Lec 52 - pathology 1

Question 1

define disease (world health organization)

Answer 1

A disordered or incorrectly functioning organ, part, structure, or system of the body resulting from the effect of genetic or developmental errors, infection, poisons, nutritional deficiency or imbalance, toxicity or unfavourable environmental factors.
presence of specific signs and symptoms

Question 2

define a syndrome

Answer 2

A recognizable complex of symptoms and physical findings that indicate a specific
condition for which a direct cause is not necessarily understood.

Question 3

what are ‘signs and symptoms’ (define each)

Answer 3

abnormalities that can indicate a potential medical condition – aids in diagnosis

sign - any objective evidence of a disease that can be observed by others ie. rash, fever, swelling

symptom - subjective and apparent only to the person ie. anxiety, pain, fatigue

Question 4

T or F: syndrome and disorder are interchangeable

Answer 4

false, disorder is a functional abnormality and is much more of a broad term

Question 5

what are the 2 types of outcome questionnaires for signs and symptoms?

Answer 5

1. disease (ie. asthma)
2. generic (ie. targets overall health and quality of life)

Question 6

T or F: disease-specific questionnaires are more sensitive to change than generic outcome questionnaires

Answer 6

true

Question 7

define morbidity

Answer 7

Refers to having a disease or a symptom of disease, or to the amount of disease within a population.

Question 8

define prevalence and its one weakness

Answer 8

Number of affected persons in the population at a specific time (provides no information on new cases)

Question 9

define cumulative incidence

Answer 9

Number of new cases of a disease that occur during a specified period of time in a population at risk for developing the disease. Time period needs to be very specific

Question 10

Person time

Answer 10

measure of the time spent in a study by a participant. can be person-years, person-minutes, etc. Once they have the disease, there time ends

Question 11

how do you calculate the incident rate

Answer 11

total person-time of disease-free individuals at the start of a study.

Question 12

define diagnosis

Answer 12

Identifying a disease from its signs and symptoms

Question 13

what is a diagnostic test

Answer 13

A test or clinical information obtained from history, physical examination and imaging procedures to facilitate identification

Question 14

describe the following terms:
1. sensitivity
2. specificity
3. positive predictive value
4. negative predictive value

Answer 14

Sensitivity = identifies people with disease
Specificity = rules out people who don’t have disease

Question 15

calculate sensitivity and specificity for the example

Answer 15

Question 16

tests with high _________ are very good for screening tests because these tests have low rate of false negatives

Answer 16

sensitivity

Question 17

tests with high _________ are very good for confirmatory tests because these tests have a low rate of false positives

Answer 17

specificity

Question 18

Describe the anterior drawer test

Answer 18

Question 19

T or F: all risk factors for a disease are modifiable

Answer 19

false, some are but some aren’t (genetics, age, sex)

Question 20

describe absolute risk

Answer 20

incidence of disease within a group initially free of the condition
= #new cases in given period of time/ #people in the group

Question 21

describe relative risk or the risk ratio

Answer 21

how many times more likely are exposed persons to become diseased or have the outcome of interest relative to nonexposed persons
RR = Iexposed/Inotexposed

Question 22

what does a relative risk (RR) greater than 1 mean?

Answer 22

it indicates that the outcome is increased in people exposed

Question 23

What does RR = 1 mean

Answer 23

Outcome is not different whether a person is exposed or not exposed

Question 24

What does RR <1 mean

Answer 24

Indicates the outcome is reduced in the exposed

Question 25

what was the effect of remdesivir on mortality in covid-19 patients

Answer 25

RR was greater than 1, therefore it increased the number of deaths for patients on ventilators

Question 26

define attributable risk or risk difference

Answer 26

difference in the incidence of the disease between those exposed and not exposed
difference between relative risk groups

Question 27

define prognosis

Answer 27

Probability of an individual developing a particular state of health over a specific time, based on the person’s clinical and non-clinical profile
outcomes are often specific events but may also be quantities (such as pain)

Question 28

why is prognosis important in PT?

Answer 28

• tells us how long they will require physiotherapy
• tells us when client will be able to return to work and/or sport

Question 29

What are 6 rates commonly used to describe prognosis

Answer 29

Question 30

what are the 2 types of prognosis and describe them

Answer 30

*Clinical course: Evolution of a disease that has come under medical care and has been treated in a variety of ways that affect the subsequent course of events

*Natural history: Evolution of a disease without medical intervention

Question 31

Describe survival curves and time to event

Answer 31

survival curves = the probability of surviving in a given length of time while
time to event = duration until a certain event happens

Question 32

what is mortality and how do you calculate mortality rate?

Answer 32

Quantitative expression for death (takes place of incidence rates when disease is severe and lethal)

Mortality rate (per 1000) = # of deaths all causes/ #people in the population x1000

Question 33

What were the leading causes of mortality in Canada (2021)

Answer 33

Question 34

what are the 3 types of prevention and describe them

Answer 34

1. Primary Prevention: measures taken to prevent the occurrence of disease (vaccines, diet, exercise)
2. Secondary Prevention: aims to reduce the impact of a disease that has already occurred, early detection and treatment and measures to prevent reoccurrence (eg. screening for early stages of disease like cancer)
3. Tertiary Prevention: managing disease after it has caused serious harm, goal of improving quality of life and reducing the symptoms of the disease (e.g., stroke patients, diabetes).

Question 35

what are some differences between curative and preventive medicine?

Answer 35

Question 36

what are 3 ways to describe the burden of disease

Answer 36

1. Quality-adjusted life years (QALY) - 1 = perfect health, 0=death, less than 0 = severe pain and disability
2. years of life lost (YLL) - years lost due to premature mortality
3. Disability-adjusted life years (DALY) - one DALY = loss of one year of full health

Question 37

what is the definition of health

Answer 37

a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

Question 38

T or F; dementia rates are higher in people living close to major roads in cities

Answer 38

true

Question 39

how does the “built” environment impact human health?

Answer 39

*Influence behaviors
*Physical activity patterns
*Social networks
*Access to resources - Significant impact on mobility

Question 40

T or F: It is important to consider indoor and outdoor barriers of facilitators in physical therapy

Answer 40

T

Question 41

what things make up our well-being

Answer 41

Question 42

what is quality of life (QoL)

Answer 42

an individuals perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns.

Question 43

define health-related QoL

Answer 43

A multi-dimensional concept that includes domains related to physical, mental, emotional, and social functioning
- It goes beyond direct measures of population health, life expectancy, and causes of death, and focuses on the impact health status has on quality of life
-There are scales to measure quality of life (eg. KOOS)

Question 44

What are the 5 dimensions of quality of life

Answer 44