Global Health Exam 3

solutions

"The girl effect" is based on the philosophy that "50 million girls" equal "50 million _________" statistics chances solutions crises

The delay in getting pregnant

(Women's Health) The 'three delays' that had been major contributors to maternal mortality in Tamil Nadu include all EXCEPT The delay in seeking appropriate obstetric care The delay in transport to appropriate facility in case of an emergency The delay in receiving emergency obstetric care at a referral facility The delay in getting pregnant

a. Access to contraception b. Education about STI's and methods of prevention c. Treatment or referral for health concerns d. Nutrition programs

1) Name 3 services also provided in family planning programs.

- Over 90% of these deaths occur in 42 low or middle income countries.

1) Where do majority of childhood deaths occur?

a. Trafficking for forced labor or sex b. Sexual harassment and abuse by authority figures c. Dowry-related violence d. Honor killing e. Sexual, physical, emotional abuse by intimate partner, family member or others

3 examples of violence against women

HIV

___ is a virus that causes a disease of the immune system and can spread through unprotected sex, mother-to-child transmission during birth, blood, or transplantation of infected organs. Tuberculosis Malaria HIV Cholera

open defecation, unimproved, shared, improved

Choose the answer below that lists the sanitation ladder in order from basic to most effective. open defecation, shared, unimproved, improved open defecation, unimproved, shared, improved open defecation, unimproved, improved, shared unimproved, shared, improved, open defecation

Globally, more people die each year from injuries than malaria, TB, and HIV/AIDS combined.

Choose the one TRUE statement regarding unintentional injuries. Approximately 65% of injury deaths occur in low and middle-income countries. Globally, more people die each year from injuries than malaria, TB, and HIV/AIDS combined. Deaths from falls were the leading cause of deaths from injuries in 2000. Men are more likely to die from injuries related to fires/burns than women.

- Sex is biological, gender is cultural § Sex characteristics: women menstruate, men have testicles, women have breasts, men have more massive bones § Gender characteristics: women earn less money than men for similar work, more men than women smoke, women do more household work than men

Difference between sex and gender? 3 examples of sex vs. gender.

- Obtaining abortion in developing world is roughly same as developed world but ability to obtain legal and safe services often differ greatly.

Differences between access and safety of abortions.

- Women have low status: low education, illiteracy, limited economic opportunity, not able to make their own health care decisions, not able to make reproductive decisions which results in STI's, more children than desired, infertility)

How is health impacted by low status of women?

8

How many Millennium Development Goals were there? 1 2 4 8 16

a. Incontinence b. PID c. Uterine Prolapse d. Obstetric Fistula e. Nerve Damaga/Infertility f. Pain

Identify 3 long-term complications of maternal morbidity and STI's.

- Antibiotics (infections), Partogram (obstructed labor), oxytocin and manual compression (severe bleeding) o Basic Prenatal Care § Clinical examination § Obstetric and gynecological examinations § Urine test § Education o Basic Delivery Care § Clean delivery technique, clean cord cutting, clean delivery of baby and placenta § Active management of third stage of labor § Episiotomy in appropriate cases

Identify maternal health interventions. Name 3 items of basic prenatal care. Name 3 cases of basic delivery care.

- Early and exclusive breastfeeding - Infection control, including cord care and hygiene - Kangaroo Mother care

Interventions that can lower neonatal deaths.

- Improve nutritional status of females - Enhance access to education - Encourage communities to put greater value on women's health - Put greater emphasis on women as people rather than child bearers

Name 3 future challenges to women's health.

first month of life

Neonatal

- An injury in the birth canal that allows leakage from the bladder or rectum into the vagina, leaving a woman permanently incontinent

Obstetric Fistula

prolonged obstructed labor, damaging internal organs

Obstetric fistula, which frequently results from ____________________: prolonged obstructed labor, damaging internal organs tearing of skin during delivery rupture of blood vessels poor bladder control

Malaria

Of the options listed below, which of the following accounts for the largest cause of death for children under age 5? Tetanus Sudden Infant Death Syndrome Malaria HIV Pneumonia

22 weeks (gestation) to first week/life

Perinatal

Less than 37 completed weeks of gestation

Preterm birth is any birth happening at: Less than 37 completed weeks of gestation More than 37 weeks of gestation Before parents desired date Before physician's desired date

ovarian cancer

Some health issues are primarily determined by biology, such as the fact that women alone suffer from ___________. breast cancer ovarian cancer bladder cancer prostate cancer

Partners in Health

The Bill & Melinda Gates Foundation has joined forces to eradicate polio by 2013 with all of the following EXCEPT: CDC WHO Partners in Health Rotary International UNICEF

Smallpox

The first illness to have an effective vaccine against it was: Smallpox Polimyelitis HIV Influenza virus Dengue

tanker truck

The following are examples of improved drinking water sources, EXCEPT: piped water into dwelling public tap/stand pipe tanker truck protected spring

Sexual violence

The following challenge(s) compound(s) the AIDS epidemics in Cape Town, South Africa (select the one right answer): Maternal Mortality Infant Mortality Sexual violence Sexual abstinence

sanitation only, water and sanitation, or hygiene only

The greatest reduction in diarrhea morbidity comes from investing in which of the following? (please select one answer) water quantity only without investment in hygiene or sanitation air quality only without investment in hygiene or sanitation sanitation only, water and sanitation, or hygiene only combination of water quality and quantity without investment in hygiene or sanitation

Costs of care

The impact of maternal mortality and gender inequality may have economic consequences. Which of the following is NOT an example of indirect costs? Costs of care Lost of productivity Lost of contribution to family

Jonas Salk

The injectable polio vaccine was developed by whom? Edward Jenner Jonas Salk Albert Sabin Carlos Finlay

Hemorrhage

The leading cause of maternal death among low and middle income countries according to estimates from the WHO is: Hemorrhage Unsafe abortion Obstructed labor Sepsis

True

The lessons learnt from the success of Nepal's Vitamin A supplementation program are important because it happened in a very poor country with extremely weak governance and poor administrative capacity, indicating it could also be successful in similar countries. True False

True

True or False: A "fragile state" is a low income country characterized by weak state capacity from poor governance, poverty or violent conflict. Water shortages can further destabilize these countries. True False

True

True or False: Economic development and changes in land use are key factors contributing to the emergence and re-emergence of infectious diseases. True False

True

True or False: In 1967, the World Health Organization (WHO) decided to mount a global vaccination campaign to wipe out smallpox forever. However, the disease was so widespread that experts predicted total eradication was doomed to failure. True False

False

True or False: Once you are married, you should forget about AIDS. True False

True

True or False: The WHO now recommends a treatment plan for MDR-TB, modeled on Partners in Health's successes in Peru. True False

False

True or False: The effect of natural greenhouse gas emission from decomposition of plants and animal matter upsets the natural balance more than human activities add to global warming.

True

True or False: The frequency of natural disasters is increasing, likely a result of climate change. True False

True

True or false: The health of women is intimately linked with the Millennium Development Goals. True False

True

True or false: a randomized controlled trial conducted in Nepal determined that periodic vitamin A delivery could reduce mortality in children ages 6 to 60 months by as much as 30%. True False

indecent assault

Under South African law, male rape does not exist. Instead, the law says it is ______________ - a much lesser crime. battery indecent assault lewd and lascivious behavior' harassment

children 0 to 4

Under-five

Cholera

Unimproved sanitation in the developing world can have global consequences. The following disease is cited as an example in the lecture: Typhoid fever Cholera Parasitic worms E. coli

Almost half of all unintentional injury deaths occurred in this age group. These years are typically the most productive in an individual's life.

What is the significance of the injury-related mortality rates in young people between the ages of 15 and 45 years, globally? Deaths due to unintentional injury for this age group are decreasing, resulting in increased rates of higher education. Almost half of all unintentional injury deaths occurred in this age group. These years are typically the most productive in an individual's life. Almost one-third of all unintentional injury deaths occurred in this age group. This high rate of deaths due to unintentional injury has contributed significantly to increasing numbers of orphans. Deaths due to unintentional injuries in this age group are negligible. The burden of deaths due to unintentional injuries continues to fall on the elderly.

all options are correct

What obstacle has prevented the final eradication of poliovirus? rumors about vaccine safety political instability and armed conflict hard to reach populations all options are correct

South Asia and sub-Saharan Africa

What two regions have the highest maternal mortality ratios? Europe and Central Asia South Asia and sub-Saharan Africa Middle East and North Africa

Eastern Africa and Central Africa

What two regions have the highest rates of unsafe abortions, according to 2008 data? (please select one answer, as all answers have two regions listed in each option). Eastern Africa and Central Africa Eastern Europe and Eastern Africa South Central Asia and Western Africa South America and Southeastern Asia

plastic

What type of trash is found in the Great Pacific Garbage Patch? paper plastic oil fabric

PEPFAR

Which HIV/AIDS program was the largest commitment by any nation for a single disease (and created by a sitting US President) and has now transitioned from an emergency response to a sustainable response at the country level? 3 x 5 initiative UNAIDS PEPFAR Global Fund to Fight AIDS, Tuberculosis and Malaria

Women's longer life expectancy.

Which of the choices below is NOT an example of gender inequality? lower socioeconomic status of women. Women's longer life expectancy. limited power of women to make decisions. increased vulnerability of women to gender-based violence.

All of the options are correct

Which of the following are responsible for the decrease in the deaths due to diarrheal disease in children? Improved nutrition of infants Better Disease recognition Improved care seeking Appropriate use of oral rehydration therapy All of the options are correct

None of the choices

Which of the following countries is larger than the continent of Africa: United States France Germany None of the choices

All options are correct

Which of the following diseases can be prevented by vaccination: Poliomyelitis Pneumonia Smallpox All options are correct

Avoiding drugs altogether and instead using herbal supplements

Which of the following does NOT contribute to the development of drug resistance? (please select one answer) Increasing use of drugs Poor prescribing and dispensing practices Failure of patients to take appropriate dose or finish course of antibiotics Too much use of antibiotics in agriculture Avoiding drugs altogether and instead using herbal supplements

All are correct

Which of the following is NOT a behavioral risk factor for cardiovascular disease? All are correct Unhealthy diet Physical inactivity Tobacco use

rotavirus

Which of the following is NOT a nationally notifiable disease in the United States? HIV plague rotavirus yellow fever

physical and sexual abuse of women

Which of the following is NOT an example of biological risks faced by women (i.e. biological determinants of women's health): iron defiency anemia related to menstruation hypertensive disorders of pregnancy physical and sexual abuse of women

all options are example of such long-lasting effects

Which of the following is NOT an example of the long-lasting effects of untreated (or not treated in a timely and appropriate manner) sexually transmitted infections in women: pelvic inflammatory disease ovarian abscesses ectopic pregnancies all options are example of such long-lasting effects

malaria

Which of the following is NOT one of the 7 infectious disease candidates for eradication? malaria mumps polio measles guinea worm

They are more likely to be overweighted

Which of the following is NOT true regarding babies born to women smokers: They are more likely to be premature They are more likely to be overweighted They are more likely to die of sudden infant death syndrome

worldwide geographic distribution

Which of the following is an indicator that, if it were true, would make guinea worm NOT a good candidate for eradication? easy diagnosis no known animal reservoir worldwide geographic distribution low cost interventions

Skin-borne

Which of the following is not a manner of disease transmission? Foodborne Waterborne Skin-borne Vector-borne

all options are correct

Which of the following is related to the fact that women are not able to make their own reproductive decisions in some socities? infertility sexually transmitted infections more children than desired all options are correct

Pneumonia

Which of the following is the main cause of death for children under age 5? Tetanus Diarrhea Malaria HIV Pneumonia

Statements I and III only.

Which of the following is true regarding the child mortality rate? I. It is the probability that child born will die before reaching age 5, using current age-specific mortality rates in the population. II. It is not usually measured in high-income countries. III. It is influenced by multiple factors, including a country's health care system, poverty, and lack of adequate nutrition. Statements I and II only. Statements I and III only. Statement I only. Statement III only.

Risk factors for cancer include tobacco use, harmful alcohol use, poor diet, and physical inactivity.

Which of the following statements about cancer is true?\ Cancer only affects adults Malaria infection increases the individual's chance of developing cancer. More than 90% of all cancer deaths are preventable. Risk factors for cancer include tobacco use, harmful alcohol use, poor diet, and physical inactivity.

It is not known what causes Type II diabetes and it is not preventable.

Which of the following statements about diabetes is NOT true? (Chose the one false statement) Type I diabetes occurs when the pancreas does not produce enough insulin. It is not known what causes Type II diabetes and it is not preventable. Approximately 90% of the people in the world who have diabetes have Type II diabetes. Type II diabetes is usually associated with excess body weight and physical inactivity.

She is likely to be married by age 16.

Which of the following statements is NOT true regarding the time frame of a girl's development, as outlined in the "Girl Effect." (Chose the one FALSE statement). When a girl turns 12, she is considered a woman now. She is likely to be married by age 16. She is likely to be pregnant by age 15.

Statements I and III only

Which of the following statements is/are true: I. Eclampsia is a life-threatening condition in late pregnancy manifested by high blood pressure and seizures II. Obstetric fistula is a serious medical condition caused by a severe infection leading to a systemic inflammatory response III. Preeclampsia is characterized by high blood pressure, protein in the urine and swelling IV. Maternal death is the death of a woman while pregant, during delivery or within 1 day of delivery Statements I, II , and IV only Statements I, III, and IV only Statements I and III only Statements III and IV only

True

According to the TB video, patients with active MDR-TB were not removed to clinics or sanatoria for treatment - they were allowed to mix with others in a big crowded city. True False

Cardiovascular disease

According to the lecture on noncommunicable diseases, what is the number one cause of death for women in the U.S.? Cardiovascular disease Osteoporosis Breast cancer Prostate cancer

Prostate Cancer

According to the textbook, all of the following are examples of emerging infectious diseases EXCEPT Ebola Nipah virus Mad Cow Disease Prostate Cancer

Education, enforcement and engineering

According to the textbook, the risk factors for road traffic accidents revolve around Poverty, education level and infectious diseases Affluence, employment and life-style diseases Education, enforcement and engineering Maternal health, employment and infectious diseases

Amazon

According to the transcript for the video 'Amazon Crude' about Chevron, the ________ is the most important rainforest on earth. Congo Amazon Nile Valley Borneo None of the options are correct

24 hours

According to the video "Bed Nets: Nigeria Leads Fight Against Malaria", how long should an insecticide treated net stay outside before it can be safely used indoors? 30 minutes 8 hours 24 hours 36 hours

1 in 4000

According to the video "No woman should die giving birth", how many women die giving birth in developed countries? 1 in 400 1 in 4000 1 in 40000 It cannot be estimated

125

According to the video "Polio: The Last Hurdle", Polio cases have declined more than 99%, and the number of polio endemic countries has dropped from _________ to only 4. 215 512 125 1200

10; 90

According to the video "Rx for Survival: AIDS in Thailand", the condom use rate in brothels rose from ____% to ____%_ 10; 90 20; 80 30; 70 20; 90

Thailand had a very profitable tourist industry

According to the video "Rx for Survival: AIDS in Thailand", why didn't anyone want to do anything about AIDS in Thailand at first? AIDS was stigmatized as a homosexual disease Thailand had a very profitable tourist industry It would require regulation of red light district It would require regulation of green light district

85%

According to the video "Rx for Survival: An Incurable TB?", how many incurable patients were free of disease following the Partners in Health drug regimen? 50% 65% 85% 90%

HIV

According to the video "The Girl Effect", a girl who marries at an early age could eventually be put at higher risk of getting and spreading: diabetes HIV Tuberculosis Poverty

1/3

According to the video "Uganda: The Condom Controversy", how much funding under the PEPFAR plan for HIV prevention promotes only abstinence, according to the video? 1/4 1/2 1/3 3/4

incontinent

According to the video 'No woman should die giving birth: Maternal Mortality in Sierra Leone', obstetric fistula often leaves women _______________ and they are shunned by their families, friends and communities. infertile disfigured incontinent disabled

South Africa

According to the video 'South Africa: An Everyday Crime", the Tutuzela Clinic is one of the few places in the whole country where rape survivors can turn to for help. What country is this clinic in? Nepal Haiti South Africa Botswana

More than medical and nursing care, it is about empowering survivors so life can go on after rape

Based on what Sister Bartlett says in the video and on additional information provided in the same video, the work performed by the Tutuzela Clinic is best characterized as: Just dealing with patient after rape More than medical and nursing care, it is about empowering survivors so life can go on after rape She does not mention anything about the work at Tutuzela Expensive

The impact of restraint use (such as seatbelt and child car seats) is presumed to be positive, but has not been scientifically evaluated.

Which of the following statements regarding road traffic accidents prevention is NOT true? (Chose the one false statement) Helmet use can reduce the risk of death due to road traffic accidents by almost 40% and reduce the risk of severe injury by almost 70%. Countries lacking the infrastructure for public and healthcare services often lack the quality pre-hospital care that can improve survival rates. Wearing a seat belt reduces the risk of death by 40-65% for a front seat passenger. The impact of restraint use (such as seatbelt and child car seats) is presumed to be positive, but has not been scientifically evaluated.

Statements II and III only.

Which of the following statements regarding wastewater is/are true? I. In developing countries, 90% of all wastewater is treated. II. When dumped into water resources, untreated wastewater creates dead zones. III. As oxygen levels become depleted in water resources, marine life cannot survive. Statement I only. Statements II and III only. Statement III only.

Only statements I, II, and IV are correct.

Which of the statements below about mental disorders is true? I. External risk factors for development of mental disorders include poverty, stressful work conditions, gender discrimination, and risks of violence. II. More than 40% of countries have no mental health policy. III. Individuals in high income countries are more likely to suffer from mental disorders. IV. Individuals of low socioeconomic status are less likely to get care for mental disorders. Only statement III is correct. Only statements I, II, and IV are correct. Only statements I and II are correct. Only statements III and IV are correct.

Lung

Which type of cancer is the leading cause of cancer deaths worldwide? Lung Stomach Liver Breast

- Women are at a much higher risk than men

Who is most affected by chlamydia?

not enough vaccine & too many people

Why was achieving vaccination target (% of population) in Nigeria impossible? too many people & rumors fearing vaccine safety rumors fearing vaccine safety & not enough vaccine not enough vaccine & too many people all options are correct none of the options are corr

5 years old

Child Mortality Rate is the probability that a child born live will die before reaching what age? 1 year old 4 years old 5 years old 12 years old 19 years old

Delay in receiving a blood transfusion

According to Dr. Bundu, the main reasons for the death of so many pregnant women are the following, EXCEPT; Delay in seeking medical care Delay in reaching a hospital Delay in receiving adequate treatment Delay in receiving a blood transfusion

It is a very expensive method of keeping the baby warm.

All of the following are correct about Kangaroo Mother Care (as it pertains to child health) EXCEPT The baby, wearing only a diaper is kept warm through contact with the mother's skin. The skin-to-skin contact between the mother and the baby enhances their psychological bond, which improves health and development The baby can nurse 'on demand', which helps low birth weight babies to gain weight and gain protection from infections. It is a very expensive method of keeping the baby warm.

multiple animal reservoirs

All of the following are good indicators for disease eradication EXCEPT: effective intervention tools multiple animal reservoirs easy diagnosis of cases political support

all women

Female genital mutilation (or 'cutting') is generally carried out on ____________. female infants female children and young teenagers older women all women

All options are correct

Extreme poverty is falling in which of the following regions of the world? Sub-Saharan Africa Latin America Asia North America Europe All options are correct

The conscious effort of couple to regulate the number and spacing of births through artificial and natural methods of contraception

Family Planning

Community saving schemes

In order to pay for emergency maternal health care, Sierra Leone's communities have found the following partial solution: Community saving schemes Establishing community hospitals Asking for help from UN agencies Nothing

12

In the video "The Girl Effect", age ______ is identified as a turning point for a girl who lives in poverty. 2 5 12 16

first year of life

Infant

- Higher rates of cerebral palsy - Sensory deficits - Learning disabilities - Respiratory illness

Long-term consequences of preterm or low birth weight babies.

False

Question 44 0 / 2 pts Incorrect True or False: Insecticide treated bed nets have been shown to reduce under-five child mortality from all causes by 50%. True False

- Causes: severe bleeding, infections, eclampsia, obstructed labor, unsafe abortion,

Regions where maternal mortality is highest, lowest. Describe major causes of maternal morbidity.

- Poverty - Inadequate nutrition - Education status of mother - Poor access to safe water and sanitation, health services and education, family income

Risk factors that contribute to childhood illness/death.

2 billion

Rotary International has helped immunize how many children against polio? 1 billion 2 billion 3 billion 4 billion

- A serious medical condition caused by a severe infection, leading to a systemic inflammatory response

Sepsis

Vitamin A

The deficiency of which vitamin in children increases their risk of dying from diarrhea, measles and malaria by 20-24%? Vitamin D Vitamin B12 Vitamin A Vitamin C

More than 3,000 miles

The distance between Freetown, Sierra Leone and Nairobi, Kenya in Africa, is: More than 3,000 miles More than 7,000 miles Less than 3,000 miles Cannot be measured because roads in Africa are in poor condition

False

Traditional Birth Attendants (TBAs) in Sierra Leone are always trained and always offer cheaper alternatives than modern medicine. True False

industry

What activity uses most of our freshwater? industry residential irrigation toilets

all options are correct

What are some of the side effects the drugs used to TB can cause? nausea depression joint pain fatigue all options are correct

long-term political commitment & strong leadership

What has Thailand shown provides a powerful prescription in the battle against HIV? strong leadership & money long-term political commitment & strong leadership money & long-term political commitment all options are correct none of the options are correct

all options are correct

What is a long-term complication of maternal morbidity? obstetric fistula pelvic inflammatory disease incontinence all options are correct

Elimination is reducing the incidence of a disease in a specific area while eradication is the termination of all cases of a disease and its transmission globally.

What is the difference between the elimination and eradication of a disease? Elimination is reducing the incidence of a disease in a specific area while eradication is the termination of all cases of a disease and its transmission globally. Eradication is reducing the incidence of a disease in a specific area while elimination is the termination of all cases of a disease and its transmission globally. Both A and B are correct Neither A and B are correct

cooking and heating with solid fuels

What is the killer in the kitchen that causes 1.5 million deaths a year? contaminated water cooking and heating with solid fuels cooking with natural gas cooking with ethanol

Sub-Saharan Africa

What is the region of the world has the highest deaths due to water-related diseases? Latin America Asia Sub-Saharan Africa Eastern Europe