(M) Natural History and Spectrum of Disease; and The Levels of Disease Prevention Flashcards
refers to the progression of a disease process in an individual over time, in the absence of treatment
Natural History of Disease
untreated infection with HIV causes a spectrum of clinical problems beginning at the time of seroconversion (primary HIV) and terminating with AIDS and usually death.
This may take 10 years or more for AIDS to develop after seroconversion.
Example of Natural History of Disease
Natural History of Disease - T or F
Many, if not most, diseases have a characteristic natural history
T
may history ang isang disease <3
the time frame and specific manifestations of disease may?
vary from individual to individua
what is the influence of a disease
Influenced by preventive and therapeutic measures
If left untreated, a disease would evolve through a series of ?
Stages
what are the series of stages are meant when a disease is left untreated?
stages that characterize its natural history
if an intervention is applied to a disease, what would happen?
the natural history is modified
T or D
when the natural history is modified, it will not produce a typical clinical course for the condition
F (it will produce a typical….)
What are the components of natural history of disease timeline
- Stage of Susceptibility
- Stage of Subclinical Disease
- Stage of Clinical Disease
- Stage of Recovery, Disability or Death
When does the exposure happen?
After the stage of suceptibility
identify what stage of the disease process
patholofic changes
Stage of Subclinical Disease
Onset of symptoms?
after the Stage of Clinical Disease
may symptoms lang pero walang manifestation of diease
can be tested, to make sure <3
When does usual time of diagnosis occurs?
Between Stage of Subclinical and Clinical Disease
what is the final disease timeline?
Stage of Recovery, Disability, or Death
womp womp
May vary from person to person and are influenced by preventive and therapeutic measures
Natural History of Disease Timeline
per person to okay? okay
The natural history of diseases for descriptive purposes has two phase
- Prepathogenesis
- Pathogenesis
his is the phase before man is involved
wala pa sakit, agents is not inside me (host)
Prepathogenesis
T or D
everyone is in the period of pre-pathogenesis of many diseases because disease agents are present in the environment where man lives
T
di lang napapasukan??? or naaffect
Interaction of the agent, the host and environmental factors, the agent finally reaches man
Period of Pre-pathogenesis
Strong winds can transport anopheline mosquitoes from an endemic area to a distant non-malarious one, thus bringing into proximity the vectors and prospective hosts.
Period of Pre-pathogenesis
The host must be in the area when the mosquitoes are blown by the wind.
This phase includes the successful invasion and establishment of the agent in the host.
Pathogenesis
what needs in the period of pathogenesis for a disease to manifest?
Incubation .
Incubation Period dude
After a period of incubation, whereby the agent multiplies and develops, or gets absorbed and fixed in the tissues, sufficient tissue or physiologic changes may have taken place to produce detectable evidence of the disease process in man
clinical horizon
Stage when diagnosis can usually be made
Pathogenesis
Pathogenesis - T or F
The disease process may never reach the clinical horizon, or it may proceed until it terminates in recovery, disability, or death, or until it is interrupted by treatment
T
I have a lab result that is positive of Myobacterium TB, what does this represents
clue: evidence
clinical horizon
detectable evidence yung labe result
how many requirements for the successful invasion of the host by an infectious agent
6 six sais
Six requirements for the successful invasion - T or F
Conditions in the environment must be favorable to the agent or the agent must be able to adopt to the environment.
T
bobo mo kung mag F ka
Six requirements for the successful invasion - T or F
Suitable reservoirs are not needed
F
it must be present
Six requirements for the successful invasion - T or F
A cute host must be present
T
if susceuptible yung cute edi T
Six requirements for the successful invasion - T or F
Satisfactory portal of entry into the host
T
Six requirements for the successful invasion - T or F
Accessible portal of exit from the host
T
Six requirements for the successful invasion - T or F
Appropriate means of dissemination and transmission to a new host
T
The signs and symptoms will vary - T or F
Characteristics and dosage of the agent, and the duration of exposure of the host to it
T
The signs and symptoms will vary - T or F
Reaction of the liver of the host to the introduction of the agent
F (tissue)
di naman lagi liver bobo
The signs and symptoms will vary - T or F
Portal of entry and tissues unaffected
F (affected)
When the host is infected, it mobilizes its?
Defenses
fill in the blanks
The infectious agent on the other hand tries to (_ _ _ _ _ ) to overcome the host’s resistance, and may elaborate toxins.
multiply
what are the four reaction that can happen when the resistance of the host FIGHT!
- The host successfully wards off the pathogen
- Balance equilibrium
- Sub-clinical conditions.
- Full-blown clinical cases
In this condition, the forces of the agent and the forces of the host are equal so that both are not affected.
Balance Equilibrium.
the host becomes a healthy carrier who can easily spread the disease to others, and evade detection.
Inapparent infection
hese refer to reactions which are very mild that they escape detections. This can also result in a carrier state.
Sub-clinical Conditions
These cases may be typical or atypical
Full-blown Clinical Cases
What are the 2 sequence of event that can happen to a full blown Clinical Case
- Death
- Recovery (Complete, Disability or Defect, or Carrier)
Pre pathogenesis or Pathogenesis?
Stage of Susceptibility
Pre-Pathogenesis
Pre pathogenesis or Pathogenesis?
Stage of Subclinical Disease, Clinical Disease, and Recovery, Disability, or Death
Pathogenesis
the process of a natural history of disease starts with?
appropriate exposure to or accumulation of factors
sufficient for the disease process to begin in a susceptible host
if u see this card
check the example for exposure for natural history of disease
After the disease process has been triggered, what changes then occur without the individual being aware of them.?
pathological changes
stage of subclinical disease, extending from the time of exposure to onset of disease symptoms, is usually called
for infectious diseases
incubation period
stage of subclinical disease, extending from the time of exposure to onset of disease symptoms, is usually called
for chronic diseases
latency period
incubation period, what does the patient shows?
shows asymptomatic (no symptoms) or inapparent
same goes for latency period
The incubation period, may vary according to the following:
- Virulence, dose, and portal of entry
- Previous experience of the host and the state of natural resistance
- The inherent character of the organism itself
T or F
Although disease is not apparent during the incubation period, some pathologic changes may be detectable with laboratory, radiographic, or other screening methods
T
what Period
Most screening programs attempt to identify the disease process during this phase of its natural history
Incubation Period
T or F
Intervention at a late stage is likely to be more effective than treatment given after the disease has progressed and become symptomatic
F (early)
=
he onset of symptoms marks the transition from
subclinical to clinical disease
Most diagnoses are made during the stage
stage of clinical disease
T or F
Some disease process may never progress to clinically apparent illness
T
identifcation
Some disease process may never progress to clinically apparent illness. In others, the disease process may result in illness that ranges from mild to severe or fatal. This range is called
the spectrum of disease
the disease process ends with?
- Recovery
- Disability
- Death ( ^0^ )
Pathology produces some form of disease, a deviation from normal function in an organ or system.
Impairment
when atherosclerotic plaque narrows coronary arteries, the patient may experience angina and normal cardiac function is impaired.
when atherosclerotic plaque narrows coronary arteries, the patient may experience angina and normal cardiac function is impaired.
T or F
Impairments are always perceived by the patient, and screening tests are used to identify impairments of which the person is not aware.
F (are not always..)
used to identify impairments
Screening Test
screening test is used for?
to identify impairments of which the person is not aware
T or F
An impairment can, although does not necessarily, lead to a disability
T
Defined as “any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being.
Disability
For instance if the patient’s narrowed arteries cause him chest pain and if this limits his ability to walk, he has a disability due to heart disease and angina.
Disability
T or F
an impairment cannot be corrected (medically, surgically or by a prosthesis), it always resulting to disability.
F (it can be correct, and not always result to disability
In its turn, disability may or may not limit the patient in performing his normal social roles.
Handicap
severe angina may prevent a patient from working, producing social, psychological, and economic hardships in terms of lost income, self-esteem, and social position.
Handicap
” disadvantage for a given individual, resulting from an impairment or a disability, that limits or prevents the fulfillment of a role that is normal (depending on age, sex, and social and cultural factors) for that individual
Handicap
RELATES the impact of a disease to the social roles of the person with it
Handicap
can prevent a disability from becoming a handicap
Practical interventions
mas pina-easy
Finding a desk job for a person with angina of effort, or making buildings wheel-chair accessible for people with mobility problems.
Practical interventions for handicap
what may happen when the disease is onset
Impairment
MAY HAPPEN OR NOT
progress of impairment will show
Signs and Symptoms
MAY HAPPEN OR NOT
Loss or abnormality of psychological,
physiological, or anatomical structure or function
Impairment
Restriction in ability to perform
a function that may result
from an impairment
Disability
progression of signs and symptoms
Disability
MAY HAPPEN OR NOT
what will happen when you are limited by your disability?
Handicapped
Disadvantage that results when a disability or impairment limits or prevents the fulfillment of a role
Handicap
Refer to underlying characteristics of society that ultimately shape the health of individuals and communities.
Determinants
They can be thought of as the causes of the causes of ill health.
Determinants
Includes
* non-specific factors (a recession, poverty, lack of education)
* particular policies (such as alcohol or tobacco laws) aimed at improving health behaviours or health in general rather than particular diseases.
Determinants
Their influence is transmitted via a chain of intermediate processes that lead, ultimately, to a specific case of a disease.
Determinants
the influence of determinants are transmitted via?
chain of intermediate processes
Increase the statistical probability that a person will fall sick
Risk Factors
if u see this card
study the table for risk factors
Based on the natural history of diseases, certain levels of prevention have been formulated to be applied to the different phases of the natural history.
Levels of Disease Prevention
How many levels of disease preventions?
- Primordial Prevention
- Primary Prevention
- Secondary Prevention
- Tertiary Prevention
Consists of actions to MINIMIZE FUTURE HAZARDS to health and hence avoid the emergence and establishment of factors
Primordial Prevention
Reduction of risk factors BEFORE the occurrence of disease condition or injury.
Primary Prevention
Levels of prevention under pre-pathogenesis
- Primordial Prevention
- Primary Prevention
Early detection of the POTENTIAL for development of a disease or condition, or the existence of a disease while asymptomatic
Secondary Prevention
Treatment of an EXISTING SYMPTOMATIC disease process to ameliorate its effects, or delay or prevent its progress.
Tertiary Prevention
if u see this card
study the preventive strategies
Levels of prevention under pathogenesis
- Secondary Prevention
- Tertiary Prevention
Consists of actions to minimize future hazards to health and hence avoid the emergence and establishment of factors (environmental, economic, social, behavioural, cultural) known to increase the risk of disease.
Primordial Prevention
addresses broad health determinants rather than preventing personal exposure to risk factors
Primordial Prevention
outlawing alcohol in certain countries would represent
primordial prevention
whereas a campaign against drinking and would be an example of
primary prevention.
Examples of primordial prevention
familiarize or memorize
- Improving sanitation (such that exposure to infectious agents does not occur)
- Environmental control of disease vectors
- Establishing healthy communities
- Eliminating predisposing factors such as illiteracy and maternal deprivation
- Promoting a healthy lifestyle in childhood (for example, through prenatal nutrition programs and supporting early childhood development programs)
- Developing green energy approaches
Concerned with protecting health and preventing the onset of disease; it aims to reduce the incidence of disease.
Primary Prevention
It involves interventions that are applied before there is any evidence of disease or injury.
Primary Prevention
The strategy is to remove causative risk factors (risk reduction), and in this goal it overlaps with health promotion.
Primary Prevention
Primary prevention: Examples
*Removal of Risk Factor
*
Familiarize or Memorize
- smoking cessation
- preserving good nutritional status
- physical fitness
- immunization
- improving roads
- fluoridation of the water supply as a way to prevent dental caries.
under primary prevention
Generally targets specific causes and risk factors for specific diseases, but may also aim to promote healthy behaviours, improve host resistance, and foster safe environments that reduce the risk of disease.
Specific Protection
example of?
thorough cleaning of operating rooms to prevent post-operative infection
Specific Protection
the protection of man himself, or the establishment of barriers against agents in the environment
Primary Prevention
primary prevention, against agents in the environment - T or F
Segregation of the reservoir or source of infection by isolation or quarantine.
T
primary prevention, against agents in the environment - T or F
No control of means of spread such as vector control, sanitation of food, milk, water, and air, proper sewage disposal, proper disposal and or disinfection of excreta of sick people, eradication of animal reservoir, etc.
F
primary prevention, against agents in the environment - T or F
Increasing the resistance of the prospective host by specific immunization active and not passive
F (both active and passive
With reference to specific protection, the points of attack depend on?
which of the three ecologic factors of disease/health are most vulnerable to corrective measures
Agent, Host, Environment
for such measures to be applied effectively and efficiently, they need to be guided properly
knowledge of surveillance and epidemiological investigation is necessary
Concerned with detecting a disease in its earliest stages, before it is symptomatic, and intervening to slow or stop its progression: “catch it early.”
Secondary Prevention
what includes under the secondary prevention?
detect and treat preclinical pathological changes
Secondary Prevention
procedures to detect serious disease as early as possible so that its progress can be arrested and, if possible, the disease eradicated.
screening tests or other suitable procedures
Secondary Prevention
The process by which otherwise unrecognized disease or defects are detected early by tests that can be applied rapidly and on a large scale.
Screening
distinguish apparently healthy people from those who probably have the disease
Screening tests
Screening is an initial examination; it is usually diagnostic and requires appropriate investigative follow-up and treatment.
NOT DIAGNOSTIC
use this card to see the principle under screening
Screening is usually undertaken by health professionals, either at the level of individual doctor-patient encounters (e.g., routine blood pressure checks) or via public health screening programs (e.g., mammography screening).
Examples of Secondary Prevention
Familiariza or Memorize
- Isoniazid treatment in PPD converters to prevent progression to active tuberculosis
- Mammogram screening to allow for earlier diagnosis of breast cancer
- PSA screening to allow for earlier diagnosis of prostate cancer
Once a disease has developed and has been treated in its acute clinical phase, tertiary prevention seeks to soften the impact caused by the disease on the patient’s function, longevity, and quality of life.
Tertiary Prevention
Refers to interventions designed to arrest the progress of an established disease and to control its negative consequences: to reduce disability and handicap, to minimize suffering caused by existing departures from good health, and to promote the patient’s adjustment to irremediable conditions.
Tertiary Prevention
Tertiary Prevention consist of?
- Disability Limiation
- Rehabilitation
- Intensive, periodic follow-up and treatment
This indicates failure of prevention at an earlier level. It requires treatment of a more or less advanced disease process.
Disability limitation
This is applied with the objective of returning the affected individual to a useful place in society and make maximum use of his remaining capacity.
Rehabilitation
This is done to prevent relapses in certain diseases; to effect complete cure in diseases which have relapse tendency.
Intensive, periodic follow-up and treatment.
Includes cardiac rehabilitation following a myocardial infarction, seeking to alter behaviours to reduce the likelihood of a reinfarction.
examples under tertiary prevention
Includes modifying risk factors, such as assisting a cardiac patient to lose weight, or making environmental modifications to reduce an asthmatic patient’s exposure to allergens.
examples under tertiary prevention
Includes ensuring regular check-ups to monitor a diabetic patient’s condition, including eye exams to check for possible adverse outcomes of the diabetes
examples under tertiary prevention
Control of diabetes mellitus to prevent or delay diabetic neuropathy
Examples of Tertiary Prevention
Use of angiotensin-converting enzyme inhibitors to prolong survival in chronic congestive heart failure
Examples of Tertiary Prevention
Treatment of hypertension with beta-blockers or diuretics to decrease the incidence of stroke
Examples of Tertiary Prevention
Where the condition is not reversible, tertiary prevention focuses on
rehabilitation, assisting the patient to accommodate to his disability.
For reversible conditions, such as many types of heart disease, tertiary prevention will
reduce the population prevalence
T or F
For reversible conditions, such as many types of heart disease, tertiary prevention will reduce the population prevalence, whereas for incurable conditions it may increase prevalence if it prolongs survival.
T
The key goal for tertiary prevention is to?
enhance quality of life.
Intervention is any attempt to intervene or interrupt the usual sequence in the development of disease
Modes of Prevention
Five modes of intervention corresponding to the natural history of any disease are:
- Health Promotion
- Specific Protection
- Early Diagnosis and Adequate Treatment
- Disability Limitation
- Rehabilitation
Levels of Prevention
Adress health determinants
Primordial
Levels of Prevention
- Health Promotion
- Specific Protection
Primary
Levels of Prevention
Early Diagnosis and Prompt Treatment
Secondary
Levels of Prevention
- Disability Limitation
- Rehabilitation
Tertiary
Levels of Prevention
Universal application and is instrumental in the accomplishment of all the measure proposed in all levels of prevention
Health Education
two basic protection measures against dangerous communicable diseases and have been very effective even in this modern times as seen during the COVID-19 pandemic
Isolation and Quarantine
as applied to patients, isolation is the separation for the period of communicability, of inflected persons or animals from others in such places and under such conditions as to prevent or limit the effect of the direct or indirect transmission of the infectious agent from those infected to those who are susceptible or who may spread the disease agent.
Isolation
The Center for Disease Control of the USPHS has recommended seven categories of isolation. There are however two basic requirements common to all seven.
- **Hands must be washed **after contact with the patient or potentially contaminated articles and before taking care of another patient.
- Articles contaminated with infectious materials should be appropriately discarded or bagged and labeled before being sent for decontamination and reprocessing.
7 Categories of Isolation
- Strict isolation
- Contact isolation
- Respiratory isolation
- Tuberculosis isolation (AFB isolation)
- Enteric precautions
- Drainage/secretion precautions
- Blood/body fluid precautions
This category is designed to prevent transmission of highly contagious or virulent infections that may be spread by both air and contact
Strict Isolation
Specifications (in addition to those above):
- a private room and the use of masks, gowns and gloves for all persons entering the room
- Special ventilation requirements (negative pressure)
Strict Isolation
For less highly transmissible or serious infections, for diseases or conditions which are spread primarily by close or direct contact.
Contact Isolation
Specification (In addition to the basic requirements):
- A private room (patients infected with the same pathogen may share a room)
- Masks are indicated for those who come close to the patient, gowns are indicated if soiling is likely, and gloves are indicated for touching infectious materials
Contact Isolation
To prevent transmission of infectious diseases over short distances through the air
Respiratory Isolation
Specification (In addition to the basic requirements):
- private room is indicated but patients infected with the same organisms may share a room.
- masks are indicated for those who come in close contact with the patients; gowns and gloves are not indicated
Respiratory Isolation
→ For patients with pulmonary tuberculosis who have a positive sputum smear or chest x-rays which strongly suggest active tuberculosis.
Tuberculosis isolation (AFB isolation)
Specifications: private room with special ventilation and the door close
- masks are used only if the patient is coughing and does not reliably and consistently cover the mouth.
- Gowns are used to prevent gross contamination of clothing.
- Gloves are not indicated
Tuberculosis isolation (AFB isolation)
For infections transmitted by direct or indirect contact with feces.
Enteric Precautions
specifications:
-private room if patient hygiene is poor
-Masks are not indicated
- Gowns should be used if soiling is likely and gloves are to be used for touching contaminated materials.
Enteric Precautions
To prevent infections transmitted by direct or indirect contact with purulent material or drainage from an infected body site.
Drainage/Secretion Precautions
- A private room and masking are not indicated;
- Gowns should be used if soiling is likely and gloves used for touching contaminated materials.
Drainage/Secretion Precautions
To prevent infections that are transmitted by direct or indirect contact with infected blood or body fluids.
Blood/Body Fluid Precautions
Specification:
- a private room is indicated if patient hygiene is poor
- masks are not indicated but gowns should be used if soiling of clothing with blood or body fluids is likely.
- Gloves should be used for touching blood or body fluids.
Blood/Body Fluid Precautions
A recent CDC recommendations states that blood and body fluid precautions be?
used consistently for all patients (in-hospital settings as well as out-patient settings) regardless of their blood borne infection status.
Blood and certain body fluids (any visibly bloody secretion, semen, vaginal secretions, tissue, CSF, and synovial, pleural, peritoneal, pericardial, and amniotic fluids) of all patients are considered potentially infectious for
HIV, HBV, and other blood borne pathogens
Intended to prevent parenteral, mucous membrane, and non-intact skin exposures of health care workers to blood borne pathogens.
Universal Blood and Body Fluid Precautions or Universal Precautions
Protective barriers include
- gloves
- gowns
- masks
- protective eyewear or face shield
Waste management is controlled by
Local and State Authority
If u see this card
Go over the “Recommended Isolation Practice for Admitted Infectious Diseases” and memorize it
tho maam just skipped it
Restriction of the activities of well persons or animals who have been exposed to a case of communicable disease during its period of communicability (i.e., contacts) to prevent disease transmission during the incubation period if infection should occurI
Quarantine
2 types of quarantine
- Absolute or complete quarantine
- Modified quarantine
The limitation of freedom of movement of those exposed to a communicable disease for a period of time not longer than the longest usual incubation period of that disease, in such manner as to prevent effective contact with those not so exposed.
Absolute or complete quarantine
A selective, partial limitation of freedom of movement of contacts, commonly on the basis of known or presumed differences in susceptibility and related to the danger of disease transmission. It may be designed to meet particular situations.
Modified quarantine
Examples are exclusion of children from school, exemption of immune persons from provisions applicable to the post or to quarters.
Modified quarantine
what includes under modified quarantine?
- Personal Surveillance
- Segregation
the practice of close medical or other supervision of contacts to permit from recognition of infection or illness but without restricting their movements;
Personal surveillance
the separation of some part of group of persons or domestic animals from the others for special consideration, control or observation, removal of susceptible children to homes of immune persons; or establishment of a sanitary boundary to protect from infected portions of a population.
Segregation
sorry ang dami <3
oo fucker ka
