Public health Flashcards

1
Q

What are causes of causes of obesity?

A

isolation lack o social support, poor social networks, poor self-esteem, low perceived power

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2
Q

What are the main policies for alcohol prevention of harm?

A

MMake alcohol less affordable, reduce availability, marketing limiting exposure especially to younger people
licensing events, resources for age checks, screening in young groups, brief interventions traiining, screening adults extended brief interventions motivational interviewing

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3
Q

What is primary prevention in the UK?

A

know your limits binge drinking campaign, awareness of risks drinkaware labelling, changes to advertising

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4
Q

What is minimum unit pricing?

A

Making it a specific cost for each unit to limit affordability. Supposed to help target the most heavy drinkers

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5
Q

What secondary prevention is recomended?

A

Ask about it routinely, especially in routine examinations, in ED in prescribing medications heavy drinking backgroun when they are having potentially alcohol induced health problems

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6
Q

What is at risk drinking?

A

Hazardous drinking cn be bringing physical or psychological harm

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7
Q

What is alcohol abuse drinking?

A

Likely to case physical or psychological harm

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8
Q

What is alcohol dependence?

A

when experience side effects it gets in the way of doing your daily activities.

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9
Q

What is FAST screening?

A

Heavy drinking days adverse consequences from drinking. unable to remember wat hapenned, others talked about cutting down

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10
Q

What are alcohol dependence treatments?

A

CBT, social support groups, drugs that make you feel hungover as soon as you drink

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11
Q

Why are linear regressions useful?

A

Model for risk prediction of a clinical outcome, estimate the risk of future outcomes, in individuals based on diferent combinations of clinical and non-clinical characteristics. classify indiciduals as likely to experience an outcome or not and develop prediction rules to direct further diagnostic evaluations

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12
Q

Why are regresssions performed?

A

To isolate a clinical outcome from other confounding factors

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13
Q

Why might linear regression not be suitable?

A

some outcoms are binary

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14
Q

What is used in logistic regression?

A

Odds ratios but have to Ln them to get a linear scale

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15
Q

How are Odds ratio coefficients calculated?

A

not in a linear fashion like risk ratio

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16
Q

What shows that it is significant in logistic regression?

A

If it doesn’t include 1

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17
Q

When is survival analysis used?

A

The time it takes for death and when not all individuals in the study die

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18
Q

What is censoring in survival analysis?

A

It happens when the data doesnt continue for that person

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19
Q

Why might a person be censored in a study?

A

They might not die before the end of the study, they might leave the area and lost to follow up, die from other cause, or reuse to be observed or even die before study starts

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20
Q

What is a Kaplan-Meier graphs?

A

Shows comparable survival ratio over time

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21
Q

What is on a Kaplan-Meier graph?

A

Time on X survival probablility Y axis, survival curves for two or more groups, start at 1, vertical lines when censoring happens Numbers underneath showing who is left in the study and median survival line shades area showing CI of that point of data

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22
Q

What is the p value for in Kaplan-Meier graph?

A

testing the difference between the two survival curves, it is a log-rank test

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23
Q

What is Cox regression?

A

It is regression for survival analysis, it handles the confounders in the study better than log-Rank test

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24
Q

What are other regression for survival analysis?

A

Weibull and Exponential they make assumptions about pattern of risk

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25
Q

What is Hazard?

A

Similar to risk

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26
Q

What is the the assumption made in Cox regression?

A

that the Hazard risk is the same throughout the study

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27
Q

What is relationship between hazard ratio and factors?

A

Multiplicative

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28
Q

What are ANCA?

A

Anti neutrophilic cytoplasm antibodies IgG. They are against the monocytes and neutrophils.

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29
Q

What are ANCA associated?

A

small vessel Vasculidities IBD Goodpastures syndrome

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30
Q

What is the pathophysiology of ANCA?

A

When monocytes and neutrophils are activated they allow the ANCA antibodies which activate the neutrophils releasing reactive oxygen species so they cause vessel damage

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31
Q

What is c-ANCA vs p-ANCA?

A

c-ANCA detects granulomatosis with polyangiitis others are for different ones

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32
Q

What is rheumatoid factor?

A

It is an antibody in the serum that is against an antibody. Auto-antibody usually IgM against Fc portion of IgG forming a complex causing inflammation

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33
Q

How sensitive and specific is RF?

A

80% sensitive vs 75% specific so it is good for ruling out RA

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34
Q

What oher diseases can RF beraised?

A

SLE, SJorgren, Interstitial pulomary fibrosis, Hep B, Infectious mononucleosis, TB Haematological malliganancies. Infective endocarditis

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35
Q

What is seronegative arthritis?

A

Inflammatory arthrisis that has negative RF, this inclused Psoriatic arthritis, Ankylosing Spondylitis, IBDassociated arthritisandreactive arthritis

36
Q

What typeof hypersensitivityreaction is inflammation caused by rheumatoid factor?

A

Type 3

37
Q

Where does synovial fluid come from?

A

The plasma,

38
Q

What is the consistency of synovial fluid in RA?

A

Lower than more swelling so more dilute fluid

39
Q

What usually causes monoarthritis?

A

Gout osteoarthritis septic arthritis lyme’s disease and trauma

40
Q

What can usually cuae oligoarthritis?

A

Psoriatic arthritis enteropathicarthritisand reactive arthritis

41
Q

What can often cause polyarthrits?

A

RA and SLE

42
Q

Which arthritises can affect the DIP?

A

OA and Psoriatic arthrits

43
Q

Which canaffect the metacarpal phallangeal joints?

A

RA, SLE, CPPD pseudogout

44
Q

Which can affect the 1st metatarsal joint?

A

OA and Gout

45
Q

Which types are arthrits can be acute?

A

Sponduloarthrits, crystaline arthritis, septic arthrits, acute rheumatic fever,

46
Q

Which arthridities are symetric?

A

RA, SLE, Psoriatic arthrits, scleroderma MCTD and viral

47
Q

Which arthridities are symetric?

A

RA, SLE, Psoriatic arthrits, scleroderma MCTD and viral

48
Q

What can be seen on arthritis X-ray?

A

Jointspace narrowing , bone erosions, hypertrophic changes, periostitis and chondrocalcinocis

49
Q

Whatare the signs of OA?

A

No signs of inflammation, no constitutional symptoms, joint pain worsens with use asymmetric, no elevated CRP ESR,

50
Q

Which jonts are affected very often in OA?

A

weight bearing joints like hip and knees

51
Q

What can increase risk of OA?

A

Trauma, obesity chronic insidious disease, manual labour

52
Q

What are main symptoms of rheumatoid arthritis?

A

inflammation of joints, fever weight loss night sweats, joint pain improves with use, symetrical involvment elevated ESR and or CRP

53
Q

What is Baker cyst?

A

At the back the nee can rupture and looks like DVT as obstructs the veins

54
Q

What does DMARD mean?

A

Disease modifying anti rheumatic drugs

55
Q

Which risks should be mentioned?

A

The most common and life threataing

56
Q

What information is needed for informed consent?

A

Details risks benefits and alternatives and risks of refusing

57
Q

What are steps for assesing capacity?

A

Understand, retain weigh and communicate their decision about the decision

58
Q

What is in the mental capacity act?

A

Presume capacity unless it is established otherwise. if no capacity all decisions are made with best interest

59
Q

What can reduce capacity for consent?

A

Learning disiblit, dementia mental illness and impaired capacity

60
Q

What happens when they dont have capacity?

A

Lasting power of attorney or advanced directive, a healthcare professional can act in their best interests, always involve the pateint as much as is possible

61
Q

What is important in urgent patient without capacity?

A

do lifesaving treatment usually unless some orders

62
Q

What is an independent mental capacity advocate?

A

They act as a friend or relative of a patient to help them make a decision

63
Q

When is court or Judge involved in consent?

A

If very serious or complex decision or conflict between healthcare team and patient views/relatives eg sterilisation, withdrawal of nutrition and hydration from a person in a vegitative state

64
Q

What shoule you do when acting in best interest of the patient?

A

Would the patient regain capacity?, past and present wishes and feelings, what are the pateint’s beliefs and values that would be likely to influence the decision other factors they might consider, consultation with people interested in their welfare

65
Q

What is Gillick competence?

A

When a child can make a decision themyself and have capacity they can make their own decision on their treatment

66
Q

What can parents allowed to consent for with children?

A

They can give treatment but cannot refuse it if it is in their best interests

67
Q

Where do respiratory viruses affect?

A

some upper only some sinuses some lower tract

68
Q

What virus causes common cold?

A

Rhinoviruses and coronoviruses

69
Q

What cause sore throats?

A

Adenovirus(can be GI), Epstein-Barr virus

70
Q

What is laryngo-tracheobronchitis?

A

Croup parainfluenza viruses

71
Q

what is RSV?

A

respiratory syncitial virus

72
Q

What are most pneumonias caused like?

A

2/3rds are viral

73
Q

What are Haemagglutinin and neuraminidase?

A

They are proteins on the cell that help them into the cell they are used to type influenza A viruses H and N

74
Q

Where are flue viruses from?

A

Mainly birds and some in mamals like pigs and horses

75
Q

What is antigenic drift?

A

the viral mutation slightly allowing it to evade the immune system

76
Q

How is influenza spread?

A

Droplets some aerosol,

77
Q

What would flu pandemic look like?

A

short incubation infection from symptoms some before hand could be 2-4 weeks frm firstcase could have first waves, could affect different ages,

78
Q

What is the use of medications in flu?

A

Reduce risk of transmission to others? reduce severity and duration of symptoms?

79
Q

Which neurological disease cause problems in the older age group?

A

Strokes and dementia

80
Q

What affects migraines (risk factors)?

A

age female sex hormones family history education, income and socio-economic status

81
Q

What can you do to prevent stroke?

A

TertiaryMDT stroke rehab units. Secondary prevention screening for risk factors mostly from hypertension 75% Primary prevention smoking alcohol diet and physical activity

82
Q

What are causing dementia?

A

genetic, multi infarct or multifactorial Alzheimer’s

83
Q

How is Parkinson’s diagnosed?

A

Tremor, rigidity, akinesia

84
Q

What neurological disease is protected from smoking?

A

Parkinsons incidence is reduced in it

85
Q

How is MS diagnosed?

A

MS lesions on the scan, but can also be on symptoms

86
Q

What is cerebral palsy?

A

Brain damage in utero that causes non-progressive brain damage before or during neo-natal period

87
Q

What is variant Creutzfeild Jacob disease?

A

different to dementia causing creutzfeild Jacob disease