PMHP Questions Flashcards
1
Q
Using a graph showing D3t, mt and ft
What is D3t , mt and ft ?
A
- D3t = decayed deciduous teeth
- Mt = missing teeth (XLA or decayed)
- Ft = filled teeth
DMFT = in adults | dmft = in children
2
Q
What is D/DMF , F/DMF and M/DMF?
A
D - indication of treatment need
F - indication of treatment provision
M - indication of treatment failure
3
Q
Name 3 reasons why a d3mft show a difference between 2 areas? (3)
A
- Socioeconomic status
- Ethnicity status
- Individual health board involvement
4
Q
At a population level, name 3 fluoride delivery methods? (3)
A
- Fluoridated water
- Fluoridated milk
- Fluoridated salt
5
Q
What 3 interventions are done in scotland on a population basis? (4)
A
- Smoking ban in public areas
- School food policy
- Sugar tax
- Minimum wage/national living wage
6
Q
What is PICO? (4)
A
- P = population
- I = intervention
- C = comparison
- O = outcome
7
Q
Example of PICO from a chart?
A
- P - children with caries in primary teeth
- I - hall technique
- C - compared with standard technique
- O - Rate of failures
8
Q
What is the relative risk?
A
- Ratio of risk of an event in the exposed group to the risk of an event in the unexposed group
- The level of increase of the disease in exposed group
If the RR is 1 = no difference in risk
No 0 values
9
Q
What the confidence interval?
A
- The range of values the ARD will take in the population
- 95% = true population ARD
- It indicated certainty of evidence
- If overlaps 0 - null hypothesis
10
Q
What are the 5 steps in clinical audits? (5)
A
- Identify problem or issue
- Set criteria or standards
- Observe practice and collect data
- compare performance with criteria and standards
- Implement change
11
Q
What other things can be done other than audit?
A
- Peer review
- Quality improvement programme
- continued professional development (CPD)
12
Q
What are the 6 dimensions of healthcare? explain each
A
- Safe - avoid harm to patients
- Timely - reduce waits and delays for patients and staff
- Efficient - avoiding waste of equipment, supplies, ideas and energy
- Equitable - providing care of same quality for everyone no matter the personal characteristics
- Effective - providing services based on scientific knowledge to all who could benefit and reframing from providing services for those who will not benefit
- Patient centered - provide care that is respectful of a responsive to individual patient preferences, needs and values
13
Q
Intra oral signs of cocaine use
A
- Xerostomia
- Bruxism
- Attrition and erosion
- Temporomandibular joint pain
- Oronasal defects
- Chronic sinusitis
- Palatal perforation
14
Q
What side effects are associated with opioid use? (5)
A
- addiction
- nausea
- drowsiness
- lethargy
- constipation
- paranoia
- respiratory depression
15
Q
Complications of using LA with adrenaline in a patient with cocaine addiction?
A
- Increased adrenergic activity
- acute increase in blood pressure
- increase the risk of seizures
16
Q
Cocaine effects on the body?
A
- increased heart rate (heart problems)
- Nausea
- Seizures
- Addiction
17
Q
Side effects of heroin
A
- Dry mouth
- itching
- withdrawal symptoms such as headaches and anxiety/paranoia
- Cognitive impairment
18
Q
What is methadone and what is it used for?
A
- A long acting opioid agonist that help manage withdrawal symptoms of people with dependance of opioids such as heroin
- It is also used for treatment of chronic pain
19
Q
What group does methadone belong to ?
A
- Opioids class A drug
20
Q
What is complications of methadone containing sugar?
A
- high caries and periodontal risk
21
Q
What is the risk of sugar free preparation of methadone?
A
- Does not contain chloroform so could be injected
- May cause diarrhoea
22
Q
What are the 3 types of consent ?
A
- Implied - patient actions or lack of action clearly indicates their wishes
- Verbal - patient clearly states their consent for procedure
- Written - patient signs declaration that they consent to procedure
23
Q
What factors relating to procedure need to be discussed with the patient to gain consent?
A
- Options for treatment, risks and potential benefits of all
- Risks and benefit of proposed treatment
- The prognosis
- The recommended opinion
- The cost of the proposed treatment
- What might happen if the proposed treatment in not carried out
- Whether the treatment is guaranteed and how long for
24
Q
What 6 factors make up consent? (6)
A
- Not manipulated
- Not coerced
- voluntary
- Valid
- informed
- with capacity
25
What makes a consent valid? (3)
* recent
* specific
* remains appropriate
26
What type of person carries consent for a 3 year old?
Birth mom
27
What type of patient carries out consent for a 16 year old patient?
* The patient have the legal capacity to consent on their own behalf to any surgical, medical or dental procedure
28
You saw 2 nurses getting off the bus with their uniforms from the practice you work in
What 2 concerns would you raise with them?
* Infection control - wearing the uniform out and in the practice
* Practice and profession reputation - as nurses have uniform that show where they work
29
Name learning outcomes from a learning session on PPE?
* Always wear PPE when carrying out procedures
* Wear fresh PPE when cleaning
* Change PPE between patients and cleaning
* Correct disposal of PPE in orange stream waste
* Protection of hands, eyes, clothing with PPE
* Protect the patient with glasses and apron
* PPE can reduce the spread of infection
30
How would you ensure staff follow instructions on PPE? (3)
* Regular inspections
* Clinical audits
* Reflections
31
What types of studies provide the highest level of evidence?
* Cochrane reviews
* Which are systematic assessments of all relevant randomised control trials (RCTs)
32
List 4 aspects of Cochrane reviews?
* Randomisations - facilitates statistical analysis
* Inclusion and exclusion criteria
* Randomised Double blinding - reduce bias
* Control groups - to investigate statical significance
33
Give three examples of study designs other than Cochrane reviews
* Randomised control trial - effectiveness and efficacy of treatments
* Cohort studies - Prospective study (now - future)
* Case control studies - retrospective study (now - past)
* Case study - one patient report
34
What is incidence?
* number of new disease cases over a period of time in a defined population
* obtained from longitudinal studies or derived from registers
35
Incidence rate
no of new cases of disease over the number of individuals at risk of the disease in a population during a defined period
36
What is prevalence ?
* The number of diseases cases in a specific time in a specific population
* Obtained from cross-sectional studies or from registers
* absence or presence of disease
37
What SiMd?
* Scottish index of multiple deprivation
* An area based index which use a range of data to decide which neighbourhoods are most deprived
* by ranling data zones in order of deprivation from 1-10 (most to least deprived)
38
What factors can influence deprivation? (7)
* Employment status
* Income
* Health and healthcare services
* Geographic access to services
* Crime
* Housing, living and working conditions
* Education, skills and training
39
What is a split mouth study design?
* trials in which each subjects receive 2 treatments each to a separate section of the mouth
40
What are the advantages of a split mouth study design?
* Both control and intervention group are exposed to same environment
* Each of the 2 treatments are randomly assigned to either the right or left side of the dentition in the same environment
* Increased efficiency
* Ability to compare treatment in same individual
* reduced inter-individual variability
41
What are the disadvantages of split mouth study designs?
* Patients cannot be blinded
* More bias in reporting
* Incorrect reporting risk
* Contamination of one treatment by the other
42
What values regarding confidence interval are important?
* n = sample size - the bigger the better
* ARD
* Width of the confidence interval = the narrower the better
* Level of confidence
* 0 is the null hypothesis
43
What is the P value?
* It is used to determine the significance of the results
* If P value is less than 0.05 = results are statistically significant
44
What is the primary appraisal in stress?
Initial assessment of stressor which can be
* irrelevant
* benign
* harmful - threat
* harmful - challenge
45
What is secondary appraisal in stress?
* Reaction to primary appraisal
- harm
- resistance
- exhastion
46
Give different responses to stress (4)
* Direct action
* Seek information
* Do nothing
* Coping
47
What is burnout? (3)
* Disengagement of a previously committed person from work due to stress
* Associated with mental and physical exhaustion
* Negative or indifferent attitude towards life
48
Give examples of coping mechanisms for stress?
* Good work/life balance
* Exercise
* Setting own targets and goals
* Knowing personal limits
49
What are the recommended allowances for alcohol intake for males and females?
* 14 units per week with
* at least 2 alcohol free days
50
How may you screen for alcohol abuse? (4)
Using screening tools such as
* AUDIT : alcohol use disorder identification test (questionnaire approved by WHO)
* Take history through CAGE
* Liver function test by GDP if concerned
* Fast alcohol screening test (questionnaire)
51
What is involved in CAGE alcohol screening?
Questions to ask patient during taking history to screen for alcohol abuse involving
C - have you felt that you should cut down alcohol?
A - have you ever got annoyed by criticism about your drinking?
G - have you ever felt guilty about your drinking ?
E - have you ever had alcohol the first thing in the morning because of a hangover?
52
What brief intervention can be used for alcohol abuse?
* Alcohol brief intervention can be used
- raise the issue about their drinking
- Screen and give feedback of risks
- listen to readiness to change
- give options, information and advice (refer)
* Use FRAMES
53
What is FRAMES alcohol intervention?
* Feedback - about risks of alcohol
* Responsibility - it is the person own choice to decide
* Advice - 12 units per week with 2 alcohol free days
* Menu of options available
* Empathy - show empathy when talking to the patient
* Self efficacy - give a positive message such as " you can do it!"
54
How do you calculate how many cigarettes pack a year?
* Used to quantify the cumulative exposure to cigarette smoking
* Number of packs per day x number of years
* there is 20 cigs in one pack
55
How do you offer smoking brief intervention?
* 5A's - Ask, advice, assist, assess , arrange
* 3A's - Ask (smoking status), advise (benefits) , Act (signpost)
* 2A1R - Ask , Advice , Refer
56
How would you communicate the risk ratio to a colleague?
If the value overlaps the risk ratio (1) then the results are not significant
57
