1 E |. Define Epidemiology A. Epidemiology is detined as the distribution and determinants of disease frequency or health events in man, Modem day epidemiology is different from the earlier period where it just referred to as study of epidemics. It now includes comprehensive methods for control of diseases, including non-eommunicable diseases. Distribution refers to the time: place nd person characteristics of disease while the determinarts (what determines discase) are generally characterized as agent, host and environmental factors. Since freedom from disease allows an individual to remain healthy. itis also important to Find out how and why individuals do not suffer from disease and remain healthy. Such analyses will help in finding solutions to disease and maintaining good health, 2. What are the uses of epides ‘A. The major uses of epidemiology are: 8, To assess the magnitude or burden of disease in community. I, therefore, helps in studying the aceurrence of disease in 2 population, b. To assess the health status of communities, It, therefore, helps in establishing a community diagnosis, «. To search for determinants of disease, To find out how and why disease is eaused is a major use of epidemiology, 4. To estimate an individul’s risks and chances of suffering from a disease and to establish the prognosis in an individual suffering trom disease, ©. To plan comprehensive health serviees, including specific strategies and ways and means of implementation £. To evaluate strategies and interventions for disease control. Such evaluation helps in identifying weaknesses and to suggest remedial measures forthe future, Evaluation of eosts and benefits or effectiveness of specific interventions is also an integral use. 2. To compl presents ints initial stages is only possible hy study 1, To forecast future disease t i.To identify syndromes. 3. What is the epidemiological triad? A. Disease is eased by an interaction between agent, host and envitonmental characteristics. When all three are in harmony, health is ensured but maladjustment in their relationships leads to disease. These three factors together constitute the epidemiological triad. he natural history of disease. In a hospital setting only the terminal cases are seen and how disease starts and disease in the community4. What i the dtference betneen retrospective and pronpective stds? ‘A Retrospective suis ste ds hat sare te investigator leks back in ins oa oa wat agate ‘hart ineling bsbis he nds wee exons oad whichcou cao disease, Cave cna sai ae ‘compe of etespectne studs Inpespetive sts dials aed cbr accrene of dese nthe te followed upiosee which individual elo dcase- The ehratersisor exposures ofthese nid seas ‘uing ages ar compe wilh carci of inidls who dnt sulle mde, This pain sachin ferdsterminan af dace 'S-What ease contr study? ‘. Nease contol study isan epidemilogial study wherea group ofinviduals wih cseas an corpare ith group | ina who ae fering om dns interme of spent cating expan. Sins the ating poet es ‘up af eons who asa fate sulered rn he dicase hs bled sa abospecte su. Relay uk ond ey eerie ~ Reavy cheap w nde Only meh uel ia are dss = Navenmssed in bles low-pass =aac—— DrFahim (Ga tinsnure elaine riko provide insiders stint. = Sometimes the ccneace fhe expose tes ie whether tesco ef the disease ay be dt © cps. CaN be wsed for ue exposes. Designing testa st nes ask, (6 What a cohort study? ‘Cob sts ne fora loking. he look for he evelopment of si ns gro afin the eso) fie ofthe same atthe Beinn. Ths proup slowed. up ovr a peo of tne Dung this prod some sans wll ‘eveop he dens under snd whi tes wll emai ofthe diene The chances {and exponre dese cosine fico) compra two how who sulle fam dase an tos fe roc te {Saco The Bla eweeting flere certo group il ss rare “Thos implies that one needs ody groups f populations who ae ofthe sess being sued and who re ‘rina espet exept he pic exponuevarabe chariot ein elated te diene ‘ing st Those goepe we Hes flowed up othe pesado Ws att kes fo Ue dese to Sevcp 7. What a Randomised Contrlled Teal? ‘AA randozed conv rial ea expeimena ectod hors adda ane rorya oan expecta ot {contol rp an tee or expose a dor intervention compen eto group The hey eur aterm’ an "cool To contre thre co ano pat hentia. hse Wa te “blinds lil meas the pales do noc know what he neretion "double" Mind meas hat ei he tient othe researcher ows wha the du’ inrventon psig swipe” Bind masta the analyse ao oer net Know whichis tie epertmentl nd which thc covto rp lth yb Boe competed ‘8 What sa Community Teal? ‘A. Weommuny tale cation ofthe lina tri wher isa of invite allocate to experimen or ‘ono! groups, oe communis ae aay allocated t reeves ieretons ni analysis de for whole ‘Snmties er tan or nvidia in he conmanites. Vian Aspplmenatin is on siplenerion iodine supplneeton als al exams of corey tale, SL What a vaccine til? ‘A. Wher aan contol ia one wet the efcny of cite preventing dete clleda ace il 10. What is the iferencebetmeen Deserptive and Analytial Epidemiology? 2 The deceptive melhasaze monly concemed wth he bution of dase bel mahal are consomed withthe dorian of daca oan contin, white aalytiealA, Sampling can be defined as the process of selecting a statistically determined number of subjects from the universe oF 1 population, whieh provides an accurate estimate of the problem being studied. Thus, only a proportion of the population is covered, bu the results approximate the actual prevalence ofthe disease condition in the reference population Strictly speaking, the results obtained are applicable only to the population from which the sample was drawn, but the resultsare generally extrapolate to ther populations that are similar tothe reference population. sample i the ‘minimum number of people or Saunt eesoaete py Pahim referen thereby permit valid inferences to be drawn, 12, What A. The different sampli the different sampling methods that you know of ‘methods inelude simple random sampling, systematic random sampling, siratifiedrandom ‘sampling, cluster sampling, multistage sampling and purposive sampling. Purposive sampling is not used in epidemiological ‘or health sciences as it gives biased results. Allother sampling methods are called prebability-sampling methods. 13, What is the difference between simple and stratified random sampling? A, In this method, every individual has an equal chance of being selected inthe sample. The first step involves enumeration ‘of the total population wherein every individual is soquentially numbered from I...n (last member in the population), The ‘enumeration lst ofthe total population from which the sample is drawnis alled the sampling frame. The next stage is the actual selection of the sample, which can be done by different methods like drawing numbers from a hat or picking numbers from a random table, ete. Statfied sampling is dane to give the different population subgroups an equal chance of being selected. In this way, male female or urban / rural can be given adequate representation to reduce bias, 14, What is systematic sampling? A, Systematic sampling isa method of probability sampling, which is used to simplify the selection procedure. After ‘enumerating the units. villages, houses, et. they are selected ata predetermined interval, i.e. every nth unit. The procedure has the advantage of easy administration in the field, but is inferior compared to the simple random sampling 15, What is cluster sampling? Give examples of wherecluster sampling has been used in reproductiveand child health? A. For conducting surveys or epidemiologic investgationson large population groups, te simple random technique is not of "much use. This is because construction ofthe sampling frame becomes very dificult when there area large number of individuals to be enumerated. n such situations, groups, rather than individuals, can be selected in the initial stags the sampling process. Inthe seletion ofthe final stage units, instead of randomly selecting the individuals to be included all the individuals inthe identified cluster ane examined, EPI vaccine coverage surveys adopted the cluster sampling technique and now this technique is widely used in many situations where coverage lameness / disability are surveyed. 16, What is an epidemic? A. The oceurrencs ofa disease clearly in excess of normal expectations is called an epidemic, The number of cases, which should be diagnosed before deck -mie status, depends on the number of eases routinely seen in that area, In an area where a disease has not been soen for many years, even the accurrence ofa single case may be sufficient to call it an epidemic. Some people took at the mean (or average) number of cases and ifthe eases are beyond two standard deviations they cal itan epidemic.17. Give some examples oF epierie diseases, hich Rave occured in areca)? A. Tho rset otk pls in na where cacy Wee pt sen fr ny ers fn xa fa ee HMiViAIDS alsa dave wih cpideme portions pidemsof dengue IE are so repartee ecnic res co motores be enmmtcble drtnt Three WHO ve caret mang erwrepimt 8 What 8 pandemic? ‘Ns Anepkente wreak out cross maby comin cll ands ie oscering aro the word 19, Name some pandemic dsesses AIIIVIAIDS an snking ean elle mod dy pandemic theta alec ils of peple sero the ‘el Chola of he os crn nencs ne nme fa propor Drag esc s ‘hea pandonie Plague was sho andr in his ics. 4. What are endemic veer? Name sme endembe eases ‘A-Tae conta eantnus or usa presen ofa Useucina dined peogrphi ac of limited erty called ae demi dione. yperandcn fer rss incase ansison an ra wh hloedsnas mats deme Sng eatin ard affecting ot ofthe opin. An ede dey Pca pce i he mamber of asc oly soot surly teas in porn, Malaria teen ey flrs car ckamples of enkanie 21 Wats preatence ate? |The proportion of pesos sullen roma pei discus ot ofthe population onal singin tha anc. a Pacisue po ime seal he prevalent laos otk ema es wel be Oem occ the {icra th pont n ine when thecxamnston nas indsaken The pontine ean be One yor one ya oF MOE ‘kpentig Upon tow mh ime ke cami the ppltion ea an are. The ose ili r he neta whieh population fos wik te al sell the aati shold Descent he mamta pat ‘fthedenoristo Foresamps, Tema ental dchrye being dominator sb oly nla te Pron who area isk of fcr fom a dacase wom, Prevents an beeps preg Some common opr 10 o 10,00 poption dene et 12, What ncdence rate? ‘Andee rat ees he umber of nw css cri in poplin oer a specif peri of ine, The mameaor ‘ould be parca th denominator am pcslence tts bt lik sm prevalence ony er see onside. a tse sued beer theeerenc poi buts cutinuing fo th preset tnt eosin Ue mune Es the "efrmce eto fom ft Jan 315m 2002 canes tt ie Int Jam 200 ta il ing wl obs Irene he mera Ieee fats geet peed as pet 1000 of 10,00 22. What the relationship between prevalence and Inidence? ‘A Pevalonc ofa dscae the rout of eke an Us dration of disease (P=1 xD) Thrfrs peace of ‘lage depends mt only oth aca abe of pee who develop dssie bt ao one drat fa dca, For eer ee rae eae ee acre “ining dows ike uber, rnin npn ab gs Des dow pene os dante rent Miaieeeents ae career ois buoree contin if m Tie douonefik dae bey bop annie) ~Thetevl fidence eth her te niet the ret the peal — proved sti of ign tt end detection oager ander ose bn bis ‘Avast f effect been, which logs He suc thin! Is gr whi sil uring om the ‘aoe ‘Asada migration of esses into an ara wher the ase mas ot ery oman cl. 25 How does prevalence of disease decree? ‘A.A very shart darto othe sss aplcabletothe cue disease codon) “axe niece dese ~ Lack of proper danse caupnet hil frie deteto of dscns ‘isan with hg nora nach ht vey ow iis avi ‘of deed nile ‘Sublishe smc higher ad tere, ier wl ote aed dg survey. One ter hand shor asian ‘nes would oecur apd eer fit tha thy cat be cramped (oe mane) tpi it te27 In which diseases incidence more appropiate and why? ‘A. locdeace itmot appropri does oat Garton sich dias my cow oan one dig tfc ‘Pr andl he pnoes ay ot De capri te pcalece oe deat nro be menue [pf stay were “ine on ahs, she aber of peoples om darts na oa yar oi was ur wo ays be ‘nach ower han th ramer of poe of death the opin rig ta en ould ale 28 What do you mean y primary ease? ‘Arte fest cao dscre veh ovcurs inn commune call the eiemay cise: Mana nee pity ease ‘may mat ogee she seme comes tones mich itr, Only hrc vic, he oes Pi ae, ebicatein sca cane nome dean ike nite conjunc mero primary car ay ocr lw 3 her itn tine in soca seman te primary cass ve fered was "Co. eae™ 48, What do you mean by an inde ease? A The intone whic comesto he tention oth sah sth inane, i fer asthe index case Sacha {ase may or may ot be fe pinay ease ‘0, What Secondary Atack Rate? [A Thesectary tack rate reso henner fcneaccring sag conta of pinay cane within the know incon aida dscse, The denominator fest the nbc scribe cnacte who ac clos ouch wth thepemary case However i whether person among te contetas resol sued fom he speeds and ‘evlool munky it town, then cot shoal be consid the deni, Such ens ‘=cusualyor momo fhe fal nighborkood stan wh say with pray ae. M.What fa secular trend? ‘Ie pate rend of dese ueny hangs ony ovr many eas then called secular ted ‘32, What eee re 4. ithe oseurene of diese changes ont shor dustin of tine ikea yer sealed yeti tod Mos epidemic sess ndiashow a eelic wend Some dices change foqincy over sons and ach change ae rf tot seasonal changes — ‘nis chickenpox are camps ofauch desc 38 What herd immuiy? Give example were li important? {A The immune tats of op of pep comanty called hol immunity ts he mun tas of the ten ot peop For many comarca aera at tice of dacs tony pont ite eve of ium sate Sow and here ara fre mmr of suscep te papain. Todas ‘kept ira sls ct, er muy pl a pt cs Hows ise ike anus rabies whe eve ini sa ik nls spel prota imnity phys nora |MG What x nosocomial inetin? ‘A Aninfecuon eure patent hospi or others and in who it ws ot [west ornithine of admission oat whales alld nostic Tee dicases arsed rasp Us suc econ ae more elo mae sey ‘ac gency resistant o os of he common ain. Nesom nfstone als nlode tose Scions wc wer cetacean ater cichrg. a ct Ta eam. DrFahim 3S, What do you understand by the erm screening? ‘A Serening denotes the scath for wsconnzednese odes in appara (or ona eathy persons the applet of rp diagnosis, examination oe prcedes The bac ebjcetive a teenie late a {ry diagnosis thatthe prognosis ean be ngoved by emedl acon. $36, What fe mass erening? ‘A: When ll member of population are sereened for suse itis calld mas seteeing. This x very costly andthe Yield of aus wally ow sal warrant sucha screening procs 237, What higher sereening?A. igh i oe sccctivesexcenig fis othe situation whet ests ar fred nly o thos iva wh ae at high ik ordcveloping a poet disease. Ths wakes the serceing process moc focused and edoes the oval cos ‘sa large suber o people who hive extemy rote chance of developing disease ate mt steed [Me What crtera shoul soe ook for before screening fr any dseane” [A The following crea should be satis sore embarking cm sescning 1 The condition shouldbe an important public Rath problem. 2 The matron fs the ate fo marfet dicate shou be aequstely understood 3. Thee ould bea vooanizable ata or eatyaypmatic teal the Usa urna which wonton will lead o improved prognosis or oacome {Tee should bea accept a effective weatent othe paints with eogniad disse 5: Fase fr fl agnostic works up and eaten should be sve There sould bea suitable tex aa whih should be ai 7 The test shoul be aespabl both th pblic a wel 3 th profesional Thc should bean pred policy on eho oats plies nclading th mmagement of bodcline cae 9. Case fading should bea cominuous ross 10, The cst of catty diagnose ad reament shouldbe economically balanced in resto othe ol expendi on mcclcre (The oppor es should be jusiblo), es DrFahim Perea sei 3. Communicable Diseases 4. What are the diferent ways in which communicable diseases can be transite? ‘Commands dicse can be waned is mumbo of ys 1 Diet uanssion: Contac asmison lade tansmison: Vehicle (oie) bom, ‘etor-borns, abo roi mle and ead dst). Teanspaceial 42. What ite period of communeabity? ‘Period o communicator conusable poo frst th time ding which an infetous go may be transfered dicey or indo fom an infested person Wo a sucepble person This period isusualy equal othe tatu known nebton psa for that ee 243 What contact texmemiin? ‘A When disease spond by etc conte with a inte person, its ale conte! anmission-This may be by sing. ooching biting sexual itercourse. Ringworm, sabi. yas care examples of sich dieses, AE What are zoonoses? ‘A; Anfafecius dace tani under rtua conditions fom vec animal tna i calla xoonoas, “There me over 50 disse common to man and ania Tes nla ana, pian, ve Mk, T slim, ‘sapanata, bovine TB, slots, Briclloni scabies agus typhus yellow fever std KE, AS What fs pase inden? ‘A Passive immunization ref toe icon of specie pees aibdis (hyper immane seu nme serum globulin cc) provide ined protection oan dial. Tramplacetl ape also a example of panne fpuniation, Here ead rade ances are pone an individ especialy in at energeey When oo anak ait forthe body 1 produe anibee. Examples are ipa tans and abies. oe Me What active innaniatin?ee BE Te aa SR ce eT re ca ET is active immunization? {A Inactive immunization, a lied vacie is injected and the body reacts By producing antibodies, which make "heise and protect again aac by tfetious agents. Active imum alo achieved alc sullen fom dia ive measles chickenpox, ec. Active immunity i ong lasing and mor fective in preven tie ‘scat. The ely drawback hat it takes time forthe Body to produce antibodies and therefore ative immunization tally not useful in an emerzency. Rabies san exception becuse the incubation pio’ ofthe dscase i ons, 447. What isthe incubation peri for chickenpox? [A tne period ie 7-21 days and commonly fs K-16 days 4K. ow does chickenpox spreal? ‘A Tecan aflet people ofall age but most commonly children below 10 years ae affected as they do nat have proce antinalies Is mont commonly spread dito respiratory scerstion rom feted pera, whi ae Iceming wit the vrs, Crist of chicken are not infective 49. What the incubation period fr measles? ‘A. The incubation period of mole ranges fom 816 days with an average incubation period of 10 days, ‘80. What are the different if threatening complications of measles? ‘A. Common fe-teatening complications of measles include broneko-pacumonia and darts. Encephalitis can also ‘veurraely. Nicht tit as caa seamen FF AAIM ‘2. How docs the rash of masks lle frm the rash of cickeopon? ‘A. An eruptive rsh appa n mca dark cules o maculopspular gras, st evident behind the ars ‘an athe junction ofthe scalp and orcad and then spreading over the Tae rank ad limb, very rapidly, The Tans for 6 dys and disappears nthe same oder in which appeared reso leaving 3 brawny isolation of the ein, The rah in chickenpox his a coatnpeal istbuton fist ppedzing on the trl and then spreading towards ths pernhery, The palm and sakes ae ot flected, The rash is sen moto the xo nrfees and peat on the ‘ory first day and thereafer in crops evolving very rapidly. The lesions are serial unocular and are srounded ‘by aredareola They are srl elipial and msl sree wth no umblcation, ‘Sh. What i German measles? ‘A Goran moines is Raela ais mild eruptive fever ike meskes Is caused by Rabel vin ‘34 What are the complications ia pregnant mother gets Rubella? ‘A. The special pubic heath significance of Rall that a hid may he bor with eangenital defects ke deafness, ‘microcephaly, mirophalmia, PDA, septal defects and othe malfomatios, which ae eae the Congenital Rubella Synitomin, ithe mother infected daring pega. The Frequency of congenital defects x 20-25% i infection ‘occurs in Ts rinks an les fier that ‘5. What MMR vaccine and how and whe should it be given? ‘A.MMI vacvine is measles, manips an rubella vaccine hich ia ive ltenuted vcs apd is administered asa ‘ingle IM dowe after 1 year of age If eaux vacine hs been anne to child st 9 noch, MMI shoal be eau suspen,110, Wht ae the fntores of oats? A Inbotlism. change of voice, dipkpa ptosis cana nerve palsies and obstinate coaspation are observed. History ‘fconsemton of ned foods uaaly observe. An ication peo of 1236 hours sens asl oars in 37 day ond morality is ih 5). TI, Who fs labeled as a conalescent career? ‘A.A convlescent caer ion wh sho fective mcro-ogasians dating the pid of convalescence. tn typhoid this fra posed of 1-2 weeks afer the temperate comes down 12, Who iealled a permanent carrier? AA permanent car tone who confines os organs forever afer the sus hasbeen cured. This is see in ‘yphotd where the gallbladder and Kidneys ar involved and bail re passed fora ong ime with interspersed periods ‘of remisson 23% of typhoid cass develop int permanent cates TIX What the inubation period of Typhoid? ‘A The commonly obser ncibaton period of typhoid fs 10-14 dys ba ican range Fm 421 ys 14 What vacins are used fr ast immunization nzsinst Typhond? ‘A. Amumber of vaccine ae uso Tor aeiv snumzatin agains thoi These inl: TAB vaclne “AKD vaccine ~ Balen vce consi S. yp and S.parayphd Live stem orl vaeein Ty 213) “TAB vaccine i the calc vaccine devslopo and was introduced in 1496 Live vaccines te now routinely wed and ate ery effective an have ls sie effects compared tthe killed vaccines. TTS. How many doses of oral eyphod vaccine are given for primary immunization? A. Asingle dose of ol vain proves long-term Booster doses should be given every S years "a, When should booster of actone kid typhoid vaccine be given? ‘A. Bonner doses shoud be given every 38 yea, 117. What advice shoul you pve to 4 perwn eho being gen AKD typhi vacine? ‘A Aperson given AKD vaccine should ot indie in hr pysicl wrk on the dy of injection as this may Ted to mor aere reactions. Fever magi and rash tthe injection site are commonly seen. The myalgia an be ebliating apd ithe whole fay simmunizd atthe sams time here maybe nobody ftw cook fo that ight Al hese reactions ae sin a gn aay within 24-36 hous, 18. Who is the reservoir of infection in Amovbiasis? i Minteccortar tats sara rFahim Tn th act pe ot hpi a pts B Maecenas Sapte te coat Tinie mio Caen ee Sear iced dN seal vce te olen pln rrr ae eees iced Spe eat as oer nea eno ne eee ees areas ete ane ag eo oc ong sams Cece eg epee re oreo Sar insta titetdehetaettupatany enor noe dae Sa Sugusteaceeltemares seats foe a Be an ng on uarwrs kane pra ae ae ee vein mpncsai case ce races i el Speen pee Cacao enc omen ein Eee nies ds yack2. Coronary Steal Dipyridamole Phenomenon 3. Comeal micro deposits | Amiodarone 4. Orange Body Fluids Rifampin 5. Red Man Syndrome Vancomycin (rapid IV) 6. Cough ‘ACE Inhibitors 7, Diabetes Insipidus Lithium 8. Fanconi’s Syndrome Tetracycline 9. Gingival Hyperplasia Phenytoin 10.Gray Baby Syndrome Chloramphenicol