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ELM2 - integrated cases > case 2 - health & illness behaviour > Flashcards

case 2 - health & illness behaviour Flashcards

1
Q

What is the acronym used for the possible reasons for pathophysiological symptoms?

A

‘AVINDICATEDPIF’

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2
Q

What are the 6 parts/steps in taking a history?

A

Sequence of events, Symptom analysis, associated symptoms, patient perspective, background medical information, personal and social history

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3
Q

What class of drug is codeine?

A

Opiate

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4
Q

What is codeine used as?

A

An analgesic, decreasing pain perception

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5
Q

What is the mechanism of action of codeine?

A

An agonist of mu-opioid receptors, which are involved in the transmission of pain.

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6
Q

What are the key side effects of codeine?

A

Drowsiness, sedation, respiratory depression, nausea, vomiting, constipation

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7
Q

What are the GI side effects of codeine?

A

Nausea, vomiting, constipation

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8
Q

What class of drug is diclofenac?

A

NSAID - non-steroidal anti-inflammatory drug)

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9
Q

What is diclofenac used for?

A

Reduce pain & inflammation

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10
Q

What is the mechanism of action of diclofenac?

A

Binds to and inhibits COX-1 and COX-2 to block the production of prostaglandin, which is involved in inflammation

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11
Q

What are the GI side effects of diclofenac?

A

Nausea, vomiting, diarrhoea

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12
Q

What is the key difference between the action of diclofenac and the action of codeine?

A

Diclofenac reduces inflammatory pain, while codeine decreases pain perception

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13
Q

What are the key personal perspectives of the doctor and patient in the doctor-patient relationship?

A

knowledge, experiences, ideas, priorities, attitudes, opinions

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14
Q

What are some of the societal factors that contribute to health behaviours?

A

Advertising, accessibility, stigma, cost, education, socioeconomic status, cultural values, religion

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15
Q

What are the 4 pillars of medical ethics?

A

Beneficence, non-maleficence, autonomy, justice

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16
Q

What is beneficence?

A

To act in the best interest of the patient

17
Q

What is non-maleficence?

A

To do no harm to the patient

18
Q

What is autonomy?

A

The patient’s right to choose or decline treatment

19
Q

What is justice?

A

Fairness and equity in the distribution and delivery of treatment

20
Q

What are the 3 parts of the ‘spirit of Motivational Interviewing’?

A

Collaborative, Honouring autonomy, evocative

21
Q

What are the core principles of Motivational Interviewing?

A

OARS: Open questions, affirmation, reflective listening, summarising

22
Q

What are the 6 stages of change in Motivational Interviewing?

A

Pre contemplation, Contemplation, Determination, Action, Maintenance, Recurrence

23
Q

What causes nausea/vomiting in a patient taking morphine?

A

Morphine, and other opioids, act on chemoreceptors in the CTZ (chemoreceptor trigger zone) in the medulla oblongata. Morphine also inhibits gut motility, causing nausea & vomiting.

24
Q

What is the name for the ‘vomiting centre’ in the medulla oblongata?

A

CTZ - chemoreceptor trigger zone

25
Q

What causes nausea/vomiting in a patient in cardiogenic shock?

A

Decreased blood flow to the GI tract slows digestion. The ischemic byproducts of damaged cardiomyocytes can trigger nausea and vomiting also.

26
Q

What causes nausea/vomiting in a patient receiving cytotoxic chemotherapeutic drugs?

A

Drugs trigger the release of substance P from neurons which acts on NK1 receptors in the brain, triggering vomiting. Cell damage in GI tract can also cause it.

27
Q

What causes nausea/vomiting in a patient who has witnessed a horrifying event?

A

Adrenaline can decrease gut motility, and the vasovagal response leads to hypotension and nausea

28
Q

What causes nausea/vomiting in a patient who is in her first trimester of pregnancy?

A

HCG, a hormone produced by the placenta, can trigger nausea. High progesterone can slow gastric motility. Increased sensitivity of CTZ in the brain

29
Q

What are antiemetic drugs?

A

Medications used to prevent nausea and vomiting symptoms

30
Q

What are the 3 key antiemetic drugs studied?

A

Metoclopramide, domperidone, cyclizine

31
Q

What is the mechanism of action of metaclopramide?

A

Antagonises dopamine-2 receptors in the CTZ to decrease sensitivity of nerves between GI tract and CTZ.

32
Q

What is the mechanism of action of domperidone?

A

Antagonises dopamine-2 and dopamine-3 receptors in the CTZ to decrease the sensitivity of nerves between the GI tract and vomiting centre.

33
Q

What is the mechanism of action of cyclizine?

A

Antagonises H1 histamine receptors to inhibit nausea and vomiting

34
Q

What is the action of metaclopramide?

A

anti-emetic

35
Q

What is the action of domperidone?

A

anti-emetic

36
Q

What is the action of cyclizine?

A

anti-emetic

ELM2 - integrated cases (9 decks)

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