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phase 2 > Public Health > Flashcards

Public Health Flashcards

1
Q

What were the findings in the 1980 black report

A

Social inequalities lead to mortality and the inequalities are widening. Answer in political intervention.

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2
Q

What are the four mechanisms outlined in the black report

A

Artifact, social selection, behaviour and material circumstance

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3
Q

What is the artifact mechanism in the 1980 black report

A

The findings are just a response of statistical anomalies

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4
Q

What is the social selection mechanism in the 1980 black report

A

People are in the lower social class because of their ill health, not the other way around

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5
Q

What is the behaviour mechanism in the 1980 black report

A

The poorer you are the harder it is to control your behaviour and choose healthy behaviour

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6
Q

What is the material circumstance mechanism in the 1980 black report

A

No control over the resources available to them to improve health

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7
Q

What was the whitehall study

A

Looked at civil servants and linked employment differences to health inequalities

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8
Q

What was the archeson report of 1988

A

It found that although mortality reduced, inequality increased and made recommendations

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9
Q

What were the recommendations of the archeson report

A

Evaluate policies, prioritise families and children, reduce income inequality and improve the housing of the poor

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10
Q

What are the three theories of causation of health inequalities

A

Neomaterialist, psychosocial and lifecourse

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11
Q

What is the lifecourse theory

A

Poorer people have fewer resources (physical and mental) to overcome the stressors which accumulate. Critical periods, accumulation, interactions + pathways

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12
Q

What is the psychosocial theory

A

Low social status, lack of friends and stress in early life

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13
Q

What is the neomaterialist theory

A

Poverty exposes to health hazards, lack of resources and systematic underinvestment across society

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14
Q

Why do women live longer than men

A

Hormones, fewer hazards and more likely to see doctor

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15
Q

Three ways to reduce the health inequalities

A

Change perspectives, change systems and change education

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16
Q

What are the two parts of the medical licensing assessment

A

Test of applied knowledge and test of clinical/proffesional skills

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17
Q

What are the three outcomes states in the 2017 GMC outcomes for graduates

A

Professional values and behaviours, professional skills and professional knowledge

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18
Q

Define patient compliance

A

The extent to which the patient’s behaviour (in terms of medications, following diets or other lifestyle changes) coincides with medical or health advice

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19
Q

What % of chronic prescribed medications arent taken

A

30-50%

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20
Q

Examples of non adherence

A

Not taking meds, wrong dose, wrong frequency, stopping meds, modifying treatment for activities, continuing behaviours against advice

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21
Q

What are unintentional (practical) reasons for non adherence

A

Capacity and Resource. Can’t understand, use, pay or remember

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22
Q

What are intentional (motivational) reasons for non adherence

A

Perceptual. Due to beliefs about disease or treatment and preferences of treatment

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23
Q

What is the necessity concerns framework

A

Adherence is improved when necessity increases and concerns are reduced

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24
Q

Define necessity beliefs

A

Perceptions of personal need for treatment

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25
Q

Define concern beliefs

A

Concerns about a range of potential side effects

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26
Q

What is the patient centredness change

A

Shift in focus from treatment to process of care

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27
Q

How does patient centredness change the consultation

A

Holistic view of the patient in a social context and a shared control of the consultation

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28
Q

What are the four consequences of good patient-doctor communications

A

1-better health outcomes 2-increased compliance 3-increased patient and clinician satisfaction 4-decrease in malpractise risk

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29
Q

What are the principles of concordance rather than adherence

A

Recognises it is a negotiation between equals and a respect for the patient’s agenda

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30
Q

What are the steps in shared decision making

A

1-define problem 2-Dr opinions differ 3-options 4-information 5-Understood? 6-concerns and expectations 7-accept? 8-involve patient 9-review 10-review

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31
Q

How are staff made aware of infection control

A

Policy development, education and audit

32
Q

What is infection

A

Affect with disease causing organism which does harm to the individual

33
Q

What does the virulence of an organism depend on

A

Ease of spread, likelihood of causing infection and consequence of infection if it occurs

34
Q

What are the infection controls at an environmental level

A

Design, clearing and isolation

35
Q

What are the infection controls at a patient level

A

Isolation and antimicrobial stewardship

36
Q

What are the infection controls at a staff level

A

Barrier precautions, isolation and handwashing and PPE

37
Q

What are the stages in identifying an infected patient

A

Risk factors, screening, clinical diagnosis and lab diagnosis

38
Q

What are the most common cause of UTI and intraabdominal infection

A

CPEs (Carbapenemase producing enterobacteriaceae) aka coliforms

39
Q

Where do CPEs colonise

A

Large bowel, skin below the waist and moist sites

40
Q

Name examples of CPEs

A

E.coli, klebsiella, enterobacter

41
Q

What are carbapenams

A

Broadest spectrum beta lactam

42
Q

What are class A carbapenamases

A

serine beta-lactamases

43
Q

What are class B carbapenamases

A

metallo beta-lactamases

44
Q

What are class D carbapenamases

A

OXA variants

45
Q

What is the MIC of an antibiotic

A

Minimum inhibitory concentration. How much antibiotic is needed to prevent the growth of an organism

46
Q

What factors increase norovirus’ deadliness

A

No envelope so easy spread of RNA, low infecting dose, short lived immunity, persists in environment and resists cleaning.

47
Q

When should you do handwashing

A

Before and after handling patients or food or carrying out an aseptic procedure. After handling soiled item, using toilet or removing protective equipment

48
Q

When should you use alcohol gel

A

When hands are visibly clean or after hand washing for invasive procedures or when barrier nursing

49
Q

What are endogenous infections

A

Infection of a patient by their own flora

50
Q

Which material is used as an antiinfective, such as for door handles

A

Copper

51
Q

What is used for killing spores

A

Hydrogen peroxide vaping machines

52
Q

What is the single most effective way of preventing cross infection

A

Hand hygeine

53
Q

Which bugs arent eliminated by alcohol gel

A

C dificile and norovirus

54
Q

What counts as a low risk encounter

A

No barrier nursing or fluid exposure - alcohol gel fine

55
Q

How does the C dificile mechanism work

A

Spores germinate into bascilli normally following antibiotic therapy. This restricts the flora of bowel and allows C dificile to grow

56
Q

What is the UNAIDS 2020 90/90/90 target

A

90% diagnosed, of those 90% on antiretrovirals, of those 90% viral suppression

57
Q

Which age group has highest prevelance of HIV

A

35-49

58
Q

Why are rates increasing in the 50-64 category

A

People stop using condoms, high divorce rate and poor sex education

59
Q

What is classed as a late diagnosis

A

CD4 count below 350

60
Q

How recent can HIV be picked up

A

4 weeks

61
Q

Define palliative care

A

Palliative care improves the quality of life of patients and families who face life threatening illness, by providing pain and symptom relief, spiritual and psychosocial support from diagnosis to end of life and bereavement

62
Q

What are the four philosophies of palliative care

A

Holistic, individualised, multidisciplinary and patients etc are clients

63
Q

What are the inequalities seen with increasing age (in life)

A

Greater impairment (from diseases+treatments), increased psychological distress, increased social isolation, poverty and poorer living conditions

64
Q

What are the inequalities seen with increasing age (in death

A

Less likely to go to hospice, die where they want, be involved in discussions or have plans. More likely to have repeated hospital admissions

65
Q

Key issues in living with COPD

A

Unpredictable illness trajectory, unsure prognosis, poor patient understanding and limited access to specialist palliative care

66
Q

How do COPD and lung cancer patients compare

A

COPD patients have more depression, worse activities of daily living, less certainty and less support than lung cancer patients

67
Q

Define epidemiology

A

The study of how often diseases occur in different groups of people and why

68
Q

Define incidence

A

The rate at which new cases occur in a population during a specified time period

69
Q

Define prevalence

A

Proportion of the population which have the disease at a given time

70
Q

How are prevalence and incidence linked in an equation

A

Prevalence=incidence x average duration

71
Q

What is mortality

A

Incidence of death from a disease

72
Q

What are reasons for geographical variations in COPD

A

Socioeconomic differences and deprivations, historic industry, developing world (indoor cooking and smoking), passive smoking

73
Q

What are the bradford-hill criteria

A

For relationship. Strength, Consistency, specificity, reverse causation, dose response, experimental evidence, biological plausibility, coherence and analogy

74
Q

What are components of good work

A

Safe, reliable, fair, social, individual control and good work/life balance

75
Q

What are sources of data for occupational disease

A

Labour force survey, death certificate, disablement benefit and surveilance schemes (SWORD and EPIDERM etc)

76
Q

Define hazard

A

Something that is potentially harmful

77
Q

Define risk

A

The probability of harm

phase 2 (17 decks)

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