Past Papers qs Flashcards

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1
Q

binge drinking definition

A

as 6 units or more

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2
Q

describe DSM-5 tool and how it used to detect if someone alcohol use disorder

A

mild = 2-3 criteria
moderate = 4-5 criteria
severe = 6+ criteria
1. recurrent use resulting in failure of obligation
2. recurrent use resulting in hazardous situations
3. tolerance
4. alcohol craving
5. important activities given up/reduced because of drinking
6. a lot of time spent obtaining, using or recovering from alcohol

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3
Q

list 3 short term and long term risks of alcohol abuse

A

short term = accidents, vomiting, HIV or STIs

long term = liver cirrhosis, acute panreatitis, irreversible neurological damage

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4
Q

list learning theories that explain alcohol dependencies.

A

Operant conditioning; behaviour = social drinking
consequence = socialise and have fun friends
result = feel compelled to drink
Social learning theory; determine behaviour (factor environmental e.g. social norms, cognitive e.g. attitude and behavioural factors e.g. self efficacy)

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5
Q

describe CAGE questionnaire to identify alcohol abuse.

What disadvantage does CAGE have?

A

C =have you felt you should Cut down on your drinking
A = Have people Annoyed you criticising your drinking
G = Have felt Guilt for drinking?
E = Have you ever drank first thing in the morning (Eye-opener)
Does not assess - bingeing, frequency, amount.

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6
Q

discuss 5As intervention for alcohol use

A
Ask all patients
Advise patients on health effects
Assess their readiness to quit
Assist strategies for reduction
Arrange follow up for further support
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7
Q

List all types of amnesia
give 4 causes of amnesia
3 ways as a physio you would give info to adapt to a patient with this condition

A

Retrograde amnesia:
– Inability to remember events that happened prior to onse= retrieval failure
• Anterograde amnesia: – Inability to take in new factual information or remember day-to-day events = consolidation failure
• Post-traumatic amnesia:
– Combines both
– Period of retrograde shrinks
– Period of anterograde determines classification
of head injury [mild, moderate, or severe]
4 causes = brain injury, drugs, alcoholism, severe emotional trauma
3 ways = don’t present too much info, order info from most important to least important, provide recall cues e.g. diagrams, info leaflets, repeat info

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8
Q

list the 3 components of memory

describe processing theory

A

encoding = info gets into memory
storage = storage maintained in memory
retrieval = info is recovered from memory
levels of processing theory - shallow = structure = appearance
- intermediate = phonemic = sound
- deep = semantic = meaning

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9
Q

give 4 reasons we forget

2 ways physios can help patient remember their treatment

A
  1. ineffective coding = lack of attention
  2. interference = competition from info - new info impair retention of old
  3. decay = memory fades over time
  4. motivated forgetting = repression willingly forget traumatic memory

2 ways to help
order info from most to least important
give visuals

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10
Q

describe multistore model

how you use your knowledge of memory to keep info you are relayde stored as long as possible?

A

sensory - momentarily preserved auditory, tactile and sensory info
short term = memory stored for 20s
long term memory = unlimited capacity info stored indefinitely
order from most to least important info
not too much info
repeat key info to promote rehearsal
make info meaningful and connected relate to current knowledge

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11
Q

define palliative care and give 5 reasons it is preferred to hospitalisation

A

palliative care = continuing active total care of patients and their families when there is no medical explanation for cure, respond to physical, psychological, social and spiritual need and bereavement support.
give highest possible quality of life for patient and family
1. affirms life, dying is normal process
2. neither hastens nor postpones death life assisted suicide or euthanasia
3. offers support system to keep patient’s active life
4. uses team approach to meet needs of patient and family
5. enhance quality of life -> positive influence on course of influence

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12
Q

levels of palliative care

A

Level one – Palliative Care Approach:
– Palliative care principles should be appropriately applied by all health care professionals.
• Level two – General Palliative Care:
– At an intermediate level, a proportion of patients and families will benefit from the expertise of health care professionals who, although not engaged full time in palliative care, have had some additional training and experience in palliative care.
• Level three – Specialist Palliative Care:
– Specialist palliative care services are those services whose core activity is limited to the provision of palliative care, under the direction of a consultant in palliative medicine.

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13
Q

definition of obesity, name 2 causes of obesity and 2 treatments of obesity and measurements of obesity

A

a very high amount of body fat relative to lean body mass, where excess body fat has accumulated to an extent that health may be adversely affected
causes, genetics, physical inactivity, medication, overeating
2 treatments = behavioural therapy (change diet and promote exercise), surgery

measurements = BMI weight/height in metres squared
waist to hip circumference ratio
waist circumference

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14
Q

strengths of weakness of the BMI

define obesogenic environment and discuss how this can affect an individual’s ability to reduce their BMI.

A

Strengths = easy to measure, cheap, high correlation w/ fat levels mainly accurate
weaknesses = does not consider age, gender or body frame, not as accurate in elderly, doesn’t distinguish body fat from muscle mass
Obesogenic environment = certain factors that influences the promotion of obesity in a population

sports and leisure - lack of school facilities few playing areas,
family - genetic predisposition, parent’s knowledge in health
food promotion = via school marketing, eating out and ads

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15
Q

Outline the DSM 5 criteria for AN
Describe three of these
warning signs, and outline the five item-screening questionnaire “SCOFF”
which is used to screen for eating disorders.

A

DSM four broad categories
are delineated:
1.Anorexia Nervosa
2.Bulimia Nervosa
3.Binge eating disorder
4. Avoidant /restrictive food intake disorder
3 warning signs - significant weight loss, feelings of guilt after eating, denial of hunger
SCOFF questionnaire
do you make yourself Sick because you feel full?
Do you worry you have lost Control over what you eat?
have lose more than One 914 points or 6.35 kg) stone?
do you think you are Fat when others say you’re thin?
would you think Food dominates your life?
2 or more score means anorexia or bulimia

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16
Q

list DSM-5 levels of Bulimia
Give 3 warning signs for Bulimia
list 3 components of treating bulimia and anorexia

A

A. Recurrent episodes of binge eating - lack of control and eating within 2 hour period lots of food
B. recurrent inappropriate compensatory behaviour to prevent weight gain/purging e.g. comitting, laxatives]
C. both binge eating and purging occurs at least once a week or 3 months
D. self evaluation of body weight and shape
Mild = 1-3 episodes or purging a week
moderate = 4-7 episodes of purging a week
severe = 8=13 episodes of purging a week
extreme = >14 eps of purging a week
3 warning signs - bingeing and purging, secretive eating, visits bathroom after eating
treatment = restore to healthy weight, treat psychological issue, eliminate behaviours to prevent relapse

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17
Q

outline the transtheoretical model
give 1 advantage and 1 disadvantage of the model
how you would apply this model when communicating to patient stage by stage

A

precontemplation - ignore problem
contemplation - aware of problem weigh pros and cons
preparation - plan behaviour change
action - perform perform behaviour
maintenance - integrate new behaviour in life
prevent relapse
advantage = recognise difficulties inherent in behaviour change, applicable to all health-related behaviours, r.g. smoking, exercise screening,
disadvantage = assumes rational thinking, doesn’t address social context
precontemplation = clarify that its their decision
contemplation = validate lack of readiness
preparation = identify social support
action = combat feelings of loss and reinforce +ive long term effects
maintenance = plan for follow up support
relapse = focus on successful part of plan

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18
Q

define conformity, whistleblowing and obedience
Provide at least two examples of how any of these three social influences are important in
healthcare settings

A

conformity = Yielding to real or imagined social pressure
whistleblowing = publicising wrong doings or failures of colleagues or employers
obedience = form of compliance that occurs when people follow direct commands, usually from someone in direct authority
1 = obedience of an order from the doctor without questioning if it is for the well being of the patient can out people’s lives at risk e.g. unknown doctor telephone ward and request nurse start does of drug and says he will do the paper and the dose is twice the daily limit, nurses obey and don’t question it
2 = whistleblowing = allows faults in the healthcare system to be recognises opens the conversation for critique outside of the work environment forcing room for change
e.g. nurses came out about insane numbers of hysterectomies conducted many w/o patient’s consent

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19
Q

stress definition

list difference between stress as a stimulus and stress as a transaction

A

Stress arises when there is a mismatch between our
appraisals of demands and of our abilities and coping resources
stress as a stimulus
- burdens and joys of life
- life events theory measures in life change unit how much disruptive change in life (marriage, getting fired, moving) are related to stress
- limitations => personality, genetic, predisposing factors e.g. life decision, lifestyle,
stress as a transaction
- mismatch between demands and your abilities and coping resources
- contributing factors => external or internal event environment, internal or external resources, individual’s characteristics

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20
Q

explain how mechanism of stress affects health

A

maladaptive coping in response to stress - poor nutrition, lack of exercise, alcohol, drug use, smoking
adaptive coping 2 types - 1. constructive problem focused coping => how to manage stressor
or 2. emotion-focused coping = change feelings about stressors
endocrine response to stress - activation of hypothalamic-pituitary-adrenocortical (HPA) system, leads to corticotrophin-releasing hormone factor - inc. blood flow, dec. immune function, inc. vigilance

21
Q

describe stress coping paradigm

list 2 ways to reduce stress

A

stimulus undergoes primary appraisal process - depending on quality and nature of stimulus the stimulus can be benign, irrelevant, or positive leading to no further action
when it is seen as possibly causing harm, loss or thress the stimulus appraised is now seen as a stressor and undergoes secondary appraisal
depending on external(social support or money) or internal(strength and will) the person can respond by seeking more info, aking direct action, doing nothing or worrying

venting providing a support system
promote regular exercise
identify behaviours and practise behavioural responses - relaxation, meditation

22
Q

define adherence, list its 2 types of non- adherence

give 5 factors for non-adherence according to WHO

A

adherence =The extent to which a person’s behaviour - taking medication, following a diet, and/or executing lifestyle changes - corresponds with agreed recommendations from a health care provider
intentional and unintentional type
1. condition-related factors - greater non-adherence in chronic illnes = faster illness progression, greater severity of symptoms and therefore disability
2. therapy-related factors: longer duration of treatment, complex treatment, frequent changes, more severe side effects
3. health system - poorly developed services, poor med distribution systems, lack of knowledge
4. socio-economic factors - illiteracy, unemployment, unstable living conditions, high cost of transport
5. patient-related factors, - lack of knowledge or competence

23
Q

give rates of non-adherence and name 3 methods you would manage intentional non-adherence and 3 ways you would manage unintenional non-adherence

A

rate vary from 4% - 92%
intentional
1. check adherence - normalise poor adherence, provide feedback
2. good relationships and satisfaction of care - develop open, communicative and non-judgemental relationship
3. patient-centred care - get patients view, cater treatment to patient’s preference

unintentional

  1. tailor treatment patients preference
  2. check understanding of how to take treatment
  3. simplify treatment
24
Q

describe piaget’s pre-operational period
list 3 PPD predictors
treatments of PPD

A

lack conservation - physical qualities remain constant after appearance changes
possess ideologies - centration (focus one feature of a problem),
irreversibility,
egocentrism(limited ability to share another POV),
animism (all things are alive)

PPD predictors
prenatal depression
low self esteem
childcare stress

support - send them to specialise for medication options, refer to support groups, hormone therapy

25
Q

list and describe 3 temperaments of kids

list symptoms of PPD

A
  1. Easy or flexible – calm, happy, adaptable, regular in sleeping and eating habits, positive in mood and interested in new experiences
  2. Difficult, Active or Feisty – fussy, irregular in feeding and sleeping habits, low in adaptability, fearful of new people or situations, easily upset, highly strung and intense in their reactions
  3. Slow to warm up or cautious – relatively inactive, reflective, tend to withdraw or react more negatively to novelty, but their reactions gradually become more positive with experience
Symptoms of ppd
sleep disturbance
suicidal ideation
fatigue
appetite disturbance
26
Q

describe first 2 stages of piaget’s cognitive development

A

stage 1
• Development of ability to coordinate sensory input with motor actions
• Emergence of symbolic thought
• OBJECT PERMANENCE (10 months approx)
–Child recognizes that objects continue to exist even when no longer visible

stage 2
lack conservation - physical qualities remain constant after appearance changes
possess ideologies - centration (focus one feature of a problem),
irreversibility,
egocentrism(limited ability to share another POV),
animism (all things are alive)

27
Q

list the 4 types of relationships of CAM
give 4 types of users of CAM
give 2 concerns for CAM

A

types of relationships
1. monopolistic - medical practitioners exclusively have this right to practice
2. Tolerant - State-funded medical system exclusive to
medical professionals, but people can pay privately for
CAM
3. Parallel - 2 of these distinct services(conventional and alternative) are available to patients
4. Integrated - all medicine is regulated to ensure high standard

4 types of users

  1. Earnest seekers - patients with stubborn health and try all types of CAM treatment pain is relieved
  2. Stable users - either use one type most of their treatment or have one problem and use one or more CAM therapies
  3. Eclectic users - use different forms of therapy depending on the problem
  4. One-off users - stop using CAM after some experimentation

2 concerns
CAM lacks evidence and effectiveness
Poor evaluation of treatments

28
Q

give definition of CAM

list and explain 5 domains of CAM

A

CAM = therapeutic approaches that are not part of the predominant biomedical system or topics not
customarily included in medical education

  1. Mind-body interventions
  2. Biologically-based therapies
  3. Manipulative/Body-based methods
  4. Biofield/Energy therapies
  5. Alternative medical systems (homeopathy, Chinese medicine,
    Ayurveda)
29
Q

Describe the OARS conversation skill to you would use when talking about someone’s smoking habits.
Give the 5As affiliated with smoke cessation

A
Open-ended questions (pros/cons of change)
Affirmation (recognition, acknowledgement)
Reflective listening (repeat back)
Summarising (main points, no judgement) 
5As
Ask - how much and how long you smoked?
Advise - discuss harmful effects
Assess willingness to quit
Assist in creating plan to quit
Arrange follow up meeting
30
Q

define randomised controlled trial

A

– An experiment in which two or more interventions are compared by being randomly allocated to participants

31
Q

define randomised placebo controlled trial

A

An inactive substance or procedure administered to a participant. Placebos are used in clinical trials to blind people to their treatment allocation. Placebos should be indistinguishable from the active intervention to ensure adequate blinding

32
Q

define randomised double blind placebo controlled trial

A

Blinding is the process of preventing those involved in a trial from knowing to which comparison group a particular participant belongs. Double blind - both clinician and participant are prevented from knowing

33
Q

give 4 theories that explain the placebo effect

3 ways to use placebo enhance practice

A

4 theories

  1. physiological: placebo activate body’s pain-killing system which reduce pain, create dependence, withdrawal, tolerance
  2. non-interactive: patient characteristics - emotional dependency or extraversion personality does not influence placebo.
  3. expectation theory - patient believes a change will occur, motivation and expectation plays a role will produce less anxiety, reporting error
  4. interactive: reporting error - confabulation = symptoms are same but patients feels better

3 ways
modality
therapeutic touch
mindset

34
Q

Behaviour Change Wheel i.e COM-C

A

Capability - do you have the; knowledge, skill abilities to have that behaviour. Psychological - experience, workshops or training and Physical - needs to be reminded, encouraged
Opportunity - is it possible - physical (time and money) and social (companionship or friends, isolating experience)
Motivation - internal process that affect our behaviour - reflective and automatic

35
Q

explain health belief model and its purpose

A

modifying factors e.g. age, gender ethnicity
influence individual beliefs

individual beliefs;
perceived benefits or barriers
perceived threat
self efficacy
cues to action

these individual beliefs lead to action being taken for their health

1 advantage of health belief - recognises and address cognitive model
1 disadvantage - lacks explanation of individuals attitude

36
Q

give an example of how the health belief model is applied

A

Susceptibility - promote awareness that the person is susceptible to risks

  • Severity - seriousness of unwanted pregnancy, HIV, chlamydia
  • Action - condoms = safer sex
  • Barriers - make contraceptives available, overcome stigma, make planning the smart choice
37
Q

list 5 stages of dying/bereavement

give 2 factors that influence severity of persons grief

A
denial
anger 
bargaining
depression
acceptance

severity

  1. how attached they were to person
  2. how much time they had to anticipate mourning
38
Q

give definition of pain

explain pain-gate theory

A

pain = An unpleasant sensory and emotional experience associated with actual or potential tissue damage

pain gate theory
A delta fibres
– myelinated pain afferents
– very strong noxious stimuli related to potential or actual damage to tissues; the
experience lasts for a short time.
• C polymodal fibres
– slow conducting, non-myelinated
– carry information about dull, throbbing, pain; experienced for a longer time period
“Anti-pain” fibres:
• A beta fibres
– myelinated mechanically (touch) sensitive afferents
– activation (e.g., through rubbing, massage, heat) inhibits perception of pain

39
Q

give 2 psychological approaches to pain management

A

– Withdrawal of attention or other rewards that were previous responses to pain behaviours
– Providing analgesic medication at set times rather than in response to behaviour

40
Q

list 5Ds of chronic pain management

A
  1. Dramatisation of complaints
  2. Disuse through inactivity
  3. Drug misuse through over-medicating
  4. Dependency on others
  5. Disability due to inactivity
41
Q

list dimensions of quality according to institute of medicine

A
  • Safety
  • Not harming people from care
  • Effectiveness • Matching scientific evidence to care
  • Patient-centredness • Patients in control of own care
  • Timeliness • Avoiding delays
  • Efficiency • Avoiding waste, duplication
  • Equity • Justice in health care, racial/socioeconomic differences
42
Q

give definition of physical disability

A

total or partial loss of a person’s bodily functions and total or partial loss of a part of the body

43
Q

explain international classification of functioning disability and health / ICF

A

A classification of health and health-related domains
Functioning and disability is a dynamic interaction between health conditions and contextual factors, both personal and environmental

44
Q

Describe ICF framework

A

identify health condition
see it influences body functions and structure, activities (difficulty executing activities) and participation and these factors relate to each other
identify how environmental factors(facilities or barriers) and personal factors (motivation self-esteem) influence activities.

45
Q

define intellectual disability

give 5 diagnostic criteria for intellectual disability

A

Involves impairments of general mental abilities that impact adaptive functioning
conceptual domain - limitations to intellectual functioning e.g. reading, writing, language
social domain - limitation to empathy, interpersonal communication skills
practical domain - self management e.g. personal care, job
impairment originates from before 18
IQ tests

46
Q

explain how intellectual disabilities can influence communicating

A

patient can have difficulties understanding spoken or written language
behavioural disorders
poor communication can lead to fear, sadness, frustration
often assumed to be incompetent

47
Q

describe social ecological model of gender based violence

A

larger society - national laws and statutes
society - social norms, acceptance of violence against women
community - poverty, low income, isolation from friends and family
relationship - marriage, family
individual - childhood exposure to abuse, educational

48
Q

describe intimate partner violence abuse continuum

A
insuluting
controlling/manipulating
isolating
threatening - violence to family
violence
49
Q

4 list ways in which adherence is measured

list 4 things adherence measurements should be

A

subjective - patient self report, patient diaries
objective - activity monitors, electric monitors

adherence should be
reliable, valid, non-invasive and safe, practical and cheap