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BECOMING A PROFESSIONAL > Public health Medicine - Term 2 [2022] > Flashcards

Public health Medicine - Term 2 [2022] Flashcards

1
Q

Where and in what year was HIV discovered?

A

USA in 1981 in homosexual men

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2
Q

When were diagnostic tests for HIV discovered?

A

1985

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3
Q

What is SIV?

A

Simian Immuno-deficiency virus from chimpanzees

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4
Q

What is the family and genus of HIV?

A

family: Retroviridae
genus: Lentivirus

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5
Q

where does the HIV mostly replicate?

A

lymph nodes

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6
Q

what are the viral set-points or rates of disease progression?

A

slow progressor
intermediate progressor
rapid progressor

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7
Q

what are the immune responses to HIV?

A

cellular [CD8 AND CD4 LYMPHOCYTES] and humoral

[NEUTRALIZATION]

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8
Q

why can HIV evade the human immune reponse?

A
  • mutations are super rapid

- integrates with the host DNA where it remains hidden in resting cells

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9
Q

give 2 modes of transmission of HIV

A

sexual intercourse and mother-to-child transmission

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10
Q

what is the vector of malaria?

A

Female Anopheles Mosquito

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11
Q

what is the name of the parasite that causes malaria?

A

plasmodium protozoa

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12
Q

which is the most common and most deadliest species of the malaria causing plasmodium parasite?

A 
common = P. vivax
deadliest = P. falciparum
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13
Q

what are the 3 main cycles of the life cycle?

A
  • exo-erythrocytic cycle
  • erythrocytic cycle
  • sporogonic cycle
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14
Q

what is the meaning of malaria paroxysm?

A

chills, fever, sweating when infected

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15
Q

what the most severe form of malaria?

A

cerebral malaria

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16
Q

what is hemolytic urinemic syndrome otherwise known as?

A

black water fever

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17
Q

when do malaria cases peak in South Africa?

A

during rainy season between September and May

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18
Q

who is most at risk for malaria?

A
  • pregnant women
  • young children under 5
  • travellers
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19
Q

give 2 examples of host risk factors for malaria?

A
  1. poverty and no sanitation

2. lack of education

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20
Q

give 2 examples of climatic risk factors for malaria?

A
  1. increase in temperature

2. rainfall

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21
Q

how can drought result in increased malaria transmission?

A

during drought, pooling occurs near streams, water is more stagnant, which is suitable for mosquito breeding

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22
Q

which species of mosquito are known to be the best vectors for malaria transmission?

A

A. gambiae

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23
Q

how does population migration affect the transmission of malaria?

A

results in deforestation which in turn creates breeding environments for mosquitos

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24
Q

what is the ABC of malaria prevention?

A
  1. AWARENESS AND ASSESMENT of malaria risk
  2. avoiding BITES
  3. COMPLIANCE with CHEMOPROPHYLAXIS
  4. DETECTION of DISEASE
  5. EFFECTIVE treatment
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25
Q

what is difference between eradication and elimination?

A 
eradication= zero cases of disease in entire world
elimination= zero cases of disease in a defined geographical population
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26
Q

what is the triad of disease?

A
  • host
  • environment
  • agent
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27
Q

how did spread of corona start?

A

people who consumed seafood and live animal in china

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28
Q

what is a pandemic?

A

disease that is prevalent over the whole world or country

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29
Q

how is corona transmitted?

A

coughing, droplets, hand-to-nose transmission

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30
Q

where is corona virus detectable in the human body?

A

nasopharynx and oropharynx [ throat ]

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31
Q

which test is performed to test for covid?

A

PCR test [ polymerase chain reaction ]

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32
Q

what is the reproductive number of corona?

A

2-3 people

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33
Q

which factors affect the survival of corona virus, which is usually 3 hours to 3 days?

A

humidity, temperature, surface type

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34
Q

what is the public health approach to dealing with an outbreak of disease?

A
  1. surveillance
  2. risk factor identification
  3. evaluation and intervention
  4. implementation
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35
Q

what are the 4 levels of prevention and the meaning of each?

A
  1. PRIMORDIAL= prevent from entering
  2. PRIMARY= vaccination, altering exposures that lead to disease
  3. SECONDARY= screening, early detection of disease
  4. TERTIARY= preventing relapse, further damage, rehabilitation
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36
Q

what is social distancing?

A

limiting public social gatherings as much as possible

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37
Q

what causes Schistomiasis?

A

Flukes of genus Schistoma

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38
Q

what is Schistomiasis otherwise known as?

A

Bilharzias / Bilharzia / Snail Fever

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39
Q

what are the 2 forms of Bilharzia?

A
  1. intestinal

2. urogenital

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40
Q

give 2 examples of Schistoma species

A
  1. S. mansoni

2. S. haematobium

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41
Q

give 2 risk factors for contracting Snail Fever

A
  1. swimming in lakes and rivers with snails

2. fishing

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42
Q

give a brief description of life cycles of Schistomiasis

A
  1. eggs secreted out through urine and faeces into river
  2. eggs hatch in water, release miracidium, enters snail
  3. snails release cercaria
  4. cercaria penetrate human skin
  5. become schistomulae
  6. migrate to organs [ liver, kidney ]
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43
Q

what physiological consequences of Snail Fever?

A
  1. portal hypertension
  2. hematuria/ dysuria
  3. formation of granuloma
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44
Q

how do you treat Schistomiasis?

A

praziquantel [ stops egg production ]

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45
Q

give 3 ways to prevent Snail Fever

A
  1. avoiding contact with fresh water
  2. molluscicides
  3. fine-mesh filters
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46
Q

who was the doctor that diagnosed the first case of Schistomiasis is South Africa?

A

Dr. Harley

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47
Q

what is Viral Hemorrhagic fever?

A

term used to describe a group of illness that result is damage of vascular system, leading to bleeding

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48
Q

what are the 2 agents of VHF?

A

arboviruses and not arboviruses

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49
Q

name 3 characteristic of VHF viruses

A
  1. zoonotic [ transmitted from animals to humans ]
  2. geographically restricted to location of host
  3. man is incidental host
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50
Q

what are the sources of VHF?

A
  1. bite from infected rodent or arthropod
  2. touching carcass of infected animal
  3. human to human contact
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51
Q

what types of virus causes Dengue Fever and what is the vector of this disease?

A

single-stranded RNA virus transmitted by Aedes aegypti mosquito

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52
Q

what causes prevalence of Dengue virus? name 2 causes.

A
  1. urbanization

2. lack of waste management and water control

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53
Q

what is the name of the Dengue vaccine?

A

dengvacia vaccine

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54
Q

how can you prevent Dengue Fever?

A
  1. prevent mosquito breeding

2. personal protection from mosquito bites

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55
Q

why is yellow fever know as “yellow”?

A

refers to jaundice that patients present with

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56
Q

how is yellow fever transmitted?

A

mosquito of species Aedes or Haemogogus

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57
Q

what are the two types of vaccine for yellow fever?

A
  1. YF- vax

2. Stamaril vaccine

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58
Q

how are Ebola and Marburg viruses transmitted?

A

from fruit bats to humans and then from human-to-human contact

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59
Q

is there any treatment for Ebola, Lassa Fever or Marburg viruses?

A

nope. You can only try to prevent the damage from getting worse as much you possibly can.

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60
Q

what is the PACE method of outbreaks?

A
  1. preparedness
  2. alert
  3. control
  4. evaluation
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61
Q

how is Crimean Congo Fever transmitted?

A

bite of Hyalomma tick

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62
Q

name 2 clinical signs of Crimean Congo Fever

A
  1. liver may be swollen

2. acute kidney failure

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63
Q

which drug should be given early during treatment of Crimean Congo Fever?

A

antiviral drug ribavirin

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64
Q

how can you reduce transmission of CCF?

A
  1. wear protective clothing to prevent tick bites

2. perform daily tick checks on clothing

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65
Q

how can you reduce ticks in the environment?

A

acaricide [ tick-killers ]

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66
Q

where is malaria endemic in SA?

A
  1. Limpopo
  2. Mpumalanga
  3. KwaZulu Natal
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67
Q

which country has highest prevalence of malaria?

A

nigeria

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68
Q

what are neglected tropical diseases?

A

diseases that are curable and treatable but mainly affect the poorer communities of the world

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69
Q

what is the world’s top 5 NTDs?

A

LOSST

  1. lymphatic filariasis [ elephantiasis]
  2. onchocerciasis [ river blindness]
  3. Schistomiasis
  4. soil-transmitted
  5. trachoma [bacteria coming into contact with eyes]
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70
Q

which tropical disease has the highest treatment target and which one has the lowest?

A

trachoma with 80%

lymphatic filariasis with 65%

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71
Q

which are the most common NTD in SA?

A
  1. soil-transmitted helminths

2. schistosomiasis

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72
Q

what is a helminth?

A

parasitic worm

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73
Q

what are the two types of helminths?

A
  1. nemathelminths [ round worms ]

2. platyhelminths [ tapeworms and flukes

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74
Q

what are the 3 types of soil-transmitted helminths?

A
  1. round worm
  2. hook worm
  3. whipworm
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75
Q

what is epidemiological triad for soil-transmitted helminth infections?

A 
host= human
agent= whipworm, round worm, hook worm
environment= water, sanitation, microclimate, macroclimate
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76
Q

how are helminth infections transmitted?

A

eggs get in contact with people, passed through faeces

contaminate the soil

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77
Q

which worm causes ascariases in children between 1 and 5 years?

A

round worm [ Ascaris lumbricoides ]

78
Q

how many developmental stages does the roundworm have?

A

5 [ 1 adult + 4 larval stages ]

79
Q

name 3 symptoms of ascariasis

A
  1. worms coming out in mouth or nose
  2. sore stomach
  3. wheezing/ coughing
80
Q

name 2 differences between whipworms and round worms?

A
  1. whipworms are shorter and thinner, whereas round worms are longer and thicker
  2. whipworms do migrate to the lungs during larvae stage whereas round worms do migrate to lungs
81
Q

which worm causes trichuriasis?

A

whip worm [ Trichuris trichiuria ]

82
Q

do whipworms cause bleeding?

A

yes, as they attach to the large intestine

83
Q

who do whipworms usually infect?

A

children over 5 years

84
Q

give two results of heavy infection due to whipworms?

A
  1. iron deficiency anaemia due to blood loss

2. loose stool with blood

85
Q

where are hookworms most commonly found?

A

warm moist climates [ north KZN , Mozambique coast ]

86
Q

which part of the body do hookworm infect on contact?

A

feet of barefoot children

once entering the body; they act like roundworms

87
Q

which two interesting symptoms do hookworms cause?

A
  1. need to eat sand

2. unusual increase in appetite

88
Q

how can the burden of worm- caused infections be managed?

A
  1. address social determinants of health
  2. teach proper hygiene
  3. encourage periodic de-worming
89
Q

what is the treatment of worm-infections?

A

mebendazole [ vermox] or albendazole

90
Q

how many 2030 goals are there for treating Soil-transmitted helminth diseases?

A

6

91
Q

what is rabies and how is it transmitted?

A

zoonotic viral infections disease passed from dogs to humans

92
Q

what is the epidemiological triad of rabies?

A
  1. host= humans
  2. agent= lyssavirus [ dogs are reservoir ]
  3. environment= population where there a lot of stray dogs and bats
93
Q

why lyssavirus considered to be neurotropic?

A

affinity to localize` in nerve tissue

94
Q

how is rabies transmitted?

A

through saliva of infected animal [ bite, lick, scratch ]

95
Q

who is most at risk of getting rabies?

A
  1. vets, children, hunters

2. poorer communities who are not able to afford vaccinations

96
Q

is rabies a neglected disease in some countries and why?

A

yes, it is preventable but strategies are not taken into priority

97
Q

what is the aim of the GLOBAL ALLIANCE FOR RABIES CONTROL?

A

raise awareness about rabies and how to prevent it

98
Q

when is world rabies day?

A

28 September

99
Q

what is the incubation period for rabies

A

2-3 months or 1 week to a year

100
Q

what are the 2 forms of rabies?

A
  1. furious rabies

2. paralytic rabies

101
Q

when is the diagnosis for rabies made?

A

post-mortem

102
Q

how can rabies be managed?

A
  1. vaccination of dogs
  2. education about what to do to prevent bites and what to do after being bitten
  3. PEP- post exposure prophylaxis
103
Q

what are the 2 leading childhood infections?

A
  1. pneumonia

2. diarrheal disease

104
Q

which disease is the leading cause of death in children under 1 year in SA?

A

cardiovascular and respiratory diseases

105
Q

give 2 risk factors for pneumonia?

A
  1. pre existing illness

2. air pollution

106
Q

which provinces in SA have the highest case fatalities of pneumonia?

A

Eastern Cape. Mpumalanga , North West

107
Q

what are the most common contaminants of diarrhea?

A

E.coli, and Rota Virus

108
Q

what are the risk factors for EOS and LOS of pediatric sepsis?

A 
EOS= low birth weight, low Apgar score
LOS= prolonged antibiotic use, repeated invasive procedures
109
Q

what is pertussis otherwise known as?

A

whooping cough

110
Q

where are tetanus infections most common?

A

rural areas, warm climates, poor communities

111
Q

how is measles spread?

A

droplets and infected airway secretions

112
Q

what are 7 pointers towards a population perspective of health?

A

ROBPAIN

  1. research
  2. organization of services
  3. burden reduction
  4. policy implications
  5. affect on community
  6. issues in public health
  7. needs due to problem
113
Q

give 2 public health issues related to TB?

A
  1. highly contagious

2. requires meds for a long time

114
Q

what factors determine individual vulnerability to get TB?

A
  1. age
  2. prior infection of TB
  3. underlying diseases
115
Q

which countries have the highest burden of MDR-TB?

A
  1. Russia
  2. China
  3. India
116
Q

how can the burden of TB be reduced?

A
  1. immunisation
  2. early detection
  3. healthy lifestyle
117
Q

what is the meaning of morbidity?

A

having a certain disease

118
Q

what is the purpose of active TB case finding on a community level and an individual level?

A 
community= reduces TB transmission
individual= improved survival
119
Q

what are the 2 main consequences of poor TB control?

A
  1. MDR-TB and XDR-TB occurs, which is expensive and difficult to treat
  2. Increase in mortality rates due to TB
120
Q

how can we prevent transmission of TB?

A
  1. n95 respirator

2. ventilation

121
Q

what family of viruses does Influenza virus belong to?

A

Orthomyxoviridae

122
Q

what are the names of the surface antigens on the flu virus?

A

Haemaglutinin and Neuraminidase

123
Q

which type of flu virus is the most dangerous?

A

type A

124
Q

what are 2 mechanisms that viruses use to evolve?

A

antigenic drift and antigenic shift

125
Q

what is antigenic drift?

A

small changes in the genetic makeup of surface proteins of virus

126
Q

what are the consequences of antigenic drift?

A
  1. virus is able evade immune system
  2. virus is able to re-infect
  3. results is epidemics
127
Q

what is antigenic shift?

A

re-assortment of gene segments in a virus resulting in pandemics

128
Q

when should antiviral medication for flu be administered after onset of symptoms?

A

within 48 hrs

129
Q

what are the two treatment meds for flu?

A
  1. OSELTAMIVIR [ Tamiflu ]

2. ZANIMIVIR [ Relenza ]

130
Q

give two symptoms of flu

A
  1. coughing

2. fever

131
Q

what is the seasonal flu vaccine that is usually administered?

A

trivalent vaccine

132
Q

give 2 examples of flu virus transmitted from animals to humans?

A
  1. Avian Flu

2. Swine Flu

133
Q

where did Avian flu virus originate from?

A

Hong Kong, from poultry

134
Q

where did swine flu originate from?

A

from pigs

135
Q

what are the 3 phases of pandemic dvelopment?

A
  1. interpandemic phase
  2. pandemic alert phase
  3. pandemic period
136
Q

what is sentinel surveillance?

A

health facilities responsible for collecting data on a specific disease or outbreak

137
Q

how is the diagnosis for flu made?

A

Immunofluorescence and PCR and Rapid tests

138
Q

how can flu be controlled in a health care setting?

A

HEPA filter in negative pressure, wash utensils, wear mask when outside, single patient room with closed door

139
Q

what are infections caused by bacteria , viruses and parasites transmitted mainly via vaginal, anal and oral sex?

A

Sexually Transmitted Illnesses

140
Q

which type of micro-organism causes chlamydia, gonorrhea and syphilis ?

A

bacteria

141
Q

which type of micro-organism causes HIV, Herpes, HPV and Hepatitis?

A

virus

142
Q

give 2 symptoms of STIs

A
  1. vaginal discharge
  2. abdominal pain
  3. genital ulcers
143
Q

give 2 causes of STIs

A
  1. gender inequality
  2. socio-economic imbalances
  3. social stigma
  4. lack of preventative programmes
144
Q

what are the 3 most common STIs

A

chlamydia, gonorrhea, syphilis

145
Q

what are the consequences if untreated gonorrhea in both men and women?

A

infertility

146
Q

which STI can lead to neonatal blindness when transmitted from mother to child?

A

gonorrhea

147
Q

how would you identify that someone has syphilis?

A

sores around the mouth or genitals, rash and sore throat

148
Q

what does untreated syphilis lead to?

A

paralysis and stroke, death

149
Q

name 2 issues we have in SA when it comes to diagnosing STI’s?

A
  1. geographically inaccessible

2. expensive and take a long time to get results

150
Q

for which two STIs do we have rapid tests for?

A

syphilis and HIV

151
Q

what approach did the WHO suggest to developing countries regarding the diagnosis of STIs?

A

syndromic management

152
Q

what is the meaning of RESERVOIR in epidemiology?

A

natural habitat of the pathogen

153
Q

what is the ATTACK RATE?

A

number of cases of disease developing in a group of exposed people

154
Q

what is the term given the number of new cases in a specific period of time?

A

INCIDENCE

155
Q

how do we describe diseases that are constantly present?

A

endemic

156
Q

what are the 3 types of reservoirs for pathogens?

A
  1. human
  2. animal
  3. environment
157
Q

give an example of a portal of exit for a pathogen?

A

leave digestive tract via feces

158
Q

what is indirect contact?

A

transmission of pathogens via inanimate objects or fomites

159
Q

what do we call the transmission of pathogens from food to food via the use of unclean work equipment such as knives?

A

cross-contamination

160
Q

how can we prevent water-borne diseases?

A

chlorination and filtration

161
Q

can droplet nuclei remain suspended in light air current indefinately?

A

yes

162
Q

what are the most common vectors?

A

arthropods

163
Q

give 2 examples of portals of entry

A

ears and eyes

164
Q

what is the ongoing systemic collection, analysis, interpretation and dissemination of health data?

A

PUBLIC HEALTH SURVEILLANCE

165
Q

what is the purpose of public health surveillance?

A

provide a factual basis from which the public can be protected and health can be promoted

166
Q

give 3 sources of data collected during public health surveillance?

A
  1. morbidity data
  2. mortality data
  3. environmental data
167
Q

what are the 4 types of surveillance?

A
  1. passive
  2. active
  3. sentinel
  4. outbreak
168
Q

what is laboratory-based surveillance known as?

A

passive

169
Q

give the notice period that is required to inform the DOH in the categories of notifiable diseases?

A

category 1 = 24hrs
category 2= 7 days
category 3= 7 days
category 4= 1 month

170
Q

who initiate active surveillance?

A

DOH

171
Q

what characterizes sentinel surveillance?

A

data is collected from a few selected sites

172
Q

what is the difference between an outbreak and an epidemic?

A 
outbreak= fewer people, localized 
epidemic= large group of people , uncontrolled burden
173
Q

why should we investigate outbreaks?

A

to plan out interventions and gather information to collect relevant data

174
Q

what are the 7 steps in an outbreak investigation?

A
  1. confirm outbreak and prepare
  2. case definition
  3. describe outbreak [ epidemic curve ]
  4. hypothesis
  5. control measures [ long term, short term ]
  6. write report
  7. distribute report
175
Q

what are the criteria of a case definition?

A

not a case, possible, probable, confirmed

176
Q

what kind of micro-organism causes cholera?

A

gram negative bacteria, Vibrio cholerae

177
Q

which 2 serogroups of cholera caused epidemics?

A

O1 and O139

178
Q

what is a serotype?

A

a variation within a species of bacteria or virus

179
Q

in what kind of environments does cholera occur in the most?

A

tropical and sub-tropical areas mostly in Africa and Asia

180
Q

true or false

cholera is a category 1 notifiable disease in SA

A

true

181
Q

what is the source of infection for cholera?

A

faeces in water or contaminated water or food

182
Q

give 4 risk factors for contracting cholera

A
  1. latrines
  2. hygiene
  3. blood type [ type O has higher risk for symptoms ]
  4. food
183
Q

what are the most common signs and symptoms of cholera?

A
  1. short incubation period
  2. painless watery stool
  3. fever, mostly children
  4. vomiting
  5. RAPID DEHYDRATION
184
Q

how is cholera diagnosed?

A

stool specimen tests positive for V. cholerae

185
Q

how do you treat cholera?

A
  1. REHYDRATION [ ORS/ IV FLUIDS ]

2. ANTIBIOTICS; CIPROFLAXIN

185
Q

how do you treat cholera?

A
  1. REHYDRATION [ ORS/ IV FLUIDS ]

2. ANTIBIOTICS; CIPROFLAXIN

186
Q

what should children under five years of age be given to treat cholera?

A

zinc

187
Q

which two treatments are ineffective when it comes to treating cholera?

A

anti-diarrheal meds and sugars drinks

188
Q

how many doses of oral cholera vaccine are given and for how long do they last?

A

2 doses for 3 years

189
Q

what is the aim of the GTFCC [ Global Task Force on Cholera Control ] ?

A

reduce cholera deaths by 90% by 2030

190
Q

give 3 ways the cholera can be prevented and controlled?

A
  1. WASH package
  2. early detection and response
  3. educating community about food safety
  4. identifying hotspots

BECOMING A PROFESSIONAL (5 decks)

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