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Phase 2A Med Concise > Public health > Flashcards

Public health Flashcards

1
Q

Consent must be 3 things

A

Voluntary
Informed
Made by someone with mental capacity

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2
Q

4 things that need to be told to patient about their treatment

A

What it involves
Risk
Benefits
Alternative options (and their risks/benefits)

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3
Q

Mental capacity act 2005

A

Used to empower and protect individuals over 16 who lack mental capacity to make decisions about their care and treatment
E.g. people with dementia, stroke, disabilities

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4
Q

Before deciding completely whether the individual does have proper mental capacity, the following things need to be considered

A

Have they been given all the info they need
Have different ways of communication been explored (non verbal)
Could anyone else help communicate with them (family/relatives)
Does capacity fluctuate with time/environment
Can decision be delayed until person is able to make one

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5
Q

What happens when it is found that individual lacks mental capacity to make a decision

A

Decision must be made in their best interests - weight up advantages/disadvantages
Advance statement/ADRT (Advanced Decision to Refuse Treatment) - Made by someone before they become incapable of making a decision
LPA (Lasting Power of Attorney) - Can grant another person authority to make decisions about your healthcare, and even property and finance affairs

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6
Q

What is used for individuals under 16

A

Gillicks competency/Fraser guidelines

The laws are mostly specific to contraceptive advice

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7
Q

Substance misuse

A

Ingestion of a substance that affects the CNS, leading to behavioural and physiological changes, for a non-therapeutic reason

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8
Q

Substances used for misuse

A

Opiates for pain relief and euphoria (heroin, morphine)
Depressants for sedation and relaxation (valium)
Stimulants for improved mood and activity (caffeine, cocaine, nicotine)
Hallucinogens for altered sensory perception and thinking patterns (ketamine, magic mushrooms)

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9
Q

Addiction - Causes

A

Illness
Genetics
Bad habit
Social problems

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10
Q

Addiction - Risk factors

A

Family history of misuse, conflict, poor familial management/parenting
Community - low academic commitment, substance availability
Individual/peer - risk taking behaviour/rebelliousness, anti-social behaviour, substance abusing peers, experience of trauma (bereavement, abuse)

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11
Q

Addiction - Management

A

National drug strategy 2010 - reducing demand, restricting supply, suport services through local councils
GP support
Needle exchange programs
Rehab/detox programmes

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12
Q

Compliance

A

Patient’s behaviour coincides with medical advice

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13
Q

Adherence

A

Patient involvement and autonomy throughout course of treatment

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14
Q

Concordance

A

Patient is equal to doctor in care-giving, involving them in decision making

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15
Q

Reasons for non-adherence

A

Financial barriers
Forgetfulness (dementia)
Language barriers
Patient’s beliefs

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16
Q

Necessity-concerns framework

A

Key beliefs influencing patients put into 2 categories - Necessity and concerns (perceived need for treatment and adverse consequences)
Adherence requires more necessity and less concern beliefs

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17
Q

Coronary heart disease - Risk factors

A 
Smoking
Diabetes
Hypertension
Obesity
High cholesterol
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18
Q

Population attributable risk

A

The disease incidence in the population that would be eliminated if the exposure (smoking) were eliminated

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19
Q

Type A personalities

A

Competitive
Hostile
Agression

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20
Q

Occupational health - Respiratory

A

Inhaling fumes, dust, gas, aerosols
Acute irritant asthma, pulmonary oedema, infection, allergy, chronic inflammation (COPD), destruction of lung tissue (fibrosis of lungs/pleura), carcinogenesis

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21
Q

Lung disease - Causes

A

Smoking
Occupational hazards
Geographical variation is due to socioeconomic differences, historic industry (mining, shipping, building)

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22
Q

Pandemic influenza - 3 Types

A

A, B, C (A/B more common)

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23
Q

Pandemic influenza - Symptoms

A 
Upper/lower respiratory tract symptoms
Fever
Headache
Malaise
Weakness
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24
Q

Pandemic influenza - Epidemics and pandemics

A

Seasonal epidemics caused by micro-antigenic variation

Pandemics caused by major-antigenic variation

25
Pandemic influenza - Treatment
Oxygen Hydration Antivirals to prevent infection spread Symptomatic relief
26
Palliative care
``` Comfort and high quality of life Meet patient and family needs Pain management and symptomatic relief Psychological, spiritual and practical support Bereavement support for family ```
27
Alcohol misuse - Psychosocial effects
Violence Criminality Work problems Driving offences
28
Alcohol misuse - Acute and chronic health effects
Acute - Injuries, pneumonia, gastritis, pancreatitis, oesophagitis, cardiac arrhythmias, cerebrovascular accidents, foetal alcohol syndrome during pregnancy Chronic - Dementia, cerebellar degeneration, fatty liver and cirrhosis, liver cancer, hypertension, peripheral neuropathy, osteoporosis, CHD
29
Alcohol misuse - Management
Primary prevention - Know your limits campaign, drinkaware labelling, minimum pricing, Think! campaign Secondary prevention - Screening Management - Therapy, social support and medication (Disulfiram), MoCAM 2006 (Model of Care for Alcohol Misusers)
30
Anorexia nervosa
Restriction of energy intake, low body weight, fear of weight gain
31
Bulimia nervosa
Recurrent episodes of binge eating (large amounts of food consumption with lack of control)
32
Diarrhoea - Transmission
Spread from person to person through exit and entry points Direct transmission - STIs, viral gastroenteritis (faeco-oral) Indirect transmission - Vector borne (malaria), HepB Airborne - TB
33
Diarrhoeal diseases
Dysentery Cholera Typhoid Hepatitis
34
Diarrhoea - Microorganisms
``` Rotaviruses Shigella E. Coli Salmonella Vibrio cholerae Norovirus (flu like) Clostridium difficile (associated with antibiotic use) ```
35
Diarrhoea - Prevention
Hygeine - Hand washing, vaccinations, sterilisation/sanitation in care giving and food preparation settings
36
Diarrhoea - Management
Fluid and electrolyte resus | Zinc
37
Back pain
Lumbosacral region and spreads to leg, feet/toes | Often numbness/parasthesia associated
38
Work related MSK disorders
``` Carpal tunnel syndrome - repetitive wrist flexion Hand-arm vibration syndrome - blanching of fingers, tingling, numbness Tendonitis/tears Epicondylitis - tennis elbow RSI Rotator cuff problems Osteoarthritis Mechanical back pain ```
39
Bradford Hill criteria
Guidelines to help provide evidence of work related disorders being due to work Backed by evidence-based research Legal impacts - Affected people are protected by The Equality Act 2010, and so employer must make appropriate adjustments
40
Chlamydia - presentation
Most common STI Chlamydia trachomatis Infects urethra, endocervical canal, rectum, pharynx, conjunctiva In males - Dysuria and urethral discharge In females - Discharge, menstrual irregularity, dysuria
41
Chlamydia - Diagnosis
Swabs | First void urine
42
Chlamydia - Management
Antibiotics - Doxycycline Partner screening and notification Test for other STIs (especially gonorrhoea)
43
Chlamydia - Complications
Pelvic inflammatory disease and subsequently infertility Ectopic pregnancy Chronic pelvic pain Neonatal transmission
44
Syphillis - Presentation
Ulcers around genital skin, nipple, mouth Skin rash Can cause still births/late miscariages in neonates
45
Syphillis - Diagnosis
Blood serology
46
Syphillis - Management
Penicillin | Partner notification
47
Public health interventions to control STIs
R=BCD (R-Reproductive rate, B-Infectivity rate, C-Partners over time, D-Duration of infection) Primary prevention - STI awareness, vaccination Secondary prevention - Screening, partner notification, treatment access
48
Diabetes - Risk factors
Sedentary job High calorie diet Low fruit/veg intake Obesity
49
Diabetes - Social factors
Culture of car usage, TV watching, cheap fast food
50
Factors maintaining obesity
More weight makes it harder to exercise, low self-esteem and comfort eating, reduced employment opportunities
51
Diabetes - Prevention
Primary - Weight loss, healthy diet, exercise Secondary - Awareness, screening Tertiary - Lifestyle changes, medication ,education, complications management
52
Obesity - Complications
``` High cholesterol Hypertension Prediabetes Bone/joint problems Respiratory problems Increased risk of CV event (MI, stroke) ```
53
Obesity - Media campaigns
Change4Life | 5ADAY
54
Obesity - barriers to weight loss
Unhealthy food is cheap Industry profits from unhealthy food Lack of motivation/energy
55
Passive vs active immunisation
Passive - Transfer preformed antibodies (natural or artificial) Active - Challenging immune system with weakened/live attenuated or dead form of pathogen
56
Factors contributing to unsafe practice
``` Communication Training Patient assessment Clinical complexity Staffing levels and competency Human error ```
57
Error types
Latent - resource allocation Organisational - management failures Technical failure - facilities Active - direct patient contact
58
Reducing errors - SBAR method of management
``` Situation Background Assessment Recommendation Maintain situational awareness, eliminate distractions, open minded diagnoses - not anchoring on ideas early on ```

Phase 2A Med Concise (18 decks)

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