⭐️ PREVMED Flashcards
Define mean.
Average, the sum of observations divided by the number of observations
Appropriate measure of central tendency in qualitative data such as gender, religion or nationality,
Mode
Define median.
Middle observation in a series of ordered observations i.e. 50th percentile
The observtion tht occurs with the greatest frequency
Mode
Define epidemiology
Studies both the DISTRIBUTION of diseases in human populations and the DETERMINANTS of the observed distribution.
What is the sampling unit in epidemiologic studies in the identification of causal factors?
A group of individuals
Ultimate goal of an epidemiologic investigation
To institute curtive, preventive, and control measures to avoid most cases
Study of the distribution of diseases in animals
Epizootiology
Define antigenic drift
Slow and provressive change in the antigenic composition of microorganisms. This alters tye immunological responses of individuals and a population’s susceptibility to that organisms.
Define antigenic SHIFT.
A sudden change in the molecular structure of a microorganism and produces new strains. This results in little or no acquired immunity to these new strains and is the ecplanation for new epidemics and pandemics.
____________ would result in influenza cases with high case fatality rates seen previously with this strain.
Vaccine failure
__________ would decrease the rate of infection by decreasing the probability that a susceptible person would come into contact with an infected person. This would not affect the clinical presentation of those infected.
Herd immunity
Define endemic.
Constant occurence
Define epidemic.
Occurence of a number of cases of disease in excess of normal occurrence of expectancy.
Define pandemic.
Epidemic involving many countries.
Also called a prospective study
Cohort
Refers to the group of subjects who are followed forward in time to see which ones develop the outcome
Cohort
Prospective studies in which an intervention is supplied
Clinical trials
Also known as a retrospective study
Case control study
Bias usually found in case control studies
Recall bias
Exposures and outcomes are measured at the same point in time
Cross sectional study
Name the type of study.
Clinical characteristic or outcome from a single clinical event or subject (n=1)
Case report
Following a prison inmate population and marking the development of MDRTB.
Name the type of study.
Cohort
A 23 year old man with MDRTB.
Name the type of study.
Case report
Name the type of study.
Clinical characteristic or outcome from a group of clinical subjects or events (n>1)
Case series
Patients in a local hospital with MDRTB.
Name the type of study.
Case series
Population group exposed to a risk factor is followed over time compared with a group not exposed to the risk factors.
Name the type of study.
Cohort
Can determine incidence and causal relationships if there is a statistical association between risk factor and disease.
Name the type of study.
Cohort
Control group is the population at risk vs. population not at risk.
Cohort
Prevalence study
Cross-sectional
Who in the community now has MDRTB?
Name the type of study.
Cross-sectional
Determines in each member of the population the presence or absence of a disease and other variables at one point in time.
Name the type of study.
Cross-sectional
Causality cannot usually be determined.
Name the type of study.
Cross-sectional
Comparing cases of MDRTB with cases of non-resistant TB.
Name the type of study.
Case-control
Assesses many risk factors for disease.
Name the type of study.
Case-control
Cannot assess incidence and prevalence of disease.
Name the type of study.
Case-control
Weakest because outcome has already happened.
Name the type of study.
Case-control
A new screening test is applied to a representative sample of 1,000 people in the population. Based on the data presented in the following table, calculate the requested screening test measures:
Diseased (pos=90 neg =10)
Well (pos=60 neg=840)
Sensitivity?
90/100 [true pos/total disease]
90%
A new screening test is applied to a representative sample of 1,000 people in the population. Based on the data presented in the following table, calculate the requested screening test measures:
Diseased (pos=90 neg =10)
Well (pos=60 neg=840)
Specificity?
840/900 [true negative/total number without disease]
93%
A new screening test is applied to a representative sample of 1,000 people in the population. Based on the data presented in the following table, calculate the requested screening test measures:
Diseased (pos=90 neg =10)
Well (pos=60 neg=840)
Positive predictive value?
90/150 [how many diseased among positives?]
Define prevalence.
Total number of cases in a population at a given time. (Old and nee, for chronic conditions)
Define incidence.
Number of new cases in a population per unit time. Incidence is new incidents. (For acute conditions)
Define sensitivity.
Number of true positives divided by the number of people with disease.
Mnemonics: PID Positive in disease; SNOUT sensitivity rules out
Define specificity
Number of true negatives divided by the number of people without the disease.
Mnemonics: NIH Negative in health: SPIN Specificity rules in
High sensitivity is desirable for which type of test?
Screening test to rule out
High specificity is desirable for which type of test?
Confirmatory test to rule in
Define positive predictive value
Number of true positives divided by the number of people who tested positive for the disease.
The probability of having a condition given a positive test
Define negative predictive value.
Number of true negatives divided by the number of people who tested negative for the disease.
The probability of not having the condition given a negative test
The most important factor for the development of breast cancer is
Age
Is smoking a major risk factor for breast CA?
No
Population affected by appendicitis? Age and sex
20 to 30s and equal among males and females
Most common site of nosocomial infections?
GU tract
Arrange the following nosocomial infections from highest incidenc e to lowest:
SSI RTI Septicemia UTI
UTI SSRI RTI Septicemia
A methylxanthine related to theophylline which is a low potency bronchodilator
Caffeine
Most common cause of cobalamin deficiency in temperate climates
Pernicious anemia
Hypercholesterolemia is associated with increased risk for gallstone formation. True or false.
False
Exposure to sulfur dioxide causes
Irritation of mucus membranes
Exposure to mercury causes
Intention tremor, delirium.
Use of mercury in felt hats led to the phrase “mad as a hatter”
Exposure to lead causes
Peripheral neuropathy and ataxia
Exposure to nitrous oxide causes
Similar to neuropathy in pernicious anemia
A fibrosing lung disease usually due to chronic occupational exposure to air with particulate matter
Pneumoconiosis
Byssinoisis is
A form of pneumoconiosis from textile, cotton, or flax
The most serious manifestation of lead intoxication is
Cerebral edema
Cerebral edema is often noted with blood lead levels exceeding
100 ug/dl
Hutchinson’s teeth is associated with
Congenital syphilis
5 b’s of congenital rubella syndrome
Bulag, bingi, bobo, butas, blueberry muffin baby
Most prevalent mental health disorder in children
Behavioral problems
Behavioral problems such as ADD and learning disabilities occur in how many percent of children?
10%
Autism occurs in how many percent of children?
0.05%
Mental retardation occurs in how many percent of children?
1%
The mother is more commonly the abuser perhaps because of the greater contact with the child. True or false.
True
Time from infection to a positive tuberculin skin test
2-8 weeks
Define immunogenicity.
Ability of a microbe or purified antigen to induce specific antibody production in a host as a result of infection or immunization.
Define pathogenicity.
Capacity of a microbe to cause symptomatic illness in an infected host
Defien virulence
Severity of the illness produced by a microbe; measure by percentage of severe or fatal cases
Define contagiousness
Ability of a microbe to spread in a population of exposed susceptible persons
Single most important preventive measure against diseases?
Water sanitation
This test is done as a prenatal test for people at high risk for thalassemia or sickle cell anemia
Electrophoresis
This prenatal test is done for women with uncertain menstrual histories or risk of IUGR
UTZ
RA 10152
Mandatory infants and children health immunization act of 2011
Why is gonorrhea treated with oral tetracycline for 7 days rather than ampicillin plus probenecid at one time?
Better coverage for chlamydia trachomatis
Tetracycline is contraindicated in pregnancy. Which alternative drug will you give?
Azithromycin
Cut off age for tetracycline and fluoroquinolones
Tetracycline -8
Fluoroquinolones -18
Prevention of human brucellosis depends on
Pasteurization of dairy products derived from goats, sheeps or cattle
Effective means of preventing trichinosis in humans
Prohibiting marketing of garbage fed hogs
Thorough cooking at temperature at least ____ helps in the control of trichinella spiralis
77 C
Absolute indication for a pap smear
Sexual activity
Signs of vitamin c deficiency
Petechiae, sore gums, hematuria, bone, and joint pain
Signs of niacin deficiency
Dermatitis, diarrhea, delirium
Signs of thiamine deficiency
Edema, neuropathy, myocardial failure
Signs of vitamin A deficiency
Xerosis conjunctivae, hyperkeratosis, and keratomalacia
Effect of calcium deficiency
Poor mineralization of bones and teeth, osteoporosis
Effect of sodium deficiency
Nausea, diarrhea, muscle cramps, dehydration
Effect of fluorine deficiency
Tendency of dental caries
Effect of zinc deficiency
Dwarfism, hepatosplenomegaly, poor wound healing
Most common cause of cobalamin deficiency in temperate climates
Pernicious anemia
Hypercholesterolemia is associated with increased risk for gallstone formation. True or false.
False
Exposure to sulfur dioxide causes
Irritation of mucus membranes
Exposure to mercury causes
Intention tremor, delirium.
Use of mercury in felt hats led to the phrase “mad as a hatter”
Exposure to lead causes
Peripheral neuropathy and ataxia
Exposure to nitrous oxide causes
Similar to neuropathy in pernicious anemia
A fibrosing lung disease usually due to chronic occupational exposure to air with particulate matter
Pneumoconiosis
Byssinoisis is
A form of pneumoconiosis from textile, cotton, or flax
The most serious manifestation of lead intoxication is
Cerebral edema
Cerebral edema is often noted with blood lead levels exceeding
100 ug/dl
Hutchinson’s teeth is associated with
Congenital syphilis
5 b’s of congenital rubella syndrome
Bulag, bingi, bobo, butas, blueberry muffin baby
Most prevalent mental health disorder in children
Behavioral problems
Behavioral problems such as ADD and learning disabilities occur in how many percent of children?
10%
Autism occurs in how many percent of children?
0.05%
Mental retardation occurs in how many percent of children?
1%
The mother is more commonly the abuser perhaps because of the greater contact with the child. True or false.
True
Time from infection to a positive tuberculin skin test
2-8 weeks
Define immunogenicity.
Ability of a microbe or purified antigen to induce specific antibody production in a host as a result of infection or immunization.
Define pathogenicity.
Capacity of a microbe to cause symptomatic illness in an infected host
Defien virulence
Severity of the illness produced by a microbe; measure by percentage of severe or fatal cases
Define contagiousness
Ability of a microbe to spread in a population of exposed susceptible persons
Single most important preventive measure against diseases?
Water sanitation
This test is done as a prenatal test for people at high risk for thalassemia or sickle cell anemia
Electrophoresis
This prenatal test is done for women with uncertain menstrual histories or risk of IUGR
UTZ
RA 10152
Mandatory infants and children health immunization act of 2011
Why is gonorrhea treated with oral tetracycline for 7 days rather than ampicillin plus probenecid at one time?
Better coverage for chlamydia trachomatis
Tetracycline is contraindicated in pregnancy. Which alternative drug will you give?
Azithromycin
Cut off age for tetracycline and fluoroquinolones
Tetracycline -8
Fluoroquinolones -18
Prevention of human brucellosis depends on
Pasteurization of dairy products derived from goats, sheeps or cattle
Effective means of preventing trichinosis in humans
Prohibiting marketing of garbage fed hogs
Thorough cooking at temperature at least ____ helps in the control of trichinella spiralis
77 C
Absolute indication for a pap smear
Sexual activity
Signs of vitamin c deficiency
Petechiae, sore gums, hematuria, bone, and joint pain
Signs of niacin deficiency
Dermatitis, diarrhea, delirium
Signs of thiamine deficiency
Edema, neuropathy, myocardial failure
Signs of vitamin A deficiency
Xerosis conjunctivae, hyperkeratosis, and keratomalacia
Effect of calcium deficiency
Poor mineralization of bones and teeth, osteoporosis
Effect of sodium deficiency
Nausea, diarrhea, muscle cramps, dehydration
Effect of fluorine deficiency
Tendency of dental caries
Effect of zinc deficiency
Dwarfism, hepatosplenomegaly, poor wound healing
Fundamental to the detection of TB infectious cases
and is recommended for case finding among adults and children who can expectorate.
Direct sputum smear microscopy
Definitive diagnosis of active TB
Direct sputum smear microscopy
Benefit of CXR in TB diagnosis
Complement bacteriologic testing in making a diagnosis. However, it has low specificity and does not differentiate drug-susceptible from drug-resistant disease.
Routine diagnostic test for drug-resistant TB
TB culture and drug susceptibility test (DST)
Basic screening tool for TB infection among children
Tuberculin skin test (TST)
Time from collection of fi rst sputum sample to initiation of treatment for TB
Turnaround time
Desired: 5 days
Define presumptive TB
Any person whether adult or child with signs and/or symptoms suggestive of TB whether pulmonary or extra-pulmonary, or those with CXR findings suggestive of active TB
Define Presumptive Drug Resistant TB
Any person whether adult or child, who
belongs to any of the DR-TB high-risk groups, such as: re-treatment cases, new TB cases that are contacts of confirmed DR-TB cases or non-converter of Category I, and
people living with HIV with signs and symptoms of TB
Define TB Exposure
A condition in which an individual is in close contact with an active adult TB case, but without any signs and symptoms of TB, with negative TST reaction, and no radiologic and laboratory findings suggestive of TB.
Define latent TB or TB infection (LTBI)
A condition in which an individual has no signs and symptoms presumptive of TB nor radiologic or laboratory evidence, but has a positive TST reaction.
Define TB disease.
A presumptive TB who after clinical and diagnostic evaluation is confirmed to have TB.
Classification of TB based on anatomical site
Pulmonary and Extrapulmonary TB
A patient with both pulmonary and extra-pulmonary TB should be classified as a case of
pulmonary TB
Classification of TB based on bacteriologic status
Bacteriologically confirmed and clinically diagnosed
What is the definition of a clinically diagnosed TB disease?
A patient with two (2) sputum specimens negative for
AFB or MTB, or with smear not done due to specified
conditions but with radiographic abnormalities
consistent with active TB;
and there has been no response to a course of empiric antibiotics and/ or symptomatic medications; and who has been decided (either by the physician and/or TBDC) to
have TB disease requiring a full course of anti-TB
chemotherapy
What is the definition of a clinically diagnosed TB disease in children?
A child (less than 15 years old) with two (2) sputum
specimens negative for AFB or with smear not done,
who fulfills three (3) of the five (5) criteria for disease
activity
(i.e., signs and symptoms suggestive of TB,
exposure to an active TB case, positive tuberculin
test, abnormal chest radiograph suggestive of TB, and
other laboratory findings suggestive of tuberculosis);
and who has been decided (either by the physician
and/or TBDC) to have TB disease requiring a full
course of anti-TB chemotherapy
Definition of a TB retreatment case
A patient who has been previously treated with anti-TB
drugs for at least one (1) month in the past.
Differentiate monoresistant vs. polyresistant vs. multi-drug resistant TB vs extensively drug resistant TB
a. Monoresistant-TB – Resistance to one fi rst-line anti-TB drug only.
b. Polydrug-resistant TB – Resistance to more than one fi rst-line anti-TB drug (other than both Isoniazid and Rifampicin).
c. Multidrug-resistant TB (MDR-TB) – Resistance to at least both Isoniazid and Rifampicin.
d. Extensively drug-resistant TB (XDR-TB) – Resistance to any fluoroquinolone and to at least one of three second-line injectable drugs (Capreomycin, Kanamycin and Amikacin), in addition to multidrug resistance.
