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MD2002 > PRACTICE OF MEDICINE > Flashcards

PRACTICE OF MEDICINE Flashcards

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1
Q

The difference between screening and diagnostic testing?

A

Normal/negative result on screening down no equal disease-free necessarily

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2
Q

What does the term sensitivity mean regarding screening?

A

how well the test picks up having the disease

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3
Q

What does the term specificity mean regarding screening?

A

how well the tests detects not having the disease

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4
Q

Sensitivity formula=

A

(no. of correctly identified diseases/no. of disease cases) x 100

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5
Q

Specificity formula=

A

(no of normals correctly detected/no of normals in total) x 100

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6
Q

What is positive predictive value and what is it’s formula?

A

How reliable the test is at showing disease is present

(no of correct positive results/total no of positive results) x 100

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7
Q

What is negative predictive value and what is the formula?

A

How reliable the test is at showing the disease is not present
(no of correct negative results/total no of negative results) x 100

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8
Q

Advantages of screening? Name 3

A
  • Reduced disease incidence
  • Reduced disease mortality
  • Overall population benefit
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9
Q

Disadvantages of screening? Name 3

A
  • False reassurance
  • Anxiety
  • Harm from screening test
  • Opportunity costs
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10
Q

Gold standard way of measuring effectiveness?

A

Randomised Controlled Trial (RCT) obby

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11
Q

What is the formula for measuring coverage?

A

(screened population/ eligible population) x 100

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12
Q

What is the formula for measuring uptake?

A

(screened population/invited population) x 100

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13
Q

Challenges with optimising coverage? (why a population in general doesn’t go to screenings?)

A
  • Minority ethnic groups
  • Immigrants
  • Travellers
  • Prisoners
  • Students
  • Reduced uptake
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14
Q

Challenges with optimising uptake? (why people that are invited to be screened don’t go?)

A
  • Change of address
  • Communication
  • Health literacy
  • Deprivation
  • Accessibility
  • Vulnerable groups
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15
Q

What are the 4 methods of abortion?

A
  1. Medical
  2. Vacuum aspiration/suction
  3. Surgical D&E
  4. Late abortions
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16
Q

How many weeks of gestation are the different methods of abortion specific for?

A

Medical- up to 13 weeks
Vacuum aspiration/suction- from 7 to 15 weeks
Surgical D&E- 15 weeks onwards
Late abortions- 20 weeks onwards

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17
Q

Active euthanasia, what is it?

A

X performs an action which itself results in Y’s death

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18
Q

What is passive euthanasia?

A

X allows Y to die. X withholds life prolonging treatment or withdraws life-prolonging treatment

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19
Q

What is voluntary euthanasia?

A

Euthanasia when Y competently requests death himself

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20
Q

Non-voluntary euthanasia, what is it?

A

Euthanasia when Y is not competent to express a preference

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21
Q

Involuntary euthanasia, what is it?

A

Death is against Y’s competent wishes, although X permits or imposes death for Y’s benefit

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22
Q

What is incidence?

A

Incidence: the rate at which new cases occur in a population during a specific period

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23
Q

What is prevalence?

A

Prevalence: the proportion of a population that are cases at a point in time

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24
Q

What is period rate?

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A

(Number of people with outcome at a point in time)/ (number of people in group)
x100

25
What is a case-control study?
Case-control study; the cases (have the outcome) and control (doesn’t have the outcome) are compared. Observational --> individual --> analytic
26
What is a cohort study?
Cohort study: prospective (looking into the future) OR retrospective (looking back in time). Follow-up populations relating information on risk factor and health states to the outcome of interest Observational --> individual --> analytic
27
What is a randomized control trial?
RCT- individuals are randomly allocated to two groups undergoing two different treatments and effect is followed up. -->Experimental
28
What is a case series?
Cases series: a series, often consecutive, of cases with the same disease Observational --> Individual --> descriptive
29
What is cross-sectional survey
Cross-sectional survey: study health and disease states in a population/populations at a defined place and time. Observational --> Individual --> descriptive
30
What is an ecological study/population case-series?
``` Ecological studies (population case-series): The unit of study is a population (not an individual). Good for study of signs/symptoms and creating disease definitions and foundations for other studies. Observational --> populations --> descriptive ```
31
What are the three main sources of major/minor life events?
Individual, family and society
32
What systems are impacted by major/minor life events?
Physiological system: sympathetic nervous system, endocrine system, heart rate, breathing, muscles Psychological aspect: Cognitive functioning (memory, attention) and emotion Social aspect: Social behavior
33
What is the main method of assessment of major/minor life events?
Social Re-adjustment Rating Scale | SRRS
34
Name 3 strengths and weaknesses of the SRRS?
``` Strengths: Quick and easy to complete Wide range of events Values assigned to events based on broad sampling Weaknesses: Events are vague Causality? Failure to distinguish between desirable/undesirable ```
35
What are the two methods for assessing the effects of daily hassles and how do they differ?
Hassles Assessment Scale for Students (HASS): Score allocated to hassle associated with health status. Is a strong predictor of psychological and physical well being Uplifts Scale: Positive events that brings satisfaction e.g. completing a task. Has little association with health status.
36
What is the advised limit for men and women's alcohol consumption?
14 units
37
How many units are women told not exceed in a day?
No units
38
How many ml's of pure alcohol is a unit?
10ml
39
What is the equation to calculate the number of units in alcohol?
No. of units= No. of litres x %strength
40
Name 4 of the actions taken by the World Health Assembly to reduce the harmful use of alcohol
1. Drink-driving policies and countermeasures 2. Pricing policies 3. Reducing the negative consequences of drinking and alcohol intoxication 4. Availability of alcohol marketing of alcohol beverages
41
Define coping
Process by which people manage the perceived demands of a situation and the resources available as they appraise a situation
42
What are the two forms of coping? And how do they differ?
Problem focused: Reduce demands of situation or expand resources to deal with it. Emotion focused: Focus on controlling emotional response to situation Emotion focused is used when people feel they can do nothing to change the situation
43
What are the 4 types of illness coping strategies? (Hint: DARN)
Denial: denies existence of symptom Accommodation: acknowledges, deals with problem Resignation- Becomes consumed by illness Normalising- Interpret symptoms as normal experience
44
Name 3 examples of coping resources?
Money Social support Personality
45
How does the COPE method assess coping?
Assesses what individuals do and feel when they experience stressful situations in 13 different scales (e.g. active coping, seeking emotional support)
46
How does social support influence health?
Buffering effect and direct effect
47
What is the buffering effect? Give examples
A way that social support influences health. Protects the individual against the negative effects on health when the stressor is strong. Eg: Enhances resources, enables reappraisal
48
What is the direct effect? Give examples
A way that social support can influence health Is beneficial to health and well-being regardless of degree of stress E.g.: healthier lifestyle, positive outlook
49
When is social support not beneficial? (4)
When it is not perceived as supportive When it encourages a damaging lifestyle When is does not match needs When is reduces self-esteem
50
What are the 3 theories for stress?
Stimulus: Environment is the cause of stress, stressors Response: Individuals reaction to stressors. The psychological and physiological response, responses are known as "strain" Transaction: Focus is on stress as a process of stressors and strains, with continuous interactions and adjustments.
51
What is stress?
The perceived discrepancy between demands of the situation and the resources of the person that they appraise in a stressful situation.
52
What is the acute and chronic physiological system response to stress?
Acute: Fight or flight Chronic: General adaptation syndrome
53
What are the two responses to stress?
``` Sympathetic activation HPA activation (Hypothalamic-Pituitary- Adrenocortical) ```
54
How does "sympathetic activation" respond to stress?
The sympathetic nervous system is activated and catecholamines (adrenaline and noradrenaline) are produced. Quick response system
55
How does HPA activation respond to stress?
Increased levels of corticosteroids (e.g. cortisol) Raised levels of brain opoids, beta endorphin and enkapthalin Slower response system
56
How does stress alter CV reactivity?
The release of corticosteroids and catecholamines promotes atherschlerosis. Consequently tachycardia and hypertension develop
57
Name 3 benefits of increasing physical activity
Reduces CHD risk Anti-depressive Increases mental health
58
What are the recommendations for exercise for 19-64yr olds?
30mins x 5 per week at moderate intensity | 20 mins x 3 per week at vigorous intensity
59
What are the exercise recommendations for 64+ yr olds?
Strengthening | Balance + coordination

MD2002 (7 decks)

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