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30 Cards in this Set
- Front
- Back
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What are the take home messages regarding meningicoccal disease
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1) Notifiable to QH Public Health unit
2) Aim is to reduce carriage of N.meningitidis 3) Uncommon 4) Clearance and vaccination of close prolonged contacts with antibiotics. This includes child care. 5) Outbreaks occur within communities eg schools and whole schoole may require prophylaxis (carriage removal) plus vaccination |
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Define a confirmed case of mengococcal meningitis
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1) Confirmed lab diagnosis by PCR or culture from a sterile site
2) Suggestive evidence of diplococci from a sterile site PLUS clinical evidence (Evidence rules out other causes PLUS rash OR close contact within 60 days with somebody infected) |
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What is the greatest affected age group of meningococcal disease
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< 5YO and 15-25 age group
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What serogroup does the meningicoccal vaccine cover
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A, C, Y, W135
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Why is ESRD such a problem in aboriginal communities
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1) Diabetes rate 30% in some communities (4x non-indigenous) - diabetic nephropathy 20-30%
2) High prevalence of hypertension, obesity, infections, smoking 3) Chronic renal failure accounts for around 40% deaths |
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What are 3 strategies aimed at improving indigenous health
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1) Closing the gap
2) Community Controlled Health Services 3) Cultural training for doctors |
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What level of care is recommended for Parkinson's and other complex management patients and why
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Coordinated care most effective for complex chronic conditions within an existing framework of available resources, however, research has found no reduction in hospitalisation with current resources but additional resources are needed to improve this.
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what is wanted from the level of care provided to neurological patients
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Improved health outcomes
Decreased carer burden Decreased hospitalisation |
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What are the dimensions of CDM
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Chronic disease management medicare items: a management plan with or without care team involvement (coordinated care team?)
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What are the elements of the chronic care model proposed by Wagner
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Population based (collaboration networks, community involvement and education)
Better registry Planning care (mutually understood care planning for teams) Team aproach Patient & carer education to empower both to take control of their management |
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How is Self Management Education different to the traditional approach
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1) Problem solving skills as opposed to technical skills and disease knowledge
2) Formulation of problems are holistic, not just reflections of inadequate disease management eg social concerns 3) Education is broad and looks at wider problem solving skills pertaining to consequenses of the disease, not just focussed on the disease itself |
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What does the colaborative care planning approach look at
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Assessment of self management behaviours
identification of problems goal setting care planning |
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List barriers to patient upskilling
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low self efficacy
psychological impairment (depression, psychosis, dementia) Physical symptoms Low social suport Cost burden Poor communication with care providers literacy, language, cultural barriers |
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What are strategies to overcome barriers to patient upskiling
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Increased consult time
Increased provision of info Med reviews Referral to community organisations & GP partners and promoting flexibility of coordinated care provision |
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Describe 3 dimensions of domestic violence
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physical
Emotional Social (access to money, social support and medical support) |
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Describe the national plan against domestic violence
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Focus on prevention, behaviour change, long term bulding of respectful relationships
Cross juristiction Holding purportrators accountable (crimminality) |
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What are the 6 national outcomes of the national plan against violence
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communities safe & free
promoting respectful relationships focus on elininating indigenous violence provision of adequate services for needs of victims justice stop perpetrators committing violence |
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Key national guidelines support
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helpline
encourage telling of story ? |
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RADAR
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Routinely screen for domestic violence
Ask questions directly Document injuries (photos, diagrams) Assess safety, develop action plan Refer to other services (shelters, support services) |
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What services are available for women suffering from domestic violence
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Advocacy
Case management Support |
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What are signs of domestic violence
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Injury
Evasiveness, denial, avoidance of eye contact, missing appontments Depression Anxiety |
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Describe who the DV protection act applies to
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Intimate partners of all types if relationships during and after relationship termination but excludes children.
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Why is Domestic Violence a medical problem
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Leading contributor to death, disability & burden on medical services by women 15 to 44 yo.
Women are likely to encounter 1st violent act during pregnancy |
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Cycle of violence
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Buildup
Explosion Remorse Pursuit Honeymoon |
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List 5 stigmatized conditions
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Epilepsy
Cerebral palsy deafness blindness Parkinson's disease AIDS, HIV, STI's, teen pregnancy |
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Define stigma
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A mark where an aspect such as a deformity, behaviour or neurological condition that causes fear, discrimination and social isolation
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Why is perceived stigma regarding eplilepsy a medical problem
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Perceptions of poor health and reduced life expectancy
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Why does less than optimal immunisation rates still provides a public health good. What is the harm
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Herd immunity
Non immunised benefit without risk The immunisation paradox is that people want the benefit but without risk, negating herd immunity Consequently, unimmunised individuals pose a risk to others not immunised and those where effectiveness is only partial (eg pertussus) |
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What are Medicare's requirements for record keeping
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1) Name
2) Date of Service 3) Details of services provided 4) Clinical description must be comprehensive enough for another doctor to be able to take over care |
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List 4 methods of Medicare overservicing
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1) Upcoding consultation items
2) Use of chronic care items 3) Referrals to allied health professionals 4) Inappropriate over ordering of investigations |
