keeping people healthy week 2

Question 1

Describe meiosis

Answer 1

DNA replication is followed by two rounds of cell division to produce four potential daughter cells, each with half the chromosomes

Question 2

Describe fertilisation

Answer 2

male and female gametes fuse during fertilisation, creating a fertilised cell with a completet set of chromosomes (22 somatic pairs, 1 sex pair)

Question 3

What are the three ways in which Down syndrome can be caused?

Answer 3

trisomy 21 - most common
translocation - extra piece of chromosome 21 attaches itself to another chromosome
Mosaicism - only some cells have an extra copy

Question 4

Describe the physical appearance of Down syndrome

Answer 4

reduced muscle tone and floppiness
small nose and flat nasal bridge
small mouth and protruding tongue 
eyes slant upwards and outwards
flat back of the head
big space between 1st and 2nd toes
broad palms and short fingers
single transverse palmar crease
below average weight and length at birth

Question 5

What are other common effects of Down Syndrome?

Answer 5

delayed development and low IQ
early onset dementia
ASD and ADHD
GI problems
hearing and vision problems
Thyroid problems

Question 6

Describe screening for Down Syndrome

Answer 6

The combined test (blood tests plus nuchal translucency ultrasound scan 11-14 weeks)
Or later just blood tests - less accurate
hCG remains higher later in pregnancy
Pappalysin 1 - pregnancy associated plasma protein is lower in Down Syndrome

Question 7

What is vaccination?

Answer 7

induced immunity using a vaccine

Question 8

what is immunisation?

Answer 8

encompasses both vaccines and passive immunity

Question 9

What is an antigen?

Answer 9

a live or inactivated substance capable of producing an immune response

Question 10

What are the aims of vaccines?

Answer 10

to save lives, protect against disability and improve health

Question 11

What is selective vaccination used for?

Answer 11

to protect those at high risk

Question 12

What is mass vaccination used for?

Answer 12

to eradicate or eliminate disease

Question 13

When might selective vaccination be used?

Answer 13

travel
occupational risk
high risk groups
outbreak control

Question 14

what is eradication?

Answer 14

wipe disease completely - small pox

Question 15

What is elimination?

Answer 15

disease to disappear from one WHO region - POLio

Question 16

What is containment?

Answer 16

when disease no longer constitutes a “significant health problem”

Question 17

What is the purpose of having intervals between vaccines?

Answer 17

to allow immune response to develop

to avoid immune interference

Question 18

What is primary vaccination failure?

Answer 18

an individual fails to make an adequate immune response to the initial vaccination

Question 19

What is secondary vaccination failure?

Answer 19

an individual makes an adequate immune response initially but immunity waves over time ( most inactivated vaccines)

Question 20

What can be done to prevent secondary vaccination failure?

Answer 20

boosters

Question 21

What is the difference between adverse effects in live and inactivated vaccines?

Answer 21

live - adverse effects fall with more doses

inactive - adverse effects rise with more doses

Question 22

What are some contraindications to live vaccines?

Answer 22

primary immunodeficiency
chemotherapy
haematopoeitic stem cell transplant
organ transplant
systemic corticosteroid use
HIV

Question 23

Describe live vaccines

Answer 23

attenuated strains which replicate in the host
acts like natural infection
strong, long lasting immunity
MMR, BCG, yellow fever

Question 24

Describe inactive vaccines

Answer 24

suspension of whole intact killed organisms - pertussis, rabies ,, hepA
acellular or sub-unit vaccines Hib, diptheria

Question 25

What are the advantages of live vaccines?

Answer 25

``` long lasting strong response can revert to virulence in pregnancy/immunosuppressed poor stability ```

Question 26

What are the advantages of inactivated vaccines?

Answer 26

``` stable constituents clearly defined unable to cause infection needs several doses adjuvent needed shorter lasting ```

Question 27

What is heard immunity?

Answer 27

for a disease there is a certain level of immunity in the population which protects the whole population because the pathogen stops spreading in the community disease can be eradicated even when some people are still susceptible

Question 28

What is R?

Answer 28

the effective reproductive number - the secondary infections produced by a typical infected person

Question 29

What is R0?

Answer 29

The basic reproductive number - the number of secondary infections produced by a typical infection in a totally susceptible population

Question 30

What does it mean in R

Answer 30

no sustained transmission

Question 31

What does it mean if R>1?1

Answer 31

Epidemic possible

Question 32

What does cvt mean?

Answer 32

1-(1/R0)

Question 33

What is passive immunity?

Answer 33

immunity from pre-formed components in order to provide protection at or time around the time of exposure to specific pathogen provides immediate but temporary protection

Question 34

What are the pros of antibody preparations?

Answer 34

rapid preventive can be those in those who can't take vaccines

Question 35

What are the cons of antibody preparations?

Answer 35

expensive potential adverse effects limited evidence base for some no lasting immunity

Question 36

What indicates there is the need for a vaccine programme?

Answer 36

``` disease incidence age distribution trends complications mortality ```

Question 37

What is the mechanism for vaccine policy

Answer 37

``` recommendation policy decisions licensing of vaccine purchase of vaccine control of vaccine ```

Question 38

What is vaccine surveillance?

Answer 38

the ongoing, systematic collection, recording, analysis,, interpretation and dissemination of data

Question 39

What is the criteria for severe acute malnutrition?

Answer 39

below 3 SDs below median weight or height, visible and severe wasting, or presence of nutritional oedema

Question 40

What is moderate malnutrition?

Answer 40

weight loss and 2-3 SDs below median for weight and height

Question 41

What are some problems caused by obesity?

Answer 41

medical social - isolation, depression economic - health care cost, ill health leading to absence from work medical - diabetes, ischaemic heart disease body image difficulty socialising stigma

Question 42

What is meant by obesogenic environment?

Answer 42

readily available high calorie foods increase labour saving devices increase in passive and motorised transport decreased participation in leisure pursuits

Question 43

What can be done to shift the population to the left with regards to obesity?

Answer 43

food restrictions, public transport

Question 44

what can be done to target outliers in obesity?

Answer 44

liposuction

Question 45

what can be done to squeeze the distribution of obesity?

Answer 45

tackle inequality

Question 46

What are protective factors for risk taking behaviour in adolescence?

Answer 46

self esteem close relationship with parents perceived control over life

Question 47

What are some risk factors for risk behaviour in adolescents?

Answer 47

``` peer pressure low parental monitoring lower socio-economic class lack of future aspiration depression ```