Notes from formative

Question 1

What causes of disability are recognised worldwide?

Answer 1

Communicable disease
Non-communicable disease
Injury
Psychological
Malnutrition
Obesity
Drugs (illicit)
Alcohol
Tobacco smoking
Drugs (iatrogenic)

Question 2

Describe inductive reasoning

Answer 2

• Can be used for patients with vague/unexplained symptoms
• Ccan be used by inexperienced doctors
• Involves sustematic and comprehensive history and examination
• Oftein involves investigations e.g. bood tests, scans
• Evidence is then assessed to find an explaination for symptoms

Question 3

Describe pattern-recognition

Answer 3

Doctor’s previous experience will allow them to recognise natural history of disease
and pattern
This allows the doctor to draw a conclusion from the pattern and reach a certain or
near certain diagnosis

Question 4

Describe hypothetico-deductive reasoning

Answer 4

• Doctor’s experience generates a differential diagnosis from presenting symptoms
• Specific questions are used to establish a diagnosis, giving consideration to conditions requiring urgent attention (e.g. MI)
• Examination and investigation are used as appropriate to help establish diagnosis

Question 5

Describe the differences between primary and secondary care

Answer 5

• GP likely to have been responsible for care for much longer (cradle to grave). Secondary care only involved to treat specific symptoms/disease
• GP provides breadth of care compared with depth of care provided by secondary care consultant
• GP likely to look after other family members
• Secondary care doctors have easier access to investigations than GP
• Risk and uncertainty relating to Andrew’s health more likely to be accepted by GP than secondary care doctors
• Quality of doctor/patient relationship likely to be improved by continuity of care in general practice
• Opportunistic health care and health promotion more likely to occur in General Practice setting
• Multiple short appointments in General Practice versus longer less frequent appointments in secondary care
• GP looks after Andrew even when his condition is stable. Likely to be discharged from secondary care once condition stable
• GP acts as gatekeeper to secondary care. Secondary care doctors rarely employ a gatekeeper role.