Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Public health 2a > Public health > Flashcards

Public health Flashcards

1
Q

What is adherence?

A

The extent to which the patient’s actions match recommendations

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

What is the necessity-concerns framework?

A

The idea that for adherence there needs to be high necessity beliefs and low concerns

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

Give an example of a necessity belief

A

The patients believes that they need the treatment

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

Give an example of a concern

A

Concern about potential side effects of treatment

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

Give the 2 reasons for non-adherence

A

Unintentional

Intentional

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Give an example of unintentional non-adherence

A

Difficulting understanding instructions
Problems using treatment
Forgetting
Unable to pay

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

Give an example of intentional non-adherence

A

Patient’s beliefs about their health
Patient’s beliefs about the treatment
Personal preferences

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

What are the impacts of good patient-doctor communication?

A

Better health outcomes
Better adherence
High patient and clinician satisfaction
Decrease in malpractice risk

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

Give 4 situations where there are ethical considerations

A

Reduced mental capacity
A decision that may be detrimental to the patient’s health
Potential threat to the wellbeing of others
When the patient is a child

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why is adherence used instead of compliance

A

More patient centred

Acknowledges patient’s beliefs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

5 key principles to improve drug adherences

A 
Improve communication 
Increase patient involvement
Understand the patient's perspective
Provide information (in different forms)
Review medication regularly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is Seehouse’s ethical grid used for

A

To enhance health care decisions and increase ethical reasoning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the 4 quadrant approach?

A

Applying 4 considerations when faced with an medical ethical dilemma:

  1. Medical indications
  2. Patient preferences / respect for autonomy
  3. QOL
  4. Contextual features
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are conscientious objections?

A

Core ethical beliefs held by the individual which mean that they cannot carry out certain procedures / treatments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is deontological ethics?

A

The belief that the morality of an action is based on whether it is right or wrong, regardless of consequences

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the universal law?

A

Consideration of ‘could you live in a world where everyone acts in the way that you intend to?’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is consequentialism ethics?

A

A branch of ethics where the consequences are the most important factor in deciding whether a decision is right or wrong

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the 4 pillars of medical ethics?

A

Autonomy
Beneficence
Non-maleficence
Justice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is confidentiality?

A

The right of an individual to have personal, identifiable medical information kept private

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the definition of epidemiology?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the definition of incidence?

A

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

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

What is the definition of prevalence?

A

The proportion of a population that have the disease at a point in time

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

What are the different types of studies?

A

Ecological - using population level data
Cross-sectional - prevalence study
Case-control - looks at people with a disease and compare to control (retrospective)
Cohort - follows a group of people over a period of time
Interventional - do something eg. give drug and then compare to a control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are 3 of the Bradford-Hill criteria? (to prove causation)

A
  • Strenth of association
  • Consistency
  • Specificity
  • Temporality - is the effect after the cause?
  • Dose response - does more = worse?
  • Removal / reversibility
  • Plausibilty
  • Coherence
  • Experiment
  • Analogy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Name 4 UK screening programmes
Breast cancer Bowel cancer Cervical cancer Abdominal aortic aneurysm
26
How is breast cancer screening done, who for and how often?
Mammography Women 50-70 Every 3 yrs
27
How is bowel cancer screening done, who for and how often?
Faecal occult blood Everyone 60-74 Every 2 years
28
How is cervical cancer screening done, who for and how often?
Cervical smear and cytology Women 25-50 every 3yrs Women 50-64 every 5 years
29
How is abdominal aortic aneurysm done and who for?
Ultrasound | Men 65-74
30
Give 3 of the Wilson-Junger screening principles
- Condition should be an important problem - Should have an acceptable treatment - Should be a recognisable early stage - Facilities are available for finding/treating - Suitable test - Test is acceptable to the population - Natural history of the disease is known - Case finding should be continuous - Early treatment makes a difference to prognosis - Economical
31
Define sensitivity
Measure of how well a test picks up those that have the disease
32
Define specificity
Measure of how well a test recognises those that don't have the disease
33
Define positive predictive value
Proportion of people with a positive test result that actually have the disease
34
Define negative predictive value
Proportion of people with a negative result that do not have disease
35
What are some arguements for screening?
Prevent suffering Early identification / treatment is beneficial for the patient Early treatment is cheaper Patient satisfaction
36
What are some arguments against screening?
False positives - unnecessary anxiety and excessive investigations False negatives - reduced awareness / overly relaxed Personal choice compromised Adverse effects of the screening tool
37
What is a passive immunisation?
Injection of human immunoglobulin-containing antibodies
38
Who are passive immunisations used for?
Immunocompromised children | Hep A infections
39
What is an active immunisation?
``` Vaccination that stimulates immune response and memory to specific antigen / infection Made from: - Inactived organism - Attenuated live organism - Constituents of cell walls - Recombinant components - Secreted products ```
40
What is primary vaccine failure?
When a patient doesn't develop immunity
41
What is secondary vaccine failure?
Initially responds, but overtime the protection decreases
42
3 main routes of infection spread in hospital
Patient to patient Patient to staff Patient to environment
43
What are preventative measures for these 3 routes of transmission?
Patient to patient - isolation Patient to staff - hand washing Patient to environment - aseptic technique
44
What is an outbreak?
2 or more linked cases
45
What is an epidemic?
Multiple cases in a country / region
46
What is a pandemic?
Multiple cases across international borders
47
3 factors that increase the cance of a pandemic
Increased travel Increased population Intensive farming
48
3 factors that decrease the risk of a pandemic
Vaccination Better nutrition Better supportive care options Better overall health
49
Which type of influenza causes pandemics?
Influenza A
50
How is influenza spread?
Droplet - coughing, sneezing, touch
51
Give 5 examples for managing an influenza outbreak / pandemic
``` Case identification Contact tracing Travel restrictions Restricting mass gathering Home isolation / quarantine Large scale prophylaxis Hygeine ```
52
Give 3 examples of notifiable diseases
``` Scarlet fever Mumps Malaria TB Tetanus Ebola Rubella ```
53
Who are these diseases notified to?
Public Health England
54
Give 3 benefits of notifying PHE about these diseases?
Allows detection of changes in the disease Early warning / forecasting Development of interventions for vulnerable groups Disease tracing Risk factor identification Prevention and prophylaxis
55
Give 2 ways that the community is protected against notifiable disease
Health promotion Education Identifying and protecting vulnerable individuals Contact tracing / partner notification
56
What is the UNAIDS 90/90/90 goal?
By 2020: 90% of people with HIV diagnosed 90% of people diagnosed on ART 90% viral suppression for those on ART
57
Give 3 negative impacts of HIV
``` Illness Stigma Loss of income Carers Orphans Increases inequality in marginalised groups Discrimination ```
58
How is HIV transmitted?
Blood Sexual Mother-to-child
59
Name 3 high risk groups for HIV
``` MSM Heterosexual women IVDU Commercial sex workers Migrant workers ```
60
Name 3 HIV preventative measures
``` HIV testing Partner notification and contact tracing Needle exchange Male circumcision Antenatal HIV screening PEP and PrEP ART - undectable = untransmissable Condom use Reduce high-risk sexual practices ```
61
What is the most common sexually transmitted infection?
Chlamydia - Chlamydia trachomatis
62
What is gonorrhoea caused by?
Neisseria Gonorrhoea
63
What is syphilis caused by?
Treponema pallidum
64
What is the clinical presentation of chlamydia?
Asymptomatic | Dysuria and urethral discharge
65
What is the clinical presentation of gonorrhoea?
Asymptomatic | Dysuria and urethral discharge (more likely than chlamydia)
66
What is the clinical presentation of syphilis?
Genital ulcers
67
Describe the STI / HIV transition model
``` R = B x C x D Where... - R = reproductive rate - B = infectivity rate - C = partners over time - D = duration of infection ```
68
Give 3 methods of primary prevention for STIs
STI awareness campagins Vaccination One-to-one risk reduction PEP / PrEP
69
Give 3 methods of secondary prevention for STIs
``` Easy access to STI testing Access to STI treatments PArtner notification Antinatal screening HIV home testing National chlamydia screening programme ```
70
Give 3 benefits of partner notification
Breaks the chain of transmission Prevents re infection Prevents complications
71
What is diarrhoea?
Increased frequency and looseness of stools (from the patient's normal)
72
Give 3 infective causes of diarrhoea
``` Norovirus Rotavirus Shigella Slamonella E. coli Giardia C. difficile Vibrio cholerae ```
73
Give 3 non-infective causes of diarrhoea
``` AI disease - Crohn's, UC Drugs - metformin, laxatives, antibiotics Malignancy Short gut syndrome Hyperthyroidism Radiotherapy Herbal remedies ```
74
Who are the 4 at risk groups for diarrhoea?
A - people with unsatisfactory hygiene B - children at preschool/nursery C - people who prepare or serve unwrapped/uncooked food D - Healthcare workers / social care staff
75
How is BMI calculated?
Weight (kg) / Height(m)^2
76
What is the BMI for obesty?
>30
77
What are the 4 classes of obesity risk factors? Give an example for each
Unmodifiable - age, gender, ethnicity, sex Lifestyle - smoking, diet, activity levels Clinical - hypertension, diabetes, hyperlipidaemia Psychological - behaviour, work, social support
78
Give 4 health implications of obesity
``` Heart disease Cancer Stroke Depression Sleep apnoea Reproductive complicaitons Asthma T2DM Osteoarthritis ... ```
79
What are the 4 tiers of management?
1. Universal prevention eg. sugar tax 2. Lifestyle intervention eg. diet, exercise 3. Specialist services 4. Surgery
80
What is the obesogenic environment?
Physical - TV remotes, cars, lifts Economic - cheap unhealthy food, expensive healthy Sociocultural - family eating patterns, eating socially
81
Name 5 risk factors for T2DM
``` Age Sex Ethnicity - asian / black populations Gestational diabetes FHx Hypertension Obesity Pre-diabetes ```
82
What are the 3 tests used to diagnose diabetes?
Fasting glucose >7mmol/L Random / 2hr post-prandial >11.1mmol/L HbA1c >48mmol/mol or >6.5%
83
Name 3 lifestyle interventions to prevent diabetes
Weight loss Increase exercise Change in diet
84
Who gets screened for T2DM?
CHD or hypertension
85
Name 3 psychosocial risk factors for CHD
Type A personality Depression / anxiety Lack of social support Job with high demand and low control
86
What is the acronym for primary prevention of CHD?
``` SNAP: Smoking Nutrition Alcohol Physical activity ```
87
What is anorexia nervosa?
A restriction of energy intake relative to requirements Features: - Fear of gaining weight - Undue influence of body weight/shape on self-evaluation - Denial of seriousness of current low body weight
88
What is bulimia nervosa?
Recurrent episodes of binge eating: - Eating large amounts of food in discrete period of time - Sense of lack of control AND recurrent inappropriate compensatory behaviour: - Vomiting - Laxatives - Excessive exercise
89
What is binge eating disorder?
Recurrent episodes of binge eating once/week >3 months | NO purging or compensatory behaviour
90
What is the triad model of eating disorders?
1. Low self-esteem 2. Perfectionism 3. A need for control - use food for this
91
What must you look for in a risk assessment of eating disorder?
``` Severe restriction of food/fluid Electrolyte imblaance Bone deterioration Physical damage Alcohol / drug intake ```
92
Psychological treatment for anorexia nervosa
Family therapy | CBT
93
Psycholocial treatment for bulimia nervosa and binge eating disorder
CBT
94
What is substance misuses?
The harmful use of any substance for non-medical purposes
95
Give 3 effects of drug misuse
``` Mortality Morbidity Social - crime, violence Economic - productivity, tax Personal - identity, stigma, relationships ```
96
What is psychological dependence?
The feeling that life is impossible without drug | Fear, pain, lonliness, guilt without drug
97
What is physical dependence?
The body needs more of a drug to get the same effect - may have withdrawal symptoms: runny nose, stomach cramps, muscle aches, itching
98
Give 5 drug misuse risk factors
``` Lack of parental support Family history of substance abuse Aggressive childhood behaviour Community deprivation / poverty Availability of drugs Academic failure Risk taking behaviour ```
99
How much alcohol is in one unit?
8g or 10ml
100
How do you calculate units?
(Strength x ml) / 1000
101
What is the alcohol harm paradox?
Lower socioeconomic groups consume less alcohol than higher socioeconomic groups, but experience greater alcohol related harm
102
Give 3 acute effects of excessive alcohol consumption
``` Accident / injury Gastric tears Pancreatitis Hypogylcaemia Resp depression --> coma / death ```
103
Give 3 chronic effects of excessive alcohol consumption
``` CNS toxicity - dementia, cerebellar degeneration, Wernicke-Korsakoff syndrome Hypertension Liver damage Peripheral neuropathy Oesophagitis ```
104
Give 3 psychosocial effects of excessive alcohol consumption
``` Interpersonal relationships - violence, rape, depression Problems at work Criminality Social disintegration Driving offences ```
105
Give 3 features of alcohol withdrawal
``` Delerium tremens Tremulousness Activation syndrome Seizures Hallucinations ```
106
What are the CAGE questions?
have you ever felt you should CUT DOWN? have you ever been ANNOYED by criticism of your drinking? have you ever felt GUILTY about your drinking? have you ever had a drink first thing in the morning? - EYEOPENER
107
What is alcohol dependence?
A set of behavioural, cognitive and physiological responses that develop after repeated substance abuse
108
What is the FRAMES model of motivational interviewing?
``` Feedback Responsibility Advice Menu Empathy Self-efficacy ```
109
Name 2 medical therapies used in alcohol dependence treatment
Acamprosate calcium Disulfiram Naltrexone Nelmefene
110
What is palliative care?
End of life care that acts to provide pain and symptom relief as well as psychological support for patient and family
111
What is specialist palliative care?
Involves healthcare professional who specialise in palliative care within an MDT
112
Give 3 providers of specialist palliative care
``` Consultants in palliative care Clincial nurse specialists Hospice nurses Specialist social workers Physiotherapists Dieticians ```
113
What is generalist palliative care?
End of life care from practitioners not exclusively concerned with specialist palliative care - available to anyone with an advanced progressive disease
114
Give 3 providers of generalist palliative care
``` GPs Hospital soctors District nurses Nursing home staff Social workers ```
115
What is the aim of palliative care?
Promote quality of life, dignity and autonomy in death
116
What is occupational health?
A branch of medicine concerned with interactions of work and health
117
Name 3 causes of work-related ill health
``` Stress, depression and anxiety MSK disorders Lung disease Cancer Hearing loss Hand-arm vibration ```
118
Give 3 features of 'Good Work' (Marmot)
``` Low precariousness Individual control Fair employment Opportunities Work / life balance Promotes health and wellbeing Prevents social isolation, discrimination and violence ... ```
119
What is QRISK2 used for?
Assess risk of heart attack / stroke in next 10 yrs
120
Give 3 things assessed in QRISK2
``` Smoking Diabetes Angina / heart attack in 1st degree relative <60yrs CKD AF RA ... ```
121
What is the GRACE score?
Risk of mortality in ACS patients
122
Name 3 things assessed in the GRACE score
``` Renal function ST segment deviation Raised troponin Heart rate Age ... ```
123
What is the FRAX score?
Calculate risk of osteoporosis-related fracture in next 10yrs
124
Name 3 things assessed in FRAX
``` Previous fracture Smoking Glucocorticoids RA Alcohol 3+ units / day Femoral neck BMD ... ```
125
What is CHADS2VASC?
Risk of stroke in patients with AF
126
What does CHADS2VASC stand for?
``` Congestive HF Hypertension Age >75 Diabetes Stroke/TIa Vascular disease Age 65-74 Sex ```
127
What is the ABCD2 score used for?
Risk of stroke after a TIA
128
What does ABCD2 stand for?
``` Age BP Clinical features Duration Diabetes ```
129
What 3 features are recorded on the Glasgow coma scale?
Best eye response Best verbal response Best motor response
130
What is GAD-7 used for?
Assessing anxiety
131
Name 3 things in GAD-7
``` Feeling nervous / anxcious Trouble relaxing Hard to sit still Easily annoyed / irritable Feeling afraid ... ```
132
What is PHQ-9 used for?
Assessing depression
133
Name 3 things in PHQ-9
``` Interest Feeling down / hopeless Sleeping changes Appetite changes Low self esteem Trouble concentrating ... ```
134
What is CURB-65 used for?
Mortality risk assessment in those with community acquired pneumonia
135
What does CURB-65 stand for?
``` Confusion Urea >19mg/dL Resp rate >30 BP - systoic <90 or diastolic <60 >65yrs ```

Public health 2a (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions