Public Health & Critical Numbers

Question 1

What is the definition of distress?

Answer 1

Negative, damaging and harmful

Question 2

What is the definition of eustress?

Answer 2

Positive, beneficial and motivating

Question 3

What are the 5 responses to stress?

Answer 3

Biochemical (altered hormone levels)
Behavioural (smoking and alcohol)
Cognitive (-ve thoughts, poor concentration)
Emotional (tearful, mood swings, irritable)
Physiological

Question 4

What are some chronic stressors?

Answer 4

Relationships
Unstable finances
Lack of friends
Poor physical health

Question 5

What are some of the migrating factors for stress?

Answer 5

Social support
Beliefs
Personality
Lifestyle

Question 6

Give three examples of how people can be encouraged to stop smoking

Answer 6

Taxation
Banning smoking in public places
Cessation services

Question 7

List 4 types of economic evaluation

Answer 7

Cost minimisation analysis
Cost effectiveness analysis
Cost utility analysis
Cost benefit analysis

Question 8

How do you calculate incremental cost ratio?

Answer 8

Incremental cost = new treatment cost – old treatment cost

Question 9

How do you calculate the effectiveness ratio?

Answer 9

Efectiveness ratio = incremental cost/difference in QALY (where QALY = years increase x utility time)

Question 10

Define prevalence

Answer 10

The number of cases of a disease that are present in a particular population at a given time

Question 11

Define incidence

Answer 11

The number of new cases that develop in a given period of time

Question 12

Define absolute risk

Answer 12

The changing in risk of an outcome of a given treatment of activity in relation to a comparison treatment or activity

Question 13

Define relative risk

Answer 13

Ratio of the probability of an event occurring (e.g. developing a disease) in an exposed group to the probability of the event occurring in a comparison, non-exposed group

Question 14

Define prevention paradox

Answer 14

Contradictory situation where the majority of cases of a disease come from a population at low or moderate risk of that disease, and only a minority of cases come from the high risk population

Question 15

Define inverse care law

Answer 15

The availability of good medical or social care tends to vary inversely with the need of the population served

Question 16

What is the equation for BMI?

Answer 16

Weight / height^2

Question 17

Define reverence probability

Answer 17

Probability of disease in the entire population at any point in time

Question 18

Define incidence probability

Answer 18

Probability that a patient without disease develops the disease during an interval

Question 19

Define sensitivity

Answer 19

Probability of a positive test among patients with disease

Question 20

Define specificity

Answer 20

Probability of a negative test among patients without disease

Question 21

Define incidence rate

Answer 21

Number of new gases per population at risk in a given time period

Question 22

Define rate ratio

Answer 22

Compare the incidence rates of events occurring at any given point in time

Question 23

What is the 95% confidence interval?

Answer 23

95% certain that the true result mean falls within the range of X & Y

Question 24

Define odds ratio

Answer 24

The odds that an outcome will occur given a particular exposure, compared to the odds of the outcome occurring in the absence of that exposure

Question 25

What is the doctrine of dual effect?

Answer 25

Aim to do good | increase QALY, decrease total years

Question 26

What are the 5 types of variables?

Answer 26

Nominal - two or more categories Binary - only take two values Discrete - can only take on finite number of values Continuous - any value between min & max Ordinal - order matters but not difference between values

Question 27

What is statistical significance?

Answer 27

P<0.05 | Reject null hypothesis

Question 28

What is clinical significance

Answer 28

Defined by the smallest clinically beneficial & harmful values

Question 29

What is the top down deductive?

Answer 29

One specific ethical theory is consistently applied to each problem

Question 30

What is the bottom up inductive?

Answer 30

Using past medical problems to create guides in practice

Question 31

What are 2 other ethical arguments?

Answer 31

An approach where theories are considered which best fit one’s own beliefs before applying. Analogies can also be used

Question 32

What are the 4 ethical principles?

Answer 32

Autonomy Beneficence Non-maleficence Justice

Question 33

What is utilitarianism?

Answer 33

Act is valued in terms of its consequences/effect | Many not few

Question 34

What is deontology?

Answer 34

The act itself determines the worthiness | Characteristics that a doctor should have (compassion, discernment, trustworthiness, integrity, conscientiousness)

Question 35

What are virtue ethics?

Answer 35

Focuses on the character of the person who is doing the act

Question 36

What are 5 GMC duties of a doctor?

Answer 36

Protect & promote health of patients & public Provide good standard of practice & care Recognise & work within limits of competence Work with colleagues in the ways that best serve patients' interests Treat patients as individuals & respect their dignity

Question 37

What is the gini coefficient?

Answer 37

Statistical representation of nation's income distribution among its residents (smaller less equality)

Question 38

What is social class?

Answer 38

Measure of occupation, stratification, social position & access to power & resources

Question 39

What are the key challenges of an ageing population? (5)

Answer 39

``` Strains on pension & social security systems Increasing demand for healthcare Bigger need for trained health workforce Increasing demand for long term care Pervasive ageism ```

Question 40

What are 5 reasons for smoking?

Answer 40

``` Nicotine addiction Coping with stress Habit Socialising Fear of weight gain ```

Question 41

Stages of change model (6)

Answer 41

1) pre-contemplation 2) contemplation 3) preparation 4) action 5) maintenance 6) relapse

Question 42

What are the 3 types of human error?

Answer 42

Omission Commission Negligence

Question 43

What is the healthy BMI range?

Answer 43

18.5-24.9

Question 44

What are some causes of obesity?

Answer 44

Physical Socio-cultural Economic

Question 45

What is opportunity cost?

Answer 45

The next best alternative forgone

Question 46

What is the equation for sensitivity?

Answer 46

Number of true positives/all with disease (TP and FN)

Question 47

What is the equation for specificity?

Answer 47

Number of true negatives/all without disease (FP and TN)

Question 48

What is the equation for the probability of it being a case? (Pe)

Answer 48

Exposed case / all exposed

Question 49

What is the equation for the probability of it being a case? (Pne)

Answer 49

Not exposed case / all not exposed

Question 50

What is the equation for the odds of a case? (Oe)

Answer 50

Exposed case / exposed non case

Question 51

What is the equation for the odds of a non case? (One)

Answer 51

Not exposed case / not exposed not case

Question 52

What is the equation for the absolute risk difference?

Answer 52

Pe-Pne

Question 53

What is the equation for the risk ratio/relative risk?

Answer 53

Pe/Pne

Question 54

What is the equation for the odds ratio?

Answer 54

Oe/One

Question 55

What is the equation for the positive predictive value?

Answer 55

true positives / all positives

Question 56

What is the equation for the negative predictive value?

Answer 56

true negatives / all negatives

Question 57

What is the equation for probability?

Answer 57

number of cases/total population

Question 58

What is the equation for odds?

Answer 58

number of cases/number of non-cases

Question 59

What is the equation for prevalence proportion?

Answer 59

number of existing cases at time t / total population size at time t

Question 60

What is the equation for incidence proportion?

Answer 60

number of new cases during period / size of population at risk at start of period

Question 61

What are the 2 main types of quantitative study designs?

Answer 61

Experimental (clinical); assign exposures | Observational (epidemiological)

Question 62

What are the 2 types of experimental study?

Answer 62

Randomised control trials | Non-randomised (quasi-) experiments

Question 63

What are the 2 main types of observational study?

Answer 63

Analytical (comparison group) | Descriptive (no comparison group)

Question 64

What are 4 types of descriptive study?

Answer 64

Case reports Case series Cross sectional Ecological studies

Question 65

What are the 3 types of analytical studies?

Answer 65

Cohort (exposure > outcome) Cross-sectional (exposure <> outcome) Case-control (outcome > exposure)

Question 66

Define standard deviation

Answer 66

Measure of the variability in the data

Question 67

Define standard error

Answer 67

Standard deviation of repeated samples from a population

Question 68

What is conditional probability? P(A|B)

Answer 68

Probability that event A will happen given that some other event B has already occurred

Question 69

What is the length time bias?

Answer 69

Diseases with a longer duration are more likely to be captured in prevalence

Question 70

What is the number needed to treat?

Answer 70

Number of people you need to treat in order to prevent one outcome