Public Health Flashcards by Ros Broe

7 duties of a doctor?

Patients = 1st concern
Knowledge = up to date
Dignity
Polite
Confidential
Promote health
Within competence

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4 psychosocial CHD

Type A
Depression
Work (hours, demand)
Social support

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Helping those with increased CVD risk?

Depression
Occupation
Social services
Vascular screening
QRISK 2
Lifestyle

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Benefits alcohol?

Euphoria
Social
Low dose = cardioprotective

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Excess alcohol problems?

Relationships (violence, depression, anxiety)
Criminal (violence)
Unemployment
Poverty
Driving offences

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Alcohol withdrawal sx?

Tremulouness
Agitation
>hr
>bp
Hallucinations
Delirum Tremens (shaking, confusion...)

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1 unit alcohol (in g/ml, eg drink, equation)

8g/10ml pure alcohol
1/2 pint beer
Small glass wine
Single measure spirits
Strength (%ABV) x Amount (L)

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Fetal alcohol syndrome?

Peri/post-natal growth retardation
CNS (mental retardation, irritability, hyper-reactivity)
>birthmarks./hernias

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Primary prevention alcoholism?

Drinkaware (alc labelling)
THINK (driving)
‘Know your limits’ campaign

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Secondary prevention alcoholism

Ask routinely (screening Q)
Detect problem drinking (inc lab tests)

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What can doctors do for alcoholics?

Screen: CAGE & AUDIT (ALcohol Use Disorders Interviews Test)
Brief Interventions: FRAMES (motivational interviewing)
Ref. specialists
Set goals, agree on plans, educational material

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CAGE?

Cut down?
Annoyed by criticism
Guilt
Eye-opener

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Alcohol abuse = ?

Role failure
Relationship problem
Run in with law
Risk of bodily harm

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Alcohol dependence?

Withdrawal sx
Tolerance
Drinking despite problems
Can't keep to limits
Lots of time drinking/recovering
Less time of imp. things

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FRAMES?

Feedback (risks)
Responsibility
Advice
Menu of alternatives
Empathy
Self-efficacy (patient feel able to cope w/goals)

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Mx alcoholism?

Naltrexone (opioid antag)
Disulfiram (>sensitivity to alc)
Acaprosate (stabilises chem balance)
Behavioral therapy
Social support (AA)

Why do people smoke?

Fear >kg
Stress
Social
Nicotine addiction
Habit

Signs stress?

Beharioral (alc, sleep, absenteeism)
Cognitive (concentration, -ve thoughts)
Physiological (headache)
Emotional (swings, tearful, irritable)
Biochem (endorphins)

NHS Screening (breast)?

Mammo
50-60
3yr

NHS Screening (bowel)

Faecal-occult
60-74
2yr

NHS Screening (cervical)

Cervical smear liquid based cytology
25 3yr
50-64 5yr

NHS Screening (3 eg other than breast/bowel/cervical)

AAA>65, newborn hearing, sickle cell & thalassaemia screen

Screening Principles?

Wilson-Jugner:
Important problem
Recognisable early stage
Facilities for dx and tx
Suitable test
Acceptable test
Natural hx
Continuous
Dx improves prog
Cost-effective

Occupational screening (5)?

What
Health re/work?
Sx home v work
Exposure (chemicals, polutants, dust, metals, noise, repetetive) - current and past
Co-workers similar

Def substance misuse?

Non-therapeutic ingestion substace affecting CNS, causing behavioural/psychological change

3 dx substance misuse

Acute intox, harmful use, dependance

4 tiers UK drug treatment

1 non-specialist (substitution) 2 open-access 3 specialist community based 4 inpatient (naltrexone, rehab)

Def malnutrition

Deficiency/excess energy/protein/other nutrients -> adverse effect tissue/body/clinical outcome

4 consequences malnutrition?

Loss muscle (resp, heart, mobility) Immunity Poor wound healing Psychosocial (depression/apathy)

Malnutrition assement?

1) BMI | 2) Unexplained

4 Q for patient re malnutrition?

Lost weight? Eating normally? Normal weight? Height?

4 functional assessments older people?

ADL = 6 Instrumental (ADL) = 7 Barthal ADL = 10 Mini Mental State Exam (orientation, registration, short-term memory, language)

Disability paradox

Profound disability -> high QoL reported | expectation?

Influenza; R number?

Reproduction no. Primary case -> x secondary cases? Level intervention to control epidem?

Influenza; pub health intervention

Hand washing Resp hygeine "catch, bin, kill" X attend large gatherings

Influenza; wide intervation

``` Travel restriction Reduce large gatherings Schools closure Voluntary home isolation Volutary isolation Screening at ports ```

3 phases mx infection threat

Identification Containment (reduce spread: hand washing, isolation etc) Management (spreading freely: protect vulnerable, vaccinate)

C Diff (SIGHT, reduce, mx)

``` Suspect (diarrhoea) Isolate Gloves & apron Hand washing (soap!) Test (stool for Toxin) ``` Control abx Vancomycin

5 types of study?

``` Ecological (pop based) Cross-sectional (incidence) Case-control Cohort (follow over time) Interventional ```