Theme C

Question 1

What is a critical incident?

Answer 1

an unplanned event or series of events that may result in an undesirable consequence

Question 2

What is an adverse event?

Answer 2

an event that results in unintended harm to the patient by an act of commission or omission rather than by the underlying disease or condition of the patient

Question 3

In 2014, what were the top 4 most commonly reported incidents?

Answer 3

1. Patient accidents 2. Implementation of care and ongoing monitoring/review incidents 3. Treatment/procedure incidents 4. Medication incidents

Question 4

What national system is used to upload all locally reported incidents?

Answer 4

National Reporting and Learning System (NRLS)

Question 5

How can NRLS help to improve the quality of healthcare?

Answer 5

Reports are analysed with expert clinical input to identify common hazards, allowing recommendations to be made and wider patterns of hazards to be identified.

Question 6

Outline the important steps in blood transfusion.

Answer 6

1. Determine the ABO and RhD status
2. Antibody screen (for atypical antibodies against RBC antigens) typically use direct and indirect agglutination test to test patient’s blood against red cells from at least 2 group O donors. If positive agglutination further testing is carried out to determine which of the potential 30+ RBC antigens are causing the problem.
3. Select appropriate donor blood and cross match by mixing the patient’s serum or plasma against the donor red cells (Often unnecessary if antibody screen was negative).

Question 7

How long would you have to wait for fully cross-matched blood to be ready to use?

Answer 7

45 minutes

Question 8

According to a recent European study of PSA testing, what was the number needed to screen to save one life from prostate cancer?

Answer 8

1 in 1000 males screened for 10 years

Question 9

Where do most prostatic carcinomas arise within the prostate?

Answer 9

Peripheral zone (85%)

Question 10

How common is breast cancer?

Answer 10

Most common UK cancer

Question 11

What is the age and location distribution of breast cancer?

Answer 11

46% of female breast cancer is diagnosed in the over 65s, it is slightly less common in women living in the most deprived areas, 6th highest breast cancer rate in Europe, rates have increased by 64% in GB since the 1970s.

Question 12

How is sensitivity calculated?

Answer 12

This is the likelihood of a test correctly identifying a specific disease (number of true positives divided by the (TP plus the FN))

Question 13

How is specificity calculated?

Answer 13

This is the likelihood of correctly ruling out a specific disease by a negative result (number of true negatives divided by the true negative and false positive together)

Question 14

What is the life saved to over diagnosis ratio for breast screening?

Answer 14

1:3 (1521 saved for 2722 over diagnosed)

Question 15

What factors are most likely to delay a woman presenting with breast cancer?

Answer 15

non-recognition of symptom seriousness, older age, lower educational level, non-white ethnicity

Question 16

Give 5 reasons why a coroner would need to be involved in assessment of death.

Answer 16

1. deceased not seen by a doctor within 14 days prior to death
2. suspicious circumstances
3. history of violence or accidental death suggested
4. death occurred shortly after detention in police custody
5. death likely to be due to industrial or occupational disease factors

Question 17

What is equipoise?

Answer 17

State of regarding to treatments as an equal bet in prospects ( no one treatment is already known to be significantly better)

Question 18

What months see the greatest proportion of suicides?

Answer 18

April, May and June