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Epidemiology

Epidemiology. Concepts and Terms. Homeostasis. Define Major systems Communication. Holistic View. Health vs. Disease Wellness Model (health focus) Awareness Education Growth Treatment Model (disease focus) Signs Symptoms Disability Death. Definitions. Pathogen Disease

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Epidemiology

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  1. Epidemiology Concepts and Terms

  2. Homeostasis • Define • Major systems • Communication

  3. Holistic View • Health vs. Disease • Wellness Model (health focus) • Awareness • Education • Growth • Treatment Model (disease focus) • Signs • Symptoms • Disability • Death

  4. Definitions • Pathogen • Disease • Morbidity • Mortality • Symptoms • Signs • Etiology • Pathogenicity

  5. Symbiosis

  6. Microbiotica • Normal • Resident • Acquired 1st months of life • Lifetime population • Transient • Competition • Immune • Opportunistic • Immune suppression • Change in competition • Change site of residence • Pathogens • Contamination • Food • Air • Water • Infection

  7. Ecological Fitness

  8. Immune Defense

  9. Portals of Entry • Skin • Mucous Membranes • Open body cavities • Placenta • Parenteral • SC • IM • IV

  10. Adhesion • Adhesion factors • Protein ligands • Examples • Fimbria • Flagella • Glycocalyx • Binding • Glycoproteins • Mannose • Galactose • Each other = Biofilms • Avirulence • No adhesion factors • No binding

  11. Disease Process • Incubation • Prodromal • Illness • Decline • Convalescence

  12. Pathogenicity • Virulence Factors • Plasmids • Resistance to Ab • Extracellular enzymes • Coagulase • Hemolysins • Toxins • Exotoxins • Cytotoxin • Neurotoxin • Enterotoxin • Endotoxins = Lipid A • Avoid phagocytosis • Capsules • Motility • Change lysosome fxn • Increased WBC destruction

  13. Toxins

  14. Sequella to Injury

  15. Portals of Exit

  16. Sources of Disease • Reservoirs • Animals • Zoonotic • Human carriers • Nonliving • Soil • Water • Food

  17. Host Life Cycles • Life Cycle • L1 • L3 • Adult • Hosts • Definitive • Intermediate • Secondary • Incidental • Dead-End • Stages • Infectious • Diagnostic

  18. Transmission of Disease • Contact • Direct • Indirect (Fomites) • Droplet • Vehicle • Air • Food • Water • Body fluids • Vector • Mechanical • Flies • Roaches • Biological • Lice • Mosquitoes • Ticks Lyme Disease

  19. Classification of Disease • Stages • Acute • Chronic • Subacute • Latent • Types • Communicable • Contagious • Non-communicable • Source • Primary • Secondary • Region • Local • Systemic • Focal

  20. Disease Diagnosis • 5 Components • Epidemiology • Etiology • Pathophysiology • Clinical Manifestations • Outcome “COPE”

  21. Koch’s Postulates • 1) Pathogen for every disease • 2) Isolate and grown in pure culture • 3) Cause disease in healthy susceptible host • 4) Reisolate pathogen from experimental host • Exceptions • Culture issues (temp, pH, O2) • Multifactoral causes • Ethical concerns (primates)

  22. Epidemiological Approaches • Descriptive • Disease data • Analytical • Koch’s Postulates • Retrospective • Experimental • Testing hypothesis

  23. Epidemiology • Epidemiology • Define • Factors • Predisposing • Precipitating • Questions • Where, When, How, Why, and Who • Related Terms • Frequency • Incidence • Prevalence • Outcomes • Morbidity • Mortality • Geography • Endemic • Epidemic • Pandemic • Sporadic Herpes D Virus (HDV)

  24. Hospital • Nosocomial • Sources • Exogenous • Endogenous • Iatrogenic

  25. CDC Reportable Diseases (examples) • Viral /Bacterial • HIV • Anthrax • Influenza • Pertussis, Diphtheria • TB, Leprosy • Botulism, Tetanus • Hepatitis • E. coli, Salmonella, Shigella • STDs • Cholera • Mumps, Measles, Rubella • Legionella • Small Pox • Tularemia • Toxic Shock • Leptospirosis • Vector Borne • Lyme • Plague • RMSF • Ehrlichia • Malaria, Yellow Fever • Zoonotic • Rabies • Brucellosis • Cryptosporosis • Toxoplasmosis

  26. Public Health Groups • CDC • WHO • US Departments • Agriculture • Health

  27. Biohazard Risk Groups

  28. Major Etiologic Categories • Genetic • Sickle Cell Anemia • CF • MD • Hemophilia A • Acquired • Infectious • Traumatic • Iatrogenic • Nosocomal • Multifactoral • CAD • DM • Cancer • Congenital Heart Disease • Hypertension • Emphysema

  29. Various Classification of Disease • Anatomical • Organ • System • Developmental (age) • Neonatology • Pediatrics • Adolescent • Adult • Geriatrics • Etiological

  30. Etiology, DAMNIT ! (DAMNIT-V) • D = Degenerative, Developmental • A = Anomaly, Accident, Autoimmune • M = Metabolic, Mechanical, Mental • N = Neoplasia, Nutrition, Neurological • I = Infectious, Immune, Iatrogenic, Idiopathic, Inherited, Inflammatory, Ischemic • T = Trauma, Toxins, Toxicities • V = Vascular

  31. My Possible Problem List • Location • Gross • Histological • Physiological • Remember: DAMNIT-V

  32. Clinical Manifestations • Symptoms /Syndrome • Patient Report • Subjective • Related Terms: Prodromal, Insidious, Latent • Signs • Health care exam • Observable phenomena • Objective • Diagnostic Criteria • Laboratory results • Imaging • Biopsy Digital Thermal Imaging

  33. Medical Records • S • O • A • P

  34. Outcome • Expected • Prognosis • Actual • Cure • Remission • Exacerbation • Complication • Sequella • Palliative • Death

  35. Stress • Define • Stressor examples • Positive • Negative • Types • Major • Minor • Symptoms • GAS • Alarm (ANS) • Resistance (H-P-A axis) • Exhaustion (+ feedback)

  36. Stress Related Disorders • Immune: Autoimmune, Neoplasia • Cardiovascular: HT, CAD, Dysrhythmias • Respiratory: Asthma, URTI, TB • Renal: Interstitial cystitis • Neurologic: Depression, MS, Headache • GI: Diarrhea, IBS, Eating Disorders • Endocrine: DM, Hyperthyroidism • Reproductive: Infertility • Musculoskeletal: RA, SLE, Chronic Fatigue • Integumentary: Eczema, Acne, Urticaria, Herpes

  37. Adaptation • Define • AKA • Compensatory mechanisms • Homeostatic Mechanisms • Control Systems • Regulatory systems • Homeostatic Control and Feedback • Limits • Energy use • Efficient (overshoot, undershoot) • Effective (prolonged response  change feedback)

  38. De-stress • Sleep • Exercise • Diet • Medical Check-ups • Energy • Attitude Stressed is Desserts spelled backwards!

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