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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
What is the USPSTF
US Prev Services Task force- independent volunteer panel of national experts/DoD reps
26
What is the purpose of the USPSTF?
Review scientific evidence regarding the effectiveness, risks and benefits of specific health care services
27
USPSTF assigns grade recommendations based upon what what 3 criteria?
Strength of evidence Balance of benefits/harms Doe NOT consider costs
28
USPSTF recommendations only apply to ?
Those w/out S/Sx of Dz in question | Services offered in PC setting
29
What does a USPSTF recommendation of no evidence mean?
Different from conclusion that service is ineffective
30
What do USPSTF grades mean?
``` 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 ```
31
What does the USPSTF recommend for primary prevention of CVD?
Statins
32
What is USPSTF's recommendation regarding syphilis screening?
Asymptomatic non-pregnant adults and adolescent who are at an inc risk for syphilis infection
33
Define Communicable Dz
Microbes (bacteria, viruses, parasites and fungi) that spread, directly or indirectly, from one person to another
34
How does the natural history of dz begin?
Appropriate exposure (microbe) to/accumulation of factors to allow dz process to begin
35
Characteristics of the Apparent/Inapparent Infection Triangle
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
36
Inapparent disease can include ? and ?
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)
37
Define Infection
Entry and development/multiplication of an infectious agent in the body
38
Infection is not synonymous with ?
Inectious dz; result may be inapparent or manifest
39
Presence of living infectious agents on exterior/clothes does not prove ? but is a ?
Infection | Contamination
40
Define Latent/Latency Period
Time from infection to infectiousness
41
Define Incubation Period
Time interval between infection and onset of clinical illness/Sxs
42
Define Communicable Period
Period of time which an infectious agent may be transferred from carrier to new host
43
In many Dzs, the ? period is shorter than the ? period
Latent shorter than incubation
44
Incubation and Communicable periods of Measles
I: 14 days for rash C: 4 days before to 4 days after rash
45
Incubation and Communicable periods of Hep A
I: 28-30 days C: latter half of incubation to few days after onset of jaundice
46
Incubation and Communicable periods of Smallpox
I: 7-17 days C: Onset of fever Sx to separation of scabs
47
Characteristics of the term of Quarantine
Individual: healthy Duration: incubation Location: home Basis of Action: rare, police power
48
Characteristics of the term Isolation
Individual: sick Duration: communicable period Location: hospital Basis of action: common standard precaution
49
What are the parts of the Epidemiologic Triad What do they represent
Susceptible Host Causative Agent Environment Factors that influence an infection
50
Human diseases result from the interaction of what four factors?
Susceptible Host Causative Agent Environment Vector
51
What are the characteristics of the 'Host' part of the epidemiologic triad?
``` Age Prior exposure Susceptibility Co-Infection Immune response ```
52
What are the characteristics of the 'Agent' part of the epidemiologic triad?
``` Toxicity Virulence Infectivity Susceptibility to ABX Survival outside of body Reservoir ```
53
What are the characteristics of the 'Environment' part of the epidemiologic triad?
Climate Physical structure Population density Social structure
54
Define Primary/Definitive Host
The organism that the pathogen reaches maturity and reproduces sexually in
55
Define Secondary/Intermediate Host
Organism that harbors the sexually immature parasite and is required for development and life cycle completion
56
Define Dead-End/Accidental Host
Organism that generally does not allow transmission to the definitive host
57
Define Natural Reservoir
Population of organisms/specific environment a infectious pathogen naturally lives and reproduces or is depended on for pathogens survival
58
A reservoir is usually ? and often ?
Living host of certain species that a pathogen survives | Often w/out causing Dz for reservoir itself
59
Define Human Reservoir
Humans infected by pathogens that exist on/in human body
60
How do carriers transmit the pathogen they're infected with?
Transmit or develop Sx
61
Define Convalescent Carrier
Capable of spreading disease following a period of illness (common in hepatits and polio)
62
Define Asymptomatic Carrier
Never exhibit S/Sx of Dz but capable of infecting others (Salmonella Typhi)
63
What are the two modes of transmission?
Direct: contact, droplet Indirect: airborne, vehicle borne (fomites), or vector borne (mechanical or biologic)
64
Give 3 examples of microbes transmitted through Direct Transmission
Herpes Syphilis Hookworm
65
Characteristics for Droplet Spread
Large drops (sneeze, cough, singing) Short distance- less than 1m Not suspended in air
66
Give 3 examples of microbes that transmit through droplet spread?
Pertussis Meningococcal Mumps
67
Define Indirect Transmission
Transfer of infectious agent from reservoir to host by suspended air particles/vehicles/vectors
68
Vehicle borne transmission includes ? Give 3 examples of microbes that are transmitted through indirect transmission?
Food, Water, Fomites Salmonella, HCV, MRSA
69
Vector Borne indirect transmission includes ? What microbes are transmitted through this method?
Arthropods- mechanical, biological Shigellosis/Bacillary dysentery, Plague (mechanical) Malaria, Dengue (biological)
70
# Define Airborne Transmission: Microbial Aerosols Give two microbe examples
Aerosolized droplet nuclei Small dust particles Less than 5 um Carried by air currents TB, Measles
71
What form of transmission is a fly that's carrying shigella from latrine to food?
Indirect vector borne, mechanical transmission
72
What form of transmission is staphylococcal poisoning from a single meal?
Indirect vehicle borne transmission, single exposure
73
What form of transmission is when a student sneezes on you in passing?
Direct transmission, droplet spread
74
What form of transmission is a cook with poor hand washing who contaminates salad?
Indirect vehicle borne transmission, probably multiple exposure
75
What form of transmission is a person with TB who repeatedly coughs during a 9hr flight?
Airborne transmission
76
What form of transmission is a child with impetigo that give you multiple hugs?
Direct transmission, person-to-person touch
77
# Define Endemic Define Sporadic
Habitual/constant presence of a disease within a geographic area Occurs infrequently and irregularly
78
Define Epidemic
Occurrence in a community or region in excess of normal expectancy
79
Difference between an outbreak and a cluster? Define Pandemic
O: more geographic limited C: aggregation Pan: worldwide epidemic
80
# Define Ratio Define Proportion
Quantitative relation between amounts Type of ratio that relates a part to a whole
81
Define Rate
Measure of the frequency of an event occurring in a define population over a specific time
82
What is the rate formula?
First- determine frequency (# of cases, population size, period of calculation) %=(# cases)/(population at risk) x 100
83
Define Morbidity Frequency Measures
Used to describe presence of Dz in population or probability of its occurrence
84
In Public Health Terms "disease" includes ?
Illness Injury Disability
85
Morbidity frequency measures includes what 5 characteristic rates?
``` Attack Incidence Secondary attack Point prevalence Period prevalence ```
86
Define Attack Rate
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
Define Secondary Attack Rate
Susceptible people who have been exposed to primary case and serves as a good measure of person-to-person spread
88
Attack rate = ?
Incidence
89
Define Incidence
Number of new cases of Dz occur during specified time in population at risk of developing the disease Measure of 'risk'
90
What are the two parts of the Incidence rate?
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
Incidence rate is sometimes uses the ?? of cases and is a ? so it must have ?
Absolute number Rate Element of time in denominator
92
Define Incidence Density
Number of new events per person-time (person months, person years)
93
Define Crude Rates
Data presented w/out any adjustment for any characteristics

IPAP (212 decks)

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