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Public health Flashcards

1
Q

What diagnoses can have social labels with potentially negative consequences?

A

Psychiatric
Sick notes
Legal claims

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2
Q

What results in stigma?

A

Negative response to a label
Presence of some deviation from normality and social reaction to the subsequent diagnosis

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3
Q

What are the political consequences of stigma?

A

Political phenomenon related to citizenship and the lack of entitlement
Applied more broadly to any condition, attribute, trait, or behaviour that marks the bearer as culturally unacceptable or inferior

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4
Q

Where can stigma reside?

A

In the person
In the audience/observer

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5
Q

What are the 3 distinct types of stigma?

A

Abominations of the body such as blemishes/deformities
Character defects such as mentally ill/criminal
Tribal stigma -> distinction between virtual social identity (normative expectations) and actual social identity (attributes individual possesses)

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6
Q

What is the difference between discreditable and discredited tribal stigma

A

Discreditable -> something that can be hidden eg mastectomy/ileostomy
Discredited -> something that is obvious eg amputation/wheelchair user

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7
Q

What is felt/enacted stigma? What is the impact of both?

A

Enacted = discrimination
Fear of stigmatisation is more disruptive than enacted discrimination

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8
Q

What is the effect of weight stigma on children?

A

Bullying and impacts socialising and academic performance

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9
Q

What is the effect of weight stigma on adults?

A

Affects employment and health
Negatively impact likelihood of engaging in pro-health behaviours

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10
Q

Name some drugs that can cause addiction

A

Benzodiazepines
Opiates

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11
Q

Name some drugs that can cause follow-on abuse

A

Alcohol
Illicit drugs

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12
Q

Name some drugs that can cause electrolyte imbalances

A

Laxatives

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13
Q

Name some drugs that can cause withdrawal symptoms

A

SSRI

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14
Q

Name some drugs that can cause convulsions/acidosis

A

Chlorphenamine
Antihistamines

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15
Q

What are the main s/e of ibuprofen?

A

GI - indigestion, bleeding, death
Hypokalaemia
Acidosis

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16
Q

What are the main s/e of paracetamol?

A

Hepatotoxicity
Death
Rebound headache

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17
Q

What is the difference between misuse and abuse?

A

Misuse = wrong dose or indication, unintentional
Abuse = deliberately exploiting side effects, experimentation

18
Q

What support is there for those abusing drugs?

A

Formal addiction services
Self-help
Involvement of GP
On-line support
Narcotic anonymous
Private clinics

19
Q

Name 3 prescription drugs that are associated with abuse and dependency

A

Opioids
Benzodiazepines
Z-drugs (zopiclone, zolpidem)
SSRIs
GABAergics (pregabalin, gabapentin)

20
Q

Name 3 OTC drugs that are associated with abuse and dependency

A

Analgesic codeine with paracetamol/ibuprofen
Opiate cough medicines
Sedative antihistamines
Laxatives
Nicotine replacement therapy
Decongestant stimulants

21
Q

Who is most likely to abuse OTC medicines?

A

Older women

22
Q

Name 3 risk factors for opiate abuse

A

Genetic predisposition
Personal psychosocial profile
Personal/family history of addiction
Psychiatric disorders
Younger
High opioid doses
Use of short-acting opioids
High pain level
Multiple pain complaints
Self-reported craving
Concurrent use of tobacco, alcohol, benzodiazepines

23
Q

How can we deal with addiction in healthcare?

A

Pharmacy -> hide product, refuse sale, record sales
Harm reduction intervention pilot
Pack warnings
Training for HCPs
Increased awareness of issue
Information for patients about risk
Prevention
Treatment
Internet support groups

24
Q

What treatment is available for addiction?

A

Depends on the medicine
Opiates -> substitution treatment (methadone)
Benzos -> tapering dose

25
What strategies are in place to minimise risk in the NHS?
Patient safety alerts Simplification and standardisation of clinical processes eg marking surgical sites, SBAR Checklists and aide memoires eg NEWS2 Information technology Tools to improve uptake of evidence based treatment Supporting better team working
26
What is mental preparedness?
Good healthcare professionals not error-free, expect, detect, and compensate for errors Watchfulness and foresight are means of preventing and recovering incidents Foresight ability to identify, respond to, and recover from initial indications that patient safety incident could take place
27
What is the three bucket model?
Self, context, task Fuller buckets are, more likely something will go wrong but buckets are never empty
28
Name 3 nutritional concerns in older adults
Change in body composition Decreased energy requirements Sarcopenia (loss of lean body mass)/obesity/ sarcopenic obesity Bone loss Chronic disease Monotonous diet Protein B12, B6 Folic acid Vit D Calcium
29
How does iron requirements change with age?
Identical for older and younger adults but lower in older women as not longer menstruating?
30
What is malnutrition?
State of nutrition in which deficiency or excess of energy, protein, and other nutrients causes measurable adverse effects of tissue/body function and clinical outcome Closely linked with mortality
31
What are the consequences of malnutrition?
Lengthened hospital stay, reduced QoL Increased risk of developing disease Loss of muscle tissue and strength -> respiratory muscle = chest infection, cardiac function = HF Mobility Reduced immune response/increased infections Poor wound healing Loss of mucosal integrity (malabsorption/bacterial translocation) Psychological decline Poor prognosis
32
What is sarcopenia?
Decrease in lean body mass associated with ageing
33
Name 3 causes of sarcopenia
Reduced physical activity Change in body composition Malnutrition Increased cytokine production Reduced sex hormones Chronic disease
34
Name a social factor affecting nutrition intake
Isolation Neglect
35
Name a psychological factor affecting nutrition
Bereavement Depression Dementia
36
Name an economic factor affecting nutrition
Cost Access
37
What social support is available for those at risk of malnutriton?
Meals on wheels Lunch clubs Home delivery services
38
Name some physiological factors affecting nutritional intake and absorption
Visual impairment Mobility Dexterity Dental health Illness/polypharmacy GI changes -> taste, hormonal, CCK, gut motility, atrophic gastritis
39
What is important to remember about geriatrics in hospital?
People > 80 twice as likely to become malnourished during a hospital stay than the under 50s
40
How can you assess nutritional status?
Anthropometric measures - BMI - Waist circumference - Body fat - Demispan Bioelectrical impedance analysis Physiological function - Hand grip strength - Timed up and go - 30 seconds chair stand test MUST MNA

Phase 3b (6 decks)

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