Public Health (Respiratory) Flashcards
Are the numbers of diagnoses of asthma increasing or decreasing?
Increasing.
Are the numbers of hospitalisations with asthma increasing or decreasing?
Decreasing
What are the risk factors for asthma?
Family history of atopic disease, co-existence of atopic disease, male (pre-pubertal) or female (childhood to adulthood), bronchiolitis in infancy, parental smoking (including perinatal), low birthweight and/or premature birth.
In what sex and where is lung cancer more prevalent?
Males, Scotland in the UK.
What socioeconomic correlation is there with lung cancer?
Correlation with deprivation and mortality.
What are the sources of information when we assess the burden of morbidity?
Hospital admissions/discharges, bed occupancy, GP contacts.
Why when looking at statistics of illnesses does setting matter?
As some conditions are managed more commonly in primary care whereas others are managed in hospitals.
What does it mean when we say there is a dose response relationship in smoking and lung cancer?
If you smoke more you will have a greater risk.
How can health inequalities be decreased?
Governments making legislative changes.
What was the effect of the Irish smoking ban on the respiratory health of bar workers in Dublin pubs?
Statistically significant improvements in pulmonary function tests, significant reduction in self-reported symptoms.
Why can we not just ban tobacco?
There is a lot of tax revenue, would add to illicit trade.
What is Scotland and England’s most popular quitting aid?
E-cigarettes.
What is the clinical presentation of influenza (what are the signs/symptoms)?
Fever (high, abrupt onset), malaise, myalgia (sore muscles), headache, cough, prostration (knocked flat).
What is the aetiology (causes)?
Classical flu (A+B), flu-like illnesses (parainfluenza viruses, many other viruses), haemophilus influenzae (bacterium, not primary cause of flu, may be a secondary invader).
Describe the surface antigens of the flu virus?
2 different types (hemaghlutin, neuraminidase).
How do we name viruses/flu?
Virus type/geographic origin/strain number/year of isolation (virus subtype).
What are the 2 complications of flu (both pneumonias)?
Primary influenzal pneumonia (seen most during pandemic years, can be disease of young adults, high mortality). Secondary bacterial pneumonia (more common in elderly, debilitated, pre-existing disease, cause of mortality in all influenza epidemics).
Describe the 2 types of therapy for flu.
Symptomatic (bed rest, fluids and paracetamol). Antivirals (oseltamivir, zanamivir, 2% of population were prescribed during 2009 pandemic, prescribed when flu is circulating, risks of complications, use in prophylaxis).
What are the differences between epidemics and pandemics?
Epidemics: in winter, seen in association with minor mutations in surface proteins of virus (antigenic drift). Pandemics: rare, unpredictable, influenza A, antigenic shift, animal reservoir/mixing vessel required.
Define endemic, epidemic and pandemic.
Endemic: occurs naturally in population. Epidemic: outbreak of an unexpected size (more than one area/country for flu). Pandemic: global distribution of disease.
Describe phases 1-6 of a pandemic.
1-3: predominantly animal infections. 4: sustained human-to-human transmission. 5-6: widespread human infection.
Describe post peak and post pandemic levels.
Post peak: possibility of recurrent events. Post pandemic: activity at seasonal levels.
Give 2 examples of flu pandemics in the past.
2009 swine flu epidemic, 1918 post world war flu epidemic.
What are the internal, external and social causes of lung disease?
Internal: genetic and uterine development. External: smoking, exposure to agents. Social: deprivation, cultural norms.
Give some examples of occupational lung diseases.
Hypersensitivity pneumonitis (extrinsic allergic alveolitis) e.g farmer's lung, bird breeder's lung, cheese workers lung, mollusc shell hypersensitivity, paprika splitter's lung. Pneumoconiosis e.g. asbestosis, silicosis, coal worker's lung, berylliosis.
What is the pathological changes in chronic hypersensitivity pneumonitis and what is the treatment focused on?
Extensive fibrosis with honeycombing and air-trapping. Treatment focused on antigen avoidance.
What is asbestosis and what is it caused by?
Fibrotic lung disease, cause by inhalation of asbestos fibres.
What are the different types of asbestos?
White (safest), brown and blue.
Is there a synergystic effect between smoking and asbestos exposure causing lung cancer?
Yes, there is some interaction between the smoking and the asbestos that causes greater cancer rates.
What industries are involved in asbestos exposure?
Shipbuilding, mining, heat insulation and building.
What are the indoor and outdoor causes of lung disease?
Indoor: asbestos, mould, cooking smoke, passive smoking, nanparticles.
Outdoor: air/traffic pollution.
What can mould in housing cause?
Respiratory problems, a lot more childhood asthma.
What is the definition of fuel poverty?
Where over 50% of your household budget is spent on heating.
What was introduced to decrease the cost of heating on an island and has it been effective?
A subsidy, no.
Why is overcrowding greater in Perth and Kinross than in Dundee?
Eastern European immigrants living in caravans for fruit picking.
What groups is overcrowding more common in?
Minority ethnic groups, poorer areas.
What can help solve the problem of cooking smoke?
Types of cooking stoves.
What makes up photochemical smog and where can it be found?
Ozone, nitrogen oxide, nitrogen dioxide, volatile organic compounds (VOCs) all produced from cars.
What makes up olden days “London” smog and what event did it affect?
Fly ash, sulphur dioxide, sodium chloride, calcium sulphate particles (all from high sulphur coal).
What are the most common hazardous materials in air pollution?
SO2, NOs, particular matter, O3, volatile organic compounds, persistent organic compounds (POPs), benzene, CO, lead and heavy metals.
What negative effects can traffic fumes have on people’s health?
Reduced lung growth in adolescence, increased rates of asthma and COPD, increased rates of respiratory symptoms like wheeze/cough/breathlessness.
What effects outside the lungs can inhaled substances have?
Low birth weight, appendicitis, stroke, neurological/neurobehavioural outcomes e.g. neurodegenerative disease, cognitive decline, depressions and suicide.
What are dioxins and what problems do they cause?
A subset of persistent organic compounds. Associated with reproductive and immunological problems. Bioaccumulates both in people and animal fat.
Why is there a cycle of smoking in deprived areas?
There are more cigarette shops.
What makes you more likely to live next to hazardous landfills? (environmental justice)
If you are poorer.
What are the causes of water scarcity?
Global population increase, growing demand for food, more agriculture needing more water, increased allocation for cities/agriculture/industries, increased tension/conflict/environmental strain.
What effect does climate change have on water scarcity?
More frequent droughts, intensified storms and flooding, destroys crops, contaminates freshwater and damages the facilities used to store and carry that water.
