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Public Health > Final Exam > Flashcards

Final Exam Flashcards

1
Q

Surveillance for Infectious and Communicable Diseases

A

To gather the who, when, what, and where to determine why
Systematically collect, organize, and analyze data for a defined disease
Surveillance for agents of bioterrorism—anthrax, smallpox
List of Reportable Diseases- varies by state
National Notifiable Diseases- infectious and non-infectious

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2
Q

Populations at increased risk for transmission and infection

A

Children
Older adults
Immunosuppressed
High-risk lifestyles
Travelers
Health care workers

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3
Q

most probable cause of the increase in new emerging infectious diseases

A

Activities or behavior of humans, including changes in the environment

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4
Q

Emerging infections

A

Those in which the incidence has increased in the past two decades or has the potential to increase in the future

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5
Q

Airborne infections examples

A

Measles
Chicken pox
TB
Pertussis
Influenza
SARS

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6
Q

Foodborne infections

A

Salmonella
Hepatitis A
Trichinosis
E. Coli
Norovirus
Botulism
Mercury poisoning

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7
Q

waterborne infections

A

Cholera
Typhoid
Dysentery (diarrhea with blood or mucus)
Giardia
Hepatitis A
Most who die from this are small children

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8
Q

vector borne infections

A

West Nile
Lyme disease
Malaria
Rocky Mountain Spotted Fever

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9
Q

direct contact infections

A

mono
lice
scabies
STDs

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10
Q

Vaccine preventable diseases

A

Measles
Mumps
Rubella
Pertussis
Influenza
Polio
Tetanus

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11
Q

Incubation/latency period

A

time interval between invasion by infectious agent and symptoms

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12
Q

Prodromal period

A

here the pathogen continues to multiply, and the host begins to experience general signs and symptoms of illness
Too general to know what it is that’s making you sick

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13
Q

Period of illness

A

the signs and symptoms of disease are most obvious and severe

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14
Q

Period of decline

A

treatment or sickness passed
Replication stops, the number of pathogen particles begins to decrease, and the signs and symptoms of illness begin to decline

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15
Q

communicable period

A

time interval during which an infectious agent may be transferred directly or indirectly from an infected person
Can happen in any stage

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16
Q

Active immunity

A

Antibodies synthesized by the body in response to antigen stimulation

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17
Q

NATURAL active immunity

A

contact with an antigen through exposure

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18
Q

ARTIFICIAL active immunity

A

immunization with an antigen

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19
Q

Passive immunity

A

antibodies produced in one individual and transferred to another

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20
Q

NATURAL passive immunity

A

immunity from the placenta transferred from mother to child

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21
Q

ARTIFICIAL passive immunity

A

injection of serum from an immune human or animal i.e. , gamma globulin

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22
Q

Herd immunity

A

Type of immunity in which a large proportion of people in a population are not susceptible to a communicable disease, and the few susceptible people will not be likely to be exposed and contract the illness

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23
Q

Flu

A

Influenza is a viral respiratory infection
Transmission is airborne
Vaccines available!

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24
Q

Symptoms of flu

A

temp 100+
cough
sore throat
underlying condition that increases risk

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25
Q

Tuberculosis

A

Caused by Mycobacterium tuberculosis
Transmission is usually by airborne droplets from persons with TB
Negative pressure room!

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26
Q

symptoms of TB

A

cough, blood-tinged sputum, fatigue, Gradual weight loss, low-grade fever, nocturnal diaphoresis

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27
Q

critical period and meds times with TB

A

Critical period 6-12 months after infection
4-9 months meds with annoying side effects, compliance is key!

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28
Q

Treatment of TB

A

Targeted tuberculin testing and treatment of latent tuberculosis infection

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29
Q

Contributing factors for TB

A

Overcrowding
Poor ventilation
Poor health
HIV/AIDS
Poor diet
Homelessness

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30
Q

TB blood tests

A

also called interferon-gamma release assays or IGRAs
measures how the immune system reacts to the bacteria that cause TB
by testing the person’s blood in a laboratory

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31
Q

IGRAs

A

QuantiFERON®–TB Gold In-Tube test (QFT-GIT)
T-SPOT®.TB test (T-Spot)

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32
Q

Positive IGRA

A

means the person has been infected with TB bacteria. Additional tests are needed to determine if the person has a latent TB infection or active TB disease. A healthcare worker will then provide treatment as needed

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33
Q

Negative IGRA

A

means that the person’s blood did not react to the test and that latent TB infection or TB disease is not likely

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34
Q

Who are IGRAs the preferred method of testing for

A

People who have received bacille Calmette–Guérin (BCG). BCG is a vaccine for TB disease.
People who have a difficult time returning for a second appointment to look for a reaction to the TEST

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35
Q

TB skin test

A

Intradermal injection in the forearm- 0.1 ml PPD
Read reaction 48-72 hours after injection
Measure and record results in millimeters of induration

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36
Q

An induration of 5 or more mm is considered positive in

A

HIV-infected people
People who have had a recent contact with another person with TB
People with fibrotic changes on chest radiograph consistent with prior TB
Patients with organ transplants
People who are immunosuppressed for other reasons (like taking the equivalent of >15 mg/day of prednisone for 1 month or longer, taking TNF-α agonists)

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37
Q

An induration of 10 or more mm is considered positive in

A

Recent immigrants (<5 years) from high-prevalence countries
Injection drug users
Residents and employees of high-risk congregate settings
Mycobacteriology laboratory personnel
Persons with clinical conditions that place them at high risk
Children <4 years of age
Infants, children, and adolescents exposed to adults at high risk for developing active TB

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38
Q

An induration of 15 or more mm is considered positive in

A

Any person, including people with no known risk factors for TB. However, targeted skin testing programs should only be conducted among high-risk groups

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39
Q

Treatment and prevention of TB

A

Long-course anti-TB medication - can be up to 6-12 months on meds for active disease
DIRECTLY OBSERVED THERAPY
Healthcare professionals observe clients to ensure that they ingest each dose of anti-TB medication to maximize the likelihood of completion of therapy.
CDC recommends video DOT (vDOT) as an alternative to in-person DOT for people in TB treatment

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40
Q

Examples of diseases of travelers

A

Malaria
Foodborne and waterborne diseases
Diarrheal diseases
Yellow fever
Hepatitis
Chikungunya
Other endemic diseases

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41
Q

Zoonosis

A

an infection transmitted from a vertebrate animal to a human under natural conditions- rabies (hydrophobia)

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42
Q

Parasitic diseases

A

more prevalent in tropical climates and countries with inadequate prevention and control methods

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43
Q

What are nosocomial infections

A

in the hospital
People coming in and out of hospital are at risk

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44
Q

What is an Emerging Infectious Disease

A

Newly appearing in a population or community that hasn’t existed before

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45
Q

Measles

A

An acute viral respiratory illness.
VERY CONTAGIOUS
Lives on surfaces 2 hours
1 person can infect 9-10 people

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46
Q

S/S of measles

A

fever (as high as 105°F) and malaise,
the three “C”s: cough, coryza, and conjunctivitis
Koplik spots - inside the mouth on the cheeks
followed by a maculopapular rash
Rash – flat, red spots that can become raised
Koplik spots – whitish-blue spots on the inside of the cheeks–followed by maculopapular rash

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47
Q

Mumps

A

A highly contagious viral illness in young adults
Transmission: coughing, sneezing, kissing, sharing food or drinks
Need to spend 9 days in isolation
No treatment or cure

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48
Q

S/S of mumps

A

Flu-like symptoms followed by painful swelling of one or both glands in cheek near jaw line**
It can start as an earache or tenderness along the jaw
Usually last for 9 days

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49
Q

What can mumps lead to

A

Meningitis
Painful swollen testicles
Painful swelling of ovaries and breasts
Pancreatitis
Permanent deafness
Spontaneous abortions

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50
Q

Rubella

A

It is a contagious viral disease that can cause a mild illness to serious health problems
Contagious for about a week before and a week after the rash appears
Transmission: coughing, sneezing, or touching contaminated surfaces

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51
Q

S/S of rubella

A

Mild fever
Headache
Sore throat
Red rash
Swollen lymph nodes.
The rash usually starts on the face and spreads to the rest of the body. About half of people who get rubella don’t develop a rash

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52
Q

Complications of rubella

A

If a pregnant woman gets rubella, she has a 90% chance of passing it to her fetus

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53
Q

Treatment of rubella

A

Usually resolves on own
Pain medications
Vaccination

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54
Q

pertussis

A

A bacterial infection that causes severe coughing fits and can be life-threatening for babies.
Spreads easily through coughing or sneezing
Babies may not cough much, or they may not cough at all. Instead, they may have apnea
If people are visiting newborn babies, make sure they’re vaccinated!

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55
Q

Treatment of whooping cough

A

Antibiotics
Rest, fluids, and avoid cigarette smoke
Vaccine

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56
Q

Polio (poliomyelitis)

A

A highly contagious viral disease that can cause paralysis and death.
Due to vaccination programs, it has been eliminated in many areas

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57
Q

Common S/S of polio

A

Fever
Headache
Fatigue
Vomiting
Muscle pain
In more severe cases, polio can cause paralysis, affecting the arms, legs, or both. Paralysis can occur within hours of infection and is usually permanent
Can cause respiratory failure and death

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58
Q

Transmission of polio

A

Person-to-person contact with infected feces, contaminated food or water, or through respiratory droplets from an infected person

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59
Q

Treatment of polio

A

No cure
Bed rest, pain relievers, muscle relaxers, and physical therapy

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60
Q

Tetanus

A

Bacterial

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61
Q

S/S of tetanus

A

Muscle spasms in the jaw, face, throat, chest, neck, back, abdomen, and buttocks
Fever
Trouble swallowing
Rapid heart rate
Incontinence

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62
Q

Treatment of tetanus

A

Focused on managing complications
Vaccination

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63
Q

Hepatitis

A

Viral hepatitis refers to a group of infections that primarily affect the liver. These infections have similar clinical presentations but different causes and characteristics

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64
Q

Hep A

A

It may last several weeks and can be debilitating, but most people recover
Affects the liver–jaundice, clay colored stools, dark urine
Vaccine preventable!!

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65
Q

Hep A route and transmission

A

Spread through fecal-oral route (when fecal matter enters the mouth)
Direct contact
Food and beverages
Cups and spoons
Objects handled by an infected person

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66
Q

Hep A S/S

A

N/V/D, stomach pain, anorexia, fever, fatigue, jaundice

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67
Q

Prevention of hep A

A

Hand hygiene education
Keeping toilets and bathrooms clean
Avoiding infected water sources
Peeling fruits and vegetables, and avoiding undercooked meat and fish
Drink bottled water or boil tap water before drinking

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68
Q

People at high risk of hep A

A

Daycare workers
People traveling to countries with high rates
IV drug users
homosexual men
anybody with chronic liver disease

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69
Q

Hep B

A

More self limited
Bigger ability to infect compared to HIV because it stays outside the body for longer
Vaccine-preventable
OSHA mandate requires healthcare workers to be offered scene at the expense of their employer

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70
Q

Hep B route and transmission

A

Spread through blood and body fluids

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71
Q

Hep B people at risk

A

IV drug users
immigrants
refugees
healthcare workers
hemodialysis patients
prisoners
persons with STDs

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72
Q

Hep B acute vs chronic

A

Acute: Will develop antibodies and rid the body of the virus on its own. You will have lifelong immunity to acute hep b
Chronic: Mostly seen in immunodeficiency, can’t rid self of virus so they will remain lifelong carriers. Can lead to hepatic carcinoma and chronic active hepatitis

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73
Q

Hep C and spread

A

Most common chronic blood-borne infection in the US
The leading cause of chronic liver disease, end-stage liver disease, liver cancer, and liver transplants. Very serious!
Spread through blood or body fluids

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74
Q

High risk of Hep C

A

healthcare workers
infants born to infected moms
IV drug users
persons with multiple sex partners

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75
Q

risk factors for STDs

A

younger than 25
minority
urban setting
poverty
using crack cocaine
older adults

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76
Q

Gonorrhea

A

Gram negative, goes for mucus membranes, affects anus, GU tract/genitals, pharynx
Can be spread from mother to child
Increased risk for PID in women

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77
Q

S/S of gonorrhea

A

Maybe no symptoms!
Abdominal pain or pain with intercourse
Vaginal discharge and bleeding
Infected kidneys
UTI (dysuria)
Burning sensation with urination
Inflammation of the penile
Swollen testicles
Green discharge from the penis

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78
Q

Syphilis

A

Risk is increasing
Babies can get this and die a lot from it

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79
Q

Stage 1 syphilis

A

Sore on entry site/chankra
Starts macular, will grow and ulcerate to create indented sore on back
30-90 days after exposure
Will go away into 3-6 weeks or continue into stage 2

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80
Q

Stage 2 syphilis

A

Body rash that starts on palms of hands and soles of feet, moves inward to trunk
Sore throat, fever, and swollen lymph nodes
4-10 weeks after initial infection

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81
Q

Stage 3 syphilis

A

Rare because of antibiotics
Affects internal organs
Can lead to blindness, psychosis, and cardiovascular damage
Can lead to death of babies, blindness, deafness, or premature birth
Meningitis, anemia, low birth weight, and death in babies born
3-15 years after initial infection

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82
Q

Chlamydia

A

The most common reportable STD in the US
About 70-80% of women with chlamydia don’t notice any symptoms
Cervix, rectum, or throat in women
Urethra, rectum, or throat in men
Treated with antibiotics
Exposure again can make you get it again

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83
Q

S/S of chlamydia

A

usually appear 1-3 weeks after exposure
Pain when urinating
Discharge
Urinary frequency
Pain in the lower abdomen
Pain in the testicles
Fever, nausea
Painful intercourse

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84
Q

Herpes

A

Can be passed in childbirth
Painful, no cure (chronic, has latency periods of dormancy and reactivation)
Linked to cervical cancer, spontaneous abortions, and high risk of transmission to newborns
Prodromal period before outbreak

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85
Q

Herpes treatment

A

Antiviral medications include acyclovir, famciclovir, and valacyclovir.
The World Health Organization (WHO) recommends starting treatment within the first three days of an initial outbreak

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86
Q

HPV

A

Genital warts found on shaft of penis or vulva/vagina/cervix and around anus
Viral infection
Caused by only a few of the 100+ strains of HPV
Transmitted by skin/skin contact in genital area
Treatable
Visual test
Common in young, sexually active women
Can cause cancer
Vaccine preventable

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87
Q

S/S of HPV

A

Genital warts
Cervical cancer
precancerous lesions
lesions of upper respiratory tract
Plantar warts
Usually no manifestations, they can be dormant and activate when there is a drop in immunity

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88
Q

Genital warts in HPV

A

Usually soft, fleshy, and moist. They may ooze, bleed, get pustular and itch, at times
In women, they can be seen on the labia majora, minora, cervix, vagina, and anus
In men, they mostly appear on the scrotum or penis

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89
Q

Cervical cancer in HPV

A

Persistent infection with high risk types of HPV increases the chances of developing cervical cancer
All cases of cervical cancer are caused by HPV infections
The high risk types of HPV can also cause cancer of the anus, mouth, and upper respiratory tract

90
Q

Precancerous lesions in HPV

A

These are pre-cancerous affections, which can progress to invasive cancer, and are most commonly seen in the genital areas
These types of HPV cause cellular changes or dysplasia in the cervix or vagina
Such lesions can be easily detected on a PAP smear

91
Q

Lesions of upper respiratory tract in HPV

A

Some strains of HPV can affect the mouth and upper respiratory tract
They could also give rise to HPV symptoms like warts on the tongue, tonsils, buccal cavity, larynx, and nose
These warts interfere with breathing and may require surgery

92
Q

Plantar warts in HPV

A

These appear on the sole of the foot
They typically have a cauliflower appearance
They may ooze blood through capillaries when the surface is cut open
They spread on contact with the virus, through cuts and abrasions on the skin

93
Q

Treatment of HPV

A

Chemotherapy, surgical removal of wart, pap smears, and HPV vaccine

94
Q

Natural history of HIV

A

Transmission via semen, vaginal secretions, blood and breastmilk
HIV is not transmitted through casual contact, touching, coughing, office equipment, dishes, insects

95
Q

Stages of HIV

A
  1. The primary infection (within about one month of contracting the virus)
  2. Clinical latency – a period with no apparent symptoms
  3. Final stage of symptomatic disease
96
Q

Progression of HIV

A

Flu like symptoms at first that go undetected
lymphadenopathy, myalgias, rash, sore throat, and fever
AIDS is the last stage. It is life threatening and disabling, caused by HIV or a CD4 T-lymphocyte count <200 mLs with HIV

97
Q

CD4

A

Good!
Between 500 and 1200: Usual for people without HIV
Below 200: Higher risk of illnesses and infections
Can also be a percentage. Above 90% is similar to above 500. Below 14% is similar to below 200

98
Q

Viral load

A

Bad
Between 100,000 and 1 million: high
Below 10,000: For people with HIV not on treatment, this is low
Below 50: Known as “undetectable”. The aim of HIV treatment is to have an undetectable viral load

99
Q

HIV testing

A

Antibody, antigen/antibody, and nucleic acid test (NAT)

100
Q

Antibody test for HIV

A

looks for antibodies to HIV in your blood or oral fluid. Most rapid tests and the only HIV self-test approved by the FDA are antibody tests.
Can take about 90 days to be detected, tell patient to come after that amount of time to make sure they’re actually negative

101
Q

Antigen/antibody test for HIV

A

Antigen/antibody test looks for both HIV antibodies and antigens. Blood draws from veins or also a rapid antigen/antibody test from a finger stick.
18-45 days from blood draw, 18-90 days from fingerstick

102
Q

NAT for HIV

A

looks for the actual virus in the blood. Done via blood draw. Determines viral load. Fastest detection of HIV presence

103
Q

PrEP for HIV

A

Oral=get tested every 3 months
Injection=get tested every 2 months
For HIV negative ppl high risk
If you are diagnosed, you are no longer on PrEP

104
Q

Opportunistic infections

A

Occurs when immune system is vulnerable, specifically HIV
Pneumocystis carinii pneumonia- most common
Tuberculosis
Cryptococcal meningitis
Fungal infections
Kaposi sarcoma

105
Q

What are Health Care Disparities?

A

Differences or inequalities in health care status due to gender, race/ethnicity, education, disability, geographic location or sexual orientation.
A goal in the United States is to eliminate health disparities by expanding access to health care for vulnerable or at-risk populations
Example: Rural residents have more chronic conditions such as diabetes and are more likely to die of heart attacks

106
Q

Vulnerability

A

Susceptibility to actual or potential stressors that may lead to an adverse effect

107
Q

Vulnerable population

A

Increased risk
Worse health outcomes

108
Q

Disenfranchised

A

Those who are marginalized from society, disconnected from community which they live and work, whether because they move around, race, ethnicity, etc
Socially excluded
Excluded from getting goods or care

109
Q

Resilience

A

Ability to resist vulnerability

110
Q

Underserved populations

A

Subgroup of the population
Higher risk of developing health problems
Greater exposure to health risk because of marginalization (age/gender/ability to access resources)

111
Q

Who suffers health disparities r/t the SDOH

A

High risk mothers
Chronically ill and disabled
HIV/AIDS
Mentally ill
Substance abusers
Homeless
Immigrants and refugees

112
Q

Risks increasing vulnerability

A

Environmental hazards-lead exposure, mold, education, etc
Social hazards-crime, violence, isolation esp in elderly and rural
Personal behaviors-smoking, diet
Biological or Genetic make-up-immune state, vulnerability to disease, etc

113
Q

Poverty/lack of health insurance

A

Poverty is defined by family income and the number of people in a family.
Primary cause of vulnerability to health problems
Poverty guidelines help determine financial eligibility for assistance
Income doesn’t increase but cost of living does
Anyone living in poverty with no health insurance is primary cause of vulnerability

114
Q

Rural vs urban

A

Rural – fewer than 20,000 residents or fewer than 99 persons per square mile.
Makes up 20% of population rn, so 20% of population faces these vulnerabilities
Urban – higher population densities; population of at least 20,000

115
Q

Rural populations

A

Higher proportions of whites in rural areas
Higher than average numbers of younger (6-17 years) and older (over 65 years)
People 18 and older are more likely to be or have been married
More likely to be widowed than urban counterparts
Fewer years of formal schooling
Tend to be poor
Higher risk of being uninsured or underinsured
High risk for injury

116
Q

Health status in rural

A

Higher infant and maternal morbidity rates
Higher rates of diabetes
Higher rates of obesity
Higher rates of suicide
Higher rates of injury
Increased occupational risks
Less likely to seek preventative care
Poorer perceptions of health and health status

117
Q

rural barriers to health

A

Distance
Lack of transportation
Unpredictable weather
Uninsured
Shortage of healthcare providers
Rural Health Care

118
Q

Seven A’s of challenges to elders in rural

A

Availability
Accessibility
Affordability
Awareness
Adequacy
Acceptability
Assessment

119
Q

Health professional shortage rural area

A

Geographic area, population group, or medical facility with shortages of health care professionals that may not allow a full complement of health care
Not enough people in one specialty
Also not enough facilities for rural areas

120
Q

Medically underserved rural area

A

Area that is determined with a calculation of a ratio of primary medical care physicians per 1,000 population, infant mortality rate, percentage of the population with incomes below the poverty level, and percentage of the population age 65 or above

121
Q

Medically underserved rural population

A

US federal designation for those populations that face economic barriers (low-income or Medicaid-eligible populations) or cultural and/or linguistic access barriers to primary medical care services

122
Q

Ranking of rural health priorities

A

Access to care
Nutrition and weight status
Diabetes
Mental health
Substance abuse
Heart disease and stroke
Physical activity and health
Concerns for the older adult
Maternal, infant and child health
Tobacco use

123
Q

Migrant farm worker

A

one whose primary employment is agriculture on a seasonal basis, who has been employed within the last 24 months and who establishes a temporary abode for the purpose of that employment

124
Q

Seasonal farm workers

A

work cyclically in agriculture but can migrate
Seasonal workers
Have temporary housing
Not covered under labor laws-no regulations
Use limited English
Have cultural practices/values

125
Q

Migrant health issues

A

Dental ($$ and causes other health conditions)
TB (overcrowding)
Chronic diseases_STIs, HIV, infectious disease
Stress/anxiety
Anemias
Cancers (pesticides and chems)
No prenatal care
STI, HIV
Pesticide exposure- headaches, dizziness, dyspnea, eye/skin irritation, anemias and cancers in chronic use
No services or access
No PTO, sick time, etc
No medicaid
Long hours during the time clinics are open
Documentation and being illegal

126
Q

Primary, secondary, and tertiary care for migrants and rural

A

Primary prevention- education, prenatal care, immunizations, dental care
Secondary- TB screenings, cancer screenings, lead screenings, pesticide exposure, illness
Tertiary- chronic conditions, treat for pesticide exposure, mobilize primary care services

127
Q

Veterans

A

Under the Department of Veterans Affairs (VA)
Health Issues
Mental health- PTSD, substance abuse
Infectious disease–migration, exposed to elements, overcrowding
Chemical exposure
TBI (traumatic brain injury)
Hearing/vision impairments (guns/bombs/chems)
Amputations
* Coordination of care is important*

128
Q

Teen pregnancy

A

At lowest rate since 1976
Area of public health concern
Higher rates for Black and Hispanic teens
May result in a cycle of poverty and school failure
Teens often feel invincible and may not recognize risks involved with behaviors
Teens often influenced by peer pressure

129
Q

Risk factors of teen pregnancy

A

Sexual victimization–whether as a result or leads to increased risk taking and promiscuity
Family structure
Parenting style
Lack of communication and education about issues of sexuality

130
Q

Post-effects of teen pregnancy

A

Limited education/job opportunities
Risk of poverty and homelessness
Risk of malnutrition- set up WIC program
Discrimination
All teen pregnancies are considered high risk*
Parental denial plays a major factor in prevention*

131
Q

Correctional system

A

Addiction
Increased mental health disorders
Increased risk of sexual assault; violence
Increased risk of infectious diseases (TB, HIV, STIs, Hep C)
Upon release- mental health issues poverty, inability to find employment/housing, chronic disease, social injustice, economic problems
Illness and injury occur before the institution, at the institution, and trickles back out when they’re released
Most inmates are male and Hispanic or AA around 37yo. Around 75% are in for nonviolent crimes (drug possession, robbery, extortion, etc)

132
Q

LGBTQIA biggest health problem

A

relationship between members of this population and the healthcare system

133
Q

LGBT youth health problems

A

Suicide, depression, peer victimization, family rejection, physical health problems

134
Q

Overall LGBT population problems

A

Homelessness, higher rates of tobacco, alcohol, and other drug use

135
Q

Gay men risks

A

HIV/STDs, especially in communities of color

136
Q

Lesbian risks

A

Less likely to get preventative services for cancer
Lesbian and bisexual females more likely to be overweight or obese

137
Q

Transgender risks

A

High prevalence of HIV/STIs, victimization, mental health, suicide

138
Q

Elderly LGBT issues

A

face additional barriers to health because of isolation and a lack of social services and culturally competent providers

139
Q

Healthy people 2030 and LGBT

A

collecting data on LGBT health issues and improving the health of LGBT adolescents.
Adding questions related to sexual orientation and gender identity to surveys
School- and family-based interventions can help reduce bullying and decrease deaths associated with suicide and illegal drug use

140
Q

Looking at the whole person in LGBT

A

It is essential to engage the whole person, not a collection of risk factors
It is important to understand that LGBT life issues are like others but also unique:
Families, Coming Out
Long Term Relationships
Reproduction, Parenting
Mental Health
Chronic Diseases
Communicable Diseases

141
Q

Ending LGBT invisibility

A

Ask questions!!

142
Q

Taking LGBT history

A

Same for all patients
Know them as a person
Inclusive and neutral language
Partner instead of husband/wife/bf/gf
No assumptions
Remember sexual health and high risk of HIV/STIs

143
Q

Sex questions for LGBT history

A

Have you had sex with anyone in the last year?
Did you have sex with men, women, or both?
Have you had oral, vaginal, or anal intercourse?
How many partners did you have?
How often do you use condoms?
Have you exchanged sex for drugs, alcohol, housing, food, or money?
Has anyone ever forced you to have sex?

144
Q

Why are families homeless

A

They don’t have enough money to afford housing!!
There is an affordable housing shortage throughout the United States.
The housing that does exist is very expensive
Families with children are the fastest growing segment of the homeless
More than 600,000 American kids will sleep in a shelter tonight
The average age of a homeless person: 9 years old.
The child who is homeless is more likely to have school absences

145
Q

Reasons for homelessness

A

Deinstitutionalization efforts of the 1960s to mainstream the mentally ill and to society.
Closure of inpatient psych centers in units due to a lack of funding.
Unemployment or under-employment.
Domestic violence.
Abandonment.
Natural disasters and fires.
Disability.
Substance abuse and addiction.
Immigration.
Political unrest and wars

146
Q

Other factors contributing to homelessness

A

Substance Abuse
Mental Illness
Domestic Violence
Family Strife
Unemployment
Disability

147
Q

Infectious disease in homelessness

A

Crowded living arrangements with many other families means more bug sharing
Upper respiratory infections
Acute otitis media
Lice
Scabies
Others

148
Q

Nutrition in homelessness

A

Income is associated with obesity for all age groups (unhealthy diet)
Homeless face additional problems in access to nutritious food
Homeless children and those in unaffordable housing situations have actually been shown to exhibit growth stunting due to malnutrition

149
Q

Dental care in homeless

A

Access to dental care is a huge problem – Medicaid does not cover dental care for adults (children yes)
Nearly 50% of school-aged children have not seen a dentist in the previous year in one study
36% of homeless children have dental problems according to family surveys
Can lead to chronic diseases

150
Q

Asthma in homeless children

A

Asthma rates are increased for children living in poverty in general, including homeless children
Associated with poor housing conditions:
Dust mites
Cockroaches
Molds
Rodents
URI’s as a trigger (increased due to crowding)

151
Q

Nurses approach to homeless people

A

Show respect and use a positive approach, which builds trust.
Support primary (advocacy), secondary (tuberculosis screening), and tertiary (“detox” treatment) prevention to make it easier to cope with difficult, challenging lives

152
Q

Factors that lead to increased violence

A

Inadequate social support
Feelings of powerlessness
Violence shown in the media
Living in a crowded environment

153
Q

Physical violence

A

Kicking, slapping, hitting, punching, pushing, pulling, choking and property damage

154
Q

Emotional abuse

A

Jealously, anger, intimidation, controlling, neglect, humiliation, threats, isolation and verbal abuse

155
Q

Social abuse

A

Being stopped from meeting or seeing friends or family, not allowed to leave the home. Being stalked

156
Q

Sexual abuse

A

Forcing and coercing sexual acts, rape and having sex without wanting to.
May not be disclosed, can’t assess for it

157
Q

Economic abuse

A

Controlling access to money and other resources, forced to live without money
Seen in elderly by adult child by being controlling or stealing money

158
Q

Indicators of violence

A

Physical injuries, no explanation for injuries or an incorrect one
Current or previous police involvements
Feelings of sadness or depression, low self-esteem , financial concerns, no social life, can’t go for healthcare, etc
Difficulty in concentration or focus
Being denied access to funds or resources and/or repeated requests for financial assistance

159
Q

What can nurses do if they suspect violence

A

Nurses partnering with associations to provide alternative activities that improve social skills is one of the best ways to prevent violence
Report incidents to child protective services or other appropriate legal authorities
Comprehensive services in locations where people live and work
Advocacy
Social justice
Culturally and linguistically appropriate health care

160
Q

Issues that impact on the incidence of violence in refugee/immigrant/migrant communities

A

Pre-arrival torture, trauma, rape, and sexual violence. These can also happen post-arrival
Post-traumatic stress disorder.
Problems experienced during resettlement
Racism
Loss of dreams
Loss of status

161
Q

Outcomes of vulnerability

A

Outcomes of vulnerability can be negative, such as lower health status, or they may be positive with effective interventions
One vulnerability usually puts one at risk for another
Cycle of vulnerability

162
Q

cycle of vulnerability

A

social isolation, hopelessness, chronic stress, powerlessness

163
Q

Pneumocystis Carinii Pneumonia

A

People often die from this rather than the actual HIV
Airborne
Yeast like fungus but antifungals don’t work
Abx, and corticosteroids in severe cases
CD4 <200 is risk for HIV
External dyspnea, fevers, chills, weight loss, chest discomfort, nonproductive cough, nosebleeds (rare)
Before antiretroviral meds, 70-80% incidence per year
People in their 80s dying from HIV die from this PNA

164
Q

Cryptococcal meningitis

A

CD4 of 100 or less is high risk
Fungal infection
Virus is seen in environment: soil and bird droppings
Inhalation → lungs, blood, spinal column, brain
Can infect lungs, or in severe cases, kidneys, skin, urinary tract, and lymph nodes

165
Q

Kaposi sarcoma

A

Cancer in lymph cells and blood vessels among people with HIV
Lesions on chest, face, limbs,
Life threatening if in GI tract, liver, lungs
Cytotoxic drugs/chemo
Rare but be aware of side effects and symptoms in HIV

166
Q

Primary prevention of HIV

A

teach safe sex, abstinence, monogamy, use and appropriate use of condoms, clean needle policy, prophylactic meds (primary prevention bc preventing but they’re at risk so secondary as well)

167
Q

Secondary prevention of HIV

A

partner notification in people newly diagnosed, screenings, antibody/NAT testings for STDs, C-sections in HIV+ women to decrease transmission risk in baby

168
Q

Tertiary prevention of HIV

A

antiretroviral meds, treatments, encourage healthy lifestyles in people with HIV, support services, resources

169
Q

Rural health challenges

A

Limited access to healthcare and resources
Social isolation
scarcity of health professionals
Lack of knowledge (health literacy)
Poverty
Language and culture barriers between migrants, farmers, etc
Traveling time and or distance to care (no transportation)

170
Q

Global health

A

the area of study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide
we try to understand underlying issues of health such as different factors like biological, environmental, financial, etc
ENTIRE HUMAN POPULATION which is ONE GLOBAL COMMUNITY working together to stay healthy

170
Q

Florence nightingale in global health

A

Through her life’s work, Florence Nightingale advocated for health at the personal, community, and global levels. In 1893 she stated, “Health is not only to be well but to use well every power we have.” As nurses we have power in numbers. But is important to remember that our power also resides in our strong caring beliefs and values

171
Q

2 factors of the foundation of global health

A

Justice
human rights

172
Q

WHO

A

Major international agency for health
Acts as a director and coordinator for international health work (domestic and worldwide)
Mission: “attainment by all peoples of the highest possible level of health” (WHO, 1948)
Premise: health is a public good requiring governmental action to achieve its objective

173
Q

World health agency

A

Highest governing body within WHO. Agency that collaborates with the UN, involved with data gathering, research, and policy organization to help the WHO achieve its mission.
Publication called world health stats that look at diseases around the globe

174
Q

Initiatives of WHO

A

Eradication/elimination programs for polio, leprosy, guinea worm and measles
Reducing transmission and incidence of HIV/AIDS (some countries don’t have vaccines!)
Launching a “Roll Back Malaria” Program
Stopping the transmission of tuberculosis
Increasing access to essential pharmaceuticals
Preventing and treating iron deficiency anemia
Reducing maternal morbidity and mortality
Promoting healthful lifestyles for all age groups
Establishing “Health Promoting Schools”

175
Q

WHO definition of health

A

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmary

176
Q

USAID

A

Government agency primarily responsible for administering civilian foreign aid
Drawn on to manage U.S. Government (USG) programs to provide low-income countries for a range of purposes
Can be when another country has a natural disaster, war, political strife, etc.

177
Q

AIHA

A

International nonprofit organization working to advance global health through locally driven, locally owned, and locally sustainable health systems strengthening and human resources for health interventions
Vision – a world with access to quality healthcare for everyone, everywhere, regardless of wealth or ability to pay
Mission – “to strengthen health systems and workforce capacity worldwide through locally driven, peer-to-peer institutional partnerships.
FORWARD THINKING…
Trying to work upstream

178
Q

World bank

A

International financial institution that provides loans to countries of the world for capital programs
Stated official goal – reduction of poverty
Mission is to reduce extreme poverty and promote shared prosperity by lending money to developing countries, providing technical assistance, and by sharing knowledge and solutions

179
Q

Nongovernmental organizations

A

Global health council
Center for international health and cooperation
CARE
Carter center
International council for nurses

180
Q

Global health council

A

Dedicated to saving lives by improving health worldwide
US based nonprofit networking organization
Connects advocates, implementers, and stakeholders around global health priorities worldwide
Dedicated to advancing policies and programs that improve global health
Represents thousands of public health professionals from 150 countries
Increases investments, robust policies, and power of collective voice
Helps influence health policy

181
Q

Center for international health and cooperation

A

Promotion of healing and peace in countries affected by natural disasters, armed conflicts, civil war, strife, and ethnic violence
Employs resources and personal contacts to stimulate interest in humanitarian issues and to promote innovative educational programs and training models

182
Q

CARE

A

Respond to famine and disasters worldwide
Saves lives, defeat poverty, and achieve social justice
Seeks a world of hope, inclusion, and social justice where poverty has been overcome and all people live with dignity and security
After the world was recovering from WWII, some people sought to help the country from poverty, creating this organization

183
Q

Carter center

A

Disease prevention and agriculture
Founded on fundamental commitment to human rights and the alleviation of human suffering
Seeks to prevent and resolve conflict, enhance freedom and democracy, and improve health
Believes that people can improve lives if provided necessary skills, knowledge, and access to resources (personal responsibility that this organization assists with)
Resolving conflicts, enhancing democracy in country, advancing human rights and giving economic opportunities
Helped prevent diseases, get mental health care and teaching farmers to increase crop production in highly agricultural countries

184
Q

International council of nurses

A

Mission: to maintain the role of nursing in health care through its global voice
Serving to maintain role of nursing in healthcare through global voice
Membership includes 120 countries
Helps enhance nurses contributions, primary care, prevention, research, developing and implementing robust programs, innovation
Assists nurses in maintaining global voice

185
Q

MDGs

A

8 international goals that all 193 United Nations member states and at least 23 international organizations agreed to achieve by the year 2015

186
Q

Aim of MDGs

A

To encourage development by improving social and economic conditions in the poorest countries

187
Q

What were the MDGs

A

eradicate extreme poverty and hunger
achieve universal primary education
promote gender equality and empower women
reduce child mortality rates
improve maternal health
combat HIV/AIDS, malaria, and disasters
ensure environmental sustainability
develop a global partnership for development

188
Q

What was bad about the MDGs

A

uneven across regions and countries, leaving millions of people behind, especially the poorest and those disadvantaged due to sex, age, disability, ethnicity or geographic location. Targeted efforts will be needed to reach the most vulnerable people

189
Q

Sustainable development goals

A

Set in january 2016 to banish a whole host of social ills by 2030
Replaces the MDGs

190
Q

What are the sustainable development goals

A

No poverty, zero hunger, good health and well-being, quality education, gender equality, clean water and sanitation, affordable and clean energy, decent work and economic growth, industry innovation and infrastructure, reduced inequalities, sustainable cities and communities, responsible consumption and production, climate action, life below water, life on land, peace justice and strong institutions, partnerships for the goals

191
Q

SDG 1 (no poverty) and 2 (no hunger)

A

Illnesses that are closely associated with poverty - tuberculosis, AIDS, malnutrition, severe dental problems - devastate the homeless population.
Health problems that exist quietly at other income levels - alcoholism, mental illnesses, diabetes, hypertension, physical disabilities - are prominent on the streets.
Human beings without shelter fall prey to parasites, frostbite, infections and violence
Nutrition, substandard housing, etc are issues
Absenteeism because children are behind on vaccinations

192
Q

Kwashiorkor

A

Edema (swelling) of arms, legs, face
Weak muscles, pale hair/skin, enlarged liver
Swollen belly because of fluid retention and weak abdominal walls that allow internal organs to sag out
Common in children weaned early; low-protein diet
Severe malnutrition and low protein communities are at risk for this

193
Q

Marasmus

A

Severe protein-energy malnutrition (PEM) – too little calories
Very low birth weight, weakness, organ failure
Skeletal appearance, wrinkled skin

194
Q

Overnutrition

A

The average person needs about 1800 kcals/day
Extra calories = extra weight
Not just from too much food, also unhealthy food
Obesity increases the risk of type 2 diabetes, hypertension, gallstones, asthma, arthritis, heart disease, strokes, some cancers, etc.

195
Q

SDG 4 (quality education)

A

Dynamic workforce and well-informed decisions
Helps with social and economic prosperity
Water impacts education (little girls carry water and miss school)
Girls don’t go to school when on period, 10-20% days missed

196
Q

SDG 5 (gender equality)

A

Termination of girl pregnancies
Genital cutting and mutilation
Gender violence, abuse, and inequality
less access to information and stuff
Less women in parliament
wage gap
No autonomy because of spouse or God opinion
Myths about medication
Low access (distance)

197
Q

UN and violence against women

A

UN declaration on the elimination of violence against women:
“Any act of gender-based violence that results in, or is likely to result in, physical, sexual, or psychological harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life.”

198
Q

SDG 3 (good health and well-being)

A

Endemics and global diseases (Malaria, Measles, HIV, Ebola, Zika, COVID-19, River Blindness)

199
Q

The Life cycle of malaria

A

Infected mosquito bites human
The parasite travels to the liver
Parasite rapidly reproduces in the liver, although some variables lie dormant for up to a year.
The parasite latches onto red blood cells, burrows into them and continues multiplying.
Infected cells burst, spreading the infection.
Fever sets in as red blood cell levels drop—circulation in vital organs clogs.
Parasites fill the bloodstream, infecting biting mosquitoes to complete the malaria cycle

200
Q

Measles

A

Vaccine preventable
Educate on importance of vaccines and increase accessibility of vaccines to other countries

201
Q

Ebola

A

Endemic mostly in Africa
From direct contact with :
Body fluids of a person who is sick with or has died from Ebola. (blood, vomit, urine, feces, sweat, semen, spit, other fluids)
Objects contaminated with the virus (needles, medical equipment)
Infected animals (by contact with blood or fluids or infected meat)

202
Q

Ebola symptoms r/t transmission

A

Ebola can only be spread to others after symptoms begin. Symptoms can appear from 2 to 21 days after exposure.
Ebola only spreads when people are sick.
A patient must have symptoms to spread the disease to others.
After 21 days, if an exposed person does not develop symptoms, they will not become sick with Ebola
MEN CAN TRANSMIT THIS THROUGH SEMEN FOR UP TO 7 WEEKS AFTER RECOVERY OF DISEASE

203
Q

Early symptoms of ebola

A

Fever
Fatigue
Headache
Vomiting, Diarrhea, & Stomach Pain (symptoms of impaired kidney and liver function)
Unexplained bleeding or bruising
Muscle Pain
Labs: low WBCs and PLTs, high liver enzymes

204
Q

Zika

A

Caused by the Zika virus (1947)
Spread through the bite of an infected Aedes species mosquito.
The illness is usually mild, with symptoms lasting for several days to a week after being bitten by an infected mosquito

205
Q

s/s of zika

A

Fever, rash, joint pain, and conjunctivitis (red eyes)

206
Q

What we know about zika

A

Although there is no test to determine if someone is protected against Zika, experts believe that once a person has been infected, they will likely be protected from future infections.
Can be transmitted from mother to child during birth and through sexual contact
There is a confirmed link between Zika and birth defects in babies born to mothers who are infected, including microcephaly.
There are no vaccines
Zika bites during daytime

207
Q

COVID-19

A

A respiratory disease spreading from person to person
Between people in close contact (within about 6 feet).
Respiratory droplets are produced when an infected person coughs or sneezes.
These droplets can land in the mouths or noses of nearby people or possibly be inhaled into the lungs

208
Q

When can COVID spread

A

They can spread it to others 2-3 days before symptoms start and are most contagious 1-2 days before they feel sick.
In some circumstances, these droplets may contaminate the surfaces they touch.
Anyone infected with COVID-19 can spread it, even if they do NOT have symptoms

209
Q

Prevention of COVID

A

Clean your hands often.
Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
Avoid touching your eyes, nose, and mouth with unwashed hands

210
Q

River blindness

A

A parasitic disease caused by tiny worms and transmitted by flies.
Symptoms include eye and skin lesions leading to blindness and skin depigmentation

211
Q

Water needs

A

Drinking
Cooking
Hygiene (hand-washing and bathing)
Cleaning (clothes, pots, homes)

212
Q

Effects of not having clean water

A

diarrhea has killed more children than all the people lost to armed conflict since World War II

213
Q

Diseases transmitted by water:

A

Cholera
Typhoid
Bacillary Dysentery
Infectious Hepatitis
Giardiasis

214
Q

Diseases caused by lack of water:

A

Scabies
Skin sepsis
Ulcers
Leprosy
Trachoma
Dysenteries

215
Q

Eradication

A

interruption of person-to-person transmission and limitation of the reservoir of infection such that no further preventive efforts are required; it indicates a status whereby no further cases of a disease occur anywhere (like smallpox, this is very hard to do)

216
Q

Elimination

A

used when a disease has been interrupted in a defined geographical area (like polio in the US and other areas)

217
Q

Control

A

indicates that a specific disease has ceased to be a public health threat

218
Q

Global Burden of Disease

A

GBD
WHO study using quantifiable data demonstrating disparities in the burden of disease worldwide, especially in children

219
Q

Disability Adjusted Life Years

A

DALY
summary measure that combines the impact of illness, disability and mortality on population health
A measure of overall disease burden, expressed as the cumulative number of years lost due to ill health, disability, or early death
Measures gap between health status and idea health situation where health population lives to advanced age with no illness or disability
Same as YLD (years lived with disability) + YLL (years of life lost)

Public Health (6 decks)

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