Case Study Flashcards
What 3 broad types of skill might you as a GP use during a consultation?
Content skills
Perceptual skills
Process skills
Different factors can affect the consultation. One such factor may be personal factors.
Can you think of another factor and give four examples of it?
Physical factors
- Site and environment
- Adequacy of medical records
- Time constraints
- Patient status
Youv take a history and examine a patient.
You do not find anything on examination byt you feel that you are not getting the whole story.
What kind of questions might you use to elicit more information?
Open ended question
Direct question
Closed question
Leading question
Reflected question
What word do we use when body language and verbal language match?
Congruence
You patient opnes up alot to you and incinuates about you telling her about her mums health (you are also her mums GP)
What is your decision?
What oath guides you about this?
No (patient confidentiality)
The Hippocratic Oath
What percentage of the population are attending the GP for care at any point in time?
19%
As part of your awareness of your learning opportunities, are there any issues in having done the majority of undergraduate training in hospital specialities when considering, for example, a child presenting with abdominal pain?
The hospital is the tip of the iceberg of care, You will see a narrow spectrum of presentations in hospital and may gain a distorted view of the presentation of illness
What form of problem slovling does a GP use to rapidly narrow down the list of likely diagnoses?
Hypothetico-deductive reasoning
What is the WHO definition of health?
Health is a state of complete phyical, mental and social wellbeing not just the absence of disease or infirmity
A patient has recently had a heart attack. In a consultation after he has decided not to start the medication he has been given.
WHat consultation model would be the preferred option when discussing Jim’s new treatment with him?
Mutual participation
Jim is an intelligent person who would likely respond to information about the risks and benefits of the proposed treatment.
It would be important to allow him to ask questions and to understand his treatment.
This would likely result in improved compliance.
What factors might put someone at risk of developing a long-term condition?
There might be genetic factors
There might be environmental factors
Long term conditions have far reaching “impacts”. Give three examples of potential “impacts” of a long term condition.
On the individual – can be negative or positive. Can include denial, self-pity and apathy.
On Family – can be financial, emotional. The health of other family members may be affected.
Community/society. Isolation of an individual may result. Physical adaptations and changes in attitude may be required.
It has been said that the success of a community can be judged on how it looks after its infirm members.
What categories does the WHO use to classify diability?
Body and Structure impairment
Activity limitation
Participation Restrictions
What members of the primary care team might become involved in a patients care with MS?
GP – coordinating care and reviewing treatment and medication
District nurse – coordinating care at home – wound care, dressings, bloods, catheter care etc.
Occupational therapist (OT) – Assessing environment around patient at home and work, and providing aids to promote independence.
Physiotherapist – looking to maximise patient’s physical function e.g. mobility, chest care
Care Manager – Coordinating social care package.
There are two different approaches health professionsals (e.g. GP, physio, OT) may use to help Alison overcome her limitations.
What approaches are they and can you define them?
Therapeutic - We change the nature of the disability – e.g. treating osteoarthritis with anti- inflammatories
Prosthetic – We change the environment – e.g. taxi card, occupational therapy, rails at home etc.
