towards the wholeness of  their being, the community and society, and other interrelations

their being, the community and society, and other interrelations based on culture, history, heritage and based on culture, history, heritage and  consciousness.

consciousness.

 ALTERNATIVE Medicine  ALTERNATIVE Medicine

Other forms of non-allopathic, occasionally

Other forms of non-allopathic, occasionally non-indigenous or imported non-indigenous or imported  healing methods, thoughhealing methods, though not necessarily not necessarily   practiced for centuries, nor handed down from one generation to another 

 practiced for centuries, nor handed down from one generation to another .. Philippi

Philippine Institute for ne Institute for Traditional and AlternativeTraditional and AlternativeHH_{ealth Care (PITAealth Care (PITA}HH_C)C)

-- was established underwas established under RRA No. 8423: Traditional and Alternative Medicine Act (TAMA)A No. 8423: Traditional and Alternative Medicine Act (TAMA)

-- objectives:objectives:

y

y encourage scientific researchencourage scientific research y

y promote and advocate usepromote and advocate use y

y coordinate skills training coursescoordinate skills training courses y

y formulate standards, guidelines and codes of ethical practiceformulate standards, guidelines and codes of ethical practice y

y formulate policies for the protection (of practitioners and materials used)formulate policies for the protection (of practitioners and materials used) y

y formulate policies to strengthen the role of TAHCformulate policies to strengthen the role of TAHC y

5.

5. Traditional medicine is not part of mainstream medicine but is recognized for its contribution to health care. TheTraditional medicine is not part of mainstream medicine but is recognized for its contribution to health care. The form of political support:

form of political support: A. A. NeglectNeglect B. B. ExclusionExclusion C. C. SupportSupport D D.. IntegrationIntegration E. E. RecognitionRecognition 6.

6. Health systems that are non-allopathic and non-indigenous are considered by the Philippine Program onHealth systems that are non-allopathic and non-indigenous are considered by the Philippine Program on Traditional Medicine as:

Traditional Medicine as: A.

A. Complementary MedicineComplementary Medicine B.

B. Traditional MedicineTraditional Medicine C.

C. BB_{iofield therapyiofield therapy} D

D.. Bioelectromagnetic modalityBioelectromagnetic modality E.

E. C andC andDDonlyonly 7.

7. Reiki is an example of this type of alternative medicine form:Reiki is an example of this type of alternative medicine form: A.

A. Body-based therapyBody-based therapy B.

B. Body-mind interventionBody-mind intervention C.

C. BB_{iofield therapyiofield therapy} D

D.. Bioelectromagnetic modalityBioelectromagnetic modality E.

E. C andC andDDonlyonly 8.

8. This form of alternative medical system This form of alternative medical system uses small amounts of medicinal substances to cure uses small amounts of medicinal substances to cure diseases/symptoms.diseases/symptoms. These same substances can cause the disease/symptoms when give in higher or more concentrated doses.

These same substances can cause the disease/symptoms when give in higher or more concentrated doses. A.

A. Traditional Chinese MedicineTraditional Chinese Medicine B. B. AyurvedaAyurveda C. C. HH_{omeopathyomeopathy} D D.. NaturopathyNaturopathy E.

E. None of the aboveNone of the above 9.

9. In the Philippines, these plants are still being screened for their medicinal properties, except:In the Philippines, these plants are still being screened for their medicinal properties, except: A.

A. Tinospora crispaTinospora crispa B.

B. Lagerstroemia speciosaLagerstroemia speciosa C.

C. E E _{hretia microphyllahretia microphylla}

D

D.. C C _{entella asciaticaentella asciatica}

E.

E. Euphorbia hirtaEuphorbia hirta

The following are currently being screened for their medicinal properties: The following are currently being screened for their medicinal properties:

COMMON

COMMON NAME NAME SCIENTIFISCIENTIFIC C NAME NAME INDICATIOINDICATIONN

Makabuhay

Makabuhay Tinospora crispaTinospora crispa anti-malariaanti-malaria Banaba

Banaba Lagerstroemia speciosaLagerstroemia speciosa diureticdiuretic Takip kuhol

Takip kuhol C C _{entella asiaticaentella asiatica wound healingwound healing}

Mutha

Mutha C C _{yperus rotondusyperus rotondus intestinal motilityintestinal motility}

Tawa-tawa/ Tawa-tawa/ Gatas-gatas

Gatas-gatas Euphorbia hirtaEuphorbia hirta

anti-dengue (

anti-dengue (platelet ct.)platelet ct.) anti-asthma anti-asthma 10.

10. Vitex negundoVitex negundo is also known asis also known as A. A. AmpalayaAmpalaya B B_{.. LagundiLagundi} C. C. Yerba-buenaYerba-buena D D.. Tsaang-gubatTsaang-gubat E.

E. Ulasimang batoUlasimang bato Integrated

Integrated

-- Part of mainstream/conventional medicinePart of mainstream/conventional medicine

Supported** Supported**

-- Not a part of mainstream medicine, but the government recognizes it and has efforts to bring it to mainstreamNot a part of mainstream medicine, but the government recognizes it and has efforts to bring it to mainstream

R

R_{ecognizedecognized}

-- The government announces its potential role in mainstream medicineThe government announces its potential role in mainstream medicine

Neglected Neglected

-- Only conventional medicine is recognizedOnly conventional medicine is recognized

**

11.

11. This medicinal plant is currently being investigated for its anti-malarial properties:This medicinal plant is currently being investigated for its anti-malarial properties: A. A. Gatas-gatasGatas-gatas B B_{.. MakabuhayMakabuhay} C. C. Takip-kuholTakip-kuhol D D.. MuthaMutha E.

E. None of the aboveNone of the above

H

H_EERBRB_{AL MEDICINESAL MEDICINES}

COMMON

COMMON NAME NAME SCIENTIFISCIENTIFIC C NAME NAME INDICATIOINDICATIONN

Akapulko

Akapulko C C _{assia alataassia alata fungal infectionfungal infection}

Ampalaya

Ampalaya Momordica charantiaMomordica charantia diabetes mellitusdiabetes mellitus Bawang

Bawang  Allium sativum Allium sativum hypercholesterolemiahypercholesterolemia Bayabas

Bayabas Psidium guajavaPsidium guajava antisepticantiseptic Lagundi

Lagundi Vitex negundoVitex negundo anti-asthmaanti-asthma Niyug-niyugan

Niyug-niyugan Quisqualis indicaQuisqualis indica anti-helminthicanti-helminthic Sambong

Sambong Blumea balsamicaBlumea balsamica anti-urolithiasisanti-urolithiasis Tsaang-gubat

Tsaang-gubat Ehretia microphyllaEhretia microphylla intestinal motilityintestinal motility Ulasimang bato

Ulasimang bato Peperomia pellucidaPeperomia pellucida anti-hyperuricemiaanti-hyperuricemia Yerba Buena

Yerba Buena Mentha cordifoliaMentha cordifolia body painsbody pains

For # 12

For # 12-16: -16: Match the herbal mediciMatch the herbal medicines in Column nes in Column A with the iA with the indications/diseases for ndications/diseases for which the DOwhich the DOHH_{has approvedhas approved}

their use in Column their use in ColumnBB_..

COLUMN

COLUMN A A COLUMN COLUMN BB

C

C 12. Sambong12. Sambong A

A 13. 13. Yerba Yerba BuenaBuena E

E 14. Bawang14. Bawang

B

B _{15. Tsaang-gubat15. Tsaang-gubat}

D

D 16. 16. Ulasimang Ulasimang BatoBato

A.

A. Body Body painspains B.

B. Intestinal Intestinal motility motility problemsproblems C. Urolithiasis C. Urolithiasis D D. Hyperuricemia. Hyperuricemia E. Hypercholesterolemia E. Hypercholesterolemia For # 17-2

For # 17-20: 0: Match the items in CMatch the items in Column A as to olumn A as to the form of Complemetary the form of Complemetary and Alternative Medicine and Alternative Medicine in Columnin ColumnBB_..

COLUMN

COLUMN A A COLUMN COLUMN BB

D

D 17. Reiki17. Reiki A

A 18. 18. Prayer Prayer healinghealing C

C 19. Osteopathy19. Osteopathy

B

B _{20. Aromatherapy20. Aromatherapy}

A.

A. Mind-body Mind-body interventionsinterventions B.

B. Biologically-based Biologically-based therapiestherapies C.

C. Manipulative Manipulative and and body-based body-based methodsmethods D

D. . Energy Energy therapiestherapies E.

E. None None of of the the aboveabove

21.

21. This theory avers that violence against women is a result of the need of men to assert power and control overThis theory avers that violence against women is a result of the need of men to assert power and control over women:

women: A.

A. Caregiver stressCaregiver stress B.

B. Trans-generational violenceTrans-generational violence C.

C. Abuser psychopathologyAbuser psychopathology D

D.. Sociological perspectiveSociological perspective E.

E. Feminist perspectiveFeminist perspective 22.

22. That media has a role in the causation of elThat media has a role in the causation of el der abuse is a theory of:der abuse is a theory of: A.

A. Caregiver StressCaregiver Stress

B

B.. Trans-generational AbuseTrans-generational Abuse

C.

C. Abuser PsychopathologyAbuser Psychopathology D

D.. None of the aboveNone of the above N 

23.

23. This theory of causation of elder abuse avers that elder This theory of causation of elder abuse avers that elder abuse is a learned behavior:abuse is a learned behavior: A.

A. Caregiver StressCaregiver Stress

B

B_{.. Trans-generational AbuseTrans-generational Abuse}

C.

C. Abuser PsychopathologyAbuser Psychopathology D

D.. None of the aboveNone of the above 24.

24. That women are inferior to men is a message of this (these) theory (theories) of causation of violence againstThat women are inferior to men is a message of this (these) theory (theories) of causation of violence against women (VAW):

women (VAW): A.

A. Social PerspectiveSocial Perspective B.

B. Feminist PerspectiveFeminist Perspective C.

C. BB_othoth

25.

25. That violence is a learned behavior is a theory of:That violence is a learned behavior is a theory of: A.

A. Sociological PerspectiveSociological Perspective B.

B. Trans-generational violenceTrans-generational violence C.

C. Caregiver StressCaregiver Stress D

D.. All of the aboveAll of the above E.

E. A andA andBB_onlyonly

26.

26. This theory avers that elder abuse is a result of the pressures of looking after an elderly person:This theory avers that elder abuse is a result of the pressures of looking after an elderly person: A.

A. Caregiver StressCaregiver Stress B.

B. Trans-generational violenceTrans-generational violence C.

C. Abuser psychopathologyAbuser psychopathology D

D.. Sociological perspectiveSociological perspective E.

E. Feminist perspectiveFeminist perspective 27.

27. In this effect of VAW, the woman-victim/survivor feels depressed, incompetent and powerless to change herIn this effect of VAW, the woman-victim/survivor feels depressed, incompetent and powerless to change her circumstances

circumstances A.

A. Post-traumatic stress disorderPost-traumatic stress disorder

B

B_.. BB_{attered wife syndromeattered wife syndrome}

C.

C. Learned helplessnessLearned helplessness D

D.. All of the aboveAll of the above 28.

28. In this effect of VAW, the wIn this effect of VAW, the woman-victim/survivor exhibits dissociation as a coping mechanismoman-victim/survivor exhibits dissociation as a coping mechanism A.

A. Post-traumatic stress disorderPost-traumatic stress disorder B.

B. Battered wife syndromeBattered wife syndrome C.

C. Learned helplessnessLearned helplessness D

D.. All of the aboveAll of the above 29.

29. Physical effects of VAW include the following:Physical effects of VAW include the following: A.

A. Sexually-transmitted diseasesSexually-transmitted diseases B.

B. SuicideSuicide C.

C. MiscarriagesMiscarriages D

D.. Maternal mortalityMaternal mortality E.

E. All of the aboveAll of the above 30.

30. Hypervigilance, sleeplessness and exaggerated startle response are symptoms of this psychological effect of Hypervigilance, sleeplessness and exaggerated startle response are symptoms of this psychological effect of  VAW:

VAW: A.

A. Learned helplessnessLearned helplessness B.

B. Battered wife syndromeBattered wife syndrome C.

C. Post-traumatic stress disorderPost-traumatic stress disorder D

D.. DDepressionepression 31.

31. A male prison guard committed lascivious acts against a female prisoner. The form of VAW committed is:A male prison guard committed lascivious acts against a female prisoner. The form of VAW committed is: A.

A. Sexual violenceSexual violence B.

B. Custodial abuseCustodial abuse C.

C. DDeprivation of libertyeprivation of liberty D.

D. A andA andBB_onlyonly

E.

32.

32. Forcing an elderly person to sign a document giving another person the power-of-attorney is a form of:Forcing an elderly person to sign a document giving another person the power-of-attorney is a form of: A.

A. Physical abusePhysical abuse

B

B_{.. Financial abuseFinancial abuse}

C.

C. NeglectNeglect D

D.. None of the aboveNone of the above 33.

33. Not taking an elderly person to the doctor to have his/her bedsores managed is an example of this form of elderNot taking an elderly person to the doctor to have his/her bedsores managed is an example of this form of elder abuse:

abuse: A.

A. Physical abusePhysical abuse B.

B. Psychological abusePsychological abuse C.

C. Physical neglectPhysical neglect D

D.. A and B onlyA and B only E.

E. B and C onlyB and C only 34.

34. Fiduciary abuse:Fiduciary abuse: A.

A. The refusal or failure to fulfill a The refusal or failure to fulfill a care-giving obligation or to provide for basic needscare-giving obligation or to provide for basic needs B.

B. Acts intended to make a women financially dependentActs intended to make a women financially dependent C.

C. The illegal or improper exploitation or The illegal or improper exploitation or use of funds or resources of the older puse of funds or resources of the older personerson D

D.. DDepriving a woman of her legal rightsepriving a woman of her legal rights F 

F _{or # 35-37 or # 35-37}  MEASU

MEASURR_{ES TES T}HH_{AT PAT P}RR_{OTECT VS. VAW/ELDEOTECT VS. VAW/ELDE}RR_AABB_USEUSE

International

International Policies/Policies/InstrumentsInstruments Universal

UniversalDDeclaration of Human Rights (1948)eclaration of Human Rights (1948) UN

UNDDeclaration on the Elimination of VAW (1993)eclaration on the Elimination of VAW (1993) UN

UNDDeclaration on the Prevention of Elder Abuse (2002)eclaration on the Prevention of Elder Abuse (2002) Philippi

Philippine Policies and ne Policies and LawsLaws

 RR_{evised Penal Codeevised Penal Code (1932)(1932)}

-- Article 246: ParricideArticle 246: Parricide

-- Article 737: Qualified SeductionArticle 737: Qualified Seduction

 Philippine ConstitutionPhilippine Constitution (1987)(1987)

-- Gender equalityGender equality

-- Prevention and elimination of violencePrevention and elimination of violence

 RR_{A 7877: Anti-SexualA 7877: Anti-Sexual}HH_{arassment Actarassment Act (1995)(1995)}

-- DDefinition and punishmentefinition and punishment

 RR_{A 8353: Anti-A 8353: Anti-}RR_{ape Law (1997)ape Law(1997)}

-- DDefinition and punishmentefinition and punishment

-- Marital rapeMarital rape

 RR_{A 8551A 8551}

-- Creation of WomensCreation of WomensDDesks in Precinctsesks in Precincts

 RR_{A 9208: Anti-Trafficking in Persons ActA 9208: Anti-Trafficking in Persons Act (2003)(2003)}

-- DDefinition and punishmentefinition and punishment

 RR_{A 9262: Anti-VAW and their Children ActA 9262: Anti-VAW and their Children Act (2004)(2004)}

-- DDefinition and punishmentefinition and punishment

Non-Government and

Non-Government and CommunityCommunityRR_{esponseesponse}

Establishment of Counseling and Crisis Centers Establishment of Counseling and Crisis Centers Policy advocacy for Womens Rights

Policy advocacy for Womens Rights FO FORR_{MS OF VAWMS OF VAW} Physical Violence Physical Violence Sexual Violence Sexual Violence Psychological Violence Psychological Violence Economic Abuse Economic Abuse Deprivation of Liberty Deprivation of Liberty

-- Restricting a womans freedom of movementRestricting a womans freedom of movement -- DDepriving a woman of her legal rightsepriving a woman of her legal rights

Medical Abuse Medical Abuse

-- Abuse by medical personnelAbuse by medical personnel Custodial Abuse

Custodial Abuse

35.

35. That employers, teachers, supervisors and persons in authority should act with care towards women in theirThat employers, teachers, supervisors and persons in authority should act with care towards women in their employ, guidance and care is embodied in this law:

employ, guidance and care is embodied in this law: A.

A. Anti-Trafficking in Persons ActAnti-Trafficking in Persons Act

B

B_{.. Anti-SexualAnti-Sexual}HH_{arassment Actarassment Act}

C.

C. Anti-Rape LawAnti-Rape Law D

D.. Anti-VAW and their Children and ActAnti-VAW and their Children and Act E.

E. All of the aboveAll of the above 36.

36. Recruitment of women to be sexual workers is a punishable crime according to this law:Recruitment of women to be sexual workers is a punishable crime according to this law: A.

A. Anti-Trafficking in Persons ActAnti-Trafficking in Persons Act B.

B. Anti-Sexual Harassment ActAnti-Sexual Harassment Act C.

C. Anti-Rape LawAnti-Rape Law D

D.. Anti-VAW and their Children and ActAnti-VAW and their Children and Act E.

E. All of the aboveAll of the above 37.

37. Republic Act 8551 is the Philippine Law that:Republic Act 8551 is the Philippine Law that: A.

A. DDefined what behavior constitutes sexual harassmentefined what behavior constitutes sexual harassment B.

B. Prescribes appropriate punishment for acts of violence against womenPrescribes appropriate punishment for acts of violence against women C.

C. DDefined traffickingefined trafficking D.

D. Created womens desks in precinctsCreated womens desks in precincts 38.

38. The following is(are) true of VAW:The following is(are) true of VAW: A.

A. Usually a one-time occurrenceUsually a one-time occurrence B.

B. Occurrence is usually sporadicOccurrence is usually sporadic C.

C. A single form of abuse is usually committedA single form of abuse is usually committed D.

D. The abuser is usually knownThe abuser is usually known 39.

39. The following is(are) true of VAW:The following is(are) true of VAW: A.

A. Elderly women are unlikely to be victims of VAWElderly women are unlikely to be victims of VAW B.

B. Most incidents of VAW get reported to authoritiesMost incidents of VAW get reported to authorities C.

C. The most commonly reported form of VAW is sexual abuseThe most commonly reported form of VAW is sexual abuse D.

D. Making a woman watch the abuse of her pet is a Making a woman watch the abuse of her pet is a form of VAWform of VAW E.

E. None of the aboveNone of the above 40.

40. This form of VAW is present in the Philippine definition of VAW (Republic Act 9262: Anti-VAW Act) but is notThis form of VAW is present in the Philippine definition of VAW (Republic Act 9262: Anti-VAW Act) but is not specified in the VAW definition of the United Nations:

specified in the VAW definition of the United Nations: A.

A. Public violencePublic violence B.

B. Intra-family violenceIntra-family violence C.

C. Economic violenceEconomic violence D

D.. Gender-based violenceGender-based violence

41.

41. Epidemics and plagues are inevitable after every Epidemics and plagues are inevitable after every disaster. Your best counter-argument is:disaster. Your best counter-argument is: A.

A. Affected population is too shocked/helpless to take responsibility for their own survivalAffected population is too shocked/helpless to take responsibility for their own survival B.

B. Local population almost always cover immediate life saving needsLocal population almost always cover immediate life saving needs C.

C. Dead bodies will not lead Dead bodies will not lead to catastrophic outbreak of exotic diseasesto catastrophic outbreak of exotic diseases 42.

42. The National Health Policy Framework on Health Emergencies and disasters has the following features EXCEPT:The National Health Policy Framework on Health Emergencies and disasters has the following features EXCEPT: A.

A. 3-phase coverage3-phase coverage B.

B. Risk Reduction FocusedRisk Reduction Focused C.

C. SelectedSelectedHH_{azard Approachazard Approach} D

D.. Integrated in Health ProgramsIntegrated in Health Programs DEFINITIONS OF VAW

DEFINITIONS OF VAW UN General Assembly, 1993 UN General Assembly, 1993 any

any act act of of gender-based violencegender-based violence thatthat results in,results in, oror isis likely to result to,likely to result to, physical, sexual,physical, sexual, oror psychological harm or psychological harm or sufferingsuffering to women, including

to women, including threats of such acts, coercion, or arbitrary deprivation of liberty threats of such acts, coercion, or arbitrary deprivation of liberty  whether occurring inwhether occurring in public or privatepublic or private life.

life.

R

R_{A 9262, 2004A 9262, 2004}

any act or series of acts committed by any person against his wife, former wife, or against a woman with whom the person any act or series of acts committed by any person against his wife, former wife, or against a woman with whom the person has or had a sexual or dating relationship, or with whom he has a common child, or against her child, whether legitimate or has or had a sexual or dating relationship, or with whom he has a common child, or against her child, whether legitimate or illegitimate, within or without the family abode, which result in or is likely to result in

illegitimate, within or without the family abode, which result in or is likely to result in physical, sexual,physical, sexual, andand psychological harmpsychological harm or suffering or

or suffering or economic abuseeconomic abuse, including threats of such acts, battery, assault, coercion, harassment, or arbitrary deprivation, including threats of such acts, battery, assault, coercion, harassment, or arbitrary deprivation of liberty.

For

For # # 43-51: 43-51: Choose Choose the the appropriate appropriate answer answer from from the the followingfollowing A. A. HazardHazard B. B. DDisasterisaster C. C. VulnerabilityVulnerability D D.. CapacityCapacity E. E. RiskRisk 43.

43. Endosulfan cargo in Princess of StarsEndosulfan cargo in Princess of Stars A 

A HH_azardazard

44.

44. Typhoon OndoyTyphoon Ondoy A/

A/BB_HH_{azard/Disasterazard/Disaster}

45.

45. First floor location of x-rays in hospitalsFirst floor location of x-rays in hospitals C  Vulnerability

C  Vulnerability 46.

46. Floating foundations for buildingsFloating foundations for buildings D  Capacity

D  Capacity 47.

47. Any occurrence that causes damage, economic disruption, loss of human lives and deterioration in health andAny occurrence that causes damage, economic disruption, loss of human lives and deterioration in health and health services on a scale sufficient to warrant an extraordinary response from OUTSI

health services on a scale sufficient to warrant an extraordinary response from OUTSIDDE the affected communityE the affected community areas

areas

B

B_{ Disaster Disaster}

48.

48. Resource, means and strength which exist in households and communities and which enable them to cope with,Resource, means and strength which exist in households and communities and which enable them to cope with, withstand, prepare for, prevent, mitigate or quickly recover from a disaster

withstand, prepare for, prevent, mitigate or quickly recover from a disaster D  Capacity

D  Capacity 49.

49. A natural or human generated event or occurrence that has the potential for causing injuries to life andA natural or human generated event or occurrence that has the potential for causing injuries to life and damaging property and environment

damaging property and environment A 

A HH_azardazard

50.

50. Anticipated consequences of a specific hazard affecting a specific community at a specific timeAnticipated consequences of a specific hazard affecting a specific community at a specific time E

-E -RR_iskisk

51.

51. A set of prevailing or consequential conditions which adversely affect peoples ability to prevent, mitigate,A set of prevailing or consequential conditions which adversely affect peoples ability to prevent, mitigate, prepare for and respond to hazardous events

prepare for and respond to hazardous events C - Vulnerability

C - Vulnerability

H H_AZAAZARR_DD

-- AA naturalnatural oror human generatedhuman generated event or occurrence that has theevent or occurrence that has the  potential  potential for causing injuries to life and damagingfor causing injuries to life and damaging property and environment

property and environment DISASTE

DISASTERR

-- Any occurrence that causes damage, economic disruption, loss of human lives and deterioration in health and Any occurrence that causes damage, economic disruption, loss of human lives and deterioration in health and  health services

health services

-- On a scale sufficient toOn a scale sufficient to warrant an extraordinary responsewarrant an extraordinary response fromfrom outsideoutside the affected community areasthe affected community areas

-- Any actual threat to public safety and/or public health where local government and the emergency services areAny actual threat to public safety and/or public health where local government and the emergency services are unable to meet the immediate needs of the community

unable to meet the immediate needs of the community VULNE

VULNERR_AABB_ILITYILITY

-- A set of   prevailing or consequential conditionsA set of   prevailing or consequential conditions which adversely affect peoples ability to prevent, mitigate, preparewhich adversely affect peoples ability to prevent, mitigate, prepare for and respond to hazardous events

for and respond to hazardous events CAPACITY

CAPACITY

-- RR_{esourceesource  , means,  , means, andand strengthstrength which exist in households and communities and which enable them to cope with,which exist in households and communities and which enable them to cope with,} withstand, prepare for, prevent, mitigate or quickly recover from a disaster.

withstand, prepare for, prevent, mitigate or quickly recover from a disaster.

R R_ISKISK

--   Anticipated consequences  Anticipated consequences of a specific hazard affecting a specific community at a specific timeof a specific hazard affecting a specific community at a specific time

-- LL_{evel of loss of damageevel of loss of damage that can bethat can be predicted to resultpredicted to result from a particular hazard affecting a particular place at afrom a particular hazard affecting a particular place at a} particular time

52.

52. A comprehensive strategy for reducing threats and consequences to public health and safety of the communityA comprehensive strategy for reducing threats and consequences to public health and safety of the community by preventing exposure to hazards, reducing vulnerabilities and developing response and recovery is known as: by preventing exposure to hazards, reducing vulnerabilities and developing response and recovery is known as:

A.

A. DDisaster Managementisaster Management B.

B. Vulnerability ReductionVulnerability Reduction C.

C. RR_{isk Managementisk Management} D

D.. MitigationMitigation E.

E. DDisaster Preparednessisaster Preparedness 53.

53. Principles involved in health emergency/disaster management EXCEPT:Principles involved in health emergency/disaster management EXCEPT: A.

A. SustainableSustainableDDevelopmentevelopment B.

B. Integrated ApproachIntegrated Approach C.

C. Millennium DevelopmentMillennium Development D

D.. Primary Health CarePrimary Health Care 54.

54. The roles of the Health Sector during the Pre-event Phase are the following EXCEPT:The roles of the Health Sector during the Pre-event Phase are the following EXCEPT: A.

A. Assess RisksAssess Risks B.

B. Reduce RisksReduce Risks C.

C. Prepare for EmergenciesPrepare for Emergencies D.

D. RR_{esponding to esponding to EmergenciesEmergencies}

For

55-For 55-58: 58: Choose from Choose from the list the list below the below the appropriate Pappropriate Phase to hase to which the which the health activity health activity belongsbelongs A.

A. Preparedness (Pre-Event)Preparedness (Pre-Event) B.

B. Response (Event)Response (Event) C.

C. Rehabilitation and Reconstruction (Post-Event)Rehabilitation and Reconstruction (Post-Event) D

D.. All phasesAll phases

55.

55. Public Health ServicesPublic Health Services

B

B_RR_{esponseesponse}

56.

56. Food/water survey and stockpilingFood/water survey and stockpiling A - Preparedness

A - Preparedness

H

H_EALTEALTHH_{ACTIVITIES FOACTIVITIES FO}RR_EACEACHH_PPHH_ASEASE

P

PRR_{E-EVENT PE-EVENT P}HH_{ASE: PASE: P}RR_EPAEPARR_EDNESSEDNESS

-- DDevelopment of policies, guidelines, proceduresevelopment of policies, guidelines, procedures

-- DDevelopment of Health Emergency Preparedness, Response, Recovery/Reconstruction Plans (HEPRR)evelopment of Health Emergency Preparedness, Response, Recovery/Reconstruction Plans (HEPRR) -- DDevelopment of organizationevelopment of organization

-- Physical infrastructure developmentPhysical infrastructure development -- Systems developmentSystems development

-- Early warning and alert systemsEarly warning and alert systems

-- Stockpile/Preposition  food, drugs, medical supplies, cadaver bagsStockpile/Preposition  food, drugs, medical supplies, cadaver bags -- Training of health staff Training of health staff 

-- Public health informationPublic health information

-- Exercises Exercises DDrills (Test/Update plan)rills (Test/Update plan)

EVENT P

EVENT PHH_ASE:ASE:RR_{ESPONSEESPONSE}

-- Mass casualty managementMass casualty management y

y On-site management  triageOn-site management  triage y

y Hospital management  definitive treatmentHospital management  definitive treatment -- Public health servicesPublic health services

y

y Environmental health  water, excreta disposal, vector controlEnvironmental health  water, excreta disposal, vector control y

y Food and nutritionFood and nutrition y

y Control of communicable diseases  immunizations, treatmentControl of communicable diseases  immunizations, treatment y

y Shelters (evacuation camps)Shelters (evacuation camps) y

y Mental Health and Psychosocial Support ServicesMental Health and Psychosocial Support Services y

y Management of Management of _DDead and Missingead and Missing -- Risk communicationRisk communication

y

y The purposeful exchange of information about the existence, nature, form, severity or acceptability of The purposeful exchange of information about the existence, nature, form, severity or acceptability of  health risks between policy makers, health care providers and public media aimed at changing behavior and health risks between policy makers, health care providers and public media aimed at changing behavior and inducing action to minimize risks

inducing action to minimize risks

POST-EVENT P

POST-EVENT PHH_ASE:ASE:RR_ECOVEECOVERR_Y/Y/RR_ECONSTECONSTRR_UCTIONUCTION

-- Restore to normal basic health servicesRestore to normal basic health services -- Repair damages to equipment and buildingsRepair damages to equipment and buildings -- Psychosocial supportPsychosocial support

57.

57. DDamage repair of buildings and equipmentamage repair of buildings and equipment C 

C RR_{ehabilitation andehabilitation and}RR_{econstructioneconstruction}

58.

58. Mass Casualty ManagementMass Casualty Management

B

B_--RR_{esponseesponse}

59.

59. Mental Health and Psychosocial Support now EXCMental Health and Psychosocial Support now EXC LULUDDES this activity:ES this activity: A.

A. Critical Incident Stress DebriefingCritical Incident Stress Debriefing B.

B. Provision of Basic NeedsProvision of Basic Needs C.

C. Provision of Appropriate Medical CareProvision of Appropriate Medical Care D

D.. Gender Sensitive Health CareGender Sensitive Health Care 60.

60. The New Republic Act 10121 changes the names of the Coordinating Councils at different administrative levelsThe New Republic Act 10121 changes the names of the Coordinating Councils at different administrative levels to:

to: A.

A. Risk andRisk andDDisaster Reductionisaster Reduction B.

B. Risk Management andRisk Management andDDisaster Reductionisaster Reduction C.

C. DisasterDisasterRR_iskiskRR_{eduction and Managementeduction and Management} D

D.. DDisaster Risk Managementisaster Risk Management

For

For # # 61-64: 61-64: Who Who among among the the patient/s patient/s would would merit/s merit/s Palliative Palliative Care?Care? A.

A. YesYes B. B. NoNo 61.

61. Carlos, 21 y/o male was brought in for the chief complaint of severe right leg pain and swelling. X-Ray showedCarlos, 21 y/o male was brought in for the chief complaint of severe right leg pain and swelling. X-Ray showed fracture of both his tibia and fibula.

fracture of both his tibia and fibula. NONO

62.

62. Carla is a 34 y/o teacher who was diagnosed to suffering from breast CA 1 year ago. She was able to finish sixCarla is a 34 y/o teacher who was diagnosed to suffering from breast CA 1 year ago. She was able to finish six cycles of chemotherapy with very minimal side effects. Last week she complained of severe right upper arm cycles of chemotherapy with very minimal side effects. Last week she complained of severe right upper arm pain. An X-ray of her right arm showed positive for metastasis. She was prescribed pain relievers and was told pain. An X-ray of her right arm showed positive for metastasis. She was prescribed pain relievers and was told that she would have to undergo again several cycles of chemotherapy.

that she would have to undergo again several cycles of chemotherapy.YESYES 63.

63. Mario is a 42 y/o male diagnosed to be suffering from pulmonary CA with brain metastasis a month ago. PatientMario is a 42 y/o male diagnosed to be suffering from pulmonary CA with brain metastasis a month ago. Patient is complaining of severe headache and cough. He was prescribed several oral analgesics which gave temporary is complaining of severe headache and cough. He was prescribed several oral analgesics which gave temporary relief. He refused to receive any chemotherapy. He is also complaining of dizziness and inability to sleep and on relief. He refused to receive any chemotherapy. He is also complaining of dizziness and inability to sleep and on and off difficulty of breathing.

and off difficulty of breathing. YESYES 64.

64. Marvin, 45 y/o carpenter started to have on and off productive cough and fever 1 year ago associated withMarvin, 45 y/o carpenter started to have on and off productive cough and fever 1 year ago associated with anorexia and weight loss. Signs and symptoms persisted until consult. One day prior to consult patient had anorexia and weight loss. Signs and symptoms persisted until consult. One day prior to consult patient had DDOBOB which prompted consult.

which prompted consult. YESYES 65.

65. True of Palliative Care:True of Palliative Care: A.

A. Aims to cureAims to cure

B

B_.. RR_{elieves sufferingelieves suffering}

C.

C. Supports the best possible quality of Supports the best possible quality of life for patients and their falife for patients and their familiesmilies D

D.. Specifically at the terminal stage of the diseaseSpecifically at the terminal stage of the disease E.

E. BB_{and C onlyand C only}

66.

66. True of the medications for palliative care:True of the medications for palliative care: A.

A. Modify the diseaseModify the disease

B

B_.. RR_{elieve the painelieve the pain}

C.

C. Prolong lifeProlong life D

D.. Hasten lifeHasten life PALLIATIVE CA PALLIATIVE CARR_EE

-- A philosophy of careA philosophy of care

-- An organized, highly structured system for delivering careAn organized, highly structured system for delivering care -- Aims to prevent and relieve sufferingAims to prevent and relieve suffering

-- Support the best possible quality of lifeSupport thebest possible quality of life for patients and their families, regardless of the stage of the disease or thefor patients and their families, regardless of the stage of the disease or the need for other therapies

need for other therapies He needs

67.

67. The disease where patients reported the highest % The disease where patients reported the highest % of pain:of pain: A.

A. COPCOPDD B.

B. Lung cancerLung cancer C.

C. CHFCHF D.

D. Colon cancerColon cancer 68.

68. The disease where patients reported the lowest % of pain:The disease where patients reported the lowest % of pain: A.

A. COPCOPDD B.

B. Lung cancerLung cancer C.

C. CCHH_FF D

D.. Colon cancerColon cancer

69.

69. The most frequent self-reported symptom Experience of Critically IThe most frequent self-reported symptom Experience of Critically I ll Cancer Patients Receiving Intensive Cll Cancer Patients Receiving Intensive C areare A. A. PainPain B B_{.. DiscomfortDiscomfort} C. C. TasteTaste D D.. AnxietyAnxiety 70.

70. What do family members want 1-2 years after bereavement?What do family members want 1-2 years after bereavement? A.

A. To be listened toTo be listened to B.

B. PrivacyPrivacy C.

C. To be remembered and contacted after the deathTo be remembered and contacted after the death D

D.. A and BA and B E.

E. All of the aboveAll of the above

71.

71. Palliative Care will NOT respond to the following imperatives:Palliative Care will NOT respond to the following imperatives: A. A. ClinicalClinical B. B. FiscalFiscal C. C. DDemographicemographic D. D. PhysicalPhysical

What Family Members Want 1-2 Years After

What Family Members Want 1-2 Years AfterBB_{ereavementereavement}

-- Loved ones wishes honoredLoved ones wishes honored -- Inclusion in decision processesInclusion in decision processes -- Support/assistance at homeSupport/assistance at home

-- Practical help (transportation, medicines, equipment)Practical help (transportation, medicines, equipment) -- Personal care needs (bathing, feeding, toileting)Personal care needs (bathing, feeding, toileting) -- Honest informationHonest information

-- 24/7 access24/7 access -- To be listened toTo be listened to -- PrivacyPrivacy

-- To be remembered and contacted after the deathTo be remembered and contacted after the death

Self-Self-RR_{eported Symptom Experience of Critically Ill Cancer Patientseported Symptom Experience of Critically Ill Cancer Patients}RR_{eceiving Intensive Careeceiving Intensive Care} F 

F _{requency of self-reported symptoms, in descending order:requency of self-reported symptoms, in descending order:} D Discomfortiscomfort Thirst Thirst Sleeping Sleeping Anxiety Anxiety Pain Pain Hunger Hunger D Depressionepression SOB SOB F  F _{or # 67-68 or # 67-68} 

Pain Data from SUPPO Pain Data from SUPPORR_TT

COLON CANCE

COLON CANCERR _60%60%

Liver

Liver failure failure 60%60% Lung

Lung cancer cancer 57%57% MOSF

MOSF + + Cancer Cancer 53%53% MOSF

MOSF + + Sepsis Sepsis 52%52% COP

COPDD 44%44% C

72.

72. Establishing attainable goal/s in palliative care iEstablishing attainable goal/s in palliative care i nclude/snclude/s A.

A. Facilitate understanding of scope of illness and likely pFacilitate understanding of scope of illness and likely p rogression of patients and familiesrogression of patients and families B.

B. Choose only the acceptable quality of lifeChoose only the acceptable quality of life C.

C. Solely determines what should be done to the patients and their familiesSolely determines what should be done to the patients and their families D

D.. A and BA and B E.

E. All of the aboveAll of the above

73.

73. Families provide _____ of long term careFamilies provide _____ of long term care A. A. 40%40% B. B. 50%50% C. C. 60%60% D. D. >70%>70% 74.

74.  ______ of the illness and its care occurs at home ______ of the illness and its care occurs at home A. A. 65%65% B. B. 75%75% C. C. 85%85% D. D. 95%95% 75.

75. Palliative care can be applied:Palliative care can be applied: A.

A. To any life-threatening diagnosisTo any life-threatening diagnosis B.

B. Whenever the patient/family is prepared to accept itWhenever the patient/family is prepared to accept it C.

C. May be focus of careMay be focus of care D

D.. A and BA and B E.

E. All of the aboveAll of the above 76.

76. 7-step protocol to negotiate goals of care (in order):7-step protocol to negotiate goals of care (in order):

1. Create the right setting; determine what the patient and family know 1. Create the right setting; determine what the patient and family know 2. explore what they are expecting or hoping for; suggest realistic goals 2. explore what they are expecting or hoping for; suggest realistic goals 3. Respond empathically; make a plan and follow-through

3. Respond empathically; make a plan and follow-through 4. Review and revise periodically, as appropriate

4. Review and revise periodically, as appropriate A. A. 1,2,3,41,2,3,4 B. B. 2,3,4,12,3,4,1 C. C. 1,3,2,41,3,2,4 D D.. 2,1,3,42,1,3,4

Establishing realistic, attainable goals of care Establishing realistic, attainable goals of care

-- Help patients and families understand the scope of the illness and likely progressionHelp patients and families understand the scope of the illness and likely progression -- Identify relevant values and goalsIdentify relevant values and goals

-- DDefine acceptable and unacceptable quality of lifeefine acceptable and unacceptable quality of life -- DDefine choices to be made and their benefits and burdensefine choices to be made and their benefits and burdens -- Help with decision-makingHelp with decision-making

-- DDevelop care plans that maximize chances that goals will be achieved.evelop care plans that maximize chances that goals will be achieved. IMPE

IMPERR_{ATIVES OF PALLIATIVE CAATIVES OF PALLIATIVE CA}RR_EE

CLINICAL Imperative CLINICAL Imperative

-- Numerous studies document patient suffering: pain, nausea, breathlessness, anxiety, depression, fatigueNumerous studies document patient suffering: pain, nausea, breathlessness, anxiety, depression, fatigue -- Poor to non-existent communication in the hospitalPoor to non-existent communication in the hospital

y

y Physicians typically elicit fewer than half of patients concerns and dont discuss values, goals of care, andPhysicians typically elicit fewer than half of patients concerns and dont discuss values, goals of care, and treatment decisions

treatment decisions FISCAL Imperative

FISCAL Imperative

-- Exponentially rising costs with effective new technologies, aging populationExponentially rising costs with effective new technologies, aging population -- In the Philippines, limited money and resourcesIn the Philippines, limited money and resources

-- Hospital and Health CareHospital and Health Care DDelivery System for the future will have to effectively treat chronically and seriously ill inelivery System for the future will have to effectively treat chronically and seriously ill in order to survive

order to survive DEMOG

DEMOGRR_APAPHH_{IC ImperativeIC Imperative}

-- The progressive and chronically ill patient, the elderly ill patient, and the patient with a severe illness accounts forThe progressive and chronically ill patient, the elderly ill patient, and the patient with a severe illness accounts for much of medical spending

much of medical spending

-- The number of sick elderly patients is increasingThe number of sick elderly patients is increasing DEMAND Imperative

DEMAND Imperative EDUCATIONA

77.

77. The following should be considered in planning for palliative care:The following should be considered in planning for palliative care: A.

A. Availability of caregivers at homeAvailability of caregivers at home B.

B. Financial capability of the patientFinancial capability of the patient C.

C. Course of the illnessCourse of the illness D

D.. A and BA and B E.

E. All of the aboveAll of the above For # 78-80:

For # 78-80: RR_{efer to the case belowefer to the case below}

Maria is a 40y/o female admitted at the

Maria is a 40y/o female admitted at the DDLSUMC with breast CA stage 4 and is undergoing chemotherapy.LSUMC with breast CA stage 4 and is undergoing chemotherapy. Presently she is having on and off vomiting secondary to the chemotherapy. Last month, she started to have moderate Presently she is having on and off vomiting secondary to the chemotherapy. Last month, she started to have moderate to severe left upper arm pain which could only be relieved by a very potent injectable pain reliever. Two weeks ago she to severe left upper arm pain which could only be relieved by a very potent injectable pain reliever. Two weeks ago she started to have dyspnea and easy fatigability. She used to be the principal of the government high school in their place. started to have dyspnea and easy fatigability. She used to be the principal of the government high school in their place. She is being seen by a psychologist for her sleepless nights. Her husband is employed but his income is not enough to She is being seen by a psychologist for her sleepless nights. Her husband is employed but his income is not enough to cover for the hospitalization of Maria. They have 3 sons who are all in high school. A Sr. of St. Pauls who is also a nurse cover for the hospitalization of Maria. They have 3 sons who are all in high school. A Sr. of St. Pauls who is also a nurse visits her regularly for her spiritual needs.

visits her regularly for her spiritual needs. 78.

78. Palliative care includes the following toPalliative care includes the following to A.

A. Giving of the potent oral pain relieverGiving of the potent oral pain reliever B.

B. Psychological supportPsychological support C.

C. Spiritual support from the Sister of St. PaulsSpiritual support from the Sister of St. Pauls D

D.. A and BA and B E.

E. All of the aboveAll of the above 79.

79. Other palliative care service/s which can be provided include/s:Other palliative care service/s which can be provided include/s: A.

A. Modify the chemotherapy to lessen the vomitingModify the chemotherapy to lessen the vomiting B.

B. Radiate the arm to lessen the painRadiate the arm to lessen the pain C.

C. Refer the family to a psychiatrist for counselingRefer the family to a psychiatrist for counseling D

D.. A and BA and B E.

E. All of the aboveAll of the above 80.

80. If this patient decides to go home, she can still be given palliative care service/s which include/s:If this patient decides to go home, she can still be given palliative care service/s which include/s: A.

A. Teach the relative on how to give the injectable pain relieverTeach the relative on how to give the injectable pain reliever

B

B_{.. Train one of the relatives on how to take care of Train one of the relatives on how to take care of the patientthe patient}

C.

C. Increase chemotherapeutic drugs to prolong lifeIncrease chemotherapeutic drugs to prolong life

Hope these help! Thank you Mau for the initiative.

Hope these help! Thank you Mau for the initiative. kkJJ_anaana

(A) is not the answer because pain is not her only symptom that needs to be addressed. (A) is not the answer because pain is not her only symptom that needs to be addressed. (C) is not the answer because palliative care does not aim to prolong life.

(C) is not the answer because palliative care does not aim to prolong life. 7 STEP P

7 STEP PRR_{OTOCOL TO NEGOTIATE GOALS OF LIFEOTOCOL TO NEGOTIATE GOALS OF LIFE}

1.

1. Create the right settingCreate the right setting 2.

2. DDetermine what the patient and family knowetermine what the patient and family know 3.

3. Explore what they are expecting or hoping forExplore what they are expecting or hoping for 4.

4. Suggest realistic goalsSuggest realistic goals 5.

5. Respond empathicallyRespond empathically 6.

6. Make a plan and follow-throughMake a plan and follow-through 7.