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Medicine Interview > Facts > Flashcards

Facts Flashcards

1
Q

Most important discoveries last 100yrs

A

Penicillin (1940) founded by Alexandra Flemming. Revolutionised surgery and lowered the risk of infection. Increasing problem of antibiotic resistance due to bacteria adapting to severe environments. Leading to longer hospital waits, increased costs, increased mortality.

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2
Q

Most important discoveries last 100yrs

A

Radiography 1896 - Non-invasive diagnosis, quick, efficient e.g. MRI, X-ray. Requires analysis from a qualified doctor.

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3
Q

Most important discoveries last 100yrs

A

Key-hole surgery - Non-invasive, quick recovery, most hospital beds available, reduced dependence on follow-up treatment

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4
Q

Most important discoveries last 100yrs

A

Discovery of DNA (1950) - Use for police investigation, analyse genetic and hereditary diseases

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5
Q

Hippocratic Oath

A

Father of Medicine who explained that illness was no a result of a disbelief in god. He was the first to state symptoms for pneumonia and epilepsy for children. He suggested that humans should complete exercise, have fresh air, stay hydrated for a healthy living. He also suggested that thoughts and beliefs came from the brain and not the brain.

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6
Q

Modern day Hippocratic Oath

A

Duty of beneficence - Respect patient and act in the patients’ best interest
Help the sick irrespective of the situation or circumstances
Non-maleficence - Do not harm the patient. Euthanasia is illegal in the UK, although abortion is legalised.
Confidentiality - Respect discussion and do not reveal them to other staff members, friends or family. In some cases, doctor must breach confidentiality if patient is in danger.

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7
Q

Guarantee of medical treatment

A

What is success? The procedure may be carried out success but have long-term effect on daily lifestyle and appearance, requiring a follow-up treatment.
Success for the doctor is that the procedure has been carried out successful and as planned. Success to the patient is whether or not the outcome of the treatment has matched expectations.

e. g. procedure may have left a scarring
e. g. hip replacement may have eased the pain but patient has trouble walking

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8
Q

Success to patient depends on…

A

Complete history notes to determine correct treatment
Physical health e.g. obese may have troubles with anaesthesia, smokers may have thinner skin prone to scarring.
Adherence to treatment plan

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9
Q

Success to doctor depends on…

A

Qualified
Received appropriate training
Prescribed appropriate drugs

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10
Q

Differences in life expectancies

A

Lifestyle choices e.g. eating, exercise, smoking
Industrial work more likely to follow bad healthy lifestyle and smoking
Increased cases of lung cancer and heart disease
Lack of education teaching good and healthy lifestyle choices and awareness for unfavourable consequences of smoking and bad lifestyle choices
Less access to healthcare in rural areas because services get centralised and smaller services are closed.

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11
Q

White coats

A

Reduce infection
Recognised as scientific status so that patients can trust the doctor
More patient prefer tie these days, to help the bond between patient and doctor.

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12
Q

MMR vaccine

A

NHS offers the combined vaccine against mumps, measles and rubella, rather than 3 separate vaccines. Allows quick immunisation. 95% for her immunity.

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13
Q

Flu vaccine

A

Elderly patients, pregnant women, children and adults with health conditions, weakened immunity are more vulnerable to the flu and should therefore receive vaccination annually. Vaccination is the best protection against an unpredictable flu. It’s not 100% guarantee because fluenza adapts every year and the vaccination is produced using global information. May protect against stroke. Unpredictable side effects.

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14
Q

Sale of tobacco

A
  1. Autonomy - Individuals can make personal choices and are responsible for own health
  2. Avoid a black market and less patients seeking medical treatment, which may escalate to more severe conditions e.g. lunch cancer.
  3. Leads to serious diseases e.g. cancer and respiratory diseases which drains government funding
  4. Second hand smoke and passive smoking. However. it has become banned in most public places.
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15
Q

Sponsorship

A
  1. increase training and education opportunities
  2. Discovery of new drugs and treatment
  3. Leads to bias in decision making, which may lead to the doctor prescribing an inappropriate drug
  4. Make sure risk does not outweigh benefits
  5. Doctors feel obliged in prescribing the drug
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16
Q

Modernising Medical Careers (MMC)

A

Reducing the amount of time junior doctors have to train to become specialists. Allows quicker turnover of new roles. European Working Time Directive stated that doctors should not work more than 48hours a week or 13hours per shift. Number of training years therefore increased.

17
Q

Calman System

A

Average of 10 years to become a consultant.
No systematic teaching, train towards exams. If doctor was not successful when trying for specialist consultant the doctor stayed in the job for long.
Pre-registration house officer (2yr)
Senior House Officer (3yr)
Specialist registrar (6yr)
Consultant

18
Q

New Training System

A 
Doctors can specialise earlier. Reduce the time in the same role. Further training if unsuccessful becoming a specialist.
Foundation (2yr)
General Medical Practice (3yr)
Specialist (2yr)
Consultant
19
Q

How long does it take to become a GP?

A

2 years experience in a hospital
1 years experience in a GP
Vocational GP training
5 years following medical school because need to complete 2 years foundation.

20
Q

How long does it take to become a consultant?

A 
7 years after medical school
Foundation years (2yr)
General Medical Training (3yr)
Specialist (2yr)
Consultant
21
Q

Shipman

A

Killed 15 patients and may more.
GMC did not strip him for opioid drug addition, instead fined him £600. Inital suspicions from funeral services that many patient death were from him. Relatives to the victim became suspicious of Shipman when he forges the victim’s will.

22
Q

Changes to Medical Practice following Shipman

A

No independent practice so that doctors can be checked on.
Tighter regulations for controlled drugs.
Need two signatures from a doctor as well as a coroner or government official.

23
Q

Problem Based Commissioning (PBC)

A

GP have a standard referral fee that comes out of their own funds. Fee is calculated based on the average cost of that services across the country each year.

24
Q

Advantages of PBC

A
  1. Standard therefore patients can choose where they want the treatment. Services increase quality of care an compete against services. Guarantee service quality.
  2. Limits number of referrals, saving money for the NHS.
25
Q

Disadvantages of PBC

A
  1. Comes out of GP funds, therefore GP may be less inclined to refer patients
  2. Patients can make a choice, which could be influenced by the doctor.
  3. Service can refer patient back to the doctor, doubling the referral fee.
26
Q

Payment by result

A

Services are being paid based on what they have provided and not what they were expected to provide. Need to show that they can carry out a good standard of care, to increase number of referrals.

  1. Competition between services based on quality of care.
  2. Rewarded based on what they have achieved and not on what they were expected to achieve.
  3. Not flexible for patient needs. They are paid for a specific procedure and not for extra complexities.
  4. More focus on competition rather than patient care.
27
Q

Evidence based practice

A

Using current research and evidence to make a decision regarding type of treatment and causality of condition.
Integrate clinical practice with clinical evidence
Using best clinical knowledge and judgement and apply it ta patient’s needs.
Research can be made by the doctor. Need to search online databases and combine evidence to reach a decision.
Randomised Controlled Trials and reading of meta-analysis ensure more robust evidence.

28
Q

Hospital at night

A

Changing the way hospitals are organised at night. European Working Time Directive regulate number of hour doctors can work each week.
Doctors who work during the day are far more busy whereas doctors work in isolation during the night.
Less doctors needed in the night because treatment, consultations and diagnosis moved to the day, unless urgent.
Duties can be carried out by other staff e.g. nurses.
Senior doctors can be called in if necessary.

29
Q

European Working Time

A

Working time reduced to 48 hours each day and 13 hours per shift.
Ensure doctors are less stressed and well rested.
More time to study and follow research
Reduced continuity of care. Patients are seen by different doctors, whereas nurses stay with the patient.
Junior doctors spend less time with patients, however have more time to study.
More medical students needed, increased roles of nurses for a continuity of care
Restructure of hospital at night
MMC to ensure quicker training

30
Q

Audit process

A 
Continuously evaluating quality of care.
Set a standard and meet the standard.
Compare with other results
Make changes to weaknesses
Re-audit following couple of months
31
Q

Clinical Governance

A

Implementation of a framework to order and monitor a long-term strategy.
Ensure good quality of care.
Effective clinical practice.
Keep up to date with research, interventions and new treatments.
Integrate clinical expertise with research.
Reduce risk.
Complete training and education e.g. PBL
Involve patients
Use clinical audits to re-evaluate patient care

32
Q

Roles of nurses

A
  1. Some able to prescribe, treat and diagnose
  2. Some specialise but general knowledge is limited
  3. More nurses needed due to European working time directive. More nurses needed to work in the night.
  4. Continuity of care for patient. Develop relationship with patient and relatives.
  5. Management roles
  6. Guide medical school students
  7. Take part in research
33
Q

Advantages of nurses

A

Reduce pressure on doctors. Nurses can prescribe, diagnose and treat within a certain speciality. Allows more free time for doctors for studying and resting.
Better continuity of care for patient and relationship between nurses and families. Patients are seeing the same doctors.

34
Q

Disadvantaged of nurses

A

Take on small procedures instead of junior doctors

Patients less confident to see a nurse

35
Q

Politics and healthcare

A
  1. NHS funded by tax and politicians can decide where that money goes.
  2. Reduced working hours for doctor
  3. Reduced funding £1.8 billion this year to improve 4. patient care, with majority going toward hospital reservations and mental health services. Increased tax in order to increase quality of care.
  4. More restriction on non-essential surgery.
  5. Raising awareness for diseases.
36
Q

Changes within the field of Medicine

A
  1. More knowledge and awareness of diseases, leading to more campaigns an development of new treatment.
  2. Penicillin and antibiotic resistance.
  3. More speciality.
  4. NHS - funded healthcare
  5. More focus on prevention rather than cure e.g. obesity
  6. More focus on teamwork and communication between health care professionals.
  7. More opportunities - teaching, tv, campaigns
37
Q

Alternative therapies

A

e.g. hypnosis, acupuncture…
Non-conventional treatment

  1. Longer contact hours, which may be beneficial to the patient
  2. No side effects from drugs
  3. Offered if conventional treatment not working
  4. Lack of evidence
  5. Not carried out by a qualified medic
  6. Poor understanding of mechanisms

Need to increase knowledge of mechanism, increase training and conduct more research.

38
Q

Promoting good health

A
  1. Set a good example
  2. Promote prevention e.g. lifestyle choices
  3. Posters
  4. Social Media
  5. Promote support groups
39
Q

Female candidates

A
  1. More girls born than boys
  2. Male-dominant job, therefore more effort is made by schools to promote medicine as a career pathway for girls
  3. , Girls perform better in school and can regulate stress
  4. Less working time - better to start a family.

Medicine Interview (1 decks)

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