Quick public health Flashcards
What are the 4 general categories of health influences?
Biological, personal lifestyle, health services, the physical and social environment.
What did the black report confirm?
Social class health inequalities in overall mortality Health inequalities are widening
What mechanisms did the black report use to explain the social class health inequalities?
Social selection, behaviour and material circumstance
What did the Acheson report in 1988 state?
Mortality has decreased in the last 50 years but inequalities remained or have widened/
What did the Acheson report recommend?
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
What are the life course theories as to how health inequality is caused?
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.
What are the psychosocial theories as to how health inequality is caused?
Social inequality may affect how people feel which inturn can affect body chemistry
What are the materialist theories as to how health inequality is caused?
Poverty exposes people to more health hazards.
Disadvantaged people are more likely to live in areas exposed to harm
What must consent be?
Voluntary, informed, made by someone with capacity
What must you tell people before they consent to something?
What, how, risks, benefits, alternatives
When does a patient become unable to make a decision?
Understand the relevant info
Retain it
Use or weight it to make a decision
Communicate the decision
What would you do if the patient couldn’t make the decision?
Check if someone else can make the decision for them.,
act in the patients best interests respecting their beliefs and values, past decisions made.
What are the CHD prone behaviours?
Competitive, hostile, impatient
Type A behaviour
What are the Whitehall studies?
They examined the mortality rates over 10 years among male British civil servants aged 20-64
What were the outcomes of the Whitehall studies?
Mortality was higher amongst those in the lower grades compared to those in higher grade jobs.
What can doctors do to try and overcome social inequalities?
Ask about occupation in history
Ask patients about available support
Identify signs of depression and anxiety.
Absolutist investigations of difference in mortality due to CHD>
Its abut poverty, absolute measures of socioeconomic deprivation.
What are the criteria for verifying someone’s death?
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.
What is the definition of palliative care?
Improves the QOL of patients and families who face life threatening illness.
Provides pain and symptom relief.
How to work out the number of units of alcohol in a drink?
(%ABV x volume in ml)/ 1000
How many units of alcohol should you not exceed per week?
14 units
What is substance misuse?
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.
What is dependance?
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
What is tolerance?
A state in which an organism no longer responds to a drug
A higher dose is required to achieve the same effect
What is the action of alcohol?
Potentiates GABA (an inhibitory neurotransmitter) Inhibits glutamate (an excitatory neurotransmitter in the CNS)
What is Wernicke’s encephalopathy?
Caused by a deficiency of B1
Common in severely dependent drinkers
Poor diet, vitamin intake and GI absorption.
How do you treat alcohol withdrawl?
Benzodiazepines
What is the STI/HIV transmission model?
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.
Primary prevention for STI’s?
Reducing the risk of acquiring STI’s:
Vaccination (HBV, HPV)
Pre and post exposure prophylaxis (pep and prep)
Secondary prevention of STI’s?
Find and treat undetected cases of infection:
Easy access to STI/HIV tests and treatment
Partner notification
Targeted screening
Tertiary prevention of STI’s?
Reducing morbiditiy/mortality
Antiretrovirals
Prophylactic ntibiotics
Acyclovir
Complications of STI’s in women>
Pelvic inflammatory disease
Ectopic pregnancy
Infertility
Neonatal transmission
Why is FGM carried out?
Seen as being pure
Unable to marry without it being performed
Complications of FGM in the days/months after?
Bleeding, infection, Pain, LUTS, period problems, anxiety, PTSD, withdrawal
Infectious conditions that new migrants may present to their GP with?
Hepatitis, TB, Malaria, HIV, parasitic infections
Why are family members often not the best to translate?
Agenda or bias
Not confidential
Interpreter may have poor English limiting the translation
What is compliance?
The extent to which the patient’s behaviour coincides with medical or health advice
What is adherence?
The extent to which the patients actions match agreed recommendations, is more patient centred
What is concordance?
Expectation that patients will take part in treatment decisions and have a say in the consultation.
What are the advantages of doctor-patient communication?
Better health outcomes, higher compliance to therapeutic regimens
Barriers to good communication?
Language barriers, deafness/blindness, medical jargon
At what gestation can abortion take place up to?
24 weeks
What is the swiss cheese model of patient safety?
Each slice is a level of defence, if the holes line up there’s a big problem
What are examples of level defence?
Checking drugs before administration
Preop checklist
Marking surgical site before operation
How many people are expected to be obese by 2034?
70%
What areas is obesity more common in?
Deprived areas, older age groups, disabled people
Interventions for obesity?
Change4life, 5-aday
More cycle paths, less car parking
Sugar tax, minimum alcohol pricing
Role of the doctor in cases of obesity
Educate patients, brief behaviour change interventions, prescribe exercise
Signpost to weight management programmes
What are the types of back pain?
Mechanical or neurological
What are the characteristics of neurological back pain?
Spreads to the leg, foot and toes.
numbness or paraesthesia can accompany pain
Where are norovirus outbreaks most likely?
Schools, cruise ships, restaurants, hospitals.
What are the approaches for C.diff in diarrhoea?
Suspect C.diff Isolate the cause Gloves and apron hand washing test stool for toxin
What is anorexia nervosa?
Restriction of energy intake
Low BMI usually
Intense fear of gaining weigh or becoming fat
Denial of seriousness
What is bulimia nervosa?
Recurrent episodes of binge eating.
What is OSFED?
Other specified feeding and eating disorders
A lot of eating disorders don’t fit into a specific category
Urgent signs in eating disorders
Muscular weakness, problems breathing, deterioration of consciousness, cardiac signs
Rapid weight loss and risky behaviours.
