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FOPC > FOPC YR 3 > Flashcards

FOPC YR 3 Flashcards

1
Q

most common causes of death?

A

cancer and IHD

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2
Q

most common cause of death in men 15-34?

A

suicide

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3
Q

terminal care

A

last phase of care when patient is close to death

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4
Q

Scotland’s national action plan for Palliative care?

A

living and dying well

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5
Q

WHO state that palliative care provides

A

pain and symptom relief, spiritual and psychological support from diagnosis to end or life as well as bereavement care

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6
Q

palliative care is a philosophy that emphasises

A

quality of life

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7
Q

how can you tell when a patient needs palliative care?

A

supportive and palliative care indicators tool

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8
Q

what is the first aspect of the palliative care tool?

A

ACP

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9
Q

palliative care in GP practice

A

register of patients
meet to discuss cases
OOH are notified

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10
Q

WHO aims of palliative care

A 
provide relief from pain 
affirms life
dying is a natural process
doesn't hasten or postpone death 
psychological and spiritual care
support to life as actively as possible 
family support 
team approach 
bereavement counselling
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11
Q

team involved in palliative care?

A

macmillan nurses
CLAN
marie curie
religious groups

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12
Q

what is a good death?

A 
pain -free death 
open acknowledgment 
at home with friends and family 
'aware' death - resolved unfinished business 
death as personal growth 
death according to personal preference
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13
Q

Gold standards framework

A

offers tools to help primary care to provide good palliative care at home

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14
Q

breaking bad news - how

A 
listen 
setting 
understanding 
what do they want to know?
don't use jargon 
review and summarise 
allow questions
agree follow up and plan
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15
Q

reactions to bad news

A

Anger, Anxiety, Bargaining, denial, distress, fear, guilt, relief, sadness

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16
Q

stages of grief in Elizabeth Kubler model?

A

stability, immobilisation, denial, anger, bargaining, depression, testing, acceptance

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17
Q

15-20% of deaths occur in

A

hospices

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18
Q

gentle or easy death?

A

euthanasia

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19
Q

types of euthanasia

A

voluntary - patient request
noon voluntary - no request
physician assisted - provides the mean s and advice

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20
Q

most common reasons to request euthanasia?

A

fear of suffering

unrelieved symptoms

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21
Q

How can you respond if a patient requests euthanasia

A 
listen, acknowledge the issue 
try to understand why 
look for treatable problems or ways to help the patient feel more in control 
remember spiritual issues 
admit that you are powerless
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22
Q

what is sociology

A

study of development, structure and function of human society

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23
Q

what does medical sociology look at?

A

interactions with HCP
how people make sense of illness
behaviour and interactions of HCP

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24
Q

why is sociology important

A

can only promote healthy behaviour if we understand the way that different groups operate within society

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25
Q

the sick role

A 
exempt from daily duties 
not responsible for being ill 
needs the help of a professional 
must seek help 
social obligation to get better ASAP
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26
Q

Role of the HCP according to the sick role?

A 
objective - don't just patients
put the patient first 
obey professional code of practice 
maintain competence and skills 
right to examine, prescribe and has wide autonomy in medical practice
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27
Q

how many social classes and how is this worked out?

A

8

based on income and position within employment

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28
Q

social influences on health

A 
gender
housing 
health system
ethnicity
education 
employment 
environment
financial security
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29
Q

gender and morbidity and mortality?

A

men have higher mortality

women have higher morbidity

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30
Q

how does education effect health?

A

healthier

understanding, more engagement with screening and health care promotion

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31
Q

employment provides

A

income and financial security
social contacts
status in society
purpose in life

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32
Q

what may be the effect of services designed to improve the whole population health?

A

cervical screening
widens health inequalities
(poor uptake in those who would benefit most)

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33
Q

WHO definition of health inequality?

A

difference in health status or distribution of health determinants between different population groups?

34
Q

what is the key determinant of health inequalities?

A

deprivation

also age, gender and ethnicity

35
Q

examples of health inequalities in deprived areas?

A 
low birthweight 
breastfeeding - less
poor dental health 
obesity- higher
teenage pregnancy
36
Q

mortality in homeless people?

A

4x - death by unnatural causes

suicide - 35 x

37
Q

alcohol and drugs - effect on homeless?

A

less likely to be able to sustain their tenancy

38
Q

which diseases are higher in the homeless population?

A

TB, HIV, Hep C

poorer oral health

39
Q

Health care contact for homeless people?

A

1/3 not registered with GP

8x higher attendance at A&E

40
Q

what factors stop a person with LD accessing healthcare?

A

transport (not accessible)
not identified as having a LD
staff not understanding
failure to recognise illness or make the correct diagnosis
care professions not communicating or working together
not enough involvement from carers
inadequate follow up

41
Q

challenges for refugees?

A
  • more concentrated on family and social issues (ignore medical problems)
  • competing demands of different services
  • language barriers
  • struggle to establish care and referral for complex conditions
  • don’t understand the system of primary care or preventative medicine
  • poor care previously has exaggerated problems
  • PTSD, depression and anxiety
  • anti-immigrant sentiments make it even more difficult
42
Q

vulnerable groups?

A

learning disability
refugees
prisoners
LGBT

43
Q

inverse care law

A

those that need are less likely to receive medical care and vice versa

44
Q

how can we reduce health inequalities?

A 
effective partnerships (promote health, improve education)
evaluate and refine integration of health and social care
government policy and legislation 
invest in more vulnerable patient 
improve access 
reduce poverty 
social inclusion policies 
improve employment opportunities 
equal access to education 
improve housing
45
Q

sustainability

A

ability to continue over a period of time

46
Q

three levels of sustainability relating to healthcare?

A

global
is the NHS sustainable?
personal and career sustainability

47
Q

why is global sustainability important to healthcare?

A 
material inequality 
population and consumption
resource depletion
climate change 
loss of biodiversity 
crisis in healthcare
48
Q

action that could be taken to limit the impact of global sustainability

A 
increased use of renewable energy 
modify human behaviour 
plant based diets
educate about carbon use 
promote patient resilience
think of humans as part of a wider ecological system
49
Q

lowering carbon use as part of the NHS?

A 
prioritise environmental health 
use safer chemicals
reduce and safely dispose of waste 
efficient use of energy - or switch to renewables 
reduce water consumption 
improve travel strategy 
safe disposal of pharmaceuticals 
adopt greener building design and construction
50
Q

changes under the new GP contract?

A
  • reduce workload and improve recruitment (says BMA)
  • additional members of the GP team
  • changes in staffing and funding –> sustainability
  • reduce risk and promote sustainability
51
Q

resilience

A

quickly return to previous good condition

52
Q

what positive factors contribute to a sustainable career in medicine?

A 
job security 
financial security 
stable terms and conditions
respect professionalism and knowledge 
appreciated for being in role 
working with a team 
ability to develop knowledge and interests
ability to fit work are interests and lifestyle choices
53
Q

challenges to a sustainable career in medicine?

A
  • considerable and rapid workload
  • time management
  • care becoming more complex
  • results coming in too fast to have time to act on them in a well thought out way
  • care vs cure (challenges of long term conditions)
  • running a business
  • ensuring the team all work together effectively
54
Q

questions to ask in an occupational history?

A

present and previous jobs
exposure to chemicals or hazards (how long and how much?)
symptoms improve when not exposed?
did they use PPE?
is there measures to maintain PPE?
do others have similar symptoms?
are there known environmental hazards in use?
any hobbies, pets, overseas work, moonlighting?

55
Q

FIT note

A

evidence of assessment by doctor as to whether a patient is fit to work (not job specific)

56
Q

purpose of a FIT NOTE

A
  • allow earlier discussion about returning to work
  • items of consideration for employers on return to work
  • only completed by a doctor
  • it is meant as advice - not binding on the employer
  • does not affect statutory sick pay
57
Q

when is a fit note required?

A

patient has been off work for more than 7 consecutive days (including non working days)

58
Q

role of OH

A

ensure the health and wellbeing of the working population by preventing ill health and providing specialist rehabilitation advice

59
Q

what do OH do?

A
  • prevent work-related ill health
  • advise on fitness for work and workplace safety
  • recommend adjustments to ensure people stay in work
  • assist management of sickness absence
  • provide rehab to help people return to work
  • implement policies to maintain and healthy and safe workplace
  • conduct research into work related health issues
  • advise on medical health and ill-health retirement
60
Q

impact of unemployment on health?

A

poorer general health, long-standing illness
mental health problems, psychological distress
more medical consultations and hospital admissions

61
Q

benefits of re-employment?

A

improved self-esteem
improved general and mental health
reduced psychological distress and psychiatric morbidity

62
Q

any planned activity designed to enhance health or prevent disease?

A

health promotion

63
Q

name four areas affecting health and identify which are affected by health promotion?

A 
genetics
access
environment 
lifestyle 
(last 3 influenced by health promotion)
64
Q

three approaches to health promotion?

A

educational - provide knowledge
socioeconomic - makes healthy the easy choice - national policies
psychological - cycle of change, willingness and individual attitude

65
Q

what is the difference between health promotion, health education and health protection?

A

promotion - enhances health (included helath education and protection) can be planned or opportunistic

  • education = communication aimed to change knowledge, beliefs or behaviour in a way which is conducive to good health
  • protection = policies which are aimed at things beyond the control of the individual
66
Q

benefits of empowerment?

A
  • ability to resist social pressure
  • ability to utilise effective coping strategy when in an unhealthy environment
  • heightened consciousness of their actions
67
Q

examples of planned and opportunistic health promotion in primary care?

A

planned - posters, clinics, vaccinations

opportunistic - advice in consultation, smoking diet, take BP

68
Q

three ways the government can carry out health promotion?

A

legislation - legal age limits, smoking ban
economic - sugar tax
education - adverts on TV

69
Q

role of primary prevention

A

prevent onset of illness

reduces probability and/or severity

70
Q

annual flu vaccine is given from?

A

age 65 onwards

71
Q

secondary prevention is

A

detection of a disease at an early (preclinical) stage in order to cure, prevent or lessen symptoms

72
Q

Wilson’s criteria for screening

A

illness - is it important, is the natural history understood, is there an identifiable pre-clinical stage?
test - easy, acceptable, cost effective, sensitive and specific
treatment - acceptable, cost effective, better if given early

73
Q

tertiary prevention

A

measures to limit distress or disability caused by a disease (OT, Physio)

74
Q

why health promotion in childhood?

A

establish a healthy lifestyle early

role of parents

75
Q

factors to consider in adolescent consultations?

A

diet
exercise
sleep
social issues

76
Q

the UK has the highest number of what in Europe?

A

single parent families

77
Q

examples of social issues that children face?

A

single-parent families

screen time

78
Q

core principles of realistic medicine?

A
  • build a personalised approach to care
  • change our style to shared decision making
  • reduce unnecessary variation in practice and outcomes
  • reduce harm and waste
  • manage risk better
  • become improvers and innovators
79
Q

what makes a good doctor

A

knowledge
good listener
friendly and approachable
clear communication

80
Q

how can we reduce unnecessary variation in practice?

A

Randomised control trials

guidelines

81
Q

diseases where over diagnosis may be an issue? and which aim of realistic medicine does this relate to?

A 
prostate and thyroid cancer
asthma, 
CKD
ADHD 
(reduce harm and waste)
82
Q

5 questions promoting better conversation between clinicians and patients?

A
  • is the test, treatment or procedure needed?
  • what are the risks and benefits
  • what are the side effects?
  • are there simpler, safer or other options?
  • what would happen if I did nothing?

FOPC (2 decks)

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