GP & Pub Health Flashcards
Name 5 common anxiety disorders
Generalised anxiety disorder (GAD) Social anxiety disorder Panic disorder Post-traumatic stress disorder (PTSD) Obsessive-compulsive disorder (OCD) Phobias
What is a self-limiting disease?
A disease process that resolves spontaneously with or without specific treatment.
What is public health?
How is it done?
Science and Art of:
- Preventing disease,
- Prolonging life and promoting health
(Done through)
organised effort and informed choices of society, organisations, individuals and public & private communities
What is screening?
Process of identifying apparently healthy, asymptomatic people who may be at increased risk of a disease or condition.
What are important stages to make screening possible?
Identifying the eligible population.
Informing individuals and offering screening examination.
Facilitating uptake.
Undertaking screen examination.
Diagnosis and intervention for individuals who screen positive.
Primary investigations for gynaecomastia?
LFTs
70% of our total testosterone is bound to a protein called sex hormone-binding-globulin (SHBG). SHBG is produced in our livers and plays an important role in regulating the amount of free testosterone in our bodies.
TSH
Gynaecomastia is caused by hormonal changes resulting from liver problems or testicular lumps. You may need to have an ultrasound scan of the breast, and occasionally a biopsy.
Zopiclone
Drug Class?
Indication?
Benzodiazepiene
Sleeping pill that treat bad insomnia.
Reduces day time anxiety;
Define Learning Difficulty?
[PSYCH]
Specific difficulties in certain aspects of learning. Learning difficulty doesn’t affect general intelligence.
e.g dyslexia
Define Oppositional defiant disorder?
DSM-V Criteria
[PSYCH]
Angry/Irritable mood, argumentative defiant behaviour lasting at least 6M.
Behaviour associated with distress of the individual or others in their immediate social context.
Impairs significantly on social, educational or occupational functioning.
What medication to help with sleep can be given in patients with learning difficulties?
Melatonin
Define learning disability?
Functional impairment that is apparent before 18yo
IQ 70
Causes of learning disability?
Genetic Downs syndrome Fragile X syndrome Phenylketonuria Neurofibromatosis Tuberous sclerosis
Perinatal
Intraventricular haemorrhage
Brain hypoxia
Prenatal Pre-eclampsia Congenital hypothyroidism TORCHinfections hydrocephalus Fetal alcohol syndrome
Postnatal
Poverty
Neglect/abuse
Head injury
Important history areas in someone with suspected learning difficulties?
Obstetric complications,
Neurodevelopmental delays,
Behavioural disturbances,
Past medical history, family history, and social history.
What is ADHD?
[DSM V Criteria]
persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development.
Symptoms evident in 2 or more settings.
Symptoms present for 6M+
Symptoms present before 12 yo
Tx - Ritalin (Methyphenidate)
What is Autism?
[DSM V Criteria]
Persistent difficulties with social communication and social interaction as well as restricted and repetitive patterns of behaviour, activity or interests.
Define Cohort Study?
Longitudinal study in similar groups but with different risk factors/treatments.
Follows up over time.
Associated with Relative Risk Calculation (RR) for risk factors
RR = Risk of diseased (exposed) / Risk of disease (unexposed)
RR >1 = Increased risk
RR<1 = Lower risk
RR =1 = Same
ADVANTAGES AND DISADVANTAGES OF Cohort Study?
Advantages
– Can follow up rare exposure
– Allows to identify risk factors
– Data on confounders collected prospectively
Disadvantages – Large sample size required – Impractical for rare diseases – Expensive – People drop out
Define RCT?
Similar participants are randomly assigned to an intervention or control group to study effect of intervention
ADVANTAGES AND DISADVANTAGES OF RCT?
Advantages
– Low risk of bias and confounding
– Comparative
Disadvantages
– High group out rate
– Ethical issues (i.e. not giving an intervention to someone who could possibly benefit)
– Time consuming and expesnive
Define Cross-sectional study? (Prevalence Study)
Observational study collecting data from a population and a specific point in time
A snapshot of a group. Provide health information for a particular period
e.g. Questionnaires, Health surveys
Advantages and Disadvantages of Cross-sectional study?
Advantages
– Large sample size
– Provides data on prevalence of risk factors and disease outcomes
– Quick to carry out (Cheap and easy)
– Repeated studies show changes over time. Used to assess health needs
Disadvantages
– Risk of reverse causality
– which came first? (Due to being collected at a certain point in time can’t tell that a particular exposure caused the disease)
– Less likely to include those who recover quickly or short recovery
– Not useful for rare outcomes
Define Case-Control?
GOOD EXAMPLES FOR USE
Observational study looking at cause of a disease.
Compares similar participants with disease and controls without – Looks retrospectively for exposure/cause
Associated with Odds Ratio (OR)
e.g. for a particular risk factor -i.e. foods in an outbreak investigation
OR = Odds of being exposed [case group/disease] / Odds of being exposed [control group/unaffected]
OR >1 - Associated w/disesase
OR <1 - Protective
OR = 1 - No association
EXAMPLES - Rare events (Motor vehicle accidents, seatbelts
Advantages and Disadvantages of Case-Control study?
Advantages
– Quick
– Good for uncommon diseases (RARE)
Disadvantages
– Difficult finding appropriately matched controls (Hard for rare exposures)
– Prone to selection and information bias
– People may not be able recall exposure accurately
How do you calculate Attributable risk?
AR = Incidence in exposed - Incidence in unexposed
