EPID 1 - Intro
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1. Define epidemiology from Greek
2. Real definition
3. What is the goal of the epidemiologist?
1. Epi = covering; demos = population; ology = study of
2. Study of the distribution & determinants of health or disease in a population, and the application of this study to control health problems.
3. Goal: to prevent & control disease, injury, and disability by applying knowledge of factors that affect their incidence & distribution
What are the 5 specific objectives of epidemiology?
1. IDENTIFY etiology/cause of disease & risk factors that increase person's risk for disease
2. Determine EXTENT of disease found in community
3. Study NATURAL HISTORY & prognosis of disease.
4. EVALUATE both existing/new preventative & therapeutic measures as well as modes of health care delivery
5. Provide foundation for developing PUBLIC POLICY and regulatory decisions relating to environmental problems.
1. How have top 10 leading causes of death changed from 1900-2004?
2. What are the four historical examples in epid to know?
3. Who conducted 1st planned clinical trial? How many treatment groups?
4. Who is considered the father of epidemiology? What did he suggest?
5. Who designed first modern epi study? Describe study. Results?
1. Changed from infectious disease (epidemics) to noncommunicable diseases (chronic diseases).
2. John Snow & Cholera; James Lind & Vit C; Jenner & Small pox; Dental caries & water fluoridation
3. James Lind & Vit C
4. John Snow - suggested that cholera was a contagious disease and was spread by contaminated water . This was not accepted at first bc there was no knowledge of germ theory/disease transmission.
5. John Snow - went door to door determining which company supplied water to the hoome and how many cholera deaths theree were. More deaths were related to one company --> closing these pumps prevented further disease.
Edward Jenner & Small Pox
1. Define variolation?
2. How did he get his initial idea?
3. What is he responsible for?
1. Variolation - transferring blood from infected person to a healthy person.
2. Examined dairy maids - noticed they developed milder form of smallpox (cowpox). Injected cowpox from dairy made into an 8 year old later. Jenner later exposed boy to smallpox but boy didn't get smallpox.
3. First vaccine.
1. What city was responsible for first fluoridating water?
2. What happened after they discontinued fluoridation in Wisconsin?
1. Newburgh ---> after 10 years of fluoridation, saw significantly less dental caries compared to Kingston (unfluoridated water).
2. Increase in dental caries again.
1. What does infectious disease result from?
2. What can it be facilitated by? Define
3. What promotes exposure?
1. Host + infectious disease + environment
2. Vector - any agent (person/animal/microorganism) that carries & transmits disease (i.e., mosquito or deer tick)
What are factors that may alter risk of human disease? (3 main ones)
1. Host characteristics - age, sex, occupation, genetic profile, immune status, nutritional status, and prior disease.
2. Types of agents - bioogic, chemical, nutritional
3. Environmental factors - temp, crowding, water, food, air pollution
1. What are modes of transmission of infectious disease? (2)
2. Describe host responses in iceberg concept of infectious disease from less rare to most rare? (5)
1. Direct transmission (person-to-person),
Indirect transmission (common vehicle (i.e., contaminated air/water supply) via single, multiple, or continuous exposures OR vector)
2. (1) Exposure w/o infection (2) Infection w/o clinical illness (3) moderate severity/mild illness (4) Classical & severe disease (5) death of organism
1. Define clinical disease
2. Define types of non-clinical/inapparent disease (4)
1. Clinical disease - characterized by signs & symptoms
- 2. Non-clinical
- Preclinical, subclinical, persistant/chronic, latent
(1) Preclinical - will eventually progress to clinical disease
(2) - Subclinical - not apparent and will NOT progress - diagnosed serologically by antibody response.
(3) Persistent (chronic) disease - postpolio syndrome - infection persists for years after infection
(4) Latent disease - infection w/ no active multiplication of agent, as when viral nucleic acid is incorporated into the nucleus of a cell as a provirus.
Define the following:
1. Epidemic - occurrence of a disease above & beyond what is expected/considered normal (must be able to measure "normal")
2. Endemic - natural/normal occurrence of disease in a certain area
3. Pandemic - epidemic that occurs over a wide geographic area (global flu, aids) H1N1
1. Define herd immunity
2. How do you examine the effect?
3. What is the logic?
4. Look at picture
1. Herd immunity - resistance of a group to an attack by a disease to which a large proportion of the group are immune
2. Subtract number of cases observed from number of cases expected.
3. If every other person is vaccinated, how will the person in the middle get the disease?
1. Define incubation period
2. START WITH PAGE 9
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