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Epidemiology > Final Exam > Flashcards

Final Exam Flashcards

1
Q

What is an infectious disease

A

A disease caused by a microorganism and pan potentially transfer to humans (e.g. food poisoning)

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2
Q

What is a communicable disease

A

An infectious disease that is contagious and transferrable from person to person (e.g. flu)

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3
Q

What is the epidemiological triangle

A

A model used to explain the etiology of infectious diseases

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4
Q

What are the 4 main factors in the pathogenesis of disease

A

Host, agent, environment, and time

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5
Q

What is the agent of infectious disease

A

Microorganisms capable of producing the disease (necessary but not sufficient cause of disease)

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6
Q

What is infectivity

A

Capacity of an agent to enter and multiply in a susceptible host and thus produce infection/disease

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7
Q

What is subclinical disease for infection response in the host

A

Infection without clinical illness and exposure without infection

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8
Q

What is clinical disease for infection response in the host

A

Moderate severity/illness, clinical and severe disease, and death

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9
Q

What is below visual change for cell response to infection

A

Exposure without cell entry and incomplete viral maturation

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10
Q

What is a discernible effect for cell response to infection

A

Cell transformation or dysfunction and lysis of cell

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11
Q

What is pathogenicity

A

Capacity of an agent to cause active clinical disease in the infected host

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12
Q

What is clinical disease

A

Obvious observable or detectable symptoms (mild, moderate, severe, and death)

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13
Q

What is virulence

A

A degree of pathogenicity that indicates the severity of disease after infection occurs

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14
Q

What is a susceptible host

A

The target of a specific infectious agent

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15
Q

What are 12 portals of exit out of a host

A

Eyes, ears, nose, mouth, broken skin, mammary glands, placenta, vaginal secretions, urethra, anus, seminal vesicle, skin flakes

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16
Q

What are 12 portals of entry into a host

A

Eyes, ears, nose, mouth, broken skin, placenta, vagina, urethra, anus, capillary, digestive tract, respiratory tract

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17
Q

What is vertical transmission

A

From mother to child

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18
Q

What is horizontal transmission

A

From infected individual to another susceptible individual

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19
Q

What are 3 modes of vertical transmission

A

Mammary glands (milk), placenta (blood), vagina (secretion, blood)

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20
Q

What are 2 modes of horizontal transmission

A

Direct (person to person) and indirect (via intermediary source)

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21
Q

What are 2 methods of direct transmission

A

Direct contact (skin to skin, exchange of bodily fluids) and droplets (sneezing, coughing, or talking)

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22
Q

What are 3 types of indirect transmission

A

Airborne, vector borne (animate objects), and vehicle born (inanimate objects)

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23
Q

How does airborne transmission work

A

Infectious agents are carried by dust or droplet nuclei suspended in air

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24
Q

What is a vector

A

A living insect or animal involved with transmission of a disease agent

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25
Q

What are 4 kinds of vehicles that can transmit disease agents

A

Water, food, soil, and fomites

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26
Q

What are fomites

A

Objects or materials likely to carry infection (doorknob, clothing, unsterilized medical equipment, etc.)

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27
Q

Can diseases have multiple modes of transmission

A

Yes

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28
Q

What is a host

A

A person or animal susceptible to disease

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29
Q

What does the degree of severity of an infection depend on

A

The host’s ability to fight off the infectious agent

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30
Q

What are the two types of defenses mechanisms in a host

A

Innate response (hours) and adaptive response (days)

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31
Q

What is acquired immunity

A

Immunity that develops during your lifetime

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32
Q

What are the two kinds of acquired immunity

A

Active and passive

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33
Q

What are the two kinds of active and passive immunity

A

Natural and artificial

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34
Q

What is active immunity

A

Develops in response to an infection or vaccination

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35
Q

What is passive immunity

A

Develops after you receive antibodies from someone or somewhere else

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36
Q

What is natural active immunity

A

Antibodies developed in response to infection, provides long lasting immunity

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37
Q

What is artificial active immunity

A

Antibodies developed in response to a vaccination, long lasting immunity

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38
Q

What is natural passive immunity

A

Antibodies received from mother (e.g. through breast milk), immediate and temporary protection

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39
Q

What is artificial passive immunity

A

Antibodies received from medicine (e.g. gamma globulin injection or infusion), immediate, temporary protection

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40
Q

Which provides a larger, faster, and stronger response (1st or 2nd exposure)

A

2nd exposure

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41
Q

What is the environment

A

The domain in which disease-causing agents may exist, survive, or originate

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42
Q

What are the two kinds of environment

A

Physical (weather, temp. humidity, etc.) and social (behavioral and cultural characteristics of a group of people)

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43
Q

What’s a reservoir

A

The habitat in which infections agents live, grow, and multiply

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44
Q

What are the 3 kinds of reservoirs

A

Environmental (e.g. plants, soil, contaminated food/water), animal or insect, and human

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45
Q

What are the 2 kinds of human reservoirs

A

Acute clinical cases and carriers

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46
Q

What are acute clinical cases

A

People infected with the disease agent who become ill

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47
Q

What are carriers

A

People who harbor infectious agents but aren’t ill

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48
Q

What are the 4 types of carriers

A

Healthy, incubatory, convalescent, and chronic

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49
Q

What is a healthy carrier

A

People with infections that will never develop the illness but can transmit it (common with polio)

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50
Q

What are incubatory carriers

A

People who will become ill but start transmitting infection before symptoms present (common with HIV or measles)

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51
Q

What are convalescent carriers

A

People who continue to be infectious after recovery from illness (e.g. salmonella)

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52
Q

What are chronic carriers

A

People who keep harboring infection for a year or longer after recovery (e.g. Hep B)

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53
Q

What are super-spreaders

A

Someone who is responsible for infecting many people

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54
Q

What is the 80/20 rule

A

In any given outbreak, 20% of individuals are thought to contribute at least 80% to transmission of pathogen

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55
Q

What type of carrier was Typhoid Mary

A

Asymptomatic/healthy and chronic

56
Q

What is an incubation period

A

The time between exposure to infectious agent and appearance of first signs and symptoms of disease which can help determine what the exposure may have been

57
Q

What is a sign of disease

A

Something which can be visibly observed (temperature, color, etc.)

58
Q

What is a symptom of disease

A

Something felt by the diseased (dizziness, nausea, exhaustion, etc.)

59
Q

What is generation time

A

Time between exposure to an infectious agent and the maximal infectivity of the host (cab be before active symptoms) which is good to determine spread of infectious agents when lots of subclinical cases

60
Q

What is an epidemic (epidemic) curve

A

A graph plotting the distribution of cases by time of onset

61
Q

What is a common source epidemic curve

A

We know exactly where the source is coming from

62
Q

What are the 3 kinds of common source epidemic curves

A

Point source, continuous, and intermittent

63
Q

What is a point source epidemic curve

A

Exposed to same common source (single meal or event), and majority of cases occur within one incubation period (e.g. food poisoning)

64
Q

What is a continuous common source epidemic curve

A

Lasts more than one incubation period (e.g. water pump)

65
Q

What is an intermittent source epidemic curve

A

Multiple peaks with no relation to incubation period (e.g. contaminated food sold over period of time)

66
Q

What is a propagated source epidemic curve (3 characteristics)

A

No common source, caused by spread of infectious agent from one person to another or via intermediate host, multiple peaks separated by one incubation period

67
Q

What are the 2 kinds of epidemic curves

A

Common source and propagated

68
Q

What is attack rate

A

The proportion of a group that experiences the outcome under a study over a given period

69
Q

When is attack rate used

A

Only for acute infectious disease outbreaks or acute exposures of large groups to toxic agents

70
Q

What is a case

A

A person in a population identified as having disease

71
Q

What are new cases

A

Initial cases and secondary cases

72
Q

What are initial cases

A

Index cases and coprimaries

73
Q

What are index cases

A

The case that first comes to attention of public health authorities

74
Q

What are coprimaries

A

Cases related so closely in time that they’re considered to belong to same generation of cases

75
Q

What are secondary cases

A

People who become ill after a disease has been introduced into a pop. from contact with a primary case

76
Q

What is secondary attack rate

A

A measure of infectivity which indexes the spread of disease in a family, household, dwelling unit, dormitory, etc.

77
Q

What is case fatality rate

A

Proportion of deaths caused by disease among those who have the disease during a time interval

78
Q

What does case fatality rate index

A

The virulence of a particular disease within a specific population

79
Q

What is basic reproductive rate

A

Measures transmissibility (contagiousness) by seeing number of infections produces on average by an infected individual when virtually all contacts are susceptible

80
Q

What are 8 control measures to stop disease spread

A

Hand washing, PPE, clean water, sanitation, food safety (clean, separate, cook, and chill), mosquito control, blood screening, vaccines

81
Q

What is herd immunity

A

Immunity of a population, group, or community against an infectious disease when a large proportion of people are immune through vaccinations or prior infections

82
Q

What does critical vaccine threshold indicate

A

The higher R(0) a disease has, the greater need their is for vaccine coverage

83
Q

What are the 10 steps of investigation infectious disease outbreaks

A

1: Establish existence of an outbreak
2: Verify diagnosis
3: Construct a working case definition
4: Find cases systematically and record info.
5: Perform descriptive epidemiology
6: Develop a hypothesis
7: Evaluate hypothesis epidemiologically,
8: Reconsider, refine, and re-evaluate hypothesis
9: Implement control and prevention measures
10: Communicate findings

84
Q

What is a case definition

A

A standard set of criteria to decide whether an individual should be classified as having the health condition of interest

85
Q

What should a case definition have

A

Clinical criteria, setting of outbreak investigation (person, place, and time), but not exposure or risk factor being evaluated

86
Q

What is passive surveillance

A

Sending letter or describing the situation and asking for reports of similar cases

87
Q

What is active surveillance

A

Telephoning or visiting facilities to collect info. on any additional cases

88
Q

What should data collection include (5 things)

A

Identifying info., demographic info, clinical info, risk factor info, and reporter info.

89
Q

What is screening for a disease

A

Presumptive identification of unrecognized disease or defects through testing, examinations, or other rapid procedures which are followed by diagnostic tests to confirm actual disease

90
Q

What are the 4 characteristics of screening tests

A

Detect potential disease indicators, target large numbers of asymptomatic individuals, simple and cheap, and results indicate suspicious of disease

91
Q

What are the 4 characteristics of diagnostic tests

A

Establish presence or absence of disease, target single asymptomatic individuals or asymptomatic individuals with positive screening test, maybe invasive and costly, provide definite diagnosis

92
Q

What are the 2 kinds of screening tests

A

Mass (population) screening and selective (targeted screening)

93
Q

What is the difference in the 2 kinds of screening tests

A

Mass screens entire population regardless of risk status (e.g. temp at airport) while selective screens specific groups at high risk for disease (e.g. HIV screening for sex workers)

94
Q

What are the 4 social considerations for screening tests

A

Health problem should be important to individual and community, diagnostic follow-up and intervention should be available for all who need them, favorable cost-benefit ratio, and high public acceptance

95
Q

What are the 3 scientific considerations for screening tests

A

Natural history of condition adequately understood (identifies early stages of disease and biological markers of progression), efficacy of prevention and occurrence of side effects is known, and prevalence of the disease or condition is high

96
Q

What are the 2 ethical considerations for screening tests

A

Program can alter natural history of condition in significant proportion of those screened and suitable, acceptable tests for screening and diagnosis as well as acceptable, effective prevention methods

97
Q

What are the 5 characteristics of a good screening test

A

Simple, rapid, inexpensive, safe, and acceptable

98
Q

What are the 2 evaluations of screening tests

A

Reliability (precision) and validity (accuracy)

99
Q

What is reliability

A

Ability of a measuring instrument to give consistent results on repeated trails

100
Q

What is validity

A

Ability of measuring instrument to give a true measure

101
Q

What are the interrelationships between reliability and validity

A

A measure can be highly reliable but invalid (e.g. broken scale) but a measure cannot be valid but unreliable

102
Q

What is the gold standard

A

The diagnostic test or benchmark that’s best available under reasonable conditions (not perfect but best available)

103
Q

What are the 6 measures of validity

A

Sensitivity, specificity, predictive positive value, predictive negative value, accuracy, and prevalence

104
Q

Which measures of validity show characteristics of a test

A

Sensitivity and specificity

105
Q

What measures of validity show clinical relevance of a test

A

Positive and negative predictive values show how well a measure is clinically testing what we want it to test

106
Q

What is special about accuracy and prevalence

A

Can only be used when the same individuals are examined in screening and gold standard

107
Q

What is sensitivity

A

The proportion of people tested positive among people who had the disease

108
Q

What is specificity

A

The proportion of people who tested negative among people who were disease free

109
Q

What is positive predictive value

A

The proportion of people who actually had the disease among people who tested positive

110
Q

What is negative predictive value

A

The proportion of people who are actually disease free among people who tested negative

111
Q

What is accuracy

A

The degree of agreement between the test result and the gold standard

112
Q

What happens to predictive values when there is a lower prevalence in a population

A

Positive predictive value will go down while negative predictive value will go up

113
Q

How should the cut point be moved to improve sensitivity

A

Towards the normal (also increases false positives)

114
Q

How should the cut point be moved to improve specificity

A

Towards the range typically associated with disease (Increases false negatives)

115
Q

What are 4 procedures to improve sensitivity and specificity

A

Retrain screeners to reduce misclassification, recalibrate screening instruments to reduce imprecision, use a different test, or use more than one test

116
Q

What are the 3 sources of bias in screening

A

Lead time bias, length bias, and selection bias

117
Q

What is lead time bias

A

The perception that a screen-detected case will live longer because the disease was identified early

118
Q

What is length bias

A

Disease identified through screening has lower, less aggressive course and therefore better prognosis (so screening doesn’t actually help that much and may actually do more harm)

119
Q

What is selection bias

A

Motivated participants have a different probability of disease than do those who refuse to participate

120
Q

What are 7 health effects attributed to environmental exposures

A

Cancer, lung disease, infertility, reproductive impacts, infectious diseases, neurologic diseases, and dermatologic problems

121
Q

What is environmental epidemiology

A

Study of disease conditions (occurring in population) that are linked to environmental factors

122
Q

What are environmental exposures

A

Exposures outside the control of the exposed individual

123
Q

What are the 2 kinds of study designs

A

Descriptive (cross-sectional) and analytic (ecologic, cohort, and case-control)

124
Q

What are the 3 characteristics of descriptive study designs

A

Helpful to set priorities, identify hazards, and make hypotheses for new occupational risks

125
Q

What are the 2 characteristics of analytic study designs

A

Used to show exposure-effect relationships and effects of low-level exposures

126
Q

What are the 2 end points for occupational exposures

A

Morbidity (self-reports and symptoms and results of clinical examinations) and mortality (compares mortality rates of exposed to nonexposed workers in same industry)

127
Q

What is the healthy worker effect

A

Employed populations tend to have lower mortality experience than general population (may reduce measure of effect for an exposure that increases morbidity or mortality)

128
Q

What is sick building syndrome

A

Symptoms diminish when affected person leaves the building

129
Q

What are the 5 tiers of hazard surveillance from most effective to least effective

A

Elimination (physically remove the hazard), substitution (replace the hazard), engineering controls (isolate people from hazard), administrative controls (change way people work), and PPE (protect worker with equipment)

130
Q

What is the sentinel health effect

A

Case of unnecessary disease, unnecessary disability, or untimely death whose occurrence is a warning signal that the quality of preventative or medical care may need to be improved (secondary prevention)

131
Q

What are the 4 noteworthy community environmental health hazards

A

Hazardous waste sites, air pollution, nuclear facilities, and drinking water

132
Q

What are 5 methodological difficulties associated with waste sites

A

Complex mixture of substances, studies may not adequately control for confounding factors, long-term effects of exposure hard to measure, effects of low-level exposures are difficult to show, and small study samples

133
Q

What are 4 methodological difficulties associated with smoking

A

Small increases in risk of death from passive smoking difficult to show, short-term vs. long-term exposure, exposure to cigarette smoke from many sources, and long latency period between exposure to cigarette smoke and onset of disease

134
Q

What are nuclear facilities

A

Weapons production plants, test sites, and nuclear power plants

135
Q

What are 7 sources of groundwater contamination

A

Industrial facilities, new human habitation, runoff from growing urbanized areas, pathogenic microorganisms, pesticides, radioactivity, etc.

Epidemiology (2 decks)

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