Equality, Diversity and Inclusion Flashcards by Michael Norton

A 78-year-old woman with new dementia seeks advice on legally appointing someone to make decisions if she loses capacity.

Which SINGLE legal term is MOST appropriate?
A. Citizens advice
B. Ordinary power of attorney
C. Independent mental capacity advocate
D. Independent mental health advocate
E. Lasting power of attorney

Answer: E. Lasting power of attorney
Justification: An LPA allows a person to appoint someone to make decisions on their behalf if they lose capacity. There are two types: property/financial and health/welfare. Must be registered with the Office of the Public Guardian.
Resource: Kumar M. The last 48 hours. InnovAiT 2021; 14(1): 27–31.

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Which ONE of the following names the core GMC guidance for professional values and behaviours expected of UK doctors?
A. Gillick competence
B. The Caldicott Principles
C. The Fraser Guidelines
D. Good Medical Practice
E. The Mental Health Act

Answer: D. Good Medical Practice
Justification: This GMC document outlines professional standards and responsibilities for UK doctors.
Resource: GMC. Good Medical Practice. 2013 (updated 2019).

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You receive a solicitor’s letter with patient consent to access records post-accident.

Within how many days must you supply the health record?
A. 7 days
B. 28 days
C. 14 days
D. 40 days
E. 60 days

Answer: B. 28 days
Justification: Under GDPR and DPA 2018, access requests must be fulfilled within 28 days.
Resource: BMA. Access to health records.

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A wife seeks benefits advice for her terminally ill 86-year-old husband with metastatic prostate cancer. Nurses suggested financial help.

In addition to Attendance Allowance, which form should be completed?
A. FW8
B. ESA113
C. DLA370
D. SR1
E. HSA1

Answer: D. SR1
Justification: The SR1 form supports benefits claims for terminal patients with <6 months life expectancy.
Resource: DWP. Special rules for end of life healthcare professional resources.

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A grateful patient gives you a thank-you card with £200 inside.

Which gifts must be recorded in the practice register under GMS contract regulations?
A. Gifts worth over £10
B. Gifts worth over £100
C. Gifts donated to the practice but not personal gifts
D. All gifts
E. Gifts worth over £500

Answer: B. Gifts worth over £100
Justification: Gifts over £100 must be recorded unless unrelated to clinical care.
Resource: BMA. Accepting donations from patients.

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Which patient is MOST likely to lack capacity?
A. 15-year-old girl seeking emergency contraception
B. 76-year-old man with mild Alzheimer’s wanting an advance directive
C. 57-year-old with pneumonia leaving against advice
D. 63-year-old refusing hospital with chest pain
E. 34-year-old sedated and ventilated in ITU

Answer: E. 34-year-old sedated and ventilated in ITU
Justification: He cannot understand, retain, weigh up or communicate information, and thus lacks capacity.

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Which condition is more common in carers than the general population?
A. Depression
B. Tuberculosis
C. Hepatitis B
D. HIV
E. Gastroenteritis

Answer: A. Depression
Justification: 1 in 3 carers providing 50+ hrs/week suffer from depression. Often under-recognised.
Resources: Carers Trust; RCGP Carers Toolkit.

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Which form allows a pregnant woman to claim statutory maternity pay?
A. MATB1 form
B. SC3 form
C. E111 form
D. MED3 form
E. MED5 form

Answer: A. MATB1 form
Justification: MATB1 is the required form for statutory maternity pay.
Resource: GOV.UK. Statutory Maternity Pay and Leave: employer guide.

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Which condition caused the highest percentage of years lost due to disability (YLD) according to WHO 2019 estimates?
A. Cancer
B. Respiratory disease
C. Stroke
D. Dementia
E. Ischaemic heart disease

Answer: E. Ischaemic heart disease
Justification: WHO lists IHD as one of the top causes of disability-adjusted life years (DALYs).
Resource: WHO Global Health Estimates 2019.

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Which benefit supports disabled individuals under state pension age whose condition affects their ability to work?
A. Statutory Sick Pay
B. Disability Living Allowance
C. Personal Independence Payment
D. Universal Credit
E. Attendance Allowance

Answer: D. Universal Credit
Justification: UC is a means-tested benefit for low-income individuals including those with disabilities.
Resource: DWP. Universal Credit.

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Which patient is MOST likely to benefit from social prescribing?
A. 7-year-old boy with school bullying
B. 84-year-old frail lady with no local family
C. 45-year-old accountant with marital issues
D. 22-year-old man with cocaine addiction
E. 40-year-old woman with refractory rheumatoid arthritis

Answer: B. 84-year-old frail lady with no local family
Justification: Social prescribing supports isolated individuals with non-medical needs using community resources.
Resource: Barnes E. Social prescribing. InnovAiT 2020.

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What ensures a Health & Welfare Lasting Power of Attorney is legally enforceable?
A. Signed in presence of solicitor
B. Signed by two witnesses
C. Copy saved in medical records
D. Completed and signed copy
E. Registered with Office of the Public Guardian

Answer: E. Registered with Office of the Public Guardian
Justification: LPAs must be registered to become legally binding.
Resource: RCGP Mental Capacity resources.

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Which statement is TRUE about Carer’s Allowance?
A. Carer must live with the person
B. Carer must provide 35+ hours/week of care
C. Cannot claim if cared-for gets Attendance Allowance
D. Affected by carer’s personal savings
E. Must be over 21

Answer: B. Carer must provide 35+ hours/week
Justification: Eligibility includes 35+ hrs/week care, aged 16+, and recipient gets AA or DLA.
Resource: DWP. Carer’s Allowance.

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A 54-year-old trans woman on oestrogen, risperidone, obese and smokes.

What disease is she MOST at risk of?
A. Hepatoma
B. Breast cancer
C. Osteoporosis
D. Prostate cancer
E. Type 2 diabetes

Answer: E. Type 2 diabetes
Justification: Risk increased by smoking, obesity, and antipsychotic therapy.
Resource: RCGP Transgender Care Guidance.

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A 35-year-old man with liver disease lacks understanding and refuses hospitalisation.

What is the MOST appropriate action?
A. Delay discussion
B. Encourage family persuasion
C. Psychiatric referral
D. Ask about communication needs
E. Emergency admission in best interests

Answer: E. Emergency admission in best interests
Justification: GMC allows treatment without consent if urgently required and patient lacks capacity.
Resource: GMC. Consent: patients and doctors making decisions together. 2008.

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26-year-old trans woman on oestrogen preparing for gender reassignment.

What is the MOST significant adverse effect?
A. Acne
B. Venous thrombosis
C. Hepatic cysts
D. Type 2 diabetes
E. Hirsutism

Answer: B. Venous thrombosis
Justification: Oestrogen therapy increases thromboembolism risk.
Resource: RCGP Transgender Health Guidance.

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What is the GMC’s main guidance document for UK doctors?
A. Relationships with patients
B. Good medical practice
C. Raising concerns
D. Appraisal and assessment
E. Good clinical care

Answer: B. Good medical practice
Justification: It outlines the ethical and professional duties of all UK registered doctors.
Resource: GMC. Good Medical Practice. 2013 (updated 2019).

A 60-year-old GP partner is late for work and smells of alcohol. A patient was not referred as promised.

What is the MOST appropriate course of action?
A. Suggest partnership meeting
B. Report to GMC
C. Wait and observe
D. Private conversation then monitor
E. Tell appraiser

Answer: A. Suggest partnership meeting
Justification: Concerns over safety require collaborative team discussion before escalation.
Resource: GMC. Good Medical Practice – working with colleagues.

78-year-old wants legal support for finances if they lose capacity.

Which option is MOST appropriate?
A. Care directive
B. IMCA
C. Lasting power of attorney
D. Enduring power of attorney
E. Advance care planning

Answer: C. Lasting power of attorney
Justification: LPA allows designated decision-makers if capacity is lost.
Resource: Courtney E. Advance care planning. InnovAiT 2020.

A 53-year-old Gypsy traveller in a parked trailer requests GP registration. No fixed address.

What is the MOST appropriate action?
A. Refer to homeless clinic
B. Temporary registration
C. Refuse registration
D. Fully register the patient
E. Send to walk-in centre

Answer: D. Fully register the patient
Justification: NHS rules permit registration without proof of address or ID.
Resources: NHS; BMA; Doctors of the World guidance.

Which of the following forms is completed to allow a pregnant woman to claim statutory maternity pay?
A. MED5 form
B. E111 form
C. MATB1 form
D. MED3 form
E. SC3 form

Answer: C. MATB1 form
Justification: The MATB1 form is used to claim Statutory Maternity Pay. MED5 was replaced by MED3 in 2010. SC3 is for statutory paternity pay.
Resource: GOV.UK. Statutory Maternity Pay and Leave: employer guide.

You are called to visit a 35-year-old man with chronic alcohol dependency and suspected fulminant alcoholic hepatitis. He cannot understand or retain your explanation.
What is the SINGLE MOST appropriate management?
A. Contact the duty psychiatrist
B. Encourage relatives to persuade him
C. Discuss at a later time
D. Arrange emergency admission without consent
E. Admit under Mental Health Act

Answer: D. Arrange emergency admission without consent
Justification: In emergencies, treatment can be provided without consent if immediately necessary to save life or prevent serious deterioration.
Resources: GMC Consent guidance; CQC Mental Capacity Act Guidance.

A 78-year-old wants to appoint someone to manage finances if they lose capacity.
What is the SINGLE MOST appropriate option?
A. Advance care planning
B. Independent mental capacity advocate
C. Enduring power of attorney
D. Care directive
E. Lasting power of attorney

Answer: E. Lasting power of attorney
Justification: LPA allows legal appointment of decision-makers and replaced enduring power of attorney in 2007.
Resource: Courtney E. Advance care planning. InnovAiT 2020; 13(2): 109–116.

A 19-year-old seeks a paternity test. His father has consented.
What is the SINGLE MOST appropriate management?
A. GP should arrange the test
B. GP should decline
C. GP should signpost to approved providers
D. GP should refer to genomic medicine
E. GP can arrange after legal advice

Answer: C. GP should signpost to approved providers
Justification: Paternity testing isn’t provided on NHS. GPs should signpost to approved providers.
Resource: Spicer J, Papanikitas A. Genomics in primary care. InnovAiT 2021; 14(2): 124–130.

A 59-year-old with breast cancer writes an advance care plan requesting a liver transplant if she develops metastases. What is the SINGLE MOST appropriate response? A. Consider her request at the time B. Refer to transplant surgeon C. Ask her to appoint attorney D. Suggest finding a supportive doctor E. Accept her decision

Answer: A. Consider her request at the time Justification: Advance plans are not legally binding but should be considered. Resource: Courtney E. Advance care planning. InnovAiT 2020; 13(2): 109–116.

Which statement about the Motability Scheme is correct? A. Parents cannot apply for children B. Can apply as a passenger C. Only if disabled person drives D. One nominated driver allowed E. Two nominated drivers allowed

Answer: B. Can apply as a passenger Justification: Motability allows leasing vehicles using mobility allowance even if the person cannot drive. Resource: Motability. Making a Difference guide.

After five tetanus doses, what is the minimum number of years required before a booster is advised for travel to high-risk areas? A. 20 years B. Five years C. 10 years D. 15 years E. 25 years

Answer: C. 10 years Justification: A booster is recommended after 10 years for those travelling to high-risk areas. Resource: Public Health England. Tetanus: the green book, chapter 30.

What is the MOST significant adverse effect of oestrogen therapy in trans women? A. Osteoporosis B. Type 2 diabetes C. Acne D. Hirsutism E. Venous thrombosis

Answer: E. Venous thrombosis Justification: Oestrogen increases VTE risk; monitoring is advised. Resource: Tavistock NHS Trust. Shared Care Guidance for Transgender Care. 2022.

A 61-year-old with MND has pneumonia and reduced consciousness. Daughters (joint attorneys) disagree on hospital admission. Who is the SINGLE MOST appropriate decision-maker? A. Court of Protection B. IMCA C. GP D. Elder daughter E. Solicitor

Answer: A. Court of Protection Justification: Where LPAs disagree and urgent decisions are needed, emergency Court of Protection application is required. Resource: GMC, OPG guidance on capacity legislation.

A solicitor requests medical records of a deceased patient on behalf of the daughter. Which legislation applies? A. Freedom of Information Act B. Data Protection Act C. Health and Social Care Act D. Access to Health Records Act E. Access to Medical Reports Act

Answer: D. Access to Health Records Act Justification: This act permits access by those with a legal claim in relation to the deceased. Resource: BMA. Fees for insurance reports and certificates.

A 54-year-old man with learning disability is aggressive and not responding to others. Normal observations and examination. What is the MOST LIKELY diagnosis? A. Depression B. Impacted ear wax C. Early onset dementia D. Urinary tract infection E. Absence seizures

Answer: B. Impacted ear wax Justification: Behavioural changes in people with learning disabilities may be due to simple sensory issues like ear wax. Resource: RCGP Curriculum Guides: neurodevelopmental disorders. 2019.

A man expecting twins wants Shared Parental Leave. He meets all requirements. What is the MAXIMUM combined leave both parents can take? A. Two weeks B. Four weeks C. Twelve weeks D. Fifty weeks E. Sixty weeks

Answer: D. Fifty weeks Justification: Shared Parental Leave allows up to 50 weeks of leave and 37 weeks of pay. Resource: Gov.UK. Shared Parental Leave and Pay.

Which ONE of the following patient ages requires child protection referral regardless of consent? A. 18 B. 12 C. 14 D. No minimum age if they appear to consent E. 16

Answer: B. 12 Justification: Under 13s cannot legally consent to sexual activity — must trigger safeguarding response. Resource: Davies E, Mulla E. The sexual health assessment. InnovAiT 2020; 13(4): 227–234.

Husband asks for wife’s mid-luteal progesterone result. What ethical principle are you prioritising by refusing? A. Beneficence B. Justice C. Maleficence D. Non-maleficence E. Autonomy

Answer: E. Autonomy Justification: Confidentiality respects the patient’s autonomy. Resources: Gillon R. BMJ 1994; GMC Confidentiality 2018.

When can MAT B1 certificate be issued? A. After positive test B. After scan confirms pregnancy C. Not more than 20 weeks before expected week of confinement D. After dating scan E. Not more than 12 weeks before expected week of confinement

Answer: C. Not more than 20 weeks before expected week of confinement Justification: MAT B1s are valid from 20 weeks before EWC. Resource: DWP. MAT B1 guidance 2012.

Which document allows a person to refuse specific future treatments? A. Advance directive to refuse treatment B. Lasting power of attorney C. Patient-specific directive D. Mental Capacity Act E. No such legal document

Answer: A. Advance directive to refuse treatment Justification: Also called an Advance Decision. Legally binding if valid. Resource: Courtney E. Advance care planning. InnovAiT 2020.

Which is TRUE about Carer’s Allowance? A. Not allowed if person gets AA/DLA B. Carer must live with person C. 35 hours of care/week required D. Affected by savings E. Carer must be 21+

Answer: C. 35 hours of care/week required Justification: Carers must spend ≥35 hours/week with the person in receipt of AA or DLA. Resource: DWP. Carers allowance.

Which statement best reflects GMC advice on disclosing genetic risks to relatives? A. Must not disclose if patient forbids B. Must always disclose C. Can disclose if the relative is your patient D. Balance patient care with protection of relative E. Consent can be overruled by clinician

Answer: D. Balance patient care with protection of relative Justification: Discretion is given to clinicians to protect others from serious harm. Resource: Lucassen A, Farsides B. InnovAiT 2017; 10(8): 481–488.

When is a Health and Welfare LPA legally enforceable? A. Signed copy completed B. Registered with Office of the Public Guardian C. Saved to records D. Signed by two witnesses E. Signed before a solicitor

Answer: B. Registered with Office of the Public Guardian Justification: LPA must be registered to be enforceable. Resource: OPG guidance; RCGP topics.

Which patient is MOST likely to lack capacity? A. 63F with chest pain refusing hospital B. 15F requesting morning after pill C. 57F with pneumonia leaving AMA D. 34M sedated/ventilated in ICU E. 76M with mild Alzheimer’s wanting advance directive

Answer: D. 34M sedated/ventilated in ICU Justification: Sedated patients cannot understand, retain or communicate → lack capacity. Resource: GMC Consent; Mental Capacity Act 2005.