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Adult Health Issues + Men's Health > Adult Health Issues > Flashcards

Adult Health Issues Flashcards

1
Q

disease profile of australian adults

A

chronic disease

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2
Q

define multimorbidity & why is it common

A

having more than one chronic disease

common due to non-curative nature of chronic disease so accumualte overtime

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3
Q

chronic diseases (biological factors) are exacerbated by ___________ factors & why

A

psychosocial issues
- commonly increase among older population as they become less connected with society

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4
Q

most prevalent chronic conditions in australia (descending order)

A
  • mental and behavioural conditions
  • back problems
  • arthritis
  • asthma
  • diabetes
  • heart, stroke, vascular disease
  • osteoporosis
  • COPD
  • cancer
  • kidney disease
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5
Q

measure of burden of disease

A

disability adjusted life year = DALY

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6
Q

what makes up DALY

A

years lived with disability (YLD) ie/ morbidity + years of life lost (YLL) ie/ premature mortality

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7
Q

burden of disease due to risk factors - top 5 RF

A
  • tobacco use
  • overweight
  • dietary factors
  • high blood pressure
  • alcohol use
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8
Q

large proportion of burden of disease in australia are actually _____

A

preventable

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9
Q

covid-19 in australia 2022 was the ____ leading cause of death

this tended to affect which population

A

3rd-leading

elderly

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10
Q

obesity itself is a ____ ___ for multiple conditions such as:

A

risk factor

  • heart disease
  • OSA
  • high cholesterol
  • some cancers
  • diabetes
  • hypertension
  • stroke
  • osteoarthritis
  • liver disease (esp fatty liver)
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11
Q

obesity tends to increase as a society becomes more ______

A

developed

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12
Q

close to x/3rd of australian adults are obese

A

1/3rd

prevalence of obesity has steadily been increasing

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13
Q

is the burden of chronic diseases affecting the healthcare system

A

yes

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14
Q

a challenge affecting the healthcare system is cost or lack of _____ in australia

A

expenditure

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15
Q

cost of healthcare in australia has been steadily ______ both in terms of _____ care as well as cost per ____

A
  • increasing
  • absolute
  • person
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16
Q

what is the only way to deal with chronic disease and why

A
  • prevention
  • because it is incurable once onset
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17
Q

bulk of health care expenditure is devoted to ___________ _______ not curative healthcare

A

preventative healthcare

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18
Q

how many levels of prevention are there

A

3
primary, secondary, tertiary

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19
Q

primary prevention is aimed at preventing

A

intervention aimed at reducing risk of onset of disease
ie/ dealing with risk factors for that disease

eg/ for CHD - incr exercise, lowering bp, lipid lowering drugs

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20
Q

secondary prevention is aimed at preventing

A

interventions that reduce risk of disease progression
- very often this means recurrence of that disease

eg/ CHD - surgery coronary arteries,

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21
Q

tertiary prevention aimed at preventing

A

(rarely used)
interventions that prevent end terminal point of that disease pathway
ie/ mortality or further morbidity

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22
Q

whether an intervention is primary or secondary depends on what

A

what reference disease actually is

23
Q

who put out the National Preventive Health Strategy
how long is it

A
  • aus gov
  • 10yr strategy
  • macro level
24
Q

the focus areas of the National Preventive Health Strategy are to

A
  • decr tobacco and nicotine use
  • improving access to healthy diet
  • improving access to physical activity
  • improving access to cancer screening and prevention
  • improving immunisation
  • decr alcohol and other drug harm
  • promoting and protecting mental health
25
Q

the focus areas of Strategy align with what

A

major disease burden risk factors

26
Q

2 common cancer screening strategies in australia

A
  • bowel cancer screening
  • breast cancer screening
27
Q

who receives bowel cancer screening and when

A
  • eligible australians aged 50-74
  • mailed free test done at home (FOBT)
  • every 2 years
28
Q

bowel cancer screening program aims to

A

reduce deaths from bowel cancer
by detecting early signs of disease

29
Q

if bowel cancer is found early, more than __% of cases can be successfully treated

A

90%

30
Q

people undergoing screening for bowel cancer criteria:

A
  • don’t currently have bowel cancer
  • are not high risk for bowel cancer (eg/ from previous condition like polyp, strong family history)
    ie/ the general population with average risk
31
Q

who receives breast cancer screening and when

A
  • women over 40yrs old
  • can have free mammogram
  • every 2 years
  • program actively invite 50-74yr olds
32
Q

breast cancer screening program aims to

A

reduce illness and death from breast cancer (breast cancer morbidity and mortality)
by detecting disease early

33
Q

age group invited to have these screens have

A

higher likelihood of having this disease

34
Q

people undergoing screening for breast cancer can have: (would be helpful for them)

A
  • previous breast cancer
  • high risk (eg/ strong family history)
    as well as general population
35
Q

[pitfalls of prevention] what is the prevention paradox

A

great benefit to the community, little average benefit to individuals

36
Q

[pitfalls of prevention] in order for prevention to be effective, ___ need to undergo preventive intervention in order to prevent ill-health in a __

A
  • many
  • few[
37
Q

[pitfall of prevention] can be ____ and potentially have ____ ____
(be cautious of preventive strategies still)

A
  • costly
  • adverse effects (eg/ radiation exposure from mammograms)
38
Q

screening is distinct from _______

A

diagnosis
- does not confirm presence of disease that has been screened

39
Q

screening is applied to which individuals, otherwise it is not a screening strategy

A

asymptomatic, well

40
Q

positive screening tests need subsequent ______ _____

provide a reason why

A

diagnostic confirmation

there are potentially other causes for the positive screening result
eg/ many conditions other than bowel cancer that can have bleeding from GI tract
eg/ not all masses detected on mammogram are breast cancer

41
Q

problems with screening

hence need _____ ____

A
  • false negatives (miss some cancers)
  • false positives (poss misdiagnose conditions)

hence need subsequent diagnostic confirmation

42
Q

likely subsequent diagnostic methods following bowel cancer screening and breast cancer screening

A

bowel cancer: FOBT
-> colonoscopy

breast cancer: mammography
-> biopsy of detected mass

43
Q

false positives can be problematic because

A
  • patient has to go unnecessary diagnostic testing - that may be physically or emotionally traumatic
44
Q

possibility that screening may not lead to ____ ___

provide example

A

overall benefit

screening may pick up on slow growing cancers
subsequent management of these cancers may not have changed their prognosis overall had they not be screened
- eg/ cancer detected later on in natural course
- eg/ cancer may not have needed to be treated because so slow growing

45
Q

clinical preventive interventions aim at preventing ___-___ disease, not curing ____ ___

A
  • end-stage
  • risk factor (generally not curable)
46
Q

what is an example of a preventative intervention that has inherent adverse effects and can be costly particularly as they can be in use for a long time

A

medications

47
Q

[compression of morbidity graph] goals of care at a macro level (should be this)

A

increase health span - less morbidity
not necessarily to increase lifespan (may be lifespan to some extent - delay death)

48
Q

[compression of morbidity graph] goal is to have what shape

A
  • square
  • someone lives in very good health until they die; with minimal or no time having morbidity before death
  • time spent in good health may or may not be longer
49
Q

[compression of morbidity graph] prioritising ____ over trying to increase _____

ie/ ? > ? which most patients prefer

A
  • morbidity
  • lifespan

ie/ quality of life > quantity of life

50
Q

value-based healthcare equation

A

value =

health outcomes that matter to patients / costs of delivering the outcomes

51
Q

value-based healthcare is a ____ model

A

funding

52
Q

value-based healthcare talks about reimbursing providers of health services only if…..

A

they achieve good outcomes - as defined by the patient (not by clinicians)

consumer first rather than provider

53
Q

current funding model in australia is ‘fee for service’ which says that

hence it does not incentivise ____

A

if we deliver a particular service we get reimbursed for it, regardless of outcome of that service

  • outcomes

Adult Health Issues + Men's Health (4 decks)

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