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.
