Oral Boards Epidemiology

• CAP is the most common cause of infection-related mortality and the sixth leading cause of death in the US.
• CAP 2-3 million cases diagnosed each year in the US.
• Highest incidence: Infants < 2 years and Elderly > 55 yrs
• Winter months more prevalent

• CAP is the most common cause of infection-related mortality and the sixth leading cause of death in the US.
• CAP 2-3 million cases diagnosed each year in the US.
• H influe most commonly in non-vaccinated children/infants < 6 years
• Chronic cardiopulmonary disease
• Following upper respiratory tract infection

• Exposure to contaminated water
• CAP or health care associated, mainly in summer/fall
• Smokers, immunocompromised, chronic lung disease

• Alcoholics, health care associated
• CAP is the most common cause of infection-related mortality and the sixth leading cause of death in the US.

• ·All age groups but prevalent in young adults (ages 5-20)
• ·commonly occurs during the summer/fall
• ·Occurs in closed populations such as schools and military installations or families.

Onset - late 30s and 40s, most commonly in smokers

Onset – after age 50 in smokers.

• Common; 5% of population affecte, M+W
• Hospitalization rates highest among blacks and children
• Death rates for asthma are consistently highest among black youth aged 15–24 years

·About 50 million adult Americans have the disease.

• ·Incidence of HTN increases with age and is more common in African-American and Hispanics than whites.
• ·It is more common in younger men than in women, till age 55 then risk is equal and after 75 women are more prone to HTN.

Already discussed in definitions

• Leading cause of morbid/mortality in US and Europe
• Males 50-60 yo, females older
• Atherosclerosis risk factors: A METHOD
• -age
• -male
• -elevated homocysteine and lipoproteins
• -tobacco
• -HTN
• -obesity
• -dyslipidemia
• family hx also a risk factor for MI

• 1 million hospital admissions
• 5 million cases in USA
• 50,000 deaths annually
• 75% of existing and new cases occur in pts. > 65

IDA is most common form of anemia, 20% of women, 50% of pregnant women, and 3% of men are iron deficient.

• ·Vitamin B12 deficiency
• o most common in patients with pernicious anemia, vegetarians/vegans surgical resection of ileum, gastrectomy, Tapeworm, Malabsorption (Crohn’s Dz)
• oimmunologic diseases such as Grave’s dz, thyroiditis, hypoparathyroidism
• ·Pernicious anemia
• oelderly females >70yo; associated with autoimmune diseases: GTAP(Graves’ disease, Thyroiditis, Adrenal insufficiency, Positive FH)
• ·Folate deficiency
• oInadequate dietary intake, malnutrition such as with alcoholics, anorexic patients.
• oMalabsorption (tropical sprue).
• oPatients with increased requirements – pregnancy, chronic hemolytic anemia.
• oDrugs: phenytoin, sulfasalazine, tmp/smx

• ·Inherited hemolytic anemias are rare; often associated with family history of anemia, jaundice, early cholecystitis, or need for splenectomy
• ·Acquired hemolytic anemias occur frequency in sick pts., secondary to malignancy, infection or drugs
• ·G6PD:
• oAutosomal recessive, occurs in 10-15% of AA males and also seen in
• Mediterraneans.
• M > F
• · Sickle cell anemia:
• oAutosomal recessive, 1/400 African Americans births produce a child
• with SCA
• ·Hereditary spherocytosis:
• oAutosomal dominant disease of variable severity

• Globally most common genetic blood disorder
• SAM ancestry
• Southeast Asian ancestry
• African ancestry
• Mediterranean ancestry
• Alpha: Asians (SE Asia & China)
• Beta: Mediterranean origin (Italian, Greek); Africans, SE Asians

• ·Transmitted via fecal-oral route
• ·Common source from contaminated water/food.
• ·Areas of overcrowding, poor sanitation, poor hygiene.

• ·Transmitted percutaneously, mucous membrane exposure to infected blood, sexual contact
• ·HBV is predominant in males: homosexual men, IVDAs
• ·Health professionals exposed to infected blood

• ·IVDAs, intranasal cocaine
• ·body piercing, tattooing
• ·hemodialysis

• 1/10,000 incidence
• Any age
• Peak incidence: 2nd and 3rd decade
• Europeans, North Americans, Jews

• ·Most common in Caucasians with an increased incidence in the Jewish population.
• ·Peak occurrence between ages 15-35, but onset can occur at any age.
• M=F
• ·More common in nonsmokers and former smokers and the severity of the disease may be less in active smokers and may worsen when smoking cessation occurs.

• ·30.4% of Americans are obese
• ·Women moreso than men
• ·African American and Mexican American moreso than white women
• ·Poor are more obese than the rich regardless of race

• 80-90% of people who have astroke due to atherosclerosis have had a TIA episode before
• Blacks>whites, men>women
• Risk highest in pts 55 yo and older

• ·Third leading cause of death, approximately 200,000 a year
• · Non-modifiable Risk Factors = increased age, male, Af. American, FH, hypercoagulable state, sickle cell dz

·Modifiable Risk Factors = hypercholesterolemia, HTN, heart disease (A-fib), TIA, smoking, OCP use, obesity, DM

• One of most common bacterial infections of childhood, accounts of 20-40% of all cases of exudative pharyngitis in children.
• Seen in patients of all ages

• Acute: Infants and children mostly, Adult can have it as well
• Chronic: Infants and children
• Serous: Children

• MOST ARE VIRAL!!
• Bacteria cause 25%; leading cause of abx resistance

• §Non-allergic rhinitis affects 5-10% of population; however, only 2-4% of pts actually seek Tx for relief of their sxs.
• §Viral is one of 7 basic sub-classifications of non-allergic rhinitis.

• Acid peptic ulcers are very common in US, 4 million (new cases and recurrences) occur per year
• More common in pts that smoke and use NSAIDS on a chronic basisMore common in men; 60-70 y/o (NSAID use)

• Most Common Type of PUD
• 6-15% of population50 y/o; has decreased in the past 20 years

• 25% of hospitalized patients will develop it
• 5% of hospital admissions and 30% of ICU

• 6% of population is in stage I or II of ESRD~ 4.5% are in stages III or IV
• Af Am > white
• >65

• Most affected areas = Sub-Saharan Africa, India, Asia (in rank of order)
• IVDU and heterosexual routes predominate
• 3 million are living with HIV, more than 80% are <30 yo

• Female > Male
• All age groups affected

• Usually begin in adolescence/early adult life and occur episodically throughout adulthood
• Women > men

• -18.2 million people in the US had DM, with about
• 1.4 with Type1.
• -90% are immune mediated
• -10% idiopathic
• -Commonly in children and young adults
• -Mean age of onset is 8-12 y/o, peaking in adolescence
• -Girls = boys equally affected
• - Racial predisposition towards Caucasians
• -African Americans have lower overall incidence

• Most 40yo and obese, incresaing in children and adolescents
• W>M in Caucasian populations
• Over 90% of DM in the US is T2DM
• More common in African Americans and Native Americans
• Strong polygenic familial susceptibility

• Patients who have received CNS radiation for leukemia 15% chance developing years later
• Females > males
• Iodine deficiency is the most common worldwide cause
• Hashimoto’s thyroiditis is most common U.S. cause
• Infants & Children– cretinism (mental/growth retardation)
• Adult onset – Myxedema (slow metabolic process, reversible w/tx)
• Pregnancy

• F:M=8:1
• M.C. cause=Grave’s dz (60-80%)
• Typical onset=20-50 y.o.

• §Most common joint disease in the U.S.,
• §100,000 people in the US can’t walk independently from bed to bathroom b/c of OA of the knee or hip.
• § >90% of persons over age 40 have some radiographic changes of OA in weight-bearing joints
• § W>M 2:1

• ·Risk factors: Female, post-menopausal, Caucasian, thin, ETOH, tobacco, Fx, sedentary lifestyle, lack of sun exposure
• Protective: Oral contraceptives, Obesity

• § Most likely to occur at the L4-L5 and L5-S1
• § Herniation is unusual prior to age 20, and risk increases as age does
• § In older patients, there is a relatively increased risk of disk herniation at the L2-L3 (L3 nerve root) and L3-L4 (L4 nerve root) levels

Age is greatest risk factor, >60

• Common in the elderly, by age 85, 30-50% of people have dementia
• Women sufer disproportinately as pts and caretakers

• More common in Asia than in Europe and North America
• Second most common cause of dementia after Alzheimers
• 9x higher in pts who have already had a stroke
• Men more than women, risk increased with age

• All ages, gender, & race
• 30% of primary care pts.
• Chronic disease and medical Conditions: CA Cardiac pathology
• Neuro disorders – CVA, Parkinson’s, dementia, MS, Alzheimer’s, brain injury, epilepsy
• Hyper/Hypothyroidism
• DM
• HIV/AIDS
• Chronic Hep C
• Disorders of unknown etiology: chronic fatigue, fibromyalgia (-) life events, stressful situations
• Post-partum

• 2nd most common reason why a person misses work
• The most common back injuries are muscle strains followed by disc injuries
• It's a common sports injury, atheltes are 80% more likely to sustain injuries in practice than during competition