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Flashcards in Formative past papers 1 Deck (31):

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


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


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


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


  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)


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


GP gatekeeper meaning

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


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


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


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


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


Possible social health effects from a job


○       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



​○       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


5 categories of hazard

●       mechanical

●       physical

●       chemical

●       biological

●       psychological / stress/ Psychosocial


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


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


   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 


       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’



 a group of people linked by biological / genetic factors


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


6 social classes

●       professional

●       managerial & technical

●       skilled non-manual

●       skilled manual

●       partly skilled

●       unskilled


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)


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


3 models of stres

  • Engineering model
  • Medico-physiological model

  • Psychological model


Engineering model

●       stress acts as a stimulus which the individual must resist

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


Possible coping mechanism for stress

●       problem focused

●       emotion focused

●       combination of problem / emotion focused


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


3 types of doctor-patient relationship

●       authoritarian / paternalistic

●       mutual participation

●      guidance co-operation


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


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)



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

1200-2000 patients each


% of people reffered on to secondary care from primary care

●       3% (accept 2-5%)