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Foundations Of Primary Care 1 > All Past Formatives > Flashcards

All Past Formatives Flashcards

1
Q

Define prevalence

A

The number of people in a population with a specific disease at a single point in time or in a defined period of time

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2
Q

Define incidence

A

The number of new cases of disease in a population in a specified period of time

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3
Q

List 5 actions the government could take to stem the rise in obesity

A
  • Health education
  • Tax (on unhealthy foodstuffs)
  • Legislation (ingredients/can labelling)
  • Enforcement of that legislation
  • Ban on advertising unhealthy food
  • Improve exercise/sport facilities
  • Funding of NHS treatment
  • Subsidise/fund healthy food
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4
Q

List 4 examples of what a GP could do to help individual patients

A
  • act as a role model
  • prescribe treatment
  • give tailored advise
  • refer for specialist treatment
  • arrange to see regularly
  • provide education of risks/illness
  • tackle underlying causes
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5
Q

List 5 health professional who could also be involved in eg obesity management or prevention

A
  • community dietician
  • psychologist
  • pharmacist
  • secondary care eg surgeon
  • practice nurse
  • health visitor
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6
Q

Explain the difference between statistical and cultural definitions of normality

A

Statistical normality = based on the normal distribution curve/standard deviation

Cultural normality = base on Norms and values within a certain group (community)

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7
Q

How might changes in cultural perceptions of normality lead to statistical differences (eg in obesity)

A

The fact that people see more obese people shifts their notion of what is normal = it becomes accept and normal to eat more junk food and take less exercise etc

Being obese becomes normal and is perceives to be related to affluence or attractiveness or health

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8
Q

How might obesity affect an individuals health risk at psychological, physical and social levels

A

Psychological = reduced self esteem

Physical = difficult to move or keep fit

Social = ostracization by peers

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9
Q

What is meant by the term gatekeeper

A

A person who controls patients access (via referral) to specialist/secondary care

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10
Q

List 2 advantages of GP’s as gatekeepers

A
  • keep people out of expensive secondary care
  • continuity of the doctor-patient relationship
  • personal advocacy
  • patient does not know where to go/allows appropriate referral/effective use of resources
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11
Q

List 2 disadvantages of GP’s as gatekeepers

A
  • patients have less choice in secondary care
  • seeing a GP may increase the time it takes to receive the needed treatment
  • dependent on individual GP knowledge, attitudes, skill and practice organisation
  • puts stress on a good doctor-patient relationship
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12
Q

Give possible physical side effects of a stressful/long hour job (eg working on an oil rig)

A
  • too tired to do long shifts
  • Potential hazards eg dangers of working/transportation on/to the oil rig
  • adjustment of day/bight shift patterns
  • potential improved physical health if made use of facilities eg offshore
  • partner may be tired of ‘single-parent’ role when patient is working
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13
Q

Give the possible psychological side effects of a stressful/long hours job eg on the oil rigs

A
  • anxiety and stress eg family separation or uncertain on return home
  • possible depression due to repeated period of isolation
  • anxiety and stress about helicopter journeys
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14
Q

Give the possible social side effects of a stressful/long hours job eg on the oil rigs

A
  • relation difficulties due to the nature of job
    Able to spend additional time with family and friends when onshore
  • discipline problems in children due to absent father figure
  • substance misuse due to nature of the job
  • well paid employment allows the family to afford a good lifestyle
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15
Q

List 4 categories of hazard

A
  • mechanical
  • physical
  • chemical
  • biological
  • psychological/stress
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16
Q

Give 2 possible side effects of a partner losing their job on the patient

A
  • exhaustion due to working extra hours to maintain family finance
  • worry/stress about the entire family’s future
  • anger for being made redundant
  • enjoyment of increased time to spend with husband
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17
Q

Give 2 possible effects being made redundant may have On a patient

A
  • feelings of worthlessness
  • guilt of no longer supporting the family
  • Depression
  • Anxiety about finding another job
  • Anger at employers
  • Enjoyment of more time with family
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18
Q

How would you deal with a patient asking you about their spouse’s health

A
  • MUST maintain the spouse’s confidentiality
  • ask patient why they are concerned
  • consider the need to maintain trust
  • consider GMC guidelines
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19
Q

List 4 ethical principles derived from deontology and utilitarianism

A
  • beneficence
  • non-maleficence
  • justice
  • autonomy
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20
Q

Define culture

A

Systems of shared ideas, systems of concepts, rules and meanings that underlie and are expressed in the ways that human beings live

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21
Q

Define ethnicity

A

Cultural practises and outloook that characterise and distinguish a certain group of people

Characteristics identifying an ethnic group may include

  • common language
  • common customs and beliefs
  • tradition
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22
Q

Define race

A

A group of people linked by biological/genetic factors

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23
Q

List 4 possible difficulties which may arise in a consultation as a result of cultural differences

A
  • language barriers
  • religious beliefs
  • racism
  • stereotyping
  • examination taboos
  • Lack of knowledge about health issues
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24
Q

List two aspects of social health you would explore in a 15 year old school girl who smokes 12 cigarettes a day

A
  • sexual health
  • alcohol
  • illicit drugs
  • diet-eating patterns
  • peer pressure
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25
Q

List the 6 social classes from the 1911 Census

A
  • professional
  • managerial and technical
  • skilled non-manual
  • skilled manual
  • partly skilled
  • unskilled
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26
Q

Give an explanation as to how culture may influence statistical normality eg smoking behaviour in different social classes

A

lower social classes see larger numbers of people smoking around them and are more likely to accept it as normal behaviour

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27
Q

Describe the 3 models of stress

A
  • engineering model
  • medico-physiological model
  • Psychological or transnational model
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28
Q

Describe the engineering model of stress

A
  • stress acts as a stimulus which the individual must resist
  • if the stimulus becomes too intense or prolonged the individual breaks
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29
Q

Give two possible coping mechanisms an individual may use when faced with a stressful situation

A
  • problem focused
  • emotion focused
  • combination of problem/emotion focused
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30
Q

Describe the ‘guidance/co-operation’ style of doctor-patient relationship

A
  • The doctor exerts a degree of authority and the patient is obedient
  • the patient does have a little feeling of autonomy and participates to a small degree in the relationship
31
Q

Name the three style fo doctor-patient relationship

A
  • guidance/co-operation
  • authoritarian/paternalistic
  • mutual participation
32
Q

List the 5 types of question that may be used in medical interviewing and describe them

A
  • Open questions = not seeking a specific answer but simply allows/signals the patient to tell their own story
  • direct questions = ask about a specific item
  • closed questions = can only be answered yes or no or an equivalent
  • reflected questions = allows the doctor to avoid answering a direct question from the patient/aids the doctor in exploring the patients own thoughts and perceptions
  • leading questions = presumes answer, best avoided
33
Q

List 5 different ways in which a doctor can facilitate the interview in a non verbal way

A
  • listening
  • use of silence
  • posture/body language
  • specific gestures
  • Eye contact
34
Q

Approximately how many patients are registered on average with each GP in the NHS in the UK?

A

1200-2000 patients each

35
Q

Approximately what percentage of illness presenting to primary care are referred on to secondary care?

A

3%

36
Q

List 4 aspects of lifestyle you may cover in a consultation with any patient when giving advice to promote a healthier lifestyle

A
  • diet
  • exercise
  • alcohol
  • smoking
  • sexual health
37
Q

List 4 aspects of health which are likely top be worse for children (of all ages) living in the most deprived areas compared to those living in the least deprived areas

A
  • lower birth weight
  • less likely to benefit from breastfeeding in infancy
  • Poorer dental health
  • higher rates of obesity
  • more likely to take up smoking
38
Q

List 6 risks to foetal wellbeing

A
  • smoking
  • illicit drugs
  • prescription drugs
  • X-rays
  • diet (poor nutrition)
  • infectious diseases (rubella)
  • maternal disease (diabetes)
39
Q

List 4 factors that would make a patient more likely to be motivated to change their behaviour. For each factor give an example relating to a mother giving up alcohol during pregnancy

A
  • state the advantages their change in behaviour would outweigh the disadvantages e.g birth of a healthy baby
  • anticipation of a positive response from others e.g mother’s partner/family want the unborn baby to be healthy
  • social pressure to change e.g very socially unacceptable to drink when obviously pregnant
  • ability to carry out the change in a range of circumstances e.g not drinking at home/parties etc
40
Q

State the WHO definition of health

A

A state of complete physical, mental and social wellbeing, not merely the absence of disease or infirmity

41
Q

List 4 factors that influence lay beliefs about health and give an example of how each of these factors may influence lay beliefs about health

A

Age = elderly concentrate on functional ability, younger people speak of health in terms of physical strength and fitness

Social class = people of low socioeconomic circumstances regard health as functional (ability to take care of others)

Gender = men and women think differently about health, women find concept of health more interesting

Culture = different perceptions of illness/disease, differences in concordance with treatment

42
Q

List 3 different routes via which someone may be exposed to a hazardous substance

A
  • blood
  • sexual contact
  • ingestion
  • inhalation
43
Q

List 2 categories of hazard. Give an example of each in relation to work in a chemistry lab

A
  • physical = heat/noise/radiation from equipment
  • mechanical = trips/slips
  • biological = spread of infection amongst colleagues
  • psychological/stress = anxiety regarding job security/relationships with colleagues/deadlines/busy
44
Q

List 4 common reasons for a child of any age to see their GP or health visitor

A
  • feeding problems
  • URTIs
  • Rashes
  • Sore throat
  • Vomiting/diarrhoea
  • Abdominal pain
  • Behavioural problems
45
Q

List 4 social influences on health

A
  • gender
  • ethnicity
  • housing
  • employment
  • social class
46
Q

List 2 health and social care team members who work within the community whom you may decide to help with your patients care.

Give an example for each in the case of a patient with cystic fibrosis

A
  • physiotherapist = to help clear chest secretions
  • dietician - nutritional assessment and advise on improving appetite/weight gain
  • counsellor - assessment and management of low mood
  • occupational therapist = assess for aids to assist daily living
47
Q

Explain beneficence

A

Care maximised ie doing what is best for the patient

48
Q

Explain non-Maleficence

A

Ensuring you do no harm to the patient eg perform appropriate investigations before treatment

49
Q

Explain autonomy

A

A patients rights not to take advised treatment even if fully informed of the benefits

50
Q

List two ethical issues regarding abortion

A
  • regions/beliefs regarding termination

- thoughts regarding bringing a child into the world that you do not feel able to care for

51
Q

List 2 psychological issues of abortion

A
  • anxiety about being pregnant
  • anxiety about going through termination
  • anxiety/stress about level of support from family
52
Q

Give 2 social issues of abortion

A
  • support network
  • social life will dramatically change after having a baby
  • ability to find a job/work
53
Q

List the 5 core concepts associated with he social cognitive theory

A
  • observational learning/modelling
  • outcome expectations
  • self efficacy
  • self-regulation
  • goal setting
54
Q

Give 3 examples of environmental factors which may influence an individuals behaviour

A
  • culture
  • social support
  • location
  • income
  • time
55
Q

Give three examples of behavioural factors which may influences an individuals behaviour

A
  • activity/exercise
  • intrinsic motivation
  • goal setting
56
Q

Give 3 examples of personal factors which may influence an individuals behaviour

A
  • knowledge/information
  • self-efficacy scale ie belief in ability to change
  • behavioural capability
57
Q

What factors might increase the chance of someone changing their behaviour

A
  • they think the advantages of change out weight the disadvantages
  • social pressure to change
  • they perceive the new behaviour to be consistent with self-image
  • they anticipate a positive response from others to their behaviour change
  • they believe they are able to carry it the new behaviour in a range of circumstances
58
Q

State 3 benefits of adopting the mutual participation style of doctor/patient relationship

A
  • greater participation by the patient means they have a feeling or relatively greater personal autonomy
  • the patient adopts great responsibility for their own health through sharing of information and decision making
  • may increase compliance with advice/concordance with treatment
59
Q

Describe the authoritarian or paternalistic doctor/patient relationship

A

The physician uses all of the authority inherent in his/her status and the patient has no autonomy.

Patient tries hard to please the doctor and does not actively participate in their own treatment

60
Q

Give a brief description of the 3 broad types of skills that are need for successful medical interviewing

A
  • content skills = what doctors communicate ie the substance of their questions and responses, the information they gather and give
  • perceptual skills = what they are thinking and feeling ie their internal decision making, clinical reasoning and awareness of their own biases, attitudes and distractions
  • process skills = how they do it ie the way the doctors communicate with patients, how they go about discovering the history or providing information, verbal/nonverbal, structure
61
Q

List 5 actions that the government might take to promote health in the population as a whole

A
  • legislation/policies on smoking/alcohol
  • improvements in housing
  • provision of health education
  • health and safety laws
  • traffic/transport legislation/polices
62
Q

What does a statistically normal distribution curve look like?

A

Curve starts low then gets high in the middle then goes low again = like a hill in the middle

63
Q

Describe the steps of the hypothetico-deductive reasoning process

A
  • is about likely diagnoses
  • use of past experience ie have you seen similar cases before and what were they
  • form a hypothesis
  • deduce predictions from hypothesis
  • Order tests investigations etc
64
Q

What might safety netting advice include?

A
  • Advise the patient of the expected course of the illness/recovery
  • Advise of symptoms indicating deterioration
  • Advise who to contact if patient deteriorates
65
Q

List 3 ways in which neighbour suggests risk can be minimised

A
  • Summaries and verbally check that reasons for attendance are clear
  • hand over and bring he consultation to a close ie hand over to the patient at the end to ensure all issues have been covered
  • deal with the housekeeping of recovery and reflection eg record keeping, referral if necessary pausing to reflect before next patient
66
Q

Give 5 examples of the use of computers in patient care within general practice

A
  • store appointments
  • book appointments
  • assist in consultations
  • electronic management of hospital letters/test results
  • e-consultations
  • public health information
  • support prescribing
67
Q

Define hazard

A

Something with the potential to cause harm

68
Q

Define risk

A

The likelihood of farm occurring

69
Q

State 3 coping mechanisms

A
  • Problem focused eg enlist help of family and friends
  • emotion focused eg seek counselling/stress management
  • combined problem and emotion focused
70
Q

State 5 factors that makes a GP the most appropriate profession to guide a patient about their current worries

A
  • aware of current and past ,education history
  • aware of patients social circumstances
  • has knowledge of a broad range of illnesses and health conditions
  • trusted health professional with perhaps lifelong rapport with patient
  • likely to be near patients home so is accessible
71
Q

What is cultural competence?

A

The understanding of diverse attitudes, beliefs, behaviours, practices and communication patterns attributable to a variety of factors

72
Q

What does cultural competence eliminate in the primary care setting?

A
  • eliminates misunderstandings in diagnosis or in treatment planning that may arise from differences in language or culture
  • improve patient adherences with treatments
  • eliminate health care disparities
73
Q

Explain the methods used to overcome language barriers

A
  • a wide variety of language interpreters are available through language line services
  • use phone interpreters
  • use on site interpreters
  • family members or translators

Foundations Of Primary Care 1 (1 decks)

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