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Preventive Medicine > Epidemiology > Flashcards

Epidemiology Flashcards

1
Q

Study (scientific, schematic, data-driven) of the distribution (frequency and pattern) and determinants (causes, risk factors) of health-related stages or events in specified populations and the application to the control of health problems

A

Epidemiology

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2
Q

Epidemiology is concerned with two key factors of health events:

A

Frequency

Pattern

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3
Q

Number of health events (such as number of cases of meningitis or diabetes) but also to the relationship of that number to the size of the population

The rate allows epidemiologists to compare disease occurence across different populations

A

Frequency

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4
Q

Occurence of health related events by time, place and person

May be annual, seasonal, weekly, daily, hourly, weekday vs any other breakdown of time that may influence disease or injury occurence (time pattern)

Geographical variation, urban/rural differences, location of work site or schools (place pattern)

A

Pattern

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5
Q

Characterizing health events by time, place and person

A

Descriptive epidemiology

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6
Q

Any factor, whether event, characteristic or other definable entity, that brings about a change in health condition or other defined characteristic

Causes and other factors that influence the occurence of disease and other health-related events

A

Determinant

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7
Q

Anything that affects the well-being of a population

A

Health-related states or events

ex. disease

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8
Q

Concerned about collective health of the people in a community or population

A

Epidemiologist

Focuses on identifying the exposure or source that caused illness, number of persons similarly exposed; the potential for further spread in the community and interventions to prevent additional cases or recurrence

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9
Q

Explained disease from rarional rather than supernatural point of view

“On airs, waters and places”

Environmental and host factors such as behavior might influence development of disease

A

Hippocrates

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10
Q

Haberdasher and councilman who published a landmark analysis of mortality data in 1662

First to quantify patterns of birth, death and disease occurence noting disparities between males and females, high infant mortality, urban/rural differences and seasonal variations

A

John Graunt 1662

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11
Q

Father of modern vital statistics and surveillance

A

William Farr 1800

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12
Q

Anesthesiologist

Father of field epidemiology

Studied cholera outbreaks discovering cause and prevention of disease

Descriptive epi -> hypothesis generation -> hypothesis testing (analytic) -> application

A

John Snow

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13
Q

John Snow developed this tool showing the geographic distribution of cases

A

Spot map

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14
Q

Rotavirus vaccine SE

A

intusucception

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15
Q

Set of standard criterua for classifying whether a person has a particularly disease, syndrome or other health condition

A

Case definition

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16
Q

Graphing annual cases or rate of a disease over period of years

Long term

A

Secular trend

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17
Q

Disease occurence can be graphed by week or month over the course of a year or more to show its seasonal pattern

A

Seasonality

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18
Q

Suggests hypothesis about the time and source of exposure, the mode of transmission and causative agent

Uses histogram

A

Epidemic period

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19
Q

Single most important “person” attribute

A

Age

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20
Q

Key feature of analytic epidemiology

A

Comparison group

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21
Q

Quantifies the association between exposures and outcomes and to test hypotheses about casual relationships

A

Analytic epidemiology

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22
Q

Two kinds of analytic epidemiology

A

Experimental

Observational

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23
Q

Investigator determines through a controlled process the exposure for each indivdual (clinical trial) or community (community trial) and then tracks the individuals or communities over time to detect the effects of the exposure

A

Experimental studies

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24
Q

Epidemiologist simply observes the exposure and disease status of each participant

A

Observational studies

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25
Q

Observational study types:

A

Cohort
Case-control
Cross-sectional

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26
Q

Epidemiologist records whether each study participant is exposed or not and tracks to see if they develop disease

Investigator observes rather than determines participant’s exposure status (not randomly assigned)

After a period of time, the investigator compares the disease rate in rhe exposed group with the disease rate in unexposed

If the disease rare is substantively different in the exposed group compared to the unexposed group, the exposure is said to be associated with illness

A

Cohort study

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27
Q

Well known cohort study that established the rates and risk factors of heart disease

A

Framingham study

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28
Q

Participants enrolled as the study begins and are then followed prospectively over time to identify occurence of the outcomes of interest

A

Follow-up/Prospective Cohort

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29
Q

Both the exposure and the outcome have already occured

The investigator calculates and compares rates of disease in the exposed and unexposed groups

Used in investigations of disease in groups if easily identified people such as workers at a participar factor or attendees at a wedding

A

Retrospective cohort study

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30
Q

Investigators start by enrolling a group of people with disease and a comparison group (without disease)

Investigators compare previous exposures between the two groups

The control group provides an estimate of the baseline or expected amount of exposure in the population.

If the amount of exposure among the case group is substantially higher than the amount you would expect based on the control, then illness is said to be ASSOCIATED with that exposure

A

Case-Control

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31
Q

Sample of persons from a population is enrolled and their exposures and health outcomes are measured simultaneously

Assess the PREVALENCE of health outcome at that point of time without regard to duration

Weaker than either because it cannot disentangle risk factors for occurence of disease (incidence) from risk factors for survival with the disease

Synonymous to

A

Cross-sectional study

Survey

Prevalance rather than incidence

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32
Q

Subjects are enrolled or grouped on the basis of their exposure, then are followed to document occurence of disease

Difference in disease RATES between the exposed and unexposed groups lead investigators to conlcude that exposure is associated with disease

A

Cohort study

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33
Q

Subjects are enrolled according to whether they have the disease or not, then are questioned or tested to determine prior exposure

Difference in EXPOSURE prevalence between the case and control allows investigators to conclude that the exposure is associated with the disease

A

Case-control study

34
Q

Measure exposure and disease status at the same time and are better suited to descriptive epidemiology than causation

A

Cross-sectional study

35
Q

Simplest model for causation

Traditional model for infectious disease

A

Epidemiologic Triad

36
Q

Epidemiologic triad

A

External agent
Susceptible host
Environment

37
Q

Chemical contaminant responsible for eosinophilia-myalgia

A

L-tryptophan

38
Q

Attempt to account for the multifactorial nature of causation

An individual factor that contributes to cause disease is shown as a piece of pie

After all the pieces of a pie fall into place, the pie is complete and disease occurs

A

Causal pie

39
Q

The individual factors in causal pies

A

Component causes

40
Q

The complete pie which might be considered a casual pathway is called

A

Sufficient cause

41
Q

A component that appears in every pie or pathway is called

without it, disease does not occur

A

Necessary cause

42
Q

Hypertension/Stroke

Cause

A

Component Cause

43
Q

Treponema pallidum/Syphilis

Cause?

A

Necessary cause

44
Q

Type A personality/Heart disease

Cause?

A

Component cause

45
Q

Skin contact with a strong acid/Burn

Cause?

A

Sufficient cause

46
Q

3 forms of route of anthrax infection

A

Cutaneous (95%)
Inhalation - fatal; mail related
Intestinal

47
Q

Progression of a disease process in an individual over time in the absence of treatment

A

Natural history of disease

48
Q

Stages of Natural History of Disease

A

Stage of susceptibility
Stage of subclinical disease
Stage of clinical disease
Stage of recovery: disability or death

49
Q

Stage of subclinical disease extending from the time of exposure to onset of disease symptoms

Asymptomatic or inapparent

Some pathologic change detectable with laboratory, radiographic, or other screening methods

A

Incubation period - infectious disease

Latency period - chronic disease

50
Q

Paralytic shellfish poisoning (tingling, numbness around lips and fingertips, giddiness, incoherent speech, respiratory paralysis, sometimes death)

Incubation period:

A

Saxitoxin and similar toxins from shellfish

Few minutes to 30 minutes

51
Q

Incubation period of radium (watch dial painters) to developing bone cancer

A

8-40 years

52
Q

Most screening programs attempt to identify the disease process during this phase of its natural history since intervention at this early stage is likely to be more effective than treatment given after the disease has progressed and become symptomatic

A

Incubation period

53
Q

The onset of symptom marks the transition from subclinical to clinical disease

Most diagnoses are made during this stage

A

Stage of clinical disease

54
Q

Illness that ranges from mild to severe or fatal

A

Spectrum of disease

55
Q

End of disease process

A

Recovery
Disability
Death

56
Q

Proportion of exposed persons who become infected

A

Infectivity

57
Q

Proportion of infected individuals who develop clinically apparent disease

A

Pathogenecity

58
Q

Proportion of clinically apparent cases that are severe or fatal

A

Virulence

59
Q

Agent leaves its reservoir or host through a portal of exit, conveyed by some mode of transmission and enters through an appropriate portal of entry to infect a susceptible host

A

Chain of infections

60
Q

Habitat in which the agent normally lives, grows and multiplies

May or may not be the source from which agent is transferred to a host

A

Reservoir

61
Q

Those who can transmit the agent during the incubation period before clinical illness begins

A

Incubatory carrier

62
Q

Those who have recovered from their illness but remain capable of transmitting to others

A

Convalescent carriers

63
Q

Continue to harbor a pathogen such as Hepatits B virus or Salmonella typhi for months or years after their initial infection

A

Chronic carrier

64
Q

Infectious disease that is transmissible under natural conditions from vertebrate animals to humans

A

Zoonosis

65
Q

Types of direct transmissio

A

Direct contact

Droplet spread

66
Q

Types of Indirect transmission

A

Airborne
Vehicleborne
Vectorborne (mechanical or biologic)

67
Q

Final link in the chain of infection

A

Susceptible host

68
Q

If a high enough proportion of individuals in a population are resistant to an agent, then those few who are susceptible will be protected by the resistant majority

A

Herd immunity

69
Q

Increase, often sudden, in the number of cases of a disease above what is normally expected in that population i that area

A

Epidemic

70
Q

Epidemic in a more limited geographic area

A

Outbreak

71
Q

Aggregation of cases grouped in place and time that are suspected to be greater than the number expected even though the expected number may not be known

A

Cluster

72
Q

Epidemic that had spread over several countries or continents usually affecting a large number of people

A

Pandemic

73
Q

Persistent, high levels of disease occurence

A

Hyperendemic

74
Q

Epidemic and their manner of spread through a population

A

Common-source
Propagated
Mixed
Other

75
Q

Group of person are all exposed to an infectious agent or a toxin from the same source

A

Common-source outbreak

76
Q

If the group is exposed over a relatively bried period so that everyone who becomes ill does so within one incubation period

A

Point source (common source) outbreak

77
Q

Point-source outbreak plot

A

Steep upslope more gradual downslope

Log-normal distribution

78
Q

Pattern reflecting the intermittent nature of exposure

A

Intermittent common source outbreak

79
Q

Transmission from one person to another by direct person-to-person contact, vehicleborne, vectorborne

A

Propagated outbreaks

80
Q

Common source outbreak followed by secondary person-to-person spread

A

Mixed epidmeic

81
Q

Neither common-source nor propagated from person to person

A

Epidemic not caused by point, intermittent or propagated source

Preventive Medicine (2 decks)

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