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Flashcards in Formative past papers 1 Deck (31):
1

Prevalence and Incidence

●prevalence = the number of people in population with a specific disease at a single point in time or in a defined period of time

●incidence = the number of new cases of disease in a population in a specified period of time

2

List actions the government could take to stem the rise in obesity:

●       health education (diet / exercise)

●       tax (on unhealthy foods e.g fat tax)

●       ban on advertising unhealthy food

●       improve exercise / sport facilities

●       subsidise / fund healthy food

●       funding of NHS treatment for obesity e.g. specialist clinics, bariatric surgery

●      legislation: proper labelling, lists of ingredients/food content

3

List examples of what the GP could do to help individual patients with weight loss:

●       role model: practise what you preach

●       tailored advice on specific diet / exercises and arrange to see regularly

●       education about risks associated with obesity

●       referral to dietician for specialiset advice

●       prescribing weight loss medication

●       treat diseases that contribute to obesity

●       tackle underlying causes  e.g depression / low self-estee

4

List 5 other health professionals who could also be involved in obesity management or prevention

●       community dietician

●       psychologist

●       pharmacist

●       bariatric surgeon (2ndary care)

●       practise/school nurse

●       health visitor

●       midwife

5

  Explain the difference between statistical and cultural definitions of normality

●       statistical normality = based on the normal distribution curve / standard deviation

●       cultural normality = based on norms and values within a certain group (community)

6

How might obesity affect an individual’s health at a psychological, physical and social level?

●       psychological = reduced self-esteem

●       physical = difficult to move or keep fit

●       social = ostracization by peers

7

GP gatekeeper meaning

○       a person who controls patients’ access (via referral) to specialist / secondary care

8

Advantages of GPs as gatekeepers

  •  keep people out of expensive secondary care
  •  continuity of the doctor-patient relationship
  • personal advocacy
  • patient does not know which speciality to go 
  • increases likelihood of referral to appropriate department so apporopriate use of resources
  • limits exposure to certain investigations e.g. MRI scan, X-rays

9

Disadvantages of GPs as gatekeepers

  • patients have less choice in secondary care
  • puts stress on GP to know everything about every disease / symptom
  • dependent on individual GP knowledge, attitudes, skill, practice organisation
  • puts stress on a good doctor-patient relationship
  • seeing a GP might increase the time it takes to receive the needed treatment

10

Possible physical health effects from a job

○       He might be too tired to do long shifts

○       dangers of working on an X (oil rig)

○       dangers of transportation to the X (oil rig)

○       adjustment to day / night shift patterns

○       potential for obesity due to abundance of food (in canteen)

○       spouse may feel the stress from having to look after kids alone   

○       potential for improved physical health in him if he makes use of healthy eating options & facilities offshore

11

Possible psychological health effects from a job

○       anxiety & stress idue to dangerous working environment 

○       anxious about the security of his employment in the current economic climate

○       anxiety & stress about uncertain return home e.g weather delay or separation from family

○       possible depression in either due to repeated periods of isolation

○       anxiety & stress in children due to separation / father’s job

12

Possible social health effects from a job

Positives 

○       well paid employment allows family to afford good lifestyle, decent car, to go on holiday

○       no smoking / alcohol (when offshore)

○       able to spend additional time with family and friends when off (during offshore period

 

Negatives

​○       relationship difficulties due to nature of job

○       may binge drink (when onshore)

○       discipline problems in children due to ‘absent’ father figure

○       substance misuse due to stressful nature of job

13

5 categories of hazard

●       mechanical

●       physical

●       chemical

●       biological

●       psychological / stress/ Psychosocial

14

How would you deal with a patient asking about the health status of a relative

●       maintain X’ confidentiality (MUST be mentioned as 1 mark)

●       consider need to maintain X’ trust

●       consider GMC guidelines

●       acknowledge their concern and ask them why she is concerned

15

4 ethical priniciples

●       beneficence (do good): maximise care 

●       non-maleficence (do no harm): minimising risk of harm 

●       justice: recieve care that everyone in their position would be entitled to

●       autonomy:a patient’s right not to take proposed treatment (e.g inhalers) even if fully informed of benefits

16

   culture def (2 answers)

  • systems of shared ideas, concepts, rules and meanings that underlie and are expressed in the ways that human beings live 
  • complex whole which includes knowledge / beliefs / art / morals / law / customs 

17

       ethnicity def

  • cultural practises and outlooks that characterise and distinguish a certain group of people;
  • characteristics identifying an ethnic group may include a common language, common customs and beliefs and tradition
  •  term preferred over ‘race’

18

Race

 a group of people linked by biological / genetic factors

19

Potential difficulties when interviewing patients with cultural differences 

●       lack of knowledge about health issues

●       fear / distrust

●       racism  or stereotyping

●       bias / ethnocentrism

●       language barriers

●       3rd part presence (family members etc)

●       differences in perceptions / expectations

●       examination taboos

●       gender difference between doctor / patient

●       religious beliefs

●      they may not be entitled to NHS care

20

6 social classes

●       professional

●       managerial & technical

●       skilled non-manual

●       skilled manual

●       partly skilled

●       unskilled

21

How may culture  influence smoking behaviour in different social classes

●       lower social classes see larger numbers of people around them smoking and are more likely to accept it as normal behaviour

●       those around them are also more likely to accept the start of another individual smoking as normal behaviour (no stigma attached)

22

Primary care proffesional to tackle obesity and give role

●       dietician = individual dietary advice

●       pharmacist = OTC anti-obesity medication or weight management programmes

●       health visitor = health education; advice on healthy diet

●       GP = advice; prescription of weight reducing drugs

●       practise nurse = weight clinics; general dietary advice

●       midwife = encourage breast feeding; early dietary advice

23

3 models of stres

  • Engineering model
  • Medico-physiological model

  • Psychological model

24

Engineering model

●       stress acts as a stimulus which the individual must resist

●       if the stimulus becomes too intense or prolonged, the individual breaks

25

Possible coping mechanism for stress

●       problem focused

●       emotion focused

●       combination of problem / emotion focused

26

Guidance/co-operation relationship

●       the doctor exerts a degree of authority and the patient is obedient

●       the patient does have a little feeling of autonomy and participates to a small degree in the relationship

27

3 types of doctor-patient relationship

●       authoritarian / paternalistic

●       mutual participation

●      guidance co-operation

28

5 types of questions used in medical interviewing 

●       open questions = not seeking any particular answer but simply signals the patient to tell their own story

●       direct questions = asks about a specific item

●       closed questions = can only be answered by yes or no or an equivalent

●       reflected questions = allows the doctor to avoid answering a direct question from the patient / aids the doctor in exploring the patient’s own thoughts and perceptions

●       leading questions = presumes the answer; best avoided

29

Nonverbal ways doctors can facilliate the interview

●       listening

●       use of silence

●       posture/ body language

●       specific gestures

●       facial expressions

●       eye contact

●       layout of room (not talking across desk)

 

30

Approximately how many patients are registered on average with each GP in the NHS in the UK

1200-2000 patients each

31

% of people reffered on to secondary care from primary care

●       3% (accept 2-5%)