FOPC Formative Flashcards
What are the WHO’s 3 catagories under which disability are described?
Give an example for each.
•Body structure and function impairment
-Is defined as abnormalities of structure, organ or system function (organ level)
•Activity limitation
-Is defined as changed functional performance and activity by the individual (personal level)
•Participation restrictions
-Is defined as the disadvantage experienced by the individual as a result of the impairments and disabilities (interaction at social and environmental level)
A patient, John Young, is brought in by his mother. He is 7 and has cerebral palsy.
He walks with a limp and has mile learning difficulties, although manages to attend mainstream school.
How would the WHO definition of disability be applied to john?
(4 marks)
- Damage to motor area of brain
- Damage to cognitive area of brain
- Limited mobility
- Learning difficulty
- Exclusion or difficulty participating in certain activities e.g. riding a bike, certain sports
Disability has far reaching implications for patients, their families and others around them.
In GENERAL, what might be the effect of a disabled child on thier parents?
Mother and/or father may not be able to combine work with the demands of caring for disabled child-financial implications for family
Guilt at having passed on the causative gene if genetic disorder
Psychological strain
Caring for disabled child may be detrimental to parent’s physical health
Some parents may have difficulty bonding with disabled child
Marital problems
Increased risk of child abuse
Over-protection of disabled child
Disability has far reaching implications for patients, their families and others around them.
In GENERAL, what might be the effect of a disabled child on thier siblings?
Resentment at time parents spend caring for disabled child
Resentment at restrictions to normal family life
May have to develop carer role
Grow up with greater understanding of disability
Disability has far reaching implications for patients, their families and others around them.
In GENERAL, what might be the effect of a disabled child on thier peers?
May “look out” for disabled child
Friend may be stigmatised along with disabled child
May grow up with greater understanding of disability
May need to adapt activities to include disabled friend
Teasing by other peers
Disability has far reaching implications for patients, their families and others around them.
In GENERAL, what might be the effect of a disabled child on thier parents?
May have lack of understanding of disability/lack of training
May have tendency to over-protect disabled child
May be lack of willingness to integrate in mainstream activities
May be additional challenges in personalising education for disabled child
Stress of managing both mainstream and additional support needs pupils in the same class
List 7 recognised causes of disability worldwide
Congenital Communicable disease Non-communicable disease Alcohol Drugs-iatrogenic Drugs-illicit drug use Tobacco use Mental illness Malnutrition Injury Obesity
List medical factors which may influence the uptake of medical care for ANY patient
New symptoms
Visible symptoms
Increasing severity of symptoms
Duration of symptoms
Psychological impact of symptoms e.g. stress, anxiety
List non-medical factors which may influene the uptake of medical care of ANY patient
- Personal/family crisis e.g. relationship difficulty, loss of job
- Peer pressure e.g. wife/friend sent me
- Patient beliefs about illness
- Patient expectations
- Social class
- Economic implications e.g. not paid if off work
- Culture
- Ethnicity
- Age
- Gender
- Media information
- Interference with social activities
- Access
Briefly describe the inductive reasoning model and its benefits
Can be used for patients with vague/unexplained symptoms (benefit)
Can be used by inexperienced doctors (benefit)
Involves systematic and comprehensive history and examination
Often involves investigations e.g. blood tests, scan
Evidence is then assessed to find an explanation for symptoms
Give a brief description of how hypothetico-deductive reasoning may be used in a patient presenting with chest pain
Doctor’s experience generates a differential diagnosis from presenting symptoms
Specific questions are used to establish diagnosis, giving consideration to conditions requiring urgent attention e.g. MI
Examination and investigation are used as appropriate to help establish diagnosis
Give a brief description of how pattern recognition may be used in a patient presenting with chickenpox
Doctor’s previous experience will allow them to recognise natural history of disease and pattern/type of spots
This allows the doctor to draw a conclusion from the pattern and reach a certain or near certain diagnosis of chickenpox
64 Year old Andrew Wilson who you are seeing for review of long term condition and medication.
Moderate heart failure, which is currently stable. Works as a joiner and reduced from full-time to part time work when he was 60
Using your knowledge of the WHO definition of health, list 3 aspects of Andrew’s health which may be affected by his HF AND give an example of the possible effect of his health under each of these headings
Physical
- Reduced mobility due to breathlessness/chest pain
- Difficulty with stairs
- Requirement for medication
- Difficulty with lifting/using tools at work
Psychological
- Anxiety that illness may become worse
- Depression secondary to long term condition
- Stress related to any time off work/no longer being able to do job to best of ability
Social
- Reduction in working hours-less social contact
- Loss of earnings if time off work
- Illness limiting social activities/hobbies
64 Year old Andrew Wilson who you are seeing for review of long term condition and medication.
Moderate heart failure, which is currently stable
List 5 examples of differences in care provided by Andrew’s GP and his secondary care doctors.
- GP likely to have been responsible for care for much longer (cradle to grave). Secondary care only involved once cardiac symptoms developed
- GP responsible for all his medical care, not just cardiac illness. Cardiac clinic only deals with his cardiac failure. i.e. GP provides breadth of care compared with depth of care provided by secondary care consultant
- GP likely to look after other family members; unlikely that secondary care will be dealing with other family members
- Secondary care doctors have easier access to investigations than GP
- Risk and uncertainty relating to Andrew’s health more likely to be accepted by GP than secondary care doctors e.g. GP more likely to use time, try empirical treatment
- Quality of doctor/patient relationship likely to be improved by continuity of care in general practice, although patient with long term condition such as Andrew also likely to have good quality relationship with secondary care
- Opportunistic health care and health promotion more likely to occur in General Practice setting
- Multiple short appointments in General Practice versus longer less frequent appointments in secondary care
- GP looks after Andrew even when his condition is stable. Likely to be discharged from secondary care once condition stable
- GP acts as gatekeeper to secondary care. Secondary care doctors rarely employ a gatekeeper role
List two advantages and three disadvantages of house calls for the patient
Patient advantages
- Convenience e.g. no travelling
- May be essential-unfit to leave the house
- Social contact e.g. if patient lives alone/isolated
- May be able to let GP see difficulties they have in home environment
Patient disadvantages
- Invasion of privacy
- Some will feel compelled to “tidy” even if feeling very unwell
- Confidentiality issues e.g. family member, carer, neighbour present
- Not every examination can be performed at home, so may be delay in diagnosis
- Lack of ability to see doctor of choice
- Lack of defined time for visit
