Y2 Session 10 - Adult Health

Question 1

Why do men typically live shorter than women?

Answer 1

Typically thought of as due to DNA and hormone regulation.
However, men tend to take more risks e.g. road injuries. As well as diet, smoking and drinking habits.
Men are less likely to seek help when they need it.

Question 2

What do men most often die of?

Answer 2

1. Heart disease
2. Road injury
3. Lung cancer
4. COPD
5. Stroke

Question 3

What are the differences between male and female suicides?

Answer 3

Males are more likely to commit suicide, 3 out of 4 people who commit suicide are men. This peaks around middle age and again at older age.

Question 4

How do we improve men’s mental health?

Answer 4

1. Workplace initiatives e.g. flexible working, sick pay, mental health days
2. Social prescribing, men prefer working alongside one another

Question 5

What is self-care?

Answer 5

What people do for themselves to establish and maintain good health.

Question 6

What are the 7 pillars of self-care?

Answer 6

1. Knowledge and health literacy
2. Mental wellbeing
3. Physical activity
4. Healthy eating
5. Risk avoidance (smoking, vaccines)
6. Good hygiene
7. Rational use of products and services (use of medicine and assets like parks)

Question 7

What is the self-care continuum?

Answer 7

A path from health behaviours to acute conditions and trauma. This shows how much we can partake in self-cae from healthy, daily choices, to being in critical condition with no ability to self-care.

Question 8

Which drug is methadone prescribed as a safer substitute for?

Answer 8

Heroin. It is prescribed to reduce withdrawal symptoms and cravings for other opioid.

Question 9

What is the alcohol harm paradox?

Answer 9

As socioeconomic status goes up, so does alcohol consumption whilst alcohol-related harm goes down.
Possibly due to drinking interfering with other risk factors e.g. no support. Also people from a low income background tend to drink more in one sitting.

Question 10

What care is available for those with harmful or hazardous alcohol misuse?

Answer 10

1. Brief advice
2. Self-help resources
3. Follow-up appointment

If unsuccessful
4. Extended brief intervention and/or CBT

Question 11

What are the symptoms of acute alcohol withdrawal?

Answer 11

1. Hypertension
2. Tachycardia
3. Sweating
4. Tremor
5. Agitation
6. Delirium tremens

Question 12

What is delirium tremens?

Answer 12

Severe, rare alcohol withdrawal symptoms

1. Confusion
2. Seizures
3. Hallucinations
4. Hypothermia

Question 13

If acute withdrawal is suspected, what would we do?

Answer 13

Admit to the hospital

Question 14

What is wernicke’s encephalopathy?

Answer 14

A consequence of alcohol misuse caused by vitamin B1 deficiency.
This is a neurological emergency.

Symptoms include gait and balance disturbance, altered consciousness, eye movement abnormalities.
Patients need IV thiamine (B1)

Question 15

What do we advise patients to do on a planned withdrawal from alcohol?

Answer 15

1. Not stop drinking suddenly
2. Inform the DVLA and stop driving
3. Assessed for alcohol-related comorbidities (mental illness, liver disease, pancreatitis)
4. Thiamine supplements given

Question 16

When should patients be taken care of in primary care for alcohol withdrawal?

Answer 16

1. If the patient is at reduced risk of adverse outcomes

2. Under the supervision of a GP with substance abuse special interest

Question 17

How are people who misuse alcohol treated in hospital?

Answer 17

First given benzos that are gradually reduced. Then provide acamprosate and therapy till the end.
Support and rehabilitation is absolutely necessary.

Question 18

What are the medication options for smoking cessation?

Answer 18

1. Bupropion
2. NRTs
3. Varenicline

Question 19

How do you take bupropion and what are the common side effects?

Answer 19

Take about a week before you plan on quitting, they work to reduce cravings, for about 9 weeks. After a week take 2 a day with 8 hours between them.

It can disturb sleep, cause nausea and a dry mouth.

Question 20

How do you take NRTs?

Answer 20

You take one long-acting patch all day with short acting ones when you have cravings e.g. a gum or lozenge.
You can use an inhalator, it looks like a cigarette.
You start the second you decide to stop.
The patch goes on a dry, hairless piece of skin and you replace it with a new one on a new piece of skin.

Question 21

How do you take varenicline and what are the side effects?

Answer 21

Start taking a week or two before you plan to quit.
The side effects are nausea, helped taken with food, headaches, sleep disturbances etc. This can take 12 weeks or longer.

Question 22

Why is reducing stress so important?

Answer 22

Stress causes oxidative stress, immune dysregulation causing chronic illness.