GI and Surgery Flashcards
Effect of stomas on image
anxiety, depression, QOL and ADL change, relationship
Shock, denial, acknowledgement and resolution
Define food poisoning
Gastroenteritis with an infectious cause
Who needs special precautions with food poisoning
Pregnant women
Young children/elderly
Immunosuppressed (or people close to them)
Work in food prep
What does the food act 1990 define
Defines food and enforcement authorities and their responsibilities
You cannot sell food unit for consumption or display food with a false label
What does section 11 of the public health control of diseases act state
You must notify local authority of any food poisoning
Rapid onset (less than 12 hrs) food poisoning organisms
Staph aureus: cooked food that is then contaminated –> toxin
Bacillus cereus: after eating cooked rice
Intermediate onset (12-48 hrs) food poisoning organisms
Norovirus: most common, RNA virus spread in close environments
Clostridium: normal flora, slow cooling/unrefrigerated food
E.coli: from milk/meat (cattle) –> watery diarrhoea and HUS
Shigella: contaminated food, watery + bloody diarrhoea
Late onset (days) food poisoning organisms
Campylobacter: common, undercooked/raw poultry, unpasteurised milk, bloody diarrhoea
Salmonella: eggs, poultry or water infected with faeces, late summer (typhoid)
Cryptosporidium: foreign travel, swimming pool or camping (severe if immunosupressed)
Legionella: Water (AC), cough, fever, D+V
Dealing with community outbreak of food poisoning
Identify and isolate source and treat individual
Dealing with infective diarrhoea in hospital
Rapid isolation and identification
Monitor protocols
Communication
Suspend admissions and visitors
Purpose of an MDT
Recommend treatment plans, collect information and refer
Risk factors for liver disease
Alcohol
Hep B/C
Genetics (haemachromatosis, A1AT, Wilsons)
Budd-Chiari
Autoimmune
Drugs (methotrexate, amiodarone, paracetamol, steroid, statin)
Hepatitis Vaccinations
Hep A: vaccinate if high risk, occupational risk, long term damage
Hep B+C
Transmission of Hep B and C
Needles, tattoo, sex
Define the term screening
The application of a test to identify individuals at sufficient risk of a disorder to warrant investigation or direct preventative action amongst persons who have not sought medical attention to account for the symptoms
2 key features of screening
Cost effective
Improve outcomes
How can you assess cost effectiveness
Number of years saved (cost-effectiveness analysis)
5 key points of the condition in screening
Condition: important, prevalent and progression understood, latent period/early symptomatic stage
5 key points of the test in screening
Simple, safe, precise, acceptable, agreed procedure with the positive results
Key point about the treatment in screening
Evidence that the treatment is more effective if given earlier
Key point about the programme in screening
Evidence it is effective in outcomes and outway costs/harms
4 dangers of screening
False positives/negatives, costs, side effects of test and treatment, public perception
Most common cancer ein the UK
Breast
7 RF for breast cancer
Low socio-economic status, family history, white, alcohol, ionising radiation, increased oestrogen exposure
Explain the standard breast screening programme
Invited between 50 and 70 and screened every 3 years
3 outliers for breast screening
47-73 in some parts of the country
Over 70 can still have it but need to ask
Moderate risk (FHx): yearly from 40-60 High risk (BRACA): yearly MRI/mammogram from 30-60
3 benefits to breast screening
Early identification means increased cure rate
Reduce deaths
Detects 90% of cancers
3 negatives to breast cancer screening
False positives and negatives give unnecessary anxiety/reassurance
Overdiagnosis/treatment - find cancer that would never have caused disease
Side effects of treatment - radiation can cause breast cancer
Explain bowel cancer screening
Male and Female over 55 offered one off flexible sigmoidoscopy test to look for polyps
60-74 offered FOB every 2 years (over 75 can ask)
Explain cervical screening
Women aged 25-49 every 3 years
Women aged 50-64 every 5 years
Other screening tests
Diabetic retinopathy Chlamydia Downs syndrome Foetal abnormalities Newborn hearing Newborn bloodspot
Explain the organisation of breast screening services
GP refer to triple assessment
- clinical examination
- ultrasound below 35, mammography and ultrasound above 35
- histology/cytology
Psychosocial impact of breast cancer diagnosis
Worry about the future (death, treatment)
Worry about responsibility, time off work
Reactions of family and society
Delayed presentation in breast cancer
Less likely to delay
Socioeconomic status, time off work, financial costs
Influenced by family
Worry about the diagnosis
