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GRACE Phase 2a Medicine > Public Health > Flashcards

Public Health Flashcards

1
Q

Epidemiology of back pain

A
  • May be simple (mechanical) or nerve root (neurological)

- Simple back pain normally presents between 20-55, mechanical in nature, normally lumbrosacral

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2
Q

Epidemiology of back pain - neurological back pain

A
  • Spreads to legs, feet and toes
  • Numbness/ paraesthesia can accompany pain
  • Red flags - very old/young, violent trauma, systemic upset, wipespread neurology
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3
Q

Physical activity advice in clinical consultations

A
  • Important, but no prioritised over medical management elements
  • Barriers for implementation of behaviour change interventions
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4
Q

4 broad categories that can influence an individual’s public health

A
  1. Biological factors e.g. gender, ethnicity
  2. Personal lifestyle e.g. exercise, diet
  3. Physical and social environment e.g. air pollution
  4. Public health services
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5
Q

What did the Black Report 1980 confirm?

A

that health inequalities were widening

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6
Q

Why do women tend to suffer more illness than men?

A
  1. Biological - role in reproduction
  2. Ageing - women live longer
  3. Material - women still seen as ‘carers’
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7
Q

4 main reasons men have higher mortality than women

A
  1. EMPLOYMENT - often higher risk occupations
  2. RISK TAKING BEHAVIOUR
  3. MEN SMOKE MORE
  4. MEN DRINK MORE ALCOHOL
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8
Q

What is the disengagement theory?

A

Process by which older people disengage themselves from roles they previously occupied in society

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9
Q

Theory of third age?

A

Describes an era after retirement with health, vigour and positive attitude

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10
Q

Association between social class and life expectancy

A

Higher socio-economic classification = higher life expectancy

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11
Q

Association between social class and smoking

A

greater % of people smoke in lower socio-economic classes

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12
Q

Association between mortality and unemployment

A

Greater in the unemployed

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13
Q

Define patient compliance

A

Extent to which a patient’s behaviour coincides with medical/health advice

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14
Q

3 disadvantages of patient compliance

A
  1. Passive - patient must follow doctor’s orders
  2. Professionally focussed and assumes Dr knows best
  3. Ignores problems patients have in managing their own health
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15
Q

What is patient adherence?

A

extent to which a patient’s actions match agreed recommendations

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16
Q

Difference between patient compliance and adherence?

A

Patient adherence is more patient centred, it empowers patients and considers them as equals.

Patient compliance is often viewed as uncaring, condescending and passive

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17
Q

Key principles of adherence?

A
  1. Improves communications
  2. Increases patient involvement
  3. Understands patient’s perspective
  4. Provision and discussion of information
  5. Assess adherence
  6. Review medicines
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18
Q

Necessity-concerns framework

A

Looks at what influences adherence, adherence increases when necessity beliefs are high and concerns are low

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19
Q

2 factors that encourage patient centred care?

A
  1. Holistic approach - focus on the patient as a whole

2. Shared control of consultation, shared decisions

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20
Q

What is concordance?

A

Expectation that patients will take part in treatment decisions and have a say in the consultation

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21
Q

5 barriers to concordance?

A
  1. Patient may not want to engage in discussions
  2. May cause worry
  3. Might just want doctor to tell them what to do
  4. Time, resources constraints
  5. Patient choice may differ from medical advice
22
Q

4 advantages of doctor-patient communication?

A
  1. Better health outcomes
  2. Higher compliance
  3. Higher patient and clinician satisfaction
  4. Decrease in risk of malpractice
23
Q

5 main duties of a doctor?

A
  1. Work in partnership with patients, treat as individuals, respect their dignity
  2. Work with colleagues in a way that best serves patients’ interests
  3. Protect and promote health
  4. Recognise and work within your limits of competence
  5. Provide a good standard of care
24
Q

Where might norovirus outbreaks be?

A

School, cruise ships, restaurants, hospitals

25
Q

What can norovirus cause?

A

Gastroenteritis, diarrhoea, vomiting

26
Q

Will norovirus be killed by alcohol hand gel?

A

No! it is resistant to conventional cleaning and is only killed by soap and water

27
Q

Why is C.difficile hard to kill?

A

Acquired in spore form and so is hard to eradicate

28
Q

2 microorganisms that are not killed by hand gel?

A

Norovirus and C.difficile

29
Q

What is anorexia nervosa?

A

Restriction of energy intake to relative requirements leading to a low body weight. Person has an intense fear of gaining weight

30
Q

BMI indicative of anorexia?

A

<17.5

31
Q

2 sub-types of anorexia nervosa?

A

restricting, binge-eating and purging

32
Q

2 characteristic features of bulimia nervosa?

A
  1. recurrent episodes of binge eating

2. inappropriate compensatory behaviour to prevent weight gain e.g. purging

33
Q

What is binge eating?

A

eating large amounts of food in discrete periods of time and having a lack of control over eating

34
Q

5 characteristics of binge eating episodes

A
  1. eating rapidly
  2. eating until uncomfortably full
  3. eating large amounts when not hungry
  4. eating alone because of embarrassment
  5. feeling depressed/guilty afterwards
35
Q

Describe the Core model (slade 1982)

A

describes the factors that contribute to the onset of EDs, says that onset is due to a combination of low self esteem + perfectionism leading to a need for control. Trigger for using food as a means of control

36
Q

According to NICE, the first line treatment for bulimia nervosa is?

A

CBT

37
Q

According to NICE, the first line treatment for anorexia nervosa is?

A

Family therapy in younger patients, CBT

38
Q

4 examples of work related MSK disorders

A
  1. Carpal tunnel syndrome
  2. Rotator cuff problems
  3. HAVS
  4. Tenosynovitis
39
Q

What is HAVS? Who might be at risk?

A

Hand-arm vibration syndrome, people who uses chain saws, drills, etc.

40
Q

Who might be at risk of carpal tunnel syndrome?

A

repetitive nature of work in abnormal wrist positions, e.g. painter

41
Q

What is an NHS health check?

A

secondary prevention - used to detect early signs of disease and control risk factors

42
Q

Risk factors for developing T2DM

A

sedentary lifestyle, obesity, FHx, history of GI disease, HTN

43
Q

What is an obesogenic environment?

A

encourages people to eat unhealthily and not to do enough exercise

44
Q

3 physical characteristics of an obesogenic environment?

A

car culture, TV remotes, lifts

45
Q

economic characteristic of the obesogenic environment?

A

expensive fruit and veg

46
Q

socio-cultural characteristic of an obesogenic environment?

A

family eating patterns

47
Q

Consent must be (3)

A

voluntary, informed (honest discussion, full details of intervention, risks/benefits), made by someone with capacity

48
Q

Mental capacity act 2005

A

A person must be presumed to have capacity unless it is established that they lack capacity

49
Q

Causes of reduced capacity?

A

Learning disability, dementia, mental illness, impaired consciousness

50
Q

No-one can give consent on behalf of another adult, unless…

A

lasting power of attorney which specifies can consent

51
Q

What is an independent mental capacity advocate

A

Appointed if no family/friend are available to advise and support the patient

52
Q

Gillick competence

A

Law to determine whether a child <16 is able to decide whether they have medical treatment or their parent does. If not Gillick competent, parent consents

GRACE Phase 2a Medicine (20 decks)

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