Public Health Flashcards
(80 cards)
1
Q
what is public health?
A
the science and art of promoting and protecting health and well-being, preventing ill-health and prolonging life through organised efforts of society
2
Q
what are the health consequences of smoking cessation?
A
- COPD
- cancers
- cardiovascular disease
3
Q
how might we affect change to promote healthy behaviours? (smoking cessation)
A
- smoking ban
- increased taxation on cigarettes
- plain packaging campaign
- highlighting dangers/inc awareness of second hand smoke
- incentivise quitting by educating damage caused by smoking
- supporting people to quit
4
Q
8 hours after quitting
A
nicotine and CO2 levels in blood reduce by more than half
5
Q
48 hours after quitting
A
lungs start to clear out smoking debris
6
Q
72 hours after quitting
A
breathing = easier
7
Q
2-12 weeks after quitting
A
circulation improves
8
Q
3-9 months after quitting
A
coughing & wheezing = reduced
9
Q
1 year after quitting
A
risk of heart disease reduces by about 1/2
10
Q
10 years after quitting
A
risk of lung cancer falls to half that of smoker
11
Q
15 years after quitting
A
risk of heart attack falls to same as someone who has never smoked
12
Q
reducing nicotine intake in smokers causes withdrawal symptoms.
what are the short-term withdrawal symptoms?
A
- light headedness
- difficulty concentrating
- sleep disturbance
- depressed mood
- irritability
- restlessness
13
Q
reducing nicotine intake in smokers causes withdrawal symptoms.
what are the long-term withdrawal symptoms?
A
- inc appetite
- weight gain
- constipation
- mouth ulcers
14
Q
how long do most withdrawal symptoms last?
A
up to 4 weeks
15
Q
how long can the urge to smoke continue for after quitting?
A
more than 10 weeks
16
Q
nicotine replacement therapy (NRT)
A
- facilitates gradual withdrawal of nicotine
- based on level of dependence and habits
- mainly chosen based on patient preference
- ideally used in conjunction with psychological support
- counselling received
17
Q
nicotine replacement therapy (NRT) products?
A
- chewing gum
- lozenges
- sublingual tablets
- transdermal patches
- inhalator
- nasal spray
- oral spray
18
Q
what are the points to consider when choosing NRT products?
A
- doses
- strength
- flavours
- length of duration
- onset time
- side effects
- compatibility with patient
- ad/disad
19
Q
NRT behavioural support?
A
- imp in combination with all pharmacological treatments
- programme of 12 weeks
consultation with trained adviser every 1-2 weeks inc:
- info on consequences of smoking
- info on withdrawal symptoms
- assess current readiness to quit and past attempts to quit
- setting quit date and prep for stopping smoking
- CO testing
- addressing any slips
- imp of abstinence and ‘not a puff’ rule
- support development of coping mechanisms and relapse prevention
20
Q
what score would you give a person who smokes within 5 mins of waking up?
A
3 (low to moderate dependence)
21
Q
what score would you give a person who smokes between 6-30 mins of waking up?
A
2 (low dependence)
22
Q
what score would you give a person who smokes between 31-60 mins of waking up?
A
1 (low dependence)
23
Q
what score would you give a person who smokes 60 mins after waking up?
A
0
24
Q
what score would you give a person who smokes 10/less cigarettes a day?
A
0
25
what score would you give a person who smokes 11-20 cigarettes a day?
1 (low dependence)
26
what score would you give a person who smokes 21-30 cigarettes a day?
2 (low dependence)
27
what score would you give a person who smokes 31 or more cigarettes a day?
3 (low to moderate dependence)
28
what does the score of 4 represent in the heaviness of smoking index?
moderate dependence
29
what does the score of 5-6 represent in the heaviness of smoking index?
high dependence
30
what does the carbon monoxide test measure?
quantity of CO in expired air
31
what is the CO test used to assess?
- nicotine independence
| - used at initial assessment and to validate quit status after 4 weeks
32
what does the CO test involve?
clients hold breath for 15-20 seconds then blow into detector
33
what level of CO should non-smokers have?
less than 10ppm
34
false positives can include what in CO testing?
CO poisoning
35
what does the CO test only represent?
smoking activity over previous 24 hours
36
16 hour smoking patches
- put on in morning and take off before bed
used most commonly for those who don't smoke after waking up
37
posology of 16 hour patches
- begin with 25mg for those smoking more than 10 per day
- begin with 15mg for those smoking less than 10 per day
don't begin with 10mg patch
38
24 hour smoking patches
- worn for 24 hours then replace
used for those who smoke during night/immediately after waking
CAN CAUSE NIGHTMARES
39
posology of 24 hour smoking patches
- begin with 21mg for those smoking 10 per day
- begin with 14mg for those smoking less than 10
don't begin with 7mg patch
40
when are quit rates higher?
when using second NRT product
prod that satisfies cravings during day:
- lozenges
- gum
- microtabs
41
some patients don't like the idea of wearing a patch and prefer only a product to deliver a dose of nicotine when they want it.
give examples of products that can satisfy this?
- quickmist oral spray
- nasal spray
- inhilator
42
BMI values?
```
<18.5 - underweight
18.5-24.9 - normal weight
25.0-29.9 - overweight
30.0-34.9 - class I obesity
35.0-39.9 - class II obesity
> or equal to 40 - class III obesity
```
43
BMI = ...
weight (kg) / height (m2)
44
what are the main causes of obesity?
- poor diet
| - physical inactivity
45
what are the risk factors of obesity?
- parental obesity
- inactive pursuits
- low socio-economic status
46
what contributes to the risk of developing obesity?
- pregnancy
- stages of life
- learning disabilities
- physical disability
- poverty
- smoking cessation
- ethnicity
47
what are the causes of obesity?
- lack of exercise
- poor diet
- calorie imbalance
- medical conditions
- genetics
- social changes
- alcohol
- anti-depressants
- convenience foods
48
what dietary advice can you give to patients who are suffering from obesity?
- lots of fruit and veg (5 a day)
- eat fish (2 portions a week - one oily)
- reduce saturated fat intake: 30g/men, 20g/women
- reduce sugar intake: >22.5g/100g = high content
<5g/100g = low content
- wholegrain food = better
- less salt - max 6g/day
- get active
- 6-8 glasses a day of water
- avoid missing breakfast
49
why should you avoid getting thirsty?
avoids dehydration and aids digestion
50
why should you avoid missing breakfast?
replenish body's low blood sugar
51
what is orlistat used for?
xenical (POM)
alli (OTC)
decreases amount of dietary fat absorbed in intestines
52
when is orlistat used?
when BMI > 30 or BMI > 28 with other weight-related conditions (diabetes, hypertension)
53
direction of usage for orlistat?
- 1 TID with meals
- over 18 years
- s/e: oily stools, needing toilet more frequently, flatulence, stomach pain
54
what is bariatric surgery only used for?
severe obesity
- BMI > 40 or BMI > 35 with other weight-related conditions
- all other measures tried and failed
- patient fit enough for anaesthesia and surgery
55
what are the most common bariatric surgery procedures?
gastric band - reversible
| gastric bypass - irreversible
56
weight management services
- make advice relatable
- involve family and friends
- non-discriminatory
- take patients height, weight and calc BMI
57
what is blood pressure?
pressure exerted by blood against walls of blood vessels
58
systolic =...
higher pressure when heart beats
59
diastolic =..
lower pressure in between heart beats
60
what affects the systolic and diastolic values?
- efficiency of hearts pumping action
- vol of blood in body
- elasticity of arteries
- viscosity of blood
61
hypertension systolic and diastolic values?
systolic > 140mmHg
| diastolic > 90mmHg
62
stage 1 hypertension
blood pressure is 140/90 mmHg or higher
63
stage 2 hypertension
blood pressure is 160/100 mmHg
64
what is ABV or alcohol by volume?
standard measure of how much alcohol contained in given vol
65
it takes an average adult around how long to metabolise and eliminate 1 unit of alcohol?
1 hour
66
how much is a UK unit of alcohol?
10ml
67
what are the short term risks of alcohol abuse?
- accidents/injuries
- alcohol poisoning
- memory loss
68
what are the long term risks of alcohol abuse?
- liver disease
- cardiovascular disease
- cancers
- social problems
69
how to discourage alcohol abuse?
- raise awareness of damage e.g. change4life
- gov through inc taxation
- support people to modify drinking behaviour
70
opioid dependence signs?
- strong desire/ sense of compulsion to take substance
- difficulty in controlling use
- neglect of alternative pleasure and interests
71
how rapidly can dependence occur?
2-10 days
72
what is methadone?
synthetic opiate agonist
73
what is the half life of methadone?
24-36 hours
74
give examples of methadone side effects?
- fluid retention
- euphoria
- sedation
- blurred vision, dry eyes
- vertigo
- nausea, vomiting
- constipation
- transient rash
- sweating
- fatigue
- weight inc
75
what are fatal doses of methadone?
30mg to non-tolerant adult
5mg to child
76
methadone initial doses
- initial dose between 10-30mg daily
- may take between 5-7 days for full effect
- increase slowly
during initial 2 weeks of treatment, clients are at particular risk of overdose
77
for most clients what is the methadone maintenance dose?
60mg-120mg daily
78
methadone overdose symptoms?
- respiratory depression
- maximally constricted pupils
- skeletal muscle flaccidity
- cold, clammy skin
- bradycardia
- hypotension
79
what are the SEVERE methadone overdose symptoms?
- apnoea
- circulatory collapse
- cardiac arrest
- death
80
what do you do if a person has missed a methadone dose?
- patient may lose tolerance and usual dose —> overdose
- contact prescriber to discuss appropriate steps
- prescriber may restart patient with initiation dose
