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Phase 2A GP > Public health > Flashcards

Public health Flashcards

1
Q

What 4 questions can be asked to assess mental capacity?

A

Does the patient understand?
Can the patient retain the information?
Can they use the information to weigh up options and make a decision?
Can they communicate their decision?

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2
Q

What is Gillick/Fraser competence?

A

If a child is under 16 they can be assessed as being Gillick/Fraser competent; this means they can make decisions about their care without parental involvement. e.g. Oral contraceptive pills

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3
Q

Describe the trans-theoretical model of behavioural change.

A

Pre-contemplation (no intention of giving up smoking).
Contemplation (consider quitting).
Preparation (get ready to quit in near future).
Action (engaged in giving up).
Maintenance (steady non-smoker).
Relapse

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4
Q

Describe the Health Belief Model (Becker 1974) of behavioural change.

A

The individual needs to believe that there are consequences and that they are susceptible to disease. They need to believe that taking action reduces the risks and that the benefits will outweigh any costs.

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5
Q

Biological features of depression

A

Loss of appetite, overeating, early morning wakening, poor memory, concentration loss, loss of libido, insomnia, constipation, diarrhoea, menstrual disturbance

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6
Q

Cognitive features of depression

A

feeling of being a failure, negative thoughts, reduced self-esteem, reduced confidence (poor memory, concentration loss – if not included in answer above) anhedonia

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7
Q

What is physical dependence?

A

Physical dependence (1 mark); Body adapts to presence of the substance and over time needs more and more for same effect (tolerance) OR Stopping use leads to withdrawal symptoms, e.g. runny nose, stomach cramps, muscle aches.

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8
Q

What is psychological dependence?

A

Feeling that life is impossible/challenges cannot be faced without the drug OR Emotional effect: feelings of fear, pain, shame, guilt, loneliness without drug (1 mark)

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9
Q

Alcohol harm paradox

A

lower socioeconomic status (SES) groups consume less alcohol than higher SES groups but experience greater alcohol-related harm

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10
Q

Examples of public health campaign - primary prevention of harmful drinking

A

Know your limits’ binge drinking campaign
Drinkaware - Alcohol labelling
Minimum Alcohol pricing in scotland

(Smoking- Stoptober, smokefree UK campaign)

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11
Q

What are the 2 types of stress?

A

Eustress (good) vs distress (bad)

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12
Q

NHS population level screening programmes

A

Breast, bowel, cervical cancer, new born blood spot screening, diabetic eye screening programme

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13
Q

Mechanisms behind the black report 1980

A
  • Artefact
  • Social selection
  • Behaviour
  • Material circumstance
  • Confirmed that there were social class health inequalities on overall mortality
  • Confirmed health inequalities are widening
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14
Q

What did the Acheson report 1988 suggest doing in order to reduce health inequalities?

A

Give high priority to the health of families with children.
Reduce income inequalities and improve living conditions.

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15
Q

Define compliance

A

The extent to which the patient’s behaviour coincides with medical or health advice.

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16
Q

Define patient adherence

A

The extent to which the patient’s actions match agreed recommendations. It is more patient centred.

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17
Q

Define concordance

A

Concordance is the expectation that patients will take part in treatment decisions and have a say in the consultation; it is a negotiation between equals.

PATIENTS HAVING AN ACTIVE ROLE IN TREATMENT DECISIONS

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18
Q

5 main duties of a doctor

A

Work in partnership with patients, treat as individuals and respect their dignity.
Work with colleagues in a way that best serve patients’ interests.
Protect and promote health.
Recognise and work within the limits of your competence.
Provide a good standard of care.

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19
Q

Describe the necessity-concerns framework.

A

The necessity-concerns framework looks at what influences adherence. Adherence increases when necessity beliefs are high and concerns are low.

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20
Q

Describe an ecological study.

A

Ecological studies use population level data e.g. mortality rates.

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21
Q

Give an advantage and a disadvantage of an ecological study.

A

Cheap and easy to perform as it uses readily available data.
Bias is possible due to variation in diagnostic criteria.

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22
Q

Give an advantage and a disadvantage of a cross-sectional study.

A

Quick and cheap. Rapid insight into current events in a community.
Prone to bias, no time reference, could be reporting medical oddities.

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23
Q

Describe a cross-sectional study.

A

Looks at the population at a point in time - prevalence study!

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24
Q

Describe a case-control study.

A

Looks at people with a disease (case) and compares with a control (matched). Retrospective.

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25
Q

What are the 4 principles of ethics?

A

Autonomy (respect the patient’s decision).
Benevolence (provide benefits to the patient).
Non-maleficence (do no harm).
Justice (ensure fairness in the distribution of treatment).

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26
Q

Give an advantage and a disadvantage of a case-control study.

A

Results can be obtained quickly due to being retrospective - cheap.
Unreliable if individuals have bad memories. Cannot calculate incidence.

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27
Q

Describe a cohort study.

A

Follows a group of people over time; prospective. Incidence study.

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28
Q

Give an advantage and a disadvantage of a cohort study.

A

Incidence can be determined, reduced chance of bias.
- Expensive, takes a long time and uses large populations. Difficulty with follow up.

29
Q

Give an advantage and a disadvantage of a RCT.

A

Confounders are equally balanced, less bias.
- Expensive, volunteer bias, ethical difficulties in withholding treatment from controls.

30
Q

What type of study might also be known as a prevalence study?

A

Cross-sectional study; looks at the population at a point in time.

31
Q

What type of study might also be known as an incidence study?

A

Cohort study; follows a group of people over time, prospective.

32
Q

Ethics: what is deontology?

A

About following moral duties and rules no matter what. It states that acts are either right or wrong and people have a duty to act accordingly.

33
Q

What are the five focal virtues?

A

Discernment.
Conscientiousness.
Trustworthiness.
Integrity.
Compassion.
(TICCD)

34
Q

Give 5 features of delirium.

A

Acute onset.
Impaired attention.
Decreased consciousness.
Usually reversible.
Often accompanied by physical illness.
Hospital acquired.

35
Q

Name 2 sub-types of anorexia nervosa.

A

Restricting.
2. Binge-eating / purging.

36
Q

Give the 2 characteristic features of bulimia nervosa.

A

Recurrent episodes of binge eating: eating large amounts of food in discrete periods of time and having a lack of control over eating.
Inappropriate compensatory behaviour to prevent weight gain - purging.

37
Q

Give 5 characteristics of binge eating episodes.

A

Eating much more rapidly than normal.
Eating until feeling uncomfortably full.
Eating large amounts of food when not feeling hungry.
Eating alone because of feeling embarrassed.
Feeling depressed or guilty afterwards.

38
Q

What is anorexia nervosa

A

BMI <!7.5

39
Q

First line treatment for eating disorders

A

Cognitive behavioural therapy

40
Q

Give 4 withdrawal symptoms.

A

Tremulousness.
Agitation.
High BP.
Increased HR.
Seizures.

41
Q

What are the 3 main features of the national drug strategy 2010?

A

Reduce demand.
Restrict supply.
Build recovery in communities.

42
Q

Define sensitivity.

A

The proportion of people with the disease who are correctly identified

43
Q

Define specificity.

A

The proportion of people without the disease who are correctly excluded

44
Q

Name 3 vaccine preventable CNS infections.

A

Tetanus.
Measles.
H.influenzae.
TB.

45
Q

Define anorexia.

A

A lack of appetite.

46
Q

Describe the satiety cascade.

A

Sensory.
Cognitive.
Post ingestive.
Post absorptive.

47
Q

What is the function of leptin?

A

It tells the brain not to eat anymore, switches off appetite.

Serum levels of leptin increase after a meal and decrease after fasting.

48
Q

What is the role of CCK in satiety?

A

CCK delays gastric emptying and gall bladder contraction - appetite decreases.

49
Q

What is the role of Ghrelin in satiety?

A

Ghrelin stimulates NPY and AGRP = increases appetite.

50
Q

What are the 5 signs of stress?

A

Biochemical - cortisol levels altered
Physiological - Shallowing breathing, raised BP, more HCl produced.
Behavioural- Over-eating,anorexia, insomnia, more alcohol or smoking or drug use.
Cognitive- Negative thoughts, no concentration, worse memory, tension headaches.
Emotional - Mood swings, irritability, aggression, boredom, apathy (lack of interest), tearfulness.

51
Q

Inheritance pattern - hypertrophic cardiomyopathy

A

Autosomal dominant

52
Q

Inheritance pattern - haemophilia A and B

A

X-linked recessive

53
Q

Inheritance pattern - Von willebrand disease

A

Autosomal dominant

54
Q

Inheritance pattern G6PD deficiency

A

X-linked recessive

55
Q

Inheritance pattern - hereditary sphereocytosis

A

Autosomal dominant

56
Q

Inheritance pattern - Thalassemia

A

Autosomal recessive

57
Q

Sideroblastic anaemia

A

X-linked recessive

58
Q

Inheritance pattern- Sickle cell anaemia

A

Autosomal recessive

Glutamic acid to valine on 6th codon

59
Q

A1AT deficiency inheritance pattern + chromosome

A

Autosomal recessive on chromosome 14

60
Q

Wilson’s disease inheritance pattern + chromosome

A

Autosomal recessive on chromosome 13 (ATP7B)

61
Q

Haemochromatosis inheritance pattern + chromosome

A

Autosomal recessive
chromosome 6 (HFE gene)

62
Q

Huntington’s disease inheritance pattern + chromosome

A

Autosomal recessive
Chromosome 4 HTT gene (huntingtin)

63
Q

Duchenne muscular dystrophy

inheritance pattern

A

X linked recessive

64
Q

ADPKD and ARPKD Chromosome

A

ADPKD 1 - 16
ADPKD 2 - 4
ARPKD - 6

65
Q

Paget’s disease inheritance pattern

A

Autosomal dominant

66
Q

Marfan’s syndrome - inheritance pattern

A

Autosomal dominant

67
Q

Ehler danlos syndrome

A

Autosomal dominant

68
Q

Cystic fibrosis

A

Autosomal recessive, CFTR gene on chromosome 7 - F508 gene deletion

69
Q
A

Phase 2A GP (6 decks)

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