Case Study Flashcards
Describe the cycle of change model and use smoking as an example
- Precontemplation (smokes regularly)
- Contemplation (considers giving up smoking)
- Ready for action (definitive plan)
- ACTION (actively not smoking)
- Maintenance (non-smoker) which can split into:
• Regression (starts smoking again)
OR
• Maintaining healthier lifestyle
Define health promotion
The way in which an activity is planned in order to enhance or prevent a disease
Three theories of health promotion
- education - provide knowledge to enable necessary skills to rate informed choices about health e.g., 1-1/group
- socioeconomic - aims to make healthier choice the easier choice
- psychological - complex relationship between attitudes knowledge, behaviour and beliefs. Activities start from the individuals attitude
group sessions are what kind of health promoting activity?
health education
what form of prevention would smoking cessation be?
primary prevention - measures taken to prevent an onset or an illness
to which criteria would people refer to when advising about appropriateness of lung cancer screening programme? List the criteria.
Wilsons criteria
- illness: important! naturally history understood, pre symptomatic stage
- test, easy, acceptable, cost effective, sensitive and specific
- treatment - acceptable, cost effective, earlier the better
what style of questioning does a GP use to arrive at a diagnosis?
hypothetico-deductive style
What signs support the diagnosis of HF?
theres so many but try give 5
- Crackles in chest
- Pleural effusion
- Tachypnoea
- Ankle swelling
- Sacral oedema
- Ascites
- Fluid overload
- Raised JVP
- 3rd/4th heart sounds
- murmur
- high BP
- tachycardia
- displaced apex beat
What blood test can we use to confirm HF?
B type Natriuretic peptide
List 2 classes of drugs used for heart failure
Diuretics
ACEis
ARB
Beta Blockers
What modifications could NHS do to improve environmental sustainability?
give 3 examples
- Teleconferencing and videoconferencing instead transport
- Switch to local food suppliers
- Car pooling
- Car sharing
- Fuel efficient vehicles e.g. hybrids
- Health services to have their own fleet of vehicles e.g. mini buses
- Reduce number of free parking spaces
- Reward multiple vehicle occupancy, low carbon emission vehicles and bikes
- Pool of fleet vehicles could be electric
- Health boards to consider reimbursement for travel at higher rate for use of low carbon options, public transport
- Have an institutional travel plan e.g. providing facilities for cyclists, measure carbon emissions
- Liaise with councils to promote bus links
If a patient becomes more debilitated and requires help at home, who might coordinate this?
care manager, they would provide advice regarding care packages available and costs of care. They would help link with sheltered housing and nursing homes if needed.
What are the 3 aspects of the trajectory graph?
- Malignancy
- Organ failure
- Dementia/ frailty
Name 5 members of the primary health care team and other community professionals who might be involved in a patients care after discharge and what might their roles be?
- GP: coordination of care and medication
- District nurse: administering medication and tending wounds/ pressure sores
- OT: assessing environment and provision of aids e.g. air bed, transfer and toilet aids
- Macmillan nurse: liaising with palliative medicine department and providing support for patient and carers
- Care manager (social work): coordination the provision of carers and financial aid for patient
- Pharmacist: assists with provision of medications for patient
- Receptionist: cording care and messages between members of the team and being first point of contact for patient
name two diseases related to indicators that suggest a patient with heart disease is at that the stage where supportive palliative care should take place
- NYHAA class 3-4 heart failure is severe valve disease or extensive coronary artery disease
- Breathless or chest pain at rest on minimal exertion
- Persistent severe symptoms despite optimal tolerated therapy
- Systolic BP <100 and/or pulse >100
- Renal impairment eGFR <30
- Cardiac cachexia
- 2 or more acute episodes needing IV therapy in the past 6 months
what sack is needed to asses and monitor changes of a serious condition?
palliative performance scale
Factors of a good death in western cultures
- open acknowledgement
- at home
- cleared the air/resolved issues
- pain free
- death as a personal growth
- Death according to personal preference and in a manner that resonates with person’s individuality
name 4 lifestyle factors that might be affecting child’s health and wellbeing
- Diet
- Exercise
- Sleep
- Screen time
Child’s parent wants them referred to hospital, how might a GP approach an anxious parent/ carer?
- Exploring underlying concerns the carer has
- Explore how carer is coping being a carer, does she need support?
- Signpost carer to appropriate sources of support
- Explain importance of good quality sleep and limiting screen time for good health
- Suggest and encourage positive changes
- Explain importance of avoiding unnecessary investigation detecting incidental findings and risks of radiation, etc.
- Provide reassurance and appropriate safety netting
- Arrange a follow up with the GP or another professional to ensure support
list 4 reasons why unemployment may be harmful to health
Psychological - poor mental health, distress
higher mortality
poorer general health e.g. longstanding illness
Higher medical consultation, admission rates
List ways in which occupation health can help an employee.
- Advise on fitness for work, workplace safety and help prevent any worsening of symptoms
- Recommend appropriate adjustments in workplace despite illness/symptoms
- Provide rehabilitation to help employee return to work e.g. reduced hours
List risks of homelessness to health.
- Premature death
- Suicide
- Assault
- Alcohol and drug problems
- Poor oral health
- Infectious disease e.g. HIV, TB, Hep C
What is the name of law that describes this phenomenon of people who most need medical care are least likely to receive it?
Inverse care law
what organisations can help the homeless?
- Alcohol and drugs action
- Cyrenians
- Cash in your pocket
- Shelter
- Marywell homelessness practice
- Citizen advice bureau
- Penumbra
- (any appropriate charity)
- what is the name collectively for voluntary/ non-profit organisations?
the third sector
