Public Health Flashcards
Age for mammography
50-69 q1-2yr
When do you do fasting lipids for screening?
- men >40
- women postmenopausal or >50
any age with risk factors
q1-3 yr
When do you do fasting glucose screening?
- > 40yr q3yr or more frequent with RF
FOBT screening at what age?
- 50yr q 1-2yr
When do you do bone density screening?
- RF osteoporosis
- previous #
- > 65yr
q3-5yr
Calculate infant mortality rate
Infant = #death in children <1yr in certain time period and population / #live births in same period and population
- > neonatal (#deaths kids <28d)
- > perinatal (# deaths in fetuses >28wk GA + infants <7d old)
Maternal mortality rate calculation
deaths related to puerperal cause in certain time period and population/ # pregnancies in same time period and population
Calculate proportionate mortality ratio
deaths due to particular cause/ total # deaths in same time period and population
Crude death rate calculation
= # deaths in population from any cause/ total population win same period
Calculate age-specific death rate
= #deaths in age group in certain time period and population/ average or mid-year population of that age group in same time period and population
Calculate case fatality rate
= #deaths from illness in certain time period/ #people diagnosed with that illness in that time period
Calculate potential years of life lost (PYLL)
= life expectance for population - age at death of individual
Calculate PYLL for population
= add all PYLL for members who died/ total # members of population under age of life expectancy
Define if test is valid
- does it measure what it claims to?
Define reliable test
- can be repeated and the same result obtained?
Define predictive value
- probability that a positive test is a true positive case or that a negative test is a true negative case; determined by the sensitivity and specificity and prevalence of the tested condition
Define efficacy
- the ability to produce a specific result
Define efficient
- is the output useful and worth the input?
Define compliance
- did someone do as instructed?
Define incidence
- the # new cases that will occur in a certain time period
Define prevalence
- the # cases present at a particular time
Define good screening test in terms of disease and the test
disease should be
- common (relatively)
- serious morbidity and/or mortality
- treatment available/ prognosis improved with early detection
test should be:
- safe
- cost effective
- specific and sensitive
- reliable and valid
-> screening test not diagnostic
Define sensitivity
- if condition is there, the probability the test will pick it up
= disease with positive test/ (disease with positive test + disease but negative test)
Define specificity
- if condition is not there, the probability the test result will be negative
= disease not present and negative test/ (disease not present and negative test + disease present and negative test)
What is positive predictive value
= disease present with positive test/ (disease present with positive test + disease not present with positive test)
What is negative predictive value
= disease not present with negative test/ (disease not present with negative test + disease present with negative test)
Are systematic reviews good?
Yes - better than an individual trial of same kind?
Type of trial with best evidence?
Randomized control trial when true randomization and allocation concealment present
What type of disease prevention when level of action before disease present? Examples?
Primary
- education
- social marketing
- public health policy
- Community organizations
Conditions prevented
- family violence
- outbreaks
- many chronic medical conditions
- accidental death
What type of disease prevention is action level in very early stages of disease allowing for effective intervention? Examples?
Secondary
- education
- social marketing
- public health policy
conditions prevented
- those for which an effective screening test is available
What type of disease prevention is level of action when the disease is established, treatment and minimizes suffering? Examples?
Tertiary
- education
- social marketing
- community organizations (support groups)
conditions prevented
- hopefully morbidity and mortality reduced
Common occupational exposures?
- inhalants
- skin contact
- blood borne
- sound
- MSK
Do you need consent to release information to worker’s compensation board?
Yes
Define outbreak
- greater than expected number of epidemiologically linked cases of a particular illness (more cases of particular illness for geographic location)
- > not just infectious agents
What is case definition
- specific criteria (sx, onset) required to label a pt suspicious for or actually infected with the illness in question; can initially be broad but becomes more defined over time
Approach to an outbreak
- Plan of action for cases
- Identify patient’s presenting with symptoms of case presentation
- Isolation of cases and confirmation through testing
- Organize a management team
- Cohort staff to limit further exposures (workers already in contact with cases stay in that role)
- Hand hygiene, gown and gloves (follow advice for contact precautions)
- Restrict new admission and transfers of non-cases; limit visitors
- Exclude symptomatic staff from facility
- Medical Officer of Health and Management Team decide end of outbreak
- Outbreak end declaration often based on type of infectious organism and length of time since pt were symptomatic
Roles of public health?
- education
- immunization/ prophylaxis strategies
- advice for health centres
- investigation of cause of outbreak (travel, food borne)
- investigation of environments involved (restaurants)
- communication with public/media
Likely exposure with nausea, GI upset, headache, seizures, irritability, Burton line?
Lead
- lead blood level
- chelation therapy
complications - coma, LD
Likely exposure with fatigue, headaches, palpitations, SOB, confusion?
CO
- CO Hbg level
- EKG
- Cr
- Hyperbaric O2
complications - arrhythmias, MI, ARF, cardiac/resp arrest, cognitive difficulties, muscle necrosis
