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Foundations of Primary Care Year 3 > Case Study > Flashcards

Case Study Flashcards

1
Q

What two different types of risk are appropriate to discuss when a patient expresses concerns about the dangers of the pill?

A

Actual risk

Relative risk

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2
Q

How might you communicate this with her?

A

Verbally
Using fractions
Using illustrations

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3
Q

What kinds of studies might have been performed to generate data that you are able to present to the patient?

A 
Descriptive studies
Cross-sectional studies 
Cohort studies 
Case-control studies
Randomised controlled trials (RCTs)
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4
Q

What word that can affect the outcome of a study describes the tendency to preferentially select a group?

A

Bias

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5
Q

What would you do if it turned out that one group smoked more than others, what kind of factor would it be?

A

A confounding factor

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6
Q

You are unsure if you and your colleagues are prescribing the contraceptive pill according to national guidelines?

A

You might perform an audit

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7
Q

What headings might you use to structure it according to the RCGP guidelines on performing an audit?

A
  • Title
  • Reason for the audit
  • Criteria to be measured
  • Standard set
  • Preparation and planning
  • Results and date of collection one
  • Description of changes implemented
  • Results and date of data collection two
  • Reflections
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8
Q

A patient attempts to stop smoking, but goes back to it. What model describes the stages that they have gone through?

A

The stages of change model

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9
Q

Define health promotion?

A
  • Any planned activity designed to enhance health or prevent disease
  • The process of enabling people to increase control over, and to improve, their health. Applied to a wide range of approaches to improving the health of people, communities and populations.
  • An over-arching principle or activity which enhances and includes disease preventing health education and health protection. It is usually planned but may be opportunistic.

ANY OF THE ABOVE 3

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10
Q

What are the 3 theories of health promotion>

A

Educational: Provides knowledge and education to enable necessary skills to rate informed choices in health
Socioeconomic: Makes healthy choices the easy choice
Psychological: Complex relationship between behaviour, knowledge, attitudes and beliefs. Activities start from an individual attitude to health and readiness to change. Emphasis on whether individual is ready to change

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11
Q

What are the 3 theories of health promotion>

A

Educational: Provides knowledge and education to enable necessary skills to rate informed choices in health
Socioeconomic: Makes healthy choices the easy choice
Psychological: Complex relationship between behaviour, knowledge, attitudes and beliefs. Activities start from an individual attitude to health and readiness to change. Emphasis on whether individual is ready to change

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12
Q

What type of health promotion activity does smoking cessation demonstrate?

A

Health education: The activity involves communication with individuals or groups aimed at changing knowledge, beliefs, attitudes and behaviour in a direction which is conducive to improvements in health

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13
Q

What form of strategy for the prevention of illness is ‘smoking cessation’?

A

Primary prevention. Measures are taken to prevent the onset of illness or injury. Reduces probability and severity

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14
Q

What are the criteria used to determine the appropriateness of screening programmes?

A

Wilsons and Jungner’s Criteria:
Illness - Important, natural history understood, clinically detectable pre-symptomatic stage
Test - Easy, acceptable, cost-effective, sensitive and specific
Treatment - Acceptable, cost-effective, better if disease found early

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15
Q

A patient presents with lower back pain, resulting from his job moving stock. What is the likely diagnosis and prognosis?

A

Mechanical lower back pain

Generally good prognosis with initial rest, analgesia and mobilisation with/without physio

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16
Q

What can you provide to help his condition?

A

Analgesia
Med 3 Fit Note
Referral to physiotherapy

17
Q

The patient has now been off work for a month and is looking better. What role has he adopted and is the role always negative?

A

The sick role

Role is not necessarily negative. Society allows for the provision of care of the infirm, there is, however, an expectation that he will eventually return to work

18
Q

Suggests 2 possible consequences of the changes shown in the population pyramids

A

Ageing population with disease and care needs
Relative smaller working population paying taxes and supporting the country financially and fewer to provide care for the older population

19
Q

What is the expected increase in people about the age of 80 between 2000 and 2050?

A

4x

20
Q

Elderly patients are likely to have multiple long-term medical conditions. What is the term used to describe ‘the co-existence of two or more long-term conditions in an individual’?

A

Multimorbidity

21
Q

A patient presents with arthritis in his hands. He has taken some of his friends diclofenac to treat is. He found it helpful and has come to ask for some. What issues should you raise with him?

A
  • Diclofenac could have a detrimental effect on his ischaemic heart disease
  • Anti-hypertensive could interact with NSAID
  • Could suffer GI SE, especially if he is also taking aspirin
22
Q

Would you refuse to prescribe the diclofenac?

A

Depends on patient’s thoughts about risk
He may believe that it is beneficial, despite having all the facts
Weigh against how symptoms affect his life
Some patients find topical preparations helpful and would carry less risk of interaction
Finding ways of tailoring treatments to an individual’s needs is a skill of generalism

23
Q

What kind of plan can prevent unwanted hospital admissions?

A

Anticipatory care plans

24
Q

What does an anticipatory care plan promote?

A

Advance and anticipatory care planning, as a philosophy, promotes discussion in which individuals, their care providers and often those close to them make decisions with respect to their future health or personal and practical aspects of care

25
Q

What may it include?

A

Legal details - power of attourney
Contact details for close friends and careres
Strategies for managing illness without admissions (home supply of antibiotics)
Advance statements
Resuscitation status
Details for out of hours service

26
Q

What may it include?

A
  • Legal details - power of attourney
  • Contact details for close friends and careres
  • Strategies for managing illness without admissions (home supply of antibiotics)
  • Advance statements
  • Resuscitation status
  • Details for out of hours service
27
Q

What modifications can be made by the NHS to make the service more sustainable?

A
  • Teleconferencing and videoconferencing
  • Switching to local food suppliers for hospitals
  • Car pooling
  • Car sharing
  • Fuel efficient vehicles
  • Health services to have their own fleet of vehicles
  • Reduce the number of free car parking spaces
  • Reward multiple vehicle occupancy, lower carbon emission vehicles and bikes
  • Pool of fleet vehicles, could be electric
  • Health boards to consider reimbursement for travel at a higher rate for use of low carbon options, public transport
  • Have an institutional travel plan
  • Liaise with councils to provide bus links
28
Q

A patient becomes debilitated and requires care at home. Who might co-ordinate this?

A

A care manager; they would provide advice regarding care packages available and costs of care. They could help link with sheltered housing or nursing homes if needed

29
Q

Name 5 members of the Primary Care Health Team that could be involved in the care of a patient with lung cancer after they are discharged from hospital. What might be their roles?

A

GP - co-ordination of care and medication

District Nurse - Administration of medication and tending to wounds/bedsores

Occupational Therapist - Assessment of the environment around the patient and provision of aids

Macmillan Nurse - Liaison with palliative medication department and provision of support for patient and carers

Care Manager (social worker) - Co-ordination of the provision of carers and financial aid for patient

Pharmacist - Assisting in the provision of medication for the patient

Receptionist - Co-ordination of care and messages between members of the team and being a first point of contact for patient

30
Q

What scale might be used to assess and monitor the changes in condition of a patient with a terminal illness?

A

The Palliative Performance Scale

31
Q

What factors constitute ‘a good death’ in Western culture?

A
  • A pain-free death
  • Open acknowledgement of the imminence of death
  • Death at home surrounded by family and friends
  • An ‘aware’ death in which personal conflicts and unfinished businesses are resolved
  • Death as personal growth
  • Death according to personal preference and in a manner that resonates with the person’s individuality
32
Q

Name 5 of the 10 emotions that might be experienced following a bereavement?

A 
Shock
Anger
Denial
Bargaining
Relief
Sadness
Fear
Guilt
Anxiety
Distress

Foundations of Primary Care Year 3 (10 decks)

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