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Phase 2a medicine > Quick public health > Flashcards

Quick public health Flashcards

1
Q

What are the 4 general categories of health influences?

A

Biological, personal lifestyle, health services, the physical and social environment.

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2
Q

What did the black report confirm?

A 
Social class health inequalities in overall mortality
Health inequalities are widening
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3
Q

What mechanisms did the black report use to explain the social class health inequalities?

A

Social selection, behaviour and material circumstance

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4
Q

What did the Acheson report in 1988 state?

A

Mortality has decreased in the last 50 years but inequalities remained or have widened/

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5
Q

What did the Acheson report recommend?

A

Evaluate policies likely to affect in terms of impact on inequality
Prioritise the health of families and children
Reduce income inequality and improve living conditions in poor households

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6
Q

What are the life course theories as to how health inequality is caused?

A

Critical periods have a greater impact i.e. measles in pregnancy
Hard blue-collar work, the hazards and their impacts add up
Interactions and pathways.

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7
Q

What are the psychosocial theories as to how health inequality is caused?

A

Social inequality may affect how people feel which inturn can affect body chemistry

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8
Q

What are the materialist theories as to how health inequality is caused?

A

Poverty exposes people to more health hazards.

Disadvantaged people are more likely to live in areas exposed to harm

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9
Q

What must consent be?

A

Voluntary, informed, made by someone with capacity

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10
Q

What must you tell people before they consent to something?

A

What, how, risks, benefits, alternatives

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11
Q

When does a patient become unable to make a decision?

A

Understand the relevant info
Retain it
Use or weight it to make a decision
Communicate the decision

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12
Q

What would you do if the patient couldn’t make the decision?

A

Check if someone else can make the decision for them.,

act in the patients best interests respecting their beliefs and values, past decisions made.

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13
Q

What are the CHD prone behaviours?

A

Competitive, hostile, impatient

Type A behaviour

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14
Q

What are the Whitehall studies?

A

They examined the mortality rates over 10 years among male British civil servants aged 20-64

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15
Q

What were the outcomes of the Whitehall studies?

A

Mortality was higher amongst those in the lower grades compared to those in higher grade jobs.

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16
Q

What can doctors do to try and overcome social inequalities?

A

Ask about occupation in history
Ask patients about available support
Identify signs of depression and anxiety.

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17
Q

Absolutist investigations of difference in mortality due to CHD>

A

Its abut poverty, absolute measures of socioeconomic deprivation.

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18
Q

What are the criteria for verifying someone’s death?

A

No heart sounds or carotid pulse for 1 minute
No breath sounds or respiratory effort for 1 minute
No response to painful stimuli
Pupils are fixed and dilated.

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19
Q

What is the definition of palliative care?

A

Improves the QOL of patients and families who face life threatening illness.
Provides pain and symptom relief.

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20
Q

How to work out the number of units of alcohol in a drink?

A

(%ABV x volume in ml)/ 1000

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21
Q

How many units of alcohol should you not exceed per week?

A

14 units

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22
Q

What is substance misuse?

A

Results in failure to fulfil roe obligations e.g. work, school, home life
May be physically hazardous
Continued misuse despite persistent or recurrent social or interpersonal problems.

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23
Q

What is dependance?

A

A state in which an organism functions normally only in the presence of a drug
Manifests as a physical disturbance when the drug is withdrawn

24
Q

What is tolerance?

A

A state in which an organism no longer responds to a drug

A higher dose is required to achieve the same effect

25
Q

What is the action of alcohol?

A 
Potentiates GABA (an inhibitory neurotransmitter)
Inhibits glutamate (an excitatory neurotransmitter in the CNS)
26
Q

What is Wernicke’s encephalopathy?

A

Caused by a deficiency of B1
Common in severely dependent drinkers
Poor diet, vitamin intake and GI absorption.

27
Q

How do you treat alcohol withdrawl?

A

Benzodiazepines

28
Q

What is the STI/HIV transmission model?

A

The reproductivity rate is equal to the:

How infectious it is x number of partners x duration of infection and how likely you are to seek help.

29
Q

Primary prevention for STI’s?

A

Reducing the risk of acquiring STI’s:
Vaccination (HBV, HPV)
Pre and post exposure prophylaxis (pep and prep)

30
Q

Secondary prevention of STI’s?

A

Find and treat undetected cases of infection:
Easy access to STI/HIV tests and treatment
Partner notification
Targeted screening

31
Q

Tertiary prevention of STI’s?

A

Reducing morbiditiy/mortality
Antiretrovirals
Prophylactic ntibiotics
Acyclovir

32
Q

Complications of STI’s in women>

A

Pelvic inflammatory disease
Ectopic pregnancy
Infertility
Neonatal transmission

33
Q

Why is FGM carried out?

A

Seen as being pure

Unable to marry without it being performed

34
Q

Complications of FGM in the days/months after?

A

Bleeding, infection, Pain, LUTS, period problems, anxiety, PTSD, withdrawal

35
Q

Infectious conditions that new migrants may present to their GP with?

A

Hepatitis, TB, Malaria, HIV, parasitic infections

36
Q

Why are family members often not the best to translate?

A

Agenda or bias
Not confidential
Interpreter may have poor English limiting the translation

37
Q

What is compliance?

A

The extent to which the patient’s behaviour coincides with medical or health advice

38
Q

What is adherence?

A

The extent to which the patients actions match agreed recommendations, is more patient centred

39
Q

What is concordance?

A

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

40
Q

What are the advantages of doctor-patient communication?

A

Better health outcomes, higher compliance to therapeutic regimens

41
Q

Barriers to good communication?

A

Language barriers, deafness/blindness, medical jargon

42
Q

At what gestation can abortion take place up to?

A

24 weeks

43
Q

What is the swiss cheese model of patient safety?

A

Each slice is a level of defence, if the holes line up there’s a big problem

44
Q

What are examples of level defence?

A

Checking drugs before administration
Preop checklist
Marking surgical site before operation

45
Q

How many people are expected to be obese by 2034?

A

70%

46
Q

What areas is obesity more common in?

A

Deprived areas, older age groups, disabled people

47
Q

Interventions for obesity?

A

Change4life, 5-aday
More cycle paths, less car parking
Sugar tax, minimum alcohol pricing

48
Q

Role of the doctor in cases of obesity

A

Educate patients, brief behaviour change interventions, prescribe exercise
Signpost to weight management programmes

49
Q

What are the types of back pain?

A

Mechanical or neurological

50
Q

What are the characteristics of neurological back pain?

A

Spreads to the leg, foot and toes.

numbness or paraesthesia can accompany pain

51
Q

Where are norovirus outbreaks most likely?

A

Schools, cruise ships, restaurants, hospitals.

52
Q

What are the approaches for C.diff in diarrhoea?

A 
Suspect C.diff
Isolate the cause 
Gloves and apron 
hand washing 
test stool for toxin
53
Q

What is anorexia nervosa?

A

Restriction of energy intake
Low BMI usually
Intense fear of gaining weigh or becoming fat
Denial of seriousness

54
Q

What is bulimia nervosa?

A

Recurrent episodes of binge eating.

55
Q

What is OSFED?

A

Other specified feeding and eating disorders

A lot of eating disorders don’t fit into a specific category

56
Q

Urgent signs in eating disorders

A

Muscular weakness, problems breathing, deterioration of consciousness, cardiac signs
Rapid weight loss and risky behaviours.

Phase 2a medicine (14 decks)

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