PH Final 2

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PH Final 2
2009-11-25 10:28:16

PH Final 2
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  1. Anthrax (bacillus anthracis): Primary, Seconday Tertiary Prevention
    Primary: sanitation, vaccine, protective workplace equipment, surveillance; Secondary; Isolation, chlorination of clothing, PEP (antibiotics); Tertiary: Isolation of corpses, sIte containment and cleanup
  2. Scalp Ringworm: Affects __-__% of children in the U.S., mostly ______. Primary mode of transmission is in _____. ___% of all positive cases are asymptomatic.
    3-8; African- Americans; classrooms; 14
  3. Scalp Ringworm: Symptoms, Diagnosis, Prognosis
    Swollen, itchy scalp, pattern baldness; Diagnosis: Microscopic examination of hairs. Prognosis: 6 week anti- fungal treatment course
  4. Scalp Ringworm: Primary, secondary, tertiary prevention
    Primary: school programs. Secondary: Anti- fungal meds and therapies. Tertiary: monitoring of anti- fungal medication side effects
  5. ____ disease pathogens account for nearly all airborne disease in the U.S.
  6. T/F Smaller sneeze droplets (in microns) are more dangerous as more remain in air for longer.
  7. Rank the following (from shortest to longest) in terms of persistence on air: Bacteria, spores, viruses
    Bacteria, viruses, spores
  8. Rank the following (from most to least) in terms of efficacy of removing spore levels from environment.
    A/C, mechanical ventilation (fans), natural ventilation (open windows), outdoor air
  9. Indirect modes of transmission
    Bloodborne (HIV, Hep B, Hep C); Food and Waterborne (cholera, salmonella, typhoid, botulism. hep A, polio)
  10. _____ and _____ have the highest incidences of foodborne illness. _____ (2) Have the lowest
    restaurants and homes; cafeterias, resorts
  11. Hepatitis B: ___% of all humans are HBV+, __-__% have chronic, symptomatic HPV. ___ annual deaths/ 100,000 in U.S./ Worldwide
    30; 2-8; 2
  12. Hepatitis B: Main transmission methods (4)
    IV drug use, unprotected sex, blood transfusion, perinatal transmission (HBV+ mothers have a 20% chance of transmitting to child. CHild has 5% chance of clearing infection)
  13. Hepatitis B is most prevalent in (3)
    Africa, SE Asia, South America
  14. Hepatitis B: Incubation, Symptoms, Diagnosis, Prognosis
    A couple of days- lifetime Symp: liver inflammation, vomiting, jaundice, fever, aches. Diag: Blood test (after 4 months) Prog: Chronic liver disease, rarely mortality
  15. Hepatitis B: Primary, Secondary, Tertiary Prevention
    Prim: Vaccination, sex and drug education, blood transfusion screening, anti- viral prophylactics for pregnant women; Secondary: at- risk screening, early antiviral treatment, co- morbidity treatment; Tert: viral load testing, anti- viral treatments, substance abuse control and liver health management
  16. Hepatitis C: ____ cases worldwide, ___ new cases/ year worldwide, ___ cases in U.S.
    200 million, 3-4 million, 4 million
  17. Hepatitis C: Leading cause of _____ and ____
    liver cancer and liver transplants
  18. Hepatitis C: ____ co-infection with HIV, ____ of prisoners are positive, ___ of cases in U.S. have been incarcerated
    35, 35, 84
  19. Hepatitis C: Sources of infection (top 3)
    IDU (60%), sexual (15%), Transfusion (before screening) (10%)
  20. Hepatitis C: Incubation, Symptoms, Diagnosis, Prognosis
    Inc: a couple days- lifetime; Symptoms: liver inflammation, vomiting, jaundice, fever, aches; Diag: blood test (4-12 months after exposure); prog: Chronic liver disease, 30% mortality
  21. Hepatitis C: Primary, Secondary, Tertiary Prevention
    Prim: Vaccination, Sex and drug education, screening of blood transfusions, anti- viral prophylactics for pregnant women; Secondary: at- risk screening, early antiviral treatment, co- morbidity treatment; Tertiary: viral load testing, anti- viral treatments, substance abuse control and liver health management
  22. Methods of Indirect (transcutaneous) Transmission (4)
    Insects, Animal bite, Latrogenic (in hospital), self- injeced
  23. Rabies: _____ annual human deaths, __ in Asia, __ in Africa
    55,000; 31,000; 24,00
  24. Rabies: Global epidemic in ____, ____ discovered vaccine, which is now ____. Lack of ___ in East Asia has led to increased incidence, led to development of ___ policy
    1800s; Louis Pasteur; routine for children and animals in developed countries; animal control; one dog policy (2006)
  25. Rabies: Incubation, Symptoms, Diagnosis, Prognosis
    2-12 weeks (up to 2 years); Sympt: anxiety, insomnia, confusion, paranoia, delusion, partial paralysis. Diag: self- reporting, symptoms, viral culture (usually postmortem); Prog: hydrophobia, encephalitis, death in 2-10 days
  26. Rabies: Primary, Secondary, Tertiary Prevention
    Prim: Vaccines, animal control, prophylactics Secon: animal euthanasia, wound hygeine, PEP; Tertiary: Induced coma, anti- viral treatments, months of isolation
  27. Methods of Vertical Transmission (2)
    Genetic (cystic fibrosis), Congenital (HIV, rubella, syph)
  28. Cystic Fibrosis: ___ cases in U.S., most common in ____ (1 in ___ are carriers, 1 in ___ born symptomatic). In 1959, life expectancy was ___
    30,000; 25; 3,000- less common in African Americans, Asians; 6 months
  29. Cystic Fibrosis: Symptoms, Diagnosis, Prognosis
    respiratory problems, pain, fever, headaches, lung disease; Diag: amniocentesis, symptomology, neonatal blood tests. Prog: severe lung disease, gastrointestinal problems, infertility, 36.8 years LE
  30. Cystic Fibrosis: Primary, Secondary, Tertiary Prevention
    Prim: genetic screening, prenatal testing; Secon: lifestyle management, gene therapies, oral antibiotics for acute infections; Tert: long- term lung disease treatments, lung transplantation
  31. Ebola: Outbreak in ____ (yr) in ____ affecting
    1976; Bumba Zone, northern Zaire; patients at Yambuku Mission Hospital, midwives, clinicians, villagers
  32. Ebola: Symptoms
    Fever, vomiting, abdominal pain, bloody stool
  33. Ebola: Mission Hospital founded by ___ in ____, served ____ including ____
    Belgians; 1935; primary source of medical care for 60,000 people; travelers from outlying areas- active prenatal care unit
  34. Ebola: Sequence of events
    Health ministry dispatch epidemiologists and microbiologists to region; 11/17 of hospital staff have died, entire Bumba Zone is quarantined; liver specimens reveal unknown virus, international commission is formed- 500 possible cases identified, link found between exposure to Yambuku Hospital and hemorrhagic fever
  35. Ebola: Most effects people in ____ age
    middle (15-49)
  36. Ebola: Identified cause
    Non- sterile injection conditions at Mission hospital
  37. Ebola: Incubation, Symptoms, Diagnosis, Prognosis
    0-12 days (mostly 10 days), Symp: fever, flu- like; Diag: symptomology, blood tests, biopsies; Prog: multi- organ failure, 67% mortality rate
  38. Ebola: Primary, Secondary, Tertiary Prevention
    Prim: clinical hygiene, case reporting, monitoring of acute fevers, vaccination Secon: hospitalization, specialized anti- viral meds; Tert: ongoing research
  39. Biggest Killers of Poor (Top 4):
    Other causes, AIDS, Diarrhoeal disease, maternal and perinatal conditions, respiratory infections
  40. Leading causes of death in U.S. (3)
    Heart disease, cancer, stroke (proportion of deaths from infectious disease is very small)
  41. Legionnaire's Disease: ___ annual incidence world- wide, risk factors (8)
    32,000; age, smoking, diabetes, chronic lung disease, kidney cancer, lung cancer, sex (male), ac use
  42. Legionnaire's Disease: Initial outbreak (3)
    Most famous case of outbreak control in PH history, 1976 American Legion convention in Philly, >150 cases, 20 deaths in 2 months
  43. Legionnaire's Disease: Incubation, Symptoms, Diagnosis, Prognosis
    2-10 days; flu- like symptoms; lab tests, chest x- rays; pneumonia
  44. Legionnaire's Disease: Primary, Secondary, Tertiary Prevention
    Prim: UV inspection of aerosolized water; Secon: antibiotics; Tert: treatment of comorbidity and immune system compromise