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Preventive Medicine and

Public Health
Boards Orientation
ROBERTO L. RUIZ, MD, MS
Department of Family and Community Medicine
College of Medicine Philippine General Hospital
University of the Philippines Manila
Scope of the PRC Physician
Licensure Examination

Preventive Medicine

Epidemiology and Biostatistics

Public Health and Preventive Medicine

Family and Community Health Care

Environmental Sanitation

Occupational Health Practice

Herbal Medicine and Nutrition


Scope of the PRC Physician
Licensure Examination

Preventive Medicine

Research Methodology

Special Problems

HIV and AIDS

Transmissible Spongiform Encephelopathy

Hepatitis

Bioengineering Genetic Disorders

Foot and Mouth Disease


Scope of the PRC Physician
Licensure Examination

Preventive Medicine

References:

Foundations of Statistical Analysis for Health Sciences by


Ophelia Mendoza, Maridel Borja, Caridad Ancheta. Ofelia
Saniel. Jesus Sarol

Research Methods in Health and Medicine (Philippine Council


for Health Research and Development), Department of Science
and Technology, Volume I by F.S. Sanchez, S.I. Morelos, J.C.
Baltazar

Reading in Preventive Medicine II (UST, Dept. of Preventive and


Social Medicine)

Bioethics by A. Angles Tan-Alora, MD

The Implementing Rules And Regulations of the National Health


and Insurance Act of 1995.

Epidemiology Manual by Dr. Rosa Santos-Carreon (UST)

Lectures and manuals on Preventive Medicine from different


Philippine Medical Schools.
I. Epidemiology and Biostatistics
1. A recent study found higher incidence of Sudden
Infant death Syndrome (SIDS) for children of mothers
who smoke. If the rate for smoking mothers is
230/100,000, and the rate for non-smoking mothers is
71/100,000, what is the relative risk for children of
mothers who smoke?

0.32

3.2

159

230

Rate for smoking mothers / rate for non-


smoking mothers

230/71 = 3.24
2. Prevalence is a measure of:

Cases occurring within an interval

Old and new cases in the community

Old cases only

New cases only

Prevalence means existing cases, both old and


new

3. When two or more observers measure


the same variable in the same subjects, it
is known as:

Instrument variability

Inter observer variation

Intra observer variation

Controlled trial variation

4. True about life expectancy in the


Philippines, EXCEPT

Rose from 61.6 in the 80s to the 70s in the


early 70s

Females higher than males

Lowest in the ARMM

Is comparable to Thailand

5. IMR is affected by socio-demographic


factors. In the Philippines, a child will most
likely celebrate his/her first birthday if:

The mother is illiterate

The child is born in the urban area

The child is born in the ARMM

The child is born less than a year after a


previous child
6. A study was conducted to assess the effects of
smoking on the memory of medical students. The
objective was to focus on all medical students with a 5
pack year smoking history . A group from 2
nd
year students
of UPCM was invited for the study. In this study, all
students who have been smoking would be the
Target population
Study population
Study sample
Population at risk
Population

Target population

Study population

7. A component part diagram such as a


pie diagram is used to portray:

Percentages

Trends

Frequencies of discreet variables

Frequencies of continuous variables

8. An epidemiologic study that provides


clues for diseases etiology and hypothesis
for further study:

Cross sectional study

Cohort study

Descriptive study

Case-control study

9. This is the measure of mortality which


reveals the rates of ten leading cause of
death

Case fatality rate

Cause specific death rate

Infant mortality rate

Proportionate death rate

10. To establish the trend of birth events in


5 years, the measure to use is

Crude birth rate (CBR)

Total Fertility rate (TFR)

Age-specific Birth Rate (ASBR)

Child woman ration


11. An age dependency ratio of 105 can be
interpreted as
100 persons are dependent on the 105
The computed value is not representative of the
number of dependents to be supported
105 persons will be supported by 100 able
bodied persons
There are less number of dependents per 100
persons

12. Which among the following is the


reference population in a research study to
test the effectiveness of a vaccine against
tetanus neonatorum?

All neonates without tetanus

Mothers who have tetanus

All patients with tetanus

All neonates with tetanus

13. A measure of prognosis that identifies


the number of those who died among
those diagnosed with the disease is

5year survival

Median survival

Relative survival

Case fatality

14. This measure is indicative of the


potential for prevention if the exposure can
be eliminated

Relative risk

Attributable risk

Prevalence risk

Proportionate mortality ratio

15. Several studies have found that


approximately 85% of cases of lung cancer
are due to cigarette smoking. This is an
example of

Incidence rate

Attributable risk

Relative risk

Prevalence risk
II. Communicable and Non-
communicable Diseases

16. The following is/are important factor/s


of the disease to be considered before
asking for a screening test.

Common disease

Cause significant morbidity

c. both

d. neither

17. Giving influenza vaccine to an elderly


diabetic is a form of

Primary prevention decrease incidence

Secondary prevention decrease prevalence

Tertiary prevention decrease disability

Waste of money

18. Patients who receive immune globulin


for prevention or modification of measles
should NOT be given measles vaccine until
after:

4 weeks

3 4 months

2 3 months

5 6 months

19. True about Measles vaccine EXCEPT

Provides protection against mumps, measles and


german measles

All children should have two doses first at 12- 15


months then at 4 6 years

All adults should receive a booster provided they have


sufficient measles antibody titers or had history of actual
disease

Infants 6-11 months should be given one dose prior


to travel to an endemic area

20. The annual chest exam as part of a


periodic health exam is meant for the early
detection of

Chronic lung disease

Cancer of the lungs

PTB

All of the above


21. The length of time between detection of
cancer with screening tests and the time in which
the disease by the presence of signs and
symptoms would otherwise have been detected
in the absence of screening is called :
Overdiagnosis bias
Selection bias
Lead time bias
Length bias

22. Vaccines should not be given to the


following:

Child who has fever of 38C and is


anorexic and lethargic

Child has allergy to duck meat

Child with history of convulsion

All of the above

23. The most effective screening tool for


colon cancer is

Clinical history and family genogram

FOBT

Annual digital rectal exam

Colonoscopy every other year

24. Risk factors that are associated with


breast cancer include all of the following
EXCEPT

menarche before age 12

menopause after age 50

obesity

no exception

25. Sunscreen of at least 15 SPF are


recommended to protect against the most
serious of dermatologic malignancies which
is

Malignant melanoma

Squamous cell carcinoma

Basal cell carcinoma

Actinic keratosis

26. False positive test may result with


FOBT if there is inadequate preparation.
For three days prior to the exam, patients
must be restricted from taking

High doses of NSAID

Vitamin C

Meat

All of the above

27. The following are live attenuated


vaccines EXCEPT

a. Measles c. Hepatitis B

b. Rubella d. Oral polio

28. The screening instrument used to


detect alcohol abuse is called

CAGE questionnaire

Family APGAR

DSM-4

Fagerstrom test

29. The drug of abuse that imposes the


largest health and economic burden on
society is

Amphetamines

Nicotine

Hallucinogens

coccaine

30. Determined efforts to reduce drug abuse led to


requirement of drug testing. Most substance of abuse
maybe detected. All of the following are correct EXCEPT

Marijuana maybe detected up to 3 -4 weeks even after


occasional use

Major metabolite of cocaine is detectable 2-3 days after use

PCP positive test means use within the previous week

Sympathomimetic agents in decongestants may test positive


for amphetamines

31. Based on the NCEPs ATP3


recommendations, a patient with 2 or more
major risk factors must aim for LDL levels

< 100

< 130

< 160

< 200

32. Osteoporosis has been associated


with

Positive family history

Poor dietary calcium particularly during


adolescence

Ingestion of large amounts of red meat

All of the above

33. Hormone replacement therapy is


absolutely contraindicated for

Undiagnosed dysfunctional uterine bleed

Active thrombophlebitis

Suspected breast cancer

All of the above

34. Sangkap Pinoy program is the


government response to micronutrient
deficiency. It has fortified food with

Vitamin A

Iron

Iodine

All of the above

35. This nematode infection is transmitted


when infective larvae penetrate the skin

Schistosomiasis

Hookworm infection

Both

neither
III. Health Systems

36. The Department of Health is the lead


agency in health. Its major mandate is to

Provide national policy direction and


develop national plans , guidelines on
health

Send representatives to local health Boards

Both

Neither
37. According to WHO, the Millennium
Development Goals and the Medium Term
Philippine Development Plan, the major goals
of the health sector is/are :
better health outcomes
more responsive health system
more equitable health financing
all are correct
38. In the Philippine health system, the ____
is the comprehensive operational framework
that will be used to implement reform
strategies as a single package.
Health Sector Reform agenda of 1999
Fourmula One for Health launched in 2005
National Objectives for Health 2005 2010
None of the above

39. The Local Health Board is

Chaired by the local chief executive

An advisory body to local executives on


matters of health

Both

neither

40. The restructuring of DOH in 1999 led to


the identification of four regulatory bodies
which include all of the following EXCEPT

Bureau of Food and Drug

Bureau of Health Facilities and Services

Bureau of Research and Laboratories

Bureau of Health Devices and Technology

41. This regulatory body is responsible for


international health surveillance and
security against the introduction and spread
of infectious diseases

Bureau of Food and Drug

Bureau of Health Facilities and Services

Bureau of Research and Laboratories

Bureau of Quarantine

42. The St. Peregrine Hospital has 5 departments which


include Family Medicine, Internal Medicine, Pediatrics ,
OB-Gyne and Surgery. It is able to manage almost all
medical and surgical conditions except those that require
neurosurgical interventions or interventional diagnostic
cardiology. It is considered a

First level referral hospital

Second level referral hospital

Tertiary level referral hospital

End referral specialty hospital

43. Republic Act 9211 otherwise known as


Tobacco Control act of 2003 regulates

Sale and distribution of tobacco producrs

Advertisements and packaging of tobacco


products

Both

Neither
44. Framework Convention on Climate Change
with the objective of reducing
greenhouse gases that cause climate change.
FCTC
Ottawa Charter
Kyoto protocol
Bangkok Charter

45. The 1995 National Health Insurance


Program covers

The employed sector

Government workers

All Filipino citizens

Indigent groups
46. Carbon monoxide poisoning can occur in
the following situations EXCEPT
a. Working with kilns, furnaces and ovens
b. Leak in a cars exhaust
c. Firefighting, particularly in mines
d. No exception
47. Osteoarthritis have been mostly linked to
occupational risks due to
a. Repetitive bending
b. Lifting of heavy objects
c. Working in kneeling or squatting
position
d. All of the above
48. Children who developed cerebral palsy,
birth defects and neonatal retardation
may have been most likely exposed to
this environmental toxin
a. Lead
b. Methyl mercury
c. Polychlorinated biphenyls
d. tobacco
48. Children who developed cerebral palsy,
birth defects and neonatal retardation
may have been most likely exposed to
this environmental toxin
a. Lead
b. Methyl mercury
c. Polychlorinated biphenyls
d. tobacco
49. The following are recognized to have
carcinogenic potentials, except
a. Arsenic trioxide
b. Chromite ore
c. Amorphous crystalline including
diatomaceous earth
d. Asbestos
50. The acceptable eight-hour noise level for
unprotected factory workers, pump-boat
operators and tricycle drivers is only up
to:
a. 50 dB
b. 70 dB
c. 90 dB
d. 110 dB
51. According to the Department of Health
HIV-AIDS March 2010 Registry, the main
mode of HIV-AIDS transmission in the
Philippines is:

a. heterosexual contact

b. homosexual contact

c. needle prick injuries (among health


workers)

d. IV drug use
52. Directing a more aggressive anti-HIV-AIDS
campaign to which vulnerable Filipino groups
would be of most value in order to significantly
lower the number of HIV seropositive cases the
soonest possible time?

a. health workers at risk of needle prick injuries

b. men who have sex with men

c. overseas Filipino workers

d. young adults in the 18-24 age group


53. Which of the following statements on the
March 2010 HIV-AIDS situation in the
Philippines is correct?

A. There are more infected males than


females.

B. There are more infected homosexual men


than heterosexual men.

C. Infection via the transfusion of infected blood


products occur more than perinatal transmission
of HIV.

D. None of the following is correct.


Epidemiology
Study of the distribution and determinants of
the health-related states or events in specified
populations and the application of this study to
control of health problems
Looks into causations, natural histories
Describes health status of populations
Evaluates interventions
Focus on the social determinants of health
Health and disease

1948 WHO definition of health:

Health is a state of complete physical, mental,


and social well-being and not merely the
absence of disease or infirmity
Health and disease

Population at risk:

part of the population that is susceptible to a disease

Prevalence of a disease:

The number of cases in a defined population at a


specified point in time

Incidence of a disease:

The number of new cases arising in a given period of


time in a specified population
Health and disease

Prevalence rate P=
Number of people with the disease
or condition at a specified time
Number of people in the population at risk at
a specified time
X 10
N
Health and disease

Incidence rate I=
Number of people who get the disease
or condition at a specified time
Sum of the length of time during which
each person in the population is at risk
X 10
N
Health and disease

Case fatality (%)=


Number of deaths from a disease
in a specified period
Number of diagnosed cases of the
disease in the same period
X 100
On HIV-AIDS in the RP

As of the March 2010 HIV-AIDS Registry of DOH

Point of diagnosis: 83%- asymptomatic, 17%- AIDS

Age: 51%- 25-34 years age range

Sex: 75% males

Mode of transmission:

53% heterosexual contact

31% homosexual contact

16% bisexual contact

0.39% blood/blood products

1.58% IV drug use

0.06% needle prick injuries

1.03% perinatal transmission


On HIV-AIDS in the RP

OFWs: account for 29% of all HIV


seropositives ever documented

Seventy-four percent (1,020) were male

Ages ranged from 18 to 69 years (median 36


years)

Sexual contact (96%) was the predominant


mode of transmission

Eighty-one percent (1,108) were


asymptomatic while 19% (265) were AIDS
cases.
54. Niyog-niyogan is a plant whose seeds
are used for the treatment of:

A. diarrhea

B. ascariasis

C. intestinal colic

D. fever
On the Sampung Halamang Gamot

Lagundi cough

Yerba buena general body aches and pains

Sambong anti-urolithiasis

Tsaang gubat stomach ache

Niyug-niyogan ascariasis

Bayabas antiseptic

Akapulko antifungal

Ulasimang bato / pansit-pansitan gout/uric acid

Bawang cholesterol control

Ampalaya blood sugar control


55. Comprehensive nutrition programs are given
impetus by the following data from the 6th
National Nutrition Survey, except:

A. Approximately 1/3 of Filipino children


surveyed were underweight when compared to
the standard

B. Approximately 1/3 of Filipino children


surveyed were Vitamin A deficient

C. Approximately 1/3 of Filipino children


surveyed were shorter when compared to the
standard

D. There is no exception.
56. An OFW can enjoy the benefits of her
PhilHealth membership:

a. even up to her third uncomplicated


delivery

b. even up to her fourth uncomplicated


delivery

c. even if it is her first pregnancy and


delivery and she is already 36 years old

d. none of the above


57. A full-immunized Filipino child, in DOH
standards-

a. is a child who does not get sick of any of the


vaccine-preventable illnesses in his or her
lifetime

b. has received complete BCG, HepB, DPT,


OPV, measles vaccine on or before his/her
1st birthday

c. remains to have good vaccine titers up until


his/her 7th birthday

d. none of the above


58. BCG vaccination

a. prevents children from getting infected


with tuberculosis

b. prevents children from getting


complications of extrapulmonary
tuberculosis

c. is an outdated mode of protecting


children from an infectious disease

d. should be removed from the EPI list


Health and disease
Crude mortality rate (%)=
Number of deaths
in a specified period
Average total population
during that period
X 10
N
Health and disease

Infant mortality rate (%)=


Number of deaths in a year of
children less than 1 year of age
Number of live births
in the same year
X 1000
Health and disease

Maternal mortality ratio =

Number of maternal deaths per


100,000 live births
Health and disease

Life expectancy

The average number of years an individual of a


given age is expected to live if current mortality
rates continue

Maybe affected by morbidity and disability


Health and disease

Disability

Impairment: loss of psychological, physiological,


anatomical structure or function

Disability: restriction or lack (resulting from impairment)


of ability to perform an activity in the manner or within
the range considered normal for a human being

Handicap: a disadvantage for an individual, resulting


from impairment or disability, that limits or prevents the
fulfillment of a role that is normal (depending on age,
sex, cultural and social factors) for that individual
59. The Influenza A(H1N1) virus is a novel
entity with DNA contribution coming from
the following species, except:

a. avian

b. bovine

c. human

d. swine
60. The causative agent for human cases of
spongiform encephalopathy is:

A. virus

B. prion

C. bacteriophage

D. protozoan
61. The directly observed therapy short
course involves the following aspects,
except:

A. Political will to implement DOTS

B. Quality microscopy for case detection

C. Standard short course chemotherapy


system for 6-8 months, at least for all
confirmed smear-positive cases

D. There is no exception.
On TB Control in the RP

DOTS: Directly Observed Therapy Short


course

Main components
Government commitment
Case detection by sputum microscopy
Standard short-course chemotherapy / DOT
Regular, uninterrupted supply of TB drugs
Recording and reporting system
62. Which of the following is not a
cornerstone or pillar of Primary Health
Care?

A.funding of government agencies

B. use of appropriate technology

C. intra-sectoral and inter-sectoral


linkages

D. active community participation


On Primary Health Care

Approach to health systems development


focusing on:

Community participation and people


empowerment

Making healthcare available, affordable,


culturally acceptable, accessible

Intersectoral cooperation and government


initiative

Review: Declaration of Alma Ata


63. A process by which an individual or group of
individuals get to know their community, identify
its needs and formulate a course of action for a
series of activities to achieve health goals of the
community is:

A. progress activity

B. community diagnosis

C. progress planning

D. health education
64. In the primary health care system,
training of health care workers are directed
to the following, EXCEPT:

A. performance of surgical procedures

B. health education and motivation

C. first aid measures

D. recognition and treatment of minor


illness
65. What is the type of transmission when
an infectious agent is lifted and transferred
from one body to another and does not
undergo changes in itself:

A. biological

B. organic

C. mechanical

D. chemical
66. A patient previously treated for TB who
has been declared cured or treatment
completed and is diagnosed with
bacteriologically positive (smear or culture)
tuberculosis is what type of TB case?

A. Relapse

B. Failure

C. Return after default

D. Transfer-in
On TB Control in the RP
TB cases
New: never treated or treated <1 month
Relapse: declared cured/tx complete, but with
positive smear/culture again
Failure: positive at 5
th
month or latter part of
treatment
Return after default: patient returns to treatment
with positive bacteriology after 2 months of
stopping DOT
Transfer in: transfer from one HC to another
67. Indigent Filipinos whose PhilHealth
membership premiums are sponsored by
an NGO or corporation enjoy the following
benefits, except:

A. Coverage for up to the fifth normal


pregnancy

B. Newborn Care Package

C. TB Treatment through DOTS

D. SARS and Avian Influenza Package


68. A 21 year old previously healthy man was
referred to a university hospital due to multiple
organ infection with Pneumocystis carinii lung
infection, CMV in the urinary tract and Candida
albicans of the upper digestive tract. The
investigator planning to report this unusual case
can BEST describe this as:

A. case series

B. cohort

C. case report

D. case-control study
69. This type of epidemiologic investigation
measures exposure after the onset of
disease or outcome under study.

A. Case-control

B. Cohort

C. Cross-sectional

D. Descriptive
On types of studies

Descriptive studies

Simple description of the health status of the


community based on routinely available data

Makes no attempt to analyze links between


exposure and effect
On types of studies

Cross-sectional studies

Prevalence study

Measurements of exposure and effects are


made at the same time
On types of studies
Case-control studies
From a general population Begin with one group
of patients with the condition and one group without
the condition then investigate whether an
exposure or non-exposure to certain causative
agents led or did not lead to presence of condition
retrospective
Longitudinal
Ex. Thalidomide babies
On types of studies

Cohort studies

Follow-up or incidence studies

From a general population Begin with one


group of patients without the condition then
investigate whether an exposure or non-
exposure to certain causative agents will lead
or not lead to presence of condition
70. Which of the following is not a correct
information to give to a patient who owns a
poultry farm regarding bird flu transmission?

A. Bird Flu is caused by Influenza A virus and


outbreaks in some countries are specifically
caused by the H5N1 strain.

B. It is best to keep their chickens, ducks,


and pigs in one area so as to give them
common collective protection.

C. Chicken should be cooked thoroughly.

D. Do not allow chickens to roam freely. Keep


them in cages and pens.
71. What is the best index utilized when
making field studies on energy nutrient
malnutrition:

A. dietary questionnaire

B. physiological abnormalities

C. anthropometric measurement

D. biochemical test
72. The best preventive measure against
Hepatitis B virus and Hepatitis C virus
infection is:

A. proper screening of blood prior to


transfusion

B. avoid cigarette smoking

C. proper hand washing

D. avoid alcohol intake


73. A Hepatitis B carrier is a person who is:

A. Hepatitis B core antigen positive for 6


months

B. Hepatitis B e antigen positive for 6


months

C. Hepatitis B surface antigen positive


for 6 months

D. None of these
74. A cook is found to be Hepatitis A
positive. You should advise that she:

A. receive Hepatitis A vaccine

B. handle only uncooked food

C. stop cooking

D. continue cooking but wash hands


thoroughly
75. Constant use of the same insecticides
results in the formation of:

A. immune strains

B. resistant strains

C. susceptible strains

D. concomitant strains
76. Transplacental transfer of antibodies
from the mother to the fetus is classified
as:

A. naturally acquired passive immunity

B. artificially acquired active immunity

C. naturally acquired active immunity

D. artificially acquired passive immunity


77. The Sanitation Code of the Philippines
prescribes the following, except:

A. Bacteriologic examination of drinking water


sources should be done as often as possible but
interval between examinations must not be more
than 6months

B. Examination of drinking water sources for


radioactive contamination should be done yearly

C. General chemical examination of drinking


water sources should be done yearly

D. None is an exception.
78. To protect drinking water from contamination,
the Sanitation Code of the Philippines mandates
the observance of the following measures,
except:
A. Washing clothes or bathing is prohibited within
25 meters of a drinking water source
B. No deep well shall be constructed within 50
meters from a source of pollution
C. No radioactive sources or materials should be
located within 25 meters of a drinking water
source
D. None is an exception
79. Sambong leaf decoction benefits a
patient as:

A. Anti-urolithiasis

B. Anti-helminthic

C. Antitussive

D. Antiseptic
80. The following are part of the 10
prescribed medicinal plants of the DOH
through the Philippine Institute of
Traditional and Alternative Health Care
(PITAHC), except:

A. Ulasimang bato

B. Oregano

C. Yerba Buena

D. Akapulko
81. The Philippine National Drug Policy aims to:

A. eliminate the need for drug importation

B. encourage tailored or targeted


procurement of drugs by government

C. increase considerably accessibility and


utilization of prescription drugs

D. replace the Generics Act of 1988 as the guide


for drug prescription by health professionals
82. Which of the following is not part of the Food
and Nutrition Research Institutes recommended
food safety and handling practices?

A. Use wooden cutting boards for preparing


food items rather than plastic ones

B. Refrigerate leftover food and do not leave


them in room temperature for more than two
hours

C. Do not buy or use canned goods that are


expired, dented, bulging and rusting.

D. Hamburgers should not be served rare


83. The Generics Act of 1988 mandates the
creation of this list of drugs that details what to
use in case medicines in the essential drugs list
are unavailable, causes hypersensitivity, or does
not work for the patient.

A. core list

B. alternative list

C. complimentary list

D. national drug formulary


84. Which of the following is not included in the action plans
of the 2000 Nutritional Guide for Filipinos?

A. Consume fish, lean meat and skinless poultry in your


daily meals.

B. Avoid foods cooked in edible/cooking oil in your


daily meals.

C. Advise intake of two servings of fruit daily, of which


one serving is a vitamin C-rich fruit

D. Provide appropriate complementary feeding starting


at about 6 months in addition to breast-feeding
85. According to the Local Government
Code, the _____ presents to the local
government council the proposal for the
budgetary allocation for the maintenance
and operation of local health facilities.

A. mayor

B. vice mayor

C. councilor for health

D. local health board


86. The four core principles of bioethics
include the following, except:

A. Beneficence

B. Malefiscence

C. Respect for autonomy

D. Justice
87. The Food and Nutrition Research Institute
recommends that Filipinos aged 60-69
years eat 2-3 servings of meat a day. One
serving of meat would approximately be:

A. the size of the patients palm

B. the size of a standard-sized small


matchbox

C. the size of the patients thumb

D. none of the above


88. Which information is not correct with regard to
meningococcemia?

A. Meningococcemia is caused by a bacteria


called Neisseria meningitides

B. Neisseria meningitides frequently lives in a


person's upper respiratory tract without causing
visible signs of illness

C. The bacteria can be spread from person to


person through respiratory droplets

D. A, B and C are correct


89. Which information is correct with regard
to Hepatitis B?

A. Persons at risk for Hepatitis B virus


infection might also be at risk for infection
with hepatitis C virus (HCV) or HIV.

B. Hepatitis B vaccine is the best


protection versus Hepatitis B infection.

C. A and B are correct.

D. A and B are both incorrect.


90. The primary health care approach aims
to make all health initiatives have the
following characteristics, except:

A. accessible

B. affordable

C. culturally acceptable

D. none is an exception
91. An infant born to a Hepatitis-B-infected
mother should get HBIG (hepatitis B
immune globulin) and vaccine within how
many hours after birth?

A. 12

B. 24

C. 36

D. 48
92. Which of the following is not the main
task of a barangay health worker (BHW)?

A. Community mobilizer

B. Health educator

C. Political liaison between the


barangay captain and the community

D. Health service provider


93. According to Food and Nutrition
Research Institute (FNRI) standards, one
cup of rice is approximately equivalent to:

A. four slices of bread or four pieces of


pandesal

B. two cups of cooked spaghetti

C. half cup of instant noodles

D. one large sweet potato (camote)


94. The following are the benefits of employed
PhilHealth members, except:

A. Coverage for dialysis or chemotherapy

B. Subsidy for room and board, drugs and


laboratories, operating room and professional
fees for confinements of not less than 24 hours

C. Coverage up to the fourth normal delivery

D. None is an exception
95. A concept for caring for dying or the
terminally-ill patients so that he can die in
dignity:

A. hospice care

B. dysthanasia

C. euthanasia

D. physician-assisted suicide
Epidemiology and Prevention

TYPES OF PREVENTION

Primordial

Primary

Secondary

Tertiary
Epidemiology and Prevention
Primordial Prevention
Aim: avoid the emergence and establishment of
social, economic and cultural patterns of living
known to contribute to an elevated risk of disease
Example: for HIV- improvement of socio-
economic conditions so that people will not resort
to prostitution
Epidemiology and Prevention

Primary Prevention

Aim: limit the incidence of disease by


controlling causes and risk factors

Examples: For HIV- use of condoms


Epidemiology and Prevention
Secondary Prevention
Aim: to cure patients and reduce the more serious
consequences of the disease through early
detection, diagnosis and treatment
Example: for HIV- psychosocial support for those
with the virus, nutrition education
Epidemiology and Prevention

Tertiary Prevention

Aim: to reduce the progress or complications


or recurrence of established disease; reduce
impairments and disabilities; minimize
suffering from departures from good health;
promote patients adjustment to incurable
conditions (often through rehabilitation
activities)

Example: For HIV- with some overlap with


secondary prevention strategies
Epidemiology and Prevention

Screening

Process by which unrecognized diseases or


defects are identified by tests that can be
applied rapidly on a large scale
Epidemiology and Prevention

Screening Program Creation Criteria

Disease: serious, high prevalence of


preclinical stage, understood natural history,
long period between first SSx and overt
disease

Diagnostic test: sensitive and specific, simple


and cheap, safe and acceptable, reliable

Diagnosis and treatment: adequate facilities,


effective, safe, acceptable treatment available
Epidemiology and Prevention

Screening Program

Sensitivity: proportion of truly ill in the screened


population who are defined as ill by the screening test

The probability of the test finding disease among those who


have the disease

Specificity: proportion of truly healthy who are so


identified by the screening test

The probability of the test finding NO disease among those


who do NOT have the disease

Specific test rules in a disease (SpIN), a Sensitive test


rules out a disease (SnOUT)
96. Which of the following is NOT included in the
ELEMENTS of primary health care?

A. Improvement of the health status of mother


and their children

B. Resolution of neuropsychological health


issues in the community

C. Ensuring the presence and delivery of safe


drinking water

D. Prevention of local and endemic diseases


97. Which of the following is true regarding the
prevention of Hepatitis B infection?

A. The efficacy of latex condoms in Hep B


infection prevention has been well-studied.

B. Precaution should be observed when


sharing personal items like razors or
toothbrushes.

C. An individual who is/was hepatitis B positive


is still encouraged to donate blood.

D. There is no cause for worry when one gets a


tattoo.
On Primary Health Care

ELEMENTS:

Education (health education)

Local and endemic disease control

Expanded program on immunization

Maternal and child health

Essential drugs

Nutritions

Treatment of common diseases and injuries

Safe water and sanitation


98. Which of the following is true regarding the
PhilHealth premium payment of an employed
PhilHealth member?

A. The employer and his/her employee each pay


50% of the employees monthly PhilHealth
premium.

B. The standard premium to be paid monthly for


an employed PhilHealth member is 2.5% of the
salary base of the range within which the
employees basic monthly salary belongs

C. A and B are both true.

D. A and B are both false.


99. Prevalence is a measure of:

A. Old cases only

B. New cases only

C. Cases occurring within an interval

D. Old and new cases in the community


100. The following are categories of
PhilHealth members, except:

A. Sponsored

B. Individually paying

C. Non-paying

D. ALL are categories of PhilHealth


membership
Useful websites

Nutrition: http://fnri.dost.gov.ph

PhilHealth: http://www.philhealth.gov.ph

Questions? Comments?
cfgomezmd@gmail.com
Very Useful Sites

Pink Sisters convent in Tagaytay

Church of Our Lady of Manaoag

Church of Mary Mediatrix Lipa City

Baclaran Church Our Lady of Perpetual


Help

Vatican, Holy Land


So be prudent,
do not mind your labor,
give yourself to your work
as an evangelist,
fulfill your ministry
I have fought the good fight,
I have finished the race,
I have kept the faith
2 Tim 4:5,7