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Phase 3A > GP lectures > Flashcards

GP lectures Flashcards

1
Q

Dangers of overprescribing antibiotics

A

Unecessary side effects
Medicalise self limiting conditions
Antibiotic resistance

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2
Q

Purposes of primary care

A

Managing illness and clinical illness over time
Finding the best available clinical solutions to clinical problems
Preventing illness
Promoting health

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3
Q

Epigenetics

A

Expression of the genome depends on the environment

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4
Q

Allostasis

A

Stability through change

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5
Q

What is allostatic load

A

Long term overtaxation of our physiological systems leads to impaired health (the pathophysiology of stress)

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6
Q

Salutogenesis

A

Favourable physiological changes secondary to experiences which promote healing and health

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7
Q

Define domestic abuse

A

Any incident or pattern of incidents of controlling, coercive, threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality

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8
Q

Give some types of domestic abuse

A 
Pscyhological
Physical
Sexual
Financial
Emotional
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9
Q

How does domestic abuse affect health

A

Traumatic injuries following assault
Somatic problems or chronic illness
Psychological or psychosocial problems

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10
Q

Standard domestic abuse risk

A

Current evidence does not indicate likelihood of causing serious harm

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11
Q

Medium domestic abuse risk

A

Idenitifiable indicators of risk of serious harm

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12
Q

High domestic abuse risk

A

Identifiable indicators of imminent risk of serious harm

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13
Q

How to deal with domestic and sexual abuse as a GP

A 
Display posters
Focus on safety
Ask direct questions
Be clear that behaviour is not ok
Give info
Be part of the process
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14
Q

Practical advice to domestic abuse patients

A

Phone a helpline

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15
Q

Domestic abuse MARAC

A

Single meeting about the abuse

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16
Q

IDVA

A

Service that works with high risk women

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17
Q

DHR

A

Review of circumstances surrounding domestic abuse deaths

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18
Q

Determinants of health

A

Genes
Environment
Lifestyle
Health Care

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19
Q

Horizontal equity

A

Equal treatment for equal need

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20
Q

Vertical equity

A

Unequal treatment for unequal need

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21
Q

Examining health equity

A 
Supply of healthcare
Access to health care
Utilisation of health care
Health care outcomes
Health status
Resource allocation
Wider determinants of health
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22
Q

Three domains of public health

A

Health improvement
Health protection
Improving services

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23
Q

Health needs assessment definition

A

Systematic method for reviewing the health issues facing a population, leading to agreed priorities and resource allocation that will improve health and reduce inequalities

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24
Q

Define felt need

A

Individual perceptions of variation from normal health

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25
Q

Define expressed need

A

Individual seeks help to overcome variation in normal health

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26
Q

Define normative need

A

Professional defines intervention appropriate for the expressed need

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27
Q

Define comparative need

A

Comparison between severity, range of interventions and cost

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28
Q

Public health approach to health needs assessment

A

Epidemiological
Comparative
Corporate

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29
Q

Epidemiological approach to health needs assessment

A 
Define problem
Size of problem
Services available
Evidence base
Models of care
Existing services
Reccomendations
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30
Q

Comparative approach to health needs assessment

A

Compares the services received by a population with others

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31
Q

Corporate approach to health needs assessment

A

Takes everyones views into account

Commisioners
Providers
Professionals
Politicians
Press
Patients
Opinion leaders
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32
Q

What is health psychology

A

Emphasises the role of psychological factors in the cause, profession and consequences of health and illness

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33
Q

3 main categories of health behaviours

A

Health Behaviour
Illness Behaviour
Sick role Behaviour

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34
Q

Define health behvaiour

A

A behaviour aimed to prevent disease

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35
Q

Define illness behaviour

A

A behaviour aimed to seek remedy

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36
Q

Define sick role behaviour

A

Any activity aimed at getting well

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37
Q

What is unrealistic optimism

A

Individuals continue to practice health damaging behaviour due to inaccurate perceptions of risk and susceptibility

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38
Q

What influences perceptions of risk

A

Lack of personal experience with problem
Belief that preventable by personal action
Belief that if not happened by now, its not likely to

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39
Q

Define need

A

Ability to benefit from intervention

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40
Q

8 NICE guidance steps on behaviour change

A 
Planning interventions
Assessing the social context
Education and training
Individual level interventions
Community level interventions
Population level interventions
Evaluating effectiveness
Assessing cost effectiveness
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41
Q

3 core principles of the NHS

A

meets needs of everyone
Free at point of delivery
based on clinical need not ability to pay

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42
Q

Health inequality definition

A

Preventable unfair and unjust differences in health status between people of different backgrounds

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43
Q

Inverse care law

A

Good medical or social care tends to vary inversely with the need of the population served

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44
Q

Vulnerable groups in NHS

A 
Homeless
Refugees
Asylum seekers
Elderly
LGBTQ
Travellers
Ex prisoners
Care leavers
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45
Q

Reasons why people may find it difficult to access care

A

Language
Cultural
No address
Fear

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46
Q

Maslows heirachy of needs

A 
Physiological
Safety
Love/ Belonging
Esteem
Self actualisation
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47
Q

Define homeless

A

People without a home or safe living space of their own

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48
Q

Causes of homelessness

A 
Breakdown of relationships
Addiction
Mental health
Poverty
Domestic abuse
Unemployment
"eviction from private landlords"
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49
Q

Where are homeless people on maslows heirachy

A

The bottom “physiological”

50
Q

Health problems in homeless people

A 
Malnutrition
Mental Illness
Substance misuse
Alcohol misuse 
Infectious diseases
STI
Poor feet and teeth
DVT and leg ulcers
51
Q

Life expectancy for homeless people

A

42 for women

44 for men

52
Q

Life expectancy for population

A

81 for women

76 for men

53
Q

Barriers to health for homeless

A

Lack of address
Lack of phone
Prioritising food etc
Drugs

54
Q

Services available for homeless people

A

Charities

55
Q

Traveller definition

A

People who are committed to a nomadic or travelling lifestyle and see travelling as an important part of their ethnic or cultural identity

56
Q

Traveller health prolems

A 
Anxiety
Pregnancy complications
Chronic bronchitis
Asthma
Smoking 
Angina
Fewer vaccinations
57
Q

Traveller barriers to healthcare

A

Language
Cultural
Fear
Education

58
Q

Services for travellers

A

Health worker and hub

59
Q

Infections likely if unvaccinated

A

Haemophilus influenza b, dipertheria

60
Q

Cause of epiglotitis

A

Hib

61
Q

LGBTQ health problems

A

Mental health

Substance abuse

62
Q

LGBTQ problems in accessing healthcare

A

Stigmatised
Discomfort/ fear of LGBTQ status
Previous negative experiences

63
Q

Reasons for homelessness in LGBTQ

A

Social isolation
Discrimation
Relationship problems
Victims of crime

64
Q

Problems for trans people in healthcare

A

Screening
Reference ranges
Effect of hormones on normal values

65
Q

Define asylum seeker

A

A person who has made an application for refugee status

66
Q

Refugee definition

A

A person granted asylum and refugee status. Usually means leave to remain for 5 years then reaaply

67
Q

Define indefinite leave to remain

A

When a person is granted full refugee status and given permenet residence in the UK

68
Q

Define unaccompanied child

A

Someone under 18 who has entered without parent or guardian

69
Q

What do asylum seekers have access to

A

Financial support
Temporary housing
NHS care
Education

70
Q

What are asylum seekers not entitled to

A

Employment

Benefits

71
Q

What are failed asylum seekers entitled to

A

Money, housing NHS care (only emergency)

72
Q

Asylum seekers health problems

A 
PTSD
Depression
Sleep disturbance
Psychosis
Slef harm
Presenting as physical symptoms
73
Q

Asylum seekers problems in accessing health problems

A

Language barrier
Health not a priority
Education

74
Q

Types of exploitation

A 
Sexual
Domestic servitude
Forced labour
Forced crime
Organ harversting
75
Q

Gender split of trafficked people

A

51% female. 2/3 children.

76
Q

Impact of trafficking on health

A

PTSD
Contact dermatitis
Work with no equipment
Pregnancy

77
Q

Red flags for trafficking

A

Timid
Terrified
Accompanied by controlling person

78
Q

Do you need to deal with immigration status

A

Just focus on patient you arent an immigration officer

79
Q

Name some models and theories of behaviour change

A

Health belief model
Theory of planned behaviour
Stages of theoretical model

80
Q

What is the Health Belief Model

A

Individuals will change if they believe that

  • theyre susceptible
  • theres consequences
  • action reduces susceptibility
  • benefits outweigh risks
81
Q

What is theory of planned behaviour

A

Intention determine by

  • attitude to behaviour
  • social norm
  • able to, percieved behaviour control
82
Q

Stage models of health behaviour

A

Stage theories see individuals located at discrete ordered stages rather than on a continuum

83
Q

Stages of trranstheoretical model

A 
Pre contemplation
Contemplation
Preparation
Action
Maintenance
84
Q

Define evaluation in the context of health services

A

Evaluation is the assessment of whether a service achieves its objectives

85
Q

Methods of classification of health outcomes

A

Mortality
Morbidity
Quality of life
Patient satisfaction

86
Q

Maxwells dimensions of quality (3Es, 3As)

A 
Effectiveness
Efficiency
Equity
-Acceptability
-Accessibility
-Appropriateness
87
Q

Define malnutrition

A

Malnutrition refers to deficiencies, excesses or imbalances in a persons intake of energy and or nutrients

88
Q

Early influences on feeding behaviour

A 
Maternal diet (early flavour exposure) and taste preference
Role of breastfeeding 
Parenting practises
Influences
Food exposures
89
Q

What is colostrum

A

Fat, protein protective factors; for 3 days after birth

90
Q

What is foremilk

A

Beginning of a feed- watery

91
Q

What is hindmik

A

End of a feed- energy dense

92
Q

Advantages of breast milk

A

Enzyme digestion
Gut protection
Anti infective
Everyday health

93
Q

Why should doctors know about nutrition

A

Enough knowledge to educate and advise patients effectively

94
Q

Diabulimia

A

Underdose on insulin to cause weight loss

95
Q

Sarcopenic obesity

A

Loss of muscle, gain weight

96
Q

When do children start tasting and smelling

A

Before birth

97
Q

Food neophobia

A

Fear of new foods, aged 2 to 6

98
Q

How does breast milk affect later diet

A

Formula fed babies are less accepting of new foods

99
Q

3 basic forms of dieting

A

Restrict total amount fo food eaten
Don’t eat certain types of food
Avoid eating for long periods

100
Q

Define restrained eating

A

Deliberate attempt to inhibit food intake in order to maintain or lose weight

101
Q

Why can dieting be unsuccesful

A

Consisdered individual differences

Explored portion sizes

102
Q

4 features of addiction

A

Craving
Tolerance
Compulsive drug seeking behaviour
Physiological withdrawal state

103
Q

Acute physical effects of dependent drug use

A

Complications of injecting (DVT, abscesses, SBE)
Overdose (respiratory depression)
Poor pregnancy
Side effects (contipation, low salivery flow)

104
Q

Chronic physical effects of dependent drug use

A

Blood borne virus transmission
Effects of poverty
Side effects of cocaine (vasoconstriction, local anaesthesia)

105
Q

Social effects of dependent drug use

A

Effects on families
Drive to criminality
Imprisonment
Social exclusion

106
Q

Psychological effects of dependent drug use

A

Fear of withdrawal
Craving
Guilt

107
Q

Aims of addiction treatment

A

Reduce harm to user, family and society
Improve health
Stabilise lifestyle and reduce use
Reduce crime

108
Q

Modalities of addiction treatment

A 
Harm reduction
Detoxification
Maintenance
Relapse prevention
Psychological interventions
Alternative therapies
109
Q

Which drugs are sued for detoxification for opioids

A

Lofexidine, buprenorphine

110
Q

Which drugs are used for maintenance on opioids

A

Methadone, buprenorphine

111
Q

Which drugs are used for relapse prevention on opioids

A

Naltrexone

112
Q

Key questions for initial addiction assessment

A 
Which drug
Route
How long addicted
Pt goal
?Referral
113
Q

When is quick detoxification more successful

A

Young user
Less time addicted
Not injecting
Lower level of drug use

114
Q

Drug used for quick detoxification

A

Buprenorphine

115
Q

Do you get seizures in opiate or alcohol withdrawal

A

Alcohol

116
Q

Heroin effects

A

Euphoria, relaxation, miosis, drowsiness

117
Q

Heroin adverse effects

A

Dependence and withdrawal

118
Q

Alcohol addiction drug

A

Chlordiazepoxide

119
Q

Drug which makes alcohol taste bad

A

Disulfiram

120
Q

Facial features of fetal alcohol syndrome

A 
Low nasal bridge
Epicanthal folds
Minor eat abnormalities
Short nose
Thin upper lip
Indistinct philtrum

Phase 3A (25 decks)

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