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GP lectures Flashcards

1
Q

Dangers of overprescribing antibiotics

A

Unecessary side effects
Medicalise self limiting conditions
Antibiotic resistance

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2
Q

Purposes of primary care

A

Managing illness and clinical illness over time
Finding the best available clinical solutions to clinical problems
Preventing illness
Promoting health

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3
Q

Epigenetics

A

Expression of the genome depends on the environment

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4
Q

Allostasis

A

Stability through change

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5
Q

What is allostatic load

A

Long term overtaxation of our physiological systems leads to impaired health (the pathophysiology of stress)

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6
Q

Salutogenesis

A

Favourable physiological changes secondary to experiences which promote healing and health

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7
Q

Define domestic abuse

A

Any incident or pattern of incidents of controlling, coercive, threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality

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8
Q

Give some types of domestic abuse

A 
Pscyhological
Physical
Sexual
Financial
Emotional
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9
Q

How does domestic abuse affect health

A

Traumatic injuries following assault
Somatic problems or chronic illness
Psychological or psychosocial problems

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10
Q

Standard domestic abuse risk

A

Current evidence does not indicate likelihood of causing serious harm

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11
Q

Medium domestic abuse risk

A

Idenitifiable indicators of risk of serious harm

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12
Q

High domestic abuse risk

A

Identifiable indicators of imminent risk of serious harm

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13
Q

How to deal with domestic and sexual abuse as a GP

A 
Display posters
Focus on safety
Ask direct questions
Be clear that behaviour is not ok
Give info
Be part of the process
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14
Q

Practical advice to domestic abuse patients

A

Phone a helpline

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15
Q

Domestic abuse MARAC

A

Single meeting about the abuse

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16
Q

IDVA

A

Service that works with high risk women

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17
Q

DHR

A

Review of circumstances surrounding domestic abuse deaths

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18
Q

Determinants of health

A

Genes
Environment
Lifestyle
Health Care

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19
Q

Horizontal equity

A

Equal treatment for equal need

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20
Q

Vertical equity

A

Unequal treatment for unequal need

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21
Q

Examining health equity

A 
Supply of healthcare
Access to health care
Utilisation of health care
Health care outcomes
Health status
Resource allocation
Wider determinants of health
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22
Q

Three domains of public health

A

Health improvement
Health protection
Improving services

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23
Q

Health needs assessment definition

A

Systematic method for reviewing the health issues facing a population, leading to agreed priorities and resource allocation that will improve health and reduce inequalities

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24
Q

Define felt need

A

Individual perceptions of variation from normal health

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25
Define expressed need
Individual seeks help to overcome variation in normal health
26
Define normative need
Professional defines intervention appropriate for the expressed need
27
Define comparative need
Comparison between severity, range of interventions and cost
28
Public health approach to health needs assessment
Epidemiological Comparative Corporate
29
Epidemiological approach to health needs assessment
``` Define problem Size of problem Services available Evidence base Models of care Existing services Reccomendations ```
30
Comparative approach to health needs assessment
Compares the services received by a population with others
31
Corporate approach to health needs assessment
Takes everyones views into account ``` Commisioners Providers Professionals Politicians Press Patients Opinion leaders ```
32
What is health psychology
Emphasises the role of psychological factors in the cause, profession and consequences of health and illness
33
3 main categories of health behaviours
Health Behaviour Illness Behaviour Sick role Behaviour
34
Define health behvaiour
A behaviour aimed to prevent disease
35
Define illness behaviour
A behaviour aimed to seek remedy
36
Define sick role behaviour
Any activity aimed at getting well
37
What is unrealistic optimism
Individuals continue to practice health damaging behaviour due to inaccurate perceptions of risk and susceptibility
38
What influences perceptions of risk
Lack of personal experience with problem Belief that preventable by personal action Belief that if not happened by now, its not likely to
39
Define need
Ability to benefit from intervention
40
8 NICE guidance steps on behaviour change
``` Planning interventions Assessing the social context Education and training Individual level interventions Community level interventions Population level interventions Evaluating effectiveness Assessing cost effectiveness ```
41
3 core principles of the NHS
meets needs of everyone Free at point of delivery based on clinical need not ability to pay
42
Health inequality definition
Preventable unfair and unjust differences in health status between people of different backgrounds
43
Inverse care law
Good medical or social care tends to vary inversely with the need of the population served
44
Vulnerable groups in NHS
``` Homeless Refugees Asylum seekers Elderly LGBTQ Travellers Ex prisoners Care leavers ```
45
Reasons why people may find it difficult to access care
Language Cultural No address Fear
46
Maslows heirachy of needs
``` Physiological Safety Love/ Belonging Esteem Self actualisation ```
47
Define homeless
People without a home or safe living space of their own
48
Causes of homelessness
``` Breakdown of relationships Addiction Mental health Poverty Domestic abuse Unemployment "eviction from private landlords" ```
49
Where are homeless people on maslows heirachy
The bottom "physiological"
50
Health problems in homeless people
``` Malnutrition Mental Illness Substance misuse Alcohol misuse Infectious diseases STI Poor feet and teeth DVT and leg ulcers ```
51
Life expectancy for homeless people
42 for women | 44 for men
52
Life expectancy for population
81 for women | 76 for men
53
Barriers to health for homeless
Lack of address Lack of phone Prioritising food etc Drugs
54
Services available for homeless people
Charities
55
Traveller definition
People who are committed to a nomadic or travelling lifestyle and see travelling as an important part of their ethnic or cultural identity
56
Traveller health prolems
``` Anxiety Pregnancy complications Chronic bronchitis Asthma Smoking Angina Fewer vaccinations ```
57
Traveller barriers to healthcare
Language Cultural Fear Education
58
Services for travellers
Health worker and hub
59
Infections likely if unvaccinated
Haemophilus influenza b, dipertheria
60
Cause of epiglotitis
Hib
61
LGBTQ health problems
Mental health | Substance abuse
62
LGBTQ problems in accessing healthcare
Stigmatised Discomfort/ fear of LGBTQ status Previous negative experiences
63
Reasons for homelessness in LGBTQ
Social isolation Discrimation Relationship problems Victims of crime
64
Problems for trans people in healthcare
Screening Reference ranges Effect of hormones on normal values
65
Define asylum seeker
A person who has made an application for refugee status
66
Refugee definition
A person granted asylum and refugee status. Usually means leave to remain for 5 years then reaaply
67
Define indefinite leave to remain
When a person is granted full refugee status and given permenet residence in the UK
68
Define unaccompanied child
Someone under 18 who has entered without parent or guardian
69
What do asylum seekers have access to
Financial support Temporary housing NHS care Education
70
What are asylum seekers not entitled to
Employment | Benefits
71
What are failed asylum seekers entitled to
Money, housing NHS care (only emergency)
72
Asylum seekers health problems
``` PTSD Depression Sleep disturbance Psychosis Slef harm Presenting as physical symptoms ```
73
Asylum seekers problems in accessing health problems
Language barrier Health not a priority Education
74
Types of exploitation
``` Sexual Domestic servitude Forced labour Forced crime Organ harversting ```
75
Gender split of trafficked people
51% female. 2/3 children.
76
Impact of trafficking on health
PTSD Contact dermatitis Work with no equipment Pregnancy
77
Red flags for trafficking
Timid Terrified Accompanied by controlling person
78
Do you need to deal with immigration status
Just focus on patient you arent an immigration officer
79
Name some models and theories of behaviour change
Health belief model Theory of planned behaviour Stages of theoretical model
80
What is the Health Belief Model
Individuals will change if they believe that - theyre susceptible - theres consequences - action reduces susceptibility - benefits outweigh risks
81
What is theory of planned behaviour
Intention determine by - attitude to behaviour - social norm - able to, percieved behaviour control
82
Stage models of health behaviour
Stage theories see individuals located at discrete ordered stages rather than on a continuum
83
Stages of trranstheoretical model
``` Pre contemplation Contemplation Preparation Action Maintenance ```
84
Define evaluation in the context of health services
Evaluation is the assessment of whether a service achieves its objectives
85
Methods of classification of health outcomes
Mortality Morbidity Quality of life Patient satisfaction
86
Maxwells dimensions of quality (3Es, 3As)
``` Effectiveness Efficiency Equity -Acceptability -Accessibility -Appropriateness ```
87
Define malnutrition
Malnutrition refers to deficiencies, excesses or imbalances in a persons intake of energy and or nutrients
88
Early influences on feeding behaviour
``` Maternal diet (early flavour exposure) and taste preference Role of breastfeeding Parenting practises Influences Food exposures ```
89
What is colostrum
Fat, protein protective factors; for 3 days after birth
90
What is foremilk
Beginning of a feed- watery
91
What is hindmik
End of a feed- energy dense
92
Advantages of breast milk
Enzyme digestion Gut protection Anti infective Everyday health
93
Why should doctors know about nutrition
Enough knowledge to educate and advise patients effectively
94
Diabulimia
Underdose on insulin to cause weight loss
95
Sarcopenic obesity
Loss of muscle, gain weight
96
When do children start tasting and smelling
Before birth
97
Food neophobia
Fear of new foods, aged 2 to 6
98
How does breast milk affect later diet
Formula fed babies are less accepting of new foods
99
3 basic forms of dieting
Restrict total amount fo food eaten Don't eat certain types of food Avoid eating for long periods
100
Define restrained eating
Deliberate attempt to inhibit food intake in order to maintain or lose weight
101
Why can dieting be unsuccesful
Consisdered individual differences | Explored portion sizes
102
4 features of addiction
Craving Tolerance Compulsive drug seeking behaviour Physiological withdrawal state
103
Acute physical effects of dependent drug use
Complications of injecting (DVT, abscesses, SBE) Overdose (respiratory depression) Poor pregnancy Side effects (contipation, low salivery flow)
104
Chronic physical effects of dependent drug use
Blood borne virus transmission Effects of poverty Side effects of cocaine (vasoconstriction, local anaesthesia)
105
Social effects of dependent drug use
Effects on families Drive to criminality Imprisonment Social exclusion
106
Psychological effects of dependent drug use
Fear of withdrawal Craving Guilt
107
Aims of addiction treatment
Reduce harm to user, family and society Improve health Stabilise lifestyle and reduce use Reduce crime
108
Modalities of addiction treatment
``` Harm reduction Detoxification Maintenance Relapse prevention Psychological interventions Alternative therapies ```
109
Which drugs are sued for detoxification for opioids
Lofexidine, buprenorphine
110
Which drugs are used for maintenance on opioids
Methadone, buprenorphine
111
Which drugs are used for relapse prevention on opioids
Naltrexone
112
Key questions for initial addiction assessment
``` Which drug Route How long addicted Pt goal ?Referral ```
113
When is quick detoxification more successful
Young user Less time addicted Not injecting Lower level of drug use
114
Drug used for quick detoxification
Buprenorphine
115
Do you get seizures in opiate or alcohol withdrawal
Alcohol
116
Heroin effects
Euphoria, relaxation, miosis, drowsiness
117
Heroin adverse effects
Dependence and withdrawal
118
Alcohol addiction drug
Chlordiazepoxide
119
Drug which makes alcohol taste bad
Disulfiram
120
Facial features of fetal alcohol syndrome
``` Low nasal bridge Epicanthal folds Minor eat abnormalities Short nose Thin upper lip Indistinct philtrum ```

Phase 3A (25 decks)

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