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1
Q

What are the two types of decision making?

A

Analytic

Intuition

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2
Q

What are the five stages of grief?

A

denial, anger, bargaining, depression, acceptance

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3
Q

What is allostasis?

A

The emerging science of stress

Stability through change

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4
Q

What is epigenetics?

A

How a person’s biography and biology interacts

genetic predisposition

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5
Q

What are the levels of Maslow’s hierachy of needs?

A 
self-actualisation 
esteem 
love/belonging 
safety 
physiological
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6
Q

What are the 5 questions of Fraser competency?

A
  1. sufficient maturity and intelligence to understand treatment
  2. cannot be persuaded to tell parents
  3. They are very likely to continue having sex with or without contraception
  4. their physical or mental health will suffer without advice or treatment
  5. advice or treatment is in their best interests
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7
Q

What are the 3 categories of health behaviour?

A

health behaviour
illness behaviour
sick role behaviour

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8
Q

In the theory of planned behaviour, what are 3 factors that influence behaviour?

A

attitudes
sujective norm
perceived behavioural control

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9
Q

In the theory of planned behaviour, what are 3 methods to make intention into behaviour?

A

anticipated regret
prepatory action
relavance to self

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10
Q

What are the 4 main models of behaviour change?

A

health behaviour model
theory of planned behaviour
transtheoretical model
social norms theory

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11
Q

What are some issues related to polypharamacy?

A

Increased prescription error
More SE
Decrased compliance
Worse quality of life for patients

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12
Q

What are the 3 main types of ethics in medical ethics?

A
  • Consequentialism/utilitarianism - act is evaluated solely in terms of its consequences
  • Virtue ethics - mortality of action is based on character of agent
  • Deontology - mortality of an action based on action’s adherence to rule or rules
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13
Q

What are the 4 principles of medical ethics?

A

autonomy, non-maleficence, beneficence, justice

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14
Q

What are the 5 focal virtues of biomedical ethics?

A

compassion, discernment, trustworthiness, integrity, conscientiousness

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15
Q

What is the doctrine of dual effect?

A

normally if you carry out an action knowing that X is a likely consequence of that act then the law regards you as intending to cause X

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16
Q

What is the seedhouse ethical grid?

A

a way of thinking about a situation in a structured, coherent and recoverable - moral theory
individuals, duties, motives, consequential, external considerations

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17
Q

What is the four quadrants approach?

A

medical indications
patient preferences
quality of life
contextual features

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18
Q

What are the duties of a doctor?

A

knowledge, skills and performance
safety and quality
communication, partnership and teamwork
maintaining trust

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19
Q

Name the 4 aspects of patient centered medicine

A

Compliance model - extent that patient follow advice
Adherence model - patient’s beliefs influence compliance
Patient centeredness
Concordance - discussion between patients and professionals

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20
Q

What are 3 theories for inequalities in health?

A

Neo materialist explanation - economic disadvantages account for the inequalities observed
Psychosocial explanation - access to resources including social support and health care are key social determinants for inequalities in health
Inverse care law

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21
Q

What is standard deviation?

A

measure of the average distance of data from the mean

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22
Q

What is standard error?

A

standard deviation of the sample mean’s estimate of a population mean

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23
Q

What is confidence interval?

A

describe the amount of uncertainty associated with a sample estimate of a population parameter

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24
Q

What is the interquartile range?

A

difference between upper and lower quartiles

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25
Q

What is the conformational bias?

A

the tendency to look for confirming evidence to support diagnosis rather than look for disconfirmation evidence

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26
Q

What is a social class?

A

A measure of occupation, stratification, social position and access to power and resources

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27
Q

What are some things stated by marmot review?

A
  • give every child the best start in life
  • enable all children, young people and adults to maximise their capacities and have control over their lives
  • create fair employment and good work for all
  • ensure a healthy standard of living for all
  • create and develop healthy and sustainable places and communities
  • strengthen the role and impact of ill health prevention
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28
Q

Name 4 things involved in reviewing research

A

validity, reliability and applicability

meta-analysis

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29
Q

What is the p value?

A

probability of obtaining the test statistic from the data, assuming that the null hypothesis is true

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30
Q

What is sociology?

A

The study of social relations and social processes

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31
Q

What is the name of the criteria for causation and name at least 3 criteria?

A

Bradford Hill criteria
-strength, consistency, specificity, temporal sequence, temporal sequence, dose response, experimental evidence, biologic plausibility, coherence, analogy

32
Q

What is the risk ratio?

A

risk in exposed/risk in unexposed = relative risk/risk ratio

33
Q

What is attributable risk?

A

absolute risk reduction/attributable risk/risk difference = risk in exposed-risk in unexposed

34
Q

What is number needed to treat?

A

1/attributable risk or absolute risk reduction

35
Q

What is the name and 10 things involved in screening criteria?

A

Wilson’s screening criteria

  • important health problem
  • treatment
  • facilities for diagnosis and treat
  • recognised late and early
  • suitable test
  • test acceptable
  • natural history understood
  • policy on who to treat
  • cost-effective
  • case finding should be continuous
36
Q

What are some disadvantages of screening?

A

overdetection of subclinical disease
SE of screening
anxiety of patients

37
Q

What is lead time bias?

A

early identification doesn’t alter outcome but appears to increase survival
e.g. patient knows they have it longer

38
Q

What is length time bias?

A

disease that progresses more slowly is more likely to be picked up by screening which makes it appear that screening prolongs life

39
Q

What are RF for health inequality?

A

PROGRESS
place of residence, race or ethnicity, occupation, gender, religion, education, socioeconomic status, social capital or resources

40
Q

What is the definition of health?

A

a state of complete physical, mental and social wellbeing, Not merely the absence of disease

41
Q

What are 5 articles in the Human Rights Act 1998 relavent to health care?

A

2 - right to life
3 - right to freedom from inhuman and degrading treatment
8 - right for privacy and family life
12 - right to marry and found a family
14 - right to freedom from discrimination

42
Q

What is an error and name 9 types?

A

an intended outcome

  • sloth error
  • lack of skill
  • communication breakdown
  • system failure
  • human factors
  • judgement failure
  • neglect
  • poor performance
  • misconduct
43
Q

What is bolam and bolitho in evaluating negligence?

A

Bolam - would a group of reasonable doctors do the same?

Bolitho - would that be reasonable? (evidence)

44
Q

What are the 3 domains of public health?

A

health improvement
health protection
improvement of services

45
Q

How do you manage diarrhoea in hospitals/nursing homes?

A

SIGHT
suspect c.diff as cause, isolate, gloves, handwashing, test for toxin
Treat with metronidazole or vancomycin

46
Q

What is the criteria for flu pandemic and which influenza strain is most likely to cause that?

A

novel virus
capable of infecting humans and causing human illness
large pool of susceptible people
ready and sustainable transmission from person to person
Influenza A

47
Q

What is the reproductive nubmer?

A

mean number of secondary cases following a single infection

48
Q

What is the circle for health needs assessment?

A

needs assessment - planning - implementation - evaluation - needs assessment -

49
Q

What is the health belief model?

A

modifying variables, perceived susceptibility & perceived seriousness — perceived benefits and barriers, perceived threat, self-efficacy, cues to action — liklihood of engaging in health-promoting behaviour

Perceived susceptibility to ill health, perceived severity of ill health, perceived benefits of behaviour change, perceived barriers to taking action

50
Q

What is horizontal and vertical equity?

A

horizontal - equal treatment for equal need

vertical - unequal treatment for unequal need

51
Q

What are the 3 factors in venn diagram of health needs?

A

Need
Supply
Demand

52
Q

What are some models of behaviour change?

A 
health belief model 
theory of planned behaviour 
stages of change/transtheoretical model 
social norms theory 
motivational interviewing 
social marketing 
nudging 
financial incentives
53
Q

What are some negatives of theory of planned behaviour?

A

Does not include relapse

relies on self-reporting

54
Q

What is the libertarian approach to resource allocation?

A

patient is responsible for own health and wellbeing (German health technique)

55
Q

What is the rule of rescue?

A

A.R.Jonsen 1986

pereived duty to secure endangered life where possible

56
Q

What are some drugs involved in renal transplant?

A

erythropetein - hormone produced by kidney to stimulate RBC production
septrin/trimetroprim
tacrolimus - immunosupressive to decrease chance of rejection
growth hormone

57
Q

What are some causes of erythema nodosum?

A

oral contraceptive pill, TB, strep, sarcoidosis

58
Q

What is a never event?

A

A significant, largely preventable event that would not occur if the relevant safety guidelines are followed e.g. misidentification

59
Q

What are 3 intestinal or 3 extra-intestinal symptoms of IBD?

A

intestinal - abdominal mass, bloody diarrhoea, fistula, anal skin tags
extra - mouth ulcers, sore joints, conjunctivitis, erythema nodulosum

60
Q

What would Crohn’s look like on histology?

A

crypt absess, goblet cell depletion, lymphocyte infiltration

61
Q

What are some side effects of steroids?

A

weight gain, increased infection, osteoporosis, thin skin, puffy face

62
Q

What are some causes of weight gain?

A 
obesity
hypothyroidism
drugs e.g. steroids 
Cushing's syndrome 
Depression
63
Q

How would you calculate BMI?

A

weight in kg / height in m squared

64
Q

What are BMI groups?

A

underweight <18.5
normal 18.5-24.9
overweight 25-29.9
obese >30

65
Q

What are some causes of weight loss?

A 
malignancy
thyrotoxicosis, DM
malabsorption - coeliac, bowel resection, IBD 
chronic disease 
psychiatric - anorexia, bulimia, depression 
failure to thrive in infancy 
addison's disease 
AIDs
66
Q

What are 3 categories for causes of tiredness?

A

physiological
psychological
physical

67
Q

What are some physiological causes of tiredness?

A 
pregnancy
disturbed sleep
old age 
overexertion 
menopause
obesity/underweight
68
Q

What are some psychological causes of tiredness?

A

psychological distress
depression
anxiety
eating disorders

69
Q

What are some physical causes of tiredness?

A

malignancy, CKD, DM, chronic infection, post viral fatigue
autoimmunity, hypothyroidism, anaemia, malabsorption, heart failure, obstructive sleep apnoea
narcolepsy, chronic fatigue syndrome

70
Q

What are some red flag symptoms in tired history?

A 
weight loss
lymphadenopathy 
night sweats 
low mood 
muscle or joint pain 
focal neuro signs 
history of travel or insect bites
71
Q

Why does obesity cause tiredness?

A

increased exertion
increased risk of physcial causes of tiredness (e.g. DM)
pro-inflammatory state
psychological distress

72
Q

What is the diagnosis of exclusion if patient presents with tiredness?

A

chronic fatigue syndrome/ME

- functional

73
Q

What are some symptoms of ME?

A

post-exertional fatigue for few days
poor concentration
sleeping problems
pain

74
Q

What are some physical causes of obesity?

A

Cushings
depression
hypothyroidism
prader Willi

75
Q

What is the age that you 100% can not give contraceptive advice to?

A

13 or under - contact social services

76
Q

What examinations should you do for every headache presentation?

A

cranial nerves
fundoscopy
- rule out tumours

GP (11 decks)

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