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CALIFORNIA MEDICAL ASSISTANTPublished Bi-Monthly by the California Medical Assistants Association, Inc. for Medical Office Professionals
CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2014 1
CM
AA
UNITY IS STRENG
TH
KNOWLEDGE
ISPO
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l
SEPTEMBER/OCTOBER2014
________________________CALIFORNIA
MEDICAL ASSISTANTSASSOCIATION, INC.
P.O. Box 5694Petaluma, CA 94954-5694Toll Free 1.888.464.2622
Fax 208.730.3763
www.cmaa-ca.orgEmail address: [email protected]
WHAT’S INSIDE� PRESIDENT’S MESSAGE .....................1
� CERTIFYING BOARD UPDATE:Increased Testing andRecertification Fees Update...............2
� 2014 FALL CONFERENCE:Tentative Agenda Update....................3Hotel Information..................................4Registration Form .................................5
� TOP SECRET:The Parable of the Pebbles ................6
� CERTIFYING BOARD UPDATE:Newly Certified CaliforniaMedical Assistants.........................7-10
� CONTINUING EDUCATION:Marfan Syndrome (MFS)..............11-13Self-Assessment Test ........................14Article Order Form..............................15
� CERTIFYING BOARD PRESENTS:Tea-riffic Ideas For Instructors ........16
Have you made your reservationsfor the 2014 Fall Conference inAnaheim? What are you waiting
for? This is a great opportunity to fillyour piggy bank with CEU’s.
The 2014 Fall Conference will be acharacter building experience. Whereelse would you have the opportunity toearn CEU’s and play with Mickey andMinnie at the “Happiest place onEarth”?
I would like to send out kudos to KellyAdams and Kelsey Tucker for making adifference in the Sonoma Region bycollecting donations for the March ofDimes. It is members like these twoladies that give CMAA a good name andspread our mission.
Many times while visiting medical assist-ing schools and medical facilities,I am asked, “what are the benefitsof being a member of the CaliforniaMedical Assistants Association”? I alwaysbegin my answer with, “there are manyreasons to become a member of CMAA”.First and foremost I state that educationis a main factor in becoming a member.Certified medical assistants must keeptheir certification current or they mayhave to retest. Attending regional orstate meetings is a great way to earn
CEU’s toward recertification and theCalifornia Medical Assistant (this publi-cation), which is published every twomonths, contains an opportunity to earnanother CEU. As you might agree, edu-cation is only one of the reasons. I havebeen a member for many years andhave gained lasting friendships and havenetworked with some of the best med-ical assisting instructors in California. Infact, networking has gotten several ofmy students hired by members ofCMAA.
What reasons did you have to become amember of CMAA? Maybe anothermedical assistant introduced you toCMAA. Please share those memorieswith us. I will have a “sharing box” atFall Conference registration table thatyou can drop in a quick note and I willcompile them for our next publication.
Before we know it anew year will beupon us. So continueto “Bank yourSuccess on CMAA”and I hope to seeyou all at the 2014Fall Conference inAnaheim.
PRESIDENT’S MESSAGEPRESIDENT’S MESSAGE
Theresa Henderson, CCMA-ACCMAA State President
California Medical Assistant
E D I T O R
VICKEY MARTINEZ, CCMA-CRiverside RegionP.O. Box 2931
Riverside, CA 92516
Email: [email protected]
P U B L I C AT I O N C OMM I T T E EC H A I R M A N
KATE LOGAN, CCMA-ACSacramento Region
Certifying Board Administrator
THERESA HENDERSON, CCMA-ACRiverside Region
C O O R D I N AT O R
JANICE SAMS, CCMA-CRedwood Region
C M A A P R E S I D E N T
THERESA HENDERSON, CCMA-AC
(951) 212-0722
Email: [email protected]
For Advertising contact:
CALIFORNIA MEDICAL ASSISTANTSASSOCIATION, INC.
at
CMAA, INC.P.O. Box 5694
Petaluma, CA 94954-5694
Toll Free: 1.888.464.2622
Fax: 208.730.3763
Email: [email protected]
Material contained herein may NOTbe used without the permission of the
California Medical Assistants Association, Inc.
ALL ITEMS FOR PUBLICATIONSHOULD BE SENT
DIRECTLY TO THE EDITOR.
2 CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2014
MISS ION STATEMENT
CALIFORNIA MEDICAL ASSISTANTS ASSOCIATION, INC.
The purpose of the California Medical Assistants Association, Incorporated,is to promote the professional and educational growth of medical assistants.
CM
AA
UNITY IS STRENG
TH
KNOWLEDGE
ISPO
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California Medical Assistant
— NEXT ISSUE —November/December 2014
To submit items to be published in thisnewsletter, please mail or email:
Vickey Martinez, CCMA-CP.O. Box 2931
Riverside, CA 92516
Email Address: [email protected]
DEADLINE: October 1, 2014All materials must be submitted by the
deadline date to be included in the next issue!
2014 FALL CONFERENCE REGISTRATION, HOTEL INFORMATIONAND AGENDA INCLUDED IN THIS ISSUE.
Initial Certification
Basic and Clinical Specialty . . . . . . . . . . . . . . . $145Basic and Administrative Specialty . . . . . . . . . . $145Basic, Clinical and Administrative Specialties . . $185
Recertification by Examination
Basic and Clinical Specialty . . . . . . . . . . . . . . . $145Basic and Administrative Specialty . . . . . . . . . . $145Basic, Clinical and Administrative Specialties . . $185
After Initial Examination (Retakes)
Second Specialty (Admin or Clinical) . . . . . $90 eachRetake (Basic) . . . . . . . . . . . . . . . . . . . . . . . . $105Retake (Clinical or Admin). . . . . . . . . . . . . $90 each
Recertification by CME/CEU
CMAA Member Non-member
CCMA-A or C $75 $120CCMA-AC/CCMA $90 $150
Certifying Board Update
As of January 1, 2015, the California Certifying Board forMedical Assistants will be increasing testing and recertificationfees. The new price increases are as follows:
CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2014 3
FALL CONFERENCE 2014Anaheim Plaza Hotel
1700S. Harbor Blvd., Anaheim, CA 92802
September 11 – 13, 2014
~ TENTATIVE AGENDA ~THURSDAY, September 11, 2014
5:00 pm Executive Committee Meeting
7:00 pm Instructor Forum hosted by CCBMA
FRIDAY, September 12, 2014
8:00 am Registration
8:30 – 9:00 am Breakfast
9:15 – 11:15 am Speaker: Jim Winn Med, ATC, PTATopic: Concussion – Management Protocol
11:30 am – 12:30 pm Speaker: R. Harris, D. Eggl, C. Nelson, T. LeeTopic: Ovarian Cancer – Symptoms and Risk Factors
12:30 – 1:30 pm Lunch
1:30 – 2:30 pm Speaker: Matthew Zahn, MD Medical DirectorTopic: Today’s Hot Topics in Public Health
2:30 – 3:15 pm Budget & Finance Reference Committee
Afternoon Education Sessions
3:15 – 4:15 pm Speaker: Bruce M. Prenner, MDTopic: Anaphylaxis
SATURDAY, September 13, 2014
8:00 am Registration Opens
8:00 – 8:30 am Breakfast
8:30 – 9:30 am Speaker: Sharine Wittkopp and Jeffrey VuTopic: Cultural Competence and Healthcare Disparitiesin the LBGT Population
9:30 – 10:30 am Speaker: TBA11:00 am – 12:00 pm Speaker: Randall Tolosa, CPC
Topic: ICD-10 Part 1
12:30 – 1:30 pm Lunch
1:30 – 2:30 pm Speaker: Randall Tolosa, CPCTopic: ICD-10 Part 2
3:15 – 4:15 pm Speaker: Lieutenant Tim SalasTopic: Mandated Reporting
C A L I F O R N I A M E D I C A L A S S I S TA N T S A S S O C I AT I O N , I N C .
CM
AA
UNITY IS STRENG
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KNOWLEDGE
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UPDATE
4 CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2014
CMAA Fall ConferenceSpecial Room Rate: $89.00
(parking included)+ applicable taxes
Spacious rooms with one king bed or two queen beds.
Mention CMAAto book at the
discounted rate.
The conference rate
will be honored before and
after the conference dates
to allow you to
enjoy the attractions
in the area.
Reserve
your room early
by calling
714.772.5900
CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2014 5
Important information on reverse side - please copy this form, complete and mail.
Name: ___________________________________________
Credentials: ______________________________________
Address: _________________________________________
Telephone:___________________________________
Email: _______________________________________
Region:______________________________________
C A L I F O R N I A M E D I C A L A S S I S TA N T S A S S O C I AT I O N , I N C .
2014 FALL CONFERENCE
OFFICIAL REGISTRATION FORMAnaheim Plaza Hotel
1700 S. Harbor Boulevard, Anaheim, CA 92802September 11 - 13, 2014
Please notify us of any food allergiesor ADA accommodations.
FREE PARKING for all conferenceattendees and hotel guests.
REGISTRATION DEADLINE: 08/20/14
No refunds after September 1, 2014
Mail to: CMAA Inc.PO BOX 5694PETALUMA, CA 94954
Please make checks payable to: CMAA
Additional inquiries or registrationBy Visa or Master Card:
Call Headquarters at 1-888-464-2622
Registration for Platinum Members(Membership includes meeting registration)
Please register for meals only$30 per day
Please circle your lunch selections:
Friday: Cobb Salad or Hoagie Sandwich
Saturday: Oriental Salad or Croissant Sandwich
Registration for Platinum Members(Membership includes meeting registration)
Please register for meals only$30 per day
Please circle your lunch selections:
Friday: Cobb Salad or Hoagie Sandwich
Saturday: Oriental Salad or Croissant Sandwich
MEETING REGISTRATION FEES:
_____ Option #1 (Best Value)Full Conference RegistrationIncludes all Education, Business, full breakfast
and lunch both days.
Members & Students . . . . . . . . . . . . . . . . . . $95.00
Non-members . . . . . . . . . . . . . . . . . . . . . . . $125.00
Please circle your lunch selections:
Friday: Cobb Salad or Hoagie Sandwich
Saturday: Oriental Salad or Croissant Sandwich
_____ Option #2Friday Registration
Includes all Education, Business, full breakfastand lunch on Friday.
Members & Students . . . . . . . . . . . . . . . . . . $55.00
Non-members . . . . . . . . . . . . . . . . . . . . . . . . $70.00
Please circle your lunch selections:
Cobb Salad or Hoagie Sandwich
_____ Option #3Saturday Registration
Includes all Education, Business, full breakfastand lunch on Saturday.
Members & Students . . . . . . . . . . . . . . . . . . $55.00
Non-members . . . . . . . . . . . . . . . . . . . . . . . . $70.00
Please circle your lunch selections:
Oriental Salad or Croissant Sandwich
TOTAL AMOUNT ENCLOSED $_______________
6 CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2014
PRESIDENT-ELECT’S MESSAGEPRESIDENT-ELECT’S MESSAGE
The Parable of the PebblesItwas a beautiful day and the young manwas walking along the path admiring thewonderful scenery. He was on his way to therich city that lay beyond the three valleys.Many people in his village had talked aboutthis city but none of those who had venturedto it had ever returned to confirm the storiesof its greatness.
The first valley was a picture to beholdand the grass was so green compared to his oldvillage, which was now a day’s walk away.The valley had a small stream running throughit and there were many flowers along itsbanks. They were small and pretty flowers,bright pinks and reds, with a fantastic scent.
He sat and took some bread and cheesefrom his small knapsack and enjoyed his sim-ple lunch in these beautiful surroundings.While he ate he let his mind wonder aboutthe rich city. After lunch he continued hislong journey.
As night fell he reached the edge of thesecond valley but it was too dark for him toappreciate its beauty. He opened his knapsackand took out his blanket and settled downfor the night. He dreamed about the rich cityand how much better his life would be formoving there; it was a long and good dream.
As the sun rose the next morning thedawn chorus of birds in nearby hedges andtrees awoke him. The young man stretchedand put away his bedding and let his eyesdrink in the splendor of the second valley,which was far more fertile and colorful thanthe previous valley.
He walked to edge of the small river andsaw that there were fish in it so he set aboutcatching one for his breakfast. Having cookedand eaten the fish the young man walkedacross the river and continued his journey.
After a few miles he saw an old manasleep at the side of the path. He asked theman if he needed any help. The old man wasvery weak and his reply was short - “I ambeyond help but thank you. I will give yousome advice though – Collect as many stonesand pebbles as you can before you cross thenext river.” The young man was puzzled andasked “Why?” but could not get an answer,the old man had gone back into a deep sleep.
The young man continued walking.Why should he collect stones? As he
thought of possible reasons he noticed two orthree little pebbles in the path so he pickedthem up and put them in his pocket. This wasa long road and every now and then hepicked up a few more pebbles. His pocket wasbeginning to get heavy and he had no ideahow much further he would have to walk. Hedecided that one pocketful of stones would beenough as he would tire himself too much ifcarried more.
Hours later he reached the third valleythat was very lush and had a wide river run-ning through it. The river was not very deep,perhaps waist high, but the current lookedstrong. The young man braced himself andcrossed the river. He struggled against thecurrent and almost slipped on two occasionswhen he would surely have been washeddown river and perhaps drowned. He finallyclambered up the other bank.
He rested and then carried on with hisjourney. After an hour or so he put his handin his pocket and realized that he still had hispebbles. He pulled them from his pocket andcould not believe his eyes – they had allturned into jewels!
The young man wished he had filled all ofhis pockets and his knapsack with stones andpebbles, imagine how rich he would be now!It was pointless to go all the way back tocross the river again, he would waste toomuch time and he could even drown if hetried to cross the river again.
He carried on to the rich city only to findthat most people were poor, as they too hadfailed to heed the advice given by the oldman.
Listening and learning is like collectingpebbles; it may seem worthless at the time butwho knows when they will turn into preciousgems or golden nuggets.
— Author Unknown
This story reminds me of myself as I embarked on a new career as a MedicalAssistant. I felt that in time I could be running the back office and maybe eventu-ally become an Office Manager. That was my ‘city of riches’ dream. I am trulyone of the fortunate MA’s because my journey took me down a path that includ-ed CMAA. As a new member I had access to many mentors who encouragedme to get involved. As I look back at the pebbles I have chosen to carry over theyears I realize that I have filled my pockets with over 19 years of continuousservice on CMAA’s Executive Committee. As I feel I have arrived in my city ofriches, my needs are met and CMAA has afforded me so many more valuableriches. The shiniest gems are the friends and mentors from all over the state thatI have been able to count on in good times and trials. Precious stones of educa-tion helping me stay at the top of my field are always available through theCMA publication and our state and local meetings. The golden opportunitiesand the richest blessings have come from serving as an Officer with CMAA. Ithas been in those roles that I have drawn close to new friends and been trulytested as a person and have grown. Admittedly, more than once I asked myself,“What have you gotten yourself into?” But many more times I have called uponan experience that serving has provided me that I have been thankful for.
Are you ready to fill your pocket with an extra pebble or two? Pick up a smallone and volunteer to write an article for our publication or volunteer at our nextmeeting, or grab a larger pebble and choose to run for an office. I can tell youfrom experience; those pebbles and your experiences will become pricelesstreasures!
Shannon Tinsley, CCMA-ACPresident-Elect
CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2014 7
• RECERT ++ ADDING 2ND SPECIALTY
C E R T I F Y I N G B O A R D U P D A T ECongratulations to the newly California Certified Medical Assistants
Certification Codes: A = Administrative C = Clinical AC = Administrative and Clinical
NAME SPECIALTY HOMETOWN NAME SPECIALTY HOMETOWN
continued on page 8
ACOSTA, TINA R. C MANTECA
ADAMS III, DAVID A. AC CLOVIS
AGUIAR, ARLENE ANN C TULARE
AGUINIGA, ELENA AC BALDWIN PARK
ALDRIDGE, SABRINA AC YUBA CITY
ALEXANDER, RAQUEL L. AC VENTURA
ALLEN, CHANTEEL AC CITRUS HEIGHTS
ALVARADO, JANINA C REDWOOD CITY
ALVAREZ, NICOLE ++ AC PALMDALE
AMJAD, IRAM • C LAGUNA NIGUEL
ANCHONDO, NORI YANELI AC CALISTOGA
ANDRADE, JILLIAN K. • C FREMONT
ARCALA, MUTYA BERNADETH CANTELA C IMPERIAL BEACH
ARIAS, MARGARITA • C BAKERSFIELD
ARMITAGE, DIANE • C HENDERSON NV
ARNOLD, DESIREE A. C VISALIA
ASIA, JERRICA C PALMDALE
BABAOKA, JULIANNE AC STOCKTON
BAILLY, MARGARET A. AC SAN JOSE
BALL, DEBORAH A. • AC BEN LOMOND
BARNETT, ROBERT CLIFF AC ALPINE
BARRAGAN, ALISSA M. AC VISALIA
BARRERAS, JANETTE AC LOS ANGELES
BENHART, KELLY DAWN AC PALMDALE
BONILLA, LYANA M. AC SAN JOSE
BORTON, ALICIA M.++ AC SAN LEANDRO
BOUZIANE, NASSIMA AC HAYWARD
BRANDT, IRENE R. AC VISALIA
BRINSON, MARY K. • AC ROSAMOND
CABRAL, ALEJANDRA A BELL GARDENS
CAHOON, JEAN LOUISE C CASTRO VALLEY
CALDERA, ESMERALDA C HIGHLAND
CAMPBELL, BRITTNEY M. C UKIAH
CARRILLO, ANA M. C PALMDALE
CARRITHERS, EDWIN F. C WINDSOR
CASH, SHERILYN JOAN • AC SAN BERNARDINO
CASILLAS, JANIN A. C SUNNYVALE
CASILLAS QUINTERO, MIRYAM A. A STOCKTON
CASTRO, ANA CECILIA A DALY CITY
CEJA, MARGIE • C SAN ANTONIO TX
CERVANTES, ANGELICA C CALEXICO
CERVANTES, DONNA ANN • AC FOLSOM
CHA, CHER THAO C OROVILLE
CHILLOUS, RACHELLE S. C UPLAND
CONTRERAZ, CHRISTINA ELAINE AC PALMDALE
CORDERO, TINA LOUISE C HIGHLAND
CORONA, CINDY PEREZ AC YUBA CITY
CORONA, MARIA Y. C SANTA ROSA
CORRALES, NELDA C OROSI
CRISLER, KAREN • AC BEN LOMOND
CUBILLOS, JAZBLEYDY L. • C PERRIS
CURRAN, SHERYL AC REDDING
DANDAN, REYNOLD C BERKELEY
DANTES, JERICO RYAN A. • C SAN JOSE
DAVI, CATHLEEN • A CHICO
DAWSON, SHAUNA AC ALAMEDA
DE VUSSER, JILL S. C TUSTIN
DEKALB, JUDY A. • C BEN LOMOND
DELA TORRE, STEPHANIE C WATSONVILLE
DIAZ, VICTORIA C SANTA ROSA
DIAZ ALBAREZ, ANGELICA AC PARAMOUNT
DOHERTY, CHRISTINA AC SANTA MARIA
DOMINGUEZ, JACQUELINE AC CITRUS HEIGHTS
DUNLAP, DIANA • C LAKEPORT
DUONG, PHUONG NGUYEN-NHA • AC SAN JOSE
DURAND-BIBBS, VIRGINIA M. • C SAN MATEO
ELY, PAULETTE P. • C TEMPLETON
ERAZO CALDERON, JOSSELYN LISSETH C LANCASTER
ESCUDERO-HERNANDEZ, EDNA LUCERO • AC CATHEDRAL CITY
ESQUIVEL, MARISA A. AC GROVER BEACH
ESTRADA, AURA ++ AC LOS ANGELES
FECANIN, PATRICIA A. • C CAMPBELL
FERNANDEZ, MARTHA PATRICIA AC BAKERSFIELD
FERNANDEZ, YESICA C WATSONVILLE
FIERRO, NICOLE STEPHANIE C LA HABRA
FISCHER-SMITH, MICHAEL C SACRAMENTO
FLORES, BLANCA AC VAN NUYS
FLORES, ESMERALDA C CLOVERDALE
8 CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2014
• RECERT ++ ADDING 2ND SPECIALTY
C E R T I F Y I N G B O A R D U P D A T E
NAME SPECIALTY HOMETOWN NAME SPECIALTY HOMETOWN
continued on page 9
– continued from page 7 –
Certification Codes: A = Administrative C = Clinical AC = Administrative and Clinical
FOSTER, DEBORAH A. AC LOS ANGELES
FREEMAN, JEANNETTE M. AC GOLETA
FREGOSO, GABRIELA • AC CALEXICO
GADDAM, JESSICA MARIE AC MODESTO
GAITHER, KRISTINE L. AC REDDING
GALACE, KEVIN RAY C SAN JOSE
GARCIA, NORMA AC RED BLUFF
GARCIA, SUSANA C SAN YSIDRO
GARCIA, VERONICA A. C SONOMA
GARDNER, LORENA AC SACRAMENTO
GARFIELD SMELTZ, RENE' C FULLERTON
GIRTON, MICHELL M. AC YUBA CITY
GIZINSKA, DAGMARA "CARRIE" • AC CAMERON PARK
GOFF, ANGELA DENISE AC CYPRESS
GOMEZ, RONALD G. C BAY POINT
GOMEZ JR., GILBERTO A CHULA VISTA
GONZALES, CAROLINA++ AC ARTOIS
GONZALEZ, ROCIO • C HAYWARD
GORDONOFF, BRANDI • AC SANTA ROSA
GREGGE, SHANITA ROSHAN A LOS ANGELES
GUADARRAMA, LETICIA C LANCASTER
GUARDADO, LAURA VERONICA C PALMDALE
GUARDADO, MAYRA ALEJANDRA AC PALMDALE
GUTIERREZ, SHANI J. • A HESPERIA
GUZMAN, DENICE • C WATSONVILLE
GUZMAN, ERICKA J. AC LANCASTER
GUZMAN, LISA M. C BLOOMINGTON
GUZMAN, ROSA AC PALMDALE
HANDLEY, MARCIA E. C PORTERVILLE
HARO, CINDY DENNISE A SAN DIEGO
HERNANDEZ, HIADINA LANDEROS C VISALIA
HERNANDEZ, JACQUELINE C BAKERSFIELD
HERNANDEZ, MIRANDA DEE AC LANCASTER
HERNANDEZ LOPEZ, KENNIA AMERICA AC SAN LUIS OBISPO
HILL, JAMIE AC SAN JOSE
HILL, MELISSA M. AC GRASS VALLEY
HOFFMAN, SARAH LISETTA C FORESTVILLE
HOGUE, MARY E. C SACRAMENTO
HOPKINS, ANGELA M. C SAN BERNARDINO
HOPSON, YAA D. C CASTRO VALLEY
HORNER, ERIC JAMES AC VISALIA
HORTON, LORA AC YUBA CITY
HURST, TERRI • AC SANTA ROSA
JACKSON, ASHLEY C SAN JOSE
JAMES, LESIA • C LANCASTER
JAMES, MARILYN KAY C LOOMIS
JANSEN VAN VUUREN, CHERISE C ROSEVILLE
JARAMILLO, MICHAEL C ELK GROVE
JOHNSON, SYLVIA L. • C OAKLAND
JOHNSTON, TISHA C McKINLEYVILLE
JONES, VANESSA MARIE AC YUBA CITY
JOSEPH, LISA MARIE ANN AC WILLITS
KING, KIRSTEN AC UKIAH
KING, SARAH C DELHI
KOTO-LEW, TRACY ANN • AC UNION CITY
LAGOMARSINO, ROXANNA K. AC ATASCADERO
LAM, LAN Y C MILPITAS
LANDA, MALINA AC REDWOOD VALLEY
LANDAVERDE, MARTA AC CORNING
LAPUC, KAROLINA W. C ROCKLIN
LARA, DIANA • C LAMONT
LEAL, JESENIA M. C LANCASTER
LEMOS, CRYSTAL V. A LANCASTER
LIU, LILY AC SAN RAMON
LOMELI-GUTIERREZ, KARLA B. A STOCKTON
LOPEZ, CHARMAINE S. C HESPERIA
LOPEZ, HERLINDA C EL CENTRO
LOPEZ, MARINA C CALEXICO
LUCAS, PATRICIA C HUNTINGTON BEACH
LUTSKOVA, LARISA A. C ROCKLIN
MAGALLON, CYNTHIA M. AC LOS ANGELES
MANJARREZ, ALMA C RIALTO
MANRIQUEZ, LESLIE • C SANTA ROSA
MARIENTHAL, LEIGH R. A MISSION VIEJO
MARSH, SUSAN LEE C STOCKTON
MARTINEZ, ADRIANA C BRAWLEY
MARTINEZ, ROSA C. C SANTA CRUZ
MARTINEZ-DIAZ, GUADALUPE C SANTA CRUZ
CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2014 9
• RECERT ++ ADDING 2ND SPECIALTY
C E R T I F Y I N G B O A R D U P D A T E
NAME SPECIALTY HOMETOWN NAME SPECIALTY HOMETOWN
continued on page 10
– continued from page 8 –
Certification Codes: A = Administrative C = Clinical AC = Administrative and Clinical
MATLOCK, MINDY MARIE • AC SHASTA LAKE
MAYS-BARBOSA, AARON R. C SAN DIEGO
MAZORRA, JOANN S. • C REDDING
McCLEARY, GAIL FAITH • C McKINLEYVILLE
McCORD, BRITTANY NOELLE AC MENIFEE
McLAIN, TERESA T. A RANCHO SANTA MARGARITA
McLEOD, TANISHA C. C SAN MATEO
MENDOZA, CORRINA ANTOINETTE C HAYWARD
MENDOZA, CYNTHIA C WATSONVILLE
MERCADO, ERIKA AC LANCASTER
MERCADO, YULIANA AC BRAWLEY
MILLER, DEBRAH L. AC LODI
MILLS, ALEXANDRA V. AC APTOS
MONDAINE, JENNIFER L. AC COTTONWOOD
MONROY, GUADALUPE LILIANA C LOS ANGELES
MONROY, SUPARAT A VISALIA
MONTANO, CARMELINA AC FREEDOM
MORA, SARAH AC PALMDALE
MORAN, ELOISA AC LOS ANGELES
MORENO, MARGARET Y. AC PALMDALE
MUNOZ GARCIA, NANCY ++ AC COMPTON
NEUO, CHHATH C OAKLAND
NUNES, VERONICA AC CAMARILLO
NURIE, MARIA ALEJANDRA • C FREMONT
O'CAIRNS, TORY C ALISO VIEJO
ORTEGA, CINDY E. • A HUNTINGTON BEACH
OSORIO, ELVIA M. C NORTHRIDGE
OSTERMANN, ARIEL AC CAMERON PARK
PALACIO, GLORIA AC LAWNDALE
PARK, TAEYOUNG (SYLVIA) C SAN RAMON
PARKER, DESHANEE L. C CERES
PARRA, MARIANNA ISABEL C SANTA ROSA
PATRICK, ROBYN DEE C FORTUNA
PAYNE, CELESTE C. • C MARYSVILLE
PEATFIELD, SUSAN JULIE AC MORGAN HILL
PEDERSEN, SALLY AC ARCADIA
PELAYO, LETICIA • C SALINAS
PENA-ESTRADA, ANTONIA C EL CENTRO
PEREZ, LORENA • C SAN JOSE
PICCIRILLO, REBECCA AC YUBA CITY
PINEDA, MAYRA B. AC PALMDALE
PIZA, IVAN C SAN JOSE
PONCE, PATRICIA • C SAN LORENZO
PURDY, MAYTUS T. AC LODI
RAEL, FABIOLA • C SANTA ROSA
RAMIREZ, DAISY C SAN MARCOS
RAMIREZ, REBECKA C RANCHO CUCAMONGA
RAMOS, ANNIE LYNN C. • C MOUNTAIN VIEW
RAUCHMAN, NATASHA AC MANTECA
RAUDA, CYNTHIA C GARDENA
REDUS, ERIN KATHLEEN AC SACRAMENTO
REGIS-RIOS, BRENDA M. C UKIAH
REMICK, TRACY AC CORNING
REMINGTON, STEPHANIE MARIE AC RANCHO MURIETA
RENDON, EDGAR T. C MOUNTAIN VIEW
REUANGBANH, POUN C SAN PABLO
REYES, ANDREA M. C RIVERSIDE
REYES, IRENE AC LANCASTER
REYES MARIN, JESSICA AC UPPER LAKE
REYES-GONZALEZ, ALEJANDRA AC BELLFLOWER
RICO, CINDY • C STOCKTON
RODENBORN, SHERRY L. • AC GUSTINE
RODRIGUEZ, BLANCA • AC WATSONVILLE
RODRIGUEZ, PATRICIA • C SAN JOSE
ROMERO, YESENIA C SANTA MARIA
ROMO, JESSICA AC CONCORD
RONQUILLO, APPLE ANN MANZANA C MOUNTAIN VIEW
ROTHWELL, CATHERINE AC VENTURA
RUECKERT, ASHLEY • C SANTA ROSA
RUGGERI, NICOLE • C FORESTVILLE
RUSHER, DENISE • C NEWARK
SALCEDO, STEPHANIE C INDIO
SAMPSON-DANG, ANH THI MINH C HUNTINGTON BEACH
SANCHEZ, ELIZABETH • C LIVE OAK
SANCHEZ, ERIKA C VACAVILLE
SANCHEZ, MYRA C WASCO
SANCHEZ, PAULA S. • AC PASO ROBLES
SANDERSON, DEBRA JO AC OAK HILLS
10 CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2014
• RECERT ++ ADDING 2ND SPECIALTY
C E R T I F Y I N G B O A R D U P D A T E
NAME SPECIALTY HOMETOWN NAME SPECIALTY HOMETOWN
– continued from page 9 –
Certification Codes: A = Administrative C = Clinical AC = Administrative and Clinical
SANDOVAL, CAROLINA AC WOODLAND
SANTANA, KIMBERLY C OCEANSIDE
SANTO DOMINGO, JUNE ALLYSON G. C DALY CITY
SCOTT, MARVINA TAMAR AC LOS ANGELES
SEPULVEDA, RACHEL AC CHICO
SERRATO OCEGUEDA, ENRIQUE C VISALIA
SHEPARD, BRANDON DEON C SAN LUIS OBISPO
SHEPARD, RENEE D. C HIGHLAND
SHIFFER, GAYLE LEE C SOUTH SAN FRANCISCO
SINGH, GEETA AC SAN DIEGO
SLOAN, KRISTEN N. • AC LODI
SMITH, ALIDA L. AC CORNING
SMITH, BRITTANY KATLYN C MAGALIA
SMITH, JACKLYN ROSE AC SANTA ROSA
SOLATRE, MARILOU • AC SAN JOSE
STARK, ROBIN SUE AC STOCKTON
STEEN, DEBBIE L. C YUCAIPA
STEPHENS, ALISHA ANN AC EAST PALO ALTO
SUTTLE, PATRICE C SAN JOSE
SVAY, AYLSA CLAIRE C RIPON
SWESTOCK, NATALYA MARIE A SAN CLEMENTE
TAVERA, YVETTE CANTU • AC WATSONVILLE
TENORIO, DONNA AC GILROY
THOMAS, JENNIFER L. C HIGHLAND
THOMAS, MICHELE AC RED BLUFF
TIRADO, YADIRA D. C LANCASTER
TODD, LEVONNE L. C YUBA CITY
TORRES, CYNTHIA A FAIRFIELD
TORRES, DIANA CARRILLO • C SAN JOSE
TRABUE, SANDRA • AC McKINLEYVILLE
TRAN, HUONG T. AC MILPITAS
TRUONG, PHUONG UYEN C WESTMINSTER
ULLEVIG, SARAH MICHELLE AC SHINGLETOWN
ULRICH, LARA L. • C SANTA CRUZ
VALLADARES, ANA CRISTINA C LANCASTER
VALLERGA, CHRISTOPHER MICHAEL AC WOODLAND
VANDER MEER, MARY CHARLOTTE AC VISALIA
VANG, TONG C FRESNO
VANPROOYEN, GERALDINE A. • AC MODESTO
VASQUEZ, MARTHA ELENA • C PERRIS
VAZQUEZ, MERI AC LANCASTER
VELEZ, MARIA CONCEPCION C PALMDALE
VENTURA BENEL, YHADIRA MELISSA AC VALLEJO
VILLASENOR, ROBIN • C SANTA CRUZ
VILLATORO, GABRIELA AC BAKERSFIELD
VIVAR, ANDREANNA AC LANCASTER
VLADIMIROVA, BORISLAVA AC PITTSBURG
WALL, JANA JOY C LOCKEFORD
WASHINGTON, TERRA UNIQUE C SANTA ROSA
WATT, BRYSON AC BAKERSFIELD
WELLINGTON, PAMELA AC YUBA CITY
WHEEL, NANCY L. C CORONA
WHITE, JASMINE VERNOYA-MARIE C STOCKTON
WHITE, KHALILAH R. C SAN BERNARDINO
WILL, BEVERLY CARYL C WATSONVILLE
WILLENS, RAHAYA C WILLITS
WILLIAMS, REGINA L. C SACRAMENTO
WILSON, JAMIE A LOS BANOS
WOLFE, FE MARPA • C SAN DIEGO
WOLTER, CAROL AC MODESTO
YAW, CATHERINE K. AC OXNARD
ZUCKERMAN, MARNIE AC CARMICHAEL
Congratulationsto each of these medical assistants.
From the California Certifying Board
for Medical Assistants
CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2014 11
CONTINUING EDUCATION
Because Marfan syndrome can affect almost any part of thebody, it may cause a variety of complications including:
• Cardio vascular
• Eyes
• Skeletal
• Lungs
• Central nervous system
CARDIO VASCULAR
Since faulty connective tissue can weaken the aorta, the mostdangerous complications include the heart and blood vessels.Those complications include:
• Valve malformations – Heart valves may be malformedor overly elastic, causing the heart to have to workharder to compensate. This can possibly lead toheart failure.
• Aortic dissection – This occurs when a tear in theinnermost layers of the aorta’s wall allows blood tosqueeze in between the inner and outer layers of thewall, causing extreme pain in the chest or back. Thisdissection can cause a rupture which may be fatal.
• Aortic aneurysm – The pressure of blood leaving theheart can cause the aorta to bulge out. In a personwith Marfan syndrome, this is mostly likely to happenwhere the artery leaves the heart (aortic root).
Marfan syndrome (MFS) is named after Antoine Marfan. Hewas a French pediatrician who first described the condition in1896 after treating a 5 year old girl. Marfan syndromeaffects the body’s connective tissue. The gene linked to thedisease was identified by Francisco Ramirez in 1991 at theMount Sinai Medical Center in New York. This generic disor-der is caused by a defect in this gene which tells the bodyhow to make Fibrillin-1 (FBN1). The fibers hold the organs,cells and tissue together and help the body grow and developproperly. Marfan syndrome is prevalent in approximately 1in 20,000 people, but only 1 in 5,000 get the disease.
Marfan syndrome is an inherited disorder and there is noracial or geographic disproportion in incidence. Males andfemales are affected equally, and each parent with MFS hasa 50/50 chance of passing the genetic defect on to anychild. In about 25% of the people with MFS, the abnormalgene doesn’t come from either parent but from the develop-ment of a new mutation. The disease usually worsens withage. The signs and symptoms of MFS vary greatly, evenamong members of the same family. Some people onlyexperience mild affects, but others develop life-threateningcomplications.
People with MFS have abnormalities in multiple organs andtissues and some of the features of Marfan syndrome areas follows:
• Tall and slender body type
• Flexible joints
• Heart murmurs
• Crowded teeth
• Flat feet
• High arched palate
• Extreme near-sightedness
• Curved spine (scoliosis)
• Long arms and legs
• Mitral valve prolapse
• Chest sinks inward or protrudes outward
• Stretch marks on the skin, not related to pregnancyor obesity
continued on page 10
MARFAN SYNDROME (MFS)Antoine MarfanMedical Doctor
Antoine Bernard-Jean Marfan was a Frenchpediatrician. He was born in Castelnaudaryto Antoine Prosper Marfan and AdélaïdeThuries. He began his medical studies inToulouse, where he stayed for two yearsbefore moving to Paris.
Born: June 23, 1858, Castelnaudary, France
Died: 1942
12 CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2014
such as scoliosis. The treatment for scoliosis is sometimes aseasy as a custom-made back brace. This is usually fitted onchildren while they are going through a growing stage andworn almost constantly until growth is complete. If the curvein the spine is too great, surgery may be necessary tostraighten the spine. Other spinal issues associated withMarfan syndrome include degenerative disk disease,spinal cysts, and a breakdown or failure of the autonomicnervous system.
LUNGS
Marfan syndrome can also cause the breastbone in the chestto either appear sunken into the chest or protruding from thechest. Surgery may be required for a sunken breast bone ifthe breathing is affected. A protruding breastbone usuallydoesn’t affect breathing or cause functional problems. Thiscan be corrected but is more of a cosmetic problem than afunctional one.
CENTRAL NERVOUS SYSTEM
Dural ectasia, the weakening of the connective tissue of thedural sac encasing the spinal cord, can reduce the quality oflife for an individual. It can be present for a long time withoutproducing any noticeable symptoms. Symptoms that canoccur are lower back pain, leg pain, abdominal pain, otherneurological symptoms in the lower extremities, orheadaches. Dural ectasia is usually not visible on an X-ray inthe early phases. However, dural ectasia that has progressedto the point of causing these symptoms would appear in anMRI image.
EXAMPLES
For a long time, it was believed that Abraham Lincoln hadMarfan syndrome. Geneticists no longer believe this to be thecase. Although he was tall and slender with a long bony faceand disproportionate limbs, doctors believe his hands weretoo strong and muscular for a person who has MFS.
Other famous people examples:
• King Tut’s father, Akhenaten, a pharaoh of the 18thdynasty of Egypt, suffered from this genetic disorder.Scientists suspect that King Tut also had this disease.
Marfan Syndrome (MFS) – continued from page 11
CONTINUING EDUCATION
Doctors often prescribe blood pressure medication, such asbeta blockers which cause the heart to beat more slowly andwith less force. These drugs will help prevent the aorta fromenlarging and, reduce the risk of rupture. If the aorta enlargesand reaches a dangerous size, usually around two inches, asurgical repair may be recommended. This would consist ofthe replacement of a portion of the aorta with a tube made ofsynthetic material. Sometimes a replacement of the aorticvalve is also indicated. Regular check-ups by a cardiologist willmonitor the condition of the heart valves and the aorta.
EYES
In Marfan syndrome patients, the eyes are greatly affected bythe following complications:
• Glaucoma or cataracts – People with MFS tend todevelop these problems at a younger age. The opticnerve can be damaged by increased pressure in the eye(glaucoma) and cataracts are a cloudiness of the lensof the eye. In 80% of the patients with MFS, there isa subluxation (dislocation) of the lens of the eye.
• Retinal problems – There is an increased risk of a tearor detachment in the retina.
Any patient with Marfan syndrome should be examined byan ophthalmologist. Sometimes surgical procedures may berequired for the more advanced cases of this disease. Apatient with a dislocated lens in the eye can be helped withglasses or contact lenses that refract around or through thelens. Often surgery is required to remove and replace theactual lens. If parts of the retina have torn or detached, thiscan also usually be surgically repaired and the success rateis high.
SKELETAL
In addition to seeing an ophthalmologist for the eyes and acardiologist for the heart and blood vessels, patients need tosee an orthopedic doctor who specializes in structural prob-lems of the skeleton and a doctor who specializes in geneticdisorders (geneticist).
Many patients with MFS grow to above average height.Many have long slender limbs, long fingers and toes. Footpain and lower back pain are also common side effects.There is an increased risk of abnormal curvature in the spine
CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2014 13
• Mary Queen of Scots inherited the throne when shewas six day old and ruled Scotland in spite of havingMarfan syndrome.
• Robert Johnson was a famous blues guitarist and livedfrom 1911-1938. It is believed that his death at age 27was caused by heart complications from MFS.
• Vincent Schavelli lived from 1948-2005. He was afamous actor and one of the first famous people to beclosely associated with the National Marfan Association.
• Jonathan Larson (1960-1996) was an Americancomposer and playwright. He died of an aneurysmcaused by an aortic dissection. He posthumouslyreceived three Tony Awards and a Pulitzer Prize indrama for his rock opera “Rent”.
• Osama Bin Laden (1957-2011) was famous for all thewrong reasons. He was a billionaire warlord, growingto the height of 6”6” and weighing 160 pounds. Hisspinal cord problems left him having to walk with acane most of the time. His disease could not bepositively diagnosed, because he spent most of histime in hills and jungles as a fugitive.
• John Tavener was a very famous composer. Manymembers of his family suffered from MFS, includinghis brother and two daughters. He needed an aorticroot development in 1991.
• Bradford Cox, lead singer for the band “Deerhunter”,was diagnosed with MFS as a child. He has spoken inthe media about his disease and feels that his uniqueappearance compliments the weird kind of music hisband plays.
Competitive sports and other strenuous activities can causean increased risk of aortic dissection or rupture.
• Isiah Austin, a sophomore basketball player withBaylor University, was recently diagnosed with MFS,ending his professional basketball career. He wasrecently granted a ceremonial first-round pick in theNBA draft.
• Flo Hyman (1954-1986) was an American volleyballplayer and silver medalist in the Olympics. She diedduring a volleyball match in 1986 in Japan. The causeof death was an aortic dissection caused by anundiagnosed Marfan syndrome. This diagnosis wasnot made until after her death.
Marfan Syndrome (MFS) – continued from page 12
CONTINUING EDUCATION
Read the Continuing MedicalEducation Article
Marfan Syndrome (MFS)located on pages 11 - 13,
then complete theSelf-Assessment Test
on page 14 for CME credit.
• Michael Phelps has been the subject of muchspeculation about whether or not he may have MFS.He states that because he was very flexible and haslong hands and feet (early MFS symptoms), he couldbe at risk for the disease. He was given an EKG atJohns Hopkins University and was told that the tissuesare strong, the aortic route clear and the heart in goodshape. Dr. Reed Pyeritz, chief of the medical divisionof genetics at the University of Pennsylvania, said thatPhelps features certainly fit the criteria of a Marfanpatient but could also fit anyone in the population.Michael Phelps will continue to get routine testing.
It used to be uncommon for anyone with MFS to live pastthe age of 40. While there is still no cure for Marfan syn-drome, life expectancy has increased and is now similar tothat of an average person.
The Marfan Foundation works tirelessly to advance researchthat saves lives and enhances the quality of life for peopleliving with MFS and related disorders. Their research hashelped reduce life-threatening problems and identified treat-ments that have eliminated some of the complications andsymptoms affecting their lives.
_____________________________________________________
REFERENCES:
• Primer on the Rheumatic Diseases, John H. Kippel
• Rheumatology, John H. Kippel and Paul Dieppe
• www.marfan.org
• www.marfansyndrome.com/Wikipedia
• www.marfanfamouspeople.com
14 CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2014
CONTINUING EDUCATION
Marfan Syndrome (MFS) – Self-Assessment Test
SELF-ASSESSMENT TESTAVAILABLE FOR DOWNLOAD SEPARATELY.
Earn Your
Continuing Education
Credits
by reading
the CME article,
completing and
passing the
Self-Assessment
Test in this issue!
CALIFORNIA MEDICAL ASSISTANT — SEPTEMBER/OCTOBER 2014 15
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