General Epidemiology (Part I )

Question 1

Mention the 4 health dimensions & give a brief description for each.

Answer 1

1. Physical health:
   - easiest to observe and feel
   - body systems are properly functioning in harmony within physiologic norms
2. Mental health:
   - a state of balance between the individual and his environment
   - ability to adjust within himself and with others
   - cope with stress
3. Social health :
   - ability of the person to adjust within a social network
   - active member of a community
4. Spiritual health:
   - personal integrity
   - principles
   - ethics

Question 2

The quality of life is affected by _____________

Answer 2

the level of health measured on a health spectrum

Question 3

State the health spectrum scale :

Answer 3

1. Ideal health
2. Positive health
3. Negative or marginal health
4. Unapparent disease: also called pre-clinical
5. Apparent disease
6. Death

Question 4

Describe the “marginal health”

Answer 4

Negative or marginal health:

• an individual has no ability to adjust to surrounding
• fall ill on the slightest adverse stimulus

Question 5

Describe the “Apparent disease”

Answer 5

• individual is aware that she/he is suffering from an illness
• whether she/he seeks medical care or not

Question 6

What is the end of the spectrum? :)

Answer 6

DEATH

Question 7

Describe the “ unapparent disease”

Answer 7

• also known as pre-clinical
• not recognized by the individual
• discovered by examination and screening tests

Question 8

Which type of the health spectrum is the one that achieves a state of dynamic equilibrium between man and his environment ?

Answer 8

Positive health

Question 9

Define community medicine.

Answer 9

deals with the study of provision of promotive, preventive, curative, rehabilitative and evaluative services to the community at large, through an organized comprehensive health care delivery system

Question 10

What is included in the “Essential Community Medicine” ?

Answer 10

• Protection of the environment
• Health education
• Health legislation and health regulations
• Prevention and control of communicable diseases
• Care for special groups as mothers, children, and workers in certain hazardous occupations
• Assessment of health needs, plans and supports the provision of health care services to the population

Question 11

Give other terminologies for community medicine.

Answer 11

• hygiene
• preventive medicine
• social medicine
• public heath

Question 12

Community diagnosis is the role of __________

Answer 12

Epidemiologists

Question 13

Define “ clinical diagnosis “

Answer 13

diagnosis made in an individual by the doctor based on signs and symptoms

Question 14

Fill in the blanks with the right answer either “ community medicine “ or “ hospital medicine “

1. Service area that provides health care to people ——> _________
2. Organizational framework that contains health centers ——> ______
3. Has Only passive operational strategy applied ——> _______
4. Has limited scope in the national health programs ——> _______
5. Exits between health department & other related health departments ——>_______

6.Gives : poor cost benefit ratio by involving maximum expenditure yielding
minimum benefits——> _______

Answer 14

Answers :

1. Service area that provides health care to people ——> “ Community medicine “
2. Organizational framework that contains health centers ——> “ Community medicine “
3. Has Only passive operational strategy applied ——> “ Hospital medicine “
4. Has limited scope in the national health programs ——> “ Hospital medicine “
5. Exits between health department & other related health departments ——> “ Community medicine “

6.Gives : poor cost benefit ratio by involving maximum expenditure yielding
minimum benefits ——> “ Hospital medicine “

• Study it better from the table slide #13

Question 15

Mention the General (non-specific) primary prevention.

Answer 15

• Health education
• Environmental sanitation
• Nutrition care
• Health life style (balanced life)
• Health legislation
• Community development and social care

Question 16

Mention the specific primary prevention.

Answer 16

• Immunization both active and passive
• Chemoprophylaxis
• Nutrient supplementation to prevent specific deficiencies

• Others, e.g.,
- therapeutic diets as for phynylketonuria

• wearing protective clothes or masks to prevent occupational hazards

Question 17

Describe the Early detection of disease in the secondary prevention.

Answer 17

1- Oriented to individuals :

• Priority is given to vulnerable groups
• focusing on the individual for early detection of any health problem

2- Disease oriented :

• community based
• screening tests applied to communities to discover a specific disease
  e. g., diabetes survey, nutrition survey

Question 18

What is the “Prompt appropriate treatment” ?

Answer 18

to achieve cure and prevent complications

Examples :

1- Selection of the antibiotic and the period of treatment ——> to prevent rheumatic fever in streptococcal pharyngitis

2- Achieve pathological cure and prevent
recurrence in case of ——> tuberculosis

Question 19

Explain “ Rehabilitation “ & its different forms.

Answer 19

Rehabilitation is : ( Tertiary prevention )

• applied to individuals with a disability
• aiming at improving their abilities to be active members of the community
• to be useful for themselves

It has different forms :

• Medical rehabilitation
• Social / Vocational rehabilitation
• Psychological rehabilitation

Question 20

What is health promotion ?

Answer 20

efforts done at all levels of prevention to improve health along the health spectrum

Question 21

State the types of curative care & give an explanation for each

Answer 21

1. Emergency care: Both medical and surgical conditions
2. Episodic care:
   - most common type
   - for acute conditions patients seek medical care for episodes of disease (e.g., diarrhea, tonsillitis, fevers)
3. Continuous care:
   - chronic disease patients need to be under continuous care (e.g., diabetes mellitus, cancer, heart disease, endocrine deficiencies)
4. Terminal care:
   - in this case the patients in the final stage of a disease, expected to die
   - require expensive forms of hospital care
   - needs to be careful considered to avoid excess burden to the families / governments

Question 22

Explain the “ individual approach” with its branches

Answer 22

The concern is for the individual care, it is usually curative care.

1. The case approach:

• physicians are concerned only with the clinical condition
• physician may miss important aspects in the diagnosis and in the management
• least type of care

2. The total person approach:

• approach the person as a whole
• medical, psychological and social aspects is assessed
• to reach a proper diagnosis
• follow appropriate lines of treatment

Question 23

Explain the “family approach” and state its conditions

Answer 23

Family practice considers the whole family as one unit for care

For implementing family practice two condition must be fulfilled:

1. Same physician or group of physicians: working in the same health facility is caring for all members of the family
2. Family health folder :
   - medical record for every individual
   - problem-oriented family record
   - easy identification

Question 24

Explain the “community approach” with its division

Answer 24

the health services provided to the community should be appropriate to:

1. address the health needs
2. promote health and wellbeing
3. prevent and control priority health problems
4. treat any disease condition

Question 25

It becomes clear that the achievement of health is _________ and needs to be viewed from a system point of view.

Answer 25

Multidimensional

Question 26

The community health promoting and preventing activities are not restricted to the health care sector alone, but may involve __________

Answer 26

inter-sectoral activities

Eg: legislations on seat belt use, pollution controls, wearing masks, etc…

Question 27

Define each term:

1. Demography
2. Biostatistics
3. Epidemiology
4. Prevention Medicine
5. Behavioral sciences
6. Health administration & planning

Answer 27

1. Demography = The Knowledge of Population to be served
2. Biostatistics = Collection, compilation and analysis of data
3. Epidemiology = Patterns of Health and disease
4. Prevention Medicine = Control and prevention of diseases
5. Behavioral sciences = Behavioral factors and their effect on Health
6. Health administration & planning = Delivery of Health Care

Question 28

What are the 3 main components of epidemiology?

Answer 28

1. Frequency
2. Distribution
3. Determinants

Question 29

What are the 2 epidemiological models

necessary to an event or disease to occur?

Answer 29

• First model:(describe Distribution of diseases) Person/Place/Time model: Who? Where? &When?
• The second model: The epidemiological Triad (Triangle) It is a model for disease causation (Determinants of diseases)

Question 30

In order for any disease to occur there must be:
1.
2.
3.

Answer 30

1. susceptible host
2. harmful agent
3. suitable environment

• The disease cannot occur in absence of one of these factors

Question 31

WHEN= TIME

• Diseases usually occur in the following patterns:

Answer 31

1- Cyclic (periodic) trend: the disease occur over a period of time which may be:

• Days: Hey fever (Monday fever)
• Seasonal: diarrheal diseases are usually linked to summer months.
• Epidemic form every some years:
  measles before vaccination tended to occur in epidemic form every 10 years.

2- Secular (long term trend):
e.g. chronic diseases (cardiovascular, diabetes, cancer…) are showing upward secular trend due to change in life style.

3- Epidemics: increased number of cases beyond the expected in a definite area.

Question 32

Occurrence of disease differs according to the nature of geographic areas such as :

Answer 32

1. World wide geographic differences: e.g. - tropical diseases are prevalent in tropical areas
   - cancer colon are common in England.
2. Local geographic differences: e.g. Malaria
3. Institutional differences:
   eg: health hazards of school children differ from those of hospital admitted patients.

Question 33

List the epidemiological Triad (Triangle):

Answer 33

A) Host: which depends on biological and social characters of the host (age, sex, immunity status…etc.)

B) Agent: which may be: biological, physical, chemical and/ or mechanical.

C) Environment: factors in the environment that may determine disease occurrence include:

1c - Physical: temperature, moisture, pollution and setting (rural or urban).

2c - Social and political: legislations, and social structure and characters of the community.

3c - Biological: the presence of a living pathogenic organism as viruses, bacteria…..