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medicine - year 1 > Health and Society (Block 1-3) > Flashcards

Health and Society (Block 1-3) Flashcards

1
Q

Define age standardisation

A

Allows populations to be compared when the age profiles of the populations are different

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2
Q

What is Giemsa banding?

How does it arrange chromosomes?

A

Pattern for each chromosome

Arranges chromosomes based on their p+q arms, shape and centromere

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3
Q

3 examples of meiosis errors

A

Unequal segregation

Chromosome non-disjunction/division

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4
Q

5 examples of chromosome abnormalities

A

Deletions, duplications, inversions, translocations and isochromosomes

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5
Q

Define polymorphism

A

2 or more phenotypes in the population of a species occupying the same habitat at the same time

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6
Q

Which diagram is used to study inheritance?

A

Pedigree diagrams

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7
Q

What are the 2 types of gene mutations

A

Somatic

Germline

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8
Q

What does it mean if a circle is coloured in on a pedigree diagram?

A

That person is affected

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9
Q

4 changes to proteins that can occur due to a mutation

A

Shorter
Wrong amino acid
Wrong structure
No binding/active site

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10
Q

Define missense mutation

A

One DNA base pair is changed resulting in a different amino acid

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11
Q

Define nonsense mutation

A

1 DNA base pair is changed which signals the cell to stop building the protein

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12
Q

Define reading frame

A

3 bases that code for an amino acid

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13
Q

Define trinucleotide

A

3 base pair repeats

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14
Q

What do you need for cancer to be inherited?

A

Many mutations

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15
Q

Define genetics

A

Bio-medical differences between individuals which you can control and manipulate
They are linked to biology and social factors

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16
Q

What happens to medical decisions over time?

A

They change as society changes

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17
Q

Define positive eugenics

A

Intervention to humans to improve the genetic inheritance of a child/community

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18
Q

Define negative eugenics

A

If you are of a lower socio-economic status then you have worse inheritance

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19
Q

What did Francis Galton believe?

A

That fitter people should breed together to produce the ‘perfect species’

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20
Q

What was the eugenics society in the UK?

When was it created?

A

Explained social status by biology

1907

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21
Q

When was DNA discovered?

A

1953

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22
Q

When was recombinant DNA discovered?

A

1973

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23
Q

When did the Human Genome Project start?

A

1990

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24
Q

What does polygenic mean?

A

Many genes have multi-factorial causes

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25
Q

What type of medicine is becoming more popular?

A

Personalised medicine

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26
Q

Define evidence

A

An observation, fact or organised body of information that helps to decrease uncertainty

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27
Q

Define decision making

A

A choice or action made to achieve goals

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28
Q

What are the 3 types of uncertainties that doctors face?

A

Technical
Personal
Conceptual

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29
Q

Give an example of a technical uncertainty

A

Wrong diagnosis

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30
Q

Give an example of a personal uncertainty

A

Not know what the patient wants

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31
Q

Give an example of a conceptual uncertainty

A

Unable to apply the knowledge to the patient

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32
Q

What is the purpose of a ‘cumulative meta-analysis’

A

Combines the research together so that time and money is not wasted if the information is already there

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33
Q

2 ways in which evidence improves clinical care

A

Increases efficiency

Standardising treatments

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34
Q

Define evidence-based decision making

A

The use of the current best evidence to make decisions about the care and value of patients so that uncertainty is reduced

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35
Q

What 4 things does evidence-based practise rely upon?

A

Research, resources, patient preferences, expertise

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36
Q

What are the CQC

A

Care and quality commission

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37
Q

Define economics

A

How people choose to allocate scarce resources

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38
Q

Define opportunity cost

A

The value of what you give up when you have to make a decision

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39
Q

2 examples of sellers in the NHS market

A

GP’s

Hospitals

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40
Q

Explain the flat curve of medicine

A

NHS first established: Little we could do but effective

NHS now: A lot we can do but not as effective

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41
Q

Describe the NHS in one word

A

Inefficient

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42
Q

Define epidemiology

A

Distribution and determinants of a populations health

Applying this to control the health of the population

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43
Q

Define descriptive epidemiology

A

How things are distributed in patterns across society

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44
Q

Define analytical epidemiology

A

Exploits the distributions to ask and answer questions

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45
Q

Define experimental epidemiology

A

Change the distributions to see the effect

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46
Q

Define incidence

A

New diagnosis and immigration of the ill

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47
Q

Define prevalence

A

Number of individuals who have the disease

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48
Q

What is the equation for incidence?

A

Number of new cases in a period / Number initially free of disease

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49
Q

What is the equation for prevalence?

A

Number with the disease at a specific time/ Total population

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50
Q

3 ways to express the answer to incidence/prevalence

A

Percentage
Decimal
Number affected per number sampled

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51
Q

What word describes cumulative incidence?

A

Rate

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52
Q

What is the difference in the trend between the whole population and smaller populations?

A

They differ

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53
Q

What is another word for incidence rates?

A

Person-time incidence rates

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54
Q

What do symptoms not always lead to?

A

Help seeking behaviour

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55
Q

Do lay people have medical knowledge.

A

Yes

56
Q

What are the 5 levels in the symptom iceberg?

A

Controlled - Diagnosed - Un/mis-diagnosed - Risk factors - Free of risk factors

57
Q

Define medical pluralism

A

Conventional and traditional medicine

58
Q

What is the lay-referral system?

A

Patients seek help from 3 sources before the doctor

59
Q

Define industrial

Which world did it happen in?

A

Encourage people to seek help

Happened in the ‘old world’

60
Q

Define information

Which world did it happen in?

A

Encourage people to self-care to save time and money

Happens in the new world as patients have the same information as doctors and don’t want to waste their time

61
Q

What is the inverse case law?

A

Increased deprivation in an area decreases the number of services which are available

62
Q

What were the classes in the 1900’s?

A

Gentry and professional
Farmers and tradesmen
Artisans and labourers

63
Q

What were the new classes?

A 
Professional
Managerial and technical
Skilled
Partly-skilled
Unskilled
64
Q

Who made and commissioned the black report?

A

Made: Labour
Commissioned: Conservative

65
Q

What are the 4 parts of the black report?

A

Statistical artefact
Culture
Health related social mobility
Materialist

66
Q

What does statistical artefact mean in the back report?

A

Inequalities are artificial due to inadequate data

67
Q

What does statistical culture mean in the back report?

A

Ill health is caused by lifestyle but behaviour is still shaped by circumstance

68
Q

What does health related social mobility mean in the back report?

A

Health determines social class

69
Q

What does materialist mean in the back report?

A

Health is determined by social structure and circumstances

These influence material conditions

70
Q

What are the two reports which followed the black report?

A 
Acheson report (1998)
Marmot review (2010)
71
Q

What is a guarantee against ill health?

A

Employment

72
Q

What 3 things can eliminate health inequalities?

A

Social accumulation, mobility and protection

73
Q

What is the difference between behaviour and physiological status?

A

Behaviour: Current social context

Physiological status: Past and present

74
Q

What 3 things contribute towards your health?

A

Position in society, material conditions and behaviour

75
Q

How many methods do you use to measure health inequalities at once?
Why?

A

More than one

Increases the accuracy

76
Q

What are the layers in the model of health inequalities?

A
  • Constitutional factors
  • Individual lifestyle factors
  • Social and community networks
  • Living and working conditions
  • General socio-economic, cultural and environmental factors
77
Q

What does the multiple index measure? (7)

How many areas in England are there?

A

Crime, education, employment, environment, health, housing and income
32,844

78
Q

Give 5 measures of current income

A 
Area of residence 
Education
Employment
Housing tenure 
Social class
79
Q

How do you measure housing?

A

By the three-fold classification

-Owner, rental or council tenant

80
Q

What is area deprivation an example of?

A

An example of a way to measure health inequalities

81
Q

Where are most resources in healthcare directed?

Where should they be directed?

A

Treatment

Prevention

82
Q

What is the ‘epidemiological transition’

A

A decrease in infectious disease

An increase in chronic and non-infectious disease

83
Q

6 determinants of health outcomes

A 
Biological
Social and economic
Environment
Lifestyle
Health services
Material deprivation and poverty
84
Q

What did the Whitehall study determine?

A

That the social class gradient leads to disease

85
Q

Define health promotion

A

People improve their own health through a range of social interactions

86
Q

Define health education

A

A voluntary change in behaviour through improvement of knowledge

87
Q

Define health protection

A

Legislation to protect public health

88
Q

What are the WHO’s 5 aspects of health promotion?

A
  1. Healthy public policy
  2. Supportive environments
  3. Community action
  4. Personal skills
  5. Re-orientating health services (downstream –> upstream)
89
Q

What are the differences between primary, secondary and tertiary prevention
Examples

A

Primary: Prevents onset (e.g. vaccination, health promotion)
Secondary: Detecting at early stages (e.g. screening)
Tertiary: Overlaps with treatment to decrease the impact

90
Q

Define authoritative intervention

A

Medical professionals or governments inform people

91
Q

Define negotiated intervention

A

Experience and knowledge

92
Q

Define health persuasion

Example

A

Professionals tell people

5-a-day

93
Q

Define personal counselling

A

Advice to patients

94
Q

Define community development

A

Community work for local needs

95
Q

Define prevention paradox

A

Benefits to the population rarely benefit the individual person

96
Q

4 problems with the idea of health promotion

A

Lack of balance between freedom of individual and societal control
Limited resources
No clear evidence
Who is responsible?

97
Q

Define diagnosis

A

Determining the nature of the disorder by looking at the patient’s signs, symptoms, background and tests

98
Q

What 2 things is the prognosis based upon?

A

Knowledge of past patients

Type of patient

99
Q

What are the 3 theories of decision making?

Define them

A

Normative: Social and professional norms
Prescriptive: Improvement
Descriptive: What YOU are doing

100
Q

What 3 things are decisions influenced by?

A

Bias
Individual variation
Experience

101
Q

What are the 5 stages of the Hypothetic-Deductive model?

A
  1. Cue acquisition
  2. Hypothesis formation
  3. Cue interpretation
  4. Hypothesis evaluation
  5. You then accept the hypothesis or make a new one
102
Q

What does the Hypothetic-Deductive mode aim to do?

When is it used?

A

Seeks evidence to disprove

When the clinician is less experienced

103
Q

How are decisions made?

A

By looking at theories

104
Q

What are the two phases of making a decision?

A

Phase 1: Framing and editing (preliminary analysis)

Phase 2: Evaluation (framed prospects evaluated)

105
Q

Define evidence

A

A factor that influences clinical decisions

Based on the results of clinical trials and studies

106
Q

Rank these in order of the hierarchy of evidence:

Case series - Randomised controlled double blind - Case control studies - Opinions - Case reports - Systemic reviews - In vitro - Animal - Cohort studies

A

In vitro - Animal - Opinions - Case reports - Case series - Case control studies - Cohort studies - Randomised controlled double blind - Systemic reviews

107
Q

What are the 5S levels of organisation of evidence?

A

Studies - Syntheses - Synopses - Summaries - Systems

108
Q

What is the purpose of the 5S levels of organisation of evidence?

A

To deal with the volume of evidence

109
Q

4 examples of research which can be used in a clinical setting?

A

Statistics, knowledge, experience and research

110
Q

What are the two acts surrounding drugs?

A

Human regulation act of 2012

Medicines act of 1968

111
Q

What agency gathers the yellow cards?

A

Medicines and Healthcare Products Regulatory Agency

112
Q

What can herbal medication affect in the body aside from other drug interactions

A

Certain enzymes in the liver and other bodily functions

113
Q

What is the role of the MHRA?

A

To give drugs a ‘market authorisation’

114
Q

What is the EMC and what does it have?

A

Electronic Medicines Compendium

A summary of the product characteristcs

115
Q

4 characteristics to be re-classified from a POM to P?

A

No danger to health
Used correctly
Not an injection
Not have products which need investigating

116
Q

2 characteristics to be re-classified from a P to a GSL?

A

Sold/supplied safely with no pharmacist

May need age limits

117
Q

What is the scale of community pharmacy schemes?

A

Local or national

118
Q

What are the 4 main roles of a community pharmacy?

A

Minor ailments
Emergency contraception/sexual health
Health education and promotion
Medicine reviews if another drug has been prescribed

119
Q

What are the 2 types of outcome variables?

A

Quantitative and Qualitative

120
Q

Define dichotomous

A

Only 2 categories

121
Q

What are the 3 types of data?

A

Interval
Ordinal
Nominal

122
Q

3 words to describe interval data

Example

A

Quantitative, discrete and continuous

E.g. Number of admissions

123
Q

2 words to describe ordinal data

Example

A

Qualitative, more than 2 categories with some order

E.g. Excellent, Good, Bad, Poor

124
Q

3 words to describe nominal data

Example

A

Qualitative, multinominal, more than 2 categories with no order
E.g. divorced/married

125
Q

What are the three approaches to statistical analysis?

Define them

A

Descriptive: Organise, summarise and describe data
Correlational: Relationships
Inferential : Stats

126
Q

What makes statistics valid?

A

If they follow the normal distribution

127
Q

3 words to describe a normal distribution

A

Continuous, symmetrical and unimodal

128
Q

What happens to the mode, median and mean in a normal distribution?

A

They are the SAME

129
Q

What is negative skew?

Is the mode or mean left of the median?

A

Skewed to + values

Mean is left of median

130
Q

What is positive skew?

Is the mode or mean left of the median?

A

Skewed to - values

Mode is left of median

131
Q

Where do the observations lie in a normal distribution?

A

68% of observations lie within 1 SD from the mean

95% of observations lie within 1.98 SD from the mean

132
Q

What are the 3 measures of location?

A

Mean, mode and median

133
Q

What are the 3 measures of dispersion?

A

Standard deviation
Inter-quartile range
Range

134
Q

What is the statistically significant P value?

A

0.05

135
Q

What is the difference between a type 1 and type 2 error?

A

Type 1: Reject null hypothesis by mistake

Type 2: Accept null hypothesis by mistake

medicine - year 1 (20 decks)

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