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Theme C continued > From consent onwards > Flashcards

From consent onwards Flashcards

1
Q

What is consent?

A

Voluntary agreement given by a competent patient that has been fully informed

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2
Q

What are the 3 requirements for valid consent?

A

Informed
Voluntary
Has capacity

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3
Q

What are the 4 forms of consent?

A

Oral
Written
Implied
Expressed

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4
Q

What information does the patient need as part of the consent process?

A

Potential benefits
Potential risks
Alternative treatment options

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5
Q

When is consent required?

A 
Before examination
Before treatment or care
Before disclosure of confidential information
For screening
For teaching
For research
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6
Q

Why is consent needed?

A

Helps trust between patient and doctor
Legal requirement
Respects autonomy
Professional duty

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7
Q

What is the Bolam Principle?

A

Practitioners are not negligent if they act in accordance with the practice accepted by a responsible body of medical opinion

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8
Q

What is negligence?

A

The concept of failure to exercise care

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9
Q

What is capacity?

A

Determined by a physician, refers to an assessment of the individuals ability to understand, appreciate and manipulate information to form rational decisions

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10
Q

What act focuses on who has capacity?

A

Mental capacity act 2005

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11
Q

Who does the mental capacity act apply to?

A

People over age 16

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12
Q

Which act says a 16 year old has full capacity?

A

The family law reform act 1969

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13
Q

What is Gillick competence?

A

A child under 16 can consent to medical treatment if deemed to be competent by a medical professional, without need for parental knowledge or consent

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14
Q

What is a POM?

A

Prescription only medicine

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15
Q

What is a P?

A

Pharmacy medicine- can get under pharmacist supervision

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16
Q

What are OTC drugs?

A

For sale over the counter, without any medical advice etc.

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17
Q

Why are P drugs used?

A

Pharmacists can ask customers questions about symptoms etc.
Ensures no red flags about how long the patient can use it for
Duration of symptom may mean its not safe to self-treat

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18
Q

Who regulates these medicines?

A

MHRA- medicines and healthcare regulatory authority

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19
Q

When can a POM change to a P?

A

When there is no danger when used correctly without doctor supervision

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20
Q

When can it go from a P to OTC?

A

When it can safely be used without pharmacy supervision

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21
Q

Name 4 community pharmacy schemes?

A

Minor ailment schemes
Emergency contraception
Smoking cessation
Health education

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22
Q

Self medication scale say patients fit into 3 main categories, what are they?

A

People reluctant to take analgesics
People who don’t think twice about taking analgesics
People who prefer to let pain run its course

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23
Q

What is quantitive data?

A

Discrete- only certain values possible
OR
Continuous- any value is possible

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24
Q

What is qualitative data?

A 
Multinominal- categories aren't ordered
OR
Ordered- categories exhibit logical order
OR
Dichotomous- 2 categories that oppose
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25
Q

What are descriptive statistics?

A

Data is collected and summarised and described in terms of means, SD’s etc.

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26
Q

What is ecological fallacy?

A

Inferences about nature of individuals are deduced from inference for the group to which they belong

27
Q

What are inferential statistics?

A

Using statistical tests to make generalisations about a population

28
Q

What are nominal data, ordinal data and interval data?

A

Nominal- categorical e.g. sex
Ordinal- categories ordered in value e.g. degree of pain
Interval- continuous data with equal intervals e.g. age, height, weight

29
Q

What are measure of locations with data?

A

Mean- average of all observations
Median- midpoint of the data set
Mode- Most frequent observation

30
Q

What are measure of dispersion with data?

A

Standard deviation
Interquartile range
Range

31
Q

What is a hypothesis?

A

An idea expressed in such a way that it can be tested and refuted

32
Q

What is a null hypothesis?

A

The hypothesis that there is no difference between 2 groups

33
Q

What is a P value?

A

The probability that the difference between groups would be as big or bigger than that observed if the null hypothesis is true

34
Q

At what point is statistical significance generally accepted?

A

P=0.05- statistically significant, strong evidence against null hypothesis so can reject hypothesis

35
Q

What is standard error?

A

Describes how good a given estimate is
Tells you how good your sample statistic is
Looks at how accurate your estimation of the mean is

36
Q

What is a confidence interval?

A

Range of values that we think contain the mean, confidence limits are the actual upper and lower boundaries of this

37
Q

Difference between race and ethnicity?

A

Race is genetic

Ethnicity is socially determined

38
Q

Why is ethnicity important in medicine?

A

Disease prevalence varies with ethnicity
Best treatment may vary by ethnicity
Affects behaviour towards others
Can look at the patient according to their own values

39
Q

What is ethnocentricity?

A

Judging 1 culture based on the values of another

40
Q

What anaemia’s are genetic?

A

Sickle cell

Thalassaemia

41
Q

What are the primary, secondary and tertiary management principles associated with sickle cell?

A

Primary- carrier screening
Secondary- Postnatal screening
Tertiary- treatment, preventative, therapeutics

42
Q

How do we decide who to screen?

A

Cost- would cost a lot to screen everyone
Could be seen as racist to screen certain people and not other by race
How is ethnicity determined to know who to screen?

43
Q

What is risk?

A

Probability that an event will occur during a specified time, only works if period is fixed

44
Q

What is relative and absolute risk?

A

Absolute- risk of developing the disease over a time period
Relative- the ratio of the probability of developing an outcome in those exposed compared to those not exposed (risk ratio)

45
Q

How to calculate risk ratio?

A

Risk in exposed divided by risk in non exposed
Risk ratio of 1 means no difference in risk between the 2 groups
Risk ratio of less than 1 means the risk is lower in experimental group than control group

46
Q

What is absolute risk reduction?

A

Difference in risk between study and control populations

47
Q

What is confidentiality?

A

Pledge of agreement to not divulge or disclose information about patients to others

48
Q

Why is it important to maintain confidentiality?

A 
Improves trust between patient and doctor
Respects autonomy
Prevents patient harm
Virtuous
Human rights act
GMC requirement
49
Q

When can confidentiality be breached?

A

Statute (law)
Consent by patient
Public best interest

50
Q

Name some laws that oblige doctors to disclose information?

A

Public health act 1984
Road traffic act 1988
Prevention of terrorism act 1989

51
Q

What is a cross-sectional survey?

A

Descriptive study, observational.

Analyses data from a population at 1 point in time

52
Q

What is an ecological study?

A

Disease rates and exposures are measured in a series of populations and examined

53
Q

What is a cohort study?

A

Prospective- have a group of people with or without risk factors and see if they develop a particular disease

54
Q

What is a case control study?

A

Retrospective- have a group of people with a disease and look back to see if they had a certain risk factor e.g. if they smoked

55
Q

What is a case report?

A

Detailed report of symptoms, signs, diagnosis, treatment and follow up of individual patient

56
Q

What is a qualitative study?

A

Seeks to understand people’s perspectives and motivations

57
Q

What is a randomised control trial?

A

Experiment where participants are randomly allocated into groups
Compare the experimental groups and control groups for outcomes

58
Q

Why randomise trials?

A

Eliminates systematic bias

Basis for statistical tests

59
Q

What types of bias are there in RCTs?

A

Selection bias
Ascertainment bias
Performance bias

60
Q

What is temporal change?

A

People get better or worse irrespective of medical intervention
Hard to distinguish whether medical action or temporal change is responsible

61
Q

What is regression towards the mean?

A

If a variable is extreme on its first measurement, it will tend to be closer to average on its second

62
Q

What is statistical power?

A

The probability of rejecting a null hypothesis when it is false

63
Q

What is a type 1 error?

A

False positive- rejecting null hypothesis when should have accepted it

64
Q

What is a type 2 error?

A

False negative- accepting the null hypothesis when should have rejected it

Theme C continued (4 decks)

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