Brainscape's Knowledge GenomeTM

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


See full index

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
Q

Name 4 UK screening programmes

A

Breast cancer
Bowel cancer
Cervical cancer
Abdominal aortic aneurysm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How is breast cancer screening done, who for and how often?

A

Mammography
Women 50-70
Every 3 yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How is bowel cancer screening done, who for and how often?

A

Faecal occult blood
Everyone 60-74
Every 2 years

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

How is cervical cancer screening done, who for and how often?

A

Cervical smear and cytology
Women 25-50 every 3yrs
Women 50-64 every 5 years

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

How is abdominal aortic aneurysm done and who for?

A

Ultrasound

Men 65-74

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

Give 3 of the Wilson-Junger screening principles

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

Define sensitivity

A

Measure of how well a test picks up those that have the disease

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

Define specificity

A

Measure of how well a test recognises those that don’t have the disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Define positive predictive value

A

Proportion of people with a positive test result that actually have the disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Define negative predictive value

A

Proportion of people with a negative result that do not have disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are some arguements for screening?

A

Prevent suffering
Early identification / treatment is beneficial for the patient
Early treatment is cheaper
Patient satisfaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are some arguments against screening?

A

False positives - unnecessary anxiety and excessive investigations
False negatives - reduced awareness / overly relaxed
Personal choice compromised
Adverse effects of the screening tool

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

What is a passive immunisation?

A

Injection of human immunoglobulin-containing antibodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Who are passive immunisations used for?

A

Immunocompromised children

Hep A infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is an active immunisation?

A 
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is primary vaccine failure?

A

When a patient doesn’t develop immunity

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

What is secondary vaccine failure?

A

Initially responds, but overtime the protection decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

3 main routes of infection spread in hospital

A

Patient to patient
Patient to staff
Patient to environment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are preventative measures for these 3 routes of transmission?

A

Patient to patient - isolation
Patient to staff - hand washing
Patient to environment - aseptic technique

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

What is an outbreak?

A

2 or more linked cases

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

What is an epidemic?

A

Multiple cases in a country / region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is a pandemic?

A

Multiple cases across international borders

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

3 factors that increase the cance of a pandemic

A

Increased travel
Increased population
Intensive farming

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

3 factors that decrease the risk of a pandemic

A

Vaccination
Better nutrition
Better supportive care options
Better overall health

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

Which type of influenza causes pandemics?

A

Influenza A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

How is influenza spread?

A

Droplet - coughing, sneezing, touch

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

Give 5 examples for managing an influenza outbreak / pandemic

A 
Case identification 
Contact tracing
Travel restrictions
Restricting mass gathering
Home isolation / quarantine
Large scale prophylaxis
Hygeine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Give 3 examples of notifiable diseases

A 
Scarlet fever
Mumps
Malaria
TB
Tetanus
Ebola
Rubella
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Who are these diseases notified to?

A

Public Health England

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

Give 3 benefits of notifying PHE about these diseases?

A

Allows detection of changes in the disease
Early warning / forecasting
Development of interventions for vulnerable groups
Disease tracing
Risk factor identification
Prevention and prophylaxis

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

Give 2 ways that the community is protected against notifiable disease

A

Health promotion
Education
Identifying and protecting vulnerable individuals
Contact tracing / partner notification

56
Q

What is the UNAIDS 90/90/90 goal?

A

By 2020:
90% of people with HIV diagnosed
90% of people diagnosed on ART
90% viral suppression for those on ART

57
Q

Give 3 negative impacts of HIV

A 
Illness
Stigma
Loss of income
Carers
Orphans
Increases inequality in marginalised groups
Discrimination
58
Q

How is HIV transmitted?

A

Blood
Sexual
Mother-to-child

59
Q

Name 3 high risk groups for HIV

A 
MSM
Heterosexual women 
IVDU
Commercial sex workers 
Migrant workers
60
Q

Name 3 HIV preventative measures

A 
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
Q

What is the most common sexually transmitted infection?

A

Chlamydia - Chlamydia trachomatis

62
Q

What is gonorrhoea caused by?

A

Neisseria Gonorrhoea

63
Q

What is syphilis caused by?

A

Treponema pallidum

64
Q

What is the clinical presentation of chlamydia?

A

Asymptomatic

Dysuria and urethral discharge

65
Q

What is the clinical presentation of gonorrhoea?

A

Asymptomatic

Dysuria and urethral discharge (more likely than chlamydia)

66
Q

What is the clinical presentation of syphilis?

A

Genital ulcers

67
Q

Describe the STI / HIV transition model

A 
R = B x C x D
Where...
- R = reproductive rate
- B = infectivity rate
- C = partners over time 
- D = duration of infection
68
Q

Give 3 methods of primary prevention for STIs

A

STI awareness campagins
Vaccination
One-to-one risk reduction
PEP / PrEP

69
Q

Give 3 methods of secondary prevention for STIs

A 
Easy access to STI testing 
Access to STI treatments
PArtner notification 
Antinatal screening 
HIV home testing 
National chlamydia screening programme
70
Q

Give 3 benefits of partner notification

A

Breaks the chain of transmission
Prevents re infection
Prevents complications

71
Q

What is diarrhoea?

A

Increased frequency and looseness of stools (from the patient’s normal)

72
Q

Give 3 infective causes of diarrhoea

A 
Norovirus
Rotavirus
Shigella
Slamonella
E. coli 
Giardia 
C. difficile
Vibrio cholerae
73
Q

Give 3 non-infective causes of diarrhoea

A 
AI disease - Crohn's, UC
Drugs - metformin, laxatives, antibiotics
Malignancy
Short gut syndrome 
Hyperthyroidism 
Radiotherapy
Herbal remedies
74
Q

Who are the 4 at risk groups for diarrhoea?

A

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
Q

How is BMI calculated?

A

Weight (kg) / Height(m)^2

76
Q

What is the BMI for obesty?

A

> 30

77
Q

What are the 4 classes of obesity risk factors? Give an example for each

A

Unmodifiable - age, gender, ethnicity, sex
Lifestyle - smoking, diet, activity levels
Clinical - hypertension, diabetes, hyperlipidaemia
Psychological - behaviour, work, social support

78
Q

Give 4 health implications of obesity

A 
Heart disease
Cancer
Stroke
Depression
Sleep apnoea
Reproductive complicaitons 
Asthma 
T2DM
Osteoarthritis  
...
79
Q

What are the 4 tiers of management?

A
  1. Universal prevention eg. sugar tax
  2. Lifestyle intervention eg. diet, exercise
  3. Specialist services
  4. Surgery
80
Q

What is the obesogenic environment?

A

Physical - TV remotes, cars, lifts
Economic - cheap unhealthy food, expensive healthy
Sociocultural - family eating patterns, eating socially

81
Q

Name 5 risk factors for T2DM

A 
Age
Sex
Ethnicity - asian / black populations
Gestational diabetes
FHx
Hypertension
Obesity
Pre-diabetes
82
Q

What are the 3 tests used to diagnose diabetes?

A

Fasting glucose >7mmol/L
Random / 2hr post-prandial >11.1mmol/L
HbA1c >48mmol/mol or >6.5%

83
Q

Name 3 lifestyle interventions to prevent diabetes

A

Weight loss
Increase exercise
Change in diet

84
Q

Who gets screened for T2DM?

A

CHD or hypertension

85
Q

Name 3 psychosocial risk factors for CHD

A

Type A personality
Depression / anxiety
Lack of social support
Job with high demand and low control

86
Q

What is the acronym for primary prevention of CHD?

A 
SNAP:
Smoking 
Nutrition
Alcohol
Physical activity
87
Q

What is anorexia nervosa?

A

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
Q

What is bulimia nervosa?

A

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
Q

What is binge eating disorder?

A

Recurrent episodes of binge eating once/week >3 months

NO purging or compensatory behaviour

90
Q

What is the triad model of eating disorders?

A
  1. Low self-esteem
  2. Perfectionism
  3. A need for control - use food for this
91
Q

What must you look for in a risk assessment of eating disorder?

A 
Severe restriction of food/fluid
Electrolyte imblaance
Bone deterioration
Physical damage
Alcohol / drug intake
92
Q

Psychological treatment for anorexia nervosa

A

Family therapy

CBT

93
Q

Psycholocial treatment for bulimia nervosa and binge eating disorder

A

CBT

94
Q

What is substance misuses?

A

The harmful use of any substance for non-medical purposes

95
Q

Give 3 effects of drug misuse

A 
Mortality
Morbidity
Social - crime, violence
Economic - productivity, tax
Personal - identity, stigma, relationships
96
Q

What is psychological dependence?

A

The feeling that life is impossible without drug

Fear, pain, lonliness, guilt without drug

97
Q

What is physical dependence?

A

The body needs more of a drug to get the same effect - may have withdrawal symptoms: runny nose, stomach cramps, muscle aches, itching

98
Q

Give 5 drug misuse risk factors

A 
Lack of parental support
Family history of substance abuse
Aggressive childhood behaviour
Community deprivation / poverty
Availability of drugs
Academic failure
Risk taking behaviour
99
Q

How much alcohol is in one unit?

A

8g or 10ml

100
Q

How do you calculate units?

A

(Strength x ml) / 1000

101
Q

What is the alcohol harm paradox?

A

Lower socioeconomic groups consume less alcohol than higher socioeconomic groups, but experience greater alcohol related harm

102
Q

Give 3 acute effects of excessive alcohol consumption

A 
Accident / injury
Gastric tears
Pancreatitis 
Hypogylcaemia
Resp depression --> coma / death
103
Q

Give 3 chronic effects of excessive alcohol consumption

A 
CNS toxicity - dementia, cerebellar degeneration, Wernicke-Korsakoff syndrome
Hypertension 
Liver damage
Peripheral neuropathy
Oesophagitis
104
Q

Give 3 psychosocial effects of excessive alcohol consumption

A 
Interpersonal relationships - violence, rape, depression
Problems at work
Criminality
Social disintegration
Driving offences
105
Q

Give 3 features of alcohol withdrawal

A 
Delerium tremens
Tremulousness
Activation syndrome
Seizures
Hallucinations
106
Q

What are the CAGE questions?

A

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
Q

What is alcohol dependence?

A

A set of behavioural, cognitive and physiological responses that develop after repeated substance abuse

108
Q

What is the FRAMES model of motivational interviewing?

A 
Feedback 
Responsibility
Advice
Menu 
Empathy
Self-efficacy
109
Q

Name 2 medical therapies used in alcohol dependence treatment

A

Acamprosate calcium
Disulfiram
Naltrexone
Nelmefene

110
Q

What is palliative care?

A

End of life care that acts to provide pain and symptom relief as well as psychological support for patient and family

111
Q

What is specialist palliative care?

A

Involves healthcare professional who specialise in palliative care within an MDT

112
Q

Give 3 providers of specialist palliative care

A 
Consultants in palliative care
Clincial nurse specialists
Hospice nurses
Specialist social workers
Physiotherapists
Dieticians
113
Q

What is generalist palliative care?

A

End of life care from practitioners not exclusively concerned with specialist palliative care - available to anyone with an advanced progressive disease

114
Q

Give 3 providers of generalist palliative care

A 
GPs
Hospital soctors
District nurses
Nursing home staff
Social workers
115
Q

What is the aim of palliative care?

A

Promote quality of life, dignity and autonomy in death

116
Q

What is occupational health?

A

A branch of medicine concerned with interactions of work and health

117
Q

Name 3 causes of work-related ill health

A 
Stress, depression and anxiety
MSK disorders
Lung disease
Cancer
Hearing loss
Hand-arm vibration
118
Q

Give 3 features of ‘Good Work’ (Marmot)

A 
Low precariousness
Individual control
Fair employment
Opportunities
Work / life balance
Promotes health and wellbeing 
Prevents social isolation, discrimination and violence
...
119
Q

What is QRISK2 used for?

A

Assess risk of heart attack / stroke in next 10 yrs

120
Q

Give 3 things assessed in QRISK2

A 
Smoking
Diabetes
Angina / heart attack in 1st degree relative <60yrs
CKD
AF
RA 
...
121
Q

What is the GRACE score?

A

Risk of mortality in ACS patients

122
Q

Name 3 things assessed in the GRACE score

A 
Renal function 
ST segment deviation 
Raised troponin 
Heart rate
Age
...
123
Q

What is the FRAX score?

A

Calculate risk of osteoporosis-related fracture in next 10yrs

124
Q

Name 3 things assessed in FRAX

A 
Previous fracture
Smoking 
Glucocorticoids
RA
Alcohol 3+ units / day
Femoral neck BMD
...
125
Q

What is CHADS2VASC?

A

Risk of stroke in patients with AF

126
Q

What does CHADS2VASC stand for?

A 
Congestive HF
Hypertension 
Age >75
Diabetes
Stroke/TIa
Vascular disease
Age 65-74
Sex
127
Q

What is the ABCD2 score used for?

A

Risk of stroke after a TIA

128
Q

What does ABCD2 stand for?

A 
Age 
BP
Clinical features
Duration
Diabetes
129
Q

What 3 features are recorded on the Glasgow coma scale?

A

Best eye response
Best verbal response
Best motor response

130
Q

What is GAD-7 used for?

A

Assessing anxiety

131
Q

Name 3 things in GAD-7

A 
Feeling nervous / anxcious
Trouble relaxing
Hard to sit still
Easily annoyed / irritable 
Feeling afraid
...
132
Q

What is PHQ-9 used for?

A

Assessing depression

133
Q

Name 3 things in PHQ-9

A 
Interest
Feeling down / hopeless
Sleeping changes
Appetite changes
Low self esteem
Trouble concentrating 
...
134
Q

What is CURB-65 used for?

A

Mortality risk assessment in those with community acquired pneumonia

135
Q

What does CURB-65 stand for?

A 
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.
© 2024 Bold Learning Solutions. Terms and Conditions