Title: Global Health FINAL / Noncommunicable diseases

Q: Noncommunicable (chronic) diseases: (3)
A: > Diseases of long duration and generally slow progression. These conditions do not result from an acute condition and so they do not resolve spontaneously, and for which a complete cure is rarely achieved.
> NCDs tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behavioral factors.
> They are the leading cause of mortality in the world.

Q: NCDs are driven by forces that include: (3)
A: 1. Rapid unplanned urbanization
2. Globalization of unhealthy lifestyles
3. Population ageing.

Q: The leading NCD in the term of premature death is cardiovascular diseases, metabollic risk factors of this diseases such as unhealthy diets and a lack of physical activity may show up in people as: (4)
A: 1. Raised blood pressure
2. Increased blood glucose
3. elevated blood lipids
4. Obesity

Q: Characteristics of NCDs: (6)
A:  Complex etiology (causes)
 Multiple risk factors
 Long latency period
 Non-contagious origin (noncommunicable)
 Prolonged course of illness
 Functional impairment or disability

Q: The four main types of noncommunicable diseases are:
A: 1. Cardiovascular diseases
2. Cancer
3. Chronic respiratory diseases
4. Diabetes

Q: Other chronic diseases: (3)
A: 1. Chronic neurologic disorders (Alzheimer's, dementias)
2. Arthritis/ musculoskeletal system
3. Unintentional injuries

Q: Behavioural risk factors for NCDs: (5)
A: 1. Tobacco use
2. Alcohol misuse
3. Poor dietary quality
4. Physical inactivity
5. Risky road user behaviour

Q: Enviromental risk factors: (3)
A: 1. Air pollution
2. Unsafe roads and vehicles
3. Built environment that impedes physical activity

Q: Physiological risk factors: (3)
A: 1. Obesity
2. High LDL and low HDL and cholesterol
3. High blood pressure

Q: Risk factor:
A: An aspect of personal behavior or lifestyle, an environmental exposure, or a hereditary characteristic that is associated with an increase in the occurrence of a particular disease, injury, or other health condition.

Q: Modifiable Risk Factor:
A: A behavioral risk factor that can be reduced or controlled by intervention, thereby reducing the probability of disease.

Q: Four modifiable risk factors WHO has prioritized:
A: 1. Physical inactivity
2. Tobacco use
3. Alcohol use
4. Unhealthy diets (increased fat and sodium, with low vegetable intake)

Q: Non-modifiable risk factor:
A: A risk factor that cannot be reduced or controlled by intervention.

Q: Examples of non-modifiable risk factors: (4)
A: 1. Age
2. Gender
3. Race
4. Family history (genetics)

Q: The top four modifiable lead to four key metabolic/physiological changes: (4)
A: 1. Raised blood pressure
2. Overweight/ obesity
3. Raised blood glucose
4. Raised cholesterol

Q: Metabolic refers to:
A: The biochemical processes involved in the body's normal functioning.

Q: WHO has prioritized the following four metabolic risk factors: (4)
A: ‒ Raised blood pressure
‒ Raised total cholesterol
‒ Elevated glucose
‒ Overweight and obesity

Q: Cardiovascular disease (CVD) is a group of disorders of the heart and blood vessels and they include: (6)
A: o Coronary heart disease
o Cerebrovascular disease
o Peripheral arterial disease
o Rheumatic heart disease
o Congenital heart disease
o Deep vein thrombosis and pulmonary embolism

Q: Coronary heart disease:
A: Disease of the blood vessels supplying the heart muscle

Q: Cerebrovascular disease:
A: Disease of the blood vessels supplying the brain

Q: Peripheral arterial disease:
A: Disease of the blood vessels supplying the arms and legs

Q: Rheumatic heart disease:
A: Damage to the heart muscle and heart valves from rheumatic fever, caused by streptococcal bacteria.

Q: Congenital heart disease:
A: Malformations of the heart existing at birth

Q: Deep vein thrombosis and pulmonary embolism:
A: Blood clots in the leg veins,  which can dislodge and move to the heart and lungs.

Q: Major modifiable risk factors for CVDs: (7)
A: 1. High blood pressure
2. Abnormal blood lipids
3. Tobacco use
4. Physical inactivity
5. Obesity
6. Unhealthy diet (salt)
7. Diabetes

Q: Other modifiable risk factors of CVDs: (6)
A: 1. Low socioeconomic status
2. Mental ill health (depression)
3. Psychosocial stress
4. Heavy alcohol use
5. Use of certain medication
6. Lipoprotein A

Q: Non-modifiable risk factors for CVDs: (4)
A: 1. Age
2. Heredity or family history
3. Gender
4. Ethnicity or race

Q: "Novel" risk factors for CVDs: (3)
A: 1. Excess homocysteine in blood
2. Inflammatory markers (creactive protein)
3. Abnormal blood coagulation (elevated levels of fibrinogen)

Q: Why are cardiovascular diseases a development issue in low- and middle-income countries? (3)
A:  People in low- and middle- income countries often do not have the benefit of integrated primary health care programmes for early detection and treatment of people with risk factors compared to people in high-income countries.
 People in low- and middle-income countries who suffer from CVDs and other noncommunicable diseases have less access to effective and equitable health care services which respond to their needs. As a result, many people in low- and middle-income countries are detected late in the course of the disease and die younger from CVDs and other noncommunicable diseases, often in their most productive years.
  At the household level, sufficient evidence is emerging to prove that CVDs and other noncommunicable diseases contribute to poverty due to catastrophic health spending and high out-of-pocket expenditure.Dr. La

Q: How can the burden of cardiovascular diseases be reduced?
A: “Best buys” or very cost effective interventions that are feasible to be implemented even in low-resource settings have been identified by WHO for prevention and control of cardiovascular diseases. They include two types of interventions: population-wide and individual, which are recommended to be used in combination to reduce the greatest cardiovascular disease burden.

Q: Examples of population-wide interventions that can be implemented to reduce CVDs include: (5)
A: o Comprehensive tobacco control policies
o Taxation to reduce the intake of foods that are high in fat, sugar and salt
o Building walking and cycle paths to increase physical activity
o Strategies to reduce harmful use of alcohol
o Providing healthy school meals to children.

Q: At the individual level, for prevention of first heart attacks and strokes:
A: Individual health-care interventions need to be targeted to those at high total cardiovascular risk or those with single risk factor levels above traditional thresholds, such as hypertension and hypercholesterolemia. The former approach is more cost-effective than the latter and has the potential to substantially reduce cardiovascular events. This approach is feasible in primary care in low-resource settings, including by non-physician health workers.

Q: For secondary prevention of cardiovascular disease in those with established disease, including diabetes, treatment with the following medications are necessary: (4)
A: o Aspirin
o Beta-blockers
o Angiotensin-converting enzyme inhibitors
o Statins.

Q: Diabetes:
A: A disorder of metabolism, the way the body uses digested food growth and energy.

Q: The four types of diabetes:
A: 1. Type 1
2. Type 2
3. Gestational
4. Pre-diabetes (impaired glucose tolerance)

Q: Practices that can prevent or delay the onset of type 2 diabetes: (4)
A: 1. Healthy diet
2. Regular physical activity
3. Maintaining a normal body weight
4. Avoiding tobacco use

Q: Major modificable risk factors for diabetes: (5)
A: 1. Unhealthy diets
2. Physical inactivity
3. Obesity or overweight
4. High blood pressure
5. High cholesterol

Q: Other modfiable risk factors for diabetes: (5)
A: 1. Low socioeconomic status
2. Heavy alcohol use
3. Psychological stress
4. High consumption of sugar beverages
5. Low consumption of fiber

Q: Non-modifiable risk factors for diabetes: (4)
A: 1. Increased age
2. Family history/ genetics
3. Race
4. Distribution of fat

Q: Other risk factors of diabetes: (2)
A: 1. Low birth weight
2. Presence of autoantibodies

Q: Cancer:
A: Generic term for a large group of diseases that can affect any part of the body. Rapid creation of abnormal cells that grow beyond their usual boundaries and which can then invade adjoining parts of the body and spread to other organs.

Q: Risk factors from the enof chronic respiratory diseases: (4)
A: 1. Cigarette smoke
2. Occupational dust and chemicals
3. Enviromental tobacoo smoke
4. Indoor and outdoor air pollution

Q: Risk factors of the individual for chronic respiratory diseases: (4)
A: 1. Genes
2. Infections
3. Socio-economic status
4. Aging populations

Q: Surveillance for non-communicable disease can be difficult because of: (3)
A: o Lag time between exposure and health condition,
o More than one exposure for a health condition, and
o Exposure linked to more than one health condition.

Q: Risk factor surveillance: (3)
A: 1. Change people's behavior
2. Reduce risk
3. Reduce burden of disease.