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MBCHB1 exam > keeping people healthy week 2 > Flashcards

keeping people healthy week 2 Flashcards

1
Q

Describe meiosis

A

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

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2
Q

Describe fertilisation

A

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

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3
Q

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

A

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

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4
Q

Describe the physical appearance of Down syndrome

A 
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
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5
Q

What are other common effects of Down Syndrome?

A 
delayed development and low IQ
early onset dementia
ASD and ADHD
GI problems
hearing and vision problems
Thyroid problems
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6
Q

Describe screening for Down Syndrome

A

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

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7
Q

What is vaccination?

A

induced immunity using a vaccine

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8
Q

what is immunisation?

A

encompasses both vaccines and passive immunity

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9
Q

What is an antigen?

A

a live or inactivated substance capable of producing an immune response

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10
Q

What are the aims of vaccines?

A

to save lives, protect against disability and improve health

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11
Q

What is selective vaccination used for?

A

to protect those at high risk

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12
Q

What is mass vaccination used for?

A

to eradicate or eliminate disease

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13
Q

When might selective vaccination be used?

A

travel
occupational risk
high risk groups
outbreak control

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14
Q

what is eradication?

A

wipe disease completely - small pox

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15
Q

What is elimination?

A

disease to disappear from one WHO region - POLio

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16
Q

What is containment?

A

when disease no longer constitutes a “significant health problem”

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17
Q

What is the purpose of having intervals between vaccines?

A

to allow immune response to develop

to avoid immune interference

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18
Q

What is primary vaccination failure?

A

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

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19
Q

What is secondary vaccination failure?

A

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

20
Q

What can be done to prevent secondary vaccination failure?

A

boosters

21
Q

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

A

live - adverse effects fall with more doses

inactive - adverse effects rise with more doses

22
Q

What are some contraindications to live vaccines?

A 
primary immunodeficiency
chemotherapy
haematopoeitic stem cell transplant
organ transplant
systemic corticosteroid use
HIV
23
Q

Describe live vaccines

A

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

24
Q

Describe inactive vaccines

A

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

25
Q

What are the advantages of live vaccines?

A 
long lasting
strong response
can revert to virulence
in pregnancy/immunosuppressed
poor stability
26
Q

What are the advantages of inactivated vaccines?

A 
stable
constituents clearly defined
unable to cause infection
needs several doses
adjuvent needed
shorter lasting
27
Q

What is heard immunity?

A

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

28
Q

What is R?

A

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

29
Q

What is R0?

A

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

30
Q

What does it mean in R

A

no sustained transmission

31
Q

What does it mean if R>1?1

A

Epidemic possible

32
Q

What does cvt mean?

A

1-(1/R0)

33
Q

What is passive immunity?

A

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

34
Q

What are the pros of antibody preparations?

A

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

35
Q

What are the cons of antibody preparations?

A

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

36
Q

What indicates there is the need for a vaccine programme?

A 
disease incidence
age distribution
trends
complications
mortality
37
Q

What is the mechanism for vaccine policy

A 
recommendation
policy decisions
licensing of vaccine
purchase of vaccine
control of vaccine
38
Q

What is vaccine surveillance?

A

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

39
Q

What is the criteria for severe acute malnutrition?

A

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

40
Q

What is moderate malnutrition?

A

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

41
Q

What are some problems caused by obesity?

A

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

42
Q

What is meant by obesogenic environment?

A

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

43
Q

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

A

food restrictions, public transport

44
Q

what can be done to target outliers in obesity?

A

liposuction

45
Q

what can be done to squeeze the distribution of obesity?

A

tackle inequality

46
Q

What are protective factors for risk taking behaviour in adolescence?

A

self esteem
close relationship with parents
perceived control over life

47
Q

What are some risk factors for risk behaviour in adolescents?

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

MBCHB1 exam (28 decks)

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