Epidemiology, Prevention & Control Of Some Respiratory Diseases

Question 1

Mention broad lines in general prevention of respiratory diseases.

Answer 1

1. Environmental sanitation
2. Health education: Personal hygeine, proper ventilation, avoid smoking in households, adequate nutrition, milk sanitation, consulting physician.

Question 2

Mention broadlines of specific measures in respiratory diseases

Answer 2

Immunization, chemoprophylaxis, health education, early detection of cases.

Question 3

Mention the role of active immunization in influenza prevention

Answer 3

Inactivated vaccine may reduce severity of disease and incidence of complications. Coupled with pneumococcal vaccine preferably.

Question 4

Mention the role of chemoprophylaxis in prevention of influenza

Answer 4

Effective only against type A, by amantadine given to non-immunized pts at high risk for complication OR immunized pts when maximal protection is desried.

Question 5

Amantadine treatment should be started with …. Hrs of onset of influenza A symptoms.

Answer 5

48

Question 6

Case definition of H1N1

Answer 6

A. Clinical criteria: fever more than 38oC OR history AND flu-like sympotoms
B. Epidemiological criteria: at least one of these during the last 7 days:
1. Close contact with confirmed or probable case
2. Travel history to area with confirmed cases

Question 7

Strains of avian influenza causing human disease.

Answer 7

A(H5N1) & A(H7N9)

Question 8

Mention specific antiviral for Avian flu

Answer 8

Oseltamivir (Tamiflu)

Question 9

Definition of probable case in MERS

Answer 9

Clinical criterial of disease
Epidemiological criteria: travel to area near Arabian Peninsula or contact with symptomatic case coming from area near Arabian Peninsula within (14 days)

Question 10

Definition of confimed MERS case

Answer 10

Case confirmed by laboratory testing

Question 11

Pneumonia is fatal disease in …..

Answer 11

Elderly

Question 12

Mention specific measures for pneumonia prevention.

Answer 12

Administration of polyvalent vaccine containing the capsular polysaccharides. For elderly every five yrs, also during epidemics of influenza & pneumonia.

Question 13

What is the golden age of TB and why?

Answer 13

5-15 yrs, age of acquiring infection but not disease.

Question 14

GR: Morb. & mort. of TB is low under 5.

Answer 14

Due to formation of 1ry pulmonary complex

Question 15

GR: Signinficant increase in susceptibility above 15 yrs of age esp in MALES

Answer 15

Due to mental & physical stresses leading to immunity decrease as well as more exposure to infections
More in males due to more exposure to stress & infection.

Question 16

GR: TB is the disease of poverty

Answer 16

Due to bad housing, overcrowding, bad ventillation.

Question 17

Exposure to …. In industry increases TB risk.

Answer 17

Silica dust

Question 18

Mention measures of environmental sanitation for TB

Answer 18

1. Good housing (avoid overcrowding & proper ventilation)
2. Adequate nutrition to raise general condition
3. Proper milk sanitation

Question 19

Type, route, effectiveness & adverse effects of BCG

Answer 19

Live-attenuated, ID single dose, 80% effective

Local ulcer, necrosis, lymphadenitis of draining lymph nodes

Question 20

C/I of BCG

Answer 20

+ve tubercelin reactors

Symptomatic HIV children

Question 21

Mention chemoprphylaxis of TB & its indications

Answer 21

Isoniazid (INH)

1. Children less than 5 exposed to TB cases
2. HIV contacts of TB cases
3. HIV patients or other immunosuppressed to prevent disease
4. Recent tubercelin convertors

Question 22

TB patient should be isolated in …..

Answer 22

Private room with negative pressure ventilation

Question 23

Mention benefits of supervision by HCW in TB treatment

Answer 23

1. Follow-up of the cases
2. Social family support
3. Rehabilitation & resettlement of the TB patient& their families after cure & finding a suitable job.

Question 24

Mention measures to contacts of TB patients

Answer 24

1. List
2. Surveillance: all identified contacts should do Tubercelin test, chest X-ray & sputum for positivie reactors.
3. Specific: active immunization for nonreactors
   Chemoprphylaxis for reactors with negative chest X-ray & sputum

Question 25

Uses of Tuberculin test

Answer 25

1. Screening test for measuring infection rates
2. Before BCG vaccine
3. To evaluate BCG vaccination program
4. To detect recent infection among high risk groups
5. To screen contacts for early case detection

Question 26

What are the next procedures for contacts of TB cases?

Answer 26

Repeat the test after 2-3 months, if still negative then TB free, if postive — recent converter

Question 27

Tools of active case detection

Answer 27

Mass Miniature Radiography
Chest X ray
Sputum examination

Question 28

Mesaures of TB burden

Answer 28

Incidence, prevalence, mortality.

Question 29

Role of surgical masks in TB patients

Answer 29

They are expensive & increase TB stigma

Question 30

What is the prevalence of lung cancer in Egyptian men?

Answer 30

3rd most common cancer

Question 31

Activities of NTP in Egypt

Answer 31

1. Immunization
2. Case finding (active & passive)
3. Treatment
4. Health education
5. Surveillance

Question 32

Mention drugs aggravating bronchial asthma

Answer 32

B blockers & aspirin

Question 33

GR: Menthol drugs are a reason for concern

Answer 33

As menthol may allow smokers to inhale more deeply

Question 34

Who are high risk individuals for lung cancers and what is recommended for them?

Answer 34

Between ages of 55 and 74, with either continued smoking or history of smoking within the past 15 years.
Yearly low-dose computed tomography