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Flashcards in other qs Deck (23):
1

A few weeks later, Lisa (pregnant) tells the GP that her partner Martin has left her, but he still turns up at her house late at night at the weekend after drinking with his friends. He is usually drunk, often upset and occasionally angry.

Are there any issues that the GP would note here? Which other health professional might the GP liaise with to get a better picture of the home situation? (Name one issue and one Health Professional)

Potential for gender based violence (domestic abuse)
Might be Child Protection issues at a later date?
The Health Visitor (regular contact with families of pre-school children)

2

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)

3

How might changes in cultural perceptions of normality have led to the observed statistical differences

● the fact that people see more obese people shifts their notion of what is normal; it becomes accepted, and normal, to eat eat more junk food, take less exercise etc
● thus being obese becomes normal; obesity may be perceived to be related to affluence or attractiveness or health

4

How might obesity affect an individual's health (3)

● psychological = reduced self-esteem
● physical = difficult to move or keep fit
● social = ostracization by peers

5

what do we mean by gatekeeper?

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

6

list 2 advantages of GPs as gatekeepers

○ keep people out of expensive secondary care
○ continuity of the doctor-patient relationship
○ personal advocacy
○ patient does not know where to go / appropriate referral / use of resources

7

list 2 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

8

Social class is a form of social stratification. The most common occupational classification currently in use, and used in Britain since the 1911 Census has 6 social classes. List these 6 social classes (6 marks):

● professional
● managerial & technical
● skilled non-manual
● skilled manual
● partly skilled
● unskilled

9

What are the three models of stress?

engineering model
medico-physiological model
psychological or transactional model

10

briefly describe the engineering model

● stress acts as a stimulus which the individual must resist
● if the stimulus becomes too intense or prolonged, the individual breaks

11

define incidince

number of new cases of a disease in a population in a specified period of time

12

prevalence

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

13

describe guidance/cooperation consultation

● 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

14

Define the different tyoes of qs that can be asked in a consultation and explain what it means briefly

● 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

15

Not all communication is verbal. List 2 different ways in which the doctor can facilitate the interview in a nonverbal way

● listening
● use of silence
● posture
● body language
● specific gestures
● facial expressions
● eye contact
● layout of room (not talking across desk)
● staying in room (not leaving to take a phone call)

16

Approximately how many patients are registered on average with each GP in the NHS in the UK (1 mark):

● 1200-2000 patients each

17

Approximately what percentage of illnesses presenting to primary care are referred on to secondary care (1 mark)

● 3% (accept 2-5%)

18

List 4 aspects of health which are likely to be worse for children (of all ages) living in the most deprived areas compared to those living in the least deprived areas (4 marks):

● lower birth weight
● less likely to benefit from breastfeeding in infancy
● poorer dental health
● higher rates of obesity
● more likely to take up smoking

19

Lay beliefs about health are influenced by a number of factors. List 4 factors which influence lay beliefs about health AND give an example of how each of these factors may influence lay beliefs about health (8 marks):

● age = older people concentrate on functional ability whilst younger people tend to speak of health in terms of physical strength and fitness
● social class = people living in difficult economic and social circumstances regard health as functional (ability to be productive, take care of others)
● gender = men and women appear to think about health differently (women may find the concept of health more interesting, women include a social aspect to health)
● culture = different perceptions of illness / disease, differences in concordance with treatment

20

List 3 different routes via which someone may be exposed to a hazardous substance (other than via skin) (3 marks):

● blood
● sexual contact
● ingestion
● inhalation

21

List 5 potential difficulties which may arise when consulting with a patient from a different culture (5 marks):

● lack of knowledge about the NHS/UK healthcare system
● lack of knowledge about common health issues / different health beliefs
● fear and distrust
● racism
● bias and ethnocentrism
● stereotyping
● language barriers
● presence of a 3rd party (family member / translator)
● differences in perceptions and expectations between patient and doctor
● examination taboos
● gender difference between doctor and patient
● religious beliefs
● difficulties using language line
● patient may not be entitled to NHS care

22

Pyrexia is a common reason for a child in the UK seeing their GP and / or health visitor. List 4 other common reasons for a child (of any age) in the UK seeing their GP and or health visitor (4 marks):

● feeding problems (newborns)
● URTIs / colds / coughs
● rashes
● otalgia
● sore throat
● vomiting + / - diarrhoea
● abdominal pain
● behavioural problems
● anxiety regarding milestones / developmental delay

23

Education is one, List 4 other social influences on health (4 marks

● gender
● ethnicity
● housing
● employment
● financial security
● health system
● environment
● social class