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Public Health > Prevention and screening > Flashcards

Prevention and screening Flashcards

1
Q

What is primary prevention? Give an example

A 
preventing disease before it occurs
Examples:
- education
- immunisation 
- fluoridation of water
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2
Q

What is secondary prevention? Give examples

A

Detects early disease to alter course or prevent recurrence of disease
Examples:
- breast cancer screening
- aspirin to prevent further MIs

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3
Q

What is tertiary prevention?

Give examples

A

Reduce impact of disease, improve QOL or function
Example:
- rehab post stroke

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4
Q

What is the prevention paradox?

A

If something brings a lot of benefit to the population, then it provides little benefit to each individual

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5
Q

What type of prevention is screening?

A

Primary or secondary

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6
Q

What are the criteria for screening called?

A

Wilson and Jungner

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7
Q

What are the criteria for screening regarding the condition?

A
  1. Should be an important problem
  2. Natural Hx should be well understood
  3. Should be a detectable early stage
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8
Q

What are the criteria for screening regarding the treatment?

A
  1. Should be acceptable rx
  2. Facilities for diagnosis should be available
  3. Adequate health service provision should exist for people found positive on screening
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9
Q

What are the criteria for screening regarding the test?/

A
  1. Suitable test should exist for early stage
  2. Should be acceptable
  3. Should be repeated
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10
Q

What are the criteria for screening regarding risks and benefits?

A
  1. Should be an agreed policy on whom to treat
  2. Costs should be balanced against benefits
  3. benefits should outweigh the risks
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11
Q

What are current screening programmes?

A
  1. Guthrie/Heel prick test
  2. Newborn hearing screening test
  3. Breast cancer screening
  4. Cervical cancer screening
  5. Bowel cancer w fecal occult blood 60-74
  6. AAA - men >65
  7. Diabetic retinopathy screening - yearly
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12
Q

When is screening performed in cervical cancer?

A

every 3 years 25-50

every 5 years 50-64

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13
Q

What types of HPV does the vaccination work against>

A

6,11,16, 18

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14
Q

What types of HPV are high risk?

A

16 and 18

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15
Q

What is the combined test in antenatal screening>?When is it done?

A

Measure of nuchal translucency, PAPP-A and bHCG

10-14weeks

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16
Q

What is the quadruple test in antenatal screening? When is it done?

A

Same as combined but doesn’t involve NT,

Is done either 10-14 weeks if can’t retrieve NT due to baby position or 14-20 weeks

17
Q

What condition does the quadruple test screen for?

A

downs

18
Q

What does the combined test screen for?

A

work out the chance of the baby having Down’s, Edwards’ or Patau’s syndromes

19
Q

What maternal infections are screened for in pregnancy?When are they tested for?

A

hepatitis B, HIV and syphilis.

usually at booking ~10 weeks

20
Q

When is the anomaly scan done in pregnancy?

A

20 weeks

21
Q

What newborn screening is done?

A

newborn hearing
newborn physical exam
Guthrie

22
Q

What conditions does the Guthrie test look for?

A 
Sickle cell
Congenital hypothyroidism
CF
phenylketonuria
Homocysteinuria
MCADD
23
Q

What is a false positive?

A

Result says they have disease when they DONT

24
Q

What are false negatives?

A

When someone is screened for a disease and they are deemed not to have the disease but go on to develop it later on

25
Q

What is sensitivity?

A

The proportion of people with a disease who are CORRECTLY identified by a screening process
Therefore: true +ve/true +ve + false -ve

26
Q

What is specificity?

A

proportion of people without the disease who are correctly excluded by the disease process
Therefore: true -ve/true -ve + false +ve

27
Q

What is positive predictive value?

A

Proportion of people who have a +ve screening result who following tests have the disease
Therefore: true +ve + false +ve

28
Q

What is negative predictive value?

A

Proportion of people w a negative result who don’t have the disease following testing
Therefore: true -ve + false -ve

29
Q

What are disadvantages of screening?

A

over detection of sub clinical disease
SE of screening
anxiety of patients

Public Health (12 decks)

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