Case Study Flashcards
(32 cards)
What two different types of risk are appropriate to discuss when a patient expresses concerns about the dangers of the pill?
Actual risk
Relative risk
How might you communicate this with her?
Verbally
Using fractions
Using illustrations
What kinds of studies might have been performed to generate data that you are able to present to the patient?
Descriptive studies Cross-sectional studies Cohort studies Case-control studies Randomised controlled trials (RCTs)
What word that can affect the outcome of a study describes the tendency to preferentially select a group?
Bias
What would you do if it turned out that one group smoked more than others, what kind of factor would it be?
A confounding factor
You are unsure if you and your colleagues are prescribing the contraceptive pill according to national guidelines?
You might perform an audit
What headings might you use to structure it according to the RCGP guidelines on performing an audit?
- Title
- Reason for the audit
- Criteria to be measured
- Standard set
- Preparation and planning
- Results and date of collection one
- Description of changes implemented
- Results and date of data collection two
- Reflections
A patient attempts to stop smoking, but goes back to it. What model describes the stages that they have gone through?
The stages of change model
Define health promotion?
- Any planned activity designed to enhance health or prevent disease
- The process of enabling people to increase control over, and to improve, their health. Applied to a wide range of approaches to improving the health of people, communities and populations.
- An over-arching principle or activity which enhances and includes disease preventing health education and health protection. It is usually planned but may be opportunistic.
ANY OF THE ABOVE 3
What are the 3 theories of health promotion>
Educational: Provides knowledge and education to enable necessary skills to rate informed choices in health
Socioeconomic: Makes healthy choices the easy choice
Psychological: Complex relationship between behaviour, knowledge, attitudes and beliefs. Activities start from an individual attitude to health and readiness to change. Emphasis on whether individual is ready to change
What are the 3 theories of health promotion>
Educational: Provides knowledge and education to enable necessary skills to rate informed choices in health
Socioeconomic: Makes healthy choices the easy choice
Psychological: Complex relationship between behaviour, knowledge, attitudes and beliefs. Activities start from an individual attitude to health and readiness to change. Emphasis on whether individual is ready to change
What type of health promotion activity does smoking cessation demonstrate?
Health education: The activity involves communication with individuals or groups aimed at changing knowledge, beliefs, attitudes and behaviour in a direction which is conducive to improvements in health
What form of strategy for the prevention of illness is ‘smoking cessation’?
Primary prevention. Measures are taken to prevent the onset of illness or injury. Reduces probability and severity
What are the criteria used to determine the appropriateness of screening programmes?
Wilsons and Jungner’s Criteria:
Illness - Important, natural history understood, clinically detectable pre-symptomatic stage
Test - Easy, acceptable, cost-effective, sensitive and specific
Treatment - Acceptable, cost-effective, better if disease found early
A patient presents with lower back pain, resulting from his job moving stock. What is the likely diagnosis and prognosis?
Mechanical lower back pain
Generally good prognosis with initial rest, analgesia and mobilisation with/without physio
What can you provide to help his condition?
Analgesia
Med 3 Fit Note
Referral to physiotherapy
The patient has now been off work for a month and is looking better. What role has he adopted and is the role always negative?
The sick role
Role is not necessarily negative. Society allows for the provision of care of the infirm, there is, however, an expectation that he will eventually return to work
Suggests 2 possible consequences of the changes shown in the population pyramids
Ageing population with disease and care needs
Relative smaller working population paying taxes and supporting the country financially and fewer to provide care for the older population
What is the expected increase in people about the age of 80 between 2000 and 2050?
4x
Elderly patients are likely to have multiple long-term medical conditions. What is the term used to describe ‘the co-existence of two or more long-term conditions in an individual’?
Multimorbidity
A patient presents with arthritis in his hands. He has taken some of his friends diclofenac to treat is. He found it helpful and has come to ask for some. What issues should you raise with him?
- Diclofenac could have a detrimental effect on his ischaemic heart disease
- Anti-hypertensive could interact with NSAID
- Could suffer GI SE, especially if he is also taking aspirin
Would you refuse to prescribe the diclofenac?
Depends on patient’s thoughts about risk
He may believe that it is beneficial, despite having all the facts
Weigh against how symptoms affect his life
Some patients find topical preparations helpful and would carry less risk of interaction
Finding ways of tailoring treatments to an individual’s needs is a skill of generalism
What kind of plan can prevent unwanted hospital admissions?
Anticipatory care plans
What does an anticipatory care plan promote?
Advance and anticipatory care planning, as a philosophy, promotes discussion in which individuals, their care providers and often those close to them make decisions with respect to their future health or personal and practical aspects of care
