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Respiratory > Environmental factors/public health/tests > Flashcards

Environmental factors/public health/tests Flashcards

1
Q

what is the epidemiology of a disease

A

what causes it, where why and when it happens and to whom

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2
Q

what are the external causes of lung disease

A

smoking and exposure to agents

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3
Q

what are the internal causes of lung disease

A

genetics, uterine development

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4
Q

what are the social causes of lung disease

A

deprivation, cultural norms

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5
Q

what are the two types of occupational lung disease and give examples of each

A

hypersensitivity pneumonitis= extrinsic allergic alveolitis (e.g farmers lung, bird breeders lung, cheese workers lung)
pneumoconiosis (e.g. asbestosis, silicosis, coal workers lung, beryiliosis)

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6
Q

what is hypersensitivity pneumonitis

A

chronic inflammatory reaction in the lung due to exposure to specific antigens/ pathogens (lots from mould spores)

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7
Q

what does chronic hypersensitivity pneumonitis result in in the lung and how is it treated

A

extensive fibrosis with honeycombing and air trapping (scarring and inflammation). antigen avoidance

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8
Q

what type of lung disease is asbestosis and how is it caused

A

fibrotic lung disease, pneumoconiosis, caused by inhalation of asbestos fibres

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9
Q

why does mesothelioma take over 20 years (after exposure) to develop

A

as fibres stay in lungs causing damage until cancer develops

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10
Q

how much does asbestos increase risk of cancer from baseline risk of 1

A

x 5

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11
Q

how much does smoking increase risk of cancer from baseline risk of 1

A

x 10

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12
Q

how much does smoking and asbestos increase risk of cancer from baseline risk of 1

A

x 53

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13
Q

how much does smoking <1 pack a day and asbestos increase risk of cancer from baseline risk of 1

A

x 87

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14
Q

what is the synergistic effect of smoking and asbestos

A

work together to increase risk of cancer (particularly mesothelioma)

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15
Q

what were the main sources of exposure to asbestos

A

shipbuilding, mining (coal particles as well), heat insulation and building

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16
Q

what are the indoor environmental sources of lung disease

A

asbestos, mould, cooking smoke, passive smoking, nanoparticles

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17
Q

what are the outdoor environmental sources of lung disease

A

air/traffic pollution

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18
Q

what are the main effects of poor housing

A

mostly respiratory but also accidents and mental health

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19
Q

what are DALY

A

disability adjusted life years- a measure of the burden of a disease as the number of years lost to ill health

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20
Q

what is fuel poverty

A

amount of income spent on fuel

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21
Q

what helped to reduce passive smoking

A

the smoking ban

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22
Q

what in relation to population can attribute to lung disease

A

overcrowding

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23
Q

what is the primary and other components of smog

A

ozone (O3) primary, nitrogen oxide (NO), nitrogen dioxide (NO2), volatile organic compounds (VOCs)

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24
Q

what is smog caused by

A

poor consumption of fossil fuels in cars

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25
Q

what are the components of london smog

A

fly ash, sulphur dioxide, sodium chloride, calcium sulphate particles

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26
Q

what creates london smog

A

smoke based fog from burning of (high sulphur) coal fires

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27
Q

what are the most common chemical hazards of lung disease

A

sulphur dioxide, nitrogen oxide, particle matter, ozone and VOCs, persistent organic compounds (POCs), benzene, carbon monoxide, lead and heavy metals

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28
Q

what are the main effects of traffic fumes

A

reduced lung growth in adolescents, increased rates of COPD, asthma and respiratory symptoms (wheeze, cough and breathlessness)

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29
Q

what are some of the wider effects of inhaled substances outside the lungs

A

low birth weight, appendicitis, stroke, neurological/ neurobehavioural outcomes

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30
Q

what are dioxins a sub group of

A

persistent organic compounds

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31
Q

why are dioxins (found in food (meat) and airborne) so potent for us

A

as they bioaccumulate

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32
Q

what are dioxins associated with

A

reproductive and immunological problems

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33
Q

how does environmental injustice influence lung disease

A

wealth determines where you live and therefore your exposure as well as social norms- poor systemically disadvantaged

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34
Q

how does the increased tobacco outlet in poorer areas affect environmental injustice

A

makes poverty and smoking cyclic

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35
Q

how will water scarcity affect global health

A

growing population will put strain as water unevenly distributed

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36
Q

how will climate change affect global health

A

more frequent droughts, storms and flooding- destroys crops, contaminates water and damages water storage and transportation facilities

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37
Q

what is the only infectious agent causing environmental lung disease

A

legionella

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38
Q

what percentage of the population would be considered smoke free

A

5%

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39
Q

how do you reduce demand for smoking

A

reduce; availability, visibility, affordability and desirability

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40
Q

how is availability of cigarettes reduced

A

age limit, proxy purchase is an offence, banned vending machines, test purchasing, tobacco register (of shops)

41
Q

how is affordability of cigarettes reduced

A

price in increase, duty escalator, increasing minimum size of pack/roll up pack available

42
Q

how is visibility of cigarettes reduced

A

advertising bans, display bans, indoor smoking ban, smoke free environments, smoke free events, outdoor bans

43
Q

how is desirability of cigarettes reduced

A

ban lipstick style packs aimed at women, plain packaging, ugly colour

44
Q

what are possible NRT

A

vaping, NUS and champix

45
Q

where are smoking rates highest in vulnerable populations

A

mental health, addiction, prisoners, homeless, LGBTQ+

46
Q

why do people smoke

A

social, culture, self-medication, boredom

47
Q

when in NRT most effective

A

when on prescription as engaged in partnership programme

48
Q

what are some incentive scheme for quitting and who is eligible

A

Quit 4 U and Give it up for baby, 40% most deprived zones, 1 in 6 signing up. get asda credit

49
Q

what is smoking role in pregnancy

A

largest preventable cause of disease and death in pregnancy

50
Q

what happens to smoking in pregnancy rates with age

A

increases as age decreases

51
Q

what is illicit tobacco

A

illegal, counterfeit, smuggled

52
Q

what is epidemiology

A

branch of medicine which deals with the incidence, distribution, and possible control of diseases and other factors relating to health

53
Q

what are the principles of epidemiology

A

what is it, where does it happen, why does it happen, why does it happen, when does it happen, who does it happen to

54
Q

what is a positive predictive value

A

percentage of people who have a positive result who have the disease

55
Q

what is prevalence

A

measure of how common disease is in the tested population

56
Q

what happens to the positive predictive value as the prevalence falls

A

decreases

57
Q

define test sensitivity

A

ability of the test to correctly identify those with the disease

58
Q

define test

A

ability of test to correctly identify those without the disease

59
Q

what are effort dependant pulmonary function tests

A

forced expiratory volumes/flow rates- spirometry

60
Q

name some effort independent tests

A

relaxed vital capacity, exhaled breath nitric oxide

61
Q

name three gas diffusion tests

A

CO transfer factor, ABG (resting), SaO2 during exercise

62
Q

what are the dynamic lung volumes

A

forced expiratory volume; from TLC to RV (FEV1, FVC, FEV1/FVC, RVC (relaxed))

63
Q

what diseases cause volume dependant expiratory airway closure

A

asthma, chronic bronchitis

64
Q

what diseases cause pressure dependant expiratory airway closure

A

emphysema

65
Q

what is PEFR

A

peak expiratory flow rate

66
Q

how is PEFR affected in obstructive/restrictive disease

A

normal in restrictive, reduced in obstructive

67
Q

how is FEV1 affected in obstructive and restrictive disease

A

decreased in both

68
Q

how is FVC affected in obstructive and restrictive disease

A

obstructive;asthma=normal, COPD= reduced

restrictive; decreased

69
Q

what is the FEV1 response to a B2-agonist in restrictive disease

A

no response

70
Q

what is bronchial challenge testing done and what does it show

A

breathes in nebulised methacholine/histamine/mannitol, marker of airway hyper-responsiveness- diagnosis of occupational asthma via spirometry

71
Q

how can exercise testing show asthma

A

reduced FEV1 and PEFR post exercise

72
Q

how can exercise testing show ILD

A

reduced SaO2 during exercise

73
Q

when would TLC be increased

A

hyperinflation, emphysema

74
Q

what is TLCO

A

total lung transfer for CO

75
Q

when is TLCO reduced

A

anaemia, emphysema, ILD, pulmonary oedema, PE, bronchiectasis

76
Q

what is exhaled breath nitric oxide a measure of

A

marker of eosinophilic airway inflammation- high levels

77
Q

what is the FEV1 response to a B2-agonist in asthma and COPD

A

> 15% in asthma

<15% in COPD

78
Q

how is TLCO affected in emphysema, asthma and restrictive disease

A

reduced in emphyema and restrictive, normal in asthma

79
Q

what is a buffy coat

A

white cells and platelets

80
Q

what does a lower Hb level suggest

A

anaemia

81
Q

what helps to determine the cause of anaemia

A

mean cell volume (red cell size)

82
Q

what does microcytic mean and suggest in patients

A

smaller cells, iron deficiency (e.g chronic blood loss)

83
Q

what does macrocytic mean and suggest in patients

A

larger cells, alcohol excess, liver disease, hypothyroidism, vitamin B12/folate deficiency

84
Q

what does normocytic mean and suggest in patients

A

normal, acute blood loss, anaemia of chronic disease e.g. inflammation, infection

85
Q

in what situation are neutrophils common

A

bacterial infection, steroid use

86
Q

in what situation are lymphocytes common

A

viral infections

87
Q

in what situation are monocytes common

A

atypical infections, cancers

88
Q

in what situation are eosinophils common

A

parasitic infections, allergies

89
Q

in what situation are basophils common

A

allergic reactions

90
Q

what suffixes are used to describe high white cell agents

A

cytosis or philia

91
Q

what can cause thrombocytosis (high plasma)

A

acute/chronic blood loss, inflammation, malignancies

92
Q

what is low platelets called

A

thrombocytopenia

93
Q

what is an epidemic

A

widespread occurrence of an infectious disease in a community at a particular time

94
Q

what is a pandemic

A

disease that is prevalent over a whole country/the world

95
Q

what is endemic

A

disease/condition that is regularly found among particular people/ in certain area

96
Q

why is influenza likely to cause a pandemic

A

as caused by different strains so hard to gain immunity

97
Q

how is influenza spread

A

droplets via cough, sneeze, touch or touching contaminated surface

98
Q

how is influenza risks managed and contained

A

index clusters identified, routine control measures, anti-virals when necessary.

99
Q

describe the WHO stages (8) of pandemic

A 
1-3;predominantly animal infections
4;sustained human-human transmission
5-6;widespread human infection
post peak;possibility of reccurence
post pandemic;seasonal levels of disease

Respiratory (26 decks)

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