Public Health Flashcards
Describe the Black report 1980
- Confirmed social class health inequalities in overall mortality
- Confirmed health inequalities are widening
Describe the Acheson report 1988
Mortality has decreased in the last 50 years but inequalities remained or widened
What must consent be?
Voluntary, informed and made by someone with capacity
What should you tell patients when obtaining consent?
- What treatment is
- How it is done
- Risks
- Benefits
- Alternatives
Describe Friedman and Rosenman 1959
Type A and type B behaviour patterns
- Type A = competitive, hostile, impatient = higher risk of heart disease and HTN
What 4 things are needed to verify death?
- No heart sounds/carotid pulse for 1 minute
- No breath sounds/respiratory effort for 1 minute
- No response to painful stimuli
- Fixed and dilated pupils
What are the recommendations on drinking alcohol?
- No more than 14 units a week
- Spread them evenly over 3+ days
How do you calculate units in a drink?
%ABV x volume (ml) /1000
Describe the action of alcohol
- Potentiates GABA (inhibitory neurotransmitter)
- Inhibits glutamate (excitatory neurotransmitter)
How do you treat alcohol/drug withdrawal?
Alcohol = benzodiazepines (e.g. chlordiazepoxide)
Drugs = methadone
Describe the STI/HIV transmission model
R = B x C x D
reproductive rate = infectivity rate x partners over time x duration of infection
Describe primary, secondary and tertiary prevention
Primary - intervening before health effects (e.g. campaigns)
Secondary - screening to identify early disease
Tertiary - managing disease to slow/stop it
Describe influenza A and B
- Main human pathogens
- Viral genome consists of 8 single stranded RNA segments
- Segmentation means gene reassortment can occur in infection
Describe antigenic shift vs drift
Drift = virus undergoes a gradual change in genetic makeup, causing a different but similar genetic makeup (season epidemics)
Shift = virus undergoes a sudden change in genetic makeup, creating a new strain (pandemics)
Differentiate outbreak, epidemic and pandemic
Outbreak = 2+ linked cases
Epidemic = more cases in a region/country
Pandemic = spans international boundaries
What is the alcohol harm paradox?
Lower socioeconomic status groups drink less alcohol than higher socioeconomic status groups but experience more alcohol related harm
Describe the effects of foetal alcohol syndrome
- Pre and post natal growth retardation
- CNS abnormalities e.g. irritability, incoordination, hypersensitivity
- Craniofacial abnormalities
- Defects of eyes, ears, mouth, CVS, GUT, skeleton
What are some notifiable dieases?
- Acute encephalitis
- Acute meningitis
- Acute infectious hepatitis
- Anthrax
- Cholera
- Legionnaires disease
- Malaria
- Measels
- SARS
- Smallpox
- TB
When can you break confidentiality?
- Risk to public safety (crime/abuse)
- Given consent
- Required by law (notifiable disease)
What are the 3 main eating disorders?
- Anorexia nervosa
- Bulimia nervosa
- Binge eating disorder
What is OSFED?
Other specified feeding and eating disorders:
- Atypical anorexia nervosa
- Bulimia nervosa/binge eating disorder of low frequency/limited duration
- Purging disorder
- Night eating syndrome
What is the process managing C. diff?
SIGHT:
- Suspect C. diff as a cause of diarrhoea
- Isolate the cause
- Gloves and apron
- Hand washing*
- Test stool for toxin
*C. diff is hard to destroy because it is spore forming
Where are norovirus outbreaks common?
- Schools
- Cruise ships
- Restaurants
- Hospitals
What influences patients’ evaluations of prescribed drugs?
- Necessity - perception of personal need for treatment
- Concerns - worries about ADR
Describe human error
- A failure of a planned action/a sequence of mental/physical actions to be completed as intended
- The use of a wrong plan to achieve an outcome
What is a never event
Serious, largely avoidable patient safety event which should not occur if the available preventative measures have been implemented
Describe the swiss cheese model
- Each slice is a level of defence
- Holes are latent conditions/poor design/poor management decisions
- If many holes line up, it gives a patient safety incident
When can abortions take place?
Until 24 weeks of pregnancy
When may an abortion take place later than 24 weeks?
If there is a risk to life or problems with the baby’s development
Define compliance
The extent to which the patient’s behaviour coincides with medical/health advice (patient must follow doctor’s orders)
Define adherence
The extent to which the patient’s action match agreed recommendation (patient has more say in management)
Define concordance
Expectation that patients will take part in treatment decisions and have a say in the consultation (negotiation between equals)
Describe the LOVERS communication model
Listen, learn what the problem is
Observe, look at body language
Verify, check you understand
Empathise
Reassure
Seek an agreeable compromise
What is the difference between incidence and prevalence?
Incidence = number of people in a population who develop a disease over a period of time (new cases)
Prevalence = number of people in a population who have a disease at one point of time (all cases)
