CARDIORESPIRATORY Flashcards

Question

What are the advantages/disadvantages of the ‘high-risk’ approach to preventing and managing diseases?

Answer 1

More effective in preventing disease amongst those most vulnerable Personalised interventions Cost-effective Less effective at reducing overall disease burden in the population May miss individuals at risk - may not identify everyone as ‘high risk’ Stigmatisation caused by targeting individuals at high risk Limited impact as only target a small popualtion

Answer 2

More cost effective and have the potential to impact a larger proportion of the population Reduces health disparities - does not target populations More sustainable as often involve changes in policy, environment or social norms which can have a lasting impact on health Broader impact which reduces overall incidence Less effecting at preventing disease in high-risk individuals Less personalised Limited effectiveness on high risk populations Costly

Answer 3

A preventative measure that brings large benefits to the community offers little to each participating individual

Answer 4

Researchers collect data from a large population of those at risk of developing CVD and then use statistical models to identify which risk factors are most strongly associated with the development of the disease They then develop a mathematical model that combines these risk factors to predict an individuals risk of developing the disease over a certain time period These can be used to inform clinical decision making

Answer 5

Community based activities - exercise groups, healthy cooking classes, regular BP and cholesterol screenings CVD education Annual QRISK2 scores Educating members of the public at a younger age to instil healthy lifestyle habits e,g. Physical activity in schools Prescribing atorvastatin when a QRISK score is >10%

Answer 6

It increases your risk of: CVD ACS CVA Cardiac failure PAD Aortic aneurysms Kidney disease Vascular depentia

Answer 7

<80 Clinic <140/90 ABPM/HBPM <135/85 >80 Clinic <150/90 ABPM/HBPM <145/85

Answer 8

<6g a day salt (ideally <3g) Reduce caffeine intake Stop smoking Drink less alcohol Balanced diet rich in fruit and vegetables Exercise more Lose weight

Answer 9

Infections Pollen, dust mites, animal fur, feathers Smoke, flumes, pollution Medicines e.g. aspirin Emotions - stress/laughter Sudden changes in temp, cold air, wind, humidity Mould or damp Exercise Cleaning and disinfectants Occupational allergens - bakers, farmers, carpenters, manufacturing plastics/foams/glues

Answer 10

Glowing up in a ‘clean’ environment makes atopy more likely as immune system recognises inert particles as allergens

Answer 11

History of DVT Cancer >60 Being overweight Male HF Medical illness e.g. acute infection Thrombophilias Inflammatory disorders e.g. vasculitis or IBD Varicose veins Smoking Recent major surgery Recent hospitalisation Recent trauma Chemotherapy Significant immobility Prolonged travel >4 hours Significant trauma or direct trauma to vein Hormone treatment - HRT or COCP Pregnancy and post partum Dehydration

Answer 12

All pt undergoing major surgery All pt admitted to hopsital with an acute medical illness and 1 or more additional risk factors Pt with stroke Pt with spinal cord injury

Answer 13

Pharmacological prophylaxis with LMWH, fondaparinux or unfractionated heparin Mechanical prophylaxis - compression stockings, intermittent pneumatic compression devices Early mobilisation Avoid dehydration IVC filters in high risk!

Answer 14

Immunisation Contact tracing Chemoprophylaxis Screening Completion and compliance wit treatment Hygeiene

Answer 15

BCG vaccine is offered to anyone at risk e.g. healthcare workers, FHx of TB or living in an area where TB prevalence is high. It’s given from birth in countries where Tb is prevalence. Note its only given to those who are tuberculin negative (Mantoux test) When someone is diagnosed with TB, public health officials conduct a contact tracing investigation to identify people who may have been exposed to the infected individual - they can then be tested and if necessary, treated. This is vital as it helps identify individuals affected at an early stage which would otherwise be difficult as TB can lie latent

Answer 16

The use of antibiotics to prevent the development of active TB in people who have been exposed to the bacteria or have latent TB Treatment is with 6 months of isoniazid alone or 3 months of isioniazid and rifampicin

Answer 17

People who have been in close contact with someone who has active TB disease. People who have recently arrived in the UK from a country with a high incidence of TB. People who work or live in environments where TB is more common, such as healthcare workers and prison staff. People with certain medical conditions that increase their risk of developing TB, such as HIV infection or other conditions that weaken the immune system. People who misuse drugs or alcohol, or are homeless.

Answer 18

Earlyt detection to prevent its spread - through targeted screening and contact tracing Effective treatment Infection control measures to prevent spread Continued research and development

Answer 19

Prevalence of TB Burden of drug-resistant TB Availability of resources to control it Effectiveness of existing TB control programs

Answer 20

>43,000 case diagnosed each year 3rd most common cancer in the UK overall Incidence is highest in ages 85-89 Over the last decade, lung cancer incidence rates have remained stable Incidence rates are lower in Asian and Black ethnic groups and in people of mixed/multiple ethnicity Most common cause of cancer death 9/10 cases occur in people >60 79% of cases are preventable

Answer 21

Cigarette smoking Radon Asbestosis Other occupational exposures - Arsenic, chromium, nickel, beryllium silica FHx Environmental air pollution Pulmonary scarring Previous radiation to chest Pulmonary fibrosis Chroni infections e.g HIV or TB

Answer 22

20 mins - pulse returns to normal 8 hours - nicotine levels reduced by 90%, CO levels reduced by 75% and oxygen levels return to normal which improves circulation 24 hours - CO and nicotine are eliminated from the body and the lungs start to clear out smoking debris 48 hours - all traces of nicotine are removed from the body 72 hours - breathing is easier as bronchial relax and energy levels will increase 2-12 weeks - circulation improves 1 month - physical appearance improves due to improved skin perfusion 3-9 months - cough and wheeze declines 1 year - the excess risk of MI reduces by half 10 years - risk of lung cancer falls to about half of that of a continuing smoker 15 years - risk of MI falls to same level as someone who never smoked Others - teeth improve, no stress about second hand smoke, home smells better, reduced risk of fire, financial and time

Answer 23

Education in school and to pt Tobacco TV and adverts banned Taxes higher Adverts on cigarette packs about risk Age restriction Smoking banned in public enclosed places Mass-media campaigns about benefits Wider access to smoking cessation services

Answer 24

Only 2-3% of smokers stop each year because of how addictive nicotine is For every year smoking persists >40, life expectancy decreases by 3 months Life expectancy for smokers is at least 10 years shorter than for nonsmokers. Quitting smoking before the age of 40 reduces the risk of dying from smoking-related disease by about 90%.

Answer 25

Precontemplation Contemplation Determination Action Relapse Mainatnence

Answer 26

5 Rs Relevance - why is it important? (2nd hand exposure, health, finances) Risks - remind them of negative impacts Rewards - benefits such as finance, improves mortality, regaining taste Roadblocks - identify what is stopping them Repetition - every time you see them release this

Answer 27

5 As - Ask to quit at every visit - Advise to quit - Assess willingness to quit - Assist quitting with pharmacotherapy and counselling - Arrange follow up

Answer 28

asbestosis - roofers, plumbers Coal - miners Aspergillosis - malt worker or farmer Cigarette smoke Radiation - radiographer Silica - metal, pottery Arsenic - paint factory

Answer 29

for people who are disabled because of an accident at work, or who have certain diseases caused by their work

Answer 30

Notify public health authority

Answer 31

Immuncompromised Pregnant women Anyone who has already had TB or the vaccine i.e. tuberculin positive

Answer 32

It increases herd immunity which will decrease population prevalence

Answer 33

a widespread occurrence of an infectious disease in a community at a particular time.

Answer 34

when that infection is constantly present, or maintained at a baseline level

Answer 35

a widespread occurrence of an infectious disease over a whole country or the world at a particular time.

Answer 36

Systematic collection and analysis of data and resultant dissemination so that appropriate measures can be taken

Answer 37

The most common form When labs, physicians or other HCP regularly report cases to the local health department

Answer 38

When collection of data from the lab, physician or other HCP is initiated by the health department Often used during an outbreak investigation or research study

Answer 39

Ongoing, systematic collection, analysis, interpretation and application of real-time indicators for disease that allows for detection before public health authorities would otherwise identify them

Answer 40

a form of public health surveillance that involves monitoring a subset of the population, often a group of healthcare providers or healthcare facilities, for the early detection of infectious diseases or other health events of public health importance. E.g. for flu - in a community, a small group of healthcare providers might be selected to report the number of cases of flu they see each week. By tracking the number of cases over time, public health officials can identify spikes in activity and respond quickly with interventions such as vaccination campaigns or increased surveillance.

Answer 41

Detecting outbreaks and clusters Identifying and monitoring health disparities Monitoring disease trends and progress Evaluating public health interventions Guiding public health policy and practice

Answer 42

Privacy concerns Data quality and completeness Resources constraints Data sharing and interoperability

Answer 43

Acute encephalitis Acute infectious hepatitis Acute meningitis Acute poliomyelitis Anthrax Botulism Brucellosis Cholera COVID-19 Diphtheria Enteric fever (typhoid or paratyphoid fever) Food poisoning Haemolytic uraemic syndrome (HUS) Infectious bloody diarrhoea Invasive group A streptococcal disease Legionnaires’ disease Leprosy Malaria Measles Meningococcal septicaemia Monkeypox Mumps Plague Rabies Rubella Severe Acute Respiratory Syndrome (SARS) Scarlet fever Smallpox Tetanus Tuberculosis Typhus Viral haemorrhagic fever (VHF) Whooping cough Yellow fever

Answer 44

Bacillus anthracis Bacillus cereus (only if associated with food poisoning) Bordetella pertussis Borrelia spp Brucella spp Burkholderia mallei Burkholderia pseudomallei Campylobacter spp Carbapenemase-producing Gram-negative bacteria Chikungunya virus Chlamydophila psittaci Clostridium botulinum Clostridium perfringens (only if associated with food poisoning) Clostridium tetani Corynebacterium diphtheriae Corynebacterium ulcerans Coxiella burnetii Crimean-Congo haemorrhagic fever virus Cryptosporidium spp Dengue virus Ebola virus Entamoeba histolytica Francisella tularensis Giardia lamblia Guanarito virus Haemophilus influenzae (invasive) Hanta virus Hepatitis A, B, C, delta, and E viruses Influenza virus Junin virus Kyasanur Forest disease virus Lassa virus Legionella spp Leptospira interrogans Listeria monocytogenes Machupo virus Marburg virus Measles virus Monkeypox virus Mumps virus Mycobacterium tuberculosis complex Neisseria meningitidis Omsk haemorrhagic fever virus Plasmodium falciparum, vivax, ovale, malariae, knowlesi Polio virus (wild or vaccine types) Rabies virus (classical rabies and rabies-related lyssaviruses) Rickettsia spp Rift Valley fever virus Rubella virus Sabia virus Salmonella spp SARS-CoV-2 Shigella spp Streptococcus pneumoniae (invasive) Streptococcus pyogenes (invasive) Varicella zoster virus Variola virus Verocytotoxigenic Escherichia coli (including E.coli O157) Vibrio cholerae West Nile Virus Yellow fever virus Yersinia pestis

Answer 45

Registered medical practitioners have a statutory duty to notify the ‘proper officer’ at their local council or local health protection team They must complete a notification form immediately on diagnosis of suspected notifiable disease and not wait for lab conformation! Send the form to the proper officer within 3 days or notify them verbally within 24 hours if urgent

Answer 46

Over 75% of CVD deaths occur in LIC and MIC but maybe this is because this is where most people live

Answer 47

a technique used to allow statistical populations to be compared when the age profiles of the populations are quite different.

Answer 48

Rates are higher in the north and Scotland compared to South

Answer 49

As affluence goes up, CHD risk decreases Higher rates in the most deprived areas

Answer 50

QRISK takes into account a wider range of risk factors e.g. FHx, BMI, ethnicity and social economic status QRISK is based on recent data whereas Framingham is from data in. 1950s QRISK is better calibrated for UK population whereas Framingham is US

Answer 51

Increase exposure to protective factors e.g. vaccines Reduce exposure to risk factors e.g. modifying personal behaviour or improving services to the population e.g. clean water

Answer 52

Screening - find people with early stages of disease and intervening E.g. smoking cessation or treating hypertension to reduce CVD risk

Answer 53

TB incidence is concentrated in large urban areas the majority of people with TB were born outside the UK TB in England continued to disproportionately affect the most deprived populations, including groups at risk of exclusion and other health inequalities It is more likely in males, people with a history of imprisonment and people with a history of drug and alcohol misuse in the non-UK-born population with TB, homelessness, asylum seeker status and mental health needs were more common than in the UK-born population with TB

CARDIORESPIRATORY Flashcards

(77 cards)