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Medical Ethics > Pass Medicine > Flashcards

Pass Medicine Flashcards

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USMLE® Step 1 flashcards
1
Q

What is an advance directive

A

Individual preferences with respect to medical Rx
Written when person is of sound mind
Must refer to Rx in specific circumstances
Cannot demand Rx

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2
Q

Advance directive = binding unless

A

Decision withdrawn
Power to make decision conferred to another person e.g. POA
Patient has acted in a way thats inconsistent with directive
Patient able to decide for themselves
Circumstances or Rx specified do not exist or have changed

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3
Q

What is POA

A

Allows person to make decisions if someone loses capacity
Health and welfare
Property and finance

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4
Q

Who do you register with

A

Office of public guardian

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5
Q

When are you entitled to careers allowance

A 
16+
35+ hours caring 
Lived in country 2 out of last 3 years and normally live here
Not in full time education
Earn no more than 110 a week
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6
Q

What is means tested

A

Carer’s allowance

110 after tax / care / pension

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7
Q

What are the types of consent

A

Informed
Expressed
Implied

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8
Q

When does someone have capacity

A 
Able to 
Understand and retain info
Believes info to be true
Able to weight up information to make a decision 
Communicate decision
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9
Q

Who can consent for minors

A

Gillick competent

Biological mother

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10
Q

When can father consent

A

If named on birth certificate or if married and biological

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11
Q

What are 4 types of consent form

A 
1 = competent but consciousness impaired e.g. GA
2 = adult consent for child who's consciousness impaired 
3 = consciousness NOT impaired
4 = adults who lack capacity
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12
Q

What are the 5 principles of adults with incapacity

A

Must assume to have capacity
Take steps to ensure decision can be made
If decision unwise doesn’t mean lack capacity
Must be done in patients best interest
Least restrictive

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13
Q

What should you do to take in best interests

A

See if decision can wait till regain capacity
Encourage and optimise participation
Think of past and present wishes
Views of other

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14
Q

What can a compliant be

A 
Verbal
Informal
Formal to doctor 
Complaint to managing body
Complaint to GMC
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15
Q

What must controlled drugs have on prescription

A

Name and address
Form, strength and preparation
Total quantity or number of dosage units to supply
Dose
Prescribers name, signature, address and date

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16
Q

Schedule 1

A

Cannabis

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17
Q

Schedule 2

A

Diamorphine / morphine
Amphetamine
Cocaine

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18
Q

Schedule 3

A

Barbiturates
Buprenorphine
Midazolam
Gabapentin / pregabalin

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19
Q

Schedule 4

A 
Benzodiazepine (except midalazam) 
Zopiclone
Androgenic and anabolic steroid
HCG
Somatotrophin
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20
Q

Schedule 5

A

Codeine

Oromorph

21
Q

What are controlled in BNF

A

Schedule 2+3

22
Q

How long are prescriptions valid for

A

28 days

23
Q

When do controlled prescriptions not apply

A

Schedule 4 + 5

24
Q

How is cremation form filled

A

2+ doctors identify case of death
Patients own GP or doctor looking after them
+ independent doctor with 5+ years registration
Discuss are

25
Q

What is not acceptable cause of death

A

Old age if <80
Natural causes
Organ failure if can’t specify why it failed

26
Q

What happens with death certificate

A

Family take it to local registrar who decides if needs reported
Gives certificate of burial or cremation + registration

27
Q

What are notifiable deaths

A 
Unexpected
No doctor in last 14 days
Within 24 hours of hospital
Accidents
Suicide 
Industrial injury
Result of neglect
During an operation or recovery 
Poison including illicit drugs
Still birth
Prisoner or police custody
Service disability pensioner
28
Q

Who decides if CPR goes ahead

A

Senior clinical if no POA or advance directive

Views of relative, best interest + chance of recovery

29
Q

What is duty of candour

A 
Must be honest when something goes wrong 
Tell patient
Apologise 
Offer resolution
Explain short and long term effects
30
Q

When must you not drive and notify DVLA psychiatric

A 
Severe depression affecting memory / concentration / sucidial thoughts
Acute psychosis
Hypomania or mania
Schizophrenia
Severe disability
31
Q

What may you be able to drive but must notify DVLA

A 
Pervasive development diosrdr
ADHD
Dementia
Mild learning disability
Personality disorder
32
Q

When do you not need to inform DVLA

A

Mild cognitive impairment

33
Q

When must you notify DVLA in regards with vision

A

Visual field defect

Monocular vision - can still drive if acuity and field normal in other eye

34
Q

GMC advice gifts

A

DO not accept if affect way prescribe, treat or refer

35
Q

GMC doctors health

A

Do not rely on own judgement of risk
Assess by appropriate professional
Seek and follow advise

36
Q

GMC partnership and teamwork

A

Respect skills
Treat fair and with respect
Communicate with colleague
Talk to person involved first

37
Q

GMC must report criminal proceeding if

A

Found guilty
Charged
Admit to criminal offence
Accept option of paying penalty for ASBO
Cannabis warning
Registration restricted by another medical body
Conduct directly contributed to organisation entering prosecution agreement

38
Q

GNC teaching

A

Must be willing to take on mentoring role

Contribute to teaching

39
Q

What do you do if problem arises

A

Begin escalating up
Colleague involved then SHO before registrar before consultant
Speak to clinical supervisor

40
Q

When do you end professional relationships

A

If breakdown of trusts means cannot provide good care
Includes violent/. theft / sexual advance
NOT due to a complaint

41
Q

How do you end

A 
Tell patient considering ending it 
Do what you can to restore 
Discuss with experienced colleague
Must not discriminate 
Make sure patient is told what is happening and why
42
Q

GMC trust

A

Show respect
Treat fair and no discrimination
Act with honesty and integrity

43
Q

Social media

A

If identify as doctor identify by name

44
Q

Treating colleagues

A

Avoid prescribing for yourself or anyone with close relationships

45
Q

Responsible clinician

A

Respect wishes of any patient who objects to info being shared unless in public interest
If patient objects to disclosure that is essential for safe care explain you cannot refer

46
Q

Accountabiliy

A

If delegating to junior doctor consultant is not accountable for decisions but accountable to ensure junior member is trained and experienced

47
Q

Chaperone

A

YUP

48
Q

Confidentiality

A

YUP

Medical Ethics (7 decks)

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