Block 13 - part 1

Question 1

Percentage of deaths caused by CHD in UK

Answer 1

29% men, 28% women

Question 2

why are death rates from CHD falling

Answer 2

improved risk factors, better treatments

Question 3

effect of health inequalities on CHD

Answer 3

lower social class at higher risk - health behaviours

Question 4

4 non-modifiable risk factors for CHD

Answer 4

increased age, fam hx, gender (men> before age of 60), race (high rate for african americans and asians)

Question 5

modifiable risks for CHD

Answer 5

Elevated blood cholesterol, high LDL, low HDL, High BP, diabetes, smoking,obesity, inactivity, excessive alcohol, excessive stress

Question 6

risk

Answer 6

probability of an event in a given time period

Question 7

equation for risk ratio

Answer 7

risk ratio = risk (exposed)/risk (unexposed)
a= risk and disease present
b= risk present, disease absent
c= risk absent, disease present
d = risk and disease absent
RR=a/(a+b)/c/(c+d)

Question 8

equation for risk difference

Answer 8

risk(exposed)-risk(unexposed)

Question 9

odds ratio

Answer 9

probability of disease occurring in exposed group/probability of disease occurring in unexposed group

Question 10

equation for odds ratio

Answer 10

a= risk and disease present
b= risk present, disease absent
c= risk absent, disease present
d = risk and disease absent

OR = (a/c)/(b/d)
=(ad)/(bc)

Question 11

population attributable risk

Answer 11

the risk of disease will increase as the exposure prevalence or relative risk increases

Question 12

leading cause of cancer mortality

Answer 12

lung cancer

Question 13

main risk factors for lung cancer

Answer 13

smoking, radon, asbestos, environmental tobacco exposure, genetics, other lung diseases, prior radiation in chest area

Question 14

percentage of lung cancer caused by smoking

Answer 14

90%

Question 15

second leading cause of lung cancer after smoking

Answer 15

radon

Question 16

types of lung cancer

Answer 16

small cell (13%), non small cell (87%): Adenocarcinoma (>40%), squamous cell carcinoma (20%), large cell carcinoma (2%)
Mesotheloma

Question 17

number of people in world infected with TB

Answer 17

1/3 of world population

Question 18

deaths by TB each year

Answer 18

3 million

Question 19

factors associated with recent increases in prevalence of TB

Answer 19

urban homelessness, IV drug use, growing neglect of TB control programs, AIDS epidemic

Question 20

time of year for peak TB incidence

Answer 20

spring/summer

Question 21

4 things which can be done to address riding rates of TB

Answer 21

put more people on ART, new vaccine, improved drugs, diagnose better

Question 22

prevention paradox

Answer 22

a preventative measure which brings large benefits to the community offers little to each participating individual

Question 23

pros of ‘high risk’ approaches to health promotion

Answer 23

appropriate to individual, motivated subject, motivated clinician, cost-effective resource use, benefit for risk is high

Question 24

cons of ‘high risk’ approaches to health promotion

Answer 24

screening is difficult, palliative and temporary, limited potential as not many people at high risk, labelling

Question 25

pros of 'population' approach to health promotion

Answer 25

large potential as targeting many peopl

Question 26

cons of 'population' approach to health promotion

Answer 26

prevention paradox, poor motivation - compliance issues, small individual benefit, benefit for risk is lost

Question 27

examples of occupational lung disease

Answer 27

occupational asthma, COPD, pneumoconiosis, toxic pneumonitis, hypersensitivity pneumonitis, infections including TB, malignancy of lung and pleura

Question 28

how has occupational health risks changed over time

Answer 28

better environment control and health and safety, depends on health of population and local industry, diagnosis of occupational lung diseases has improved, biological factors (predisposing/genetic)

Question 29

occupational asthma

Answer 29

characterised by airway inflammation, reversible airways obstruction, and bronchospasm, caused by something in workplace environment

Question 30

causes of occupational asthma

Answer 30

bakers, welders, paint sprayers, laboratory workers

Question 31

expected Hx from pt with occupatinal asthma

Answer 31

symptoms worse at work and better away from work, e.g. weekends and holidays, peak flow falls at work and improves away from work

Question 32

occupational causes of COPD

Answer 32

coal mining, agriculture, construction, dock workers, brick making

Question 33

pneumoconiosis

Answer 33

occupational restrictive lung disease caused by inhalation of dust (coal dust, silica, asbestos)

Question 34

simple coal workers pneumoconiosis

Answer 34

after around 10 years coal mining, small nodules are present, shouldn't cause major impairment in lung function, some coal workers have symptoms of chronic bronchitis

Question 35

possible complications with coal workers pneumoconiosis

Answer 35

scarred fibrotic lung distorts remaining lung (gross obstruction and restriction)

Question 36

silicosis (type of pneumoconiosis)

Answer 36

occupational lung disease caused by inhalation of crystalline silica dust, marked by inflammation and scarring in the form of nodular lesions in upper

Question 37

siderosis

Answer 37

deposition of iron in lung tissues - no effect on lungs so no associated fibrosis or narrowed airways

Question 38

acute pneumonia

Answer 38

acute inhalation of a substance that causes symptoms immediately, can be caused by chlorine, ammonia, organic chemicals, metallic compounts, form of acute RDS

Question 39

hypersensitive pneumonia

Answer 39

type 3 hypersensitivity reaction, inflammation of the alveoli due to inhaled organic dust

Question 40

causes of hypersensitive pneumonia

Answer 40

bird fancier's lung (due to feathers and bird droppings), farmer's lung (due to mouldy hay), metalworking fluids

Question 41

% of lung cancers in men related to occupation

Answer 41

10%

Question 42

asbestos

Answer 42

used a lot in 1950s and 1960s as a building material, fire retardant and could be used as cement.

Question 43

problem with asbestos

Answer 43

found to cause malignant mesothelioma (pleural tumour) in 1960s

Question 44

two types of asbestor fibre

Answer 44

serpentine (curly, white asbestos (relatively harmless), cleared with mucocilliary escalator) amphibole (short sharp blue/brown asbestos - malignant potential)

Question 45

mesothelioma

Answer 45

cancer of mesothelium, almost invariably caused by exposure to asbestos, latency period of around 40 years

Question 46

where are claims submitted for compensation for occupational illness in the UK

Answer 46

disability benefits centre of benefits agency (DSS)