Y1 SAP Exam 97 Questions with Verified Answers
Describe the bio-psycho-social model and its impact on health and healthcare - CORRECT ANSWER focuses on
... [Show More] the hollistic care of medicine by combining biological components with psychological components eg lonliness and social components eg living conditions
treats the person and not the illness lending to patient centred medicine
Describe the concept of patient centred medicine and the importance of patients being at the centre of medical practice and health care - CORRECT ANSWER to integrate diagnosis of diease with the understanding of a patients own experince of life and illness. It focuses on an individuals needs and concerns
facillitates shared decision making and makes the patient feel confident in their treatment
Describe the role of family, doctors and other health and social care professionals in the care of a patient [SAP] - CORRECT ANSWER multidisciplinary team - helps to treat all aspects of illness (biopsychosocial model)
Describe the four principle approach to bioethics and its limitations - CORRECT ANSWER autonomy - patients have the right to chose their own treatment and should be actively involved in decision making
beneficience- having the best outcome for the patient in mind at all times
non-maleficience - do no harm
justice - actions must be legal and respect the human rights of patients eg treating everyone fairly
limitations are that some of the pillars may counteract each other making it hard to know which decision to make
Describe the principle features of deontological, utilitarian and virtue ethics and the ethics of care - CORRECT ANSWER deontological - intentions matter , ethical decisions are good if they are made on a basis of some rules ( rules are based on the recognition of duties )
however always following rules can also have negative consequences
utalitarianism - focuses on consequences and if the consequences produce happiness , we should try to produce the greatest amount of hapiness
should happiness be all that matters?
virtue ethics - focus on role models rather than consequences or rules
care ethics-the right conduct emerges from a caring relationship
Describe the relevance of ethics to medicine - CORRECT ANSWER we need to be able to sytematise , defend and recommend concepts of right and wrong behaviour to get the best outcome for patients under our care
Recognise preconceptions and assumptions that may underpin discussions and arguments in ethical debate - CORRECT ANSWER religion
health beliefs
social background
upbringing
culture
education level
Describe the role and functions of the General Medical Council (GMC) - CORRECT ANSWER the GMC has statutory power to regulate medicine in the uk and provides ethical guidence
decide which doctors are qualified to work in the UK
oversee UK medical education and training
set the standards doctors need to follow throughout their careers
where necessary, take action to prevent a doctor from putting the safety of patients, or the public's confidence in doctors, at risk
List the "Duties of a Doctor" as defined by the GMC - CORRECT ANSWER Knowledge, skills and performance
Make the care of your patient your first concern.
Provide a good standard of practice and care.
Keep your professional knowledge and skills up to date.
Recognise and work within the limits of your competence.
Safety and quality
Take prompt action if you think that patient safety, dignity or comfort is being compromised.
Protect and promote the health of patients and the public.
Communication, partnership and teamwork
Treat patients as individuals and respect their dignity.
Treat patients politely and considerately.
Respect patients' right to confidentiality.
Work in partnership with patients.
Listen to, and respond to, their concerns and preferences.
Give patients the information they want or need in a way they can understand.
Respect patients' right to reach decisions with you about their treatment and care.
Support patients in caring for themselves to improve and maintain their health.
Work with colleagues in the ways that best serve patients' interests.
Maintaining trust
Be honest and open and act with integrity.
Never discriminate unfairly against patients or colleagues.
Never abuse your patients' trust in you or the public's trust in the profession.
Define reflection and explain the importance of reflection in clinical practice - CORRECT ANSWER reflection is thinking about clinical experiences and learning from them
important as it can help develop actions to improve practice
helps to develop self awareness and helps to deal with uncertainty
identifies opportunities to improve patients safety in organisations
Describe the experiential learning cycle and three stage model of reflection - CORRECT ANSWER three stage model of reflection- what? experiences and thoughts at the time, so what? why is this relevant now what? how can i improve in the future
experiential learning cycle - 1. Concrete Experience - a new experience or situation is encountered, or a reinterpretation of existing experience.
2. Reflective Observation of the New Experience - of particular importance are any inconsistencies between experience and understanding.
3. Abstract Conceptualization reflection gives rise to a new idea, or a modification of an existing abstract concept (the person has learned from their experience).
4. Active Experimentation - the learner applies their idea(s) to the world around them to see what happens.
Describe the professional responsibilities and standards of professional behaviour expected of medical students - CORRECT ANSWER must behave professionally both in and outside of medical school.
Describe the factors that influence fitness to practise as a doctor, and the implications for studying medicine - CORRECT ANSWER conviction or caution
drug or alchohol misusen
agressive/ violent behaviour
persistant inappropriate attitide
cheating or plagiarising
dishonesty / fraud
unprofessional behaviour
health concrtns eg not following medical advice
may have to undergo fitness to practice and be removed from the couse/struck off
Describe the role of fitness to practise in context of professionalism and General Medical Council policy - CORRECT ANSWER FTP is used if there are concerns about an individuals behaviour that may break the GMC policy and it is used to keep patient safety the top priority
Describe the basic structure of the Calgary-Cambridge framework - CORRECT ANSWER initiating the session - establiship rapport and identifying reasons for cosultation
gathering information - explore the pateints problems and understand the pateints perspective
physical examination
explanation and planning - providing the correct amount and type of info
shared decision making
closing the session
Describe the benefits of good communication to the healthcare professional and the patient - CORRECT ANSWER patient - allows correct consent to be given
increases concordance with treatment
direct theraputic effects
helps to gather all the information needed
healthcare professionals - helps handovers to run efficiently
increases patient safety amd reduces the number of errors
Discuss the communication challenges facing health care at the present time - CORRECT ANSWER technology - eg diagnosis without seeing pateint
increased socio-cultural diversity - eg language and expectations
aging population - eg hearing impairments
increased expectation of patient involvement can creat challenging conversations eg end of life care
Discuss the variety of contexts in which communication takes place in health care - CORRECT ANSWER doctor pateint
doctor to other healthcare professionals
Describe when hand washing should be performed in clinical practice - CORRECT ANSWER 5 moments of hand hygiene
before patient contact
before aspectic technique
after body fluid exposure
after pateint contact
after contact with patient surroundings
Describe the concept and importance of consent and confidentiality in medicine - CORRECT ANSWER consent - the principle that a person must give their permission before the recieve any type of medical treatment, exam or test.
must be voluntary consent , informed and the patient must have capacity
confidentiality - information that is confdential must be kept private
both are important to preserve the trust between pateints and doctors
Describe the content of the GMC's ethical guidance - CORRECT ANSWER good medical practice
confidentiality and consent
shared decision maing
leadership and management
Describe how to care for your hands in order to reduce risk of transmission of infection - CORRECT ANSWER keep hands moisturised to stop and cracks in skin
no nail polish
short nails
List the most frequently missed areas of the hands during hand hygiene - CORRECT ANSWER the sides of the little finger and thumb
wrists
Describe interprofessional education - CORRECT ANSWER students from two or more professions in health and social care learn together during all or part of their professional training with the object of cultivating collaborative practice for providing client-or patient-centered health care.
Describe stereotyping and professional prejudices and the impact of these on interprofessional working - CORRECT ANSWER people may be sterotypes for reasons such as race gender background age etc
the impact of these on interprofessional working can put a strain on professional relationshops and make people feel uncomfortable and can ultimately compromise patient care
Describe the changing nature of health and social care boundaries - CORRECT ANSWER
Describe the principles of interprofessional education in terms of improving teamwork and patient care - CORRECT ANSWER practices communication skills and allows teamwork to generate the best patient centred medicine
Describe the main sources of demographic information available in the UK, and other countries - CORRECT ANSWER uk - public health england
nomis
global WHO
Describe correct and safe disposal of waste within the clinical environment - CORRECT ANSWER all sharps must be disposed of in the sharps bin , needles must ne removed without touching the needle
clinical waste must be disposed of in the clinical waste bin
Describe how to measure and record blood pressure - CORRECT ANSWER ensure arm is at the levl of the heart
remove clothing
inflate cuff until pulse vanishes
inflate and extra 30mmhg
redice cuff pressure slowly until pulse is felt again
this is estimated systolic
fully deflate cuff
put stethescope over brachial artery and inflate to 30mmhg above estimated sytolic
let pressure out slowly - systolic is 1st korotkoff sound
diastolic is 5th
record time and date
name
which arm
position of patient
systolic/diastolic
Describe key patient safety and health and safety issues relevant to venepuncture - CORRECT ANSWER clean area and do not repalpate
consent , allergies , arm preference
release tornique first before needle
bevel must be up , 15-30 degree angle
apply cotton wool
Describe the rate, rhythm, volume and character of relevant pulses on examination - CORRECT ANSWER rate - how fast
rhythm - regular/irregular
volume ( brachial ) - weak or strong
character - waveform or shape of pulse
Describe the recommended procedures for dealing with accidental needle stick injuries and blood spill - CORRECT ANSWER if needlestick injury - encourage bleedinfg
wash witn soap and water
attend occpational health
spills - clean up wearing gloves and inform colleagues
Describe the significance of the following abnormal findings: radio-radial delay; radio-femoral delay; presence of an arterial bruit - CORRECT ANSWER radio-radial delay can mean narrowing of the aorta or a tear
radio-femoarl delay - coartication of the aorta
bruit - obstriction in artery eg atheroma
Record and document your findings with respect to pulse and blood pressure - CORRECT ANSWER
Describe a range of question types that may be used when gathering information - CORRECT ANSWER open questions - cannot be answered by yes or no
closed - answered yes or no
clarifying questions - check statements which may be vague
probing questions - looking more in depth eg how does that make ypu feel
statement questiosn
Describe and apply the basic skills of 'active listening' - CORRECT ANSWER nonverbal behaviour
faciliatory response
allows the patient time to respond
picking up on verbal and non-verbal cues
Describe the importance of non-verbal communication - CORRECT ANSWER importance - allows the patient to feel comfortable and listened to so may give up more important informarion
theraputic benefits
Describe the non-verbal cues and gestures used in transmitting messages and interpreting behaviour - CORRECT ANSWER posture
touch
body movements
facial expressions
eye contact
vocal
Calculate the volume of distribution, half-life, clearance and loading dose of a drug - CORRECT ANSWER volume of distribution is the dose / conc of drug in plasma ( C0)
may need to extrapolate graph to get C0 ( initial conc of drug in plasma)
half life - look time taken for conc to half
clearance - the volume of plasma cleared per unit of time
loading dose = vd x desired steady state plasma
Define health inequalities and discuss trends in health inequalities - CORRECT ANSWER health inequalities are the sytematic differences in health between different socio-economic groups
eg north south divide
most perived areas have the lowest lifespan
Describe how social class can classified - CORRECT ANSWER social class is a group of people of similar status
cam be determined by socio-economic status , based on wealth social life and activities or neighbourhood deprovation
Describe the main explanations for the relationship between social class and health - CORRECT ANSWER social determinants - the conditions in which people are born work and grow affect health
behavioural culture explanation- main cause of inequality os the difference in health realted behaviour due to health beliefs and what is culturally acceptable
economic material explanation - income levels determine heath inequalities as they enable acess to schools trasnport etc and lower exposure to risk
psychosocial explanation - how social inequality makes people feel and the biological conequences eg stress in work place
Describe the causes, underlying pathophysiology and clinical consequences of various forms of arteriosclerosis - CORRECT ANSWER arteriosclerosis is the thickening and loss of elasticity to the small arteries, restricting bloof flow due to hypertension smoking etc
it maye present as weakness, facia or lower limb numbness, confision , bisual problems
atherosclerosis is a form of arteriosclerosis with the development of fatty plaques as part of the inflammatory response
mockenbergs arteriosclerosis is clacific sclerosis mostly in the elderly
hyperplastic affects medium and large arteries
hyaline is the deposition of homogenous hyaline in small arteriesn
Describe the main types of aneurysms and describe the main pathogenic mechanisms, morphological features and clinical course - CORRECT ANSWER aneurysm is a localised permanent dilation od the artery
a fake aneurysm is a blood filled space around a blood vessel
dissecting aneurysm - intimal tear so blood can move into the muscle wall forming a dissection
can be caused by atherosclerosis
hypertension
atheroma
clinical course - must be monitored very closely and surgery
Describe the pathophysiology of hypertension particularly in end stage organ damage [ - CORRECT ANSWER hypertension can weaken the vessel walls of the eye , kidney and brain causing retiinopathy and renal failure
it can cause arteriosclerosis whic can cause an thrombus/embolus causinf MI and ischaemia and the increased afterload can cause heart failure
Describe the main clinical effects of atheroma - CORRECT ANSWER aneurysm and rupture
thrombus embolus
critical stenosis
cam cause acute cornory syndromes and stable angina
also acute limb ischaemia
Describe the principles and process of clinical reasoning - CORRECT ANSWER process by which we gather information from the patient and use or own knowlege to come up with a hypothesis
we then seek confirmation with examination and investigations may need to do this step multiple times
then make management decisions
important to have differential diagnosis and think about thw worst case scenario
Describe the ways used to explore the patient perspective, for example, the patients ideas, concerns, expectations, feelings and impact - CORRECT ANSWER ICE ICE BABY
Describe how the basic BLS technique may be modified to protect casualty and rescuer from potential harm - CORRECT ANSWER may do compression only CPR
Describe and identify the appropriate anatomical locations for connecting an individual to electrocardiogram (ECG) recording equipment - CORRECT ANSWER left leg
left arm
right arm
Describe the diagnostic value of electrocardiograms (ECGs) in the detection of arrhythmias, heart block, ischaemic heart disease, myocardial infarction and hypertrophy - CORRECT ANSWER check ecg interpretation notes ( case 2 )
Define patient self-care and describe the key elements and impact on a patient's health - CORRECT ANSWER self care - the actions that individuals take for themselves on behalf of and with others in order to develop protect maintian and improve health and wellbeing
Describe and apply the concepts of illness and disease - CORRECT ANSWER disease is an organic patholofy/abnormality
illness is a subjective expreience of ill health to a patient and those around them
Describe how patients define their own health referenced to medical, functional and idealist models of health - CORRECT ANSWER medical model - absence of disease , illness and injury
functional ( social) - the ability ot function in a normal social role
idealistic model - sate of complete physical , mental and social wellbeing
most people see health as functional
Describe the factors that influence consulting behaviour and demonstrate their association with the iceberg of health - CORRECT ANSWER frequency/ seriousness of symptoms not a good indicator of when a pateint will present
triggers ro consult
interpersonal crisis
percieved interference w social relationships
sanctioning
percieved interference w vocational/physical activity
temproralising of symptoms
Describe the significance of health (or lay) beliefs to consulting behaviour and their link to the patients' perspective - CORRECT ANSWER patient will decide to seek help when it seems rational to them and their own health beliefs
eg when they feel it is possible to adress the problem with a positive expectation of the outocme
when they feel like they can take the proposed action
Describe causes and consequences of myocardial infarction - CORRECT ANSWER STEMI caused by complete occlusion eg due to thromobotic reupture
NSTEMI - incomplete vascular occlusion eg may be caused by atheroma thrombosis embolus spasm
vasculititis
Describe the causes and pathophysiology of hypoxic damage in the heart - CORRECT ANSWER caused by vascular occlusion of the BV and can be caused by atheroma
thrombosis
embolus
spasm
etc
can cause ischaemic heard disease and can cause part of the muscle to infarct
Describe the epidemiology and pathophysiology of ischaemic heart disease - CORRECT ANSWER can be chronic ischamic heart disease and be silent/stable/variant angina or acute coronary syndrom - unstable angina , stemi nstemi
epidemiology is that its a big killer in developed countires and is more prevelant in men
Describe the main causes of valvular heart disease and the clinical consequences - CORRECT ANSWER mitral and aortic valve disease are the most common
the main causes are
mitral - mv prolapse due to degeneration , L V dilation , rheumatic heart disease and infective endocarditis
can cause heart failure and atrial fibrillation
aortic valve disease - caused by infective endocarditis , rheumatic HD , congenital defects , calcification and bicuspid valve
can cause left ventricular hypertrophy which can cause ischaemia and HF
Describe the pathogenesis, aetiological agents and clinical manifestations of infective endocarditis - CORRECT ANSWER often caused by staph aureus
bacteria enters blood and when it reaches the heart it can colonise a thrombus
this causes an infective vegetation which protects the bacteria from blood as more of the clot is formed
can cause a septic emboli
can damage heart valves
can cause general symptoms of infection
and can also cause janeway lesions and splinter hameorrages
Describe the cause and pathophysiology of left and right sided heart failure
do a mindmap and compare to poster - CORRECT ANSWER
List the cardinal symptoms of heart disease - CORRECT ANSWER shortness of breath
oedema
syncope
palpitations
chest pain
Describe and identify arrhythmias and the different degrees of heart block from electrocardiogram (ECG) recordings
look at notes - CORRECT ANSWER
Describe the electrocardiogram (ECG) changes that occur in hypertrophy - CORRECT ANSWER tall R waves
deep s waves
inverted t waves
Describe the electrocardiogram (ECG) changes that occur in ischaemic heart disease - CORRECT ANSWER ST depression
inversion of t waves
( similar to NSTEMI)
Describe the electrocardiogram (ECG) changes that occur in myocardial infarction - CORRECT ANSWER ST elevation - STEMI
Describe the pathogenesis, morphological features and clinical course of cardiomyopathy
do mindmap and compare to poster - CORRECT ANSWER
Describe the imaging techniques used in cardiovascular disease, e.g. echocardiography and coronary angiography - CORRECT ANSWER echo - ultrasound of heart can see parts of the muscle not contracting well, hypertrophy etc
coronary angiooraphy can see an occlusions in the coronary artery
Describe the main advantages and disadvantages of MRI, ultrasound, plain radiography and CT scans
Describe the principles and clinical use of MRI, ultrasound, plain radiography and CT scans in clinical radiology - CORRECT ANSWER check against case 2 self directed imaging notes
Explain the limitations of applying clinical trial data to individual patients - CORRECT ANSWER different clinical trials may have different outcomes
may not be able to apply all clinical trials to all patients eg demographics / location
Describe a variety of different models of the doctor-patient relationship and their influence on decision making - CORRECT ANSWER mutualistic - both doctor and patient have an important tole in decision making
paternalistic - doctor had more important role in decision making , often used in emergency situations where the patient cannot be consulted
consumerist - patient has expectations about healthcare and has the most control in the decision making often used in private healthcare
defualt - both patient and doctor are passive in decision making
Describe the reasons for involving patients in decision making about their treatment - CORRECT ANSWER increases compliance with treatment
allows the healthcare professional to tailor the treatment to the patient
both feel supported and impowered to make informed choices
Describe the causes and underlying pathophysiology and clinical consequences of chronic kidney disease - CORRECT ANSWER causes of CKD:
hypertension can causes thickening of the renal artery causinf reduced bloof flow to the kidney by activating RAAS and leading problems with the filtration barrier
diabetic nephropathy - hyperglycaemia can cause damage to the kidney
isachaemia of renal tissue
consequences: accumulation of uremic toxins: fatigue, anorexia,itch, pericarditis , vit d deficiency , can increase blood pressure
anaemia as epo not made
Describe the causes and underlying pathophysiology and clinical consequences of acute kidney injury - CORRECT ANSWER causes: pre renal - eg dehydration and low blood volume , hypotension , heart failure
intrinsic - glomerularnephritis - nephrotic/nephritic syndrome
also tuberointerstitial eg infections sepsis
post renal - occulsion eg clots stones and enlarged prostate
clinical consequences eg acidbase disorders , ion disorders same as ckd
List the cardinal symptoms relating to kidney disease - CORRECT ANSWER swelling /fluid retention
shortness of breath
fatigue
confusion
nausea
decreased urine output
Describe the causes and effects of hyperkalaemia and hypokalaemia - CORRECT ANSWER check against poster
Describe and apply the concept of clinical uncertainty - CORRECT ANSWER 3 types of uncertainty - lakc of knowledge
uncertainty of how to interact
and intrinsic uncertainty to do with the world around us and how little control we have
Describe the signs and symptoms of anaemia - CORRECT ANSWER symptoms- fatigue
lethargy
breathlesness
palpitations
fainting
signs - pallor
tachycardia
fast breathinh
hypotension
Describe and interpret the blood indices and other blood tests relevant to anaemia - CORRECT ANSWER do seminar anaemia sheet
Describe the characteristic features of benign neoplasms and malignant neoplasms - CORRECT ANSWER benign = slow growth rate , no invasion of tissue , well differentiated , exophytic growth
malignant = fast growth poor differentiation invasion endophytic growth
Describe the criteria that should be met before implementing a screening test - CORRECT ANSWER the disease must be an important well understoof health problem with a detectable risk factor and a long latent period
the screening must be valid, acceptable and reliable
the diagnosis and treatment must be agreed upon and cost effective with adequate facillities to meet demand
the programme must decrease mortality and have staffing and facillities and must allow patiens to malke an informed choice
Describe the causes, pathology and clinical features of colonic carcinoma - CORRECT ANSWER genetic mutations can cause colon cancer some risk factors can increase the chance :
over 65
FH
IBS
type 2 diabetes
unhealthy lifestyle
often no symptoms but can present as anaemia especially RHS
LHS rectal bleeding and bowel occlusion is common
Describe the different clinical features of the different types of diabetes mellitus - CORRECT ANSWER type 1 : presents in young people and often in acute situation , often no complications
no family history
type 2 : may not have synptoms and may present because and with complications
family history
#older and obesity
secondary diabetes - from medication possible pancreatic illness/surgery
monogenic - eg neonatal and often develops before 25, runs in family
gestational - diagnosed in pregancy
Describe the pathology of diabetes mellitus and the long term complications of the disease - CORRECT ANSWER long term complications
microvascular - retinipathy, neuropathy nephropathy, erectile disfunction
CDV- stroke , hypertension
CVD PVD absent foot pulses
Describe the role of health psychology approaches in understanding a patients experience of health and illness - CORRECT ANSWER
Describe communicable and non-communicable disease at the population and global level - CORRECT ANSWER most common cause of female death is cancer and male is heart conditions
communicable disease are a larger cause of death in developing countires
Describe the importance, and challenges, of public involvement in health care decision making including shared decision making - CORRECT ANSWER important as it can help to prevent illness and increase quality of life and decrease burden on NHS
challenges are that it has a high cost and time
hard to know who to target
Describe the models of health education and behaviour change - CORRECT ANSWER health education is enhancing learning experiences that enable people to increase theit control of the determnants of health and health behaviours to improve their health stati=us
behaviour change is precontemplation
contemplation
decision
action and maintainence
Describe the role of Public Health in the planning and evaluation of health services - CORRECT ANSWER
Describe the factors that form health beliefs and the impact they can have on health seeking behaviour - CORRECT ANSWER percieved barriers vs benefits
percieved threat
self efficacy
cues to action
Describe the role of doctors in promoting health as well as managing illness and disease - CORRECT ANSWER role as a doctor is to understand a patients health belief
understand where they are in the cycle of change and then used shared decision making to come up with and action plan
Describe how to assess a patient's readiness to change a health-related behaviour, identify appropriate interventions that may be offered and apply these to obesity, smoking and alcohol consumption - CORRECT ANSWER goal setting is a useful tool
pointing patients to support eg self helf groups
apps
fitness groups
and repeat consulations
Describe the consequences of over-nutrition - CORRECT ANSWER increases the risk of typ2 2 diabetes , sleep apnoea
CHD, hypertension , osteoathritis
cancer , fertility impairment
Describe how health systems are structured and function differently across the globe - CORRECT ANSWER private - out of pocket or health insurnace
tax based - comes from 1 pot, government funded
social health insunrance- many pools that people pay into
Discuss the essential components of a health system, using the World Health Organisation - CORRECT ANSWER service delivery
healthworkforce
health infromation systems
acess to essential medicine
financing
leadership/governance [Show Less]