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3A > Public Health > Flashcards

Public Health Flashcards

1
Q

Define Error of inheriting thinking?

A

when a working diagnosis is handed over and accepted without pause for consideration and determining whether it has been substantially proven or whether it matches the overall clinical picture

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2
Q

Define Error due to failure to consider alternatives?

A

when one abnormality is found that fits a particular diagnosis and so you stop searching for other potential clues that may change your differential

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3
Q

Define Error of overattachment?

A

conducting tests to confirm what we expect or want to see and not ruling out other causes

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4
Q

Define Error of bravado?

A

typically working above competence in a show of over confidence that is not safe

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5
Q

Define Error of ignorance?

A

Unconsiouss incompetence

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6
Q

Define horizontal and vertical equity?

A 
Horizontal = equal treatment for equal need
Verticle = unequal treatment for unequal need
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7
Q

Define an epidemiological health needs assessment?

A

Defines a problem and size of the problem. Looks at current services and recommends improvements.
Uses existing data!

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8
Q

Define a comparative health needs assessment?

A

Compares the services recieved by one population to another.

May examine health status, service provision and service utilisation

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9
Q

Define a corporate health needs assessment?

A

Asks the local population what their health needs are, uses focus groups, interviews etc.
Also takes into account views of health care proffessionals, busniessess, social workers and politicians etc.

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10
Q

Define felt need?

A

Individual perceptions of deviations from normal health

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11
Q

Define expressed need?

A

Seeking help to overcome variation in normal health

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12
Q

Define normative need?

A

Professional defines intervention for an expressed need

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13
Q

Define comparative need assessment?

A

Comparisons between severity, range of interventions and cost

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14
Q

What are the 3 methods of resource allocation?

A

Egalitarian (provide all care that is necessary and appropriate to everyone)
Maximising (based soley on consequence and need)
Libertarian (each individual is responsibe for their own health)

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15
Q

Define health behaviour, illness behaviour and sick role behaviour?

A

Health behaviour = aimed at preventing disease (e.g. going for a run)
Illness behaviour = seeking remedy (e.g. going to the gp for a symptom)
Sick role behaviour = activity aimed at getting well (e.g. taking antibiotics)

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16
Q

What are the stages of the transtheoretical model (for change)

A

Precontemplation, Contemplation, Preparation, Action, Maintenance (relapse can occur at any time)

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17
Q

In the theory of planned behaviours how can we bridge the gap between intention and behaviour?

A 
Preparatory actions,
Percieved control,
Anticipated regret,
Implementation of intentions,
Relevance to self
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18
Q

Name the elements of the health belief model?

A

Perceived susceptibility, prercieved severity, health motivation, percieved benefits, percieved barriers

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19
Q

What is a Never Event?

A

A serious, largely preventable patient saftey incident that should not occur if available, preventative measures have been implemented.

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20
Q

What is a cross-sectional study?

A

A snapshot of data of those with and without disease to find associations at a single point in time.
Used to generate hypotheses but are prone to bias

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21
Q

What is a case-control study?

A

A retrospective study which looks at certain exposures and compares similar participants with and without the disease. Can only show association (not causation) and relies on people having good memory

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22
Q

What is a cohort study?

A

A prospectivee study which takes a population without a disease and records their exposures and conditions which they develop. Can show causation

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23
Q

What is a Randomised Control Trial?

A

A group of similar participants randomly sorted into intervention or control groups to study the effect of the intervention.
GOLD STANDARD but there are ethical issues around withholding Tx

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24
Q

What is a confounder?

A

A risk factor other than those being studied which influence the outcome

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25
Q

Define bias?

A

A systematic error that results in a deviation from the true effect of an exposure on an outcome

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26
Q

Define selection and publication bias?

A

Selection bias = discrepancy of who is involved in a study or who is allocated to which study group
Publication bias = some trials are more likely to be published than others

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27
Q

Define the types of information bias?

A

Measurement bias = different equipment used or instruments are wrongly calibrated
Observer bias = the reporter is incorrect when observing or recording data
Recall bias = past events are remembered incorrectly
Reporting bias = responder doesn’t tell the truth

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28
Q

Define epigenetics?

A

Expression of a genome depends on the environment

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29
Q

Define allostasis?

A

Stability through change, our physiological systems have adatpted to react rapidly to environmental stressors

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30
Q

Define allostatic load?

A

Long term overtaxaion of our physiological systems leads to impaired health (stress)

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31
Q

Define salutogenesis?

A

Favourable physiological changes secondary to experiences which promote healing and health

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32
Q

Define emotional intelligence?

A

The ability to identify and manage ones own emotions as well as those of others

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33
Q

Under which circumstances should you always prescribe antibiotics (pt.1)

A

Bilateral otitis media in <2 years.
Acute otitis media with otorrhoea.
Acute sore throat with 3 or more of: exudate, fever, tender cervical lymphadenopathy, absence of cough.
Systemically very unwell.

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34
Q

Under which circumstances should you always prescribe antibiotics (pt.2)

A

High risk.
Age >65 and 2 of the following or >80 and 1 of the following: hospital admission within the last 12 months, type 1 or type 2 diabetes, congestive HF, glucocorticoid use.
Complications: pneumonia, mastoiditis, peritonsilar abscess and cellulitis

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35
Q

Which Abx is most appropriate in otitis media?

A

Amoxicillin 5 days

36
Q

Which Abx is most appropriate in sinusitis?

A

Amoxicillin 5 days or Doxycycline 5 days

37
Q

Which Abx is most appropriate in tonsillitis?

A

Penicillin 10 days

38
Q

Which Abx is most appropriate in LRTI?

A

Amoxicillin 5 days

39
Q

Which Abx is most appropriate in UTI?

A

Trimethoprim 3 days or Nitrofurantoin 3 days

40
Q

What are the 3 domains of public health?

A

Health improvement - social interventions
Health protection - measures to control infectious disease, risks and environmental hazzards
Improving services - organisation and delivery of safe and high quality services

41
Q

What is a health needs assesment?

A

A systematic method for reviewing the health issues facing a population

42
Q

What is a health needs assement based on?

A 
Need = ability to benefit from an intervention
Demand = what people ask for
Supply = what is provided
43
Q

Define primary, secondary and tertiary prevention?

A 
Primary = preventing a disease before it has happened
Secondary = catching diseases in the pre-clinical or early phase
Tertiary = preventing complications of disease
44
Q

What is the prevention paradox?

A

A preventative measure which brings much benefit to the population often offeres little to each participating individual

45
Q

Define screening?

A

A process which sorts out apparently well people who probably have a disease (or precursors/susceptibility to a disease) from those who probably do not. NOT diagnostic!

46
Q

What is the Wilson and Junger criteria for screening?

A

The condition = an important health problem, latent/preclinical phase, natural history known
The test = suitable and acceptable
The treatment = effective and agreed policy on who to treat
The organisation and cost = facilities available, costs of screening is balanced in relation to healthcare spending as a whole

47
Q

Define sensitivity?

A

The proportion of people with the disease who are correctly identified by the screening programme
TP/(TP + FN)

48
Q

Define specificity?

A

The proportion of people without the disease who are correctly excluded by the screening test
TN/(TN+FP)

49
Q

Define positive predicitve value? How does preverlance affect this?

A

The proportion of people with a positive test result who actually have the disease.
Higher if prevelance is higher
TP/(TP+FP)

50
Q

Define negative predicitve value? How is this affected by prevelance

A

The proportion of people with a negative test who do not have the disease
Lower if prevelance is higher
TN/(FN+TN)

51
Q

What is an ecological study?

A

Uses routinley collected data to show trends in data and is useful in generating a hypothesis. It shows preverlance and association but can not show causation.

52
Q

Define epidemiology?

A

The study of the frquency, distribution and determinants of dieases and health related states in populations in order to prevent and control disease

53
Q

Define incidence?

A

New cases of a disease in a population over a specified period of time

54
Q

Define prevelance?

A

The proportion of persons in a population who have a particular disease at a specified point in time

55
Q

Define relative risk?

A

How many times more likely it is that a health event will occur in the one group compared to another (intervention group compared to the control)

56
Q

Define number needed to treat?

A

The number of patients who we need to treat to prevent one bad outcome

57
Q

What are the symptoms of drug addiciton?

A

Craving, tolerance, compulsive drug-seeking behaviour, priortising drugs, psychological withdrawal state

58
Q

What is the first-line drug used in detoxification of heroin? Who is this likely to work on?

A

Buprenorphine

Younger users, less time addicted, often not injecting, lower level of drug use

59
Q

Which medications can be used in maintenance of heroin abstinence?

A

Methadone, buprenorphine

Naltrexone - prevent relapse

60
Q

What drug treatments can be offered to aid smoking cessation? Which is the most affective

A 
NRT, Varenicline or Bupropion
Combined NRT (a patch plus a short acting preparation) or Vareniciline
61
Q

When should you start taking the different nicotine replacement therapies?

A 
NRT = on the day of quitting
Varenicline = 7-14 days before quitting
Bupropion = 7-14 days before quitting
62
Q

How long can NRT patches be used for?

A

16 hours (and taken off over night) or 24 hours

63
Q

What drug treatments can be offered to aid smoking cessation in pregnant or breastfeeding women?

A

NRT - this can only be precribed if she has previously failed to quit without NRT!

64
Q

How quickly must you provide information to the Health Protection Agency if requested?

A

In writing within 3 days

65
Q

Define an outbreak?

A

2 or more related cases of a communicable disease

66
Q

What are the health problems commonly found amoungst homeless people?

A

Infectious disease (TB and hepatitis). Poor condition of feet and teeth. Respiratory issues. Injuries following violence and rape. Sexual health issues. Serious mental illness. Poor nutrition. Addictions

67
Q

What are the types of leadership?

A

Inspirational, transactional, laissez-faire, transformational

68
Q

Define Bolam test (in relation to negligence)?

A

Would a group of reasonable doctors do the same?

69
Q

Define Bolitho test (in relation to negligence)?

A

Would it be reasonable of them to do so?

70
Q

What are the types of learner?

A

Theorist, Activist, Pragmatist, Reflector

71
Q

Define Ethnocentrism?

A

The tendency to evaluate other groups according to the values and standards of ones own cultural group with the conviciton that ones own cultural group is superior

72
Q

Define Stereotype?

A

Involves generalisations about the ‘typical’ charcteristics of members of a group

73
Q

Define prejudice?

A

Attitudes towards anotehr person based soley on their membership of a group

74
Q

Define discrimination?

A

Actual positive or negative actions towards the objects of prejudice

75
Q

Define rationing?

A

A resource is refused because of lack of affordability rathter than clinical ineffectivness

76
Q

What are the GMC duties of a doctor?

A

Make the care of your patient your first concern.
Protect and promote the health of patients and the public.
Provide a good standard of practice and care.
Treat patients as individuals and respect their dignity.
Work in partnership with patients.
Be honest and open and act with integrity

77
Q

What are the stages of wound healing?

A

Vascular response, inflammatory response, proliferation and maturation

78
Q

What are the elements of the 4 quadrant approach to ethics?

A 
Medcial indications (beneficence and non-maleficence)
Patient preference (respect autonomy)
Quality of life (beneficence and non-maleficence)
Contextual features (loyalty and fairness)
79
Q

What is invovled in the seed house ethical gird?

A

Transparency and honesty, respect and care, consious freedom, experiential and tacit awareness, reflexive practice

80
Q

What are the core features of the seed house ethical grid?

A

Core rationale, deontological layer, consequential layer and external considerations

81
Q

Transition points are a thing in life which may influence someone to be more or less likely to change their behaviours. Give 4 examples?

A

Becoming a parent, becoming unemployed, bereavement and leaving school

82
Q

Which score is used to assess pressure ulers?

A

Waterlow score

83
Q

What are the elements of maxwells dimensions of quality?

A

Effectivness, acceptability, efficiency, access, equity and relevance

84
Q

What is in the Bradford-Hill criteria?

A

Strength (effect size), consistency (reproductibility), specificity, temporality, dose-dependant relationship (biological gradient), plausability, coherence, experiment and analogy

85
Q

What are the 4 componenets of negligence?

A

Duty of care, breach in this, harm, harm because of breach

3A (11 decks)

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