Yr 3 Case study

Question 1

discussing risk with a pt - 2 different types

and the more important type

how to communicate risk

Answer 1

actual + relative

actual more important

communicate verbally with statistics + illustrations

Question 2

kinds of studies? presented to its

Answer 2

cohort studies
RCTs
descriptive studies 
cross sectional studies 
case control studies

Question 3

when a study describes the tendency to select preferentially from a group

Answer 3

bias

Question 4

one variable increased in one group but not the others

Answer 4

confounding factor

Question 5

unsure if practise following guidelines?

Answer 5

perform an audit

Question 6

headings for an audit

Answer 6

reason 
criteria measured 
standards set 
prep + plannings 
results + data collection 
description of change implemented 
results + data collection two 
reflections

Question 7

model when trying to quit smoking

Answer 7

stages of change model

Question 8

steps of change model

Answer 8

pre contemplation
contemplation
action
maintenance - maintaining it or regression

Question 9

define health promotion:

Answer 9

1) Any planned activity designed to enhance health or prevent disease
2) The process of enabling people to increase control over, and to improve, their
health. Applied to a wide range of approaches to improving health of people,
communities and populations.
3) An over-arching principle/activity which enhances health and includes disease
preventing health education and health protection. It is usually planned but may be opportunistic, e.g. in a GP consultation

Question 10

3 theories of health promotion

Answer 10

1. educational: knowledge to rate informed health choices: can be one-to-one or group
2. socioeconomic: national policies to make being healthy an easy choice
3. psychosocial: whether individual is ready to change

Question 11

funding of group session on smoking cessation - type of health promotion?

Answer 11

education

Question 12

smoking cessation education - form of prevention?

Answer 12

primary prevention - preventing onset of illness

Question 13

example of secondary prevention?

Answer 13

screening

Question 14

criteria that lists the appropriateness of a screening programme?

Answer 14

wilson + Jungner’s criteria

Illness - understand
test - easy, acceptable, cost effect, spec + sens
testment - acceptable, cost effective, better if early

Question 15

diagnosis + prognosis if sharp lower back pain on physical activity

Answer 15

mechanical low back pain

rest, pain killers, mobilise

Question 16

back pain - had OTC drugs - unsure if he can work - you’re a GP - what can you offer?

Answer 16

• different analgesia
• Med 3 Fit Note: alter duties, adaptations
• referral to physio

Question 17

‘sick’ pt remaining at home - not distressed - what role is he adopting?

Answer 17

the sick role

expectation that they will get well and return to work

Question 18

sketch pop for
1950
2000
2050

Answer 18

1950: pyramid
2000: fat ice cream cone
2050: slim ice cream cone with a bulge of ice cream

Question 19

2 consequences of changes to population pyramids

Answer 19

• ageing pop with disease + care needs

- fewer younger people to pay taxes+ support the country/older pop

Question 20

by 2050 - pop >80yo set to rise compared to 2000

Answer 20

4 fold

Question 21

co-existence of two or more long term conditions in an individual

Answer 21

co-morbidity

Question 22

problems of NSAIDs - if IHD

Answer 22

diclofenac has a detrimental effect on IHD + BP + renal function + irritates the stomach

Question 23

problems of a drug having risk + prescribing

Answer 23

ask pt’s thoughts about risk

present risk + see what they decide.

or tailor meds - give a topical cream that will have less side effects

Question 24

a plan that avoids predictable admissions?

Answer 24

an anticipatory care plan

Question 25

what does an anticipatory care plan promote?

Answer 25

promotes discussion - where individuals, care providers + relatives - make decisions about future health, personal, practical aspects of care

Question 26

anticipatory care plan include?

Answer 26

power of attorney contact details of fam strategy to manage care outwith hospital resus status details for out of hours team

Question 27

modifications to the NHS to improve environmental sustainability?

Answer 27

``` local food suppliers teleconferencing car pooling / sharing hybrid vehicles NHSG mini buses reward multiple vehicle occupancy facilities for cyclists promote bus links ```

Question 28

if house bound - care at home? who coordinates this?

Answer 28

care manager - advice on care packages - costs of care - sheltered housing

Question 29

Members involved in terminal care after discharge and their roles

Answer 29

- OT: mobility around the house, environ, aids - care manager: financial aid, carers - macmillan nurse: palliate symptoms, support - GP: coordination of care, meds - district nurse: administer meds, wounds, bedsores - pharmacist: provides meds

Question 30

scale to monitor changes in palliative conditions

Answer 30

palliative performance scale

Question 31

factors contributing to a good death

Answer 31

- death as personal growth - painfree - comfortable - open acknowledgement - death at home - death according to personal preference

Question 32

10 emotions experienced following a bereavement

Answer 32

- sadness - anger - guilt - denial - shock - bargaining - relief - fear - anxiety