Health promotion

Question 1

What is the recommended alcohol limit in the UK?

Answer 1

No more than 14 units a week spread across 3 days or more.

Question 2

What is a healthy BMI?

Answer 2

18.5-25 kg/m2

Question 3

What is the recommended exercise amount of adults?

Answer 3

• Strengthening workout twice a week

- 150 mins mod intensity activity a week

Question 4

What are the stages in the Stages of Change model?

Answer 4

1. Precontemplation
2. Contemplation
3. Preparation
4. Action
5. Maintenance
6. Relapse

Question 5

What are the risks of excessive drinking?

Answer 5

• Stroke
• Heart disease
• Liver disease
• Brain damage and nervous system damage
• Oral, oesophageal/pharyngeal and breast cancer
• Mental health effects

Question 6

What is single session drinking? What are the risks?

Answer 6

Binge drinking

• Accidents/injuries, risky behaviour
• Vomiting while unconscious
• Hypertension and heart attack
• Gastritis, pancreatitis, encephalitis
• Alcohol poisoning - seizure, V, low RR
• More likely to develop drinking problem and alcoholism

Question 7

What drugs shouldn’t you drink alcohol with?

Answer 7

• Sedatives eg. diazepam, increase risk of overdose and resp depression
• Analgesics (all), liver damage, GI problems and PUD, resp depression
• Antidepressants - worse sx and drowsy
• Anticoag - increase risk of bleed
• Antihyperglycaemic - drunk can mimic hypoglycaemia
• Anticonvulsants - increased drowsiness
• Antihypertensives - long term drinking increases BP

Question 8

What is the advise around alcohol and pregnancy?

Answer 8

Should never use alcohol while pregnant = foetal alcohol spectrum disorder, miscarriage, premature birth and low birth weight.

Question 9

What is the advice for older people and drinking?

Answer 9

Older people more likely to take medication (interaction) and aren’t able to breakdown alcohol as efficiently.

Question 10

What is a CAGE questionnaire?

Answer 10

Used to assess whether a person engages in harmful drinking and if they are alcohol dependent:
Feel should Cut down
Annoyed by criticism of drinking
Guilt
Eye opener - had drink first thing in the morning?

Question 11

When would you recommend structured community based intervention for alcohol reduction?

Answer 11

People w alcohol dependence who:

• Limited social support
• Physical or psychiatric comorbidities
• Not responding to other interventions

Question 12

When would you offer psychological intervention for someone w alcohol dependence? What do you offer?

Answer 12

For harmful drinkers w mild alcohol dependence offer:

• CBT
• Behavioural therapies focused on alcohol problems
• Couples therapy

Question 13

What are the signs and sx of Wernicke’s encephalopathy?

Answer 13

Ataxia (can’t coord voluntary movement). confusion and mental state alt and eye problems eg. paralysis, nystagmus

Question 14

What are Wernicke and Korsakoff syndromes?

Answer 14

Due to deficiency of thiamine/VitB1.

Wernicke’s is more acute, if untreated transitions to Korsakoff which is irreversible and chronic.

Question 15

How is Korsakoff syndrome characterised?

Answer 15

Short term memory loss = can’t form new memories or retain new info

Question 16

How is Wernicke’s managed?

Answer 16

Parentral thiamine (usually IM), plus Vit B12 and folate orally.

Question 17

What are the w/drawal symptoms for smoking?

Answer 17

• Weight gain due to increased appetite, usually about 5-9 kg if no attempt to exercise or eat healthy
• Irritability, depression, restlessness
• Poor conc
• Disturbed sleep

Question 18

What is VBA in smoking?

Answer 18

Very brief advice:

• Current and past smoking behaviour
• Info about risks of smoking and benefits of stopping
• Options for quitting
• Refer to local smoking cessation service

Question 19

What options of there for quitting smoking?

Answer 19

• Non pharmacological - NHS stop smoking services

- Pharamcological - NRT, bupropion, varenicline

Question 20

What are the recommended calorie intakes in men and women?

Answer 20

Women - 2000

Men - 2500

Question 21

What groups are at risk of substance abuse?

Answer 21

• FH substance abuse
• Childhood sexual abuse
• Mental health issues
• Problem w sexual orientation/gender identity
• Low academic achievement

Question 22

When is it important to ask about recent drug use?

Answer 22

• Acute chest pain in young person
• Acute psychosis
• Mood and sleep disorders

Question 23

What is harm reduction?

Answer 23

People will continue using drugs, a why to reduce the harm they get because of drug use:

• Needle exchange
• Drug testing in clubs and at festivals
• Info for safer drug use
• Drug consumption rooms

Question 24

What is methadone?

Answer 24

Long acting synthetic opioid - used for treating opioid dependence. Normally viscious oral solution (can’t be injected)

Question 25

What is bupenorphine?

Answer 25

Partial agonist properties and antagonists properties. Will block the effects of additional opioids. Better than methadone as can't use heroin on top and gives you a clearer head.