Download Preventive Medicine Exam Question and Answer and more Exams Nursing in PDF only on Docsity!
Preventive Medicine Exam Question and
Answer
Branch of Medicine that concentrates on keeping people well with the goal of disease prevention and health promotion - Answer - Preventive Medicine Natural History of Disease - Three stages - Answer -1. Predisease Stage
- Latent (Asymptomatic) Disease Stage
- Symptomatic Disease Stage - Clinical manifestations Measurements of Health status What is the difference between Health status index and Health profile? What scale is used for cancer patients? What scale is used for stroke patients? - Answer -1. Years of Potential Life Lost (YPLL)
- Health status index - Single score
- Health profile - Person's health based on different dimensions
- Quality Adjusted Life Years
- Health Life Expectanct
- Disability-adjusted life years
- ADL Index
- Karnofsky index - For cancer
- Barthel Index - For stroke Levels of Prevention - Answer -1. Primordial -Broad heath determinants; Mostly to do with legislative action
- Primary -Targets predisease stage -Prevent onset of disease
- Secondary -Targets latent disease stage -Favors early diagnosis, prompt treatment, and screening programs to reduce impact of a disease
- Tertiary -Targets symptomatic disesae stage -Limitation of disability and rehabilitation from the disease -Aims to "soften" impact of an ongoing disease What are the areas for priority action based on the Ottawa Charter for Health Promotion? - Answer -1. Build healthy public policy
- Create supportive environments
- Strengthen community action
- Develop personal skills
- Reorient health services What are the main healthy promotion strategies? - Answer -1. Educational
- Organizational
- Legislative
- Community/Social
- Economic What are the 4 paradigms of Caplan and Holland's Analytic Model? - Answer -1. Traditional Perspective --> Knowledge lies with experts
- Humanist Perspective --> Educational approach; individuals can use their own resources to maximize health
- Radical Humanist Perspective --> promotion is designed to empower individuals
- Radical Structuralist Perspective --> Structural inequalities are the cause of many health problems
a. Precontemplation: Not even thinking about changing b. Contemplation: Thinking about it, balancing pros and cons, seeking support c. Preparation: Planning to take action within the month d. Action: Making a change, dealing with barriers, constraints, and unrealistic goals e. Maintenance f. Termination of undesired behavior or relapse
- Theory of Planned Behavior -Affected by the ff. factors a. Attitude b. Behavioral intention - motivation c. Subjective norms d. Social norms e. Perceived power f. Perceived behavior control - ease or difficulty in performing behavior of interest
- Precaution Adoption Process Model -Explain how a person comes to decisions to take action a. Ignorance or unawareness b. Un-engagement c. Undecided about acting d. Decides on whether or not to act e. Acting f. Maintenance
- Social Learning and Social Cognitive Theory -Acknowledge constant interaction that exists between individual and their environment -3 personal cognitive factors: a. Observational learning - more likely to perform if observed in others
b. Outcome expectations - Likely to perform if they believe benefits outweigh costs c. Self-efficacy - Perform if they perceive that they have the necessary skills and capacity Precede-Proceed Model - Answer -Precede --> Planning Phase 1 - Social assessment Phase 2 - Epidemiological assessment Phase 3 - Ecological assessment Phase 4 - Identify administrative and policy factors and match appropriate interventions Proceed --> Implementation Phase 5 - Implementation Phase 6 - Process Evaluation Phase 7 - Impact Evaluation Phase 8 - Outcome evaluation Screening for the ff in children:
- Blood Pressure
- Vision
- Urinalysis
- Hyperlipidemia - Answer -1. Blood Pressure - 3 years old
- Vision - birth to <3 years old annually
- Urinalysis - 5 years old
- Hyperlipidemia - 2 years old What is the Screening test that can be used to measure developmental problems in young children based on ability of child to perform age-appropriate tasks? - Answer -Denver Developmental Screening Test Target: Infants and pre-school children
Screening for Prostate cancer - Answer -Average risk --> Start at age 50 (+) BRCA --> Start at 40 For black or if with fam hx --> Start at 40- Screening is done via PSA alone Colorectal CA screening - Answer -Average risk patients --> Start at age 50 Annual FOBT Colonoscopy every 10 years Sigmoidoscopy and Double contrast barium every 5 years May stop screening as early as 75 or as late as 85 years Cervical CA Screening - Answer -Women aged 21-29: Pap smear alone every 3 years Age 30-65: Co-testing with pap smear and HPV every 5 years Women <21 should not be screened regardless of sexual activity Breast Cancer screening - Answer -Average risk:
- Monthly Breast self exam beginning at age 20
- Annual CBE at age 25
- Annual mammography at age 40 Women with family history
- Monthly BSE at age 20
- CBE every 3-6 months starting no later than 10 years before earliest Breast CA diagnosis in family
- Annual mammography starting 10 years prior to earliest diagnosis but not earlier than 25 years or later than 40 years
- Consider annual MRI Basic source of vital statistics Within how many days must a birth certificate be filed after live birth? In what instance can a body be buried without a death certificate?
- Answer -1. Marriage Certificate
- Certificate of Live Birth --> Must be filed within 30 days of birth
- Certificate of Death* --> Must be filed within 48 hours (Except in epidemics)
- Certificate of Fetal Death *No human body can be buried without a proper death certificate EXCEPT during an epidemic In a certificate of death, if all three causes (Immediate, Antecedent, and Underlying) are filled up, which one is counted in the cause-of-death statistics? - Answer -Underlying cause is counted in the cause-of-death If only two lines, then entry in the last line is counted as underlying Situations in which a death certificate cannot be issued - Answer -
- Suspicion of unnatural cause of death (Foul play)
- Dead on arrival - no medical attendant present at the time of death
- Death occurs before full recovery from surgical operation 2 types of Census - Answer -Census - Enumerated every 5 years -RA 10625: Philippine statistical act of 2013 Defacto census
Last resort: Bury unidentified corpses in individual graves Facts:
- Dead bodies do not cause pandemics
- Infectious organism are not viable after 48 hours
- Dead bodies should ideally be refrigerated; Do not use lime, muriatic acid, or potassium alum as preservatives
- If decay cannot be prevented, use body bags and bury shallowly Steps in making a good community diagnosis What objectives should be formulated? - Answer -1. Definition of the problem
- Appraisal of existing facts - State of knowledge of etiology (Literature)
- Formulation of hypothesis
- Testing of hypothesis
- Conclusion and practical application Objectives:
- Health status objective
- Risk reduction objective
- Service objective What are the phases of Community Organizing Participatory Action Research (COPAR)? What is the phase in which leaders are selected? What is the most crucial phase? What is the most important phase? - Answer -1. Pre-entry phase - Selection of target community with at least 50 families; Identification of preliminary records via secondary records or ocular inspection
- Entry phase - Involves integration process and acquisition of relevant information; Identification of potential leaders
- Formation phase - Core group is created and trained
- Organization - Building phase (MOST CRUCIAL STAGE) -People are mobilized through the organization
- Sustenance and strengthening phase - MOST IMPORTANT PHASE -End portion but point at which community is being built to be self- reliant 5 stages of grief - Answer -1. Denial - Refusal to believe diagnosis; initial shock
- Anger
- Bargaining - Guilt is the primary emotion
- Depression - Associated with insomnia, anorexia, inability to concentrate
- Acceptance Hospice Care vs Palliative care - Answer -Hospice Care -Provides compassionate care for people in last phases of incurable disease Palliative care -Given at any stage of a serious illness -Focus on providing relief from symptoms and stress of a serious illness The 5 star Filipino Doctor vs the 5 star doctor (WHO) - Answer - Filipino
- Health care provider
- Teacher/academician
Which type is likely to result in an achievement-oriented child? - Answer -1. Democratic Parenting -Establish clear rules and expectations and discuss them with their children -Use reason and power to enforce standards -Result: Energetic, friendly, self reliant, and cheerful achievement- oriented child
- Authoritarian parenting -Rigid rules and expectations -Demand extreme obedience and loyalty -Result: Unfriendly, conflicting, irritable; Unhappy and unstable child
- Permissive Parenting -Let the child's preferences take priority, rarely force child to conform to standards -Result: Impulsive and rebellious, low-achieving child
- Rejecting parenting -Do not pay attention to children's needs and seldom have expectations -Result: Immature, psychologically troubled child
- Uninvolved Parenting -Often ignore child and let preferences prevail as long as they do not interfere -Result: Lonely and withdrawn, low-achieving child Leves of orders of magnitude of change - Answer -First order change - Need to DO Second order change - Need to BE Family Life Cycle - Answer -1. Unattached Young Adult
-Separation from family without abandoning emotional refuge -Established in self work and develop intimate peer relationships
- Newly Married Couple -Honeymoon stage (0-2 years): Commitment to marriage -Early Marriage (2-10 years): Maturing of relationship -Middle Marriage (10-25 years): Post-care review -Late Marriage (25+ years): Farewells and planning
- Family with Young Children - First child reaches 12 y/o -Increasing flexibility to boundaries to include children independence -Permits adolescent to move in and out of the system -Beginning shift towards the older generation
- Launching Family - When first child leaves home -Accepting multitude of entries and exits -New satisfaction in relation with spouse -Adult to adult relationship between children -Dealing with deaths of grandparents
- Families in Later Life - Departure of last child -Adjusting to physiologic changes in later life -Maintaining contact with younger generation -Support for more central role of the middle generation -Dealing with loss Family illness Trajectory stages Which is the most difficult stage for the patient? Which is the most challenging/rewarding stage for the physican - Answer -Stage 1: Onset of illness to diagnosis -Most difficult stage for the patient -Stage prior to contact with the physician -Role: Explore fear that patient brings
Family assessment tools - Answer -1. Family Genogram -Too to learn about family structure, illnesses, inheritance, and family relationships
- APGAR --> Level of satisfaction with family -ADAPTATION: capability to utilize and share inherent resources -PARTNERSHIP: solving problems by communication and shared decision making -GROWTH: Freedom to grow and change -AFFECTION: Intimacy and emotional interaction -RESOLVE: Satisfaction with commitment made by family members
- Minuchin Family map --> family dynamics -Enmeshment: Over involvement of family members -Disengagement: Isolation of family members from each other -Triangulation: Family members talk directly to each other -Coalition: Taking sides
- SCREEM - Sources of help and capacity for coping during crisis -Social -Cultural -Religious -Economic -Educational -Medical
- Family Lifeline -Shows significant events among family members over a period of time in chronological order
Infectious vs Communicable vs Contagious disease - Answer - Infections - Caused by a microorganism and potentially transferable; may or may not be communicable Communicable - Contagious diseases which can be transferred to other sources Contagious disease - Very communicable disease 3 elements of a communicable disease - Answer -1. Agent infectivity - virulence, qualities, immunogenicity, antigenicity, pathogenicity
- Environmental exposure - Climate, sanitation, access to health care
- Host susceptibility - Genetics, nutrition, immune system, motivation, etc Define the ff terms
- Pathogenicity
- Virulence
- Immunogenicity
- Antigenicity - Answer -1. Pathogenicity -Capacity of an agent to induce clinically apparent disease
- Virulence -Ability of agent to produce serious illness measure in terms of fatality
- Immunogenicity -Ability of agent to induce immunity or stimulate host to produce defense mechanism
- Antigenicity
Quarantine -Separates and restricts movement of people who are exposed -Lasts as long as necessary What are the vectors for the ff diseases?
- Dengue
- Chikungunya
- Malaria
- Filiariasis
- West nile fever
- Leshmanisasis
- Chagas disease
- Sleeping sickness
- Lyme disease
- Scabies
- Leptospirosis
- Schistosomiasis (Intermediate host?)
- Trichominiasis
- Bubonic plage - Answer -1. Dengue - AEDES MOSQUITO
- Chikungunya - AEDES MOSQUITO
- Malaria - ANOPHELES MOSQUITO
- Filiariasis - AEDES/CULEX
- West nile fever - CULEX
- Leshmanisasis - SAND FLY
- Chagas disease - REDUVIID BUG/TRIATOME
- Sleeping sickness - TSE TSE FLY
- Lyme disease - TICKS
- Scabies - SARCOPTES SCABEII MITE
- Leptospirosis - RATS
- Schistosomiasis (Intermediate host?) - ONCHOMELANIA (SNAILS)
- Trichominiasis - PIG
- Bubonic plage - FLEAS
Epidemic vs Outbreak vs pandemic - Answer -Epidemic - Sudden increase*in number of cases above what is expected Outbreak - Epidemic within a limited geographical area Pandemic - Spread over several countries and continents *Determinants of increase
- Exceeds 95th percentile for 2 weeks
- More than double the incidence rate over a certain time
- Dr. Ricardo's Index - Comparison of indices to last 5 years via median Types of Epidemic patterns - Answer -1. Common source outbreak -Exposure of population to a common source (i.e. water supply) -Exposure continues over longer period
- Point epidemic -Exposure of population at the same time; but it is brief and only a single exposure that does not persist over time -All cases have the same incubation period
- Prolonged-Progressive -Transfer of pathogenic agent from one host to another -Extends over a number cases in each successive time period
- Mixed epidemics -Involve both single common exposure and secodary propagative spread to other individuals Steps in outbreak investigation - Answer -1. Field work
- Establish existence of outbreak
- Verify diagnosis - Frequency distributions
