Test questions Flashcards
(166 cards)
1
Q
Cohort or caseontrol:
Exposure is measured prior to onset of disease
A
Cohort study
2
Q
Cohort or casecontrol:
The connection between an exposure and multiple outcome measures can be assessed simultaneously
A
Cohort study
3
Q
Cohort or casecontrol:
Incidence can NOT be directly measured
A
Casecontrol study
4
Q
Cohort or case control:
Study design is prospective, but may be historic
A
Cohort study
5
Q
Cohort or case control:
A longer stretch of time can be assessed with regards to exposure
A
Case control
6
Q
Cohort or case control:
Assesment of exposure mya be biased by innacurate recall of subjects
A
Case control
7
Q
Cohort or case control:
Incidence can be measured directly
A
Cohort stydy
8
Q
Cohort or case control:
Odds of past exposure can be calculated in both case and control groups
A
Case control
9
Q
Cohort or case control:
Relative and attributable risk can be calculated from incidence figures
A
Cohort study
10
Q
Cohort or case control:
Study design is retrospective
A
Case control
11
Q
Cohort or case control:
Multiple exposure can be assessed in connection with a single outcome measure.
A
Case control
12
Q
Cohort or case control:
The relative risk of becoming a case on exposure as compared to non-exposure can be approximadet with the odds ratio of the case and control groups
A
Case control
13
Q
Cohort or case control:
Usually quite expensive and time-consuming
A
Cohort study
14
Q
Cohort or case control:
Studies typically require large efforts in organization and managenet, compliance of subjects is variable, many subjects may discontinue their participation.
A
Cohort study
15
Q
Cohort or case control:
Relatively low budget, and requires relatively little time
A
Case control
16
Q
Yellow fever vaccine is a_________vaccine
A
Live, attenuated
17
Q
Measles is a _vaccine
A
Live, attenuated
18
Q
Subunit or surface antigen vaccines consisting
essentially of____
A
purified hemagglutinin and neuraminidase from which other virus components have been removed
19
Q
Whole virus vaccines consisting of ____ viruses
A
inactivated viruses
20
Q
Split virus vaccines consisting of ______
A
inactivated virus
particles disrupted by detergent treatment
21
Q
Live attenuated (cold-adapted) virus vaccines consisting of \_\_\_\_\_\_\_\_
A
weakened (non-pathogenic) whole virus
22
Q
Cholera is a______vaccine
A
killed, inactivated
23
Q
Typhoid is a __vaccine
A
Live attenuated
24
Q
HPV is a _______vaccine
A
Protein subunit
25
Tetanus is a _______vaccine
Toxoid
26
Mumps is a ______vaccine
Live, attenuated
27
Polio is a _______vaccine
Killed, inactivated (IPV type)
Live, attenuated (OPV type) is an oral vaccine, most commonly given to eradicate polio, mono, bi or tri-valent (Sabin) types. Bivalent is the one used in routine immunization after april 2016. (before it was trivalent)
28
Diphteria is a__vaccine
Toxoid
29
Hep A (HAV) is a___________vaccine
Killed, inactivated
30
Lyssa (rabies) is a _______vaccine
Killed, inactivated
31
Measles is a ____vaccine
Live, attenuated
32
Hep B (HBV) is a ________vaccine
Protein subunit
33
Influenza is a _______vaccine
both in killed inactivated, and subunit forms
34
Rubella is a ________vaccine
Live, attenuated
35
BCG (M.tuberculosis) is a _______vaccine
Live, attenuated
36
Plague is a ________vaccine
Subunit
37
Meningococcus is a _________vaccine
Reverse (genome-based approach to vaccine development)
38
Haemophileus type B is a ___________vaccine
Conjugate
39
Yellow fever is a _________vaccine
Live, attenuated
40
Bubonic plague is a ________vaccine
Killed, inactivated
41
Rotavirus is a ____vaccine
Live, attenuated
42
Varicella is a ________vaccine
Live, attenuated
43
MMR is a __________vaccine
live, attenuated
44
ABSOLUTE contraindications to vaccination
• Unexplained encephalopathy after a previous pertussis containing vaccine - no further
doses of pertussis. (Refer to immunization clinic)
• Anaphylaxis after a previous dose
• Immunodeficiency - for live vaccines (e.g. Rotavirus, MMR, Varicella)
45
Relative contraindication for vaccination
- Evolving (undiagnosed) neurological illness.
| - Temperature >38.5.
46
Not contraindications for vaccination
• Egg allergy and MMR (NB: anaphylactic reactions to eggs are a contraindication to
influenza vaccine)
• Non-anaphylactic reactions to previous vaccines (discuss with immunization service if
in doubt
47
In 2008, how many % of total deaths were due to non comunicable diseases?
68% (36mill/ of total 57mill)
48
DASH diet consist of
DASH diet
- high in: nuts, fish, fruits and vegetables,
- low in: sweets, red meat and fat
49
Water-borne:
oral-fecal diseases transmitted through ingestion of contaminated water (cholera, typhoid fever, amoebiasis)
50
Water-washed:
usually oral-fecal or contact diseases resulting from inadequate personal hygiene due to lack of water (salmonellosis, typhoid fever, trachoma, amoebiasis, hepatitis A and E… etc.)
51
Water-based:
the pathogen spends a part of its life-cycle in water and infection occurs through ingestion or contact (schistosomiasis, dracunculiasis)
52
Water-related vector-borne:
the life-cycle of a primary arthropod vector of the
| pathogen is connected to water (malaria, dengue, filariasis, yellow fever)
53
Water-dispersed:
pathogen lives and reproduces in water and transmission occurs
by dispersion of contaminated water droplets into the air and subsequent inhalation
(legionellosis).
54
How many % of earths water is fresh-water?
2.5%
55
In developing countries, how many % of diseases is water-related?
80%
56
What is the temperature rise in farenheit due to global warming over the last century?
1.4 F
57
Most important greenhouse gasses?
The most important green house gases are the following:
• Carbon dioxide (CO2): from burning fossil fuels, solid waste and wood products.
• Methane (CH4): from production and transport of coal, natural gas, oil; and livestock
and other agricultural practices.
• Nitrous oxide (N2O): from agricultural and industrial activities.
• Fluorinated gases* are emitted from a variety of industrial processes (High Global
Warming Potential gases- "High GWP gases").
58
London type smog : source and composition
Mainly from carbon fuel (coal) --> SO2, CO2, dust
59
LA type smog: source and composition
Mainly from heavy traffic, high UV radiation, increased temperatures and little air movement -->O3, NOx, CO
60
Peking smog
Combination of London and LA type smog
61
Transmission: Airborne
Airborne: tuberculosis, measles (2 hours), varicella,
| smallpox, SARS, avian influenza, smallpox (<10u droplet size, suspended for a longer time in the air)
62
Transmission: Droplet
Droplet: meningococcal meningitis, rubella, pertussis, mumps, common cold, SARS, influenza* (also airborne)
63
Transmission: Indirect contact
Indirect contact: (fomite) RSV, SARS, influenza (15 min
| hands, 2-48 hours on certain surfaces)
64
Which body fluid is not potentially infective?
Sweat
65
Kwasikor is a deficiency in
Protein > energy
| symptoms: edema of legs and arms, moonface, hepatomegaly, pale thin skin and hair
66
Marasmus caused by
deficiency of protein + energy (equal)
| symptoms: extremely low weight, extreme wasting, pot belly, old person's face
67
Beriberi is caused by
B1 (thiamine) deficiency
| symptoms: polyneuritis and cardiac failure
68
Lack of vit A causes
Xeropthalmia
69
Deficiency in Vit D causes
Rickets, osteomalacia
70
Vit C deficiency causes
Scurvy
71
Vit K deficiency causes
Neonatal (and other) hemorrhage
72
Vit B3 (niacin) deficiency causes
Pellagra
| symptoms: dermatitis and diarrhea
73
Vit B12(cyanocobalamine) deficiency causes
pernicious anemia
74
Iodine deficiency can cause
Goiter and cretinism
75
Iron deficiency may cause
macrocytic (?) anemia
76
What is KURU
a prion disease caused by consumption of human meat (cannibalism)
77
what is the desinfection proceedure required to kill prions?
Autoclaving at 121'C for 150 min
78
which mycotoxins are carcinogenic?
Patulin, Aflatoxin, Ochratoxin
79
Botulism is caused by
Clostridium botulinum ssp
adults --> ingestion of preformed toxin
infants --> ingestion of spores (usually for honey)
80
Neonatal mortality rate (NMR)
death of infants <28 days /1000 live births
81
Post-neonatal mortality rate (PNMR)
Death of infants >28days-12months / 1000 live births
82
Fetal mortality rate (FMR)
fetal deaths in last trimester resulting in still birth
83
Perinatal mortality rate (PMR)
death of fetuses older than 28 weeks + infants <7 days /1000 live biths
84
which diseases are obligatory to screen for in children 0-8 month of age?
Phenylketonuria, galactosemia, hypethyreosis and biothinidase deficiency (hypothyreosis having the highest occurence frequency: 1:3,800)
85
How often should children ages 1-6 be screened?
Annualy
86
How ofthen should children ages 6-18 be screened?
every two years
87
Leading health problem in school children?
Dental caries
88
Most common cause of acute heavy metal poisoning in adults
Arsenic
89
Most common cause of acute heavy metal poisoning in children
Lead (Pb)
90
Sound exposure limit on a 8 hour shift
87dB
91
Shift of the hearing threshold due to sound injury starts at
4000Hz
92
Vibration: limit and action values
action: 2.5m/s2 - 8 hour shift
limit: 5.0 m/s2 - 8 hour shift
93
Hyperbaric work can cause
Barotrauma (Decompression sickness)
94
In adverse climatic conditions (as a physical health hazard), which parameters are measured
air temperature, air speed, humidity and radiant heat)
Work intensity (affecting heat produced by metabolism) must be taken into concideration
95
TLV of heat exposure in celcius
office work: 31
light physical work: 31
Moderate physical work: 29
Heavy physical work: 27
96
Biological health hazard class 4 viruses
Ebola, Marburg, smallpox
97
maximun premissible radon exposure dose for workers
0.4 WL
98
which organ is the most sensitive to radiation
Gonads (ovaries and testes)
99
Maximal premissible dose (MPD) of ionizing radiation to workers
-20 mSv (avgeraged over 5 years with max 50 mSv in any one year)
100
how many percentace of all yearly deaths globally are caused by infectious diseases?
25-28%
101
How to calculate units of alcohol?
Total Units = Volume of the drink (ml) x abv (%)
| 1000
102
One standard drink is how much alcohol?
12g
103
class 2 (at risk) drinking is defined as a consumption above
Men: 5 units/day
Women: 4 units/day
104
class 3 (binge/heavy drinking) is defined as
drinking more than 60g alcohol in one day/sitting
105
what is the lifetime prevelance of alcoholism?
around 10% (USA)
106
How many of the worlds poulation are smokers?
1.2 billion!
107
How much of all cancer deaths are related to smoking
30%
108
How large % of human total diseases is esimated to have a genetic component?
10%
109
Live expectancy of regular smoker vs non-smoker
6-8 yrs less
110
Colorectal cancers related to smoking
20%
111
Sigarette smoke contains how many chemicals?
>4000, >60 of which is carcinogenic
112
Smoking cessation reduces teh risk of lung cancer and AMI by
50%
113
Cannabis use worldwide
145 million users (2,5% of total population)
114
How long does THC stay in the body?
30 days
115
Global Heroin use (millions)
>9 million users
116
Which drug causes the stronges mental dependency?
Cocaine and crack cocaine
117
MDMA streetname
Ecstasy
118
Three most common cancertypes worldwide
1) Lung (12.3%)
2) Breast (10.4%)
3) Colorectal (9.4%)
119
Major cause of death in children age 4-14
Cancer (leukemia, lymphoma, bone and soft tissue tumors)
120
Limit for hypercholesterolemia
>6,2mmol/l serum cholesterol
121
How many % of population have hypercholesterolemia?
~15% (but twice as high is some countries)
122
Number of diabetic people worldwide
150 million (90% of which is DM type 2)
123
Age adjusted mortality in diabetic people?
1.5-2.5 times higher than general population
124
Wich communicable disease seems to influence the developement of atherosclerosis?
Chlamidia pneumoniae
125
an increase in blood cholesterol from 5.2 mmol/l to 6.2 mmol/l has been shown to increase the risk if Ischemic heart disease in men by________times
2x (doubles)
126
Riskfactors included in the Framingham study for CVD
Age, gender, systolig pressure, cholesterol, smoking, LV hypertrophy
127
% deaths (of total) due to non-communicable diseases
80%
128
What does "DALY" mean?
DALY, Disability-Adjusted Life Years (DALY) ... One DALY can be thought of as one lost year of "healthy" life
129
Total world fertility rate
2.52
130
major DALY's in both female and male
Perinatal conditions (6.2-6.9% respectively)
131
major DALY's for female population?
1) Perinatal conditions
2) LRT infections
3) HIV / AIDS
132
Major DALY's for male population?
1) Perinatal conditions
2) HIV / AIDS
3) LRT infections
133
Average total exposure pr year by natural (external) radiation)
1.0-1.5 mSv/year
134
Average total exposure pr year by natural (internal: food , water, ect) radiation
1.3 mSv/year
135
CXR average exposure dose
0.10 mSv
136
Average yearly exposure dose for all man made sources
0.5 mSv/year
137
How much of total yearly radiation exposure is form man made sources (like medical equipment) vs natural radiation
20% vs 80%
138
Tissue sensitivity to ionizing radiation most sensitive --> least sensitive
Listed most to least sesitive:
1) gonads
2) red BM, colon, lungs, stomach
3) Bladder, breast, liver, esophagus, thyroid
4) skin
139
Radiation absorbed dose is measured in which unit (SI)
Gray (Gy)
| 1Gy=100 rad = 1 Joule/Kg
140
Dose equivalent is measured in which (SI) unit?
Sievert (Sv)
| old unit was rem=roentgen equivalent man
141
Dose equivalent (DE) express?
express the differences in biological effectiveness of various types of radiation as compared to X-rays.
142
what does ALARA mean when it comet to radiation exposure?
keep exposure "as low as reasonable achievable"
143
what is INES
Ineternational Nuclear Event Scale
144
How many levels does the INES scale have?
7 levels of severity for nuclear events.
| only level 4-7 is concidered accidents
145
Global mean indor radon concentration
39Bq/m3
146
when was the Tjernobyl accident?
Pripjat, May 1986
147
Wavelenght of UV radiation
380-10nm
148
Major cause of death in diabetic patients?
CVD (50%)
149
Most common complication of DM
neuropathy (50%)
150
best prevention of DM?
Weightloss, exercise
151
How many people globally are concidered overweight?
| BMI >25
>1 Billion adults are overweight,
| 300 million are OBESE (BMI>30)
152
Obesity can be a risk factor of?
DM type 2, CVD, Hypertension, Stroke, Cancer
153
Key causes og obesity?
increased consuption of energy dense food, and reduced physical activity
154
Infant mortality rate in developing countries
10%
155
People affected with AIDS (not HIV)
13 mill.
156
average water requirement adult
35-45 ml /day/kg bodyweight (2.5-3 liters)
157
Waterborne disease definition
arise from contamination of watersources by animal or human urine or feces infcted with pathogen, which is directy transmitted when water is consumed.
(cholera, adbominal thyphoid, dysentery, hepatitis, cryptisporidium ect.)
158
charecteristics of waterborne diseases:
short incubation time, affect every age group and both genders, can be linked to contaminated watersource, identification of source stops epidemic
159
Which air pollutant causes athma and hay fever?
Nitrogen oxides (LA / summer smog)
160
which airpollutant causes emphysema?
Sulfur dioxide (london/winter smog)
161
Risk factors for domestic accidents
Age: toddlers, children and elderly
Irresponsibility, carelessness and inexperience
Bad technical conditions
162
highest incidence of traffic related mortality?
Greece, followed by Hungary (men dominate!)
163
Number one effective road safety intervetion
Seat belts!
| reduce fatal or serious injury by 40-65%
164
Match with discovery:
1) Lind
2) Ramazzini
3) van Leuwenhoek
4) Edward Jenner
5) Semmelweis
6) Karl Crede
7) Joseph Lister
8) John Snow
9) Louis Pasteur
10) Robert Koch
11) Max von Pennenkoffer
12) Peter Pazmany and Joszef Fodor (hungarian)
13) Otto van Bismarck
14) Abdel Omran
1) Scurvy
2) Occupational diseases
3) Microscope
4) Smallpox vaccine
5) Perpetual (childbed) fever
6) Silver nitrate eyedrops for neonatel to prevent N.gonorhea related eye infection
7) Carbolic acid spray (desinfection)
8) London cholera outbreak
9) Germ theory, pasteurization, rabies vaccine
10) recognises the causes of Cholera and tuberculosis, and wrote the Koch postulates for infectious diseases
11) Est. the first university publich health chair
12) Est, hungarian public health chair
13) compulsory health insurance
14) epidemiologic transition theory
165
When was WHO created?
April 1948, as part of the UN.
166
When did WHO declare the eradication of smallpox?
1979
