Pass Medicine

Question 1

What is an advance directive

Answer 1

Individual preferences with respect to medical Rx
Written when person is of sound mind
Must refer to Rx in specific circumstances
Cannot demand Rx

Question 2

Advance directive = binding unless

Answer 2

Decision withdrawn
Power to make decision conferred to another person e.g. POA
Patient has acted in a way thats inconsistent with directive
Patient able to decide for themselves
Circumstances or Rx specified do not exist or have changed

Question 3

What is POA

Answer 3

Allows person to make decisions if someone loses capacity
Health and welfare
Property and finance

Question 4

Who do you register with

Answer 4

Office of public guardian

Question 5

When are you entitled to careers allowance

Answer 5

16+
35+ hours caring 
Lived in country 2 out of last 3 years and normally live here
Not in full time education
Earn no more than 110 a week

Question 6

What is means tested

Answer 6

Carer’s allowance

110 after tax / care / pension

Question 7

What are the types of consent

Answer 7

Informed
Expressed
Implied

Question 8

When does someone have capacity

Answer 8

Able to 
Understand and retain info
Believes info to be true
Able to weight up information to make a decision 
Communicate decision

Question 9

Who can consent for minors

Answer 9

Gillick competent

Biological mother

Question 10

When can father consent

Answer 10

If named on birth certificate or if married and biological

Question 11

What are 4 types of consent form

Answer 11

1 = competent but consciousness impaired e.g. GA
2 = adult consent for child who's consciousness impaired 
3 = consciousness NOT impaired
4 = adults who lack capacity

Question 12

What are the 5 principles of adults with incapacity

Answer 12

Must assume to have capacity
Take steps to ensure decision can be made
If decision unwise doesn’t mean lack capacity
Must be done in patients best interest
Least restrictive

Question 13

What should you do to take in best interests

Answer 13

See if decision can wait till regain capacity
Encourage and optimise participation
Think of past and present wishes
Views of other

Question 14

What can a compliant be

Answer 14

Verbal
Informal
Formal to doctor 
Complaint to managing body
Complaint to GMC

Question 15

What must controlled drugs have on prescription

Answer 15

Name and address
Form, strength and preparation
Total quantity or number of dosage units to supply
Dose
Prescribers name, signature, address and date

Question 16

Schedule 1

Answer 16

Cannabis

Question 17

Schedule 2

Answer 17

Diamorphine / morphine
Amphetamine
Cocaine

Question 18

Schedule 3

Answer 18

Barbiturates
Buprenorphine
Midazolam
Gabapentin / pregabalin

Question 19

Schedule 4

Answer 19

Benzodiazepine (except midalazam) 
Zopiclone
Androgenic and anabolic steroid
HCG
Somatotrophin

Question 20

Schedule 5

Answer 20

Codeine

Oromorph

Question 21

What are controlled in BNF

Answer 21

Schedule 2+3

Question 22

How long are prescriptions valid for

Answer 22

28 days

Question 23

When do controlled prescriptions not apply

Answer 23

Schedule 4 + 5

Question 24

How is cremation form filled

Answer 24

2+ doctors identify case of death
Patients own GP or doctor looking after them
+ independent doctor with 5+ years registration
Discuss are

Question 25

What is not acceptable cause of death

Answer 25

Old age if <80 Natural causes Organ failure if can't specify why it failed

Question 26

What happens with death certificate

Answer 26

Family take it to local registrar who decides if needs reported Gives certificate of burial or cremation + registration

Question 27

What are notifiable deaths

Answer 27

``` Unexpected No doctor in last 14 days Within 24 hours of hospital Accidents Suicide Industrial injury Result of neglect During an operation or recovery Poison including illicit drugs Still birth Prisoner or police custody Service disability pensioner ```

Question 28

Who decides if CPR goes ahead

Answer 28

Senior clinical if no POA or advance directive | Views of relative, best interest + chance of recovery

Question 29

What is duty of candour

Answer 29

``` Must be honest when something goes wrong Tell patient Apologise Offer resolution Explain short and long term effects ```

Question 30

When must you not drive and notify DVLA psychiatric

Answer 30

``` Severe depression affecting memory / concentration / sucidial thoughts Acute psychosis Hypomania or mania Schizophrenia Severe disability ```

Question 31

What may you be able to drive but must notify DVLA

Answer 31

``` Pervasive development diosrdr ADHD Dementia Mild learning disability Personality disorder ```

Question 32

When do you not need to inform DVLA

Answer 32

Mild cognitive impairment

Question 33

When must you notify DVLA in regards with vision

Answer 33

Visual field defect | Monocular vision - can still drive if acuity and field normal in other eye

Question 34

GMC advice gifts

Answer 34

DO not accept if affect way prescribe, treat or refer

Question 35

GMC doctors health

Answer 35

Do not rely on own judgement of risk Assess by appropriate professional Seek and follow advise

Question 36

GMC partnership and teamwork

Answer 36

Respect skills Treat fair and with respect Communicate with colleague Talk to person involved first

Question 37

GMC must report criminal proceeding if

Answer 37

Found guilty Charged Admit to criminal offence Accept option of paying penalty for ASBO Cannabis warning Registration restricted by another medical body Conduct directly contributed to organisation entering prosecution agreement

Question 38

GNC teaching

Answer 38

Must be willing to take on mentoring role | Contribute to teaching

Question 39

What do you do if problem arises

Answer 39

Begin escalating up Colleague involved then SHO before registrar before consultant Speak to clinical supervisor

Question 40

When do you end professional relationships

Answer 40

If breakdown of trusts means cannot provide good care Includes violent/. theft / sexual advance NOT due to a complaint

Question 41

How do you end

Answer 41

``` Tell patient considering ending it Do what you can to restore Discuss with experienced colleague Must not discriminate Make sure patient is told what is happening and why ```

Question 42

GMC trust

Answer 42

Show respect Treat fair and no discrimination Act with honesty and integrity

Question 43

Social media

Answer 43

If identify as doctor identify by name

Question 44

Treating colleagues

Answer 44

Avoid prescribing for yourself or anyone with close relationships

Question 45

Responsible clinician

Answer 45

Respect wishes of any patient who objects to info being shared unless in public interest If patient objects to disclosure that is essential for safe care explain you cannot refer

Question 46

Accountabiliy

Answer 46

If delegating to junior doctor consultant is not accountable for decisions but accountable to ensure junior member is trained and experienced

Question 47

Chaperone

Answer 47

YUP

Question 48

Confidentiality

Answer 48

YUP