Medical Assistant

5 job-interview mistakes to avoid

People are often wrongly dressed for the interview. Usually they are overdressed, have on too much makeup and jewelry or impractical shoes.

When explaining decisions you have made, like why you are changing jobs, the interviewer is often interested in hearing about your motivations and attitude. Never complain about a former job or situation. Find a positive way to frame what you want to say.

Many people have negative speech habits, such as using hedges like just, actually, kinda and almost. Using them makes you seem less confident, less authoritative and therefore less employable. Don’t undermine your credibility.

At an interview talk only about the things that directly correlate with your ability to do the job: know your knowledge, skills and abilities. Talk about the job not your likes and dislikes.

Too many people walk into an interview with tons of extraneous items. Do not bring in your cell phone. Don’t bring in reading material. A water bottle may be acceptable but better off without a drink in hand. Companies hire people not just on a set of skills but take everything you do into account to determine if you fit in to their business.


April 10th is… National Alcohol Screening Day

The AUDIT C is a condensed, hence “C”, version of the full 10 question AUDIT tool. The AUDIT C contains 3 questions which quantifies the amount of alcohol a person drinks. Using a validated scoring system it helps to determine which people might be at higher risk for having a problem with alcohol.

As is true with many screening tools a positive score does not diagnose a person with alcoholism. Rather the tool is used  to assist in deciding which patients need a more elaborate tool, like the full AUDIT, to help determine if they indeed have a substance abuse problem.

Entira Family Clinics Monitor April 2014

Conditions that mimic dementia

Dementia is an umbrella term for a range of symptoms that affect memory and thinking. Alzheimer’s disease is only one type of dementia.

Normal pressure hydrocephalus is caused by a gradual buildup of spinal fluid in the brain. The resulting swelling and pressure over time can damage brain tissue. The symptom that usually isn’t noticed at first is a distinctive gait problem like a slow shuffle. A shunt surgically inserted into the brain can drain fluid and usually corrects situation.

Drug interactions can be a problem because the body metabolizes and eliminates medication less efficiently as one ages and drugs can build up and cause memory glitches and other side effects that look very similar to dementias. If troublesome symptoms begin after starting a medication, follow up on it. Let the provider know about all medications taken including supplements.

When someone is depressed, regions of the brain crucial for memory, thinking, mood, sleep and appetite are impaired. A depressed person would express sadness whereas someone with a dementia related depression may not realize he has memory problems or may not want to take on new activities but may not necessarily feel sad.  Depression can be treated successfully with medication, regular exercise, cognitive therapy and stress reduction techniques.

UTIs are often missed in older people because some rarely have the typical symptoms of fever or pain. Instead there may be memory problems, confusion, delirium, dizziness, agitation and hallucinations.  UTIs are easily treated with antibiotics.

30 million people have thyroid disease. Most of those are over 50 and half don’t know it. People feel sluggish, depressed, forgetful or anxious. Symptoms of thyroid disease are often mistaken for normal aging. Both too little or too much thyroid hormone may trigger dementia-like symptoms. A simple blood test measures thyroid hormone levels.

As some people age they become unable to absorb vitamin B-12 which leads to a condition called pernicious anemia. The result is nerve damage such as numbness or tingling in the hands and feet, confusion, personality changes, irritability, depression and forgetfulness.

25% of Americans over the age of 6 have diabetes. Too much or too little glucose damages blood vessels in the brain. The result is memory problems, confusion, irritability and inattention. Good control of the condition is important.

Alcohol abuse and even binge drinking for a short time destroys brain cells in areas critical for memory, thinking, decision making and balance. Depending on the damage, the effects of long-term alcohol abuse can sometimes be reversed.

AARP Bulletin/Real Possibilities April 2014

What do your nails say about your health?

White spots signify damage to the cuticle that acts as a seal, keeping in moisture and blocking out bacteria and drying chemicals. Irritants can slip below the surface, compromising the nail-growth process.

A deep horizontal groove emerges after a single traumatic event. The more intense the circumstances, the more severe the . Illness, fever, pregnancy and even stress such as grieving can cause one. This line takes up to 6  months to grow out.

Horizontal depressions usually happen when you’ve done something directly harmful to the nail matrix such as shutting a drawer on your finger. Often a telltale sign of repetitively picking at or pushing back the cuticle.

Split nail tips is probably due to overexposure of water and chemicals which weaken nails. Get the daily recommended intake of 30 micrograms of biotin (fish and eggs). Pull on a pair of cotton lined rubber gloves to do the dishes. Avoid dehydratuing alcohol based hand sanitizers. Use non-acetone nail polish removers.

Rough white patches are probably keratin granulations that were caused by wearing polish for too long or using drying polish remover too often. A one-month holiday from nail polish and remover will clear the nail plate nicely.

Smooth longitudinal ridges are normal for people over 30. If the lines emerge suddenly you may have a symptom of a range of inflammatory skin conditions.

A thick, yellow toenail covering most of the nail may indicate a fungal infection. Affects about 10% of the population and is treatable with a dermatologist-prescribed topical or oral medication. Takes 12 to 18 months to disappear.

April 2014

Eat Red for Heart Health

Diet can have a tremendous impact on heart health- and should be the first line of defense when treating high cholesterol or high blood pressure, two of the biggest risk factors for heart disease. Add the antioxidant-rich fruits listed below to your diet.

Tomatoes- eating these lycopene-rich fruits more than five times a week over an 11-year period reduced coronary disease risk by 26%. Cook them though because the heating process allows lycopene to be better absorbed.

An apple a day can reduce LDL (bad) cholesterol by as much as 40 percent. A link was found among postmenopausal women studied for 18 years, that a link between eating apples and a lowered risk of dying from heart disease. Much on fruit rather than drink juice because the peels house most of the antioxidants.

Drinking 3 cups of cranberry juice daily can raise HDL (good) cholesterol levels by 10 percent and reduce heart disease by 40 percent. This juice decreased diet-caused atherosclerosis by preventing plaque from forming. If 3 glasses are difficult to stomach, drink a reduced amount.

AARP The Magazine February-March 2014

Five ways to beat a cold

1. Get a move on by taking a walk of doing a light workout which has a stimulatory effect on the immune system.

2. New research found that those who take ibuprofen are significantly more likely than those who take acetaminophen to return to the doctor with unresolved or worsened cold symptoms.

3. Another study showed people 50 or older who practiced mindfulness mediation had fewer and less severe colds.

4. Cold feet constrict the blood vessels in the upper airways, and reduces defense against viruses, so keep your toes warm.

5. Vigorous nose blowing can actually push mucus from the nose up into the sinuses, increasing a cold’s severity or leading to a secondary sinus infection.

AARP The Magazine February-March 2014

Can Statins Save Your Life?

Physicians have prescribed statins based primarily on the numbers from cholesterol testing. If numbers were too high, and client was deemed at risk for heart problems, they were urged to take one of these drugs to bring the numbers down. New recommendations were released at last fall’s annual meeting of the American Heart Association. The guidelines represent a major shift in how physicians determine whether one should take a statin to reduce the risk of heart disease. They focus not only on specific cholesterol numbers but on four broad categories of people at risk of having either a heart attack or stroke if they didn’t take a statin.

How to know if you are at risk: If in one of the four high-risk categories, new cholesterol guidelines say taking a statin could help you avoid a heart attack or stroke.

1. You’ve been diagnosed with heart disease or already had a heart attack

2. Your level of LDL, the harmful type of cholesterol, is 190 mg/dL or higher

3. You have type 1 or 2 diabetes and your LDL is 70 mg/dL or higher

4. Your risk of having a heart attack or stroke in the next 10 years is 7.5% or higher according to the guidelines’ controversial new health risk calculator

Additional points:

If your only risk factor is your age, you may not need to be on a statin. Lifestyle changes are more important.

If already on a stain, talk to your physician about the risk factors that put you on it originally. Your risk may be the same.

About 18% report a side effect and there is evidence that older people have more side effects including muscle aches, cognitive impairment, sexual dysfunction, increased risk of diabetes, and liver dysfunction.  If at high risk, a person should probably fear a heart attack or stroke more than side effects.

Lifestyle changes are a critical component of reducing heart disease risk. Follow a heart-healthy Mediterranean diet and get regular physical activity.

AARP Bulletin/Real Possibilities January-February 2014

Smell the peanut butter

is a simple test that detects Alzheimer’s disease. Alzheimer’s typically affects the sense of smell because the area of the brain that processes odors, (olfactory cortex) is the first to show sign of dysfunction. Normal aging can affect sense of smell, but peanut butter isn’t an odor usually lost with time. Researchers measured the distance at which participants could smell peanut butter through the left nostril compared to the right. Those with early Alzheimer’s could not detect the smell until it was an average of almost 5 inches closer to the left nostril compared with the right!

What to do: With a partner, close your eyes and ask partner to hold a small jar of peanut butter 12 inches away from your left nostril while holding your right nostril closed. Slowly move the jar closer until able to detect the smell. Next test the right nostril. You should be able to smell the peanut butter equally well in both nostrils. If you can’t see your doctor to rule out treatable conditions that affect small.

AARP The Magazine February-March 2014

Assess sleep quality

is a test used to detect Parkinson’s disease. Subtle symptoms may provide earlier clues to this condition than the appearance of tremors. Patients were given questionnaires to evaluate pain, sleep and gastrointestinal symptoms and their olfactory function was assessed. Compared with a control group, the Parkinson’s patients were more likely to suffer abnormal REM (dream stage) sleep, a loss of smell and constipation.

What to do: ask yourself these questions-

1. Do you act our your dreams through talking or fighting (a sign of REM sleep disorder)?

2. Are you having problems with smell, (especially pungent foods such as garlic)?

3. Have you been dealing with constipation for a month or longer?

If you answered yes to all of these, you may want to see your doctor. While there are no lab tests to diagnose Parkinson’s, your physician may want to conduct neurological and clinical exams which can lead to early treatment.

AARP The Magazine February-March 2014

Food Safety

Foodborne illnesses are a burden on public health and contribute significantly to the cost of healthcare. Foodborne illness is a preventable and under reported public health problem that presents a challenge to both healthy and at-risk populations. Food contamination can occur at many points in the food supply chain, including production, processing, transportation, storage and preparation. According to the CDC, about 48 million Americans each year suffer from a food-borne illness; of that number, 128,000 are hospitalized and 3,000 die. Data from a multiyear surveillance study show that while children under 4 years have the greatest number of food-borne illnesses, people 50 and up are hospitalized most often and die most often of food-borne illness.

 Campylobacter infections are usually caused by consumption of unpasteurized milk, raw or under-cooked meat or poultry, or other contaminated foods or water and contact with feces from infected animals. Campylobacter are potent bacteria: as few as 500 organisms can cause illness. Symptoms can include fever, abdominal cramping and diarrhea (often bloody); complications may include meningitis, urinary tract infections and rarely Guillain- Barre syndrome.

While Campylobacter can make anyone ill, infants, young children, pregnant women and fetuses, older adults and people with weakened immune systems are most susceptible to infection.

Four-step consumer program designed to help ensure safe food-handling practices at home. 1) Clean: Wash hands and surfaces often; 2) Separate, don’t cross contaminate; 3) Cook to the right temperature; and 4) Chill: Refrigerate promptly. These simple measures can greatly reduce the risk of food-borne illness at home.