Public health misc Flashcards

1
Q

Define health

A

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

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2
Q

What factors affect patient compliance

A
Socioeconomic - long distance from treatment setting
Health System - supply of medication
Condition - memory impairment
Therapy - complex tx regimes
Patient - disbelief/denial of dx
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3
Q

What is an occupation disease?

A

any disease contracted primarily as a result of an exposure to risk factors arising from work activity.

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4
Q

What is a work-related illness?

A

multiple causes, where factors in the work environment may play a role, together with other risk factors, in the development of such diseases

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5
Q

Name occuptation diseases?

A
Asbestosis
Silicosis
Coalminers’ pneumoconiosis
Occupational dermatitis
Tenosynovitis
Mesothelioma
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6
Q

What is tenosynovitis?

A

repetitive / excessive movement of tendon causing inflammation
Who at greater risk? - chefs, cleaners, computer users, waiters / waitresses

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7
Q

Work related disease?

A
Occupational stress
Work-related MSK disorders
Occupational lung cancer
Occupational cancer
Noise-induced hearing loss
Hand-arm vibration
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8
Q

Difference between hazard and risk?

A
Hazard = potentially harmful
Risk = probability of harm
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9
Q

Marmot 10 key componants for good health?

A

Precariousness- stable, safe
Individual control- part of decision making
Work demands- quality and quantity
Fair employment
Opportunities
Prevents- social isolation, discrimination and violence
Share information
Work/life balance
Reintegrates sick or disabled wherever possible
Promotes health and wellbeing

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10
Q

OH screening? what would you ask?

A

What type of work do you do?

  1. Do you think your health problems might be related to your work?
  2. Are your symptoms different at work and at home?
  3. Are you currently exposed to chemicals, dusts, mentals, radiation, noise or repetitive work? In the past?
  4. Are any of your co-workers experiencing similar symptoms?
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11
Q

What can workers be potentially exposed to?

A

chemicals, dusts, mentals, radiation, noise or repetitive work? In the past?

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12
Q

What can influenza A affect and thereby cause??

A

infect pigs, cats, horses, birds and sea mammals. The cause of severe and extensive outbreaks and pandemics.

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13
Q

Where is influenza B most affecting?

A

prone to mutation) but tends to cause sporadic outbreaks (schools, care homes, garrisons) that are less severe. More often in children

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14
Q

What is an epidemic?

A

an increase in the prevalence of a disease above the number usually observed in the population in a particular area

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15
Q

Pandemic?

A

an epidemic which occurs in several countries or continents (crosses border). Most people will have limited immunity to the virus due to absence of previous exposure.

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16
Q

What is antigenic shift?

A

is the process by which two or more different strains of a virus, or strains of two or more different viruses, combine to form a new subtype having a mixture of the surface antigens of the two or more original strains.

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17
Q

Primary influenza prevention?

A

Hand washing

  1. Respiratory hygiene: ‘Catch it, Bin it, Kill it’
  2. Reduce social contact: not attending large gatherings
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18
Q

Secondary influenza prevention?

A

Travel restrictions

  1. Restrictions of mass public gatherings
  2. Schools closure
  3. Voluntary home isolation of cases
  4. Voluntary quarantine of contacts of known cases
  5. Screening of people entering UK ports
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19
Q

who is offered the influenza vaccine (esp what group of patients/)

A

Reps patients esp asthamtic and COPD sufferers and immunocomprimised, older and children and pregnant women

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20
Q

key ideas of pallitive care?

A
Treatment to remove pain 
Control symptoms 
Aims to improve quality of life
Supports families
Designated health care professionals
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21
Q

what Abx CAUSE clostridium difficile?

A

Ciprofloxacin, cephalosporins, clarythromycin, co-amoxiclav

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22
Q

WHAT is used to TREAT clrostridium difficale?

A

Vancomycin + metranidalzole

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23
Q

Treating diarrhoea?

A

Fluids and zinc treatment

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24
Q

CAGE questionnaire?

A

Cut down? other people annoyed? Guilty? Drink first thing in the morning? eye opener

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25
Q

What other alchol explorative devices?

A

FAST, AUDIT and CAGE, clinical interview. 14 units a week is healthy

26
Q

Alcohol withdrawla symptoms?

A

tremours, HTN, HR, seizures, hallucinations, confusion, desorientation, sensitivity to light

27
Q

Alcohol primary preventions?

A

minimum pricing/ tax?, tv averts. THIINK driving campaign. ‘Know your limits’ binge drinking campaign

28
Q

What can decrease the desire for alcohol? drug therapy?

A

Naltrexone

29
Q

What is the rick of pregnant women drinking?

A

fetal alcohol syndrom: CNS abnormalities, pre and post natal growth retardaion, craniofacial abnormalities. higher incidence of hernias and congenital defects

30
Q

GP smoking strategies?

A
  1. Ready: mentally prep yourself, understand process
  2. Steady: throw away ashtray, lighter, set quit date
  3. Stop: reward yourself for not smoking, avoid triggers

3A’s ask, advice, assist

31
Q

Stages of smoking cessations

A

Precontemplation – smoker, not thinking about quitting
Contemplation – smoker, thinking about quitting but not ready yet (“ready”)
Preparation – smoker, thinking about quitting and taking steps to prepare for quitting (“steady”)
Action – ex-smoker, quit for <6 months (“stop”)
Maintenance – non-smoker, quit for >6 month
Relapse – quit smoking then had a lapse (1 cigarette) that led to smoking being resumed

32
Q

Secondary prevention for STIs?

A

those who have to stop it spreading.
access to tests, anonymous and confidential services. tell partners. targeted screening eg. HIV and syphillis, chlamydia etc and home testing kits

33
Q

Tertiary prevention for STIs?

A

Antiretrovirals for HIV
Acyclovir for suppression of genital herpes
this reduces complications when they do have it

34
Q

Complications of malnutrition?

A

Resp conditions because of resp muscles not contracting properly. lost of immune response. poor wound healing. loss of mucosal integrity so more bacterial infections. physiological decline - depression

35
Q

Hospitals to minimise malnutrition?

A

‘protected mealtimes’, educating staff on care of elderly ‘food aware’. assessment for malnutrition at regular intervals. impliment a ‘red tray’ system. use volunteers

36
Q

What to ask patients you suspect of malnutrition?

A

BMI? uninentional weight loss?eating less than normal? what is their normal weight? exclude other causes

37
Q

What is the health determinents model?

A

sex, age and hereditary factors
individual lifestyle factors
sociala nd community influences
living and working conditions
general sociioeconomic, cultural and environment conditions
(all of these are depend on eachothe s welll)

38
Q

What is the inverse care law?

A

Those who need health care the most are lead likely to access it

39
Q

What report was published in 1980?

A

Black report

40
Q

What is the black report? 1980?

A

Material (environmental causes, might be mediated by behaviour)

ii) Artefact (an apparent product of how the inequality is measured)
iii) Cultural / Behavioural (poorer people behave in more unhealthy ways)
iv) Selection (sick people sink socially and economically)

All these factors that contribute to health inequalities

41
Q

What does the black reprt say the factors that contibute to health inequalities?

A
  1. Matiera (env), artefct (inequality measure), cultural, selection (socioand econ)
42
Q

What is the criteria for disclosure?

A

Allowed to Breach When:

i) Required by law (e.g notifiable disease, ordered by a judge or the police etc)
ii) Patient Consent
iii) Public Interest

Criteria:
i) Anonymous
ii) Patients consent
iii) Kept to a necessary minimum
iv) Meets current Law
After death confidentiality continues.
43
Q

What model was proposed by becker in 1974?

A

Health brief model

44
Q

What does the health brief model dictate?

A

individuals must believe they are susceptible to the condition, has serious consewuences and must believe tat taking action reduces their risks. also the benefits of taking action outwight the risks

45
Q

GMC duties of a docot?

A

patience and confidntiality, knowledge up to date, listen and repsond ot patients, treat patients in best interests. dont discriminate

46
Q

4 pillars of medical ethics?

A

Autonomy - respect the decision of the patient. The decision must be intentional, done with
understanding and there are no major controlling influences over the decision.
Benevolence - Do good
Non-Maleficence - Do no harm
Justice - Need vs Benefit, QALYs, Fairness

47
Q

What is utlarianism?

A

act is based soley on consequences, maximising good and minimising harm, the greatest happiness principle. criticisms - cant predict the moral outsome of the act becore doing it

48
Q

what is a utilitarianism criticism?

A

Cant predict the moral outcomeof the act before doing it

49
Q

What is deontology

A

Act itself determines worthiness, folllow natural laws and rights.
But - might not be best for everyone, lack of emotion and moral conflicts

50
Q

Deontology criticisms?

A

conflicting moral duties, rules might not be best for everyone, lack of emotion when applying ethics

51
Q

What is ask, advise, assist used for ?

A

Smoking cessation

52
Q

Ty2DM preventions?

A

Primary - Lose weight, eat a better diet, do exercise etc
Secondary - Population Screening, Diabetic Eye Screening etc
Tertiary - Medication such as Metformin, bariatric surgery

53
Q

What is sensitivity?

A

The proportion of people with the disease who are correctly identified by the screen test

54
Q

Specificity?

A

The proportion of people without the disease who are correctly excluded by the screening test

55
Q

What is prevalence?

A

the proportion of a population found to have the disease

56
Q

what is incidence?

A

the number of new cases within a specified time period

57
Q

Error of negligence?

A

the actions or omissions do not meet the standard

58
Q

Error of omission?

A

required action is delayed or not taken

59
Q

NHS screening programmes?

A
Newborn hearing screening 
Breast screening
Bowel cancer screening 
Cervical screening
Sickle cell and thalassaemia screening
60
Q

Addiction?

A

physical and psychological dependency