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H&S Year 1 > Revision Questions > Flashcards

Revision Questions Flashcards

1
Q

Name professional attitudes expected of medical staff and students

A
  • care of patient 1st concern
  • protect and promote health
  • good standard of practice keeping up to date
  • treat patients as individuals
  • work in partnership with patients
  • honest and open
  • confidentiality
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2
Q

Role of medical schools and GMC?

A
  • sets guidance in Tomorrow’s Doctors
  • taught by medical schools
  • examined formally using exams, reflective essays, attendance and punctuality etc
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3
Q

Benefits of good communication?

A
  • more accurate diagnosis
  • more accurate data gathering
  • increased adherence with treatment
  • more effective patient-doctor relationship
  • increased satisfaction
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4
Q

Consequences of poor communication?

A
  • inaccurate diagnosis
  • less recognition of ice
  • non-adherence to treatment
  • decreased satisfaction
  • more complaints
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5
Q

Can communication skills be taught?

A

Yes:

  • skilled training leads to improvement
  • self reflection
  • specific, descriptive, non-judgemental feedback
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6
Q

Why is Calgary Cambridge important?

A
  • every patient has own problems and it explains it with own framework
  • understanding CC model can help to treat them better and communicate within their own framework
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7
Q

Which models explain differences in people?

A
  • biomedical model relies on biology
  • social models explain differences via social interactions
  • faith system
  • epigenetics (combines biological and social)
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8
Q

What makes science social?

A
  • decisions about research funding
  • pharmaceutical industry
  • ethical issues
  • nature of scientific work
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9
Q

What is eugenics?

A
  • improving a population by controlled breeding

- encourages good genetics, discourages bad genetics

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10
Q

What is positive eugenics?

A

Encourages good genetics

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11
Q

What is negative eugenics?

A

Discourages bad genetics

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12
Q

What are the 6 criteria to patient centred care?

A
  • explores patients main reasons for visit
  • seek integrated understanding of patients world and looks at whole person
  • finds common ground on problem, mutually agreeing on management
  • enhances prevention and health promotion
  • enhances continuing relationship between patient and doctor
  • is realistic
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13
Q

What is the patient expected to do in sick role?

A
  • must want to get well as quickly as possible
  • should seek professional medical advice and cooperate with the doctor
  • allowed to shed normal activities and responsibilities e.g. work
  • regarded as being in need of care and unable to get better by his or her own
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14
Q

What must a doctor do to uphold the sick role?

A
  • apply a high degree of skill and knowledge
  • act for welfare of patient, not self interest
  • be objective and emotionally detached
  • be guided by rules of professional practice
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15
Q

What 4 sources are used when making a clinical decision?

A
  • patient preferences
  • available resources
  • research evidence
  • clinical experience
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16
Q

Why is evidence-based decision making important?

A
  • deals with uncertainty
  • medical knowledge incomplete/shifting
  • patients receive most appropriate treatment
  • constant need for info/improvement
  • improving efficiency of healthcare services
  • reduces practice variation
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17
Q

4 ways in which evidence based decision making can be implemented?

A
  • evidence based clinical guidelines
  • summaries of evidence provided to practitioners
  • access to reviews of research evidence
  • practitioners evaluating research for themselves
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18
Q

What right does a doctor have in the sick role?

A
  • right to examine patients
  • granted autonomy in professional practice
  • occupies position of authority in regard to the patient
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19
Q

Criticism of the sick role

A
  • symptom iceburg
  • chronic illness and MUS (if cause unknown, patients can’t enter sick role due to uncertainty)
  • patients try to label themselves as sick
  • conflict between best interests for the patient and cost to society in allocation of resources
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20
Q

Give 3 aspects of opportunity cost decisions

A
  • time (time spent on one person could be spent on another)
  • overspending budget cuts another elsewhere
  • good medical practice means you must be aware of the cost of the care you deliver
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21
Q

Sources of NHS funding?

A
  • tax finance (national insurance)

- some user charges e.g. prescriptions

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22
Q

How is the NHS organised?

A
  • 209 clinical commissioning groups (buyers)

- public hospitals and GPs (sellers)

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23
Q

What is flat of the curve medicine?

A

Where lots of things do not improve health but increase cost

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24
Q

What is the best choice of treatment?

A

Must have clinical effectiveness and cost effectiveness

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25
Q

What are the two agendas?

A
  • disease

- illness

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26
Q

What is the difference between disease and illness?

A
  • disease is what is wrong with the body

- illness is the way the patient experiences the disease

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27
Q

Why is it important to discuss the two agendas?

A
  • disease, means you treat the correct condition and improves biomedical health
  • illness, can discover how illness impacts a patients life which improves patient satisfaction and enhances doctor-patient relationship
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28
Q

Potential difficulties when assessing patients best interest?

A
  • difficulties in predicting future outcome
  • conflict between benefits of treatment and patients own views
  • patient may be unable to communicate relevant information
  • conflict between patient and doctors views of best interest
  • emotional attachment may distort doctors views
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29
Q

Where can you look at disease distribution?

A
  • globally
  • regionally
  • locally
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30
Q

Why do we need to study population?

A
  • to find out about risk

- need to use evidence of what has previously happened to a population to work out how drugs act etc

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31
Q

3 types of epidemiology

A
  • descriptive, tells us how things are distributed
  • analytical, how we can exploit those distributions to ask questions
  • experimental, change the distributions ourselves to see what happens
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32
Q

How can epidemiology be useful in smoking research?

A
  • identify the cause of disease
  • guides preventative action, identifies targets for new information
  • surveillance of populations and smoking can measure effects of intervention
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33
Q

Give examples of lay people

A
  • friends
  • relatives
  • pharmacists
34
Q

What is the symptom iceberg?

A
  • only a small minority of symptoms are seen by health professionals
  • patients only report 5-15% of symptoms
35
Q

Who is most healthcare work done by?

A

Lay people - lay referral system

36
Q

What demographic/social factors influence help seeking and illness behaviour?

A
  • gender
  • age
  • social class
  • race
  • culture
37
Q

What are Zolas triggers to help seeking behaviour?

A
  • interference with work or activity
  • interference with social relations
  • interpersonal crisis e.g. death in family
  • putting a time limit on symptoms
  • sanctioning, relative/friends tell them to seek help
38
Q

What influences help seeking behaviour?

A
  • perceptions and evaluation of symptoms
  • perceived risk
  • previous experience
  • psychological factors (fear)
  • denial
  • concern about using NHS resources
39
Q

Barriers to help seeking behaviour?

A
  • provision and availability of services
  • access to transport
  • disruption to work
  • attitudes of staff
  • inverse care law
  • geographical distance
  • time, effort
  • long waiting times
40
Q

What are the WHOs 5 aspects of health promotion?

A 
H - Healthy public policy
A - Action in the community
R - Re-orientating health services
P - Personal skills
S - Supportive environment
41
Q

What are the 4 different approaches to health promotion?

A
  • medical, focuses on disease and prevention
  • behavioural, focuses on attitudes and lifestyles
  • client-centred, focuses on empowering individuals
  • societal, focuses on political and social action
42
Q

What is primary health prevention?

A
  • aims to prevent onset of disease
  • screening risk
  • health protection
  • health education
43
Q

What is secondary health prevention?

A
  • detect and cure disease at early stage

- e.g. cancer screening

44
Q

What is tertiary health prevention?

A

Minimise the effects or reduce the progression of irreversible disease

45
Q

What is Beattie’s typology of health promotion?

A
  • health persuasion
  • legislative action
  • personal counselling
  • community development
46
Q

What are social inequalities in health?

A

Differences in people’s health linked to social inequalities in their lives

47
Q

Are new diseases inversely related to social class?

A

No, but as disease progresses the social gradient tends to re-emerge

48
Q

What is the gini coefficient?

A

Measure of inequality, area between Lorenz curve and perfect distribution

49
Q

Give some examples of social inequalities in health?

A
  • routine manual workers have higher chance of infant mortality
  • mortality from injury and poisoning in children is higher in lower social groups
  • teenage pregnancy more common in lower social groups
50
Q

What did the black report show?

A
  • confirmed social health inequalities are involved in mortality
  • shows health inequalities were widening
51
Q

When was the black report published?

A

1980

52
Q

What are the 4 explanations of socioeconomic inequalities in the black report?

A
  • a statistical artefact
  • natural selection, peoples health drives their social class, healthy people are more likely to get promoted, whilst unhealthy people are likely to lose their jobs
  • result of differences in health behaviour
  • poverty causes poor health
53
Q

How do childhood circumstances influence inequalities?

A
  • childhood is a period of rapid development and heightened sensitivity to environmental influences
  • fathers occupation at birth is a strong indicator of life expectancy
54
Q

What are some government initiatives to help reduce child poverty?

A
  • national minimum wage
  • increase child benefit
  • increase income support
  • teenage pregnancy strategy
55
Q

Why has child poverty increased?

A
  • unemployment
  • lower pay
  • more single parent families
  • freezing/abolition of some benefits
  • more indirect taxation
56
Q

What is the marmot report 2010?

A

Proposes evidence based strategy to address health care inequalities

57
Q

What are the 6 policies of the marmot report?

A
  • create and develop healthy and sustainable places and communities
  • ensure healthy living standard
  • enable everyone to maximise capabilities and have control over lives
  • fair employment and good work for all
  • give a child the best start in life
  • strengthen the role and impact of ill-health prevention
58
Q

Why do people self care?

A
  • many people will self treat before seeing a doctor

- many cultures have strong non-western medical traditions

59
Q

Why are CAMs used?

A
  • easily accessible
  • control over treatment
  • dissatisfaction with health care
  • poor doctor-patient relationship
  • desperation
  • perceived effectiveness and safety
60
Q

Why is prognosis important?

A
  • it can help diagnostic and treatment decisions

- it is important for patients to know the likely course of disease

61
Q

What are the types of theory that decision making focuses on?

A
  • descriptive, what are you doing?
  • normative, what should you be doing?
  • prescriptive, how can we improve what you are doing?
62
Q

What is the hypothetic-deductive model?

A
  • cue acquisition
  • hypothesis formation
  • cue interpretation
  • hypothesis evaluation
63
Q

Where can good evidence be found?

A
  • cochrane database
  • evidence-based journals
  • medline
64
Q

What are 3 requirements for valid consent?

A
  • informed
  • voluntary
  • with capacity
65
Q

What are the 4 forms of consent?

A
  • oral
  • expressed
  • written
  • implied
66
Q

What information does the patient require as part of the consent process?

A
  • potential benefits
  • potential risks
  • alternative treatment options
67
Q

When is consent required?

A
  • before examination
  • before treatment or care
  • disclosure of confidential information
  • screening
  • teaching
  • research
68
Q

Why is consent needed?

A
  • improves trust between patient and doctor
  • legal requirement
  • respects autonomy
  • professional duty
69
Q

What is the Bolam principle?

A

Practitioners are not negligent if they act in accordance with practice accepted by a responsible body of medical opinion

70
Q

Which act focuses on who has capacity?

A

Mental capacity act 2005

71
Q

Who does the mental capacity act apply to?

A

People 16 and over

72
Q

Why are P drugs used?

A
  • pharmacists can ask customers questions about who it is for, symptoms etc
  • ensures no ‘red flags’ about how long the patient can use it for
  • duration of a symptom may mean it is not safe to treat
73
Q

When can a POM change to a P?

A

No danger when used correctly without the supervision of a doctor

74
Q

When can a P change to an OTC?

A

Safe to sell without the supervision of a pharmacist

75
Q

Name 3 community pharmacy teams

A
  • minor ailment schemes
  • emergency contraception
  • smoking cessation
  • health education
76
Q

Self medication scale of analgesics say that the belief of patients can fit into which 3 categories?

A
  • people reluctant to take mild analgesics
  • people who ‘don’t think twice’ about taking mild analgesics
  • people who prefer to let pain ‘run its course’
77
Q

What is quantitative data?

A

Discrete: - only certain values possible
Continuous: - any value is possible

78
Q

What is qualitative data?

A

Multinomial: - categories aren’t ordered
Ordered: - categories exhibit logical order
Dichotomous: - two categories that oppose

79
Q

At what point is statistical significance generally accepted?

A
  • P = 0.05
  • strong evidence against null hypothesis, can reject null hypothesis
  • statistically significant
80
Q

What is standard error?

A
  • describes how good a given estimate is
  • tells you how good your sample statistic is
  • looks at how accurate your estimation of the mean is

H&S Year 1 (2 decks)

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