AS - Non-communicable dieases

Question 1

Four types of non communicable dieases

Answer 1

Cancer
Chronic Respiratory Diseases
Cardio Vascular Diseases
Diabetes

Question 2

Risk

Answer 2

Number of people experiencing an event / (devided by) Number of people exposed to the risk factor

Question 3

Risk: Conditions, behaviour, hereditary

Answer 3

Conditions: Other medical conditions that increase the risk of a NCD
Behaviour: Lifestyle choices e.g. smoking
Heredity: Family history

Question 4

Stroke risk factors

Answer 4

Conditions: Increased age, high blood pressure
Behaviours: Excess salt intake, physical inactivity, excess alcohol
Hereditary: sickle cell disease

Question 5

Lung Cancer risk factors

Answer 5

Conditions: Exposure to radiation, increased age
Behaviours: smoking, radon gas in home
Hereditary: first-degree family member with lung cancer

Question 6

Asthma risk factors

Answer 6

Conditions: Having another allergic condition
Behaviours: Being overweight, smoking, exposure to allergens
Hereditary: Having a blood relative with asthma

Question 7

Type 2 diabetes risk factors

Answer 7

Conditions: older than 45, gestational diabetes
Behaviours: physically active less than 3 times a week, being overweight
Hereditary: parent/sibling with diabetes

Question 8

Epidemiological evidence and cancer

Answer 8

Strength of association, temporality, consistency, biological plausability, coherance, specificity, dose response relationship,experimental evidence, analogy

Question 9

Strength of association

Answer 9

The stronger the relationship between independent variable (smoking) and the dependent variable (lung cancer) the less likely the relationship is due to another variable)

Question 10

Temporarily

Answer 10

The exposure must precede the disease by a reasonable amount of time. There is a time delay between an increase in smoking and an increase in lung cancer

Question 11

Consistency

Answer 11

multiple observations of association with different people under different circumstances

Question 12

Biological Plausability

Answer 12

It is easier to accept an association as casual when the conclusion is supported by known biological facts.

Question 13

Coherance

Answer 13

A “cause and effect” interpretation is possible if all the available data from different types of experiments is consistent and there are no conflicting theories

Question 14

Specificity

Answer 14

Ideally the effect (lung cancer) only has one cause

Question 15

Dose response relationship

Answer 15

There should be a positive correlation between the dose and the disease

Question 16

Experimental evidence

Answer 16

Any related research that supports the epidemiological findings adds to the “cause and effect” conclusion

Question 17

Analogy

Answer 17

Sometimes a commonly accepted phenomenon in another area can be applied

Question 18

Benign tumour

Answer 18

Slow growing tumours tend to be located in ONE SPECIFIC TISSUE. Cells don’t break off and spread to other parts of the body and so these tumours tend to be non-life threatening.

Question 19

Malignant tumour

Answer 19

Rapidly growing tumour that can be very damaging if not detected early. Some cells can break off from the original tumour and spread to other tissues via lymphatic system or in blood plasma. - then described as metastatic and is now classified as cancer

Question 20

Proto-oncogene

Answer 20

-Stimulates cell division
- normally requires growth factors as signals
Effects of mutation = Becomes an oncogene, triggers cell division regardless of appropriate stimulation

Question 21

Tumour supressor gene

Answer 21

Prevent cell cycle from continuing when DNA error is identified
Effects of mutation: Cell divides regardless of DNA faults

Question 22

3 types of mutagen:

Answer 22

Physical
Chemical
Biological

Question 23

X-rays

Answer 23

CT Scan: patient lies on a platform which passes through the CT scanner, takes X-ray pictures from many angles
Mammogram: Breast X-ray between two plates an unusual lump shows up as a lighter area

Question 24

Ultrasound

Answer 24

Uses sound waves to build up an image. It is particularly useful for detecting tumours in soft parts of the body. It is cheaper and more portable method than others

Question 25

Pet scan

Answer 25

Patient injected with a radioactive substance which breaks down in the body emitting gamma waves. The most metabolically active parts emit the most gamma rays. The pattern builds up into an image

Question 26

Biopsy

Answer 26

Piece of tissue is removed from the body to be analysed in a labatory for a definitive cancer diagnosis
Bone marrow biopsies may be taken from the hip bone under local anaesthetic
Soft tissue biopsies can be used when a lump can be felt under the skin or endoscopic biopsies can be carried out through the mouth or rectum

Question 27

BRCA1 + BRCA2

Answer 27

Two genes that produce tumour suppressor proteins. As a result mutations in these genes can lead to cancer. Betwee 45 and 90% of women carrying these mutations will be diagnosed with breast cancer during their lifetime.

Question 28

HNPCC

Answer 28

There are mutations in five genes that normally repair mismatched DNA that may lead to hereditary non-polyposis colorectal cancer. About 70% of women and 90% of men carrying this mutation will develop bowel cancer by the age of 70 years. They are also at enhanced risk of cancer of the uterus, gastrointestinal tract and ovary

Question 29

A positive gentic test

Answer 29

Gene mutation found
Doesn’t mean definitely get cancer
Continued screening reduces risk
Consultation with genetic counsellor helps patient understand risks

Question 30

A negative genetic test

Answer 30

Gene mutation not found - No increased risk
Increase screening and test again
Survivor guilt

Question 31

Treating Cancer: Mastectomy

Answer 31

Surgical removal of the whole breast

Question 32

Treating Cancer: Radiotherapy

Answer 32

Ionising radiation kills more cancer cells than normal cells as they are more actively growing

Question 33

Treating Cancer: Lumpectomy

Answer 33

Surgical removal of the tumour and some of the surrounding tissue

Question 34

Treating Cancer: Chemotherapy

Answer 34

Drugs that are toxic to dividing cells. Cancer cells are dividing at a faster than normal cells

Question 35

Treating Cancer: Immunotherapy

Answer 35

Herceptin is an antibody that attaches to receptors so preventing growth factors attaching

Question 36

Treating Cancer: Complementary therapies

Answer 36

including meditation, hypnotherapy and aromatherapy. A holistic approach that seeks to treat the whole person. Often used alongside medical treatments

Question 37

Treating Cancer: Hormone treatment

Answer 37

which prevents oestrogen attaching to the cancer cells by blocking their receptors