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Phase 2a > Public Health > Flashcards

Public Health Flashcards

1
Q

What is health?

A

A complete state of physical, mental and social well being - not just the absence of disease

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2
Q

When are you allowed to breach confidentiality?

A
  • Required by law (e.g. notifiable disease, ordered by police/judge)
  • Patient’s consent given
  • It is in the best interest of the public
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3
Q

How can doctors help smokers?

A

AAA

A - ask (are you a smoker?)
A - advise (smoking is bad)
A -assist, i.e. refer to NHS Smoking Cessation Service (nicotine patches/gums etc.)

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4
Q

Describe the stages of the transtheoretical model of change, giving examples of a smoker

A
  • Precontemplation = smoker, not thinking about quitting
  • Contemplation = smoker, thinking about quitting but not ready yet
  • Preparation = smoker, thinking about quitting and taking steps to prepare for quitting
  • Action = ex-smoker, quit for < 6 months
  • Maintenance = ex-smoker, quit for > 6 months
  • Relapse?? = quit smoking, then had a lapse that led to smoking being resumed
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5
Q

Give an example of an alcohol screening tool

A

CAGE questionnaire:

  • have you ever felt you should CUT down on your drinking?
  • have you ever felt ANNOYED because someone criticised your drinking habits?
  • have you ever felt GUILTY about drinking?
  • have you ever taken a drink first thing in the morning (as an EYE-OPENER)?
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6
Q

How do you calculate a unit of alcohol?

A

Units = strength of drink (%ABV) x volume of liquid (mLs) / 1000

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7
Q

How many units of alcohol are you allowed per week?

A

You shouldn’t exceed 14 units of alcohol per week

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8
Q

Give some examples of public health campaigns to prevent alcohol abuse

A
  • Know your limits (binge drinking campaign targeting 18-24 year olds)
  • Drinkaware labelling
  • ‘THINK!’ (drink driving campaign)
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9
Q

What is patient compliance?

A

The extent to which a patient’s behaviours coincide with medical or health advice given

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10
Q

Give some factors which can affect patient compliance

A
  • Access to resources/facilities, e.g. distance from treatment setting
  • Condition, e.g. memory impairment
  • Complex treatment regimes
  • Disbelief/denial of diagnosis
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11
Q

What is an occupational disease?

A

A disease where work is considered to be the main cause

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12
Q

Give some examples of occupational diseases…

A

Lungs:

  • Asbestosis
  • Mesothelioma
  • Silicosis
  • Coal worker’s pneumoconiosis

Skin:
- Occupational dermatitis

MSK:
- Tenosynovitis

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13
Q

Give some examples of criteria for ‘good work’ from the Marmot review

A
  • Precariousness (stable and safe)
  • Work/life balance
  • Prevents social isolation, discrimination and violence
  • Promotes health and well being
  • Reintegrates sick and disabled where possible
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14
Q

What are the public health interventions for reducing the spread of flu?

A
  1. Hand washing
  2. Encouraging respiratory hygiene… ‘catch it, bin it, kill it’
  3. Reducing social contact, e.g. not attending large gatherings
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15
Q

What are the aims of palliative care?

A
  • Improve quality of life for patients and their families
  • Provide pain and symptom relief
  • Provide spiritual and psycho-social support
  • Provide care from diagnosis through to end-of-life and bereavement
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16
Q

Describe the interventions to help prevent the spread of C. difficile

A

SIGHT

S - suspect C. difficile
I - isolate patient
G - gloves and apron
H - hand washing with soap and water (alcohol gel won’t kill)
T - test stool for toxin or perform stool culture to identify the strain

17
Q

Give some examples of antibiotics which cause C. difficile

A

Ciprofloxacin
Cephalosporins
Co-amoxiclav

18
Q

Describe the pharmacological management of C. difficile

A

Vancomycin and Metronidazole

19
Q

Describe the WHO prevention and treatment package for diarrhoea

A

Prevention:

  • Vaccination: rotavirus and measles
  • Promote early and exclusive breastfeeding and vitamin A supplementation
  • Promote hand washing with soap and water
  • Safe treatment and storage of drinking water
  • Community-wide sanitation promotion

Treatment:

  • Fluid replacement to prevent dehydration
  • Zinc treatment
20
Q

Give some examples of groups most at risk of diarrhoea

A
  • Poor personal hygiene

- Young (e.g. nursery) and elderly (e.g. nursing home)

21
Q

Give some psycho-social factors which increase risk of CHD

A
  • Type A personality (hostile, competitive, impatient)
  • Depression/anxiety
  • Work characteristics: high demand, low control; long hours
  • Lack of social support
22
Q

Describe some psycho-social impacts of alcohol abuse

A
  • Relationship problems (violence, rape, depression/anxiety)
  • Work problems
  • More likely to engage in criminal behaviour
  • Driving offences
23
Q

Describe the symptoms of alcohol withdrawal

A
  • Tremulousness (‘the shakes’)
  • Agitation
  • Hallucinations
  • Seizures
24
Q

Give the definition of substance misuse

A

Ingestion of a substance affecting the CNS which leads to behavioural and psychological changes (non-therapeutic use)

25
Q

What is Gillick competence?

A

The ability of a child (person under the age of 16 years) to consent to their own medical treatment, without the need for parental knowledge or permission

26
Q

What is sensitivity?

A

The proportion of people WITH a disease who get a POSITIVE result in a screening test

27
Q

What is specificity?

A

The proportion of people WITHOUT the disease who get a NEGATIVE result in a screening test

28
Q

What are the 4 mental capacity requirements?

A
  1. Ability to understand information
  2. Ability to retain information
  3. Ability to evaluate information
  4. Ability to communicate decision (verbal or non-verbal)
29
Q

What is incidence?

A

Number of new cases of a disease in a population per unit time

30
Q

What is prevalence?

A

Number of existing cases of a disease in a population at a given point in time

31
Q

What is primary prevention?

A
  • Aims to prevent onset of disease
  • Involves interventions that are applied before any stages of disease are present
  • E.g. public health campaigns
32
Q

What is secondary prevention?

A
  • Aims to detect disease in its earliest stages before symptoms are present
  • Involves interventions that stop, slow or reverse disease progression
  • E.g. Screening programmes
33
Q

What is tertiary prevention?

A

Interventions which aim to stop the progression of established disease and minimise its negative consequences

34
Q

Give some examples of screening programmes

A
  • Bowel cancer
  • Breast cancer
  • Cervical cancer
  • AAA
  • Newborn heel prick test
  • Diabetic eye screening
35
Q

What is the name of the screening principles criteria?

Give some examples of criteria

A

Wilson and Junger criteria:

  • Important condition
  • Population for screening identified, e.g. women aged 25-50
  • Cost effective
  • Natural history of the disease is known
  • Suitable test identified
  • Acceptable and effective treatment
  • Case-finding is a continuous process
36
Q

What is positive predictive value?

A

Probability that the disease is present when the test result is positive

37
Q

What is the negative predictive value?

A

Probability that the disease is not present when the test result is negative

38
Q

What are the limitations of screening?

A
  • False positives = unnecessary stress
  • Negative results = people feel like they have a licence to take risks
  • Over detection of sub-clinical ‘harmless’ cases
  • ‘Harm’ from screening, e.g. radiation exposure form mammography
39
Q

What is one pack year?

A

Twenty cigarettes smoked every day for one year

Phase 2a (16 decks)

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