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What is hydrocephalus?
Pressure build up of CSF in the ventricles of the brain - can occur if a blockage in one of the ventricles, problem with arachnoid villi so fluid unable to filter into blood vessels, brain starts to produce too much CSF
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How does a VP shunt work?
Ventriculoperitoneal - a catheter that is surgically fitted to drain any excess CSF from the brain and pass it down into the abdomen - when the pressure build up is too much, a valve opens and the CSF is drained.
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How did the medical community enhance the lives of your brother and family?
Enabled Finn to live a relatively normal life, free from any of the more debilitating effects of hydrocephalus; consequently increased quality of life of family
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What were your duties as a respiratory ward assistant?
Involved doing the Sunday lunch round; chatting; refilling hand gel dispensers, glove boxes etc; wiping down tables; serving tea; helping the nurses with filing - loved chatting to the ward matron and helping her with the bed linen
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What are some examples of conditions that the patients on your ward had?
Cystic fibrosis; lung cancers; TB; chronic emphysema; chronic bronchitis; and other diseases because there weren't enough beds on other wards, e.g. multiple sclerosis
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What is the NHS?
National Health Service, started by Lord Bevan in 1948; free at point of delivery, based on clinical need not ability to pay; funded out of taxes paid to government each year; 'purpose of gaining power is to give it away'
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What are current issues within the NHS?
Long-term issues: funding and rationing of resources, postcode lottery, waiting lists, European working time directive; short-term issues: restructuring - changing role of the GP, junior doctors contracts
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What are the challenges faced on a day-to-day basis by medical staff working on the wards?
Dealing with patients, cooperation; dealing with families; ethical dilemmas; under-funding and under-staffing; death and disease
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Could you outline some of the main duties of a doctor?
CARE! - maintaining patient safety, providing good services, teaching and training
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Give an example of some teamwork that you witnessed whilst on the ward.
MDT - doctors diagnosing, nurses nursing, cleaners, ward matron, porters, physiotherapists, occupational therapists, priests etc.
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What did you learn from speaking to the patients?
How important it is just to listen - most of them elderly, with few people left to talk to, all they needed was somebody to chat with - learnt about their past, families, current lives, how they felt about their illness etc.
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What are the key features of a multi-disciplinary team meeting?
Sat in on two - one on a cardiology ward and one on a urology ward - pathologists, consultants, junior doctors, nurses; patient notes presented, scans analysed, best course of action decided
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What are the stages of a post-mortem?
Incision down from of body, all organs removed, pathologist exams organs for cause of death, organs placed in plastic bag and stuffed back into body, body sewn up. If examining brain then face peeled off, skull sawed open, brain removed.
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What surgeries did you witness?
Aortic root replacement, knee replacement, removal of varicose veins (ligation and stripping), stent into the descending aorta
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What was it like to be in the operating theatre?
Bewildering at first; never knew where to stand so I would be out of the way; careful when asked to approach patient; once when patient was losing too much blood and they had to do an emergency transplant was quite frightening; fascinating
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What are sutureless valve replacements?
Aortic valve replacement surgery using minimal/ no stitches - can be carried out more quickly than traditional method therefore side effects from op. reduced
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Can you tell me about some other recent advancements in surgical technology?
Microsurgery means that patients now often able to go into surgery and leave on the same or following day - brilliant because means that fewer side-effects
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What kind of conditions do the children you work with have?
Down syndrome; angel man syndrome; Asperger's syndrome; cerebral palsy; severe autism as a result of another condition that they have
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Can you detail the different forms of communication you need to use?
The usual - talking etc.; also exaggerated facial expressions, speaking slowly and clearly, body language, sign language (Makaton)
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Tell me about working at the care home.
Serving tea, chatting to patients about their lives, learning how to knit, playing bingo - one man visiting Germany again where he had fought in the war
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Can you elaborate about the research company you visited?
Heptares - clinical stage drug company research cure for Alzeimhers - G-protein couple receptors
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What are the ethical issues involved in offering surgery?
Have to consider when risks of surgery will outweigh benefits, preventative or curative, possible side effects
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Why is the accuracy of medical statistics important?
Bc. patients need to be able to see the risk they are taking, but also need to be correctly informed in a way that they can understand - transparency of simple numbers e.g. EuroSCORE
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What kind of music do you enjoy?
Depends what mood I'm in - usually when playing music go for something relaxing like Einaudi, or film music; usually if listening whatever's on the radio - indi-rock bc. that's what I was brought up on
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Give an example of a time that passing on your knowledge ended up badly.
Whilst at CHIPS talking to severely autistic child about how its okay to touch things like leaves and insects as long as you wash your hands bc. of the microbes on them - he left with a mortal fear of touching anything that hadn't been deep-cleaned
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What did your roles as medical officer and accountant entail?
Medical officer = making everyone drunk enough water/ had enough to eat/ checking if anti-malarials everyday/ general well-being; accountant = entire funding for the whole trip/ distributing amongst people to look after/ budgeting
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What was it that made you realise the importance of teamwork whilst you were in Vietnam?
Coordinating people to get from place to place and get jobs done, e.g someone books taxi, someone buys food, someone searches for accommodation - needed a whole team with specific roles to function properly
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Give an example of a time when, as a leader, you were faced with a difficult decision.
One of taxis didn't show up in Vietnam to get us to station - had to decide what to do next, whether the group should stick together or whether we should separate - in the end small groups went to station whilst I stayed an hailed another cab
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Why is a career in medicine so tough?
Long training, distressing scenarios, difficult to maintain work-life balance, large student debt followed by not very high salary to begin with, social responsibility, difficult ethical decisions
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Where do you see medicine in 20 years time?
Large dependence on technology definitely with rapid pace of advancement in surgery; may be battling infections without antibiotics bc. resistance; who knows where the NHS will be
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What would make medicine such a rewarding career for you?
Fascination with working in a rapidly advancing, highly respected profession; unending variety; amazing people; someone place trust in you and share hopes and fears; very demanding; assimilating, weighing and balancing info. to diagnose disease
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Tell me about NICE.
Lots of drugs proven to work after clinical trials; NICE (National Institution for Health and Care Excellence) - filter: works on rationing and social justice - decides if drug available on NHS
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What NHS policy changes have the coalition government undertaken and what are your views on it?
Released a white paper giving GPs 60-80% of NHS budget to buy services for their patients; save money (jobs lost), longer waiting lists; do they have enough expertise?, GPs shape how services provided. Don't know effect of policy, £2bn wasted, saved £5bn
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What do you think about having private healthcare as an option in the UK?
Private healthcare = healthcare provided by entities other than government - reduces NHS waiting times, pay twice so good for NHS users, doctors supplement income, personal freedom, benefits wealthier people, financially driven, save NHS £1bn
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What does the 'postcode lottery' mean to you?
Geographical healthcare inequalities, e.g. urban areas have increased resources; 'inverse care laws', e.g. NHS availability of MS drug beta interferon (reduces relapse rate by 30%); combatted by making GPs service buyers
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What is the current structure of the NHS?
Secretary of state for health (Jeremy Hunt) FUNDING AND REFORM; NHS England (level competition b/ween NHS and private sector); 200 x clinical commissioning groups (manage 60-80% NHS budget - run by GPs); foundation trusts etc.
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What is happening with junior doctor contracts?
Changing standard working hours from 7-7 Monday to Friday to 7-10 Monday to Saturday; 50% increase in working hours; J Hunt conceded 11% pay rise but out of hours work now much harder to earn, strikes now not going ahead; no unilateral contract
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Would you strike if you were a junior doctor?
Strike means outpatient care & routine ops. postponed; create fair/safe contract; doctors strike in safe way; pop. may lose faith; inconvenient; probs. vote against bc. primary duty care; long hours part of job
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What is the role of a doctor and the role of a nurse?
Doc: examine, diagnose, manage treatment, more decision making; nurse: procedures, gives drugs, educates, continuous involvement in patient care; doctors more overall responsibility for clinical decisions.
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How would you save money in the NHS?
Homeopathy (cost £3-4mn a year); 3.5mn appointments missed last year in London (cost £100mn); lung cancer (cost £2.4 bn a year); medical tourism (cost £500mn a year) - preventative rather than cure
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What was the past structure of the NHS?
Secretary of state for health (Andrew Lansley) FUNDING AND REFORM; 10x strategic health authorities (manage regional health services, performance); 152x primary care trusts (commission, manage and fund local health services)
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You are a junior doctor and you notice your consultant smells of alcohol - what do you do?
Patient safety! Ensure not dealing with patients, ask senior nurse/other doctor for advice, be discrete, ensure adequate cover, make sure colleague safe
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Why Bristol?
Russell Group uni; intercalation; study abroad during elective; beautiful and vibrant city; like how can intercalate in Global Health - something I'm interested in; like lecture-based integrated approach
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Other cards in this set

Card 2


How does a VP shunt work?


Ventriculoperitoneal - a catheter that is surgically fitted to drain any excess CSF from the brain and pass it down into the abdomen - when the pressure build up is too much, a valve opens and the CSF is drained.

Card 3


How did the medical community enhance the lives of your brother and family?


Preview of the front of card 3

Card 4


What were your duties as a respiratory ward assistant?


Preview of the front of card 4

Card 5


What are some examples of conditions that the patients on your ward had?


Preview of the front of card 5
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