Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 2 > Public Health > Flashcards

Public Health Flashcards

1
Q

What are the most common type of autopsy

A

Medico-legal autopsies (NOT hospital autopsies)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When are hospital autopsies done

A

Audit
Teaching
Governance
Research

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When are medico-legal autopsies done

A

Coronial autopsies

Forensic autopsies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What types of deaths are referred to the coroner

A
  1. PRESUMED natural (cause of death not known and not seen by doctor in last 14 days)
  2. PRESUMED iatrogenic (Postoperative deaths, anaesthetic deaths, abortions and complications of therapy)
  3. Presumed unnatural (accidents, neglectiion)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Who makes referrals to the coroner

A
  1. DOCTORS
  2. Registrar of BDM
  3. Relatives
  4. Police
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Do doctors have a statutory duty to refer to the coroner

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Who has a a statutory duty to refer

A

Registrar of BDM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Who usually performs autopsies

A

Histopathologists: Hospital and coronial autopsies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When do forensic pathologists perform autopsies

A 
Homicide
Death in custody 
Neglect 
Drowning 
Fire deaths
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What four questions do coroners try to answer in the coronal autopsy

A
  1. Who
  2. When they died
  3. Where they died
  4. How they died
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the Coroners Act of 1988

A
  1. Allows coroner to order an autopsy where death is due to natural causes = CAN’T AUTHORISE SPECIAL INVESTIGATIONS
  2. Allows coroner to order an autopsy where death is unnatural and inquest is needed = CAN authorise special investigation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the Coroners Rule of 1984

A
  1. Autopsy as soon as possible
  2. By a pathologist of suitable qualification
  3. Report findings promptly and only to coroner
  4. Autopsy only on appropriate premises
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the Amendment Rule of 2005

A
  1. Pathologist must tell coroner what materials have been retained
  2. Coroners authorise retention and sets proposal date
  3. Informs family of retention
  4. Family choice evaluated
  5. Coroner informs pathologist of family’s decision
  6. Pathologist keeps record
  7. Autopsy report MUST declare retention and disposal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What choices do the family have in regards to retention of material by the pathologist

A
  1. Return material back to them
  2. Retain for research
  3. Respectful disposal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the Coroners and Justice Act of 2009

A
  1. Coroner can defer opening inquest and launch an investigation
  2. Inquests have conclusions and not verdicts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the Human Tissue Act of 2004

A
  1. Autopsies can only be performed on liscenced premises
  2. Consent from relatives for any use of tissue at autopsy if not used of criminal justice purposes
  3. Public display of information requires consent from the DECEASED
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Outline the stages of an autopsy

A
  1. History
  2. External Examination
  3. Evisceration
  4. Internal Examination
  5. Reconstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What three investigations can be done during external examination of the body

A
  1. Microbiology
  2. Toxicology
  3. Radiology
  4. PHOTOGRPAHY
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What four investigations are done in internal examinations

A
  1. genetics
  2. Photography
  3. Histology
  4. Microbiology
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is external examination

A
  1. Formal identifiers: Age, body habits, jewellery, body modifications (tattoos), clothing)
  2. Disease + Treatment (why)
  3. Injuries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How is Evisceration carried out

A
  1. Y-shaped incision

Open all body cavities and examine in situ

Remove abdo and thoracic organs

Remove Brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is internal examination

A
  1. Examine organs, VESSELS, systems (CNS, GU)

Like a biopsy (cross-section samples taken)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Why is compliance to therapy important

A
  1. Costs of unused medicines (have to be returned and disposed of)
  2. Impact life expectancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Define compliance

A
  1. Patient SHOULD follow doctors orders (passive patients)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Define Adherence

A
  1. The extent to which the patient’s actions match AGREED recommendation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Examples of non-adherence

A
  1. Not taking prescribed medication
  2. Taking bigger/smaller doses than prescribed
  3. Taking more or less medication than prescribed
  4. Modifying treatment to accommodate other activities
  5. Continuing with behaviours against medical advice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Unintentional reasons for non-adherence

A
  1. Difficulty understanding instructions
  2. Problem using treatment
  3. Can’t Pay
  4. Forgetting

CAPACITY AND RESOURCES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Intentional reasons for non-adherence

A
  1. Patient belief about their condition
  2. Beliefs about treatment
  3. personal preferences

PERCEPTUAL BELIEFS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Consequence of non-compliance in organ transplant post-op treatment

A

DEATH or rejection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the Necessity-Concerns Framework

A

NECESSITY BELIEFS - Perception of personal need for treatment
CONCERNS - About a range of potential adverse consequences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What happens to Necessity beliefs and concern levels in achieving adherence

A

Necessity beliefs increase

Concerns DECREASE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is Patient-Centredness

A
  1. Encourages focus in consultation on patient as a whole person who has individual preferences
  2. Shared control of consultation, decisions and management of health with patient
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What ar the four imparts of good doctor-patient communication

A
  1. Better health outcomes
  2. High adherence to therapeutic regimens in patients
  3. High patient and clinician satisfaction
  4. Decrease in malpractice risk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Define Concordance

A
  1. Doctors are not INSTRUCTING but consulting with patients as equals = on the same page as each other
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Outline concordance

A
  1. Take into account both yours and patient views
  2. Outline options
  3. Check understanding
  4. Explore concerns
  5. Consent
  6. Review over time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are some barriers to concordance

A
  1. Patients may not want to engage in a convo with doctor

2. Patients might want doctors to tell them what to do

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

How can health professionals cause barriers to concordance

A
  1. Not have time/rescources
  2. Patient choice vs evidence
  3. Lacking social skills
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the health Act of 2006

A
  1. Infection control is EVERY health care workers responsibility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are some of the key departments which have th ereposnsibility of infection prevention and control

A
  1. Infection prevention and control team
  2. Ward teams
  3. Microbiology labs
  4. Estates
  5. Domestic services
  6. Pharmacy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Infection vs colonisation

A
  1. Infection involves harm to individual

2. Colonisation is the presence of bacteria in the body but not harm is being done

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What are the principles of IPC

A
  1. Identify risk
    2 .ROutes and mode of transmission
  2. Virulence of organism (so how easily it spreads, likelihood of infecting and consequence of infection)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

How can infections spread in a hospital

A
  1. Environment (if not sterile)
  2. Patient if not isolated
  3. Staff
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What bacteria produce Carbapenemase

A

Enterobacteriacae (Coliforms, E.coli)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What have we started replacing beta-lactam antibiotics with

A

Carbapenems

So they are becoming ineffective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Name the type of carbapenemases

A
  1. Class A (KPC)
  2. Class B (NDM-1, IMP)
  3. Class D (OXA)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What does Norovirus cause in adults

A

GASTROENTERITIS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

How is norovirus spread

A

CLOSE CONTACT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

How do prevent most infections

A

HAND WASHING

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

When should we wash our hands

A 
Between meeting patient s
In/Out of toilets
After handling items that are soiled
Before and after an aseptic procedure 
After removing protective clothing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

When should we use alcohol gel

A

Before and after invasive procedure
Following handwahsing
Between tasks when hands ar visibly clean

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What are endogenous infections

A

Infection of a patient by their own flora

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

How do prevent endogenous infections

A
  1. Hydration
  2. Antisepsis
  3. Underlying disease control
  4. Remove catheters and lines asap
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Define appetite

A

Desire to eat food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Define hunger

A

Need of eating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Define anorexia

A

Lack of appetite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Define satiety

A

Feeling of fullness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Define BMI

A

Weight (kg) / Height^2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Risks of obesity

A

Type II diabetes

  1. Hypertension
  2. CAD
  3. Osteoarthritis
  4. Carcinoma of breast, colon and prostate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Why od we eat

A
  1. Internal physiological drive

2. External stimuli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What part of the brain is the hunger centre

A

LATERAL hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Where is the satiety centre located

A

VENTROMEDIAL hypothalamic nucleus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Why si diabetes a public health issue

A
  1. MORTALITY (under-reported on certificates)
  2. DISABILITY (neuropathies and PAD)
  3. Co-morbidity
  4. Reduce QOL
  5. Increasing prevalence and affecting younger people
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Who is at risk of diabetes

A
  1. Sedentary jobs, sedentary leisure activities
  2. Diet high in calorie dense foods
  3. Obesogenic neviornment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is an obesogenic environment

A
  1. TV, car culture, lifts (physical envionrment)
  2. Cheap fatty foods, expensive veg (economic environment)
  3. Safety fears family eating patterns (sociocultural environments)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What mechanisms maintain being overweight

A
  1. Physical (more weight = more difficulty in exercising and changing diet)
  2. Psychological (low self-esteem and guilt = comfort eating)
  3. Socioeconomic (reduced opportunities of employment, relationships and social mobility)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

How do we prevent diabetes

A
  1. Sustained increase in physical activity
  2. Sustained change in diet
  3. Sustained weight loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

how can we diagnose diabetes earlier

A
  1. Raise awareness in community
  2. Raise possible symptom awareness in health professionals
  3. Using clinical records to identify those at risk
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

How is NHS England investing in type II diabetes prevention

A
  1. Healthier You: NHS Diabetes Prevention Programme

2. Programme of lifestyle education : Weight loss support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Supporting self-care for diabetes

A
  1. Self-monitoring
  2. Diet
  3. Exercise
  4. Drugs (taking medications)
  5. Education
  6. Peer support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Outline the four stages of managing diabetes

A
  1. Identify those at risk
  2. Early prevention
  3. Diagnosing diabetes earlier
  4. Management and support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What are the characteristics of a virtuous doctors

A
  1. Flexible

2. Compassionate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Define a virtuous doctors

A

One who decides which opportunities of goo neighbourliness respond to the basis of need than favouring people of a particular race religion or charm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is the four quadrant approach of medical ethics

A
  1. Medical Indications (Beneficence and Nonmaleficience)
  2. Patinet preferences
  3. QoL (Beneficence and Nonmaleficience)
  4. Contextual features (loyalty and fairness)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What is medical indications

A

Include a review of diagnosis and treatment options

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What is patient preferences

A

Patient values are integral to encounter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What is QoL

A

Objective of all clinical encounters is to improve QoL for patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What are contextual features

A

Encounters involve family, law, policy and insurance companies etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What is the complexity theory

A

Requirement to understand why we need to consider the ‘connectedness’ of the living world

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Define connectivity and interdependence

A

Behaviour of one individual may affect others or wider systems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Define co evolution

A

Adaptation or changes by one organism alters other organisms (patient and doctor coevolve)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Define far from equilibrium

A

Exploring possibilities of being pushed away from equilibrium is essential for surviving and flourishing (string away from your comfort zone)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What makes a good doctor

A
  1. Connectivity and interdependence
  2. Co evolution
  3. Far from equilibrium
  4. History
  5. Feedback
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Define history

A

Patient and doctors are influenced from pas events

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What is Gestalt principle

A

Whole is more than the sum of paths (self-organisation and creation of new order)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

Define the inverse care law

A

Availability of good medical care tends to vary inversely with th need for it in th population served

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

IN what community is type II diabetes most common in in sheffield

A

Pakistani

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Why is this the case

A
  1. No Community Diabetes Education courses)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What community has a large prevalence of hep B

A

Roma Slovak

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What are BAME groups

A

Diverse and heterogenous group with varying experiences of inequity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What is the difference between Race and ethnicity

A

Race: Based on physical characteristics on which human kind was divided

Ethnicity: Group of people whose members identify with each other through common heritage (language, culture and ideology)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Define BME

A
  1. Umbrella term to describe people from minority groups who share common experiences of discrimination of inequality because of their ethnic origin, language and religion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Define inequity

A

Lack of fairness of justice (factors controlling health lead to disadvantages of a group of people- health inequity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Difference between inequity and inequality

A

Inequity = how things shouldn’t be

Inequality = descriptive concept

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

3 features of socioeconomic positions

A
  1. Income
  2. Class
  3. Status
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Define vulnerable

A

Inability to cope in a hostile environment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

Define social exclusion

A

Inability of an individual group to participate effectively in economic, social, political and cultural life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

What factors affect health

A
  1. Gender
  2. Geography
  3. Disability
  4. Age
  5. Ethnicity
  6. Artefact
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What genes are reposnsible for increased cancer risks in jewish community

A

Ty-Sachs gene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

Define consanguinity

A

Reproductive union between two relatives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Define social prescribing

A

Helping patients to improve their own health by connecting them to community services

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Define meritocracy

A

Certain things such as power or economic goods should be vested din individuals on the basis of talent, effort and achievement than sexuality ,race, gender age or wealth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

Define egalitarianism

A

Quality for all people (all people should be treated the same)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Define libertarianism

A

AUTONOMY (stresses freedom of choice)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Define utilitarianism

A

Actions are right if they benefit a majority

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

Define health literacy

A

Degree to which individuals have the capacity to obtain, process and understand basic health information to make appropriate decision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

What fie principles of truth-telling do doctors have to consider

A
  1. Do no harm
  2. Do not kill
  3. DO not bear false witness
  4. Keep patient’s secrets
  5. Don’t have inappropriate relationships with patients
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Define medical ethics

A
  1. Critical evaluations of assumptions and arguments

2. Inquiry into norms and values (what is good or bad, right or wrong)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Define clinical truth

A

Contextual, circumstantial and person truth that is objective

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

Define deontology

A

We owe a duty of care to each other

110
Q

Define formula of universal law

A

Before acting, consider: could I live in a world where everyone acted this way

111
Q

Define formula of humanity

A

People are always treated as ends themselves not as means to an end

112
Q

How do deontology and truth-telling relate

A

Compels whole truth telling in a way that is not necessarily the most helpful (telling a patient they are terminal when relatives said he would kill himself if the news was bad)

113
Q

Cons of deontology in truth telling

A

Ignores consequences

114
Q

Define consequentialism

A

Consequences are important, actions are not

115
Q

Con of consequentialism

A

Hard to predict consequence of one’s actions

Actions can be wrong even if consequences are good

116
Q

Define virtue ethics

A

Characteristics that promote human flourishing

117
Q

Name some virtue ethics

A
  1. Compassion
  2. Patience
  3. Kindness
  4. Fidelity
118
Q

Pros of virtue ethics

A

Centres ethics on the person and what it means to be human

119
Q

Cons of virtue ethics

A
  1. No clear guidance on moral dilemmas
  2. No agreement on what constitutes a good virtue
  3. Relative to the culture
120
Q

Define autonomy

A

Right to self-determination

121
Q

What can limit autonomy

A

Lack of mental capacity or in children

122
Q

Con of autonomy in truth-telling

A

Reduces doctor to information-provider

123
Q

How does autonomy link to truth telling

A

Insist on telling whole truth without delay

124
Q

Define beneficence

A

Medical practice always seeks to benefit patients

125
Q

Define non-maleficience

A

Medicine aims to do no harm to patients

126
Q

When can non-maleficence be broken

A
  1. Medication side-effects
  2. Surgical wounds
  3. Infections risks
127
Q

Define justice

A
  1. Discrimination should not be done on basis of race, gender or disability
  2. Efforts should be directed without reference to our likes or dislikes
128
Q

Why should we tell patients they are about to die

A

Can prepare physically, emotionally and spiritually

129
Q

What ethical principles are we considering when disclosing death to patient

A
  1. Beneficence

2. Non-maleficence

130
Q

What is hippocratic paternalism

A

When bad news could be taken as destroying hope so concealment might be in the patient’s interest

131
Q

What is candour

A

Openness without compulsion

Used to disclose error or uncertainty to patient

  1. Put matters right
  2. Apologise
  3. Explain to the patient what has happened and its effects
132
Q

Define aleatory uncertainty

A

I can’t know anymore

133
Q

Define Epistemic uncertainty

A

I don’t know any more

134
Q

Define ethical uncertainty

A

I don’t know what I should do

135
Q

Define choice uncertainty

A

I don’t know what I want to do

136
Q

What is whistle-blowing

A

Raising concerns about a person, practice or organisation (going to the press etc)

137
Q

What is the plant in a team

A

Solves difficult problems

138
Q

What is a source investigator

A

Develops contacts

139
Q

What is a co-ordinator

A

Clarifies goals, promotes decision making

140
Q

What is the shaper

A
  1. Tries to overcome obstacles
141
Q

What is a monitor evaluator

A

Sees all options

142
Q

What is a teamworker

A
  1. Listens
  2. Builds
  3. Averts friction
143
Q

What is the implementer

A

Turns ideas to action

144
Q

What is a completer

A

Searches out errors and omissions and delivers on time

145
Q

What is a specialist

A

Provides knowledge and skill in rare supply

146
Q

5 problems in teamwork

A
  1. Lack of teamwork
  2. Lack of leadership
  3. Lack of effort
  4. Lack of communication
  5. Lack of challenge
147
Q

What is the SBARR framework

A
  1. Situation (what is it)
  2. background (what is it)
  3. Assessment (what is the problem)
  4. Request
    5 - Recommendation (what should be done)
148
Q

What is a steep authority gradient

A

Fear of challenging the leader

149
Q

What is a shallow authority gradient

A

Familiarity in opinions (no devil’s advocate)

150
Q

3 stages of situational awareness

A
  1. What (noticing)
    2/ So what’s? (understanding)
  2. Now what (predicting)
151
Q

Outline the four-step graded assertiveness

A
  1. Express concern
  2. Offer solution
  3. Seek explanation
  4. Directly challenge
152
Q

3 aspects of consent

A
  1. Voluntary
  2. Informed
  3. Made by someone with capacity
153
Q

What do you need to tell people about their treatment

A
  1. What
  2. How
  3. Risks
  4. Benefits
  5. Alternatives
154
Q

What is the mental capacity act 2005

A
  1. A person must be presumed to have capacity unless it is established they lack it
  2. An act done on behalf of this person must be made in their best interest
155
Q

How do we assess mental capacity

A
  1. 2 part test (S2)
156
Q

How do we treat people who are incompetent

A
  1. Check is someone can make a decision on their behalf

2. Healthcare professional can act in connection with patient’s care and treatment

157
Q

When do healthcare professionals decide to treat in patient’s best interest

A
  1. Relatives are refusing consent

2. no one is consenting

158
Q

What is Gillick competence

A
  1. Making sure a child understands the consequence o their decision, including social and emotional implications
159
Q

Primary prevention of alcoholism

A
  1. Know your limits binge drinking campaign - targeted at 18-24 year old binge drinkers
  2. Drinkaware - alcohol labelling
  3. THINK! drink driving campaign
  4. Ofcom alcohol advertising campaign (antisocial behaviour awareness)
  5. Minimum unit pricing
160
Q

Secondary prevention of alcoholism

A
  1. Ask about consumption routinely
  2. Ask about consumption using screening questions/tools
  3. Detect problem (liver enzymes, MACROCYTOSIS and high carb deficient transferrin)
161
Q

How do we screen for alcoholism

A
  1. Clinical interview
  2. FAST (Fast Alcohol Screening Test)
  3. AUDIT (Alcohol Use Disorders Identification Test)
  4. CAGE
162
Q

Define at risk drinking

A

A pattern of drinking which brings about risk of physical and psychological harm

163
Q

Define Alcohol Abuse

A

A pattern of drinking which likely causes physical or psychological harm

164
Q

Define alcohol dependance

A
  1. Set of behavioural, cognitive and physiological repossess that can develop at repeated substance use
165
Q

Guidelines to ALchol Abuse

A
  1. Roel Failure
  2. Risk of bodily harm
  3. Run ins with the law
  4. Relationship trouble
166
Q

Guidlines to Alcohol Dependance

A

3 of the following:

  1. Tolerance
  2. Withdrawal
  3. Failed attempts to stay in limits
  4. Spent less time on other matters
  5. Keep drinking despite problems
167
Q

How is alcohol dependance treated

A
  1. Acamprosate Calcium
  2. Disulfiram
  3. Nalmedene

THERAPY
Social support - ALCHOLICS ANONYMOUS

168
Q

What is the FAST test

A

FAST positive - 3 or more scored

169
Q

Intervention of at-risk drinking

A

FRAMES
F - Feedback about the risk of personal harm or impairment
R - Responsibility for making change
A - Advice to cut down on drinking
M - Menu of alternative strategies for changing drink patterns
E - Empathetic interviewing style
S - Self efficacy

170
Q

Treatment of alcoholism

A
  1. Behavioural Change
  2. Motivational-Enhancement Therapy
  3. Motivational Interviewing by GP or NHS specialist provider
171
Q

Significance of the following AUDIT score and intervention used for them

A

0-7: Lower risk + Positive reinforcement
8-15: Increased risk + Brief Intervention Level 1
16-19: Higher Risk + Biref Intervention Level 2
20-40: Possible dependance + Further assessment

172
Q

What is the Severity of Dependence Questionnaire (SADQ)

A
  1. 20 Qs
Physical withdrawal symptoms
Affective withdrawal symptoms
Relief drinking 
Frequency of alcohol consumption 
Speed of onset of withdrawal symptoms
173
Q

What SADQ score indicates severe alcohol dependance

A

31 or higher

174
Q

Treatment for alcoholics who score 16+

A

Chlordiazepoxide Detoxification

175
Q

How does alcohol cause withdrawal physiologically

A
  1. Potentiates GABA

2. Inhibits Glutamate and NMDA

176
Q

Treatment of patients dependant on alcohol

A
  1. Community based assisted withdrawal
  2. ORAL BENZODIAZEPINE (anxiety)
  3. ORAL CHLORDIAZEPOXIDE (Muscle spasm and relief of withdrawal)
177
Q

Pharmacokinetic (ABSORPTION) properties of ORAL CHLORDIAZEPOXIDE

A
  1. Highly lipophilic
  2. Half life of 6-30 hours
  3. Protein Bound
  4. well absorbed at small intestine
178
Q

Distribution and metabolism properties of ORAL CHLORDIAZEPOXIDE

A
  1. Metabolised by liver
  2. Crosses BBB
  3. Activein CNS grey matter
179
Q

What is the active metabolite of ORAL CHLORDIAZEPOXIDE

A

Des methyl-chlordiazepoxide

180
Q

How is ORAL CHLORDIAZEPOXIDE

A
  1. Excreted in the urine
  2. Conjugated with glucuronide and sulphate
  3. No biliary excretion)
181
Q

Pharmacodynamic of ORAL CHLORDIAZEPOXIDE

A
  1. Enhances action of GABA
182
Q

Contraindications of ORAL CHLORDIAZEPOXIDE

A
  1. Hypersensitivity to benzodiazepines
  2. Chronic psychosis
  3. Pregnancy
  4. Hepatic insufficiency
  5. MG
183
Q

Side-Effects of ORAL CHLORDIAZEPOXIDE

A
  1. Drowsiness
  2. Ataxia
  3. Agression
  4. Headache
  5. Amnesia
  6. Respiratory depression
  7. Impaired liver function
184
Q

What causes Wernicke’s encephalopathy

A
  1. Deficiency of Thiamine
  2. Poor diet
  3. Poor intake of vitamins
  4. Gastritis
185
Q

Describe the bristol stool chart

A 
Type I: Separate hard lumps (like nuts) - hard to pass
Type 2: Sausage shaped and lumpy 
Type 3: Sausage but cracks on surface
Type 4: Smooth sausage
Type 5: Soft blobs 
Type 6: Fluffy, mushy pieces
Type 7: Water
186
Q

What are non-infective causes of diarrhoea

A
  1. Neoplasms
  2. Inflammatory
  3. Hormonal
  4. Chemical
  5. Anatomical
187
Q

What are notifiable diseases

A

Legal obligation for any doctor to suspect a case of a specific disease to the proper officer of the local authority

188
Q

Name some notifiable diseaes

A
  1. Acute encephalitis
  2. Acute meningitis
  3. Acute poliomyelitis
  4. Meningococcal septicaemia
  5. Whooping cough
189
Q

Why do we notify the authorities of certain diseases

A
  1. Outbreak detection
  2. Early warning
  3. Forecasting
  4. Track extent and severity of disease
  5. Allows development of interventions targeted at vulnerable groups
190
Q

What is passive natural immunity

A

Protection provided from the transfer of antibodies (cross-placental)

191
Q

How long does passive immunity last

A

A few weeks or months

192
Q

What is passive artificial immunity

A

Injection of human immunoglobulins containing antibodies to target infection (already pre-made)

193
Q

What patients are usually given passive artificial immunity

A

Children who are immunocompromised

194
Q

What is active natural immunisation

A
  1. Vaccination stimulates immune response and memory to a specific antigen or infection
195
Q

What are vaccines made of

A
  1. Inactivated
  2. Attenuated live
  3. Secreted products
  4. Constituents of cell walls
  5. Recombinant components
196
Q

Cons of polysaccharide vaccines

A
  1. Not long-lasting

2. Response in children is poor

197
Q

Cons of live attenuated vaccines

A
  1. Mild form of the disease could manifest

2. Takes time to work

198
Q

Define primary vaccin effilure

A

Person doesn’t develop immunity from vaccine e

199
Q

Define secondary vaccine failure

A

Initially responds and protection wanes over time

200
Q

What is Sequela

A

Chronic condition from disease, injury or trauma

Brian abscess, brain damage, organ failure, gangrene, death from illness

201
Q

How to we prevent spread of notifiable disease

A
  1. NOTIFICATION
  2. CONTACT TRACING
  3. PROPHYLAXIS
202
Q

What is the STI/HIV transmission model

A 
R = BCD
R = Reproductive rate
B = Infertility Rate
C = Partners over time
D = Duration of infection
203
Q

Primary prevention of stopping STIs (change behaviour of patient)

A

Reduce risk of acquiring STI:
One to one risk reduction discussion
Vaccination (Hep B)
Pre and post exposure prophylaxis

204
Q

Secondary prevention of STIs

A

Find and treat undetected cases of infection, reducing problem in community pool

205
Q

Tertiary prevention of STIs

A

Reducing morbidity and mortality

206
Q

Anti-retroviral primary prevention techniques (3)

A
  1. Post-exposure prophylaxis at A+E
  2. Pre-exposure prophylaxis
  3. Treatment as prevention
207
Q

Secondary prevention strategies for STIs

A
  1. Easy access to STIs/HIV
  2. Partner Notification (contact tracing!)
  3. Targeted Screening
208
Q

What type of prevention is contact tracing

A

SECONDARY

209
Q

Tertiary prevention for STIs/HIV

A
  1. Anti-retrovirals
  2. Prophylactic antibiotics
  3. ACYCLOVIR for genital herpes e.g.
210
Q

Why do we trace partners of people with STIs

A
  1. Break chain of transmission

2. Prevent re-infection

211
Q

How are partners traced for STIs

A
  1. Patient referral
  2. Provider referral
  3. Conditional or contract referral
212
Q

What are the challenges faced in partner notification

A
  1. Hard to reach client groups (homeless, social exclusion, jail)
  2. How to get those contact details is hard
213
Q

What is the polypharmacy stopp/start guidance

A
  1. Guidance of assessing if medication to older people is potentially inappropriate
214
Q

Benefits of Polypharmacy STOPP/START guidance

A
  1. Prevent adverse drug effects

2. Reduce drug costs

215
Q

What is the loss-aversion theory

A
  1. People’s tendency to prefer avoiding losses to gaining (patients would rather keep a medication than to lose the side-effects of it)
216
Q

How do we approach older people

A
  1. Eye contact
  2. Avoid medical jargon
  3. Ask if patient understands
  4. What doe the patient want
  5. CHECK HEARING AID
217
Q

Examples of primary health care

A

Walk in centres, GP, Dentists and opticians

218
Q

Define primary care neurology

A
  1. GPs as expert medical generalists

2. Work in MDTs to diagnose and manage neurological illness

219
Q

What are the challenges we face in trying to care for patients in a complex health system

A
  1. ERRORS to be expected
220
Q

What causes adverse events

A

Factors

221
Q

How do we solve the challenges of errors

A
  1. View errors as a result of problematic mental process
  2. Focus on unsafe acts of sharpeners
  3. Need a detailed analysis and no covering up of the truth
222
Q

Define culture

A
  1. Shared values and beliefs that interact with an organisation’s structure and control systems to produce behavioural norms
223
Q

Define a positive safety culture

A
  1. Where staff have a constant and active awareness of potential for things to go wrong
224
Q

4 characteristics of a positive safety culture

A
  1. Open and fair environment: encourages people to speak up about mistakes
  2. Shared values and responsibilities
  3. Beliefs that interact with an organisation’s structure and control systems
  4. To produce behavioural norms where everyone takes responsibility for patient safety and acts when necessary
225
Q

Define Just culture

A
  1. Healthcare workers treated fairly, with empathy when they have been involved in an incident
226
Q

Define informed culture

A

Organisation has learnt from past experience and has the ability to now identify and prevent future incidents

227
Q

Name some vaccine preventable neurological infections

A
  1. POLIOMYELITIS
  2. TB
  3. MENINGOCOCCUS
228
Q

Define epidemiology

A

Study of distribution and determinants of health-related statements or events in specified populations and application of this study to control health problems

229
Q

Define clinical epidemiology

A

Uses information about distribution and determinants in a clinical setting - ESPECIALLY IN DIAGNOSIS

230
Q

What are the key issues in euro-epidemiology

A

CASE DEFINITION: clinical, imaging, pathological

CASE ASCERTAINMENT: Diagnosis, reporting

231
Q

Define cerebral palsy

A

Non-Progressive brain damage before or during neonatal period causing wide spectrum of physical and mental impairment

232
Q

What is Creutzfeldt-Jakob Disease (of public health importance apparently)

A
  1. Rapidly progressive dementia with no identifiable cause (prion accumulation unexplained)
233
Q

Clinical presentation of CJD

A
  1. Dementia
  2. Cerebellar signs
  3. Myoclonus
  4. Ataxia
  5. Depression/anxiety
  6. Positive tonsil biopsy

LASTS longer than 6 months

234
Q

Difference between CJD and variant CJD

A

Variant CJD effects people in their 20s (peak at 27) whilst CJD effects 55-75

235
Q

Risk factors for CJD

A
  1. AGE

2. Prion protein gene mutation

236
Q

How is CJD diagnosed

A
  1. Electroencephalography (periodic sharp wave complexes)
  2. CSF (elevated proteins)
  3. MRI of the brain (caudate nucleus affected)
237
Q

How is CJD managed

A

Palliative care

238
Q

Define palliative care

A

Care for the terminally ill and their families by an MDT

239
Q

Specialist palliative care vs general palliative care

A

Specialist: Involves professionals who have training in more complex problems (e.g. doctors, nurse specialists and counsellors, physiotherapists and dieticians)

General: Day to day palliative care from people who will not provide specific things to the patient (GP, district or community nurses, social worker, care worker)

240
Q

Define occupational medicine

A

Branch of medicine concerned with interaction between work and health

241
Q

What are some work-related ill healths

A
  1. Occupational stress
  2. Occupational lung disease
  3. Hand arm vibration
  4. Noise-induced hearing loss
242
Q

Where is occupational illness data collected from

A
  1. Labour force Survery
  2. Death certificate
  3. Disablement benefit
  4. Surveillance Schemes
243
Q

What study design is best suited to calculating attributable risk

A

COHORT STUDIES

244
Q

What are cohort studies

A

Individuals are assembled based on exposure status and followed over a period of time

245
Q

4 ways health is effected during work

A
  1. Acute
  2. Cumulative
  3. Progressive after exposure ceases
  4. Diseases with latencies
246
Q

Positive effects of work on health

A
  1. Work is better than unemployment for mental health
247
Q

Ten key components to ‘good work’

A
  1. Precariousness
  2. individual control
  3. Work Demands
  4. Fair employment
  5. Opportunities
  6. Prevents social isolation
  7. Share information
  8. Work/Life balance
  9. Reintegrates disabilities into society
  10. Promotes health and wellbeing
248
Q

What is an occupational cause for an illness

A

Illness that fails to reposed to standard treatment, doe snot fit typical demographic profile or is of unknown caused

249
Q

What questions would you ask someone who you suspect is having an occupation-based disease

A
  1. What type of work do you do
  2. Are your symptoms different at work and home
  3. Exposures at work
  4. Are any of your co-workers experiencing similar symptoms
250
Q

What is the GP role in occupational Health

A
  1. Have to issue sickness certificates authorising leave of absence from work
251
Q

What details are seen on a sickness certificate

A
  1. Not fit for work
  2. Whether patient will benefit form return to work
  3. Amended duties request
  4. Altered hours
  5. Workplace adaptations
252
Q

Cons of sickness certificate

A
  1. Spend time finding out nature of patient’s work

2. Requires knowledge and understanding of workplaces

253
Q

What is the definition of disability

A

A physical or mental impairment which has substantial long-term adverse effects on a person’s ability to carry out normal activities

254
Q

How should employers adjust for disabilities

A
  1. Alter working hours
  2. Allows absences for medical treatment
  3. Give additional training
  4. Getting special equipment or changing existing
  5. Making adjustments to premises
255
Q

Primary, secondary and tertiary prevention to occupational health

A

1 - Monitor risk, control hazards, promotion
2 - Screening, early detection, task modification
3 - Rehabilitation and support

256
Q

Define mental health

A
  1. State of balanced mental functioning which comes up naturally and spontaneously when we are not in a stressed state
257
Q

Define Mental Health Issues

A

State of feeling vulnerable and anxious, leading to symptoms and further problems if not alleviated

258
Q

What is considered mild to moderate mental health issues

A
  1. Depression
  2. Anxiety
  3. PTSD

INTERNALLY CREATED STRESS which can lead to more conditions or be prevented

259
Q

What are considered severe mental health issues

A
  1. SEVERE DEPRESSION
  2. BIPOLAR
  3. PSYCHOSIS
260
Q

Clinical Presentation of Anxiety

A
  1. Feeling nervous
  2. Not being able to stop worrying
  3. Trouble relaxing
  4. Agitated and restless
  5. Easily annoyed
  6. Feeling afraid
  7. Tachycardia
  8. Racing thoughts
261
Q

Clinical Presentation of Depression

A
  1. Poor concentration
  2. Low self-esteem
  3. Low energy
  4. Low motivation
  5. Feeling sad and hopeless all the time
  6. Guilt
  7. Suicidal
  8. Irritability
  9. Anxiety
  10. Low appetite
  11. Weight loss
  12. Loss of libido
  13. Sleep problems
262
Q

How do we try maintain our mental health

A
  1. Life balance
  2. Handling unrealistic expectations
  3. Holding up with peer pressure
  4. Using less alcohol
  5. Reduce academic worries
263
Q

Treatment of Anxiety

A

Progressive Muscular Relaxation
Activity Scheduling
Compassion-Focused Therapy

264
Q

How does PMR help reduce anxiety

A
  1. Calms down sympathetic NS

2. Parasympathetic NS is activated which calms the body down

265
Q

Three aspects of Compassion Focused Therapy

A
  1. Manage distress and promote bonding (soothing)
  2. Incentive and resource focused (DRIVE)
  3. Threat detection and protection (THREAT SYSTEM)
266
Q

What is the stress particle theory (OUTSIDE-IN)

A

When people try to deal with perceived stress outside when it is actually coming from inside (we are creating our experience form the inside out and projecting it out and what we feel as a consequence is what we think is actually happening when it isn’t.
)

267
Q

What is the Inside-Out theory

A
  1. We cannot solve our problems with the same thinking we used to create them - new thinking is needed so we have to get out of our thought bubble)
268
Q

What is the state of mind theory

A
  1. We can’t control our thoughts

2. We can’t stop thoughts coming up but we choose which ones to take seriously

269
Q

Signs of a burnout

A
  1. Overworking
  2. Diminished personal contacts
  3. Work avoidance
  4. Increased minor illnesses
  5. Objectification (distancing)
270
Q

Benefits of talking about mental health issues

A
  1. More self-understanding and feel back in control of your life
  2. Feel caring and kindness for yourself
  3. Help you become more self-accepting
271
Q

Define emotional resilience

A

People who are self-aware emotionally and believe they are in control of their lives

Year 2 (155 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions