Public Health Admin Flashcards
What does NARMS stand for?
National Antimicrobial Resistance Monitoring System for Enteric Bacteria
What agencies are involved in NARMS?
NARMS is a collaboration among state and local public health departments, CDC, the U.S. Food and Drug Administration (FDA), and the U.S. Department of Agriculture (USDA).
Describe the objectives of NARMS.
This national public health surveillance system tracks changes in the antimicrobial susceptibility of certain enteric (intestinal) bacteria found in ill people (CDC), retail meats (FDA), and food animals (USDA) in the United States. The NARMS program at CDC helps protect public health by providing information about emerging bacterial resistance, the ways in which resistance is spread, and how resistant infections differ from susceptible infections.
What is the definition of a Schedule I (one) drug?
Schedule I drugs, substances, or chemicals are defined as drugs with no currently accepted medical use and a high potential for abuse.
From what sources does NARMS monitor antimicrobial resistance among enteric bacteria?
Humans, Retail Meats, Food Animals
What are the four major food borne bacteria currently under surveillance by The National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS)?
Campylobacter, Enterococcus, E. coli, Salmonella
Provide 2 examples of Schedule I drugs.
Heroine, LSD, Marijuana, Ecstasy, Methaqualone, Peyote
Which Governmental agency regulates controlled substances?
Drug Enforcement Agency
Name 2 organisms that goats, sheep and/or cattle may shed during the birthing process that are transmissible to people.
Q fever (coxiella burnetii) Brucellosis (several species)
What are some steps fairs can take to protect visitors from disease transmission at livestock birthing exhibits?
Ensure barriers are sufficient to separate visitors from the exhibit and not allow contact with the animals.
Provide handwashing stations near exhibits.
Locate birthing exhibits away from food stands or eating areas.
Skin contact with animals in public settings such as at a petting zoo, pet store, or circus can result in human skin infections and or infestations. Name two organisms and/or parasites of human concern.
Ringworm (fungal)
Orf (viral)
Mange (sarcoptes scabiei)
Skin contact with animals in public settings such as at a petting zoo, pet store, or circus can result in human skin infections and or infestations. Name two steps that can be taken to reduce the risk of exposure.
Visual inspection of animals before allowing contact with the public.
Providing handwashing stations.
Discouraging visitors from nuzzling or kissing animals.
Practice good disinfection of animal areas.
- The Horse Protection Act is concerned with eliminating which practice?
a. Administration of performance-enhancing drugs to racehorses
b. Slaughter and processing of horses for human consumption
c. Participation of sored horses in shows, exhibits, or sales
d. Abandonment of unwanted horses
c. Participation of sored horses in shows, exhibits, or sales
- The OIE was formed in response to an outbreak of which disease?
a. Classical Swine Fever
b. Foot-and-Mouth Disease
c. Rinderpest
d. Rift Valley Fever
e. Surra
c. Rinderpest
Which agency is responsible for administration and enforcement of the Country of Origin Labeling (COOL) program?
b. AMS
What to the following Acronyms stand for? APHIS AMS ARS FSIS
APHIS-Animal and Plant Health Inspection Service
AMS- Agricultural Marketing Service
ARS- Agricultural Research Service
FSIS- Food Safety and Inspection Service
The CDC regulates the importation of which one or more of the following animals?
a. Horses
b. Dogs
c. Bats
d. Snakes
e. Fish
f. Monkeys
g. Ferrets
b. Dogs
c. Bats
f. Monkeys
Which of the following is not part of the command staff within the incident command system structure:
a. Liaison officer
b. Safety officer
c. Planning chief
d. Public information officer
c. Planning chief
Of the following, which of the following categories of controls for workplace hazard exposure is considered to be the least effective at protecting employees against a hazard of concern?
a. Engineering control
b. Administrative control
c. Personal protective equipment
d. Employee training
c. Personal protective equipment
The best disaster preparedness starts at what level?
a. Personal
b. Local
c. State
d. Federal
a. Personal
According to the FDA, which one or more of the following animals is a minor species?
a. Turkey
b. Sheep
c. Pig
d. Goat
e. Pheasant
f. Llama
g. Cat
h. Horse
b. Sheep
d. Goat
e. Pheasant
f. Llama
Product “X” is recalled once the FDA determines that there is a high probability that the use of this product will result in serious adverse health effects to the user. Which class of recall did the FDA initiate?
a. Class I recall
b. Class II recall
c. Class III recall
d. Class IV recall
Class I recall
What is an FDA Class I recall?
A situation in which there is a reasonable probability that the use of or exposure to a violative product will cause serious adverse health consequences or death.
What is an FDA Class II recall?
A situation in which use of or exposure to a violative product may cause temporary or medically reversible adverse health consequences or where the probability of serious adverse health consequences is remote.
What is an FDA Class III recall?
A situation in which use of or exposure to a violative product is not likely to cause adverse health consequences.
What is an FDA market recall?
Occurs when a product has a minor violation that would not be subject to FDA legal action. The firm removes the product from the market or corrects the violation. For example, a product removed from the market due to tampering, without evidence of manufacturing or distribution problems, would be a market withdrawal.
The National Poultry Improvement Plan (NPIP) does not include testing and monitoring for which one or more organisms?
a. Salmonella enteritidis
b. Avian Influenza
c. Newcastle Disease
d. Salmonella typhoid
e. Mycoplasma meleagridis
c. Newcastle Disease
- Match the organization to the location of its headquarters:
a. World Organization for Animal Health (OIE)
b. Centers for Disease Control and Prevention (CDC)
c. World Health Organization (WHO)
d. Food and Agriculture Organization of the United Nations (FAO)
i. Rome, Italy
ii. Geneva, Switzerland
iii. Atlanta Georgia
iv. Paris, France
a. World Organization for Animal Health (OIE) Paris
b. Centers for Disease Control and Prevention (CDC) Atlanta
c. World Health Organization (WHO) Geneva
d. Food and Agriculture Organization of the United Nations (FAO) Rome
Which one or more of the following is considered a foreign animal disease in the United States?
a. Aujeszky’s disease
b. Bovine babesiosis
c. Contagious bovine pleuropneumonia
d. Equine viral arteritis
e. Bovine viral diarrhea
f. Epizootic hemorrhagic disease
b. Bovine babesiosis
c. Contagious bovine pleuropneumonia
The Federal Emergency Management Agency (FEMA) falls under which of the U.S. Federal executive departments?
a. Department of Labor
b. Department of Homeland Security
c. Department of Health and Human Services
d. Department of the Interior
b. Department of Homeland Security
Which one or more of the following birds is regulated as livestock by USDA APHIS?
a. Pigeon
b. Macaw
c. Swan
d. Finch
e. Dove
f. Owl
a. Pigeon
c. Swan
e. Dove
The Animal Welfare Act regulates the care and treatment of which one or more of the following animals?
a. Rabbit in a research laboratory
b. Privately-owned cat
c. Iguana for sale at the pet store
d. Goat raised for meat
e. Mouse in a research laboratory
a. Rabbit in a research laboratory
If everything else remains constant, the positive predictive value (PPV) of a specific diagnostic test will be the greatest in which situation?
a. The disease prevalence in the population is high.
b. The disease prevalence in the population is low.
c. The PPV of a test is specific to the test itself and doesn’t depend on disease prevalence.
d. The test is considered highly sensitive.
a. The disease prevalence in the population is high.
Approximately how often is the Agriculture Improvement Act (“Farm Bill”) updated?
a. Yearly
b. Every other year
c. Every five years
d. Every 10 years
c. Every five years
Which of the following is not a branch of the USDA?
a. Foreign Agricultural Service
b. Food and Nutrition Service
c. National Institute of Food and Agriculture
d. Center for Food Safety and Applied Nutrition
d. Center for Food Safety and Applied Nutrition
The FDA’s Federal Food, Drug, and Cosmetics Act requires that pet foods meet which one or more of the following standards:
a. Produced under sanitary conditions
b. Be truthfully labeled
c. Do not contain harmful substances
d. Be safe to eat
a. Produced under sanitary conditions
b. Be truthfully labeled
c. Do not contain harmful substances
d. Be safe to eat
Which of the following constitute extralabel use of an approved drug (Drug A)?
a. Drug A is given SQ to Daisy the dairy goat and is labeled for use in bovines but not for use in caprines.
b. Drug A is used to treat a bacterial urinary tract infection in Fluffy the cat, but the drug label only states that Drug A is to be used in cats to treat skin infections caused by susceptible strains of Pasteurella multocida.
c. The drug label says to administer Drug A IM every 8 hours, but Bob works 12-hour shifts, so he administers a dose-and-a-half worth of Drug A IM every 12 hours instead.
d. The package insert for Drug A says to give a dog of Buster the dog’s weight one capsule every 12 hours for up to seven days, but Buster doesn’t seem 100% back to normal after seven days, so the veterinarian advises the owner to continue giving Drug A every 12 hours for another five days.
e. All of the above constitute extralabel drug use.
e. All of the above constitute extralabel drug use.
Which of the following products are regulated by the FDA? For the choices not regulated by the FDA, which agency regulates them?
a. Smart TVs
b. Pet food
c. Alcohol
d. Human vaccines
e. Heroin
f. Advertisement for regular-strength Tylenol
g. Baby toys
a. Smart TVs-FDA
b. Pet food-FDA
c. Alcohol-Bureau of Alcohol, Firearms, Tobacco and Explosives
d. Human vaccines- FDA
e. Heroin-DEA
f. Advertisement for regular-strength Tylenol-Federal Trade Commission
g. Baby toys- Consumer Product Safety Commission (CPSC)
Which one or more of the following is a Category A bioterrorism agent?
a. Nipah virus
b. Ricin toxin
c. Francisella tularensis
d. Burkholderia pseudomallei
e. Lassa virus
c. Francisella tularensis
e. Lassa virus
Of those listed, which control method is most preferred for protecting employees from workplace hazards?
a. Exposure and worker health monitoring
b. Administrative controls
c. Engineering controls
d. Personal protective equipment
c. Engineering controls
After being accredited in state A, a veterinarian establishes a practice in state B. To be able to issue health certificates on livestock movements, the veterinarian must:
a. Write the state board in state B
b. Practice in state B for one year
c. Do nothing since his accreditation is accepted in all states
d. be licensed and accredited by state B
e. write the USDA in Washington D.C. and request permission to perform official work in state B
d. be licensed and accredited by state B
Which one or more of the following is incorrect?
a. Both an R95 respirator and a P95 respirator are expected to filter at least 95% of airborne particles, but the P95 respirator is expected to be more resistant to oils than the R95 respirator.
b. An N100 respirator is expected to filter at least 99.97% of airborne particles but is not resistant to oils.
c. A P99 respirator has a longer certified service life than an R99 respirator.
d. The agency that regulates N95 respirators falls under another agency that falls within the U.S. Department of Health & Human Services.
e. All choices are correct.
a. Both an R95 respirator and a P95 respirator are expected to filter at least 95% of airborne particles, but the P95 respirator is expected to be more resistant to oils than the R95 respirator.
The Easter Bunny wants to get a head start on planning his Easter deliveries. He remembers that the baby chicks he’ll put in his baskets are inspected by __________, the _______ regulates shell eggs, the ________ regulates egg products, and the _______ regulates chocolate candy eggs.
a. USDA, USDA, FDA, FDA
b. USDA, USDA, USDA, FDA
c. FDA, FDA, FDA, FDA, FDA
d. USDA, FDA, USDA, FDA
e. USDA, FDA, FDA, FDA
d. USDA, FDA, USDA, FDA
Among all weather-related hazards, which type is responsible for the greatest number of annual human deaths?
a. Wildfire
b. Flooding
c. Avalanche
d. Lightening
e. Extreme heat
f. Extreme cold
e. Extreme heat
Who is considered the father of modern epidemiology?
a. Robert Koch
b. John Snow
c. Anthony Fauci
d. Edward Jenner
e. Louis Pasteur
b. John Snow
Which one or more of the following organisms should only be studied and worked with within the confines of a BSL-4 laboratory?
a. Nipah virus
b. Coxiella burnetii
c. Yersinia pestis
d. Marburg virus
e. Crimean-Congo hemorrhagic fever
f. West Nile Virus
a. Nipah virus
d. Marburg virus
e. Crimean-Congo hemorrhagic fever
- The Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) is administered and regulated by which agency?
a. U.S. Environmental Protection Agency
b. Centers for Disease Control and Prevention
c. Food and Drug Administration
d. U.S. Department of Agriculture
a. U.S. Environmental Protection Agency
Of its 182 (as of this date) member countries, approximately what percentage are considered FMD free without vaccination by the OIE?
a. 7%
b. 71%
c. 36%
d. 95%
e. 15%
c. 36%
Dr. Danelle works in Mosquito City and her veterinary clinic goes through hundreds of in-house, rapid Canine Heartworm antigen test kits every year. Which agency regulates these heartworm tests?
a. FDA CVM
b. USDA AMS
c. USDA CVB
d. FDA FSAN
c. USDA CVB
Which one or more of the following is not considered a U.S. foreign animal disease?
a. Equine Infectious Anemia
b. Bovine Babesiosis
c. New World Screwworm
d. Peste des petits ruminants
e. Newcastle Disease
f. Porcine reproductive and respiratory syndrome
a. Equine Infectious Anemia
f. Porcine reproductive and respiratory syndromesis
The first priority of the National Animal Vaccine and Veterinary Countermeasures Bank (NAVVCB) is to increase the U.S. stockpile of which animal vaccine?
a. African Swine Fever
b. Foot and Mouth Disease
c. Exotic Newcastle Disease
d. Avian Influenza
b. Foot and Mouth Disease
Which of the following agencies has been delegated the authority and responsibility for controlling the interstate movement of livestock in the United States?
a. Veterinary Service of State Department of Agriculture
b. Packers and Stockyards Administration
c. U.S. Department of Commerce
d. Veterinary Service of the USDA Animal and Plant Health Inspection Service
e. USDA Food Safety & Quality Service
d. Veterinary Service of the USDA Animal and Plant Health Inspection Service
Which of the following is/are not among the U.S. Animal Health Program diseases?
a. Chronic Wasting Disease
b. Swine Brucellosis
c. Rabies
d. Bovine Spongiform Encephalopathy
e. Equine Infectious Anemia
f. Avian Influenza
c. Rabies
f. Avian Influenza
The U.S. Fish and Wildlife Service is an agency within the Department of _______, and the National Oceanic and Atmospheric Administration is an agency within the Department of ____.
a. Interior, Agriculture
b. Interior, Commerce
c. Agriculture, Health and Human Services
d. Agriculture, Commerce
e. Commerce, Agriculture
b. Interior, Commerce
Both Nexgard (chewable product) and K9 Advantix II (topical product) are labeled for the control of fleas and ticks in dogs. However, the orally administered product is regulated by ______ while the topically-applied product is regulated by ______.
a. FDA, EPA
b. FDA, USDA
c. EPA, FDA
d. EPA, USDA
a. FDA, EPA
Which one or more of the following food animals is not protected under the Humane Methods of Slaughter Act?
a. Pig
b. Cow
c. Turkey
d. Sheep
e. Horse
f. Salmon
c. Turkey
f. Salmon
- Based on the following 2x2 table for a diagnostic test, write the equation and (brief) definition for each term below:Disease No Disease
Test Positive a b
Test Negative c d
a. Sensitivity
b. Specificity
c. Prevalence
d. Positive predictive value
e. Negative predictive value
a. Sensitivity: a/(a+c)
The ability of a diagnostic test to identify the true positives (false negatives).
b. Specificity: d/(b+d)
The ability of a diagnostic test to identify true negatives (false positives).
c. Prevalence: (a+c)/(a+b+c+d)
The proportion of a population that have a specific disease at a specific point in time.
d. Positive predictive value: a/(a+b)
A measure of certainty that a positive test result depicts the true disease status of an individual. Increases as disease prevalence increases within a population increases.
e. Negative predictive value: d/(b+d)
A measure of certainty that a negative test result depicts the true disease status of an individual. Increases as disease prevalence decreases within a population.
Define Sensitivity
a/(a+c)
The ability of a diagnostic test to identify the true positives (false negatives).
Define Specificity
d/(b+d)
The ability of a diagnostic test to identify true negatives (false positives).
Define Prevalence
(a+c)/(a+b+c+d)
The proportion of a population that have a specific disease at a specific point in time.
Define PPV
d. Positive predictive value: a/(a+b)
A measure of certainty that a positive test result depicts the true disease status of an individual. Increases as disease prevalence increases within a population increases.
Define NPV
e. Negative predictive value: d/(d+c)
A measure of certainty that a negative test result depicts the true disease status of an individual. Increases as disease prevalence decreases within a population.
- A Chihuahua patient of yours comes in for a routine wellness visit and tests positive on an in-house test for heartworm disease. The owner says this is impossible because she gives the dog its heartworm preventative tablet every month as directed, plus the dog spends very little time outdoors. The package insert for the in-house test reports a sensitivity of 99% and specificity of 95%. The prevalence data for the area indicates 1.5% of the dog population actually has heartworm disease.
- Taking these numbers into account, how certain are you that the positive test result is correct? (Hint: what is the PPV of this test result?)
Disease No Disease Total
Test + a = 14.85 b = 49.25( 64.1 – 14.85) 64.1(1000-935.9)
Test - c = 0.15 d = 935.75 935.9(0.15+935.75)
15* 985 (1000-15) 1000*
Se = 0.99 = a/(a+c) =a/15 = 0.99 = a = 15*0.99 = a = 14.85 Sp = 0.95 = d/(b+d) = d/985 = 0.95 = d = 985*0.95 = d = 935.75
PPV = a/(a+b) = 14.85/(14.85+49.25) =14.85/64.1 = 0.22166927 (* 100 = 23.2%)
I am 23.3% certain that Sprinkles’ positive test is a true positive.
A Chihuahua patient of yours comes in for a routine wellness visit and tests positive on an in-house test for heartworm disease. The owner says this is impossible because she gives the dog its heartworm preventative tablet every month as directed, plus the dog spends very little time outdoors. The package insert for the in-house test reports a sensitivity of 99% and specificity of 95%. The prevalence data for the area indicates 1.5% of the dog population actually has heartworm disease.
a. Taking these numbers into account, you are 23.2% certain that the positive test result is correct?
b. Sprinkles’ owner is upset about your conclusion in part A. (“What a waste of money! This is a terrible test!” she complains.) Despite being a little high maintenance, Sprinkles’ owner is a good client and you want her to continue to come back for Sprinkle’s care. Write a response in 2-4 sentences that you might give to Sprinkles’ owner about the above result and your certainty about Sprinkles’ diagnosis, paying particular attention to using layman’s terms to describe what PPV means and its relationship to prevalence.
“I know it seems silly that this test result says Sprinkles is positive when we don’t think she is. This is because there are so few cases of heartworm in dogs in this area (because of owners like you that give the monthly preventative medication regularly)! This screening test actually over estimates the number of dogs with heartworm, and so we are actually are less likely to miss a positive, which could be really terrible for that dog’s health, and we can run a simple, easy, inexpensive test to make certain that Sprinkles doesn’t actually have heartworm disease.”
What is the difference between the National Veterinary Services Laboratory (NVSL) and the National Animal Health Laboratory Network (NAHLN) and the location(s) of each?
National Veterinary Services Laboratory (NVSL) co-located with the National Animal Disease Center (USDA-ARS) and the Center for Veterinary Biologics to form the National Centers for Animal Health in Ames, IA. Their mission is to safeguard U.S. animal health and contribute to public health by ensuring that timely and accurate laboratory support is provided by their nationwide animal-health diagnostic system. The NVSL serves as the reference laboratory for the National Animal Health Laboratory Network and oversees the annual proficiency testing of these laboratories as part of this approval process.
National Animal Health Laboratory Network is located throughout the country at various State, university, and private animal diagnostic laboratories within the U.S. They are a network of animal disease diagnostic laboratories that works effectively as a team, provides ongoing disease surveillance, responds quickly to disease events, communicates diagnostic outcomes to decision makers in a timely manner, and has the capability and capacity to meet diagnostic needs during animal disease outbreaks. The National Animal Health Laboratory Network (NAHLN) is part of a nationwide strategy that enhances the Nation’s early detection of, response to, and recovery from animal health emergencies. It is a partnership of over 60 Federal, State and university-associated animal health laboratories distributed throughout the U.S., and is capable of testing large numbers of samples for specific disease agents originating from food animals.
Define what is meant by a DIVA vaccine and give an example. What body regulates veterinary vaccines? List the Program, Agency, and U.S. Department that houses this regulatory body.
DIVA = Differentiating Infected from Vaccinated Animals
DIVA vaccines were first used for the eradication of Aujeszky disease in pigs, since then they have advanced to cover infectious bovine rhinotracheitis (IBR) of cattle, foot-and-mouth disease (FMD), classical swine fever (CSF), avian influenza infection (H7N1), and more recently Peste des petits ruminants (PPR).
Veterinary vaccines are regulated by the Center for Veterinary Biologics, within the Veterinary Services Program of the Animal and Plan Health Inspection Service (APHIS) of the United States Department of Agriculture (USDA).
Besides the Veterinary Services (VS) what other programs fall under APHIS?
The other 5 programs of APHIS are Animal Care, Biotechnology Regulatory Services, International Services and Trade Support Team, Plant Protection and Quarantine, and Wildlife Services.
Briefly describe the PETS act
a. PETS Act, Pets Evacuation and Transportation Standards Act (2006):
The PETS Act amends the Robert T. Stafford Disaster Relief and Emergency Assistance Act to ensure that State and local emergency preparedness operational plans address the needs of individuals with household pets and service animals following a major disaster or emergency.
The PETS Act authorizes FEMA to provide rescue, care, shelter, and essential needs for individuals with household pets and service animals, and to the household pets and animals themselves following a major disaster or emergency.
For DHS and its agency that oversees emergency response – the Federal Emergency Management Agency (FEMA) – to implement the PETS Act effectively, two other documents support FEMA’s activities to ensure optimal preparedness and response associated with companion animals: Post-Katrina Emergency Management Reform Act (PKEMRA) and the
National Response Framework (NRF).
Briefly describe AMDUCA
b. AMDUCA, Animal Medicinal Drug Use Clarification Act of 1994:
The Animal Medicinal Drug Use Clarification Act of 1994 (AMDUCA) permits veterinarians to prescribe extralabel uses of certain approved new animal drugs and approved human drugs for animals under certain conditions. Extralabel use refers to the use of an approved drug in a manner that is not in accordance with the approved label directions.
Briefly describe CERCLA
c. CERCLA, Comprehensive Environmental Response, Compensation, and Liability Act (a.k.a. Superfund) (1980):
provides a Federal “Superfund” to clean up uncontrolled or abandoned hazardous-waste sites as well as accidents, spills, and other emergency releases of pollutants and contaminants into the environment. Through CERCLA, EPA was given power to seek out those parties responsible for any release and assure their cooperation in the cleanup.
Briefly Describe FSMA
d. FSMA, Food Safety Modernization Act (2011):
Congress enacted FSMA in response to dramatic changes in the global food system and in our understanding of foodborne illness and its consequences, including the realization that preventable foodborne illness is both a significant public health problem and a threat to the economic well-being of the food system. FDA has finalized seven major rules to implement FSMA, recognizing that ensuring the safety of the food supply is a shared responsibility among many different points in the global supply chain for both human and animal food.
Briefly describe RCRA
e. RCRA, Resource Conservation and Recovery Act (1976):
The public law that creates the framework for the proper management of hazardous and non-hazardous solid waste. The law describes the waste management program mandated by Congress that gave EPA authority to develop the RCRA program. The term RCRA is often used interchangeably to refer to the law, regulations and EPA policy and guidance.
Which of the acts listed below gives veterinarians the ability to prescribe extra-label drug use?
a. PETS Act
b. AMDUCA
c. CERCLA
d. FSMA
e. RCRA
b. AMDUCA