NUR 480 EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS

NUR 480 EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS Terms in this set (98) Epi triad Host (human, animal) Environment (physical, biological, social, & cultural) Agent (bateria, fungi, parasites, & viruses) Surveillance When data is gathered to make informed diseases. The continuous, systematic collection, analysis and interpretation of health- related data needed for the planning, implementation, and evaluation of public health practice -Epidemic -Endemic -Pandemic Epidemic A significant increase in disease Endemic The constant number of disease within a population Pandemic Disease that occurs over a wide geographic area and affects a very high proportion of the population. Emerging infections: History Despite extraordinary advances in development of countermeasures: -The ease of World travel and increased Global interdependence have added layers of complexity to Containing infectious diseases that affect not only the health but economic stability of societies -Infectious diseases have been emerging and reemerging over millennia and are driven by numerous factors. The deadliest pandemics in history -Black Death (bubonic/pneumonic plague) in the 14th century (25-40 million deaths), -1918 influenza pandemic (50 million deaths) -HIV/AIDS pandemic (35 million deaths) Categories of emerging infections 1. Newly emerging 2. Reemerging Newly emerging diseases Diseases recognized in the human host for the first time -(HIV/AIDS) Reemerging diseases Diseases that have historically infected humans, but continue to appear in new locations or drug-resistant forms, or that reappear after apparent control or elimination -(Dengue & West Nile Virus) Influenza An example fo a reemerging disease: -Viruses evolve rapidly in response to changing host & environmental circumstances -Able to evolve continually by antigenic drift, intra-subtyic reassortment & antigenic shift - 2009 H1N1 virus was a descendant of 1918 virus -Reason that new vaccines is develop annually Infection The invasion and multiplication of microorganisms in body tissues -RF: AI diseases (DM), pre-existing respiratory illness -Consequences: death, economic depression Steps of outbreak investigation 1. Prepare for field work 2. Establish the existence of an outbreak 3. Verify the diagnosis 4. Construct a working case definition 5. Find cases systematically and record information 6. Perform descriptive epidemiology 7. Develop hypotheses 8. Evaluate hypotheses epidemiologically 9. As necessary, reconsider, refine, and re-evaluate hypotheses 10. Compare and reconcile with laboratory and/or environmental studies 11.Implement control and prevention measures 12.Initiate or maintain surveillance 13.Communicate findings Case definition (step 4 of outbreak investigation) -A standard set of criteria for deciding whether an individual should be classified as having the health condition of interest. -Includes Clinical Criteria and - in the setting of an outbreak investigation - restrictions by time, place and person (descriptive epi) -Investigators may classify cases as confirmed, probable or possible. -May be a "loose" definition, which may be tightened later on. Example: Abdominal cramps and diarrhea (at least three stools in a 24 hr period) in a school-age child with onset during the same period. Descriptive epidemiology The aspect of epidemiology concerned with organizing and summarizing health- related data according to time, place, and person -Collection & analysis of data -Epi curve: uses histogram to illustrate mode of spread, periods of exposure Communicate findings (step 13 of outbreak investigation) Notifiable infectious diseases -Providers MUST report to local/regional health departments - state health department - CDC -Report weekly in the MMWR -State health departments have the responsibility for monitoring and controlling communicable diseases within their respective states; they determine which disease will be reported within their jurisdiction What are the most common ways that a local health department uncovers the outbreak? Receiving calls from affected residents Receiving calls from healthcare providers: Most outbreaks come to the attention of health authorities because an alert clinician or a concerned case-patient (or parent of a case-patient) calls. The other methods listed occasionally detect outbreaks, but less frequently. Factors that influence a health department's decision whether or not to conduct a field investigation in response to one or more cases of disease include: -The nature of the disease -The number of cases -Resources available -Health department's traditional attitude toward conducting field investigations All of the above A case definition during an outbreak investigation should specify -Clinical features -Time -Place -Person NOT hypothesized exposure of interest: if not true may lead to missed cases and during analytic step disease status & exposure must be determined independently to avoid bias Causes of emerging infectious disease -Previously undetected or unknown infectious agents -Known agents that have spread to new geographic locations or new populations -Previously known agents whose role in specific diseases has previously gone unrecognized -Re-emergence of agents whose incidence of disease had significantly declined in the past, but whose incidence of disease has reappeared. Emerging infectious disease considerations -Around 40 infectious diseases have been discovered since the 1970's -Can be due to both natural and human factors -Travel, increasing density of population centers, closer contact with wild animals, or even potential threat for bio-terrorism has influenced -Research continues - vaccine development and antimicrobial drugs are critical, but challenges will be ongoing Emerging infectious disease other considerations -Can be due evolution over time but more likely the result of human behavior and practices (rural to urban shift, international air travel, poverty, wars, destructive ecological changes) -Two events have to occur: 1. Infectious agent has to be introduced into a vulnerable population 2. Agent has to have the ability to spread readily from person-to-person and cause disease. -Many infectious diseases arise when infectious agent in animals are passed to humans (zoonoses) -Antimicrobial resistance - acquired resistance of pathogens to medications such as antibiotics is especially important in re-emergence of diseases -Climate change - global warming alters habitats, disease spreads into new geographic areas (mosquitoes expand their range into new regions)