What are the 6 orientations of the Regional Public health program?
Children who are born and grow up healthy
young people in good health who succeed in school
workplaces exempt of health risk
a population immunized and protected against infections, chemical and physical threats
Healthy urban environment
According to deontology, what should think about while making a decision?
Follow the rules!
According to consequentialism, what should think about while making a decision?
Name the 2 sub types of liberalism and for each say, what should think about while making a decision.
libertarian : "Laisser-faire"
egalitarian : fairness of opportunity for everybody
What are the main goals of population health?
improve overall population's health
decrease the iniquities among the population
What is the difference between disease and illness?
Disease is the physiological dysfunction as illness refers to the subjective perception.
What are the main function of public health?
What is the Calgary-Cambridge guide?
A tool to help you do a good interview with a patient.
Name all types of primary tissues.
What are the Golgi apparatus for?
They are used for protein transportation and secretion
How is called the condensed form of DNA? and the dispersed?
dispersed : euchromatin
What is proper connective tissue? and specialized?
proper : nutritive and excretory roles
specialized : bone, teeth...
What is the name of the cells that synthesize collagen?
What is a syndrome?
A set of symptoms (history) and signs (examination) that often occur together.
What is etiology?
It is the cause
What is stenosis?
It is a narrowing of a lumen
What is sepsis?
It is a generalized inflammation caused by a severe infection
What is the difference between hyperplasia and hypertrophy?
hyperplesia : increase in cell number
hypertrophy: increase in cell size
What is metaplasia?
It is the replacement of one cell type to another. It is always a pathological manifestation.
What are the 4 main ways for a cell to adapat from an injury?
What happen if a cell cannot adapt?
There is a cell injury. It can be reversible(fatty change, dilatation ER, swollen, blebbing...) or irreversible (apoptosis, necrosis)
What are two irreversible cell injury?
apoptosis and necrosis
Name 4 types of necrosis.
What is Karyolysis?
Nuclear fading that occurs during necrosis
What is Karyorrhexis?
nuclear fragmentation that happen during necrosis
What is pyknosis?
Nuclear and chromatin shrinkage occurring during necrosis.
Does apoptosis produce inflammation? and necrosis?
Apoptosis don't, but necrosis do
What are two kinds of calcification?
What are their main differences?
dystrophic: site of a previous lesion and calcium is concentrated in vesicles within cells with a membrane damage.
metastatic: Occurring because of a hypercalcemia that may be due to hyperparathyroidism (increase the bone reabsorption)
What is the TI (therapeutic index)? and How do you calculate it?
It is LD50/EC50 and that gives us an idea of the safety of a drug. The bigger It means the best security factor.
*EC50 is called the potency
What is pharmacodynamics?
It is the relation between the amount of drug and the magnitude of effect.
What is pharmacokinetics?
It relates the dose, the frequency and the route of administration with the drug concentration of the body.
What are the 6 outcomes of a disease? (clue : 6 D's)
What is an attack rate?
It is a rate of people infected over the people exposed
How do you measure an incidence density and in what situation is it useful to calculate?
It is useful to know in a changing population as we will add the years contribution of everybody.
What is cumulative incidence?
It is a percentage of person that gets the disease during a specified time period.
What are the 5 steps in EBM? (Clue: 5 A's)
Name the four important treaties for aboriginal people and what were they about.
Royal proclamation (1763) : It forms the basis of land claims for Aboriginal people
British North America Act (1867) : Established that "Indians" were under federal authority
Treaty 6 (1876) : provide a Basis health benefits program (non-insured) *
Indian act (1876) :defines and give rights to "Indians"
* Cause a debate now, because the government doesn't consider this as a treaty right, so they might take it away anytime...
Name 3 reasons why Canada would accept immigrants?
Labor market needs
What is steatosis?
What is cirrhosis?
It is a fibrosis (scar) of the liver
What are the markers of a MI (myocradial infarct)?
What are the 2 types of infarcts?
white : no more blood supply
Red : There was a dual blood supply, so there is still blood
What does the Canadian task force do?
It tells us if and how to screen for some disease.
What are the vascular changes during an acute inflammation reaction?
Arteriolar dilatations/ opening of capillary beds
What are the steps of leukocytes migration?
transmigration across endothelium --> diapedesis
piercement of the basement membrane
Migration and cell-matrix interactions
What are cytokines (eg. TNF and IL-1)for?
They increase the adhesion on the leukocytes and the endothelial cells for the diapedesis.
What are TLRs (toll-like receptors)?
They are on the leukocytes and they recognize the pathogen, activates other leukocytes and initiate an inflammatory response
What does a labile regeneration mean?
It means a fast regeneration, eg the skin.
What is a granuloma?
It is lymphocytes + epithelioid cells (macrophage resembling epithelial cells). Sometimes epithelioid cells fuse in giant mutlinucleated cells.
Why is ECM (extracellular matrix) useful?
An intact ECM is needed for regeneration
It provides a mechanical support
it regulates cell proliferation and differenciation
What is angiogenesis?
It is the development of new blood vessels.
What are the current target of antibiotics?
cell wall synthesis
nucleic acid synthesis
cell membrane integrity
What is a ROC curve?
It is a Receiver Operating Characteristic that indicates what would happen to specificity and sensitivity when the cutoffs change.
What is lyonization?
It is the x-chromosome inactivation in females.
What is a founder mutation?
It is a mutation inherited from an ancestor many generations ago.
What is pleiotropy?
It is when we can see phenotypes of the mutation in different system of the body and in a variety of ways.
How are mitochondrial DNA disorders inherited.
It is always inherited from the mother.
What is uniparental disomy?
It is when someone inherit chromosomes from only one parent. It occurs because of an error during meiosis.
How can you recognize an autosomal dominant on a pedigree?
Males and females affected in equal proportions
Affected individuals in multiple generations
How can you recognize a autosomal recessive on a pedigree?
-Males and females affected in equal proportions
-Affected individuals usually in only a single generation
*Is more current if there is cosanguinity in the family
How can you recognize a X-Linked Recessive inheritance on a pedigree?
Only males usually affected
Males cannot transmit the disorder to their sons
How can you recognize X-Linked Dominant Inheritance on a pedigree?
Males and females affected but often an excess of females
Females less severely affected than males
Affected males can transmit the disorder to their daughters but not to sons
How to recognize Y-Linked Inheritance on a pedigree?
Affected males only
Affected males must transmit it to their sons only
What is epigenetics?
It is a heritable alterations of gene expression that do not involve a primary DNA sequence variation. eg. Methylation
What is mosaicism?
Not all the cell in the body will have this DNA mutation.
What is a standard deviation?
It measures how far, on average, the observations are from the mean.
What is a standard error?
It measures how close to the population mean is you sample mean.
What is the principle of regression to the mean?
If your results are very far from the mean, there is a chance that it is not valid. Retesting it will probably give a more logical result. It is therefore important to retest when you are not sure.
What does CAPUP stand for? (clue : it is for Canada health act)
What is DALY?
It is the Disability Adjusted Life Years that takes into account premature mortality and disability.
What does GBD stand for?
Global Burden of Disease
What is the treatment gap?
It is a percentage of people that would need to be treated but do not receive it.
What are the key questions to ask when you want to evaluate a program?
What are the 4 types of evaluation for a program?
formative: before the implementation
process : to evaluate the implementation
outcome: short and medium effect
impact: long term changes
What are the 8 millenium development goals?
eradicate extreme poverty and hunger
achieve universal education
improve maternal health
combat HIV, AIDS, malaria and other
reduce child mortality
create a global partnership for development
What are the 6 levels of observation?
behavior and interactions
medium (more or less useful for observing a patient)
*subject-object dichotomy (they influence each other)
What is a polyp?
It is a lesion or a mass at the surface level(skin or lumen)
What does anaplasia mean?
What is a hamartoma?
It is a tissue normally present but in an improper proportion or organization.
What is a choristoma?
It is a normal tissue but at a abnormal site.
What brings the nutriment to the neoplastic cells?
What is the usual metastatic route for a carcinoma?
It starts in the lymph vessels and then go into the blood vessel.
What does transcoelomic mean?
It is a route for metastatic spread within the body cavities.
What is the difference between grading and staging for a neoplasia?
Grading concerns the degree of differentiation of the neoplastic cells. (low grade --> well differentiated--> good sign!)
staging concerns the size and the extent of spread
What are 3 types of screening?
Mass screening (everyone)
targeted screening (a specific population at risk)
case finding (opportunity of a health contact)
What is length-time bias during screening?
It just means that you have more chance to detect people having a slow progression disease than those with a fast progression(because they have a shorter pre-clinical phase and they will be "normally" diagnosed)
What is lead-time bias?
The lead time is the moment between detection by screening and detection when clinical signs appear. If you look at the survival time, people that you detect first (even if they get the cancer at the same time) will appear to live longer
How can you be sure that you remove all the tumor during a surgery?
You need to put stain around it and when you look at it the margins should be clean. (so the tumor is inside that "box")
What does pleomorphic means?
It means that they are variable in size and shapes
What is a leukoplakia?
It is a white patch that cannot be scraped-off and is not linked with another disease. It is white because it is keratinized.
What is the difference between an initiator and a promoter?
The initiator causes the first mutation and the promoter just increase the rates of division
Who is going to have a good mark on the exam?
What is called the fact to look and count all the chromosomes?
What is CMR? and U5MR?
CMR : Crude Mortality Rate
U5MR : Under 5 Moryality Rate
What is FISH?
It is looking at the absence or the presence of a specific sequence with a radioactively labeled probe
Explain the selectivity of the K+ channel.
The pore of the channel is so small that the particules have to get rid of the water bound molecules before going trough, but this "cost" energy. The only way to "pay" it back is to make links with the oxygen molecule inside the pore. But the Na+ molecule is to small to make enough link (it doesn't "touch" enough).
What is a neoplasm?
It can be malignant or benign and it is characterized by unceasing proliferation (might be slow or fast) that does not response to growth control.
What is the characteristic that assure you it is a malignant neoplasm?