Prev Med Flashcards

1
Q

natural h/o dz: pre dz vs latent dz vs symptomatic dz

A

susceptibility stage vs subclinical stage, pathologic changes vs onset of sxs, clinical stage, time of dx

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2
Q

primary vs secondary vs tert prevention

A

before onset of dz; prevent dz from occurring or inc resistance of dz vs in subclinical stage; screening & early detection to interrupt dz before becoming sx vs clinical stage; limit physical & social conseq of sxs

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3
Q

2 main ways to eval preventive med programs: cost effectiveness vs cost/benefit. cost benefit analysis?

A

expenditures required to achieve effect vs ratio b/ expenditures to make program & beneficial results. compare costs of intervention to health benefits –> helps govt determine budget

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4
Q

challenges of preventative programs: demonstrating benefits vs delay benefits vs accrual of benefits vs discounting vs priorities

A

need scientific proof but unethical to do RCT –> animal/observational studies, also $$$; varying risks & exposures across diff pop; t/dx = sponsored by pharm companies vs no instant gratification; worse for dzs w/ long latent periods; affects political support vs ins, health maintenance companies, govt & individuals get benefits but if only individuals -> less politically attractive vs present value of benefits = discounted -> hard to show cost/effective or post cost/benefit vs current & urgent probs = more attractive

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5
Q

def of social determinant of health vs health disparities

A

conditions in which ppl are born, grow, work, live, age & the systems in place to address illness vs health diff linked w/ soc/econ/environ disadvantage; obstacles of health based on race, religion, SES, gender, age

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6
Q

trends w/ education & health outcomes

A

higher ed –> healthier, live longer, more autonomy. low income, disability, social discrimination -> struggle w/ math & reading -> less likely to graduate; low income -> less money for food/exer/med, stress -> chronic dz

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7
Q

health professional shortage area vs medically underserved areas

A

shortage of primary medical/dental/mental health providers determined by provider ratio; geographic & pop HPsA vs area designated dby HPsA as having too few pcp, high infant mortality/poverty/elderly

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8
Q

econ vs health vs soc conseq of healthcare shortage?

A

nonins pt, cost of medicare, missed workdays/employment vs supply/demand of meds & staff, delayed/declined high quality care vs inc morbid/tality, extra stress, med bills

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9
Q

fed qualified health centers aka community health centers

A

fed supported safety-net programs giving services to special pop -> improve access to primary healthcare to ppl regardless of location, age, sex, race, dz status

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10
Q

FQHC eligibility requirements

A

in medically underserved area; mandated to give med/dental/behavioral health services; governed by board of directors; accessible, sliding scale to adjust fees, culturally competent, accept medicaid&care

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11
Q

equality vs equity vs justice

A

everyone benefits from same supports -> equal tx vs everyone gets support they need vs causes of inequity was addressed -> systematic barrier removed

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12
Q

3 steps to approach equity

A

value all ppl equally, rectify injustices, provide resources according to need

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13
Q

implicit vs explicit bias. systemic racism?

A

unconscious & unintentional asmptns we make d/t unconscious assoc about diff social groups vs intentionally not liking ppl. collection of policies perpetuating status quo of racial inequities

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14
Q

pathways to health equity: intraperson vs interperson vs institutional vs community vs systemic lvl

A

internal racism, stereotype threat, embodying inequities vs overt discrim, implicit bias vs hiring/promotion practice, under/over eval of contributions vs diff resrc allocation, racially/class segregated schools vs immigration, incarceration, predatory banking

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15
Q

areas to address sDOH at community vs pop vs clinical lvl

A

health & crisis intervention, strengthening fam/children, self sufficiency vs screen for social needs, pop-based & individual-targeted preventive strats = complementary (not exclusive) vs screening to ID sDOH, know your community-based partners & resrcs

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16
Q

steps to do outbreak investigation

A
  1. prepare field work
  2. est outbreak
  3. verify dx
  4. case def
  5. find cases systematically
  6. descriptive epidemiology
  7. hypothesis
  8. eval hypothesis
  9. reeval hypothesis
  10. lab & environ studies
  11. ctrl & prevention measures
  12. surveillance
  13. communicate results
17
Q

ctrlling an infxn requires knowing…? 6 universal strats to prevent & ctrl infxn

A

how it’s spread/transmission. wash hands, decontaminate/disinfect, infxn ctrl precautions like masking, quarantine exposed, prophylaxis of exposed, ctrl vectors/carriers

18
Q

abx = inappropriately/unnecessarily rxed, leading to…? abx stewardship?

A

adverse drug reactions (Amoxicillin for mono), C.difficile, antibiotic resistance, and increase mortality. effort to measure and improve how abx = prescribed by clinicians & used by pts

19
Q

explain process of vax safety

A

development -> safeguards; lab tests for safety; clin trials -> safe? effective? rxn?; manufacture w/ FDA; batch test -> purity? potency? sterile?; cont monitor w/ FDA & CDC

20
Q

vax indic vs vax CI vs missed opportunities

A

target/at-risk pop vs no live atten for immunocompromised, allergy, current infxn vs pt = eligible for vax but didn’t finish it completely (likely d/t misperception that pt didn’t need it at the time)

21
Q

what is pop-based/herd immunity? standards of immunization practice for peds vs adults

A

large portion of pop = immune to virus/bacteria –> resistant –> bug has nowhere to go. avail of vax, assess immunization status, effective communication to parents, storage & admin, vax coverage vs recommend vax, assess immunization status, admin or refer to vax provider

22
Q

why are vax hard to talk about? how to communicate it better?

A

changing, conflicting, time = limited, diff groups -> diff interests/needs (rural pts = hard to trust drs). Corroborate: acknowledge pt’s concern; About me: build knowledge/expertise, “I did research”; Sci: give documented accurate info; Explain/advise: advise pt/parent based on science.

23
Q

Healthy People 2030 goals

A

Improve health by preventing, detecting, and responding to public health events by inc # trained ppl, # of events, lab/diag test & surveillance and dec dz & death

24
Q

Disability-Adjusted Life Year vs Years of Potential Life Lost vs Mortality Rates Among Children Under Five

A

length of health lost d/t dz and time spent w/ dz vs measures premature mortality in diff age groups; more wt on death v probability a newborn baby will die before reaching 5yo; #/1,000 live births

25
Q

what is the world’s leading health problem?

A

noncommunicable dz: CVD, ca, DM, chronic lung dz d/t obese/diet, lack exer, smoking

26
Q

International Association of Patient Organizations developed 7 principles for universal health coverage :

A

Accessibility
Patient-centeredness and equity
Choice and empowerment
Quality
Partnership and collaboration
Sustainability and value
Accountability and transparency

27
Q

health vs public health vs global health

A

not just sick or not sick; state of physical, mental, social well-being vs preventing dz, prolonging life, & promoting physical/mental health thru community measures vs applying principles of public health over nat’l boundaries

28
Q

what’s a chronic dz? top 5 chronic dz?

A

> 1yr requiring ongoing med attn & limiting daily living; >1 cause, degen/physio imbal, not directly transmissible, dx at younger ages now. obese, T2DM, CVD, chronic lung dz, ca

29
Q

human vs financial toll of chronic dz

A

longer life expectancy -> inc chances of degen, D/QALY, 1/2 of world’s pop died by top 5 chronic dzs vs direct costs from tx; indirect costs from sick leave/still going to work while sick, dec prod, mental health; basically high financial burden d/t indirect cost even tho low cost prevention

30
Q

4 main modifiable risks of chronic dz. other?

A

tob (leading cause of preventable disease, disability, and death in the US; secondhand exists too), diet (low in fruit/veg; high in sodium, added sugars, and sat fat), activity (>50 years are inactive), alc. obese, illicit drugs, soc/environ determinants

31
Q

CDC’s 4 Domains For Chronic Disease Prevention

A
  1. Epidemiology and surveillance
  2. Environmental approaches
  3. Health care system interventions
  4. Community programs linked to clinical services
32
Q

Personal barriers vs Public barriers vs clinical barriers to prevention of chronic dz

A

lifestyle, motivation, skills, resrcs/education, environ vs modern living fuel (overconsumption), social norms, govt, work/life bal vs focus on medically urgent issues, no time or supportive resrcs, inadequate clinician training/reimbursement, low pt demand

33
Q

opportunities for chronic disease prevention in a clinical setting?

A

ID problems from pt’s perspective, day to day management, health literacy, give pts resrcs, help self-manage, group visits & f/u

34
Q

chronic care model w/ essential elements vs expanded chronic care model

A

transform care of pts with chronic illness from acute and reactive to proactive and population based; safe high quality health system, community support, self management support, decision making support w/ pt preference, effic/ective delivery system, organized clinical info system vs integrates pop health -> support community health, find soc determinants, make connections b/w community w/ healthcare

35
Q

pt = frustrated w/ chronic dz: BATHE framework vs 5 A’s of brief intervention

A

background, acknowledge, trouble, handling, empathy vs ask, assess, advice, assist, arrange

36
Q

why do motivational interview? how do it? know OARS

A

help patients come to their own decisions by exploring their uncertainties -> uncover self-management issues -> inc pts’ motivation and readiness to change -> acceptance & compassion. directive questions and reflective listening, conversation style, open-ended questions, empathy. peer tutor guide pg 27

37
Q

Shared Decision Making Model

A

patients and providers consider outcome probabilities & patient preferences -> reach mutual decision -> improve quality of decision-making process that’s value-based -> adhere to tx

38
Q

criteria for successful vaxing

A

storage/handling/admin, pt edu on risks & benefits, pt acceptance

39
Q

4 pathophyio pathways of chronic dz

A

senescence: gradual attenuation of fxn -> termination of cell renewal & formerly fxnal cells
degen: cumulative injury, wear/tear
[O]: free radicals as defense against pathogens & byprod of metab
inflamm: in/dep to infxn; diet imbal -> hormonal imbal -> chronic inflamm