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how are generalizations different from stereotypes?
generalizations are starting points to understanding the beliefs, practices, and physical characteristics of groups. Stereotypes predetermined conclusions
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what factors increase suscepibility to health problems in ethnic groups?
- disease
- environmental factors
- general physical status
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what ethnic groups are more likely to get TB?
Native Americans, Vietnamese, Mexical American
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what population is most at risk for Cystic Fibrosis?
Whites
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what population is most at risk for Sickel Cell Anemia
African Americans
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what is G6PD Deficiency?
- (Glucose-6-Phosphate Dehydrogenase deficiency)
- the deficiency of the enzyme G6PD
- it is an x-linked recessive chromosome defect
- causes hemolysis of RBCs and anemia
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what ethnic populations have the highest rate of G6PD deficiency?
- African Americans (10%)
- Greek
- Italian
- Asian
- people of Mediterranean origin
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what drugs can precipitate hemolysis in G6PD deficiency?
- antimalarial agents (quinine derivatives)
- sulfonamides (antibiotic)
- ASA
- NSAIDs
- high doses of vitamin C
- Thiazide Diuretics
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what foods can precipitate hemolysis in G6PD deficiency?
horse/ broad beans (fava beans and their pollen)
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what is lactose intolerance?
deficiency of the enzyme Lactase needed to metabolize lactose
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what ethnic populations often have lactose intolerance?
southern europeans, jews, arabs, african americans, and native americans
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what are some common S/S of lactose intolerance?
- diarrhea
- abdominal pain
- abdominal distention
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in what ethnic population do infants and children tend to be quieter, more adaptable, and coordinated sooner?
asians
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what ethnic population views slightly overweighs children as healthy?
african americans
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in what ethnic population is iron deficiency prevalent?
African americans
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what ethnic populations frequently have low birth weight babies?
African Americans and hispanics
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what are prevalent health disorders in African Americans?
diabetes, iron deficiency, lactose intolerance, HTN, arthritis, G6PD deficiency, parasites, TB, hepatitis, STDs, and sickel cell anemia
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define ethnopharmacology
the study of the effects of ethnicity on how drugs work
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explain the ethnopharmacological effect on ACE inhibitors
they typically work better for HTN on euro-americans than african americans & other blacks
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explain the ethnopharmacological effect on Thiazide diuretics
lower HTN better in african americans & other blacks than Euro Americans
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what health disorders are more prevalent in Asians?
G6PD deficiency, TB, dermatitis, nasopharyngeal and liver cancer
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what is another name for G6PD defiency?
alpha thalassemia
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what are some major health disorders for hispanics?
iron deficiency, lactose intolerance, exposure to pesticides, lead poisoning, diabetes, HTN, arthritis, parasites, TB, hepatitis
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what can increase susceptibility of the lower-class to TB?
crowded living conditions
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how does lead poisioning cause anemia?
lead interferes with heme synthesis
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what are the general clinical manifestations of lead poisoning?
- anemia
- acute cramping/abdominal pain
- vomiting
- constipation
- anorexia
- HA
- fever
- short stature and decreased weight (long term)
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what are the early clinical manifestations of lead poisoning? (CNS)
- hyperactivity
- aggression
- impulsiveness
- decreased interest in play
- lethargy
- irritability
- delay orreversal in verbal maturation
- lass of newly acquired motor skills
- clumsiness
- deficits in sensory perception
- learning difficulties
- short attention span
- distractibility
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what are the late clinical manifestations of lead poisoning? (CNS)
- mental retardation
- paralysis
- blindness
- convulsions
- coma
- death
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what are the two main clinical manifestations of pulmonary TB?
Fever and weight loss
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what are general clinical manifestations of pulmonary TB?
- (may be asymptomatic)
- malaise
- anorexia
- caugh (may or may not be present)
- aching pain and tightness in chest
- hemoptysis (rare)
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what clinical manifestations of pulmonary TB suggest worsening?
- increased respiratory rate
- poor expansion of lung on effected side
- diminished breath sounds and crackles
- dullness on percussion (lungs full of fluid)
- persistant fever
- pallor, anemia, weakness, and weight loss
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in terms of health beliefs, explain natural, supernatural, and imbalances in foces (what ethnic populations believe this?)
- natural - cold entering the body can cause sickness
- supernatural - evil spirits, evil eye, or a curse could be responisble for sickness
- imbalances - hot/cold (yang and yin) balance not maintained could cause sickness so treat with hot or cold remedies
- (hispanic, filipino, chinese, and arab)
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what is a curandera?
a hispanic folk healer
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what could be one draw back to folk remedies?
if they do not help or harm, they may delay seeking professional medical help
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what are some examples of folklore related to prenatal influences?
- the mother's thoughts can cause impressions on the fetus
- scratching can give your baby a birthmark in that area (a way to explain abnormalities and defects)
- eating clay to get needed minerals (can hurt mother and fetus)
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what are some guidelines for using an interpreter?
- meet in advance to discuss what questions you will be asking
- avoid pulling the same staff member away from their job to act as interpreter
- introduce interpreter to family and allow them time to get acquainted
- maintain eye contact with client, don't focus on the interpreter
- discuss the interview with the interpreter after it is complete and ask for any impressions or feedback they can give
- try to use the same interpreter for a particular pt
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what are some potential problems in communicating to people of a different culture?
- they may smileand nod when they actually don't understand what you are saying
- eye contact varies in appropriateness
- expression of emotions can vary
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describe Roman Catholic beliefs in regards to birth, death, food, etc
- birth: baptism is mandatory (especially if prognosis is poor), and anyone can do it
- death: anointing of sick and last rites sacrament. organ donation deemed ok by vatican as an act of charity
- food: fasting during lent (children and the sick are exempt)
- etc: religous articles are very important
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describe Jehovah Witness beliefs in regards to birth, death, food, etc
- birth: no baptism
- death: no official last rites
- food: can't ingest blood (this applies to blood transfusions or autolgous-self donated but some will take plasma expanders)
- etc: often need a court order to consent for child's transfusion
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describe Muslim (Moslem) beliefs in regards to birth, death, food, etc
- birth: first words said in infant's right ear are "Allah-o-Akbar" (god is great), circumcision of male child
- death: spacific rituals required (bathing, and wrapping of body)
- food: no pork products, fasting during 9th month of Islamic year called Ramadan (children and the sick are exempt)
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describe Judism beliefs in regards to birth, death, food, etc
- birth: no baptism, ritual circumcision on 8th day
- death: family/friends stay with deceased
- food: kosher
- etc: may refuse surgery on sabbath, no mutilations (refuse autopsies)
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describe Buddhist beliefs in regards to birth, death, food, etc
- birth: no baptism
- death: last rite chanting at bedside
- food: discourage alcohol/drug use
- etc: optimistic outlook, teach ways to overcome fear, anxiety, and apprehension.
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