Epidemiology of Health and Disease

Question 1

The most important risk factor far the development of breast cancer, like most cancers, is ___

Answer 1

AGE

Question 2

___ may have a protective effect on breast cancer, it is of nowhere near the magnitude of the effect of age

Answer 2

Nursing

Question 3

NOT a major risk factor for breast cancer

Answer 3

Cigarette smoke

Question 4

Early diagnosis of breast cancer, if it had any effect, would be expected to ___ the incidence rate

Answer 4

increase
(since some cases might be discovered that otherwise might spontaneously resolve or not be noticed before the woman dies of another cause)

Question 5

Appendicitis:
An important cause of morbidity in the Western world but mortality is ___
Boys and girls are ___ affected
Most common in ___ and ___ decades of life
During pregnancy, displacement of the appendix by the uterus can make diagnosis difficult

Answer 5

decreasing
nearly equally
2nd and 3rd

Question 6

The bacteria that are involved in nosocomial infections are transmitted most often by ___

Answer 6

direct hand contact

Question 7

transmission of bacteria from patient to patient most commonly occurs via the ___ of hospital personnel
Airborne, transmission, indirect exposure, and common source exposure are much less important than direct spread

Answer 7

hands

Question 8

Example of source of nosocomial infection endogenous to the patient, NOT a source of transmission of infection

Answer 8

Indwelling catheters

Question 9

What will highly decrease the transmission of nosocomial pathogens?

Answer 9

Meticulous handwashing

Question 10

Most common site of nosocomial infections?

Answer 10

GUT

Question 11

UTIs account for 35% of all nosocomial infections. About 70 to 80% of nosocomial UTIs are related to ___ and ___

UTI > ___ > RTI > Septicemia

Answer 11

catheters
urinary tract manipulation
SSI

Question 12

Triggers for acute episode of asthma:
Dust, animal dander, RTIs, ozone pollution, aspirin, emotional factors

___: a methylxanthine related to ___, a ___ potency bronchodilator
Theobromine is found in?

Answer 12

caffeine
theophylline
low
chocolates

Question 13

T/F: Obesity is a major risk factor for coronary heart disease

Answer 13

FALSE

Question 14

T/F: Genetic factors contribute to obesity

Answer 14

TRUE

Question 15

T/F: A sedentary lifestyle appears to be the most important cause of obesity in the Western populations

Answer 15

TRUE

Question 16

T/F: A woman whose body fat is >30% of her total mass is obese

Answer 16

TRUE

Question 17

T/F: Osteoarthritis is less common among obese persons because of decreased activity

Answer 17

FALSE

Question 18

T/F: Obese persons are significantly less active than non obese persons

Answer 18

TRUE

Question 19

T/F: The apparent association between obesity and hypertension is probably due to the use of inappropriately small blood pressure cuffs in obese subjects

Answer 19

FALSE

Question 20

T/F: In a normal person, 300 calories of excess CHOs will lead to the same weight gain as 300 calories of excess fat

Answer 20

FALSE. It’s not the calories consumed but the composition that determines weight gain

Question 21

To maintain current weight, one must exercise for ___ a day

To lose weight, one must exercise for ___ a day

Answer 21

60 minutes

90 minutes

Question 22

Present when body fat is >25% BW in men, >30% BW in women

Answer 22

Obesity

Question 23

Obesity: major risk factor for ___

It is a relatively unimportant risk factor ___ except at extremes of weight distribution

Answer 23

DM type 2

CHD

Question 24

Both behavioral and genetic factors contribute to obesity T/F

Answer 24

TRUE

Question 25

Arthritis, particularly at the ___, is more common among obese patients -- due to mechanical stresses on the joints

Answer 25

hip

Question 26

Normal persons can compensate for excessive carbohydrate intake by increasing ___

Answer 26

metabolic rate

Question 27

Cobalamin deficiency: ___: most common cause of cobalamin deficiency in temperate climates --- gastric mucosal atrophy --- ___ reaction against gastric ___ cells Increased risk in patients with a personal or family history of ___ e.g. Graves disease ___: fish tapeworm

Answer 27

``` pernicious anemia autoimmune parietal cells autoimmune disease Dipyllobothrium latum ```

Question 28

The major risk factor for stroke

Answer 28

Hypertension

Question 29

Other risk factors for stroke, besides HPN: (4)

Answer 29

smoking vascular disease DM TIA

Question 30

Gallstones: Extremely common in 20% of women and 8% of men above 40 Diabetics: increased risk for gallstones, as well as mobidity and mortality associated with the disease Chronic ___ --- formation of calcium bilirubinate stones Other risk factors: (3)

Answer 30

hemolysis age obesity chronic biliary infection

Question 31

Since gallstones contain cholesterol, hypercholesterolemia is associated with an increased risk of cholelithiasis. T/F

Answer 31

FALSE

Question 32

There has been increasing age adjusted mortality in the past 25 years from cancer of the ___

Answer 32

LUNG

Question 33

Cancers related with smoking? (3)

Answer 33

LUNG PANCREAS GUT

Question 34

Mortality from uterine malignancy has declined ainly due to the acceptance of ___

Answer 34

Pap smear

Question 35

Cigarette smoking increases the risk for liver cancer T/F

Answer 35

FALSE

Question 36

Worldwide, the most common risk factor for liver cancer is ___ ___ or ___ infection

Answer 36

chronic HBV or HCV

Question 37

The most common site for cancer in females in developing countries is ___

Answer 37

Breast

Question 38

Cancer MORBIDITY in DEVELOPING COUNTRIES Male: ___ Female: ___ Cancer MORTALITY in DEVELOPING COUNTRIES Male: ___ Female: ___

Answer 38

Lung and bronchus Breast Lung and bronchus Breast

Question 39

The development of neuropathic symptoms is associated with chronic exposure to: (3)

Answer 39

Mercury Lead Arsenic

Question 40

Intention tremor, delirium | Use of it in the manufacture of felt hats = "mad as a hatter"

Answer 40

Organic mercury

Question 41

Peripheral neuropathy and ataxia; irreversible CNS defects in children

Answer 41

Lead

Question 42

Similar to neuropathy seen in pernicious anemia

Answer 42

Nitrous oxide

Question 43

Irritation of mucous membranes

Answer 43

Sulfur dioxide

Question 44

Causally associated with pneumoconiosis?

Answer 44

Dust particles

Question 45

Delirium, coma

Answer 45

Arsenic

Question 46

A fibrosing lung disease usually due to chronic occupational exposure to air with particulate matter

Answer 46

Pneumoconiosis

Question 47

e.g. anthracosis, silicosis, asbestosis, berylliosis, farmer's lung, byssinosis

Answer 47

Pneumoconiosis

Question 48

molasses, baganese

Answer 48

Bagassosis

Question 49

cotton, flax, hemp

Answer 49

Byssinosis

Question 50

sulfur dioxides, nitrogen oxides, oil fumes and cigarette smoke --- cause acute ___ or exacerbate chronic ___ and ___

Answer 50

bronchospasm bronchitis emphysema

Question 51

What is common among these occupations? Battery maker Gasoline boy Solderer

Answer 51

Occupational exposure to lead

Question 52

Most serious manifestation of lead intoxication is ___

Answer 52

Cerebral edema

Question 53

Cerebral edema is often noted with blood lead levels exceeding ___ ug/dL

Answer 53

100

Question 54

5Bs of Congenital Rubella Syndrome

Answer 54

cataracts, SN deafness, MR, PDA, blueberry muffin baby

Question 55

Most prevalent mental health disorder in young children is ___

Answer 55

behavioral problems

Question 56

Parents who abuse their children are likely alcoholics | T/F

Answer 56

TRUE

Question 57

Parents who abuse their children are likely to be men than women T/F

Answer 57

FALSE

Question 58

Parents who abuse their children are found in all social classes T/F

Answer 58

TRUE

Question 59

Parents who abuse their children are likely to have been abused as children T/F

Answer 59

TRUE

Question 60

Child Abuse: | ___ > sexual > ___

Answer 60

neglect | physical

Question 61

Child Abuse: | The ___ is more commonly the abuser, perhaps of greater contact with the child

Answer 61

mother

Question 62

Child Abuse: | Abusing/abusive parents are usually psychologically immature and have poor ___

Answer 62

impulse control

Question 63

Oral contraceptives are associated with increased: thrombophlebitis T/F high levels of high density lipoproteins T/F carbohydrate intolerance T/F premature epiphyseal closure T/F

Answer 63

TRUE TRUE TRUE FALSE (OCPs in the available doses contain too little estrogen to close growth plates) Also, most females use OCPs after the growth spurt

Question 64

``` Anabolic steroid use among adolescents is associated with: testicular atrophy T/F enhanced school performance T/F aggressive behavior T/F cholestasis T/F ```

Answer 64

TRUE FALSE (school performance usually deteriorates as a result of mood changes and aggressive behavior) TRUE TRUE

Question 65

Tuberculosis: Humans are the only reservoir of MTB T/F The causative agents of human TB include M. bovis T/F The time from infection to the development of a positive tuberculin skin test is about six months T/F HIV infection is an independent risk factor for the development of active TB T/F

Answer 65

TRUE TRUE FALSE TRUE Note: the immunosuppression of HIV infection can lead to reactivation of latent TB, often the AIDS defining illness in these patients --- TB #1 Killer in AIDS

Question 66

Tuberculosis: time from infection to positive TST = ___ weeks

Answer 66

2 to 8

Question 67

Ability of a microbe or purified antigen to induce specific antibody production in a host as a result of infection or immunization

Answer 67

Immunogenicity

Question 68

Capacity of a microbe to cause symptomatic illness in an infected host

Answer 68

Pathogenicity

Question 69

Severity of illness produced by a microbe; measured by the percentage of severe or fatal cases

Answer 69

Virulence

Question 70

Ability of a microbe to spread in a population of exposed susceptible persons

Answer 70

Contagiousness

Question 71

Immunogenicity? Pathogenicity? Contagiousness? Virulence? | Neutralizing antibody develops in 95% of people after an attack of measles

Answer 71

Immunogenicity

Question 72

Immunogenicity? Pathogenicity? Contagiousness? Virulence? | Febrile respiratory tract disease develops in approximately 80% of children infected with influenza

Answer 72

Pathogenicity

Question 73

Immunogenicity? Pathogenicity? Contagiousness? Virulence? | Death occurs in approximately 20% of cases of pneumococcal meningitis

Answer 73

Virulence

Question 74

Immunogenicity? Pathogenicity? Contagiousness? Virulence? | Approximately 50% of household contacts of a child who has a common cold become infected

Answer 74

Contagiousness

Question 75

Dengue, yellow fever, chicken pox ``` Bacterial infections? Zoonoses? Person to person spread? Viral infections? Arthropod borne infections? ```

Answer 75

Viral infections

Question 76

Scabies, measles, shigellosis ``` Bacterial infections? Zoonoses? Person to person spread? Viral infections? Arthropod borne infections? ```

Answer 76

Person to person spread

Question 77

Rabies, psittacosis, salmonellosis ``` Bacterial infections? Zoonoses? Person to person spread? Viral infections? Arthropod borne infections? ```

Answer 77

Zoonoses

Question 78

Walking pneumonia, brucella, strep throat ``` Bacterial infections? Zoonoses? Person to person spread? Viral infections? Arthropod borne infections? ```

Answer 78

Bacterial infections