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Phase 2a NEW > Public health > Flashcards

Public health Flashcards

1
Q

Adherence vs compliance

A

Adherence preferred terminology rather than compliance
Adherence acknowledges the importance of patient beliefs
Adherence is much more patient centered

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2
Q

Non-adherence examples

A

Antibiotics - stopping the medicine without finishing the course
Dementia (forgetfulness)
Skipping physiotherapy
Modifying treatment to accommodate work/social life
Continuing with behaviours against medical advice (diet, smoking, alcohol)

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3
Q

Reasons for non-adherence

A

Unintentional (capacity and resource) - difficulty understanding instructions, inability to pay, forgetting
Intentional (perceptual) - Patients beliefs about their health/condition, personal preferences (Jehovahs witnesses)

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4
Q

Necessity-Concerns framework

A

Necessity beliefs - perceptions of personal need for treatment
Concerns - potential adverse effects
Increased adherence = increased necessity beliefs, decreased concerns

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5
Q

Patient centredness

A

Shared control of consultation, decisions about interventions or management of health problems with the patient
Patient as a whole person

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6
Q

Concordance

A

Process of being patient centered

Negotiation between equals

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7
Q

Barriers to concordance

A

The patient may simply want the doctor to tell them what to do, where medical decisions were complex or based on complicated info (stats)

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8
Q

Ethical considerations

A

Mental capacity (dementia, severe learning disability, brain injury, mental health condition)
Potential threat to health of others
When patient is a child - 3rd party (parents)

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9
Q

Public health act

A

Provides a basis to detain and isolate an infectious individual

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10
Q

RF types

A

Unmodifiable risk factors - Age, sex, gender, ethnicity
Lifestyle risk factors - Smoking, diet, physical activity level
Clinical risk factors - Hptn, diabetes, lipids
Psychosocial risk factors - Work/occupation, anxiety/depression

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11
Q

Coronary prone behaviour pattern

A

Type A behaviour - Competitive, hostile, impatient

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12
Q

Assessing behaviour

A

Questionnaires - MMPI
Self report
Structured clinical interviews - Speech, answer content, psychomotor responses, non-verbal

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13
Q

Cardiology counseling

A

Fewer cardiac events occur as a result of this educational approach

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14
Q

Anger and hostility

A

Key RF
Verbal or physical aggression
Annoyance
Feelings of anger

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15
Q

Type A behaviour modification

A

Educational and psychological

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16
Q

Depression/anxiety and CHD - Measurement tools

A

MMPI -
BDI - Beck depression inventory
GHQ - General health questionnaire

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17
Q

Psychosocial work characteristics

A

High demand/Low control = Raised MI risk

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18
Q

Whitehall studies

A

Lower work grade = Greater CHD mortality rate

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19
Q

Working hours and CHD

A

Working more than 11 hours a day increases heart attack risk by 67% than those working the standard 7-8hrs

20
Q

Social support

A

Loneliness and social isolation are RFs for CHD and stroke

21
Q

What can doctors do

A

Observe behaviour patterns
Identify signs of anxiety/depression
Use assessment tools
Ask about occupation

22
Q

Hepatitis B

A

Common in Roma Slovak community

23
Q

Inverse care law

A

Availbaility of good medical care tends to vary inversely with the need for it in the population served

24
Q

Socioeconomic position and circumstance

A

Income
Class (ownership of assets)
Status (hierarchy/prestige)

25
Q

CHD risk

A

Higher risk in south asian people

26
Q

Cancer rates lower in

A

BME ethnic minority groups

27
Q

Risk factors for VitD deficiency

A

Reduced sunlight exposure

Pigmented skin

28
Q

VitD deficiency - Symptoms

A

Bone pains/fractures
Muscle weakness
Dental deformities
Rickets (in children) - Bowed legs (bent), big and bumpy joints

29
Q

Female genital mutilation

A

More common in BME minority groups

30
Q

BME

A

Black minority ethnic group

Non-white descent

31
Q

Stroke risk

A

F>M

32
Q

IHD risk

A

M>F

33
Q

Rose hypothesis

A

A large number of people at a small risk may give rise to more cases of disease than the small number who are at high risk

34
Q

Social inequality - Principal RF in mortality

A

Smoking

35
Q

How to protect communities against infectious disease (notifiable)

A

Investigation - Contact tracing, partner notification

Identify and protect vulnerable persons - Chemoprophylaxis, immunisation, isolation

36
Q

Meningococcal infection

A

Vaccine preventable disease
Infection presents as meningitis or septicaemia
Caused by neisseria meningitidis
Transmitted from person to person by inhaling respiratory secretions from mouth/throat or direct contact (kissing)
Majority of infections occur in children with a small secondary peak in young adults
Seasonal peak in winter

37
Q

Meningococcal infection - Complications

A 
Brain damage/abscess
Seizures
Hearing impairment 
Gangrene+autoamputations 
Death - more deaths due to septicaemia than meningitis
38
Q

Gangrene pathopshyiology in meningococcaemia

A

Infection causes arterial occlusions leading to gangrene of extremities and auto-amputations

39
Q

Meningococcal infection - Treatment

A

Antibiotic therapy - Cefotaxime/ceftriaxone

Supportive - fluids

40
Q

Meningitis - Prophylaxis

A

Antibiotic chemoprophylaxis - Ciprofloxacin or rifampicin
Vaccination (depends on serogroup)
Glass test - Petechial spots do not blanch on pressure

41
Q

Meningitis - Routine childhood immunisations

A

MenB
MenC
MenACWY (year 9 school)

42
Q

Travel vaccination

A

MenA/C/ACWY especially for Hajj/umrah

43
Q

Diseases/problems associated with ageing

A 
Osteoporosis, falls and fractures
Osteoarthritis 
Dementia, delirium, cognitive impairment
Parkinson's
Stroke 
Macular degeneration
Cataracts 
AF
Hptn
Angina
44
Q

Polypharmacy

A

5 or more meds

45
Q

Erythema ab igne and Onychogryphosis

A

Erythema ab igne - rashy legs can indicate hypothyroidism (cold) due to excessive exposure to heat from fireplaces etc
Onychogryphosis - Outgrowing toenails

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