Module 4-5

Question 1

What does GBD stand for?

Answer 1

Global burden of disease

Question 2

How many diseases and countries are being tracked since 1990?

Answer 2

About 300 diseases in 195 countries

Question 3

What are the three groups into which GBD classifies all diseases?

Answer 3

CMNN (communicable, maternal, neonatal, and nutritional), NCDs (non-communicable: CVD, cancers, diabetes, COPD), Injuries/Accidents

Question 4

What is SDI?

Answer 4

Socio-economic development index: GDP proxy for wealth, education years proxy for literacy, and fertility rates proxy for social status of women

Question 5

Why does GBD monitor SDI in addition to disease burdens?

Answer 5

Your health status can affect all of these things like your wealth, education, and fertility rates

Question 6

What communicable disease created a ‘hiccup’ in the general reduction of CMNN burdens globally?

Answer 6

Spanish influenza, HIV/AIDS, and Covid-19 possibly

Question 7

What kind of nutrient is composed of amino acids? How many are there?

Answer 7

Proteins and 20

Question 8

What are essential amino acids?

Answer 8

Amino acids that you need in every meal (8-10)

Question 9

How do vegetarians get adequate essential amino acids?

Answer 9

Grains + legumes, grains + milk products, seeds + legumes

Question 10

What percent of our daily caloric intake should come from proteins?

Answer 10

10-35%

Question 11

What 3 conditions generally affect a person’s caloric needs?

Answer 11

Age, sex, and activity levels

Question 12

If only minimal recommended calories are available, what percent of the calories should be from proteins?

Answer 12

35%

Question 13

Who is most vulnerable to energy/protein deficiencies? Why?

Answer 13

Children (still developing) and women of childbearing age (body is trying to prepare if a pregnancy was to occur and if it does then growing a fetus needs supplied as well)

Question 14

What are the three types of energy deficiency diseases?

Answer 14

Underweight, stunted, and wasted

Question 15

Underweight and wasted consequences

Answer 15

Compromised physical development and immune system function, increased risk of illness and death from common infectious diseases especially diarrhea and pneumonia

Question 16

Stunted consequences

Answer 16

Compromised physical and immune system development, compromised mental and intellectual development, perpetuating (make) poverty. For girls: increased risk of pregnancy/childbirth complications, and low birth-weight babies

Question 17

Kwashiorkor

Answer 17

Acute protein deficiency that leads to higher mortality

Question 18

Marasmus

Answer 18

Chronic caloric and protein deficiency that leads to severe wasting

Question 19

What are the three dimensions and 4 indicators for the global hunger index?

Answer 19

Three dimensions: food supply, child mortality, and child undernutrition
4 indicators: food supply: per capita calories, child under nutrition: prevalence of stunting and wasting, under 5 mortality

Question 20

What SDG does the GHI inform?

Answer 20

GHI informs SDG 2: eliminate extreme hunger

Question 21

Globally, but more so in LMIC countries, what are the two leading causes of infectious disease deaths? Are these a problem in the USA?

Answer 21

Pneumonia and diarrhea, yes, but not nearly as severe

Question 22

What are risk factors for pneumonia? Causes?

Answer 22

Inflammation and fluid leaks into the alveolus, O2 is hydrophobic, O2 can’t cross into blood, blood O2 levels drop

Question 23

How does pneumonia cause death?

Answer 23

Literally ‘drown’ in your own fluids

Question 24

What are the three types of diarrheal diseases?

Answer 24

Osmotic, motility, and infectious-secretory

Question 25

How can diarrhea cause death?

Answer 25

Through dehydration and electrolyte imbalance

Question 26

What is the care and treatment of a child/infant with diarrhea?

Answer 26

Oral rehydration therapy/salts after every watery stool, WASH, eat as normally as possible, continue breastfeeding infants, and antibiotics for bacteria/parasites

Question 27

Uterus changes

Answer 27

Size increases 15x and volume >500x

Question 28

Cardiopulmonary changes

Answer 28

Blood volume and cardiac output increase as much as 60%, blood pressure should stay the same or even decrease due to vasodilation signals in from progesterone, increased ventilation rates, lower CO2 improves O2 to baby

Question 29

Endocrine-metabolic changes

Answer 29

Increased need for iron, Ca+, folate, protein, and calories, insulin sensitivity increases in early pregnancy: occasional hypoglycemia, but decreases in late pregnancy: occasional gestational diabetes

Question 30

Musculoskeletal changes

Answer 30

Joint laxity, postural changes, low back pain

Question 31

What are the three stages of labor and delivery?

Answer 31

1. Cervical effacement and dilation 2. Birth or parturition {up to 4 hours} 3. Delivery of placenta {5-30 minutes}

Question 32

Describe the three primary complications of pregnancy

Answer 32

Placental placement - risks hemorrhage, previa: placenta blocks the cervix and requires a C-section, accreta: placenta invades uterine wall and requires hysterectomy, Pre-eclampsia- abnormal hypertension >140/90 and proteinuria, can progress to maternal seizures, low platelets {requires delivery ASAP}, Gestational diabetes - exaggerated insulin resistance, risk include: family history/ethnicity, obesity, poor nutrition, inactivity, other pro-inflammatory stresses

Question 33

Describe the three primary complications of delivery

Answer 33

Failure to progress or obstructed labor - requires C-section, Non-reassuring fetal status - fetal distress caused by maternal anemia, hypertension or placental complications {C-section}, Maternal hemorrhage - due to placental anomalies or HELLP

Question 34

What are the most common risks to neonates?

Answer 34

Aspiration of amniotic fluid- fluid in lungs, asphyxia - poor O2 to brain, ability to suction and provide O2 save lives

Question 35

What are the risks of teen pregnancies?

Answer 35

Death, more likely to seek abortion {most unsafe}, have poor access, long term negative consequences

Question 36

Besides consensual sex, what are some causes of teen pregnancies?

Answer 36

Rape, early marriage, sex trafficking

Question 37

What communities in LMIC and HIC are teen girls most vulnerable to unwanted pregnancies?

Answer 37

10-19 year old age group

Question 38

What are the most common bacterial STDs? Viral?

Answer 38

Genital herpes simplex {HSV}, human papilloma virus {HPV} hepatitis B {HepB}, HIV

Question 39

How are bacterial and viral STDs prevented and treated differently?

Answer 39

Prevention - monogamous sexual relationships and barrier contraception - condoms, drug resistance {antibodies} is increasing - gonorrhea and syphilis

Question 40

What was the Tuskegee syphillis experiment? How has that affected reproductive health among African Americans?

Answer 40

‘Using’ uninformed black men - longitudinal study to examine long term consequences of syphillis, African Americans have become more untrustworthy of health care providers after these experiments

Question 41

Gravidity

Answer 41

Number of pregnancies - includes stillborn, miscarriages, abortion, and live births

Question 42

Parity

Answer 42

Number of live births - population statistics

Question 43

Fertility rates

Answer 43

Average number of children born to a women {used in SDI}

Question 44

Replacement population

Answer 44

Maintaining stable population with ‘2 children to replace 2 parents’ fertility rates

Question 45

What are the leading causes of maternal mortality?

Answer 45

Pre-eclampsia and hemorrhage

Question 46

Besides mortality, what are some possible morbidities of maternal complications?

Answer 46

Still birth, maternal obstetric fistula, and paralysis

Question 47

What are some etiological risks/exposures increasing maternal morbidity-mortality?

Answer 47

Infection risk, tearing during delivery, postpartum hemorrhage, increased need of C-section, and short or very long spacing between pregnancies

Question 48

Why is focusing on adolescent health important?

Answer 48

Largest population in world, healthiest time of our lives

Question 49

Globally what are three ways to reduce maternal mortality rates?

Answer 49

Education and opportunities for girls, reduce early and frequent births, and access to prenatal care and attended births

Question 50

What are the top 3 reasons for neonatal {0-28 days} and child {1 month-5 years} mortality globally?

Answer 50

Neonatal: preterm complications, asphyxiation, and sepsis Child: diarrhea, acute respiratory infections- pneumonia, and malaria

Question 51

What are essential birthing interventions for delivery and neonatal care?

Answer 51

Aspiration capacities, oxygenation, antibiotics, and kangaroo care

Question 52

Describe the SOCHAU Nutri-bracelet. What are nutrition recommendations for 0-24 months of age?

Answer 52

0-6 months exclusively breastfeeding 6-24 months gradually introduce cereals, meats, fruits, and vegetables in addition to breastfeeding

Question 53

List three benefits of breastfeeding each for babies and moms

Answer 53

Babies: higher IQ, heart and circulatory system, and immune system Moms: releases oxytocin, helps your uterus, and helps burn extra calories