Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PPD SEM 4 > WEEK12: Screening and secondary prevention > Flashcards

WEEK12: Screening and secondary prevention Flashcards

1
Q

What is prevention?

A
  • modifying or removing risk factors that are causally related to the disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is primary prevention?

A
  • aims to remove cause of the disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Give examples of primary prevention?

A
  • stopping smoking
  • increase host resistance e.g. vaccination, nutrition= to avoid infections
  • safe sex
  • safe water (chlorination)
  • remove lead in paint
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is secondary prevention?

A
  • Screening for early stage disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is tertiary prevention?

A
  • Treatment of established / late disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What outcome on the disease does primary prevention have?

A
  • less incidence

(bc removing cause of the disease)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What outcome on the disease does secondary prevention have?

A
  • early intervention
  • can treat
  • better management strategy
  • improve prognosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What outcome on the disease does tertiary prevention have?

A
  • managing and controling consequences of the disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the iceberg of disease?

A
  • Everything above the water level is what is known about the health services
  • everything below the water level is not known
  • people below water line= have disease but don’t know it yet
  • ocean around the iceberg= people who are disease free
  • tip of the iceberg (At the top of water)= tertiarty care= in hospitals
  • when you screening, you are trying to identify the people beneath the iceberg who have not pick up disease yet (primary and secondary prevention)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is secondary prevention?

A
  • SCREENING:
  • get eligible population (ASYMPTOMATIC PERSON)
    = certain tests for different groups e.g. antenatal for preggo women
  • perform test- NOT diagnostic
  • it tried to identify people at high risk
  • high risk people may need further investigation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Lets say we are testing for cancer. What happens if someone screens negative?

A
  • screen negative= means NO CANCER POSSIBILITY
  • wait for next screening
  • no action till next screening
  • there will be some people in the group that were missed and that will develop cancer= FALSE NEGATIVE
  • Some dont end up with cancer= TRUE NEGATIVE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What happens if they screen positive?

A
  • called for further investigation
  • will either be positive again (WILL HAVE CANCER)
  • or will be negative
  • if positive, send for biopsy
  • if malignant = TRUE POSITIVE
  • if benign = FALSE POSITIVE (bc not acc cancer lol)
  • for the malignant, start treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the consequences of screening?

A
  • detection of cases early
  • more are detected early but at cost of individuals who don’t have disease but have to still undergo tests e.g. false positives
  • health service needs to cope with increasing demand of managing positive screening results
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the 3 main things performances are summarised by?

A
  • DETECTION RATE
  • FALSE POSITIVE RATE
  • OAPR
  • PPV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is detection rate?

A
  • how sensitive the detection is
  • proportion of affected individuals (i.e. with disease) that have a screen positive test result
  • the number of people that got detected to have the disease over the the total number of people with the disease (i.e. the ones that have disease but weren’t detected+ the detected disease ones)
  • percentage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is false positive rate?

A

1- specificity

  • proportion of unaffected individuals (i.e. healthy
    individuals) that have a screen positive test result
17
Q

What is OAPR?

A

odds of being affected given a positive result

  • out of people who have positive test results, what is the ratio between number of affected individuals to the number of unaffected individuals
18
Q

What is PPV?

A
  • positive predictive value
  • probability
  • Number of affected individuals screen positive results/
    Total number of people with screen positive results
19
Q

What is specificty?

A

1- FPR (false positive rate)

20
Q

What is OAPR for ovarian cancer?

A
  • OAPR (or PPV) are pretty high
  • But 30% of screen positive women have further investigative techniques, which are quite invasive and don’t have cancer
    o laparoscopy / laparotomy / oophorectomy
    • 50% of cases of ovarian cancer not picked up by screening test
    • It is likely that a population screening programme would perform less well
21
Q

What is the point of screening?

A
  • NOT A DIAGNOSIS
  • filtering people into high risk groups
  • high enough to want further investigations
22
Q

What do you need for a worthwhile screening programme?

A
  • Disorder - Well defined medically
  • Prevalence - Known & of public health importance
  • Natural - Possible to identify early disease from healthy
  • History- Need to know how the disease is progressing
  • Treatment- Effective treatment is available to all
  • Test- should be simple, safe, easily implemented, acceptable
  • Test Performance- expected performance of the screening test must be known

• Ethical
o Adequate health provision for the extra clinical workload resulting from the screening
o There are consequences on doing invasive procedures on those who do not actually have the disease

• Access- people who could benefit should have access to the test

• Financial
o Cost-effective – do we prolong life? Is there a better quality of life? Do the hazards outweigh the benefits?
o Early detection & treatment vs. late diagnosis & treatment
o Costs should be balanced against: -
o risks- hazards associated diagnostic test, interventions / treatment
o benefits - reduction in morbidity or mortality

23
Q

How common is malignant melanoma in the UK?

A
  • 5th most common

- 4% of all new cases

24
Q

How many new melanoma cases are there each year?

A
  • 15,000 new cases of melanoma skin cancer in UK every year
25
Q

Why aren’t there any screening tests available for melanoma?

A
  • No accurate screening test available
  • No general screening programme in the UK for
    malignant melanoma
  • would examine everyone for abnormal moles
  • takes up time
  • lot of money
  • people would be having unnecessary surgery
26
Q

What is the prevention strategy for melanoma?

A
  • slip slop slap = in australia
  • • Primary prevention
    • Has worked as rates of melanoma are decreasing in the children age group
27
Q

How common is spina bifida?

A
  • 2/1000 births per year
28
Q

What is the test for spina bifida?

A
  • Alpha-fetoprotein (AFP) is measures in mother’s blood

- Levels tend to be high in affected pregnancies

29
Q

What is the risk for spina bifida?

A
  • if have high AFP (>2MoM)= high risk
  • MoM= multiple of median
  • express AFP in relation to median in unaffected pregnancies it’s simply the scale used for AFP

PPD SEM 4 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions