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1

What 3 broad types of skill might you as a GP use during a consultation?

Content skills

Perceptual skills

Process skills

2

Different factors can affect the consultation. One such factor may be personal factors.

Can you think of another factor and give four examples of it?

Physical factors
-Site and environment
-Adequacy of medical records
-Time constraints
-Patient status

3

Youv take a history and examine a patient.

You do not find anything on examination byt you feel that you are not getting the whole story.

What kind of questions might you use to elicit more information?

Open ended question

Direct question

Closed question

Leading question

Reflected question

4

What word do we use when body language and verbal language match?

Congruence

5

You patient opnes up alot to you and incinuates about you telling her about her mums health (you are also her mums GP)

What is your decision?
What oath guides you about this?

No (patient confidentiality)

The Hippocratic Oath

6

What percentage of the population are attending the GP for care at any point in time?

19%

7

As part of your awareness of your learning opportunities, are there any issues in having done the majority of undergraduate training in hospital specialities when considering, for example, a child presenting with abdominal pain?

The hospital is the tip of the iceberg of care, You will see a narrow spectrum of presentations in hospital and may gain a distorted view of the presentation of illness

8

What form of problem slovling does a GP use to rapidly narrow down the list of likely diagnoses?

Hypothetico-deductive reasoning

9

What is the WHO definition of health?

Health is a state of complete phyical, mental and social wellbeing not just the absence of disease or infirmity

10

A patient has recently had a heart attack. In a consultation after he has decided not to start the medication he has been given.

WHat consultation model would be the preferred option when discussing Jim's new treatment with him?

Mutual participation

Jim is an intelligent person who would likely respond to information about the risks and benefits of the proposed treatment.
It would be important to allow him to ask questions and to understand his treatment.
This would likely result in improved compliance.

11

What factors might put someone at risk of developing a long-term condition?

There might be genetic factors

There might be environmental factors

12

Long term conditions have far reaching "impacts". Give three examples of potential "impacts" of a long term condition.

On the individual – can be negative or positive. Can include denial, self-pity and apathy.

On Family – can be financial, emotional. The health of other family members may be affected.

Community/society. Isolation of an individual may result. Physical adaptations and changes in attitude may be required.

It has been said that the success of a community can be judged on how it looks after its infirm members.

13

What categories does the WHO use to classify diability?

Body and Structure impairment

Activity limitation

Participation Restrictions

14

What members of the primary care team might become involved in a patients care with MS?

GP – coordinating care and reviewing treatment and medication

District nurse – coordinating care at home – wound care, dressings, bloods, catheter care etc.

Occupational therapist (OT) – Assessing environment around patient at home and work, and providing aids to promote independence.

Physiotherapist – looking to maximise patient’s physical function e.g. mobility, chest care

Care Manager – Coordinating social care package.

15

There are two different approaches health professionsals (e.g. GP, physio, OT) may use to help Alison overcome her limitations.

What approaches are they and can you define them?

Therapeutic - We change the nature of the disability – e.g. treating osteoarthritis with anti- inflammatories

Prosthetic – We change the environment – e.g. taxi card, occupational therapy, rails at home etc.

16

A patientv could reat to their diagnosis in a number of ways.

What factors may influence the way in which she reacts?

The nature of the disability

The information base of the individual, ie education, intelligence and access to information

The personality of the individual

The coping strategies of the individual

The role of the individual – loss of role, change of role

The mood and emotional reaction of the individual

The reaction of others around them

The support network of the individual

17

Suggest three areas of someones life where they may be effectes by a diagnosis?

Personal

Economic

Social

18

What barriers are there to people smoking?

People most often use smoking as a coping strategy to manage alot of ther life stresses.

Until they find ways of coping it is likely that they will return to smoking.

There may be peer pressure from other friends/relatives who smoke (cultural normality)