Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Final > PH > Flashcards

PH Flashcards

1
Q

Causes of associations of outcome in a study

A

1) Bias
2) Chance
3) Confounding
4) Reverse causality
5) True association

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a bias

A

Systematic error resulting in deviation from true effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Types of bias

A

Selection bias (non-response by certain groups, loss to follow up etc)

Allocation bias (Groups with differing traits allocated to diff groups)

Information bias

  • Measurement bias (diff equipment gives diff reading)
  • Observation bias (observers expectations influence
  • Recall bias (memory)
  • Reporting bias (don’t report the truth)

Publication bias (negative results less likely to get published

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Bradford Hill criteria (9 things to prove a relationship is causal)

A

Strength of association (high relative risk)

Consistently shown across studies

Temporality

Dose response

Reversibility

Biological plausibility

etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Randomised control trial

2 Pros and 2 Cons

A

Low risk of bias and confounding + can show causality

Time consuming
Expensive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Case control:

What is it?
2 Pros + 2 Cons

A

Observational study comparing those with disease (case) to those without (control). Looks retrospectively at exposures.

Pro: Quick, good for rare diseases

Cons: difficult finding appropriate controls, Selection and information bias prone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Cross sectional study:

Basics
Pros + Cons

A

Collects data from population at a point in time (snapshot)

Pro: large sample size, Provides prevalence data

Cons: Risk of reverse causality (which came first)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is reverse causality?

A

Outcome mau have been caused by exposure

E.g. in depressed people who are obese which caused which

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Cohort study

Basic
Pros + Cons

A

Longitudinal study of similar groups getting different Tx/RFs
Follows them over time

Can follow up rare exposures
Allow Rfs to be identified

Takes a long time
High drop out rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

50 cases in 1000 people over ten years. What is the incidence per year?

A

10yrs

= 0.5% per year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How to calculate the relative risk (ratio)

A

(% with disease in exposed) / (% with disease in control)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How to calculate attributable risk of smoking

A

(% with disease in exposed) - (% with disease in control)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How to measure number needed to treat (the number which would save 1)

A

1/Attributable risk

%diseaseexposed - %diseaseunexposed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Wilson + Jungner screening criteria

A

INASEP

Important disease

Natural Hx under

Acceptable intervention

Simple + Safe

Effective Tx with early detection

Policy of who should get tx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Disadvantage of screening

A

Overdetection of subclinical disease

False +ve: worry and exposure to harmful further testing

False -ve: more dangerous as gives false sense of health

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Positive predictive value

A

% of positives who are positive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Negative predictive value

A

% of negative who are negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Sensitivity

A

% of those with the disease who are detected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Specificity

A

% of those without the disease who are negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Lead time Vs Length time bias

A

Lead time = false sense of increased survival time due to early detection

Length time = a disease with a slower progression/low aggression more likely to be picked up by screening giving false idea screening is reason for good prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

PROGRESS mnemonic for health inequality

A

Place of residence

Race/Ethnicity

Occupation

Gender

Religion

Education

Socioeconomic status

Social capital resources

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Definition of health:

A

A state of complete physical, mental and social wellbeing. No merely the absence of disease or infirmity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Causes of Errors

A

System Error

  • staffing
  • Equiptment unavailability

Human Error

  • memory
  • skill
  • timing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Types of errors & model

A

Latent (system), Active (human)

Swiss cheese model

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

4 Questions in breach of negligence

A

1) Was there a responsibility of care
2) Was there a breach of duty
3) Was the patient harmed
4) Was the harm due to breach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

3 domains of public health

A

Health Protection

Health improvement

Delivery of safe & high quality services

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Aim of Health needs assessment

A

Systematic review to allow resource allocations which improve health equity and reduce inequalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

The 4 types of need (Bradshaw taxonomy)

A

Felt need (individual perception e.g. back pain need help)

Expressed need (Help seeking- going to Dr)

Normative need - Profession defines what intervention is needed

Comparative need compares the needs of different groups (e.g. diff locations)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

3 approaches to to Health needs assessment

A

Epidemiological
- defines problem by looking at epidemiological data

Comparative
- Looks at services/health outcomes and compares to similar area

Corporate
- Asks local population / Health professionals/gov what needs are

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Epidemiological HNA Pros and Cons

A

Uses existing data, Incidence morbidity/mortality, evaluate trends over time

Variable data qual, data collected may not be required, doesn’t consider felt needs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Comparative HNA Pros and Cons

A

Quick/Cheap, shows if better/worse than other areas

Difficult to find comparable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Corporate HNA Pros and Cons

A

Based on felt/expressed need
Make use of experience/knowledge

Cant establish need from demand, Vested interest, political agendas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Types of health behaviour

A

Health behaviour (prevent disease)

Illness behaviour (going to Dr)

Sick role behaviour (taking medication)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Transtheoretical model behaviour change

PCPMAN

A

Pre-contemplation (not ready yet)

Contemplation

Preparation

Action

Maintenance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Nudge model behavioural change

A

Nudge the env for positive change (e.g. fruit near checkout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Theory of planned behaviour

A

Three things lead to intention and subsequent behaviour

1) Attitude to the behaviour
2) Subjective norms (perceived social pressures)
3) Perceived behavioural control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are never events

A

Serious
Largely preventable
Compromise in patient safety
Would not have occurred if preventative measures in place

  • wrong site surgery, psych escape, wrong route chemo etc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What does egalitarian mean?

A

All people are equal and deserve equal rights and opportunities.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

unfits of cohort study

A

Assessment of multiple RF

Assess rare disease

RCT can not be used to assess pathological exposures ethically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Role on communicable disease control consultant

A

Surveillance

Notification

Prevention

41
Q

Causes of homelessness

A

Relationship breakdown

Domestic abuse

Dispute with parents

Bereavement

42
Q

Barriers to healthcare for travellers

A

GPs reluctant to register

Communication difficulties

Lack of permanent site = poor continuity of care

Professional mistrust

43
Q

Barriers for healthcare to homeless

A

Access

Lack of trust

Dont prioritise health (Maslows hierarchy)

44
Q

Presenting illnesses of Asylum seekers

A

Common illnesses

Injuries from travelling/Malnutrition

Untreated Chronic disease
Lack of screening/Immunisations

Mental health: PTSD, depression, psychosis

45
Q

Error of:

  • Intention
  • Action
  • Outcome
  • Context
A

Failure to achieve planned action. Skill/knowledge based

Task specific failure (e.g Wrong order / Omission of something in Tx)

Near miss/Death

Team/Env factors

46
Q

Strategies to reduce errors

A

Simplification

Standardisation of procedures

Checklists

Practice/Training

47
Q

How is risk identified

A

Audit
DATIX
Complaint forms

48
Q

Relative reduction in risk

A

(Risk exposed - risk unexposed) / Unexposed

49
Q

What can be offered to a Drug abuser

A

Health check

Screen for blood borne viruses

Contracepton

Smear and immunisation

Drug services info: Needle exchange

50
Q

Principles in addiction management

A

Harm reduction (advise on risky behaviour_

Intervention: Explain risks, effects and advise on controlling use

Referral to specialist advice

51
Q

Aims of drug use Tx

A

Reduce harm to under/family/society

Improve health

Reduce crime

52
Q

What is domestic abuse?

A

Any incident/pattern

controlling, coercive, threatening behaviour
Violence or abuse

Between those aged over 16

Have been Intimate partners or family

53
Q

Types of abuse

A 
Psychological
Physical
Sexual
Financial
Emotional
54
Q

Role of doctor in abuse

A

Healthcare records

Give helpline

Patient safety

Non-Judgemental

55
Q

Domestic abuse levels of risk

A

Medium: RFs identified. Unlikely to happen without change in circumstance.
- give abuse contact details

High: risk of imminent harm
- Refer to MARAC (multi-agency risk assessment conference)

56
Q

DASH score

A

Used for risk of domestic abuse

Domestic
Abusive
Stalking
Harassment

57
Q

Equity Vs Equality

A

Equity identifies unequal needs which need proportional help

58
Q

Definition of health need

A

Ability to benefit from an intervention

59
Q

Positive and Negative conditioning in addiction

A

Positive: inc intensity of desire to use

Negative: Fear of withdrawal stops not quitting

60
Q

Alcohol dependency

A 
Tolerance
Withdrawal
Neglect of other activities
Continued use despite negative effects
Narrowing repertoire
61
Q

Wernickes Triad

A

Ophthalmoplegia
Ataxia
Mental confusion

GIVE PABRINEX

62
Q

Given to stop alcohol

A

Disulfram (sick)

Acamprosate (GABA blocker)

63
Q

Emotional needs of elderly

A 
Security
Attention
Autonomy
Intimacy
Part of community
64
Q 
Maslows hierarchy of needs
Pyramid 1 (bottom) to 5 (tip)
A

1) Physiological (food, water, sleep)
2) Safety
3) Belonging and love (intimacy/friendship)
4) Esteem: feeling of accomplishment
5) Self actualisation (reaching full potential,)

Need fulfilled 1->5 Some people however to emphasise slightly differently

65
Q

Epigenetics

A

Env influence on genetic regulation

Disease = Genetic predisposition + epigenetic changes

66
Q

Child abuse

A

Abuse in someone under the age of 16

67
Q

Major RF for domestic abuse

A

Preg
Threats
Obsessive

68
Q

Prevention:

Primary
Secondary
Tertiary

A

Prevent onset of disease (vaccinations)

Detect pre-clinical level (screening)

Interventions arrest progress of disease

e.g. of cervical cancer
1 - HPV vaccine
2 - Screening
3 - Tx of cancer

69
Q

Benefits of equity over equlity

A

Leads to equal health

70
Q

Horizontal Vs Vertical Equity

A

H: Those in identical situations should get same Tx

V: Those in different situations treated differently

71
Q

3 Domains of PH

A

Health improvement /Protection at:

1) Indvidual: patient education, immunisations etc
2) Community: Community health groups, green spaces, playgrounds, Vit D for at risk
3) Population: Screening, Sugar and alcohol tax, School meals, Fortified cereals, public smoke ban

Alc E.G.: 1) individual consumption levels, 2) Local alc sales/avail, 3) taxation

72
Q

Theory of planned behaviour problem

A

Doesn’t take into account emotions or habit or routine

73
Q

Typical Transition points for health behaviour

A 
Leaving school
Entering work
Becoming parent
Unemployment
Retirement
Bereavement

Can be +v or -ve

74
Q

What is a meta analysis

A

Compiles stats of research in particular field to give one P-Value

75
Q

Reason for risk taking behav

A

Unrealistic optimism (inaccurate perception of risk)

76
Q

Top down needs management

A

Population level

Manage end result

77
Q

Bottom up needs management

A

Individual approach.

78
Q

Supplied, demanded and needed

A

Contraception, cataract, liability access

79
Q

Types of needs assessment + resource allocation

A

Population/Subgroup e.g. Hillsborough
Condition e.g. COPD
Intervention e.g. Smoking cessation

80
Q

5 step approach to HNA

A

1) Situational analysis (audit current practice)
2) Gap analysis
3) Methods of fixing
4) Implementation
5) Evaluation (re-audit)

81
Q

What is methadone + what used for?

A

Opioid receptor agonist

Used in drug and alcohol misuse to prevent withdrawal

82
Q

Alcohol issue in GP

A

Liver/Kidney failure
CVD
Cacer (2nd after smoking)

83
Q

Alcohol Weekly

A

14 units (1 unit = 8g alcohol)

84
Q

Alcohol related death

A 
Accidents + Violence
CVD
Malignancies (Head and neck , liver, breast, stomach, pancreas)
Cardiomyopathy (dilated)
Cirrhosis
85
Q

Alcohol in Preg

A

ESPECIALLY not 1st trimester

Underweight
Mental retardation
Facial appearance (Flat nasal bridge, epicanthic fold, Micrognathia)
Cardiac/Renal/Occular abnorm

86
Q

Delirium tremens

  • Cause
  • Pres
  • Tx
A

Dec alcohol in dependant individual

Hallucinations (lilliputian), Marked tremor

Supportive: fluids, BZD if fitting, Pabrinex

87
Q

Alcohol screening

A

GGT
Carbohydrate deficient transaminase

CAGE

88
Q

Model for healthcare evaluation

A

Donabedian model

89
Q

Donabedian model sections

A

Structure (what resources, eg building staff eqpt)

Process (how is it done, eg how many patient seen, 2weel wait % etc)

Outcome (5Ds: Death, Disese, Disability, Discomfort, Dissatisfaction)

90
Q

Problem with measuring health outcomes of service changes

A

lots of cofounders

Difficult to link cause and outcomes

91
Q

Maxwells 6 dimensions of quality (EEEAAA)

A

Effectiveness (desired effect)
Efficiency (maximal output)
Equity (fair)

Acceptable
Access (cost, availability)
Approp (right Tx to right people)

92
Q

When to notify of disease

A

One case of a notifiable disease

Contaminations (Infections e.g. restaurant, Chemical, Radiological)

Significant risk: chicken pox in healthcare worker, SARS

93
Q

Social exclusion in the elderly initiatives

A

Age UK over 50 club, Dementia Cafes

94
Q

What is the inverse care law

A

Care is inversely available to those who need it

95
Q

Kordakoffs

A

Profound memory loss

Confabulation (fabricated, misinterpreted memories)

96
Q

Gillick competence

A

Allows child under 16 to consent Tx if deemed Gillick competent
(Sufficient understanding + intelligence)

97
Q

Fraser guidelines

A

Allows child with understanding to consent for contraception

98
Q

When to break confidentiality for underage sex

A

Over 18

Position of power (e.g teacher, Dr etc)

Final (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions