Public health/Disaster/Immigrant Flashcards
% death under age 5 YO due to perinatal
40%
3 causes of eosinophilic meningitis
Angiostrongylus cantonensis
Gnathostoma spinigergum
T. solium (neurocysticercosis)
Ackee fruit
in West Africa and Carribean, unripenned fruit leads to hypogycemia
acute diarrhea leading to bacteremia
shig, salmonella, campy
Adoptee growth failure- 2 types
< 18 mo- nutritional, rickets > 18 mo- stunting, delayed puberty
Aeromonas assoc with
reptile and leeches
annual deaths related to cook stove exposure
4 million
as poverty improves, birth rates go ?
down
asylum seekers- torture, PTSD
torture 45% PTSD 65%
B1- name, deficiency, source
thiamine Wernicke (encephalopathy), beriberi (neuropathy, hiigh output failure) infantile beriberi in SE Asia due to BF on restricted diet of milled grains unprocessed grains
B12- name, deficiency, source
cyanocobalamine cheliosis, glossitis, anemia, cord degeneration meat and dairy
B2- name, deficiency, source
riboflavin cheliosis, magenta tongue, seb derm, poor Fe absorption all foods
B3- name, deficiency, source
niacin pellagra- 3D- (photo)dermatitis, diarrhea, dementia hyperpigmentation meat, fruit, veg assoc with maize diet (low tryptophan niacin precurser)
B6- name, deficiency, source
pyridoxine neuropathy (esp INH, cycloserine, PZA) meat, fruit, veg
Bantu siderosis
South Africa beer brewed in iron pots
BCG reduces pediatric CNS TB by
80%
BCG side effect
risk of LAD, avoid vaccine in same arm for 3 months
Betel nut
chewed by 15% of world stimulant assoc with head and neck CA
Burn fluid replacement (Parkland)
LR 4 mL/kg/%burn- ½ over 8 h then rest over 16 h
Cancers by region
SE Asia: Lung >breast >liver East Africa: Kaposi’s sarcoma >cervix >lung US: Breast >prostate >lung
Capnocytophaga
gram neg rod assoc with dog/cat bites
causes of genital ulcer (5)
HSV, syphilis, chancroid, lymphogranuloma venereum, granuloma inguinale
CDC Quaratine substations
20 across US isolate sick, quarantine exposed
cervical cancer deaths
275K/yr- 85% in developing
Chest tube level depending upon purpose
T2-3 for pneumothorax T 5-7 for effusion
Chronic diarrhea (> 14 d) causes- bacteria (5), protozoa (5), worms (1), viral (5)
Bacteria: EAEC, EPEC, Shigella, Yersinia, Campylobacter
Protozoa: Crypotosporidium, Cyclospora, Isospora, Microsporidium, E.histolytica
Worms: Strongyloides
Viral: adeno, noro, CMV, roto, HIV
Class A immigrant restrictions
active TB Untreated syphilis, chancroid, GC, granuloma inguinale, lymphogranuloma venerum Untreated Hansen’s dz Drug/mental with harmful behavior
common definition of migrant and temporary worker
change of country for > 12 mo temporary worker is migrant who traveled > 24 h
Congenital syphilis Sx
rhinits, rash, HSM, LAD, bones, CNS, deaf, keratitis, anemia, low PLT frontal bossing, saddle nose, peg teeth
Contraindications to lumbar puncture (3)
Papilledema Focal neuro signs Too unstable to position
COPD highest in? related to?
India and Asia Biofuels (poverty more associated with COPD than smoking)
CPR ratio- infants, children
3:1, 15:2
Deaths under 5 in 2014; % neonatal
> 6 million 44%
deep sedation- ketamine- age, SE, NPO
down to 3 mos may have nystagmus or jerking NPO- 8 h solid, 6 h formula, 4 h breast, 3 h clear
dehydration causes what % deaths < 5 YO
15%
Dhaka solution compared to Ringers
more K, bicarb, chloride. Also has glucose
Diarrhea related to GBS
campy
Diarrhea related to HUS
shig, EHEC
Diarrhea related to reactive arthritis
campy, salmonella, shigella
Eclampsia management
BB- labetalol Vasodilator- hydralazine, methyldopa Magnesium sulfate- IV or IM
Eikinella
gram neg rod infecting 15% of human bites
exceptions from overseas immunization requirement
adoptees < 10 YO, refugees; otherwise imigrants get exam and immunization before entry
Excess fluoride
Fluorosis if high in drinking water (Rift Valley, Punjab); teeth color, rigid joints
Famine defined (3)
acute malnutrition > 30 % death rate > 2/d per 10,000 Death > 2 adults or 4 children per day per 10,000
Female circumcision types
1- clitoral hood +/- clitoris 2- clitoris +/- labia minora 3- infibulation- remove most with partial closing 4- unclassified/other
folate- deficiency, source
tube defects, IUGR, anemia fruits and veg
food requirements (cal)
2100 kcal/person/d
Genital warts- common cause, prevalence, Tx
HPV 6 and 11 (most) almost 50% sexually active are positive (most subclinical)
halothane
CHF, malignant hyperthermia
HBV serotypes and special
A B- more resistant to lamivodine C- more HCC, more resistant to interferon
HBV- #infected, #deaths/yr
2 billion > 500K due to cirrhosis and HCC
HBV- causes what percent HCC, relation to cirrhosis
80% HCC (30% without cirrhosis)
HBV- main mode of transmission
perinatal
Health effects of immigrating to US
more DM and CVD with poorer outcome less CA deaths (less gastric in Japanese BUT more breast in Asians)
Hindmilk
higher in calories and fat
how many immigrants in world
> 200 million (3% of world) live outside country of origin
how many lack clean water? basic sanitation
1 billion 2.5 billion
how much does hand washing reduce diarrhea by
45%
How often does oral rehydration work
96%
HPV- high risk strains, vaccine coverage
high- 16, 18, 31, 33 Gardasil- 6, 11, 16, 18 Cerbarix- 16, 18
IASC- emergecy categories
InterAgency Standing Committee #3 is highest
IGRA/Quantiferon- how, specificty
mix serum with antigen and test interferon release Not cross react with BCG, but does other myobacteria
Immigrant cancer screening improves with (3)
Duration of residence Hx of previous cancer screenings More primary care visits ER vists use of interpreter
Important vitamins to give with diarrhea
zinc, vit A, folate
Incidence
new cases over time
Indian childhood cirrhosis
1-3 YO high mortality ? due copper intake
infectious agent related to adult T-cell leukemia
HTLV-1
infectious agent related to cervical CA
HPV
infectious agent related to gastric CA/MALT
H. pylori