Exam 1 Flashcards
(251 cards)
1
Q
public health def
A
social enterprise, work to fill gap w/ services, population centered nursing care
2
Q
contract w/ society
A
est. standard of care
nursing as a profession is awarded society’s trust in exchange for work on the behalf of society’s well being
3
Q
pre 1800’s public health
A
religiosity
sick because you angered god
4
Q
1850-1949
A
sanitary reform, germ theory, antiseptic technique, start to dev theories about exposure and transmission
5
Q
Lillian wald
A
coined term “public health”
est 1st clinic for poor in NY
6
Q
late 20th century public health
A
antib resistance dev
7
Q
2000’s public health
A
researching about chronic diseases
ex. Heart disease, cancer
8
Q
21st century public health
A
genomics
recurrence of infectious disease and antib resistance
dev risk management techniques
9
Q
public health mandate purpose
A
effects individ and populations
works to mitigate risk and control outbreaks
10
Q
mandate examples
A
communicable dis
environmental issues
prevent injuries
health beh
disaster and recovery
quality and accessiblity
11
Q
health impact pyramid
-main point
A
policy and infrastructure changes will have a greater and longer impact on PH than education
12
Q
factors that affect large populations
A
socioeconomic and social determinants of health
13
Q
social determin. of health and PH takeaway
A
social determinants affect QOL and length of life more than access to care
14
Q
3 essential services*****
A
assessment (assess needs)
policy dev
assurance (assure resources are available)
15
Q
population impact strategies- local
A
local health depart. ( maternal health, immunizations, communicable dis etc)
16
Q
population impact strategies- state
A
dev policy and codes that are enforced at local lvl
ex. dis outbreaks, hazards
17
Q
population impact strategies- federal
A
collect tax dollars
dev health standards/practices
assessment of overall public health
coordinate report cards
18
Q
core functions of public health *****
A
assessment
policy dev
assurance
19
Q
public health assessement
A
ex. beh risk factor surveillance system
gauges how ppl in specific age groups and geographical areas sleep, mood, work etc
20
Q
PH policy dev
A
CMS
Medicare
21
Q
PH assurance
A
ex. annual review of PH agency
annual school immuniz records
ppl need EB care that meets minim. standards
22
Q
plans that support indivi. and PH
A
systematic planning
tracking measurable objectives (needed for funding)
dev regulations, policy’s and codes
23
Q
gap filling
A
form of hands-on direct care
24
Q
health promotion characteristics in PH
A
confidentiality (social contract)
privacy
autonomy
ethics
resilience (despite outside factors)
25
community def
social grp determined by geographical place or shared values (ex. norms, beliefs etc)
26
function of community
indiv work together to est. social control, adaptation, mutual aid and socialization
27
geographical examples of community
town
county
geopolitical<<
28
community care characteristics
population centered
health promotion
*can wrk w/ families and indivi but interventions are intended to affect entire pop
29
examples of indivi interventions that affect entire population
infectious dis, tobacco cessation, immunizations, water quality
30
what helps guide community interventions
data analysis
status, structure, process and survey findings
ex. what resources are available and how are ppl utilizing those resources
31
healthy people def
multi-disciplinary approach to achieving
health
equity
reducing disparities
32
types of home visits
skilled care
PH visits
case management
33
skilled care def
reimbursable by medicare
short term
directs nursing care
34
PH visits def
health promotion
help family work towards health-related goals
35
case management visit
private funding or medicaid
focus on chronic health
goal is to keep client in home via prevention and referral services
36
advantages of home health
access to debilitated (gap filling)
awareness of quality of family life
family less anxious, inc readiness to learn
37
barriers/challenges of home health
privacy w/ client
focused/prepared material by nurse
38
disadvantages of home health
increased distractions from others
hard to reach client by phone, hearing loss
have to problem solve independently
39
phases of home visit (5)
initiation phase
pre visit- initiate contact w/ family
in home- build trust (focus on interventions clients are most passionate about)
termination- summarize and set next app.
post visit- charting/documentation
40
types of home health agencies
private, non-profit
proprietary (For profit)
official (riverstone)
hospital-based
combo
41
current issues- home health
indigent care
no health insurance
42
current issues- home health
discharge planning
SNF, swing bed, etc
43
current issues- home health
use of tech. in home
ex. DM care
44
current issues- home health
family and nurse stressors
ex. cost of care, parental duty, heavy pt load, transportation
45
current issues- home health
lack adeq funding and fraud
ex. families charged by insurance for services they never received
solution- inc documentation to demonstrate need and ensure service was preformed
46
influenza transmission
respir tract infection
airborne, direct contact with infected droplets
47
type A influenza
large epidemics
most virulent
found in animals (aquatic birds, domestic chickens, pigs) saliva, intestines and respir tract
48
type B influenza
regional epidemics
49
type C influenza
sporadic, mild illness
not targeted w/ annual flu vaccine
50
influenza-like illness
fever > 100 F and cough w/ sore throat
51
minor antigenic changes
lead to antigenic DRIFT
responsible for yearly regional outbreaks
d/t point mutation during viral replication
52
indication for annual flu vaccines
antigenic changes cause antigenic drift and point mutation
53
major antigenic changes
antigenic SHIFT
only apparent w/ type A influenza
54
influenza categorization
surface proteins/antigens
hemoglutinan (18)
neuraminidase (11)
55
influenza genetic material
lipid envelopes w/ capsid
RNA
56
avian flu transmission
direct contact w/ infected droplets from birds
wild birds can infect poultry
57
avian flu prevention
avoid infected areas
bird poop
animal barns at fairs
58
mixing vessel
two + separate viruses infected same animal
replicate and create new "novel virus"
ex. h7n9 virus in China from birds
59
naming of influenza
type / place 1st id / lab ID# / yr of discovery / protein surface type
ex.
A/hong Kong/156/97 (H2N1)
if non-human infection include host species
ex. A/Chicken/Hong Kong/156/97 (H2N1
60
influenza complications
viral or bac pneumonia
death
61
influenza high risk populations
children <2yr
elderly
ppl w/ chronic cond
neuro conditions
preg wmn (very common to be hospitalized)
immunocomp
62
factors that affect pandemic flu fatality
access to healthcare
living conditions
comorbid
age (commonly affects younger populations)
63
R0 of seasonal flu v pandemic flu
1.2 to 1.8+
64
avian flu concerns w/ seasonal flu
hinders vaccine efforts (need eggs for flu shot)
65
5 categories of surveillance
viral surv.
surveill for NOVel type A
out pt illness surv (id influenza by age grp)
mortality surv
hospitalization surv
summary of geographic spread of influenza (from monitoring labs)
66
5 categories of surveillance
viral
surv for novel type A
out pt illness (id by age grp)
mortality
hospitalization
summary of geographic spread (done by labs)
67
purpose of influenza surveillance
predict virus in next flu vaccine
68
types of influenza vaccine
egg based
cell recombiant
trivalent and quadrivalent
69
flu vaccine contraindicated pop
<6 mo
anaphylaxis (gelitin, antib)
*still can get if allergic to egg, just must be supervised
70
effectiveness of influenza in older pop
less effective
have weaker immune systems
71
ages approved to receive live, attenuated influenza vaccine
2-49yrs
nasal mist
72
high dose inactived influenza vaccine (HD-IIV4)
ppl >65
73
antiviral meds and influenza
option for those who can't get vaccine
ex. <6mo, allergy
starting at 2 wks infant can get antiviral and at 6 mo can get flu shot
74
infant protection during influenza spread
preg mom get tdap at 36 wks
herd immunity
antiviral at 2wks
flu shot at 6mo
75
conflict btw pandemic and minority populations
pandemics dispropor affect
highlight pre-existing health disparities
higher infection rate
higher death rate
often chose not to stay home when sick- inc community spread
76
epidemiology def
study of what happens to people, factors, and patterns of distribution
ex. consequences of hurricanes (inc communicable dis)
77
father of epidem.
john snow
pump handle
cholera in london
78
descriptive v analytic epidemiology
descrip- id dis entity according to person, place and time (foodborne outbrks)
analytic- id etiology of dis
ex. scientific studies
79
types of analytic epidem (4)
1- cross sectional
2- retrospective (id risk f)
3- prospective, cohort, longitudinal
(determine incidence of health condition w/ exposed v unexposed (attack table))
4- clinical/experimental
(control v experiem grps)
80
pre-pathogenesis
what happened before dis
81
pathogenesis
what needs to happen for condition to occur
82
discernable early lesions
first s/s
83
natural history epidemiology components
pre pathogenesis
pathogen
discernable early lesions
advanced dis
84
infectivity v virulence
infectivity- ability to enter host
virulence- ability to produce illness (severity lvl)
85
validity v reliability
reliability (consistency or ability to be repeated)
validity- accuracy
86
rate v risk
rate- ratio
frequency of a health event
risk-probability that event will occur in specified time
87
secular pattern
long term, can reflect changes in social beh or health practices
88
cyclic pattern
dis occurrence or event r/t time patterns
89
point epidemic
certain point in time/space w/ large concentration of cases
used to chart an outbreak
helps to id incubation period
90
epidemic v pandemic
epidemic- regional
pandemic- worldwide
91
agent
cause of health issue
bacterial, toxin, etc
92
host
who is experiencing health condition
ex. animals or humans
factors
genetic susceptibility
immutable characteristics (age, race)
lifestyle (diet, tobacco, exercise)
93
infectivity v pathogenicity
ability to enter host and mulitply
capacity to cause dis in infected host
94
virulence v invasiveness
virul- ability to produce illness (lvl of severity)
95
types of agents
chemical
biological
psychosocial (war, suicide, economic downturn)
96
relationships btw variables in epidem
est. weak or strong assoc.
cannot prove
97
ex. web of causation
factors assoc. w/ htn
ex. genetics, lifestyle, physiological changes w/ aging
have to address all factors to improve dis
98
prevalence rate
measure of existing dis in pop at given time
inc rate= inc risk
ex. chronic conditions
DM, obesity, HTN
99
incidence
proportion of pop at risk for NEW health even
used only in conditions that have not been dx in person or are time limited
ex. influenza, pertussis (not conditions that are chronic)
100
crude mortality
propor death from any cause
101
case fatality
d/t specific cause
102
infant mortality
reflects countries ability to provide for most vul pop= gauges quality and infrastructure of healthcare system
103
attack table
used to determine offending source of food in outbreak
104
attack table- odd ratio
odds of getting sick if eat food
1=baseline
<1= not likely
>2= likely
105
major contributors to chronic dis
lifestyle factors
lack physical act.
tobacco
poor nutrition- access whole foods
excessive etoh use
SDOH
health literacy
environm/living conditions
106
high risk DM groups
native americans 2x
family hx (genes, obesity/eating habits)
sedentary job
107
carbs/meal
45-60
avoid sugary drinks
108
exercise/ day
30 min 5 days wk, 20 min 7 days/wk or 150 min /wk
109
target weight loss goal
5-7% (dec insulin resistance)
110
s/s of type 2 dm
polyuria
polydipsia
polyphagia
blurry vision
obesity
111
A1C DM pts v normal
DM= > 6.5%
pre dm= > 5.7%
normal <5.7%
112
dm dx- fasting/ non fasting
2 readings on seperate occasions
>100 mg/dl= pre d
>126 mg/dl= dm
113
DPP
dm prevention
more effective than meds
ex. exercise and dietary group for pre-dm
114
risk factors for dm
obesity
not physically active
baby >9lbs
polycystic ovary syndrome
family hx
gestational dm
115
risk factors for dm- non modifiable
inc age
men>wmn
inc BMI
african american, latin a, hispanic and native a
116
A1C goals NO DM
a1c <5.7
150 min exercise / wk
5-7% wt loss recc.
117
A1C goals for DM
6.9 or under
(>6.5= dm)
DPP, dm ed support services
118
prevention lvls for dm
primary- playground for kids
secondary- walking group for pre-dm pts
45+ need yrly screening
tertiary- A1C control, prevent MODS, BP control
119
ae of dm
retinopathy, nephropathy, neuropathy (autonomic and gastroparesis)
vascular damage (cerebral, cardiac, carotid)
Hispanics 50% more likely to die of dm than white
120
vascular disease prevention lvl examples
primary- diet, exercise, lifestyle
secondary- bp mgmt, meds
tertiary- cardiac rehab
121
downstream vascular dis outcomes
stroke
MI
CHF
Dementia (sclerotic cereb arteries)
122
risk factors for vascular dis
uncontrolled bp
high sodium intake
dm
obesity
physical inactivity
excessive etoh
123
htn s/s
blurry vision
HA
fatigue
chest pain
124
htn risk factors
obesity
family hx
sedentary lifestyle
dietary habits (high Na and not enough whole grains)
comorbidities (DM)
125
HTN supplemental treatments
wt loss
DASH diet
Na reduction
inc K (4-5 servings fruits/veg)
exercise program
reduce etoh (wmn 1/day; men 2/day)
126
BP goal
130/80
post stroke/TIA- 140/90
127
LDL goal
<129 mg/dL
<100 is ideal
128
CHF and ethnicity
blacks 2x likely to die
Hispanic paradox-
25% less likely than whites despite inc health dispa. (access, safety, quality health care etc)
129
CHF readmission
medicare will not pay for readmit w/in 20 days of 1st DC
could be d/t poor pt ed
lack out pt/community resources
illness progression
130
main risk factors for CKD
DM and HTN= CKD= ESKD
131
end stage kidney dis and ethnicity
blacks 3x more likely than whites
132
prevention lvl exaples ESKD
primary- exercise, diet, smoking cessation
secondary- education, BP control, monitor creatinine,manage dm, awareness of nephrotoxic meds
tertiary- prevent infection, inc QOL on dialysis
133
Healthy BMI
waist circum
18-24.9 BMI
men < 40 in
wmn < 35 in
134
primary prevention policy ex
school lunch
monitoring advertisements to children
bike paths
workplace wellness
tax on soda
*target SDOH
135
SDOH
economic stability
neighborhood/physical environm
education
food
community and social context
health care system
136
dis surveillance
systematic collection and analysis
used to monitor and improve health, eval interventions and plan programs
137
dis surveillance examples
geographic distribution
detect epidemics
changes in infectious agents
evaluate control measures (hand washing, respir precautions)
138
role of PHN
reporting
id factors that contrib to outbreaks
educate
139
population lvl intervention examples
contact tracing
partner notification
140
common causes of foodborne illness
campylobacter (poultry)
salmonella (eggs/poultry)
cyclosporine (produce)
e coli
141
bacterial foodborne illnesses
salmonella
(carried by poultry/reptiles)
campylobacter
142
bac. foodborne s/s
sudden HA, abd pain, diarrhea (bloody if campylobacter), nausea, fever
143
dx and tx for campylobacter
stool cul
antib
144
clostridium perfingens
spore forming bac
raw meat and poultry
dx stool cul
tx- NO antib
145
botulism causes
canned foods (esp. veget), wound, infant, adult intestinal, iatrogenic
146
botulism s/s
musc weakness, respir paralysis, blurred vision, slurred speech
147
botulism dx and tx
dx- hx, ct, xray
tx- supportive, mech ventilation, antitoxin
148
honey in babies
contraindicated if < 12 mo
149
waterborne illnesses
cryptosporidiosis
giardia
150
prevention lvl examples for waterborne illn.
primary- well checks, filters
secondary- screening
tertiary- antib for diarrh.
151
high risk pop for waterborne dis
elderly
kids < 5yrs old (higher body water percentage)
152
giardia dx and tx
HAS to be treated w/ antiprotozoal antib
dx- 3 stool samples on diff days, fecal immunoa.
153
giarda s/s
greasy stools that float
diarrh
abd cramping
154
5 keys to safe food
keep clean
keep raw and cooked separate
cook thoroughly
food at safe temps
use safe water and raw materials
no cross contamination
155
vector prevention- 4 D's
deet
drain standing water
avoid dusk and dawn
dress long sleeves
156
malaria onset, prevention
onset 10-15 days after exposure
mosq. nets
157
zoonotic examples
rabis, toxoplasmosis (cats), brucellosis, hanta virus
158
zoonotic prevention
education
vaccination
policy
159
parasites- 3
protozoa
helminths
ectoparasites
160
TB transmission
airborne
droplet
161
areas of body affected by TB
lungs
brain
spine
bone
kidney
lymph nodes
162
latent TB tests
detectable 2-8wks after infection
TST (skin)
interferon-gamma release assay (IGRA) (blood)
*NOT used to dx TB, need other supporting data
163
latent tb v active tb
latent- infected by NOT infectious
active- infected and INFECTIOUS, onset can be yrs later
164
tb s/s
prolonged cough (3+ wks)
hemoptysis
chest pain
night sweats
fever
fatigue
165
high risk pop for TB
ppl w/ close contact
ppl who have visited TB prev. countries
166
environmental risk factors for TB
small spaces
poor ventilation
positive air pressure
167
TST reading
48-72hrs
measure area of induration (not redness)
if no induration record 0 mm
168
TST > 5mm
positive in
HIV
contact w/ infectious tb
abnormal chest x-ray
immunosuppressed
169
TST >10mm
positive in
iv drug users
high risk employees
children < 5yrs
arrival from notorious countries
general pop
170
TB DX criteria
abnormal chest xr
3 sputum cul
171
false positive TST ex.
BCG vaccine
172
false negative TST ex.
low protein
very young or advanced age
recent TB infection
renal or lymphoid dis
173
latent v active dx differences
latent- positive tst but negative cxr and smears
active- everything positive
requires isolation and respir precautions
174
TB and DOT
directly observed therapy
ex. staff watches pt swallow e dose
can reduce drug resistance, trtmnt failure and relapse
175
latent TB tx
6-9 mo isoniazid monotherapy (INH)
or
3-4 mo rifamycin based (RIF)
176
things to monitor w/ isoniazid monotherapy
periph neuropathy
hepatitis if preg/postpartum
liver enzymes
177
drug resistant TB v regular TB
DR-TB is NOT more infectious
178
general summary of rural health pop
sicker
older
less educated
dec income
not insured
inc health costs
179
rural def
all population, housing, and territory not incl in urban
can be determined at county lvl, by zipe code or census data (ppl/square mile)
180
rural pop- finance
more likely to be widowed
lower income
less likely to have private insurance (usually public or uninsured)
181
rural health disparities
education
distance
child care
less anonymity
poor internet access
less resources (school nurse, specialist)
182
rural health- higher rates
trauma
cancer
allergies
resp conditions
mvc
death d/t opioid OD
infant/maternal morbid rates
183
rural pop- preven. care
less likely to participate
(bp, leisure physical act, seat belts)
more likely to chose radical treatment
184
rural pop- chronic conditions
more likely
heart dis
copd
htn
arthritis
Cardiovasc dis
cancer (cervical)
185
telemed barriers
billing
wifi
low literacy levels
"digital divide"
186
rural pop- CAM
complementary/alt meds
popular w/ older rural ppl
187
CAM reasons for use
desire for control
concerns abt ae o/ meds
ineffectiveness of allopathic trtmnts
188
CAM- possible complications
med interactions
side effects
polypharmacy (coumadin)
seeking care
189
rural- response to illness (SLP)
self care (watch and wait)
lay resource (friends advice)
professional resource (for emergencies)
190
approaches to inc rural health
screenings (cancer, htn)
dec obesity
(healthy eating, encourage leisure time physical act)
mental health support
(MV safety (seat belt, car seat), safer opioid prescribing, smoking cessation))
191
ecological public health model strategies (5)
address health determinants-
build healthy policy
creat supportive environm
strengthen community action
dev personal skills
reorient health services
192
rural access to care model principles (5)
health of indiv is paramount
health is an individ capacity to pursue needs
all indiv must have same opport
local capacities for health services
public policy should facil. navigation of the system
193
5 P's of STD screening
partners
practices
prvention of preg
protection from STI
past hx of STI
194
gen pop at inc risk for STI
partner has hx of STI
multiple partners
not using condom
pre-existing STI- usually get multiple STI at same time
gay
MSM
younger 15-24
195
ae of STI
sterility or infertility
birth defects if preg
196
bacterial STI
chlamydia
gonorrhea
syhpillis
bac vaginitis
197
viral STI
hiv
hsv2
hpv
hep a-c
198
fungal STI
yeast infection (candida)
199
parasitic STI
trichomonas vaginalis
pubic lice
scabies
200
bacterial STI s/s
genital lesions (syphil, hpv, hsv)
lymphadenopathy
perineal itching, erythema
pain w/ urination
foul discharge (change in amnt, color or smell can indic infection)
201
chlamydia
most reported STI
many asympt- goes untreated
effects men, wmn, babies
can infect throat, rectum and eyes
trtmnt- 1 gm azithromycin PO
or doxycycline 100 mg PO BID x7 (contraind in preg)
202
gonorrhea
women less likely than men to present w/ s/s
thick discharge
can affect joints, blood, eyes, throat, rectum
trtmnt- no sex during trtmnt and for 7 days after (reduces r/f antib resistance surge)
500 mg ceftriaxone IM x1
203
syphilis
10-90 incubation period
3 stages
1st- 3wks w/ chancre
2nd- 42-6mo flu like s/s, hair loss, RASH on palms and soles
can get warts on tongue
3rd- w/in 1 yr, s/s absent, serious nervous system damage, mental changes
cannot be spread in latent phase
204
syphilis trtmnt
penicillin (benzathine pen G)- 2.4 million units IM x1
test for concurrent HIV
re-exam at 3 and 6mo
can be reinfected
205
syphilis target pop
very prominent in MSM
206
congenital syphilis
50% mort rate
primary- educating teens
secondary- prenatal screening
tertiary- Pen Ben G im x 1 or x3
207
STI screening
13-64 tested at least once for HIV (if injects- annually)
annual chlamydia sexually active <25 yr
syphilis, hiv, chlamydia, hep b and gon for preg
MSM (gay and bisex) q3-6mo
208
STI disparities
15-24yr olds
non-hisp blacks
MSM, gay (syphilis and gonorrhea)
*differences reflect access to care and risk of encountering an infected indiv. not sexual practices
209
herpes simplex virus 2 (HSV2)
periodic exacerb
buring, flu like s/s, rash,blisters, lymphad
210
herpes types
1- oral
2- genital= inc rf cervical ca
if active lesions= c section
211
herpes trtmnt
acyclovir 400 mg TID (5x) 7-10days
NO CURE
212
Human papillomavirus (HPV)
wmn- warts, cancer, birth defects
men- warts, cancer
prevention- vaccination (Cervarix, Gardasil)
trtmnt- topical, removal
213
HPV prevention
vacc age 11-12 (cervical cells changing)
pap screening q3yr >21 yrs
annually if abnormal
214
molluscum contagiosum
poxvirus
commonly in children
rash everywhere except palms and soles
umbilicated papule (ulcerated in middle)
trtmnt- removal prn, self limiting
215
trichmoniasis
protozoal infection
trtmnt- metronidazole 2 gm PO x 1
men usually no s/s
wmen- frothy green disch w/ stong odor
can be transmitted from men (urethra) or wmn
216
yeast infection
causes- recent antib, douching, high sugar diet, can occur w/ HIV
trtmnt- antifungal cream
if pt has burning they need to be assessed. could have UTI or yeast infection
217
pubic lice
parastitic mites, feed on blood
trtmnt- mech removal, topicals w/ permethrin, wash clothing/linens in hot water and hot dryer
218
scabies
itch mite
direct prolonged skin to skin contact
itching and pimple like rash (burrows) in armpits, belt area and webbing of fingers
cannot get from clothing, pool, animals etc
219
scabies trtmnt
scabicides
wash in hot water, dry with hot dryer or seal in plastic bag for at least 72 hr
220
incarceration- rates and consequences
inc in areas of poverty and ppl of color live
inc money on corrections= dec funding for education and prevention
221
pre v post arrest diversion programs
pre- train officers to id ppl. w/ mental health illness
post- eval for mental h and substance abuse
222
prisoners rights
access care, refuse trtmnt
right to informed consent and medical confidentiality
223
population at risk for jail
low ses
males
black or hispanic
many have chronic dis or infectious dis
224
nursing care for inmates
education
screenings
preventative services
manage chronic conditions
health assessment required w/in 14d of admin
225
who shapes correctional care
nurse practice act, code fo ethics, federal and state laws, regulations and supreme court decisions
226
common inmate health problems
mental health
drug abuse
communicable dis
chronic conditions (TBI)
227
inmate pop at risk for suicide
female
younger
white
suffer most from mental h problems
inc risk if committed violent crime
228
inmmates- communicable dis
tb, mrsa, influenza, hep c, sti, hiv/aids
spreads quickly
most prisons prohibit condom distribution
eval upon admit- look for retinal hemorrh and hepatitis
229
future inmate trends (pop)
older, sicker
live and dying in prison
females
more chronic conditions
230
alt/ast range
>35= injury
most commonly inc d/t fatty liver dis, hepatitis (inflamm of liver) or hemochromatosis
231
hepatitis gen s/s
fatigue, upper r quadrant pain, jaundice, clayish/white stool, dark urine, fever
232
hep a transmission
NOT lead to chronic ilness
fecal/oral (contaminated food/water) (produce)
233
hep a s/s
gain natural immunity for life after recover
234
pop at rf hep a
poor sanitation, lack safe water
sexual partner w/ someone who has hep a
traveling to areas w/o being immunized
injecting drugs
homeless
gay, MSM
incarcerated
undeveloped countries-
commonly in children
235
hep. a dx, tx and prevention
dx- blood test
tx- immunoglobulin for s/s, fluids
prevention- vaccine, sanitary practices
vaccine for children >1, employees at day cares, travelers, MSM, employees in nursing homes
NOT for preg moms
236
hep b transmission
blood, semen, body fluids
237
hep b s/s
avg 90d incubation
acute phase- non s/s, may be sick for couple days
severe sickness= fulminate hepatitis
most healthy adults can recover completely
238
pop at rf hep b
sex w/ infected partner
contact w/ blood (healthcare workers)
mother to child transmission
sharing needles, razors, toothbrushes
tattoo/acupuncture
endemic in china and asia commonly in childhood
239
hep b prevention, tx, dx
dx- blood test (antigen will show + before develop s/s)
tx- meds, hydration
prevention- vaccine (1st dose at birth, 2nd before 6mo)
240
hep b antigen v antibody
antigen- + if exposed
if persistently += carrier
antibody- + if someone has been vaccinated (passive immunity)
or
+ indicates end of acute infection
* does not always mean person has had the actual dis
241
hep c transmission
bloodborne
asymp
if s/s dev will have cirrhosis
DO NOT dev natural immunity -can be reinfected even after recover
242
hep c acute v chronic phase
acute- w/in 6 mo
most often progresses to chronic
chronic- lifelong infection if untreated
ae- cirrhosis, ca, death
243
pop at rf hep c
0-19 and 19-29 yr olds
injecting drugs
blood transfusion before july 1992
blood or organ from hep c + person
sharps injury
hep c infected mother
common in egypt
244
hep c dx, prevention
dx- blood test, genetic testing (genotype 1 in US0
liver biopsy
prevnetion- NO vaccine
avoid blood products and blood
sexual transm is low among monogamous couples
get vacc for hep a and b
245
hep c trtmnt
antiviral
wkly injections (interferon alfa)
ribavirin PO BID
expensive trtmnt 24-48 wks
246
hep d
have to have had hep B
prevention- hep b vaccine
247
hep e
fecal contaminants
ages 15-40
no vaccine
dx- stool study
treatment- symptomatic
prevention- sanitary practices
hep a vaccine?
248
where to report hep cases
state health dept and billings area IHS
federal, state, county, tribal
249
popular areas. for hep dx
ER
treatment centers
homeless sites
adult book stores, massage parlors
family planning
institutional settings
250
hep- public health action
awareness
mobilize resources
screening
marketing
media campaigns
task forces (tribal)
251
