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Public Health > Concise - CHD, alcohol, drugs, eating disorders > Flashcards

Concise - CHD, alcohol, drugs, eating disorders Flashcards

1
Q

duties of a Dr

A
  1. Make the care of your patient your first concern
  2. Keep your professional knowledge and skills up to date
  3. Treat your patient politely and considerately
  4. Respect your patient’s right to confidentiality
  5. Listen to patients and respond to their concerns and preferences
  6. Never discriminate unfairly against patients or colleagues
  7. Work with colleagues in the ways that best serve patients’ interests
  8. Treat patients as individuals and respect their interest
    Some duties conflict
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2
Q

what can Drs do for those with CHD risk?

A 
Identify depression/anxiety
Ask about occupation
Liaise with social support services
Vascular screening
Risk reduction through promoting healthier lifestyles
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3
Q

benefits of alcohol consumption

A
  1. Mildly euphoriant for many
  2. Socialization
  3. Cardioprotective in low doses
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4
Q

psychological effects of excessive alcohol consumption

A
  1. Interpersonal relationship problems (violence, rape, depression or anxiety)
  2. Criminality/violence
  3. Problems at work/unemployment
  4. Social disintegration (poverty)
  5. Driving offences
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5
Q

withdrawal alcohol symptoms

A
  1. Tremulouness: ‘the shakes’
  2. Activation syndrome: tremulouness, agitation, rapid heart beat, high bp
  3. Seizures
  4. Hallucinations
  5. Delirium tremens
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6
Q

UK alcohol limits

A

Men: 3-4units/day
Women: 2-3units/day
Pregnant women: avoid alcohol altogether, never more than 1-2 units once or twice a week

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7
Q

1 unit of alcohol

A 
8g/10ml of pure alcohol 
Half a pint of beer
Small glass of wine
Single measure of spirits
= Strength of drink (%ABV) x amount of liquid (ml) / 1000
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8
Q

fetal alcohol syndrome

A

Pre and post-natal growth retardation
CNS abnormalities: mental retardation, irrability, incoordination, hyperactivity
Craniofacial abornalities, Congenitial defects, increase in incidence of birthmarks and hernias

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9
Q

Primary prevention (health promotion) of alcoholism

A 
Drinkaware – alcohol labelling
THINK! – drink driving campaign
‘Know your limits’ binge drinking campaign 
Restriction on alcohol advertising
Minimum pricing
Legislation – e.g. age limit
Opening hours
Glass substitution
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10
Q

Secondary prevention: screening & intervention

A

Ask about it routinely using screening questions/tools

Detect problem drinking (including laboratory tests)

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11
Q

What can doctors do for alcoholics?

A
  • Screening: CAGE and Alcohol Use Disorders Identification Test (AUDIT)
  • Brief interventions: FRAMES
  • Referral to specialist
  • Help set goals, agree on plan, provide educational materials
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12
Q

signs of alcohol abuse

A
  1. Role failure
  2. Relationship problems
  3. Run-ins with law
  4. Risk of bodily harm
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13
Q

alcohol dependence (3+ in the last 12 months)

A
  1. Withdrawal symptoms
  2. Tolerance
  3. Keep drinking despite problems
  4. Cannot keep within drinking limits
  5. Spend a lot of time drinking/recovering from drinking
  6. Spend less time on other impt matters
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14
Q

FRAMES: motivational interviewing

A
  1. Feedback about the risk of personal harm or impairment
  2. Stress personal Responsibility for making change
  3. Advice to cut down or, if necessary, stop drinking
  4. Provide a Menu of alternative strategies for changing drinking patterns
  5. Empathetic interviewing style
  6. Self efficacy: intuitive style which leaves patient enhanced in feeling able to cope with goals they have agreed
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15
Q

treatment for alcoholism

A

drugs
behavioural therapy
social support - AA

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16
Q

stop smoking

A
  1. Ready: mentally prep yourself, understand process
  2. Steady: throw away ashtray, lighter, set quit date
  3. Stop: reward yourself for not smoking, avoid triggers
17
Q

Occupational screening

A
  1. What type of work do you do?
  2. Do you think your health problems might be related to your work?
  3. Are your symptoms different at work and at home?
  4. Are you currently exposed to chemicals, dusts, mentals, radiation, noise or repetitive work? In the past?
  5. Are any of your co-workers experiencing similar symptoms?
18
Q

Occupational good work

A
  1. Precariousness – stable, risk of loss, safe
  2. Individual control – part of decision making
  3. Work demands – quality and quantity
  4. Fair employment – earnings and security from employer
  5. Opportunities – training, promotion, health, growth
  6. Prevents social isolation, discrimination & violence
  7. Share information – participate in decision-making
  8. Work/life balance
  9. Reintegrates sick or disabled whenever possible
  10. Promotes health and wellbeing – psychological needs
19
Q

first aid

A
  1. Assess the situation – do not put yourself in danger
  2. Make the area safe
  3. Assess all casualties and attend first to any unconscious casualties
  4. Send for help – do not delay
  5. Gently shake the casualty’s shoulders and ask loudly, ‘Are you all right?’ If there is no response:
  6. Shout for help (call 999)
  7. Open the airway
  8. Check for normal breathing
  9. Take appropriate action: 30 chest compressions, 2 rescue breaths, repeat
20
Q

first aid ABC

A

Airway: place your hand on the casualty’s forehead and gently tilt the head back; lift the chin with two fingers
Breathing: look for chest movement; listen at mouth for breath sounds; feel for air on your cheek
CPR: arms straight, centre of breastbone 5-6cm, rate: 100-120times/minute

21
Q

sustainable healthcare

A

Global warming -> change to diseases
Change to the way we deliver care (reduce waste, recycle, think of environmental consequences)
NHS Carbon Footprint: 18.6mill. ton, 25% of public CO2
Intervention: Take a walk, not a pill
-exposure to natural environment reduces disorders

22
Q

substance misuse

A

Substance misuse: Ingestion of a substance affecting the CNS which leads to behavioural and psychological changes, implicitly non-therapeutic use

23
Q

types of substances for misuse

A

opiates, depresseants, stimulatns, hallucinogens

24
Q

addiction

A

Physical + Psychological dependence

25
Q

diagnostic criteria for drug additction

A

Acute intoxication, harmful use, dependence

26
Q

UK drug treatment tiers

A

Tier 1: non-specialist, generic
-substitution treatment: wean patient off drug
Tier 2: open-access services
Tier 3: specialist community-based drug services
Tier 4: specialist inpatient services
-detoxification -> Naltrexone (opioid antagonist)
-residential rehabilitation

27
Q

malnutrition

A

State of nutrition in which deficiency or excess of energy, protein and other nutrients causes measurable adverse effects on tissue/body function and clinical outcome

28
Q

consequences of malnutrition

A
  1. Loss of muscle tissue & strength
    - respiratory muscles (chest infection)
    - cardiac function (heart failure)
    - mobility
  2. Reduced immune response/increased infections
  3. Poor wound healing
  4. Loss of mucosal integrity (malabsorption/bacterial translocation)
  5. Psychological decline – depression, apathy
29
Q

7 steps to end malnutrition in hospitals

A
  1. Hospital staff must listen to older people, their relatives and carers and act on what they say
  2. All ward staff must become ‘food aware’
  3. Hospital staff must follow their own professional codes and guidance from other bodies
  4. Older people must be assessed for the signs or danger of malnourishment on admission and at regular intervals during their stay
  5. Introduce ‘protected mealtimes’
  6. Implement a ‘red tray’ system and ensure that it works in practice
  7. Use volunteers where appropriate
30
Q

methods to improve or maintain nutritional intake

A
  1. Oral nutrition support – food, fortified, sip feeds
  2. Enteral tube feeding – delivery of a nutritionally complete feed directly into the gut via a tube
  3. Parenteral nutrition – delivery of complete nutrition intravenously
31
Q

what is nutritional screening?

A

To identify malnourished patients by medical & nursing staff.

32
Q

nutritional assessment

A

To fully assess, monitor & support malnourished patients by dieticians and nutrition nurses

33
Q

malnutrition universal assessment tool

A 
takes into account BMI, unexplained weightless in past 3-6 months, acute disease.
gives:
low risk = routine clinical care 
medium risk = observe
high risk = treat
34
Q

eating disorders

A

Anorxia nervosa, Bulimia nervosa, Binge-eating

  • set of beliefs about importance of weight & size as an index of personal worth
  • lead to stereotyped behaviours to manipulate food intake & energy expenditure
  • disrupt normal physiology; predictable & profound effects on health & functioning
  • problems maintaining positive self-image, perfectionism, seeking control & ‘ideal’ body, difficulties to early attachment, once established, powerfully addictive
35
Q

psychological principles of eating disorders

A
  1. Judge self-worth exclusively in terms of shape, weight and their control
  2. Control of eating and shape is socially re-inforced and apparently more controllable than other aspects of life
  3. Individual vulnerability plus challenges of adolescence can start the disorder
  4. Thinness= competence, attractiveness, control, independence
36
Q

difficulty in treatment: anorexia > bulimia

A
  • People with anorexia are less likely to want treatment and are unlikely to persevere with efforts to change
  • Higher mortality rate

Public Health (13 decks)

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