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IPAP > MPH Block 1 > Flashcards

MPH Block 1 Flashcards

1
Q

What is Charles Winslow’s definition of Public Health

A

Science and art of preventing Dz, prolonging life and promoting health and efficiency thru organized community effort

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2
Q

Epidemiology is based on what two fundamental assumptions?

A

Dz do not occur by chance

Dz are not distributed randomly in a population so indicates how/why dz process has occurred

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3
Q

What are the objectives of epidemiology?

A 
ID etiology of dz and risk factors
Determine extent of dz in community
Natural hx and prognosis of dz
Evaluate existing and new prev/therapy measures
Provide foundation for policy
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4
Q

Epidemiology is a ___ focused science

A

Population

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5
Q

What happens to many …..?

What happens to one …..?

A

Many- focus of epidemiology on occurrence of health and dz in population

One- Population approach contrasts w/ clinical medicine’s primary concern w/ health and dz in the individual

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6
Q

Diseases are expressed biologically in ____ but ?

A

Individuals

No epidemiology study can be done on one person

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7
Q

Epidemiology studies humans in ______

A

Aggregate (groups)

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8
Q

Epidemiology conclusions as a population science are directly applicable to ?

A

Groups studied and only indirectly applicable to the groups studied

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9
Q

Top 10 achievements of Public Health (ELO)

A 
Immunications
Vehicle Safety
Workspace safety
Infectious Dz control
Decrease CAD/CVA
Safe/healthy foods
Healthy mother/baby
Family planning
Fluoridation of water
Tobacco as a hazard
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10
Q

In 1900 the top 3 causes of death were ?

A

Infectious Dzs: Pneumonia, Flu, TB, and GI infections

Diphtheria was #10

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11
Q

Infectious Dzs are ___ by nature

A

Volatile

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12
Q

What are the top risk factors for death today?

A

Heart Dz
Cancer
CVA
COPD

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13
Q

What are the top life style risk factors that risk death as of today?

A 
Tobacco/ETOH
Nutrition
Obesity
Inactivity
Occupation/Environment exposure
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14
Q

What 4 parts of preventative medicine have been integral parts of military activities?

A

Clean
Field Hygiene / Sanitation
Force protection

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15
Q

Who is responsible for troop health?

A

CDRs

Legal and regulatory basis and rarely accomplished by medical channels alone

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16
Q

What part of the COC is the bridge between command and military medicine?

A

Special Staff Medicine

CDR and staff relationship

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17
Q

What DoD instruction directs all services to have programs and take action under the umbrella of Public Health/Force Health Protection?

A

DoDD 6200.04

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18
Q

Military PrevMed milestones include ?

A 
Isolation wards
US weather bureau- surveillance
Vectors as Dz transmission mode
Water sanitation- chlorination
Sodium Hypochlorite
Vaccines
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19
Q

What are the military PrevMed milestone distinguished persons?

A 
James Tilton
Joseph Lovell
Walter Reed
Carl Darnall
Joseph Lyster
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20
Q

In prevention, what is the goal?

A

Preserve and promote health and well being

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21
Q

Prevention in public health moves interventions from ? to ?

A

Individual level to population level

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22
Q

What are the 3 levels of protection?

A

1: prevents onset of illness/injury prior to dz process beginning (imms)
2: measures leading to early Dx and prompt Dz treatment (screening- PAPs)
3*: reduction of morbidity and mortality from existing dz (events in medical treatment)

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23
Q

Define CPS as it’s mentioned in DHA-PI 6200.06

A

Services recommended by USPS/STF to prevent/reduce risk for HDz, cancer, infectious dzs, or other conditions that impact health

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24
Q

When was the USPSTF created?

A

1984

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25
Q

What is the USPSTF

A

US Prev Services Task force- independent volunteer panel of national experts/DoD reps

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26
Q

What is the purpose of the USPSTF?

A

Review scientific evidence regarding the effectiveness, risks and benefits of specific health care services

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27
Q

USPSTF assigns grade recommendations based upon what what 3 criteria?

A

Strength of evidence
Balance of benefits/harms
Doe NOT consider costs

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28
Q

USPSTF recommendations only apply to ?

A

Those w/out S/Sx of Dz in question

Services offered in PC setting

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29
Q

What does a USPSTF recommendation of no evidence mean?

A

Different from conclusion that service is ineffective

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30
Q

What do USPSTF grades mean?

A 
A- substantial
B- benefit is moderate
C- can do it, considered on individual PT level
D- don't do it
I- idk, insufficient current evidence
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31
Q

What does the USPSTF recommend for primary prevention of CVD?

A

Statins

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32
Q

What is USPSTF’s recommendation regarding syphilis screening?

A

Asymptomatic non-pregnant adults and adolescent who are at an inc risk for syphilis infection

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33
Q

Define Communicable Dz

A

Microbes (bacteria, viruses, parasites and fungi) that spread, directly or indirectly, from one person to another

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34
Q

How does the natural history of dz begin?

A

Appropriate exposure (microbe) to/accumulation of factors to allow dz process to begin

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35
Q

Characteristics of the Apparent/Inapparent Infection Triangle

A

Apparent: Severe Dz, Mild Illness

Inapparent:
Preclinical: not clinically apparent but destined to be
Subclinical: infection w/out illness
Exposure w/out infection = no infection

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36
Q

Inapparent disease can include ? and ?

A

Latent: infection w/ no active multiplication of the agent

Carrier: PT harboring the organism but is not infected to the point of detection by serology (limited or chronic)

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37
Q

Define Infection

A

Entry and development/multiplication of an infectious agent in the body

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38
Q

Infection is not synonymous with ?

A

Inectious dz; result may be inapparent or manifest

39
Q

Presence of living infectious agents on exterior/clothes does not prove ? but is a ?

A

Infection

Contamination

40
Q

Define Latent/Latency Period

A

Time from infection to infectiousness

41
Q

Define Incubation Period

A

Time interval between infection and onset of clinical illness/Sxs

42
Q

Define Communicable Period

A

Period of time which an infectious agent may be transferred from carrier to new host

43
Q

In many Dzs, the ? period is shorter than the ? period

A

Latent shorter than incubation

44
Q

Incubation and Communicable periods of Measles

A

I: 14 days for rash
C: 4 days before to 4 days after rash

45
Q

Incubation and Communicable periods of Hep A

A

I: 28-30 days
C: latter half of incubation to few days after onset of jaundice

46
Q

Incubation and Communicable periods of Smallpox

A

I: 7-17 days
C: Onset of fever Sx to separation of scabs

47
Q

Characteristics of the term of Quarantine

A

Individual: healthy
Duration: incubation
Location: home
Basis of Action: rare, police power

48
Q

Characteristics of the term Isolation

A

Individual: sick
Duration: communicable period
Location: hospital
Basis of action: common standard precaution

49
Q

What are the parts of the Epidemiologic Triad

What do they represent

A

Susceptible Host
Causative Agent
Environment

Factors that influence an infection

50
Q

Human diseases result from the interaction of what four factors?

A

Susceptible Host
Causative Agent
Environment
Vector

51
Q

What are the characteristics of the ‘Host’ part of the epidemiologic triad?

A 
Age
Prior exposure
Susceptibility
Co-Infection
Immune response
52
Q

What are the characteristics of the ‘Agent’ part of the epidemiologic triad?

A 
Toxicity
Virulence
Infectivity
Susceptibility to ABX
Survival outside of body
Reservoir
53
Q

What are the characteristics of the ‘Environment’ part of the epidemiologic triad?

A

Climate
Physical structure
Population density
Social structure

54
Q

Define Primary/Definitive Host

A

The organism that the pathogen reaches maturity and reproduces sexually in

55
Q

Define Secondary/Intermediate Host

A

Organism that harbors the sexually immature parasite and is required for development and life cycle completion

56
Q

Define Dead-End/Accidental Host

A

Organism that generally does not allow transmission to the definitive host

57
Q

Define Natural Reservoir

A

Population of organisms/specific environment a infectious pathogen naturally lives and reproduces or is depended on for pathogens survival

58
Q

A reservoir is usually ? and often ?

A

Living host of certain species that a pathogen survives

Often w/out causing Dz for reservoir itself

59
Q

Define Human Reservoir

A

Humans infected by pathogens that exist on/in human body

60
Q

How do carriers transmit the pathogen they’re infected with?

A

Transmit or develop Sx

61
Q

Define Convalescent Carrier

A

Capable of spreading disease following a period of illness (common in hepatits and polio)

62
Q

Define Asymptomatic Carrier

A

Never exhibit S/Sx of Dz but capable of infecting others (Salmonella Typhi)

63
Q

What are the two modes of transmission?

A

Direct: contact, droplet

Indirect: airborne, vehicle borne (fomites), or vector borne (mechanical or biologic)

64
Q

Give 3 examples of microbes transmitted through Direct Transmission

A

Herpes
Syphilis
Hookworm

65
Q

Characteristics for Droplet Spread

A

Large drops (sneeze, cough, singing)
Short distance- less than 1m
Not suspended in air

66
Q

Give 3 examples of microbes that transmit through droplet spread?

A

Pertussis
Meningococcal
Mumps

67
Q

Define Indirect Transmission

A

Transfer of infectious agent from reservoir to host by suspended air particles/vehicles/vectors

68
Q

Vehicle borne transmission includes ?

Give 3 examples of microbes that are transmitted through indirect transmission?

A

Food, Water, Fomites

Salmonella, HCV, MRSA

69
Q

Vector Borne indirect transmission includes ?

What microbes are transmitted through this method?

A

Arthropods- mechanical, biological

Shigellosis/Bacillary dysentery, Plague (mechanical)
Malaria, Dengue (biological)

70
Q

Define Airborne Transmission: Microbial Aerosols

Give two microbe examples

A

Aerosolized droplet nuclei
Small dust particles
Less than 5 um
Carried by air currents

TB, Measles

71
Q

What form of transmission is a fly that’s carrying shigella from latrine to food?

A

Indirect vector borne, mechanical transmission

72
Q

What form of transmission is staphylococcal poisoning from a single meal?

A

Indirect vehicle borne transmission, single exposure

73
Q

What form of transmission is when a student sneezes on you in passing?

A

Direct transmission, droplet spread

74
Q

What form of transmission is a cook with poor hand washing who contaminates salad?

A

Indirect vehicle borne transmission, probably multiple exposure

75
Q

What form of transmission is a person with TB who repeatedly coughs during a 9hr flight?

A

Airborne transmission

76
Q

What form of transmission is a child with impetigo that give you multiple hugs?

A

Direct transmission, person-to-person touch

77
Q

Define Endemic

Define Sporadic

A

Habitual/constant presence of a disease within a geographic area

Occurs infrequently and irregularly

78
Q

Define Epidemic

A

Occurrence in a community or region in excess of normal expectancy

79
Q

Difference between an outbreak and a cluster?

Define Pandemic

A

O: more geographic limited
C: aggregation

Pan: worldwide epidemic

80
Q

Define Ratio

Define Proportion

A

Quantitative relation between amounts

Type of ratio that relates a part to a whole

81
Q

Define Rate

A

Measure of the frequency of an event occurring in a define population over a specific time

82
Q

What is the rate formula?

A

First- determine frequency (# of cases, population size, period of calculation)

%=(# cases)/(population at risk) x 100

83
Q

Define Morbidity Frequency Measures

A

Used to describe presence of Dz in population or probability of its occurrence

84
Q

In Public Health Terms “disease” includes ?

A

Illness
Injury
Disability

85
Q

Morbidity frequency measures includes what 5 characteristic rates?

A 
Attack
Incidence
Secondary attack
Point prevalence
Period prevalence
86
Q

Define Attack Rate

A

Number of people at risk when a disease develops /
Total # at risk
Time is NOT specified

Special type of incidence rate applied to narrow population observed for limited time, such as during an epidemic

87
Q

Define Secondary Attack Rate

A

Susceptible people who have been exposed to primary case and serves as a good measure of person-to-person spread

88
Q

Attack rate = ?

A

Incidence

89
Q

Define Incidence

A

Number of new cases of Dz occur during specified time in population at risk of developing the disease
Measure of ‘risk’

90
Q

What are the two parts of the Incidence rate?

A

Numerator- new cases of dz reported in a time interval

Denominator- average population at risk during time interval (only those who can become a numerator)

91
Q

Incidence rate is sometimes uses the ?? of cases and is a ? so it must have ?

A

Absolute number
Rate
Element of time in denominator

92
Q

Define Incidence Density

A

Number of new events per person-time (person months, person years)

93
Q

Define Crude Rates

A

Data presented w/out any adjustment for any characteristics

IPAP (212 decks)

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