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3a Public and Community Health > 3a Community Health > Flashcards

3a Community Health Flashcards

1
Q

DOMESTIC ABUSE

Define domestic abuse

A

Any incident or patterns of incidents of controlling, coercive, threatening behaviour, violence or abuse, between those aged 16 or over who are, or have been, intimate partners or family members regardless of gender or sexuality.

Can encompass but not limited to:

  • psychological
  • physical
  • sexual
  • financial
  • emotional
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2
Q

DOMESTIC ABUSE

What in the hx is a key indicator of domestic abuse?

A

Reported as ‘unwitnessed by anyone else’

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3
Q

DOMESTIC ABUSE

What are the 3 risk levels? Explain what they mean

A

STANDARD - current evidence does NOT indicate likelihood of causing harm

MEDIUM - there are identifiable indicators of risk of serious harm. Offender has POTENTIAL to cause serious harm, but unlikely unless change in circumstances

HIGH - there are identifiable indicators of IMMINENT risk of serious harm. Dynamic - could happen at any time and impact would be serious

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4
Q

DOMESTIC ABUSE

What is the HARK framework?

A

Questions for helping identify people who have suffered domestic abuse:

H - Humiliated
A - Afraid
R - Rape
K - Kick

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5
Q

MULTIMORBIDITY AND POLYPHARMACY

Define multi-morbidity

A

3 or more chronic conditions, often long term and require complex and ongoing care

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6
Q

MULTIMORBIDITY AND POLYPHARMACY

Which drugs can cause orthostatic hypotension?

A
  • Anti-HTXs - hydrochlorothiazide, lisinopril
  • Diuretics - furosemide
  • Antidepressants - trazodone
  • Alpha blockers - terazosin
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7
Q

MULTIMORBIDITY AND POLYPHARMACY

When are the appropriate timings for med reviews?

A
  • If 5 or more medications, every 6 months

- If on any repeat med, every 12 months

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8
Q

MULTIMORBIDITY AND POLYPHARMACY

What is appropriate vs problematic polypharmacy?

A 
Appropriate = optimised, according to best evidence 
Problematic = inappropriate, intended benefit not realised
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9
Q

MULTIMORBIDITY AND POLYPHARMACY

What does the target BP change to in diabetics?

A

130/80

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10
Q

MULTIMORBIDITY AND POLYPHARMACY

What are the normal, pre-diabetic and diabetic HbA1c values/ranges?

A

normal = below 42

pre-diabetes = 42-47

diabetes = 48 or over

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11
Q

MULTIMORBIDITY AND POLYPHARMACY

When do NICE say you should consider anti-hypertensives in people over 80?

A

Clinical BP of over 150/90

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12
Q

MULTIMORBIDITY AND POLYPHARMACY

What can stopping statins in the elderly do?

A

Cardiovascular event requiring admission

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13
Q

OPIOIDS IN PRACTICE

What are the 3 opioid receptors?

A

MOR, KOR, DOR

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14
Q

OPIOIDS IN PRACTICE

Where in the nervous system are opioid receptors located and what is their mechanism of action?

A
  • Mainly the CNS, some in the PNS

- Inhibit presynaptic neurotransmitter release

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15
Q

OPIOIDS IN PRACTICE

What are some negative SEs of opioids?

A
  • GI: constipation and nausea
  • Resp: sleep disordered breathing
  • CVS events
  • Neuro: dizziness, sedation (falls), hyperalgesia
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16
Q

OPIOIDS IN PRACTICE

What are some negative SEs of CONTINUED opioid use?

A

Tolerance, withdrawal, weight gain, reduced fertility, irregular periods, erectile dysfunction, hyperalgesia, depression, dependance, addiction, reduced immunity, constipation, osteoporosis

17
Q

OPIOIDS IN PRACTICE

What are the pharmacological options for managing chronic pain?

A

Non-opioids: NSAIDs, cox-2 inhibitors, paracetamol

Opioids: Intermittent usage/ slow and low

Adjuvant analgesics: anticonvulsants, antidepressants, lidocaine patches

18
Q

SOCIAL EXCLUSION IN OLDER PEOPLE

Who is most at risk of loneliness?

A
  • Older males (50+), widowers, poor health, low income, living in rented housing, few qualifications
  • care plans lack social dimension
19
Q

SOCIAL EXCLUSION IN OLDER PEOPLE

What are the 5 domains of social exclusion?

A
  • material resources
  • civic activities
  • basic services
  • neighbourhood
  • social relationships
20
Q

SOCIAL EXCLUSION IN OLDER PEOPLE

What are some of the causes of social exclusion?

A

-Poor health, sensory impairment, poverty, housing issues, fear of crime, transport, problems on the roads, discrimination (external and internalised), insufficient range and fragmented services, lack of imagination, poor coordination, fragility of networks

3a Public and Community Health (2 decks)

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