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Year 1 Flashcards

1
Q

WHO definition of health

A

“A state of complete physical, mental, and social well-being
and not merely the absence of disease or infirmity.”

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2
Q

What are the types of questions used in a consultation

A 
Open ended 
Direct
Closed 
Leading 
Reflected
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3
Q

What is an open question

A

Is not seeking a particular answer but simply signals the patient to tell his story

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4
Q

What is a direct question

A

Ask about a specific item

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5
Q

What is a closed question

A

Can only be answered with yes or no

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6
Q

What is a leading question

A

Presumes the answer

Is best avoided

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7
Q

What is a reflected question

A

Allows the doctor to avoid answering a question

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8
Q

Example of open question

A

Tell me about the pain

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9
Q

Example of direct question

A

Where is the pain

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10
Q

Example of closed question

A

Is the pain severe

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11
Q

Example of leading question

A

The pain is severe?

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12
Q

Example of reflected question

A

You want to know the cause of the pai

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13
Q

Which 3 styles of doctor patient relationships has Szasz and Hollender describes

A

Authoritarian or Paternalistic
Guidance/co-operation
Mutual Participation

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14
Q

How long does an average GP consultation take

A

10 mins

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15
Q

What 3 separate activities does a consultation typically involve

A
  1. Talking together (always)
  2. Doctor examining patient (often)
  3. Performing Procedures (sometimes)
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16
Q

Culturally what is described as normal

A

What is defined as normal will depend on expectations and standards of the society

Thus on political, economic and social factors

Criteria may differ between societies, over time within the same society, and between groups within the same society

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17
Q

Which factors can determine expectations and standards of normal culturally

A

Political
Economic
Social factors

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18
Q

Describe a mutual participation relationship

A

Active involvement of patients as more equal partners

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19
Q

What is the lay age belief about health

A

Older people concentrates on functional ability in their daily lives

Younger people tend to speak of health in terms of physical strength and fitness

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20
Q

What is the lay social class belief about health

A

People living in difficult economic and social circumstances regard health as functional – the ability to be productive, to cope and take care of others

Women of a higher social class or educational qualifications have a more multidimensional view of health

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21
Q

What is the gender lay belief about heath

A

Men and women appear to think about health differently

Women may find the concept of health more interesting

More likely to attend their GP

Women include a social aspect to health

Men tend to leave their health to get worse for longer

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22
Q

What is the training path to becoming a GP

A 
5yrs med school 
FY1 and 2
GP 3yrs training path
- 2yrs hospital training
- 1yr GP training
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23
Q

Who is the first point of contact for patients needing to see a doctor

A

GP

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24
Q

Which wide range of skills do GPs need to have

A 
Problem solving 
Managing risk and uncertainty 
Evidence based medicine 
Wide range clinical skills 
Holistic approach aimed at managing risk and dealing with uncertainty and complexity
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25
Who can GP practices be owned by
GP themselves | Or Local NHS organisations
26
What is the trend in types of practices
Tend to be large primary health care centres now
27
Which aspected of lifestyle may be covered in a GP consultation
``` Diet Exercise Alcohol Smoking Illicit Drug Use Sexual Health ```
28
What are the used of computers in GP practices
``` Online transactions Appointment booking Repeat prescriptions Support prescribing Assist in consultations Allow GPs to manage hospital letters Allow GPs to manage blood results Keeping records (digital record keeping) ```
29
Do GPs own and run businesses by themselves or in partnership with others
Can be either
30
What is a GP running the business responsible for
Providing: Adequate premises and infrastructure To provide safe patient services and employ/train practice staff
31
Advantages of using technology in GP practices
Patient data can be easily accessed by any approved member of staff at any time and sometimes any place when working remotely Patient data can be listed, graphed and searched easily (enabling GPs to convey and track information)
32
How often do GPs need to revalidate their qualifications
Every 5yrs
33
How do GPs prepare for appraisal
Reading literature Attending courses Performing audits
34
Who composes the practice team
``` Manager IT/Admin Staff Secretarial Staff Reception Staff Nurses- Junior/Senior Advanced Nurse Practitioners/Physicians Assistants Phlebotomists/Health Care Assistants ```
35
What is a major key attraction of GP
Ability to be flexible and make own decisions about the balance of their team to address the needs of their own practice
36
What are options within GP
``` Partner Special interest (e.g Obs & Gynae, Diabetes, Minor Surgery) Salaried GP Part time (3 days rather than 5) Medical education Sports doctors ```
37
Are GPs now required to work out of hours
No | No longer required
38
What is meant by longitudinal care
Possibility to work with someone from birth right through to adult life
39
What does effective communication improve?
``` Patient satisfaction Patient recall Patient understanding Patient concordance And outcomes of care ```
40
Which 3 broad types of skills are needed for successful medical interviewing
Content skills Perceptual skills Process skills
41
What can body language include
Gaze behaviour Posture Specific gestures
42
Which factors influence the consultation
Physical factors Personal factors - doctor - patient
43
What are Roger Neighbours tasks in a consultation
Connect with the patient Summarise and verbally check that reasons for their attendance are clear Hand over and bring the consultation to a close i.e hand over to the patient a the end to ensure all issues have been covered Ensure safety net exists in that no serious possibilities have been missed To deal with housekeeping of recovery and reflection
44
What are the 3 aspects of safety netting
Advise the patient of expected course of the illness/recovery Advise of symptoms indicating deterioration - Highlight things to look out for Advise who to contact if patient deteriorates Double check the patient has understood all of this
45
What is a risk
``` Chance of (or of bad) consequences Implies chance ```
46
Definition of uncertain
Not able to be relied on, not known or definite
47
Definition uncertainty
state of being not completely confident or sure of something
48
What is resilience
Positive capacity of people to cope with change and stress
49
What are the protective factors for resilience
Positive early upbringing Self confidence Social support Good problem solving skills
50
Give an example of Hypothetico-Deductive Reasoning
Maybe 4 or 5 diagnostic hypotheses Rare but not immediately concerning diagnoses excluded at this stage Strengthen case for diagnoses through brief history and examination Extend the search thereafter if no diagnoses identified Not about common diagnoses, rather about likely diagnoses
51
What is a hazard
Something with the potential to cause harm
52
What is a risk
Likelihood of harm occurring
53
What is a risk factor I
Increases the risk of harm
54
What is a protective factor
Decreases the risk of harm
55
What is susceptibility
Influences the likelihood that something will cause harm
56
Give the types of hazards
``` Physical Chemical Mechanical Biological Psychological ```
57
Routes of exposure of hazards
Skin Blood/sexual Inhalation Ingestion
58
Which factors influence the degree of risk
How much a person is exposed How the person is exposed Conditions of exposure
59
What does risk combine
The probability that a particular outcome will occur and the severity of the harm involved
60
Which 3 principles govern the perception of risk
Feeling in control Seize of the possible harm Familiarity with the risk
61
What are involuntary risks
Involuntary risks are situations where we are believed to have little control Perceived as having greater risk E.g plane trip
62
What are voluntary risks
Voluntary risks are situations we believe we have some control over Perceived as less risk E.g Car Trip
63
Are risks involving greater or lesser harm perceived as having more risk
Greater possible harm | Even if the less harmful events are more likely
64
Are risks that are more of less familiar perceived as having greater risk
Less familiar
65
What does risk perception depend on
``` Peoples beliefs Previous experience Attitudes towards risk Judgements Feelings Beliefs Personality Wider social values Wider cultural values Demographic factors Socio-economic factors ```
66
Examples of environmental chemical risks
Pesticides | VOCS
67
Examples of environmental physical risks
Ionising and non-ionising radiation | Noise and vibration
68
Examples of environmental biological risks
Infectious agents | Allergic substances
69
Examples of hazardous diet
``` Fat Salt Bacteria Pesticides Acrylamide Phthalates ```
70
Examples of hazardous inhalation
``` Environmental tobacco smoke Smog Asbestos Legionella Pesticides ```
71
Examples of hazardous dermal risks
UV-A/UV-B Bacteria Cosmetics Pesticides
72
What are the 3 main components of NHS structure
Primary Care Secondary Care Tertiary Care
73
Describe primary care
``` Illness first presents Most illness managed Gatekeeper function Prevention Accounts for 90% of all patient contact ```
74
Describe secondary care
Hospital consulting role
75
Describe Tertiary care
Regional centre
76
Name 2 out of hours services
G-Med | NHS 24
77
Describe a typical GP day
``` Morning and afternoon surgeries Paperwork (results, letters, ect) and telephone calls interspersed throughout day House calls Extended hours Duty doctor/emergencies Practice business/staff issues ```
78
What % of people are referred to secondary care
1%
79
Who is is easier to change behaviours in
Women and elderly
80
What factors motivate people to change their behaviours (use alcohol in pregnancy as an example)
The advantages of not drinking (healthy baby) outweigh the disadvantages You anticipate a positive response from others to your behaviour change (e.g your partner also wants the unborn child to be healthy) There is social pressure for you to change (very socially unacceptable to drink when obviously pregnant) You perceive the new behaviour to be consistent with your self-image (earth mother) You believe you are able to carry out the new behaviour in a range of circumstances
81
What does self-efficacy underpin
Goal setting Effort investment Persistence in face of barrier And recovery from setbacks
82
What actions can the government to decrease obesity
``` Health education – diet and exercise Tax on unhealthy foods Legislation-proper labelling, lists of ingredients/food content Enforcement of legislation Ban on advertising unhealthy food Improve exercise/sport facilities Subsidise healthy food Transport policy e.g cycling lanes Funding NHS treatment for obesity e.g specialist clinics, bariatric surgery ```
83
Qualifications of a practice nurse
Fully registered nurse often with additional training
84
What is the role of a practice nurse
Works in the practice premises alongside the doctors | Does a variety of diagnostic and treatment procedures, health clinics
85
What is the role of a district nurse
Has his or her own independent work but is also ‘attached; to practice(s) and liaises with them
86
What is the role of a health visitor
Works mainly in the fields of prevention, health promotion, and public health, with responsibility for children aged 0-5yrs
87
What is the role of a midwife
Entirely responsible for their own caseload of pregnant women, but liaise with general practice
88
What is the role of the receptionist?
Reception and administrative responsibilities (e.g filing). Should not undertake any medical tasks as they are not trained for this
89
What is the role of a pharmacist
Local ('community') pharmacists are variably involved with general practice. Some health centres house their own pharmacy. At another level health boards employ pharmacists to provide general advice to groups of practices.
90
What is the role of a dietician
Interpret and communicate the science of nutrition to enable people to make informed and practical choices about food and lifestyle. In both health and disease
91
What is the role of an OT
Help people overcome the effects of disability caused by physical or psychological illness, ageing or accident and promote independent function in all aspects of daily life
92
What is the role of a physio
Concerned with human function and movement and maximising potential. It uses physical approached to promote, maintain and restore physical, psychological and social well-being, taking account of variations in health status
93
What is the role of a social worker
Concerned with human function and movement and maximising potential. It uses physical approached to promote, maintain and restore physical, psychological and social well-being, taking account of variations in health status
94
What is morality
Our attitudes, behaviour and relations to one another
95
What is consequentialism
the moral worth of an action is determined by its outcome
96
What is deontology
Duties 'right and wrong' actions absolute values
97
What is utilitarianism
Look at benefits and harms to individual and society; look at the consequences Type of consequentialism
98
Give examples of duties of doctors laid out by the GMC
Make the care of your patient your 1st concern Treat every patient politely and considerately Respect patients dignity and privacy Listen to patients and respect their views Give patients information in a way they can understand Respect the rights of patient to be fully involved in decisions about their care Keep your professional knowledge and skills up to date Recognise the limits of your professional competence Be honest and trustworthy Respect and protect confidential information Make sure that your personal beliefs do not prejudice your patients care Act quickly to protect patients from risk if you have good reason to believe that you or a colleague may not be fit to practice Avoid abusing your position as a doctor and Work with colleagues in the ways that best serve the patients’ interests
99
What are the 4 principles of ethics
Autonomy Non-malfeasance Beneficence Justice
100
What is autonomy
Promote the right to self determination | Confidentiality, informed consent, promote capacity
101
What is beneficence
to do good
102
What is justice
Fairness/equity (non-discrimination, equal treatment for equal need)
103
Describe a non-judgemental approach
you must not discriminate on grounds of age, colour, culture, disability, ethnic or national origin, gender, lifestyle, marital or parental status, race, religion or beliefs, sex, sexual orientation, or social or economic status.
104
Describe fitness to practice
Specific duty to take appropriate action to protect patients, not just by your own action but also to protect patients if your or others are unfit to practice
105
Which ethical principles are particularly relevant to GPs
``` Non-judgemental approach Not imposing personal views Respecting patients views Confidentiality Not exceeding competency Fitness to practice ```
106
What is duty of candour
Must be open and honest with patients when something goes wrong with a patient’s treatment or care which causes or has the potential to cause harm or distress
107
What should you do if something goes wrong with a patients care
Be open and honest with the Patient (duty of candour) If unsure of consequences immediately seek advice of appropriate senior colleague Apologise to the patient and offer appropriate remedy or support Put matters risk and explain fully the short and longer term consequences fo what has happened
108
To influence action/behaviour what must information given be?
Relevant to current goals Easily understood and remembered Readily available in the moment of decision or action

FOPC (4 decks)

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