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Phase 3a conditions list flashcards > Public health > Flashcards

Public health Flashcards

1
Q

What are the 4 types of prevention of disease?

A
  • Primary
  • Secondary
  • Tertiary
  • Quaternary?
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2
Q

What is primary prevention?

A

Preventing disease onset e.g. 5-a-day; vaccinations

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3
Q

What is secondary prevention?

A

Early detection/ optimise prognosis/ prevent recurrence e.g. screening

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4
Q

What is tertiary prevention?

A

Effective symptom management e.g. medications

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5
Q

What is quaternary prevention?

A

Prevent overmedicating patient??

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6
Q

What are two approaches to disease prevention?

A
  • Population - for all
  • High risk - for high risk groups
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7
Q

What is the prevention paradox?

A

Measures to improve public health will have little effect on MOST people

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8
Q

What is sensitivity?

A

True positive/ (true positive + false negative)
% diseased population testing +ve

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9
Q

What is specificity?

A

true negative/ (true negative + false positive)
% without disease who test negative

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10
Q

What is positive predictive value?

A

TP/(TP+FP)
% who test positive who are actually positive

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11
Q

What is negative predictive value?

A

TN/(TN+FN)
% who test negative who are actually negative

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12
Q

What are the different types of screening (3)?

A
  • Population
  • Opportunistic
  • Occupational
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13
Q

What are some cons of screening (5)?

A
  • Subclinical diagnosis?
  • Fase reasurance
  • Invasive/ uncessarsarry Tx/ Ix
  • Expensive
  • Anxiety/ worry
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14
Q

What is the name of the criteria to screen successfully?

A

Wilson junger criteria

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15
Q

What are the 10 Wilson junger criteria?

A
  • Important health condition
  • Available treatments and diagnostic facilities
  • Treatable disease
  • Recognisable latent period
  • Obvious diagnostic test
  • Generally accepted (the test to screen)
  • Economically viable
  • Natural history of untreated disease is known
  • Issued agreed policy (on who to treat)
  • Continuously done (not abruptly stopped)
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16
Q

What are two biases of screening that might make it appear to work?

A
  • Lead time - cases picked up earlier so gives illusion of people living longer
  • Length time - slower progressing disease more likely to be picked up on screening than faster progressing disease
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17
Q

What are the types of study design (6)?

A
  • Ecological - observational across whole population (using census data)
  • Cross sectional - looks at 1 point in time, assesses prevalence of disease and RFs at that point in time
  • Case control - compares a group with a disease and a group without a disease and assesses their past exposure to RFs
  • Cohort - follows a group with AND without a RF overtimes and assesses their development of a disease
  • RCT - randomly assign an action to a group and compare their likelihood of disease with that of a control group
  • Systematic review - combine currently existing studies into larger review
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18
Q

What is incidence?

A

Number of new cases in given time

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19
Q

What is prevalence?

A

Total number of cases at one point in time

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20
Q

What is relative risk?

A

The increased likelihood of an event occurring given exposure

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21
Q

What are odds?

A

Ratio of event happening/not happening

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22
Q

What are odds ratio?

A

Odds in exposed group/ odds in control group
this results in an amplification of the increase in likelihood

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23
Q

What are some types of bias (6)?

A
  • Selection bias - includes if people drop out of study
  • Recall bias (problem in how participants recall information)
  • Reporter + observational bias
  • Publication bias (results not published/ included in meta analysis)
  • Measurement
  • Observer - actions of participants change when they know they are in study
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24
Q

What criteria are used to assess causation?

A

Bradford hill criteria

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25
Q

What are the Bradford hill criteria?

A
  • Dose - response
  • Reversibility
  • Consistency
  • Biological plausibility
  • Temporality (effect occurs after cause)
  • Coherence (between lab and people)
  • Analogy
  • Strength
  • Specificity
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26
Q

What are the 3 domains of public health?

A
  • Improving health promotion
  • Protection of health
  • Service improvement
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27
Q

What is equality?

A

Everyone treated the same

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28
Q

What is equity?

A

People treated according to need

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29
Q

What is vertical vs horizontal equity?

A
  • Horizontal = equal treatment for equal need
  • Vertical = unequal treatment for unequal need
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30
Q

What are the 3 levels interventions can be delivered at?

A
  • Individual
  • Community
  • Population
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31
Q

What are the two types of health behaviour?

A
  • Health promoting
  • Health damaging
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32
Q

What are the 3 types of health promoting behaviours?

A
  • Health behaviour (e.g. exercise)
  • Illness behaviour (e.g. seek remedy)
  • Sick role (e.g. resting)
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33
Q

What are some reasons for damaging health behaviours (3)?

A
  • Cultural
  • Unrealistic optimism (e.g. infrequent so unlikely to do harm)
  • Stress
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34
Q

What are the 3 models of behaviour?

A
  • Becker (health belief model)
  • Transtheoretical
  • Theory of planned behaviour
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35
Q

What is the Becker model (health belief model) of behaviour (4)?

A

Individual will change if they believe they are:
* Susceptible
* Acknowledge consequences
* Believe action decreases susceptibility
* Action consequences outweigh continuing

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36
Q

What are the steps in the transtheoretical model of behaviour (6)?

A

Precontemplation –> contemplation –> preparation –> action –> maintenance –> relapse

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37
Q

What is the theory of planned behaviour (3)?

A
  1. Attitude + Subjective norm (others attitudes towards behaviour) + perceived behaviour control
  2. Intention
  3. Action
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38
Q

What is the nudge theory?

A

Changing environment can influence an individuals chance of choosing an action e.g. putting fruit near checkout makes people more likely to buy fruit

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39
Q

What is motivational interviewing?

A

Counselling approach to encourage patients to change their behaviour through exploring conflicting emotions

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40
Q

What is a model to describe health needs?

A

Bradshaw model

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41
Q

What is Bradshaw model (4)?

A
  • Felt need - feeling short of breath
  • Expressed need - attending GP
  • Normative need - need determined by expert
  • Comparative needs - comparing services received by one group of people with that of another
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42
Q

What is the health needs assessment cycle (4)?

A
  1. Assess
  2. Plan
  3. Implement
  4. Evaluate
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43
Q

How can health needs be assessed (assessment approach) (3)?

A
  • Epidemiological - uses data on prevalence and incidence to evaluate needs
  • Comparative - compare 2 demographically different services e.g. geographically
  • Corporate - based on professionals POV/ organisational goals
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44
Q

What are some examples of services supplied +/- demand +/- need (3)?

A
  • Supplied, not needed or demanded = ??75+ health checks??
  • Supplied, needed, not demanded = heal prick newborn test
  • Supplied, needed and demanded = surgery
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45
Q

How are health needs evaluated (evaluation approach) (2 methods)?

A
  • Donabedian approach
  • Maxwell dimensions
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46
Q

What is the donabedian approach to evaluating health needs (3)?

A
  • Structure - what’s there
  • Process - what’s done
  • Outcome
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47
Q

What are the Maxwell dimensions to evaluate health needs (6)?

A
  • Accessible
  • Acceptable
  • Appropriate
  • Effective
  • Efficacy
  • Equity
48
Q

How many grams + ml is 1 unit of alcohol?

A
  • 8 grams
  • 10 ml
49
Q

How much alcohol is recommended to not drink over each week?

A

14 units

50
Q

What is considered binge drinking?

A

Drinking more than 6 units at once

51
Q

What is an error?

A

A preventable unwanted outcome due to human factor

52
Q

What 2 models are used to explain errors?

A
  • Swiss cheese model
  • 3 bucket model
53
Q

What is the Swiss cheese model?

A

All holes line up to allow for an error to occur

54
Q

What are the 3 aspects of the 3 bucket model?

A
  • Self
  • Context
  • Task
    e.g. tired nurse, on a busy ward, fails an ECG
55
Q

What is a never event?

A

A largely preventable outcome that shouldn’t have happened, provided adequate measures were put in place

56
Q

Who should a never event be reported to?

A

Care quality commission

57
Q

What is the consequence of some never events?

A

Fitness to practice

58
Q

How can errors be minimised (2)?

A
  • Regular training opportunities
  • SBAR communication tool
59
Q

What are two outcomes of errors in medicine?

A
  • Near miss
  • Adverse event occurs
60
Q

What should the doctor do if an error leads to an adverse event?

A

Apologise + inform patient by duty of CANDOUR

61
Q

What are the 2 types of abuse in domestic violence?

A
  • Physical
  • Psychological/ emotional
62
Q

Which gender most commonly is the perpetrator of domestic violence?

A

Male

63
Q

What are some risk factors for domestic violence (2)?

A
  • 20-25 year old female (young female)
  • Pregnancy
64
Q

What are some features of domestic abuse that a GP may notice (4)?

A
  • Only attend with partner
  • Delayed presentation
  • Multiple bruises at different stages of healing
  • Recurrent GP appointments
65
Q

How should domestic abuse be investigated (2)?

A
  • Speak to patient alone
  • Fill out DASH form (domestic abuse and sexual harassment)
66
Q

What should you ask a patient you suspect is suffering domestic abuse about (3)?

A
  • Directly ask about abuse
  • Condemn and tell patient it is not ok
  • DO NOT tell patient what to do
67
Q

How should mild/ moderate domestic abuse (according to the DASH form) be managed?

A

Signpost to domestic abuse support services

68
Q

How should severe domestic abuse according to the DASH form be managed?

A

Fill out MARAC (multi agency risk assessment conference) form

69
Q

What are the 3 core NHS principles (3)?

A
  • Free
  • Universal
  • Accessible
70
Q

What is the inverse care law?

A

Those with best healthcare access need it least + vice versa

71
Q

What theory shows the needs of a person and their importance?

A

Maslows hierarchy of needs

72
Q

What are the 3 basic levels of maslows hierarchy of needs?

A
  • Self actualisation (developed)
  • Esteem; love + belonging (psychological)
  • Food, shelter and safety (physiological)
73
Q

What are some causes of homelessness (4)?

A
  • Eviction
  • Lost job
  • Can’t afford rent
  • Separation
74
Q

What are some health complications of being homeless (4)?

A
  • Reduced life expectancy (around 40)
  • IVDU
  • STI
  • Poor mental health + suicide
75
Q

What 4 things affect food security?

A
  • Affordability
  • Accessibility
  • Utilisation
  • Stability
76
Q

What things early on in life may influence diet (3)?

A
  • Maternal diet
  • Breastfeeding
  • Age of solid food
77
Q

What is restraint theory on eating habits?

A

When dieting restraint theory predicts that the person will eat more due to imbalances in ghrelin and leptin

78
Q

What are 3 forms of dieting?

A
  • Decrease calorie intake
  • Decrease window food is eaten within
  • Decrease the number of types of food eaten
79
Q

What age is sex considered to always be rape in the uk?

A

Under 13
as children under 13 are considered to not be able to consent

80
Q

How should sex under 16 (but over 13) be managed?

A

Assess child’s gilick-fraser competence

81
Q

What does Fraser guidance relate to and how should a doctor manage it?

A

Contraception specific guidance - give contraception if in child’s best interest + they are competent

82
Q

What are the aspects to gilick competence (3)?

A
  • Cannot be persuaded to tell parents
  • Will likely have UPSI
  • Mental health will suffer if not given
83
Q

How should capacity be assessed in children (4)?

A

Understands –> retains –> weighs up –> communicates information

84
Q

What are the parts of the human rights act that are relevant to healthcare (5)?

A

Article:
* 2 = right to life
* 3 = free from inhumane treatment
* 8 = respect family/ private life
* 12 = to marry/ conceive
* 14 = not to be discriminated against

85
Q

What is an absolute vs qualitative right?

A
  • Absolute = NEVER limited
  • Qualitative = MAY be limited (e.g. article 8)
86
Q

What are exceptionality criteria of the human rights act?

A

When human rights cannot be fulfilled due to certain exceptions e.g. withholding treatment due to lack of funding

87
Q

What is rationing in healthcare?

A

Restricting resources due to reduced availability/ funding

88
Q

What are 3 theories that explain how resources can be delivered?

A
  • Egalitarianism
  • Utilitarianism
  • Libertarianism
89
Q

What is egalitarianism?

A

Everyone is equal and should be given equal amounts of resources

90
Q

What is utilitarianism?

A

Utilising resources to get the most overall benefit

91
Q

What is libertarianism?

A

Patient responsible for own health and getting/ requesting resources
unfair for some e.g. genetic disorders

92
Q

What is the harm principle?

A

The actions of an individual should only ever be limited to prevent harm to another individual

93
Q

What is jonsens rule of rescue?

A

The obligation people feel to save lives wherever possible

94
Q

What is negligence?

A

Breach of care which results in damage

95
Q

What are the 4 questions that should be fulfilled for there to be negligence (4)?

A
  • Was there duty of care?
  • Was there breach of duty?
  • Did harm occur?
  • Was harm due to breach?
96
Q

What are two tests to judge whether there has been negligence?

A
  • Bolam = would other doctors act the same way
  • Bolitho = was what happened a reasonable course of action
97
Q

What is the type of compensation given if a doctor has been found to be negligent and what 3 factors should be fulfilled?

A

Financial compensation if:
* Duty of care
* Breech
* Irrepairable damage as a result

98
Q

What is the amount of financial compensation given for negligence based upon (3)?

A
  • Loss of income
  • Cost of care
  • Pain/ suffering
99
Q

What are the 4 ethical pillars?

A
  • Autonomy
  • Non-maleficence (do no harm
  • Beneficence (best interest)
  • Justice (greater good)
100
Q

What are 5 different ethical frameworks?

A
  • Deontology
  • Utilitarianism
  • Consequentialism
  • Virtue ethics
  • Egoism
101
Q

What is deontology?

A

Morality of action based on whether that action itself is right or wrong

102
Q

What is utilitarianism (in terms of ethics)?

A

Greatest good for the greatest number
type of consequentialism

103
Q

What is consequentialism?

A

Morality should be judged by evaluating the consequences it will have on others

104
Q

What is virtue ethics?

A

The action is good if it is what a virtuous person would do

105
Q

What is egoism?

A

We by nature act selfishly

106
Q

How can you adapt communication style if a patient has a visual problem (4)?

A
  • Bigger writing/ diagrams
  • Textured
  • Brighter
  • Use audio instead
107
Q

How can you adapt communication style if a patient has a hearing problem (4)?

A
  • Sign language
  • Lip reading
  • Slow speech
  • Interpreter
108
Q

What is a 4 step process that is effective for learning?

A
  • Demo
  • Demo + explained
  • Demo + student explains
  • Student demo + explains
109
Q

What are 5 types of leadership?

A
  • Authoritarian
  • Participation (democratic)
  • Delegative
  • Transactional - offers incentives
  • Transformational - influence + inspire
110
Q

What are 3 core duties of a doctor?

A
  • Maintain knowledge, skills and performance
  • Safety + quality
  • Maintain trust
111
Q

What are determinants of health (6)?

A
  • Residence
  • Race
  • Occupation
  • Gender
  • Socioeconomic background
  • Education
112
Q

What are some of the conditions screened for in pregnancy (4)?

A
  • Infections (e.g. HIV, syphilis, HepB)
  • Sickle cell
  • Thalassaemia
  • Foetal abnormalities
113
Q

What are 3 screening tests for a newborn?

A
  • NIPE < 72 hours
  • Blood spot test (5 days)
  • Ottoacoustic emission test
114
Q

What are 5 screening tests done on adult population?

A
  • Cervicle
  • Breast
  • AAA (men 65 invited for USS)
  • Diabetic eye
  • Bowel cancer (50-74, FIT test every 2 years)
115
Q
A

Phase 3a conditions list flashcards (31 decks)

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