Ravilya Preventive Epidemiology And Prevention Of Noncommunicable And Chronic Disorders

Front 1

fluoridesupplementation

Back 1

No supplements are necessary
before 6 months of age.
If the water supply has levels less than 0.3 parts per million (ppm), the recommended dose is 0.25 mg/day for children
aged 6 months to 3 years, 0.50 mg/day for children aged 3 to 6 years,
and 1.00 mg/day for children aged 6 to 16 years.

If the water level is between 0.3 and 0.6 ppm, supplement is not recommended for children
younger than 3 years,
0.25 mg/day should be given to children aged 3 to 6
years,
and 0.50 mg/day for children aged 6 to 16 years. No supplement is
necessary if the level is 0.6 ppm or higher.
Fluorosis, a white or brown discoloration
of the teeth, can occur if ingestion of fluoride exceeds 4 to 8
mg/day

Front 2

lead

Back 2

The single most important intervention
in reducing elevated blood lead levels in children is the elimination of lead
in their environment, regardless of the level

Chelation therapy is
recommended for all children with blood levels above 45 μg/dL.

CDC recommends that an EDTA mobilization
test be considered for children with blood levels between 25 and
44 μg/dL. If the test is positive, which, according to one study, can occur in up to 35% of children with venous lead levels between 25 and 35 μg/dL, then chelation therapy should be administered

Chelation agents include
BAL, EDTA (edetate calcium disodium), DMSA, and d-penicillamin

Iron
supplements are recommended if the child with elevated blood levels has
iron deficiency anemia.Supplements also decrease the absorption of lead
and may be considered even in the absence of iron deficiency

Front 3

25-year-old woman wants
to lose weight before going on a trip
to the Caribbean. She has joined a
health club and signed up for classes
with a stationary bike in which each
40-min session burns up 500 calories.
She is taking two sessions a
week. Assuming her caloric intake
remains the same, how many weeks
will it take to lose 6 pounds

Back 3

It takes a 3500 deficit in calories to lose 1 pound of fat.

If exercise only is used to produce
the deficit of 1000 calories per week, it will take her 21 weeks to lose 6
pounds of fat

Front 4

cholesterol test

Back 4

persons with borderline-high cholesterol 200 to 239 mg/dL with
two or more risk factors for coronary heart disease (CHD), in this case, smoking
and male = 45 years of age, should have a lipoprotein analysis performed,
even if the HDL is 35 mg/dL.

Dietary therapy would be the recommendation
(no CHD, two or more risk factors) if the LDL is ≥130 mg/dL.

Drug therapy is recommended by the NCEP if, despite dietary therapy, the following conditions
are present: (1) LDL remains ≥190 mg/dL in the absence of CHD and
fewer than two risk factors,

(2) the LDL ≥160 mg/dL in the absence of CHD

and two or more risk factors for CHD,
(3) LDL ≥130 mg/dL in the presence
of CHD.

Dietary changes can reduce the cholesterol levels by as much as
15%, particularly if associated with weight loss and exercise

Front 5

A 27-year-old pregnant
woman is brought to the emergency
room with multiple ecchymoses to
the chest and abdomen. Her breath
smells of alcohol. The most likely
cause of these findings is

Back 5

domestic violence

20 and 25% of pregnant women suffer
from domestic violence, and pregnancy is a particularly high-risk period
for abuse. Battered women are much more likely to be injured on the chest,
breasts, and abdomen than nonabused women. Over half of women who
are battered eventually abuse alcoh

Front 6

What proportion of the U.S.
adult population is estimated to
have a mental or emotional problem
that requires therapy?

Back 6

The estimated overall
prevalence of mental disorders in the United States is 10 to 15% in children
and 15% in adults. Anxiety disorders are the most prevalent, with an estimated
15 to 20% of clinic patients affected.

Front 7

most important
risk factor for developing osteoporosis
is

Back 7

Bone loss increases
with age, particularly in women after menopause, when lack of estrogen
accelerates the process. To a lesser extent, smoking, lack of physical activity,
and alcohol abuse can also increase the risk of osteoporosis. Obesity,
presumably because it is accompanied by an increase in estrogen production,
does not increase the risk of osteoporosis.

Front 8

You want to check the
childs blood lead level. Which of
the following is the most accurate
method of screening for lead poisoning

Back 8

Venipuncture is
the best way to accurately measure blood lead levels. Capillary blood is often
contaminated and results in falsely elevated levels. It is more cost-effective to
collect venous blood initially than to do so only if the capillary blood level is
high. Although many infants with lead poisoning will also have iron deficiency
anemia, the complete blood count will not identify all cases of lead poisoning.
The erythrocyte protoporphyrin is no longer recommended for
screening as it will not identify lead levels below 25 μg/dL. It may be used for
the detection of iron deficiency. Ferritin is used to estimate iron body stores.

Front 9

Which of the following types
of cancer is the most frequent cause
of gynecologic cancer deaths

Back 9

Ovarian
cancer is responsible for 55% of all gynecologic cancers deaths, while
endometrial and cervical cancers are responsible for 23 and 18%, respectively

Front 10

A 50-year-old woman comes for
her periodical health examination.
Her body mass index is 29 kg/m2.
Her blood pressure is 120/80. She
has no family history of cardiovascular
disease. Her total cholesterol is
200 mg/dL (5.2 mmol/L), her HDL
is 35 mg/dL (0.9 mmol/L), and her
LDL is 100 mg/dL (2.6 mmol/L).
328. This patient is at highest risk
for developing which of the following
conditions

Back 10

Type 2 diabetes mellitus is almost nonexistent in individuals with a
BMI below 22kg/m2. Prevention of obesity prevents diabetes. Even modest weight reduction (5 to 10 kg) decreases insulin resistance and the resulting hyperinsulinemia.

Increased mortality from obesity results from cardiovascular
disease, hypertension, diabetes, and some types of cancer. Obesity is
associated with hypertriglyceridemia, decreased HDL, and increased LDL.

Front 11

patients weight increases
the risk for which of the following
cancers?

Back 11

Obesity is a risk factor particularly for endometrial cancer, although it may
also increase the risk of postmenopausal breast cancer and colon cancer

Front 12

The most appropriate initial
intervention for weight loss is

Back 12

Diet is the first step in reducing weight. Reducing or eliminating alcohol
intake and taking frequent small meals helps to reduce food intake. Exercise
helps maintains weight loss, but is not a primary strategy. Medication
is reserved for women with a BMI above 30 or 27 kg/m2 if comorbidity is
present, and surgery for above 35 kg/m2.

Front 13

Anorexia/ bulimia.

Back 13

Anorexia occurs predominantly
in females and begins either before or shortly after puberty.
Binge eating may occur, although it is uncommon and more closely associated
with bulimia. Weight is decreased in anorexia whereas it is near normal
in bulimia. Ritualized exercise is usual in anorexia, but not in bulimia.
Amenorrhea is always present in anorexia because of weight loss. Antisocial
behavior is more frequently associated with bulimia than with
anorexia, and the depression in bulimia tends to be more severe than in
anorexia, making suicide a definite ris

Front 14

Which of the following is the
most important risk factor for developing
cervical cancer?

Back 14

HPV DNA is present
in 95% of all cervical cancers and is the most important risk factor, in fact,
etiologic agent, for developing neoplasia. Only certain types of HPV have
oncogenic potential: 16, 18, 31, 45, and 5153. Most patients who die
from invasive cervical cancer have never had a Pap smear in their lives

Front 15

Above which level of desired
body weight can someone be described
as obese?

Back 15

Although a
percentage of ideal body weight can be used, obesity is best defined by
measuring the body mass index: (weight in kg/height in m2) > 26 BMI. Fat
mass can also be a useful measure: obesity is arbitrarily considered to be
present when body fat is >25% in men and >30% in women.

Front 16

The leading cause of death for men between the ages of 25 and 44

Back 16

The leading cause of death for men between the ages of 25 and 44 is now
HIV infection, followed by unintentional injuries, heart disease, cancer,
and homicide. Homicide is the leading cause of death for African American
men between the ages of 15 and 24.

Front 17

risk for stroke

Back 17

Hypertension is a major risk factor for hemorrhagic (through elevated
arterial pressure and microaneurysm) and ischemic stroke. Treatment of high blood pressure is the most efficacious way to prevent stroke, including in the elderly.

Other risk factors for strokes include smoking, vascular disease, and
diabetes mellitus. In individuals with cerebral vascular disease, the risk of
developing a stroke within one year for a patient with an asymptomatic
carotid disease is 1.3% and with a transient ischemic attack is 3.5%; the greatest
risk is for the patient with ≥70% symptomatic carotid stenosi

Front 18

A 50-year-old alcoholic male
presents to the emergency room
with upper gastrointestinal (GI)
bleeding. Examination reveals
ataxia, confusion, and ophthalmoplegia.
In addition to treating the
GI bleeding, he would benefit from
receiving

Back 18

The patient has Charcots triad of ataxia, confusion, and ophthalmoplegia,
which occurs in malnourished individuals. Parenteral thiamine may
reverse the disease if given within a few days of the occurrence of symptoms.
Prolonged untreated deficiencies can result in permanent damage

Front 19

cr in kids, beast , prostate cr statistics

Back 19

Reductions of mortality
in cancer in children result from prolonged survival due to improved therapy.
The incidence of breast cancer and prostate cancer has increased probably
largely due to increased screening; however, mortality rates have remained
rather stable, reflecting little improvement in survival. There has been both
an increase in lung cancer rates (due to smoking) as well as mortality.

Front 20

vit toxicity
A
C
E
D
B1
K

Back 20

Chronic toxicity of
vitamin A (25,000 units or more for a protracted period) symptoms
include bone pain, hyperostosis, hair loss, dryness and fissures of the lips,
and weight loss

High doses of vitamin C for long periods can cause an
increase in the risk of oxalate kidney stones and cause uricosuria

Vitamin
E excess is present in persons receiving anticoagulants and in premature
infants and can prolong prothrombin time

Vitamin D excess will result in
hypercalcemia

Vitamin B1 or thiamine excess has not been described

Vitamin
K excess will result in blocking the effect of anticoagulants

Excess
most frequently occurs in fat-soluble vitamins (A, D, K, E).

Front 21

What is the lifetime risk of
developing breast cancer for a
woman in whom the BRCA-1 has
been detected?

Back 21

80% or more


Having the BRCA-1 gene is associated with
a very high risk of developing breast cancer, with a 70% chance before age
60. Late menarche and early menopause (less lifetime exposure to estrogen)
can reduce the risk of developing breast cancer by 50 to 60% and
35%, respectively. Full-term pregnancy before age 18 can decrease the risk
by 30 to 40%. Nulliparity is a risk factor for the disease.

Front 22

WHAT
is most likely to decrease the
lifetime risk of developing breast
cancer in women?

Back 22

Late menarche and early menopause (less lifetime exposure to estrogen)
can reduce the risk of developing breast cancer by 50 to 60% and
35%, respectively. Full-term pregnancy before age 18 can decrease the risk
by 30 to 40%. Nulliparity is a risk factor for the disease.

Front 23

Which of the following mental
disorders is more likely to occur
in men compared to women?
a. Affective disorders
b. Anxiety disorders
c. Nonaffective psychosis
d. Substance abuse or dependence
e. Simple phobia

Back 23

Overall, women are more
likely to suffer from affective disorders (depressive and manic) and anxiety
disorders (phobia and anxiety). Prevalence of any substance abuse/dependence
is 16.6% in men and 6.6% in women

Front 24

A 75-year-old widowed
woman is brought to the emergency
room because she fell while trying to
go to the bathroom. Her daughter
states that she has been getting more
confused over the last few weeks.
She has been disabled by arthritis
for many years. She lives with her
daughter who is single and works
full-time. The examination reveals
multiple ecchymoses on different
areas of the body. She is very underweight,
but her daughter states that
she refuses to eat. Which of the following
factors is most likely to cause
the clinical findings

Back 24

Elders who are
disabled are more likely to suffer from physical abuse or neglect. Most
abuse is by a relative, and most abused elders are likely to live with the
abuser, who is often stressed both emotionally and financially as the elder
requires more care. Many abused elders become depressed as a result of
abuse.

Front 25

A 27-year-old man is brought
to the emergency room by his
friends because he has delusions
about being followed by the FBI
and has paranoid thoughts and
behaviors
DRUG?

Back 25

Chronic cocaine use can occasionally cause paranoid behavior.

Hallucinations and acute psychosis with extreme violent behavior is associated with LSD.

Chronic use of LSD may lead to similarities with mentally ill persons reporting profound religious experiences.

Chronic use of marijuana can lead to disinterest in desirable social goals.

Major issues about chronic opiate intake is related to acquiring HIV and
other infectious diseases.

According to the Treatment Outcome ProspectivE Study, the most important predictor of success of drug treatment was length of time in the program, regardless of type of drugs used.
Being in a program for at least 6 to 12 months was associated with abstinence, reduction
of crime, and full-time employment.

Front 26

factors associated with
decreased drug use in young adults

Back 26

Older age at initiation
of drug use, employment, and marriage are factors associated with
decreased drug use in young adults. Parental drug use and educational
level, peer drug use, early drug use, sensation seeking, deviance, poor
school grades, depression, agression, and low socioeconomic status are all
risk factors associated with drug use

Front 27

The single most
important factor that has had some impact on the ultimate outcome, that
is, drug use, is

Back 27

The single most
important factor that has had some impact on the ultimate outcome, that
is, drug use, is interaction with peers, regardless of socioeconomic status or
race/ethnicity. Larger programs have been less effective than smaller programs
in reducing drug use regardless of type

Front 28

oral
contraceptives

Back 28

Abnormal vaginal bleeding needs to be investigated before oral
contraceptives can be used.

Migraine headaches are not a contraindication to their use: some patients experienced improvement in the headaches.
A trial can be done with a low dose. Gestational hypertension is not a contraindication to OCs: blood pressure can be monitored after administration of a lowdose
OC.
Tobacco use would be an absolute contraindication if the patient
was 35 or older.

History of stroke, thrombophlebitis, pulmonary embolism,
and coronary artery disease are all absolute contraindications to OCs

Front 29

Oral contraceptives
have been shown to reduce the risk of

Back 29

Oral contraceptives
have been shown to reduce the risk of ovarian cancer, the leading
cause of death from gynecological cancer, by up to 80%. They can also
reduce the risk of endometrial cancer. They have no effect on the risk of
developing vulvar cancer. The issue of whether they increase the risk of
breast cancer and cervical cancer is debatable. Any potential increase in the
risk of breast cancer is likely to be very small and to occur only in a certain
subgroup of women: the benefits of using OCs far outweigh any risks.

Front 30

leading cause of death among women of all ages

Back 30

Heart disease remains
the leading cause of death among women of all ages, followed by cerebrovascular
disease, lung cancer, and breast cancer. Breast cancer is the leading
cause of death for women between the ages of 45 and 54. Motor vehicle
accidents are the leading cause of death for women aged 24 to 34

Front 31

aspirin chemoprophylaxis
be CONTRAINDICATED

Back 31

IN P with uncontrolled HTN
This patient is at high risk of a hemorrhagic stroke.
Aspirin can reduce the risk of thrombotic stroke. Other contraindications
for aspirin use include gastrointestinal bleeding, allergy, diabetic retinopathy,
kidney and liver disease, and dyspepsia. There is currently no data that
aspirin prophylaxis is as effective in women

Front 32

Persons are considered
at moderate risk of developing
cardiovascular disease if their
total cholesterol is between 200
and 239 mg/dL (5.26.2 mmol/L)
and at high risk if their total cholesterol
is 240 mg/dL or more (>6.2
mmol/L).

Which of the following dietary
restrictions could be associated with
a decrease in HDL?

Back 32

Both step 1 and 2 recommend that total dietary fat represents <30%
of kcal intake, carbohydrate, 5060%, protein, 1020%, monosaturated fat
and polyunsaturated fat represent 1015% and <10% of kcal intake, respectively.
Step one recommends that total cholesterol intake be less than 300
mg/dL, while step two recommends less than 200 mg/dL. The other difference
is in the intake of saturated fat: 810% of total kcal for step one versus
<7% for step two. Reducing the total fat intake has been associated with a
decrease in HDL and an increase in triglycerides in some patients (potentially
due to the increase in carbohydrate and polyunsaturated fats). They should
be advised to substitute monosaturated fat (which increases HDL and
decreases LDL) for saturated fat.

Front 33

may reduce the risk of developing
cancer?

Back 33

A diet rich in fiber with
plenty of vegetables and fruits, particularly those rich in β-carotene and vitamin
C, and low in fat (30% or less in total kcal intake) may reduce the risk of
developing cancer. Limiting or eliminating alcohol, avoiding obesity, and limiting
the consumption of cured or smoked meats may also be helpful.

Front 34

epidemiology
of hypertension in the United
States?

Back 34

Alcohol use has been
shown to increase blood pressure. There is a favorable association between
low salt intake and change in blood pressure with age. Systolic blood pressure
tends to increase with age. Both systolic and diastolic blood pressure
have independent contributions to the risk of mortality. Obesity is associated
with hypertension.

Front 35

most important risk factor for
developing insulin-dependent diabetes
mellitus (IDDM)?

Back 35

There is strong association between IDDM and the HLA region
of chromosome 6. Approximately 95% of all IDDM patients are HLA-DR3,
HLA-DR4, or both.

Front 36

most likely to occur in
a 35-year-old patient diagnosed
with IDDM at age 15

Back 36

After 20 years of IDDM, virtually all patients have some form of diabetic retinopathy.
As many as 70% may also have proliferative changes that may lead to blindness.
About 40% of patients with IDDM eventually develop significant proteinuria and renal disease.

Lower blood sugar levels can prevent or delay clinical neuropathy which can occur in as much as 70% of patients after 30
years.
CVD increases with years of duration and is the leading cause of
mortality in patients with IDDM for over 30 years.

Front 37

After 20 years of
IDDM, virtually all patients have some form of diabetic retinopathy. As
188 Preventive Medicine and Public Health
many as 70% may also have proliferative changes that may lead to blindness.
About 40% of patients with IDDM eventually develop significant proteinuria
and renal disease. Lower blood sugar levels can prevent or delay
clinical neuropathy which can occur in as much as 70% of patients after 30
years. CVD increases with years of duration and is the leading cause of
mortality in patients with IDDM for over 30 years.

Back 37

diabetic nephropathy accounted for 37.5% of all ESRD, followed
by hypertensive nephropathy (30.3%), glomerulonephritis (12.3%),
cystic kidney disease (3%), interstitial nephritis (3%), collagen vascular
disease (2.2%), and obstructive nephropathy (2%).

Front 38

is most
strongly predictive of mortality due
to asthma in children?

Back 38

severety of disease


Risk factors for developing
asthma include male gender,
family history,
respiratory tract infection,
ambient air pollution,
environmental tobacco smoke, and bronchial hyperactivity.

Age-adjusted mortality from asthma has increased in the United
States, although it is still a rare event. It is more common among adults
than children.
Studies have demonstrated that the severity of illness is the
most important predictor of death.

Recently, discontinuation of inhaled
steroids has been proven to be a risk factor for asthma-related death

Front 39

A 52-year-old patient with
chronic cough and shortness of
breath is diagnosed with chronic
obstructive lung disease. Which of
the following factors is the most
important contributor to this finding?

Back 39

From 80 to 90% of all cases of COPD in the United States is attributable to
cigarette smoking. Some occupations with particle or dust exposure may
also be associated with COPD. Deficiency of α-antitrypsine is uncommon
and is generally associated with emphysema. There is some data to suggest
that severe viral pneumonia early in life may lead to obstructive disease.

Front 40

A 25-year-old woman presents
to the delivery room in labor.
She has had no prenatal care. The
female newborn weighs 4.5 pounds
and has episodes of seizures shortly
after birth. Irritability and hypertonicity
are also noted. The most
likely cause for these findings in the
newborn is

Back 40

The findings are typical of cocaine use during pregnancy, which has also been
associated with impaired fetal growth and increased risk of placenta abruptio.
Infants exposed to opiates during pregnancy may exhibit symptoms of withdrawal


Fetal alcohol syndrome is characterized by microcephaly, stunting, flattened nasolabial facies, and narrow palpebral tissues.

HIV infection is asymptomatic at birth.

Front 41

Postmenopausal women who
are not on hormone replacement
therapy can benefit from daily calcium
intake to reduce the risk of
fractures secondary to osteoporosis.
Which of the following is the
recommended amount of calcium
to be consumed daily?

Back 41

Adolescents should take 12001500 mg/day and women 25 to 50
years of age should take 1000 mg/day. Postmenopausal women will probably
benefit more from HRT to reduce osteoporosis, but calcium supplements
of 10001500 mg/day may also be helpful. For those without HR T,
a dose of 1500 mg/day is recommended

Front 42

A 22-year-old male presents to the student health center complaining
of scrotal discomfort and swelling. He has no complaint of urethral discharge,
fever, or genital lesions. He has been sexually active with the same
partner for 3 years and uses condoms regularly as their method of birth control.
He is otherwise healthy. The examination reveals a tender mass in the
posterior aspect of the left testis. The most likely diagnosis is

Back 42

History and
physical examination rule out orchitis (painful testis but no mass), varicoceles
(bag of worms), and spermatoceles (painless mass). Patients may
often present with these symptoms instead of the pathognomonic painless
testicular mass. Primary germ cell tumors account for 95% of all testicular
cancers. Cure rates are 90% for noninvasive tumors, and with the advent of
cisplastin chemotherapy, cure rates of 70 to 80% are expected for metastatic
cancers. Most tumors occur in men between the ages of 20 and 40. Cryptorchidism
is a risk factor for the disease. Orchiopexy can reduce this risk.

Front 43

who is at highest risk of adverse
effects from iron deficiency anemia?

Back 43

A 10-month-old with a diet of cows
milk

Infants on
cows milk are at highest risk of iron deficiency anemia, which can be associated
with abnormal growth and development. A study on iron therapy in
a high-risk population has shown an important effect of iron therapy on
development. Postmenopausal women are not at high risk of anemia.
Elderly persons, because of poor diet, may be at higher risk. Breast feeding
(with iron-fortified supplements added at 4 to 6 months) and feeding ironfortified
formula can reduce the incidence of iron deficiency anemia.

Front 44

Which of the following public
health interventions has been the
most successful in preventing initiation
of smoking or reducing the
prevalence of smoking?

Back 44

Studies have shown that
teenagers are very sensitive to the price of cigarettes. Some studies have shown that an increase in the price of cigarettes by 10% can reduce the number of teens who smoke by 7 to 12%.
Inversely, when the price of a
brand of cigarettes particularly favored by teens was reduced by the
tobacco company, the proportion of teens who smoked increased from
23.5 to 28% over three years

Front 45

depression - statistic

Back 45

Depression is more common in persons who are young,
female, divorced, single, separated, seriously ill, or have a prior history or
family history of depression. Suicide occurs in 15% of untreated major
depressive disorders, with most patients having sought help from a physician
within the month. Depressed patients frequently present with a variety
of physical complaints, often leading to unnecessary procedures and
intervention. The annual economic burden has been estimated to be almost
$44 billion

Front 46

Rp and mental diseases

Back 46

Panic disorders appear to be associated with increased noradrenergic discharges,
general anxiety disorders with aberrations of benzodiazepine GABA
receptors, and depression associated with lower levels of serotonin. Of additional
interest: risk factors for schizophrenia include genetic vulnerability
(i.e., family history), early developmental insults, and winter birth.

Front 47

A 22-year-old female presents
with a history of abdominal
cramps, diarrhea, weight loss, and
blood and mucus in the stools.
Which of the following is a risk factor
for developing this condition?

Back 47

The use of oral contraceptives
has been linked to increased risk of developing ulcerative colitis
(UC). Smoking actually decreases the risk (although no one would
advocate smoking to decrease the risk . . .). Diet, coffee consumption, and
stress have not been shown to be risk factors. The highest reported rates
occur in countries distant from the equator. Latitude accounts for more
than 40% of the geographic variation in rates. Rates have been reported to
be higher in Jew

Front 48

A man afflicted with neurofibromatosis
is the parent of a
healthy, unafflicted female child.
What is the probability that this
child will transmit the disease to
her own offspring if her partner is
asymptomatic of the disease?

Back 48

Neurofibromatosis is an
autosomal dominant disease, with a 50% probability of transmission to the
child. If this child does not have the disease, then she does not have the
gene. If she does not have the gene and her partner is asymptomatic, therefore
without the gene, then they have 0% probability of transmitting the
disease to their child.

Front 49

Which of the following genetic
abnormalities is responsible
for most cases of untreatable severe
mental retardation?
a. Sex chromosome disorders
b. Autosomal chromosome disorders
c. X-linked recessive disorders
d. Autosomal dominant disorders
e. X-linked dominant disorders

Back 49

Autosomal chromosome disorders

Down syndrome, or trisomy
21, is the most common recognizable cause of mental retardation in
the Western world

Front 50

types pf prevention

Back 50

Primary prevention prevents the occurrence of the condition/disease. Thus, using condoms prevents the acquisition
of an STD, and pasteurizing milk prevents brucellosis and other
diseases.

The treatment of syphilis during pregnancy prevents the infection
of the fetus and congenital syphilis, and thus is a primary prevention for the newborn. Treating the mother also prevents the complications of untreated syphilis, such as neurosyphilis, and thus is a measure of tertiary prevention for the mother.

Secondary prevention measures are used to detect and treat disease before it becomes clinically manifest.

Screening for hypertension in
asymptomatic persons is both a secondary measure and a primary measure as it also prevents the occurrence of strokes.

Front 51

deficiency
to the proper minera

lFluorineCopperZincSodiumCalcium

Back 51

Fluorine is found in water, seafoods, and plant and animal foods depending upon the concentration of fluorine in the soil and
water.
It is retained when the intake is 0.6 mg/day and it is excreted in
urine and sweat. Supplementation for infants and children in areas without
fluoridation of public water supplies is recommended

Copper has many
functions. It is a catalyst in hemoglobin formation, essential in production
of red blood cells, and required for absorption of iron. The highest concentration
is in the liver and central nervous system. It is excreted mainly
via the intestinal wall and bile. Good dietary sources of copper are liver,
oysters, meats, fish, and whole grains

Zinc is a constituent of enzymes involved in carbon dioxide exchange
and hydrolysis of protein. It is found in liver, bones, and red and white
blood cells and is excreted mainly from the intestine. Children have a
higher tissue concentration of zinc than adults

Sodium helps to maintain cellular osmotic pressure, acid-base balance,
and muscle and nerve function. It is absorbed easily from the intestine
and excreted in the urine and sweat. It is coupled with chloride in
many biochemical processes. Table salt, milk, eggs, seasonings, and preservatives
are dietary sources of sodium.

Calcium is required for growth of bones and teeth, muscle contraction,
nerve irritability, coagulation of blood, cardiac action, and production of
milk. It is absorbed from the small intestine with the help of vitamin D.
Most is excreted in the feces; the amount retained depends upon the
growth rate. Good dietary sources include dairy products, green leafy vegetables,
canned salmon, clams, and oysters