Oral Boards Epidemiology

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Oral Boards Epidemiology
2011-07-19 09:45:28
oral boards

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  1. Pneumococcal Pneumonia
    • CAP is the most common cause of infection-related mortality and the sixth leading cause of death in the US.
    • CAP 2-3 million cases diagnosed each year in the US.
    • Highest incidence: Infants < 2 years and Elderly > 55 yrs
    • Winter months more prevalent
  2. H. Flu Pneumonia
    • CAP is the most common cause of infection-related mortality and the sixth leading cause of death in the US.
    • CAP 2-3 million cases diagnosed each year in the US.
    • H influe most commonly in non-vaccinated children/infants < 6 years
    • Chronic cardiopulmonary disease
    • Following upper respiratory tract infection
  3. Legionella Pneumonia
    • Exposure to contaminated water
    • CAP or health care associated, mainly in summer/fall
    • Smokers, immunocompromised, chronic lung disease
  4. Klebsiella Pneumonia
    • Alcoholics, health care associated
    • CAP is the most common cause of infection-related mortality and the sixth leading cause of death in the US.
  5. Mycoplasma Pneumonia
    • ·All age groups but prevalent in young adults (ages 5-20)
    • ·commonly occurs during the summer/fall
    • ·Occurs in closed populations such as schools and military installations or families.
  6. Chronic Bronchitis
    Onset - late 30s and 40s, most commonly in smokers
  7. Emphysema
    Onset – after age 50 in smokers.
  8. Asthma
    • Common; 5% of population affecte, M+W
    • Hospitalization rates highest among blacks and children
    • Death rates for asthma are consistently highest among black youth aged 15–24 years
  9. HTN
    ·About 50 million adult Americans have the disease.

    • ·Incidence of HTN increases with age and is more common in African-American and Hispanics than whites.
    • ·It is more common in younger men than in women, till age 55 then risk is equal and after 75 women are more prone to HTN.
  10. Angina
    Already discussed in definitions
  11. MI
    • Leading cause of morbid/mortality in US and Europe
    • Males 50-60 yo, females older
    • Atherosclerosis risk factors: A METHOD
    • -age
    • -male
    • -elevated homocysteine and lipoproteins
    • -tobacco
    • -HTN
    • -obesity
    • -dyslipidemia
    • family hx also a risk factor for MI
  12. CHF
    • 1 million hospital admissions
    • 5 million cases in USA
    • 50,000 deaths annually
    • 75% of existing and new cases occur in pts. > 65
  13. IDA
    IDA is most common form of anemia, 20% of women, 50% of pregnant women, and 3% of men are iron deficient.
  14. Megaloblastic Anemia
    • ·Vitamin B12 deficiency
    • o most common in patients with pernicious anemia, vegetarians/vegans surgical resection of ileum, gastrectomy, Tapeworm, Malabsorption (Crohn’s Dz)
    • oimmunologic diseases such as Grave’s dz, thyroiditis, hypoparathyroidism
    • ·Pernicious anemia
    • oelderly females >70yo; associated with autoimmune diseases: GTAP(Graves’ disease, Thyroiditis, Adrenal insufficiency, Positive FH)
    • ·Folate deficiency
    • oInadequate dietary intake, malnutrition such as with alcoholics, anorexic patients.
    • oMalabsorption (tropical sprue).
    • oPatients with increased requirements – pregnancy, chronic hemolytic anemia.
    • oDrugs: phenytoin, sulfasalazine, tmp/smx
  15. Hemolytic Anemia
    • ·Inherited hemolytic anemias are rare; often associated with family history of anemia, jaundice, early cholecystitis, or need for splenectomy
    • ·Acquired hemolytic anemias occur frequency in sick pts., secondary to malignancy, infection or drugs
    • ·G6PD:
    • oAutosomal recessive, occurs in 10-15% of AA males and also seen in
    • Mediterraneans.
    • M > F
    • · Sickle cell anemia:
    • oAutosomal recessive, 1/400 African Americans births produce a child
    • with SCA
    • ·Hereditary spherocytosis:
    • oAutosomal dominant disease of variable severity
  16. Thalassemia
    • Globally most common genetic blood disorder
    • SAM ancestry
    • Southeast Asian ancestry
    • African ancestry
    • Mediterranean ancestry
    • Alpha: Asians (SE Asia & China)
    • Beta: Mediterranean origin (Italian, Greek); Africans, SE Asians
  17. Hep A
    • ·Transmitted via fecal-oral route
    • ·Common source from contaminated water/food.
    • ·Areas of overcrowding, poor sanitation, poor hygiene.
  18. Hep B
    • ·Transmitted percutaneously, mucous membrane exposure to infected blood, sexual contact
    • ·HBV is predominant in males: homosexual men, IVDAs
    • ·Health professionals exposed to infected blood
  19. Hep C
    • ·IVDAs, intranasal cocaine
    • ·body piercing, tattooing
    • ·hemodialysis
  20. Crohns
    • 1/10,000 incidence
    • Any age
    • Peak incidence: 2nd and 3rd decade
    • Europeans, North Americans, Jews
  21. UC
    • ·Most common in Caucasians with an increased incidence in the Jewish population.
    • ·Peak occurrence between ages 15-35, but onset can occur at any age.
    • M=F
    • ·More common in nonsmokers and former smokers and the severity of the disease may be less in active smokers and may worsen when smoking cessation occurs.
  22. Obesity
    • ·30.4% of Americans are obese
    • ·Women moreso than men
    • ·African American and Mexican American moreso than white women
    • ·Poor are more obese than the rich regardless of race
  23. TIA
    • 80-90% of people who have astroke due to atherosclerosis have had a TIA episode before
    • Blacks>whites, men>women
    • Risk highest in pts 55 yo and older
  24. CVA
    • ·Third leading cause of death, approximately 200,000 a year
    • · Non-modifiable Risk Factors = increased age, male, Af. American, FH, hypercoagulable state, sickle cell dz

    ·Modifiable Risk Factors = hypercholesterolemia, HTN, heart disease (A-fib), TIA, smoking, OCP use, obesity, DM
  25. Streph pharnygitis
    • One of most common bacterial infections of childhood, accounts of 20-40% of all cases of exudative pharyngitis in children.
    • Seen in patients of all ages
  26. OM
    • Acute: Infants and children mostly, Adult can have it as well
    • Chronic: Infants and children
    • Serous: Children
  27. Acute sinusitis
    • Bacteria cause 25%; leading cause of abx resistance
  28. Viral Rhinitis
    • §Non-allergic rhinitis affects 5-10% of population; however, only 2-4% of pts actually seek Tx for relief of their sxs.
    • §Viral is one of 7 basic sub-classifications of non-allergic rhinitis.
  29. PUD-Gastric
    • Acid peptic ulcers are very common in US, 4 million (new cases and recurrences) occur per year
    • More common in pts that smoke and use NSAIDS on a chronic basisMore common in men; 60-70 y/o (NSAID use)
  30. PUD: Duodenal
    • Most Common Type of PUD
    • 6-15% of population50 y/o; has decreased in the past 20 years
  31. ARF
    • 25% of hospitalized patients will develop it
    • 5% of hospital admissions and 30% of ICU
  32. CRF
    • 6% of population is in stage I or II of ESRD~ 4.5% are in stages III or IV
    • Af Am > white
    • >65
  33. HIV/AIDS
    • Most affected areas = Sub-Saharan Africa, India, Asia (in rank of order)
    • IVDU and heterosexual routes predominate
    • 3 million are living with HIV, more than 80% are <30 yo
  34. Tension HA
    • Female > Male
    • All age groups affected
  35. Migraine
    • Usually begin in adolescence/early adult life and occur episodically throughout adulthood
    • Women > men
  36. T1DM
    • -18.2 million people in the US had DM, with about
    • 1.4 with Type1.
    • -90% are immune mediated
    • -10% idiopathic
    • -Commonly in children and young adults
    • -Mean age of onset is 8-12 y/o, peaking in adolescence
    • -Girls = boys equally affected
    • - Racial predisposition towards Caucasians
    • -African Americans have lower overall incidence
  37. T2DM
    • Most 40yo and obese, incresaing in children and adolescents
    • W>M in Caucasian populations
    • Over 90% of DM in the US is T2DM
    • More common in African Americans and Native Americans
    • Strong polygenic familial susceptibility
  38. Hypothroid Disorders
    • Patients who have received CNS radiation for leukemia 15% chance developing years later
    • Females > males
    • Iodine deficiency is the most common worldwide cause
    • Hashimoto’s thyroiditis is most common U.S. cause
    • Infants & Children– cretinism (mental/growth retardation)
    • Adult onset – Myxedema (slow metabolic process, reversible w/tx)
    • Pregnancy
  39. Hyperthyroidism
    • F:M=8:1
    • M.C. cause=Grave’s dz (60-80%)
    • Typical onset=20-50 y.o.
  40. OA
    • §Most common joint disease in the U.S.,
    • §100,000 people in the US can’t walk independently from bed to bathroom b/c of OA of the knee or hip.
    • § >90% of persons over age 40 have some radiographic changes of OA in weight-bearing joints
    • § W>M 2:1
  41. Osteoporosis
    • ·Risk factors: Female, post-menopausal, Caucasian, thin, ETOH, tobacco, Fx, sedentary lifestyle, lack of sun exposure
    • Protective: Oral contraceptives, Obesity
  42. Disc herniation
    • § Most likely to occur at the L4-L5 and L5-S1
    • § Herniation is unusual prior to age 20, and risk increases as age does
    • § In older patients, there is a relatively increased risk of disk herniation at the L2-L3 (L3 nerve root) and L3-L4 (L4 nerve root) levels
  43. Spinal stenosis
    Age is greatest risk factor, >60
  44. Degenerative Dementia
    • Common in the elderly, by age 85, 30-50% of people have dementia
    • Women sufer disproportinately as pts and caretakers
  45. Vascular dementia
    • More common in Asia than in Europe and North America
    • Second most common cause of dementia after Alzheimers
    • 9x higher in pts who have already had a stroke
    • Men more than women, risk increased with age
  46. Depression
    • All ages, gender, & race
    • 30% of primary care pts.
    • Chronic disease and medical Conditions: CA Cardiac pathology
    • Neuro disorders – CVA, Parkinson’s, dementia, MS, Alzheimer’s, brain injury, epilepsy
    • Hyper/Hypothyroidism
    • DM
    • HIV/AIDS
    • Chronic Hep C
    • Disorders of unknown etiology: chronic fatigue, fibromyalgia (-) life events, stressful situations
    • Post-partum
  47. Lumbar sprain/strain
    • 2nd most common reason why a person misses work
    • The most common back injuries are muscle strains followed by disc injuries
    • It's a common sports injury, atheltes are 80% more likely to sustain injuries in practice than during competition