Medical Case Study Answers

1. Why are the who, when, and where questions useful in determining the causes of disease? Give examples.
The who question, “Characterizes the disease victims by such factors as age, sex, race, and economic status (pg. 66). Example would be that more women get breast cancer than men or that most people with sickle cell disease are of the African American ancestry.
The when question, “looks for trends in disease frequency over time: incidence increasing, decreasing, or remaining stable (pg 66-67). For example we can determine that the flu is a seasonal disease that begins in mid-winter and lasts until early spring.
The where question, “looks at comparisons of disease frequency in different countries, states, counties, or geographical divisions”

Think of a medical test that you or someone you know has undergone. Was it more important for the test to be sensitive or for it to be specific?
I recently had to get blood work completed at St. Mary’s before I could start my clinical rotation. In my opinion it is more important for these tests to be sensitive than specific. If the test came back positive it would not be safe for me to be in the hospital setting. If I had a false negative from a Tuberculosis skin test and continued to going into patient rooms then I would run the risk of spreading the disease. If I had false positive results then I would be faced with taking a medication to treat TB and undergo multiple chest x-rays. Also it would hamper when I got to start clinical

Visit the Web site of the Centers for Disease Control and Prevention (www.cdc.gov)
a. Where in the US is rabies endemic in animals? Have there been any cases of human rabies in the last year or two?
The CDC determined that ninety-two percent of reported rabid animals were wildlife. Most cases occur on the East coast and Midwest states. Two cases of human rabies have been reported in the last four years, one in Maryland and the other in Texas. The patient in Maryland developed rabies from a kidney transplant. The case from Texas is still an unknown as no source of exposure has been determined. Both cases were fatal.
b. Where in the US have there been measles outbreaks in the last year or two? What was the source of the outbreak?
A large scale measles outbreak occurred at an amusement park in California. The CDC found that the outbreak most likely started from a traveler who became infected overseas. The CDC were unable to identify a source from this outbreak. Another large scale outbreak with 383 cases reported occurred in Ohio. The outbreak occurred in an unvaccinated Amish