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General medicine > ABC of patient health > Flashcards

ABC of patient health Flashcards

1
Q

Top 10 causes of death, internationally:

A
  1. Ischaemic heart disease (8.9 million deaths in 2019: 16%)
  2. Stroke (11%)
  3. Chronic obstructive pulmonary disease (COPD): 6% airflow blockage & breathing-related probs
  4. Lower respiratory infections (decreasing: 2019 = 2.6 million deaths)
  5. Neonatal conditions (great decrease: 2 million in 2019)
  6. Trachea, bronchus, lung cancers (increase: 1.8 million)
  7. Alzheimer’s + other dementia’s (65% = women)
  8. Diarrhoeal diseases (great decrease, 1.5 mil)
  9. Diabetes Mellitus (great increase, largest rise in male deaths)
  10. Kidney diseases (increase: 1.3 mil 2019)

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2
Q

How much % of the worlds deaths is due to Ischaemic heart disease?

A

16%

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3
Q

Which diseases are increasing rapidly? Why?

A

Diabetes and kidney diseases increasing rapidly (bc of obesity)

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4
Q

What is the biggest difference in top 10 diseases of low and high income countries?

A

Low: 6 of 10 = communicable

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5
Q

What are four characteristics of the low-income top 10 list of diseases?

A
  • More likely to die of communicable disease
  • Malaria, tuberculosis, HIV/AIDS = top 10 (but falling, especially HIV/AIDS)
  • Diarrhoeal = top 5 (but falling)
  • COPD = infrequent, not in top 10
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6
Q

What are five characteristics of the lower-middle-income top 10 list of diseases?

A
  • Diabetes rising (9th)
  • Diarrhoeal in top 10
  • Biggest decrease absolute deaths
  • Increase ischaemic heart disease
  • HIV/AIDS, not in top 10
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7
Q

What are six characteristics of the top 10 diseases of upper-middle-income income countries?

A
  • High rise in lung cancer deaths
  • Stomach cancer
  • Big decrease COPD
  • Ischaemic heart disease: increased majorly
  • One communicable disease in top 10: Lower resp infections
  • Lower suicide
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8
Q

What are five characteristics of the top 10 diseases of high income income countries?

A
  • Ischaemic heart disease + stroke only deaths that have decreased in no
  • However they are still top 3
  • Hypertensic heart rate deaths rising
  • Alzheimers + other dementia: increase
  • Only lower resp infection as comm. Disease remains
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9
Q

What is the (newest, 2011) definition of health?

A

= The ability to adapt and self-manage in the face of social, physical and emotional challenges

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10
Q

What is
a) mean age of people
b) % of people that visits at least once a year
c) average no of visits

to the GP in NL

A

a) 42 years
b) 75%
c) 5

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11
Q

Common reasons for GP visits in NL: (top 6)

A
  1. Hypertension
  2. Urinary tract infections
  3. Diabetes
  4. Coughing
  5. Fatigue
  6. Acute upper airway infections
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12
Q

Common reasons for GP visits in NL: (top 6)

A
  1. Hypertension
  2. Urinary tract infections
  3. Diabetes
  4. Coughing
  5. Fatigue
  6. Acute upper airway infections
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13
Q

What are, broadly speaking, the three steps and substeps in the diagnostic process of a GP?

A
  1. Anamnesis
  2. Examination (inspection, auscultation, percussion, palpation)
  3. Investigation
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14
Q

Anamnesis: what to ask?

A

duration
severity
smoking
occupation
localisation of pain
medication use (and past medical history), living situation
height + weight

ICE

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15
Q

Examination: explain the substeps with examples

A

Inspection: use eyes: is patient pale/feverish, discoloration skin, problems posture, tremors,..

Ausculation: what can you hear: heart sounds, breathing sounds, gurgling sounds

Percussion: use your hands: tapping the abdomen/chest

Palpation: what can you feel: feel for lumps, firmness, nodules

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16
Q

Investigation: examples

A

Imaging techniques
blood sampling (glucose, lipids, inflammation) urine sampling (glucose, protein, infection) spirometry (lung function)
ECG
Tissue biopsy

For the patient cases, you should know what kind of further investigation you would do

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17
Q

What does ICE stand for in anamnesis?

A

▪ ICE: ideas, concerns, expectations.
Ideas: What do they think might be going on? Have they done any reading about their symptoms? Asked anyone they know?
Concerns: Are they feeling anxious/worried? What causes concern?
Expectations: What are they hoping for?

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18
Q

Three strategies to taking a good patient history (anamnesis)?

A

3 strategies to taking a good patient history:
1. Listen well + empathize
2. Summarize
3. ICE (Ideas, concerns, expectations): ask patient about their ideas

19
Q

Primary care = A
Secondary care =

A

A) GP
B) Referral to medical specialist

20
Q

What techniques use radiography? (= most common form of medical imaging)

A

X-ray, CT-scans

21
Q

How does radiography work?

A

Uses electromagnetic (ionizing) radiation
-> structures that absorb the high energy beams will appear in white: bones and prosthetics (dense structures and high atomic number)

22
Q

Radiography: expensive?

A

▪ relatively inexpensive

23
Q

What is a CT-scan?

A

CT-scan (or CAT-scan) = ‘layered X-ray’ computed tomography: several high-res cross-sectional images are taken to create a more 3-D view of the body parts (position and shape)

24
Q

what are CT-scans used for?

A

bone structures (fractures), solid tumours, prostheses, (blood clots, infections?). Can also take CT-scan of the brain (3D image and more precise location)

25
Q

What is MRI and how does it work?

A

MRI = (magnetic resonance imaging)
- uses magnets and radio waves to produce an image of the soft tissues (low-energy particles will take up energy via the radio waves, then emit it again)

26
Q

What is MRI used for?

A

Soft tissues: body tumours, organ damage, brain activity

27
Q

What is MRI used for?

A

Soft tissues: body tumours, organ damage, brain activity

28
Q

2 Advantages and 2 disadvantages MRI?

A

Adv:
- high res imaging
- does not use radiation: safe!
Disadv:
- based on movement of protons in the body. Patients need to lay there for half an hour, still
-expensive

29
Q

How does an ultrasound (echography) work?

A
  • uses high frequency sound waves
  • Hard tissues (white) and soft tissues (grey tones) can be viewed using an ultrasound machine
30
Q

What is US used for?

A
  • capture movement (live images)
  • diagnose diseases, monitor a foetus during foetal development, viewing blood flow through the body, and viewing the heart. Overall boundaries of different tissues and organa
31
Q

Two adv of US?

A

▪ Does not use radiation: safe!
▪ Small, portable machines
(can capture movement)

32
Q

How does nuclear medicine work? (e.g. PET scan)

A

▪ Uses radioactive tracers (isotopes) bonded to a carrier molecule (e.g. modified glucose)
▪ Administration: intravenous, oral, inhalation (thallium, iodine, xenon). More absorption = more activity of organ
▪ Produces 3-D image through detection of photons

33
Q

PET scan is used for..

A

Active metabolism, functionality (tumours, metastasis)

34
Q

In descending order: the techniques with the highest resolution

A
  • CT scan
  • MRI
  • X-rays and US
  • Pet-scan
35
Q

In descending order: the techniques with the highest risk

A

PET-scan (low from radioactive tracers)
CT-scan (low-dose radiation: possible reaction to contrast material)
X-rays (very low-dose radiation)
MRI + US (No risk)

36
Q

In descending order: techniques that require the most time

A
  1. PET + MRI (30 mins)
  2. CT (5 mins)
  3. US (quick: mis)
  4. X-rays (quick)
37
Q

For imaging compact bone, you would use A over B
choose from:
- CT scan
- plain X-rays

A

A) CT
B) plain x-rays

38
Q

X would be a good choice for a detailed image of the brain

A

= MRI

39
Q

On an US, bony structures appear A, while cavities/fluids appear B

A

A = white
B = black

40
Q

US does not use iodizing ….

A

radiation

41
Q

When detecting biochemical changes before anatomical changes occur, you use X
(choose imaging technique)

A

PET-scan

42
Q

X is not a major type of medical imaging

A

Radioactive medicine

43
Q

MRI is better for X tissue structures, compared to CT, PET, X-rays

A

X= soft

44
Q

X would make the most sense for taking a quick, rough look at an internal organ like the liver

A

US

General medicine (27 decks)

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