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138 Cards in this Set
- Front
- Back
4 goals of public health:
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prevent disease, create healthy communities, reduce environmental hazards, link people to HCPs
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sudden and widespread outbreak of disease within population, group or area
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epidemic
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ongoing presence of disease within population, group or area
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endemic
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disease occuring over large geographical area
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pandemic
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# new cases
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incidence
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# total cases at a given time
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prevalence
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2 factors that affect prevalence:
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incidence and duration of disease
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proportion of people with disease who test +
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sensitivity
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proportion of people without the disease who test negative
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specificity
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promotion of health at individual and community levels by promoting healthy behavior and preventing onset
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primary prevention
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identify and control disease in early stages, reduce prevalence
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secondary prevention
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prevent disability by restoring affected individuals to their optimal level of functioning after a disease or injury, prevent recurrence and slow progression
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tertiary prevention
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5 steps of public health prevention
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define problem and implement surveillance, ID causes, develop and test interventions, implement interventions, evaluate interventions
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means of zoonosis transmission
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farming, handling raw animal products (bonemeal, hides), hunting/camping, eating untreated/uncooked meat or dairy, consuming animal urine
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diseases associated with untreated dairy:
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brucellosis, campylobacter, E coli, haverhill fever, Q fever, salmonella, tick borne encephalitis
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diseases associated with skinning/butchering wild animals
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plague, rabies, tularemia
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diseases associated with butchering farm animals
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anthrax, brucellosis, crimean-congo, skin infections, strep skin and suis infections
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diseases associated with uncooked meat
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campylobacter, E coli, tapeworms, salmonella, toxoplasmosis, trichinellosis
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diseases associated with urine
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leptospirosis and lyme disease
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diseases associated with warm climates
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arbovirus, borreliosis, hantavirus, tick borne encephalitis
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incubation period of brucellosis
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1-2 mo
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irregular fever, sweats, malaise and headache, variable organ involvement
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brucellosis
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dx and tests of brucellosis:
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blood culture (7-21 days), bone marrow culture, serology
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disease caused by Yersinia pestis
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plague
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means of transmission of plague
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regurgitated through mouthparts of infected fleas, often found on rodents; also transmitted through droplets from person to person
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incubation period of plague
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1-7, up to 12 days
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abrupt onset of sx, fever, chills, toxemic, bacteremic, localized infection, hemorrhage, buboes surrounded by boggy hemorrhagic edema and possible pus discharge, pneumonitis toward end
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plague
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dx and tests for plague
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pulmonary failure in 24-36 hours, chest x ray, gram stain smears of lymph node aspirate pus, sputum gram stain
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complications of plague
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hemorrhagic necrosis and degeneration of organs
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sexual cycle of toxoplasmosis occurs in:
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cats
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tachyzoites localize in neural and muscle tissue and develop into tissue cyst bradyzoites
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toxoplasmosis
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major killer of humans until beginning of 20th century
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infectious diseases
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rule 1 of Koch's postulate
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organism must be present in every active case of disease
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rule 2 of Koch's
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organism must be isolated and grown in lab culture
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rule 3 of Koch's
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when injected with lab grown culture, test animals must develop disease
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rule 4 of Koch's
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organism must be isolated from newly infected animals and repeated process must produce same result
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Rhabdoviridae causes
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rabies
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means of rabies transmission
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saliva of bats (most common) or other infected animals
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first line of defense for rabies prevention
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vaccinate dogs and cats
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rabies progression
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infects brain then travels to salivary glands when it is them transmittable
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means of transmission for smallpox
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aerosol or touch
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cluster of cognitive, behavioral and phsyiological sx indicating that individual continues use of substance despite significant substance-related problems
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dependence
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need for greatly increased amounts of the substance to achieve intoxication or a markedly diminished effect with continued use of the same amount
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tolerance
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maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to repeated use of substance
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substance abuse
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required time for substance abuse
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continuous use over 12 mo
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plasma concentrations of nicotine reach their peaks at
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1.5-3 min
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plasma concentrations of nicotine return to baseline after
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2-3 hours
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2 phases of nicotine dependence
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stimulation of pleasure response and relaxed state
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levels of dopamine are ____ with smoking
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increased
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3 classifications of smoking cessation interventions
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behavioral, pharm and alternative
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5 As of smoking intervention
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Ask, Advise, Assess, Assist, Arrange
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anti-depressent used for smoking cessation
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Bupropion
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partial agonist selective for nicotine acetylcholine receptor subtypes
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varenicline
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CV risk factors:
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high cholesterol, smoking, high BP and DM
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2 causes of death encompassed by CVD
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heart disease and stroke
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1st stage of plaque development
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fatty streak
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2 components of tobacco that increase risk of CVD the most
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CO and nicotine
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risk factors for BP:
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obesity, smoking, stress, increased Na intake
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study of distribution and determinant of disease in humans
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epidemiology
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type of epidemiology focused on population/communities, studies origin of health problems especially those related to nutrition and environment, human behavior, social/psych/spiritual
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classical
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type of epidemiology focused on study of actual patients in health care setting
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clinical
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type of epidemiology focused on the nature and pathogenesis of infection, structure and classification of pathogens
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infectious disease
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type of epidemiology focused on chronic degenerative diseases that affect people in their prime thus taking away productive years
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chronic disease
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type of epidemiology focused on study of use and effects of drugs in large # of people
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pharmacoepi
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type of observational study: # with disease and exposed compared to unexposed; most common
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cohort
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type of observational study: 10-20 years or longer, also called follow-up, longitudinal
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prospective cohort
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type of observational study: past records are used
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retrospective cohort
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type of observational study: 2 groups are compared: 1 with disease and 1 without
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case-control
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type of observational study: subjects selected regardless of exposure of disease
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cross-sectional
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it is determined that the exposure is associated with the disease when it isn't
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type I error
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it is determined that there is no association between exposure and the disease when there really is
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type II error
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cause of most type I and II errors:
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small N value
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probability that a person with disease was exposed
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odds ratio, a x d / b x c
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probability that new persons moving into contaminated area (+factor) will develop disease
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risk ratio, a/a+b / c/c+d
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equation for sensitivity
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a/a+c
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equation for specificity
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d/b+d
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portion of those people who test negative who are actually free of disease
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positive predictive value, a/a+b
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proportion of those people who test negative who are actually free of disease (actually free of disease/all who test negative)
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negative predictive value, d/c+d
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high priority agents, easily disseminated or transmitted, high mortality rates
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category A
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category A agents
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anthrax, botulism, plague, smallpox, tularemia, viral hemorrhagic faver
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moderately easy to disseminate, moderate morbidity and low mortality
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category B
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category B agents
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brucellosis, epsilon toxin of clostridium perfringens, food safety threats, glanders, melioidosis, psittacosis, Q fever, ricin toxin, staph entertoxin B, typhus fever, viral encephalitis, alphavirus, water safety threats
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capable to be engineered for mass dissemination in future because of availability, ease of production and dissemination; potential for high morbidity and mortalitity
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category C
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category C agents
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hantavirus, nipah virus
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ideal qualities of biological agents (8)
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high rate of illness, high rate of death, short time between onset and death, low level of immunity, no effective tx, transmitted person to person, easy to produce/disseminate, difficult to dx
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steps for epidemiological assessment
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formulate case definition to determine actual # of cases and attack rate; describe epidemic
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target of HIV
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CD4-T lymphocytes
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most common route of HIV transmission in US; developing countries
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IV drug use; heterosexual relations
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reservoir for most emerging viruses
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animals
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most common zoonotic reservoirs
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rodents and arthropods
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common transmission pattern of zoonotic diseases (3 steps)
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ingestion, penetration, multiplication
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ecological factors of zoonotic diseases (7)
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population, deforestation, irrigation, increased long distance travel, increased long distance shipping of livestock and bird migration, breakdown of PH efforts
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coronavirus causes
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SARS
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means of SARS transmission
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close person to person contact; person to surface contact
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fever, headache, hemmorrhage, acute renal failure, pulm edema and shock, mortality rate of 5-10%
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Hantavirus
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unfamiliar features of travel associated diseases
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vulnerability to infections unfamiliar to their home based medical services; includes presenting features, dx method, management requirements, unexpected complications, unexpected infections
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factors that increase traveler vulnerability
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food, water, sexual contact, animals, different epidemiology of some disease in different climate, incomplete understanding of disease, stress
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diseases common world wide
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flu, community acquired pneumonias, UTI, meningococcal disease, STD
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diseases related to climate/envir
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sunburn, heat exhaustion/stroke, dermatophyte infection, folliculitis, cold injury, altitude sickness
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diseases controllable by PH measurse
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Hep A and E, viral gastroenteritis, traveler's diarrhea, bacterial food poisioning, bacillary dysentery, cholera, amoebiasis, cryptosporidiosis, helminth infection, HIB, STD, diptheria
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diseases associated with mud/water
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leptospirosis, hookworms, strongyloidiasis, guinea worms, liver flukes
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meningococci vaccine affective against; needed every 3 years
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group A and C
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most common form of meningococci disease
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group B
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transmission of cholera
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drinking fecally contaminated water, shellfish, infection due to E1 Tor biotype
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incubation period of cholera
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3-4 days
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abrupt diarrhea (watery and brown to pale fluid with cell debris), shock due to fluid loss
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cholera
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inflammatory mediators associated with fever
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IL-1 and 6, TNFa, interferon gamma
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3 criteria to dx FUO
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lasting at least 3 weeks, fever of more than 38.3/100.9, no dx after routine work up for 3 days
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3 major categories of possible causes of FUO
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infection, neoplasm, autoimmune
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6 minor categories of possible causes of FUO
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granulomatous disease, regional enteritis, familial Med fever, drugs, PE, facticious fever
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transmission of rat bite fever (Haverhill)
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rat bit, contact with fluids, ingestion of contaminated food/water
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infected part of body with Haverhill in rodents
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upper respiratory tract of rodents
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strep moniliformis and spirillum minus cause
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haverhill fever
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incubation period of moniliformis
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7-10 days; most common
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incubation of minus
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1-4 weeks, relapses
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fever, peripheral rash on trunk and extremities (popular or petechial, small pustules), chills, myalgia, arthralgia, headache, splenomegaly, swollen bite site
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haverhill
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rickettsia rickettsii causes
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RMSF
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incubation period of RMSF
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2-14 days (median 7)
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transmission of RMSF
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dog ticks, wood ticks, lone star ticks
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fever, chills, headache, nausea, vomiting, cough, pneumonitis, rash (macule to large maculopapules and petechiae) that begins in wrist and ankles then spreads to arm/leg/trunk and is absent at onset
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RMSF
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coxiella burnetii causes
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Q fever
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reservoirs of Q fever
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sheep, goat, cattle, dogs, cats, birds, rodents
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transmission to humans of Q fever
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inhalation of dust with dry feces, milk and tissue
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incubation of Q fever
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1-3 weeks
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fever, headache, myalgia, nonproductive cough, pneumonitis, endocarditis
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Q fever
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togavirus causes
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dengue fever
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reservoir for dengue fever
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aedes mosquito
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incubation of dengue fever
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7-10 days, self limiting after 3-4 days
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acute fever, rash in remission phase (maculopapular, petechial from hands/feet to arms/legs/trunk), leucopenia, thrombocytopenia
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dengue fever
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spirochetes of Borrelia
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tick born relapsing fever
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transmission of tick born relapsing fever
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ticks and lice (louse-borne)
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acute fever with spontaneous decline and rise, thrombocytopenia, hepatosplenomegally, chills, nausea, vomiting, arthralgia, headache, rashes, delirium
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tick borne relapsing fever
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most common form of malaria
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falciparum and vivax
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least common form of malaria
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malariae
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pathogenesis of malaria
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destruction of RBCs
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overweight bmi
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>25
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obese bmi
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>30
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morbidly obese bmi
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>40
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