cmed recon EVALS 5

 ________________________________________________  ____________________ _____________________________________________________ ________________________________________________ ________________________________  _________ 

EVALS 5 (22 OCTOBER 2010) TOPICS COVERED:   DOH Programs: TB DOTS (items 1 ± 15) ± ISP as prepared by Dr. Ambat   Rabies Control: (items 15 ± 30) ± ISP as prepared by Dr. Ambat   Substance Abuse: (items 31 ± 50) ± Dr. Ambat H1N1: (items 51 ± 60) ± ISP as prepared by Dr. Ambat     Environmental Pollutants: (items 61 ± 75) ± Dr. Gonzaga   Occupational Health: (items 76 ± 100) ± Dr. Dacayo Sources: Commed Book, intelligent answers of the transcriber and one-on-one w/ doc Gonzaga (ahaha charos! Jok lng:P)

REAL SOURCES: HANDOUTS given by the dept, past cor TRANX 2011 & witty guessing of the transcriber :p PLS. TAKE NOTE OF THE SET: SET: THIS RECON IS FOR EVALS 5 correct answers are BOLDED and ITALICIZ ED. ED.

22 OCTOBER 2010 , and the

ahabol P ahabol

Greetings: ALOHA nlng ulet sa mga friends ko, Belated Hapi Balentayms mga beki!!! Hehe!  Hapi aral guys! FIGHTING BATCH 2012!!!~mamau    ________________________________________________  ____________________ _____________________________________________________ ________________________________________________ ________________________________  _________ 

EVALS 5 22 OCTOBER 2010 DOH Programs: TB DOTS (items 1 ± 15) 1. The priority target group of the National TB control control program is/are:  A. Sputum positive cases B. Patients Patient s with clinical clinical findings suggestive of P T  TB   C . Sputum negative cases but with chest xray findings suggestive of P T  TB   D.  All of the above M emorize. emorize.  

2. The most effective method to control TB infectivity is:   A. Isolation of TB patients B. BCG vaccination C . Prompt drug treatment  D. Health education This is where DOTS or Directly Observed Treatment, Short Course comes in. It is the framework  of TB control, and it employs health workers to counsel and observe their px  swallowing each dose of medicines, and monitor their progress until they are cured.  And chemotherapy is the only way to stop the transmission of TB (Case Holding) 3. The following following are components of the ³Tutok Gamutan´, except: . hemoprophylaxis of those who are not yet infected   A C hemoprophylaxis B. Case detection detection through case case finding by sputum sputum smear microscopy C. Regular and uninterrupted supply supply of all all essential essential anti-TB drugs D. Standardized short course chemotherapy of of all smear positive cases under proper case management conditions Five elements of the DOTS strategy: Directly ± microscopy services (choice B) Observed  Treatment  Short Course ± choice D; drug supplies (choice C) 4.

This plays a secondary secondary role in the diagnosis of TB: TB: hest radiography  C hest B. Sputum culture C. Tuberculin test D. BCG vaccination

 A.

ou Y ou

request CXR only after sputum collection is smear-negative.

5. The key to success in the treatment of OTB OTB is/are: is/are:  A. Adequate information and education education to the patient patient B. Regimen used used is affordable affordable to the patient patient C . Regular monitoring of the patient  D. All of the above Five elements of the DOTS strategy: Directly 

Observed  Treatment ± monitoring systems Short Course Choices for 6 ± 10:   A. Failure B. Relapse C. New D. Transfer-in E. Return after default th

6. Rizalino Jose, 47 year old is smear positive at the end of 5 month of treatment.  A. Failure -   A patient who, while on treatment, is sputum smear positive at five months or  later during the course of treatment  7. Two months ago, Geraldine Velasco, 50 years old took anti-tuberculosis drug for only 2 weeks. weeks. She now has been diagnosed with pulmonary smear positive PTB. C . New  -  A patient who had never had treatment for TB or who has taken anti-tuberculosis drugs for less than one month. 8. Neil Jabon has been been receiving treatment for OTB at Alfonso RHU as a new patient. patient. He will continue his treatment at Silang RHU. An NTP referral form was sent from Alfonso RHU so that a new NTP card can be opened. D. T ransfer-in ransfer-in -  A patient who has been transferred from another facility with proper referral slip to continue treatment. 9.

James Colarina was was diagnosed to have PTB last year. He has completed the treatment treatment for 6 months and was declared cured. He has cough f or 3 weeks now and is sputum smear positive. B. Relapse -   A patient previously treated for tuberculosis, who has been declared cured or  treatment completed and is diagnosed with bacteriologically positive (smear or  culture) tuberculosis. nd

10. Marissa Buladas was was smear negative after her 2 month of treatment. She stopped collecting her  medications for 3 months. She now is returning for treatment and is smear positive. E. Return after default  -  A patient who returns to treatment with positive bacteriology (smear or culture), following interruption of treatment for two months or more. Choices for 11 ± 15:   A. Discoloration of urine B. Deafness C. Optic neuritis D. Peripheral neuritis E. Gout 11. Streptomycin B. Deafness (or hearing impairment), impairment),   pain at injection site, severe skin rash due to hypersensitivity, ringing of the ear, dizziness due to damage to CNVIII, oliguria or  albuminuria albuminuria due to renal disorder  12. Ethambutol neuritis, there is impairment of visual acuity & color vision due to optic neuritis C . Optic neuritis, 13. Pyrazinamide E. Gout  (or hyperuricemia), there is arthralgia due to hyperuricemia, jaundice due to hepatitis 14. Rifampicin intolerance, flu-like symptoms like fever,  A. Discoloration of urine (orange or red), GIT intolerance, muscle pains, inflammation of the respiratory tract, jaundice due to hepatitis, oliguria or albuminuria due to renal disorder, thrombocytopenia, anemia, shock  15. Isoniazid D. Peripheral neuritis (or peripheral neuropathy), there is burning sensation in the feet  due to peripheral neuropathy, jaundice due to hepatitis, psychosis & convulsion Rabies Control: (items 15 ± 30) Choices for 16 ± 21:

Superficial bite wounds

Category of Exposure:   A. I B. II C. III

16. B ± Category II includes

Management:   A. May give pre-exposure prophylaxis B. Vaccine C. Rabies immunization D. Vaccine and rabies immunoglobulin 17. B ± Give vaccine only 

Bite on the head

Feeding and touching the animal

licking of skin; superficial bites without bleeding  18. C    ± Category III includes bites which bleed; splashing or  splattering of saliva or CSF or  other infectious body fluids into eyes/mouth; scalpel nicks or  needle stick injuries where the needle is in contact with CSF, nervous tissue, ocular tissue, internal organs, saliva or other  infectious body fluids 20.  A   ± Category I includes sharing of food/drink with rabid   patient; casual contact 

19. D   ± Requires vaccine and  RIG

21 . A ± No prophylaxis is required but may give preexposure prophylaxis (D0, D7,D28) if desired 

For 22 ± 26:  A 26 y/o male and a 28 y/o female got accepted at the Rabies diagnostic laboratory as a nurse and a m edical technologist respectively. 22. Among the two, who should be given the pre-exposure prophylaxis?  A. Nurse B. Medical T echnologist  echnologist  C .  A and B re-exposure P re-exposure

prophylaxis should be given to high risk personnels such as:

Veterinarians,  Animal handlers, Lab workers, Hospital staff (rabies patients) 23. The schedule for pre-exposure prophylaxis is:  A. 0, 7, 28  B. 0, 3, 28 C. 0, 3, 7, 28 D. 0, 7, 30 Regimens: P VRV VRV (0.5 ml) or  P DEV DEV (1.0 ml) I M  M  at 1 site on days 0, 7, and 28  VRV (0.1 ml) or  P DEV DEV (0.2 ml) ID at 1 site on days 0, 7, and 28  P VRV 24. If the first dose of the v accine is given on March 5, the next doses will be on:   A. March 12, April 4 B. March 12,  A pril 2  C. March 11, April 1 Compute:   arch 5=day 0  M arch arch 12=day 7  M arch  April 2=day 28  25. The site of immunization is the:   A. Gluteal area B. Anterolateral area of the thigh C . Deltoid area I can¶t really find the exact phrase in our handouts wherein it is said that Deltoid area is for   pre-exposure prophylaxis, but I guess that¶s the answer because Gluteal area & Anterolateral  thigh are used more for P OST-exposure OST-exposure treatment. 26. Because of a continuing risk of exposure, a booster dose should be given:   A. Every 6 months B. Every 5 years C. No booster dose is needed D. Every 1 ± 3 years Booster dose (every 1 ± 3 years) is required for those with continuing risk. 27. A five year old boy was bitten by a rabid dog on his left leg on Feb 1. There was bleeding at the bite site. He was brought to the animal bite center on Feb 5. The physician prescribed postexposure treatment to the patient. This should include:  A. Equine rabies immunoglobulin (ERIG) at 40 unit/kg on days 0, 3, 7, 30 and 90 B. Human rabies immunoglobulin (HR I IG) G   ) at 20 units/kg on day 0 

C .

Purified vero cell rabies vaccine vaccine at 0.1 ml intradermally intradermally at 2 sites on days days 0, 3, 7, and 1 site on days 30 and 90  D. A and C E. B and  C  Choice A is not the answer because Equine rabies immunoglobulin should be given 40  units/kg on day 0 ONLY . 28. A few hours prior to consultation, a 9 year old girl was bitten by her sister¶s pet dog on her  right leg. The wound was immediately washed with soap and water before she was brought to the animal bite center. Past medical history revealed a cat bite when she was 5 years old and she was given a complete treatment for Category 3 exposure. Being the physician at the animal bite center you should give:   A. No post-exposure treatment B. Two booster doses of purified purified vero cell rabies rabies vaccine on days 0 and 3 C .  Another full course of active immunization D. HRIG at at 20 units/kg on day 0 E. B and D I can¶t really find the exact phrase in our hand-outs explaining why choice C is the answer. So  please do memorize. And I guess if years already have passed after your first immunization, you must get another one. And vaccination is only effective during the incubation period, which is usually within 20-90 days after the exposure/bite. 29. In most cases, death is an outcome in rabies and is often due to:   A. Acute encephalitis B. Cardiac arrest C . Respiratory paralysis D. All of the above emorize.   M emorize. 30. The most m ost important initial management of dog bite is:  A. Administration of anti-tetanus vaccine B. I rrigate rrigate saliva containing bite wound  C. Use of antibiotics D. Administration of anti-rabies vaccine Imperative initial management of the dog bite is to immediately wash vigorously and flush with soap and water, detergent or water alone the bite wound. Choices A, C, and D are done later on. Substance Abuse: (items 31 ± 50) 31. The agency responsible for enforcing all legal provisions related to dangerous drugs is:   A. Dangerous Drugs Board (DDB) B. Department of Health (DOH) C. Food and Drug Administration Administration D. Phil. Drug Enforcement  Enforcemen t  Agency (PDE  A ) DEA P DEA

is responsible for all legal provisions related to dangerous drugs. DDB would retain  policy and oversight functions. DOH will develop policies and standards for the licensing and  accreditation of drug testing laboratories, and drug treatment and rehab facilities, they also train and accredit substance abuse physicians and paramedical workers (thus the administration of all government-managed drug treatment and rehab centers would be transferred to DOH). 32. The most common dangerous drug being chosen by users is:   A. Marijuana B. Methamphetamine C. Heroine D. Ketamine emorize. Shabu.   M emorize. 33. The follow f ollowing ing is/are reason/s why adolescents drink alcoholic beverages:  A. Peer influence B. C uriosity  uriosity  C. Problems in the family D.  A and B E. All of the above emorize. P eer eer M emorize.

influence and curiosity are the top 2 most reasons for the use of alcohol  among adolescents. O, nanggaling din kau jn ahaha. :D

34. The following is/are true about tobacco smoking as reported by the global youth tobacco survey.   A. In the Philippines 4 out of 10 students aged 13-15 years old had ever smoked cigarettes. B. Adolescent boys were significantly significantly more likely likely to have ever smoked than adolescent adolescent girls. students who had had ever smoked smoked took their fisrst fisrst cigarette before the age C . 1 out of 8 students of 15. D. All of the above. I don¶t know why choice C is the only answer. According to the hand-out that the department  gave us, all should be correct. So the answer should be choice D. It¶s either the answer key is wrong, or I copied the wrong answer :p 35. Abused substances produce some form of i ntoxication that may alter:  A. Physical control  B. Judgement  C .  Attention D. Perception E.  All of the above emorize.   (sori M emorize.

puro ganto, yan na kse mismo ang nasa past cor/handout)

36. The following are true in the diagnosis of substance abuse, EXCEPT:  A. Urine, blood test and  CT  scan are useful in the diagnosis of substance abuse. B. 37% of substance abusers have serious mental illness. illness. C. Interviewing parents, teachers and caregivers regarding the current behaviour behaviour of the patient is important. D. The major problem in the diagnosis of substance substance abuse is the consideration of of dual diagnosis. sually U sually

the diagnosis of substance abuse is very difficult. But urine and blood tests are usually done to know if the person is a user or not. Choice A is w rong because of the item CT  Scan (Nothing is mentioned in the past cor that CT scan can be useful in the diagnosis). The rest of the choices are right.

37. The following is/are true of drug dependence: recoveri ng from the substance  A. Large periods of time spent in obtaining, or recovering B. Substance is taken in larger amounts over long periods periods of time than what is intended  ontinued use of alcohol or other drugs while knowing that it may cause a lot of  C . C ontinued  problems. D.  A and B E.  All of the above Dependence can be considered if at if at least 3 of the ff. Factors are present: 1. Substance is continually taken taken in larger amounts amounts or in longer periods periods than what is expected  2. A persistent persistent desire with fail fail efforts efforts to control the use 3. Large periods of time spent obtaining, taking or recovering from the substance substance 4. Frequent periods periods of intoxication intoxication or detoxification detoxification especially especially when social and major role obligations are expected  5. C ontinued ontinued use even while knowing that it is creating problems socially, physically  and psychologically  psychologically  6. Increased tolerance 7. Withdrawal symptoms 8. Substance taken to relieve withdrawal symptoms 38. This substance is used by body buil ders to stimulate muscle growth.   A. LSD B. Ketamine C. Rohypnol D. Gammahydroxybuty Gammahydroxybutyric ric acid  E. Phenycyclidine   Actually I don¶t know why this is the answer. Cos in the past cor GHB (Liquid XTC, G, Bluenitro), is defined as a drug that can cause mild relaxation but can also lead to coma in high amount. It is usually used as a date-rape drug because it is easy t o put into drinks due to its tasteless and colorless characteristics. It is also a powerful sedative. So google nyu nlng  kung pde xang pampalaki ng katawan haha. Wag wiki a, unreliable un. :p 39. The follow f ollowing ing factor/s should be considered in substance abuse treatm ent, EXCEPT:   A. Gender  B. Food preference preferen ce C. Age and developmental stage D. Cooperation of family members E. Values and culture

Factors when considering treatment: 1.  Age, developmental stage and maturity  2. Values and cultures because this can affect some forms of treatment  3. Gender  4. Co-existing mental disorders disorders which can interfere with the the patient¶s ability to successfully  successfully   participate in the treatment program 5. Family factors like cooperation of the family members in the treatment for better  results 40.

The following is/are true of substance abuse:  A.  A public health concern B.  A socio-cultural socio-cultural problem nation¶s public enemy enemy number number 1 C . Regarded as the nation¶s D.  A and B E.  All of the above Substance abuse is regarded as the nation¶s public enemy number 1 . It is a  public  health concern because it affects a large percentage of the population, a socio-cultural   problem,  problem, an economic burden, most probably because it affects the working age group in our country, and a peace and order problem rolled into one.

For nos. 41 ± 60 (Matching type), pls. Memorize!  41.

Tobacco ± Nicotine is addicting (choice A) Marijuana ± Hashish causes intoxication (choice B) ± A popular anesthetic  popular anesthetic substance substance (choice D) 43. Ketamine ± A 44. Phenycyclidine ± Effects are stronger than ketamine (choice E) opular in the 1960¶s (choice C) 45. LSD ± P opular 42.

(Other names: usually as to what they look like) Ecstasy ±  Adam (choice C) Snow  (choice E) 47. Cocaine ± Snow (choice 48. Methamphetamine ± C rystal (choice rystal (choice B) 49. Heroine ± Smack (choice Smack (choice D) 50. Rohypnol ± Roofies (choice A) 46.

H1N1: (items 51 ± 60) 51. Antigenic Shift ± Changes in proteins through genetic reassortment (choice reassortment (choice C) roduces different viruses not covered by annual vaccine P roduces 52. Pandemic ± W orldwide orldwide epidemic (choice D) 53. Antigenic Drift ± Ongoing and basis for change in vaccine every year (choice A) Changes in proteins by genetic by genetic point mutation & selection 54. Epidemic ± A ± A located cluster located cluster of cases (choice B) 55. Social distancing ± Closing of schools (choice B)... or prohibiting large gatherings. It is a range of nonquarantine measures that might serve to reduce contact between persons 56. Quarantine ± Separation from circulation of  asymptomatic  persons (choice C)... in the community that may have been exposed to infection 57. Isolation ± Sequestration of symptomatic  of  symptomatic patients patients (choice A)... either in home or hospital so that they will not infect others 58. Probable case ± With acute febrile respiratory illness who is  positive for influenza  A but  negative for H1 and H3 virus (by RT-P CR, CR, or (+) for influenza A by an influenza rapid test or an influenza IFA plus meets criteria for a suspected case) (choice C) 59. Confirmed case ± With acute febrile respiratory illness and laboratory and  laboratory confirmed (real confirmed  (real time RT-P CR CR & viral culture) H1N1 virus infection (choice B) 60. Suspected case ± With acute febrile respiratory illness and  has a close contact with confirmed H1N1 case w/in 7 days (or w/in 7 days travel to community where there are 1 or  more confirmed A(H1N1) cases, or resides in a community where there are 1 or more confirmed  swine influenza cases) (choice A) Environmental Pollutants: (items 61 ± 75) 61. Ecosystems matter to Human Health for ³ecosystems´ means: st   A. 21 century source of health risks B. Planet¶s Planet¶ s life life support systems for the human species and all other forms of life C. Fundamental need for food, water, air, air, shelter etc. etc. D. A and B E. B and C Ecosystems are the planet¶s life support systems²for the human species and all other forms of life. Human biology has a fundamental need for food, water, clean air, shelter and reltive climatic  constancy. 62. Degradation of ecosystem services result in harmful effects being borne

 A. B. C. D.

Proportionately within the wealthy Disproportionately Disproportionately by the the poor  poor  Proportionately by all economic economic status Disproportionately by the wealthy

Like more traditional risks, the harmful effects of the degradation of ecosystem services are being borne by the poor (ex. U nequal nequal effects seen in the aftermath of the typhoon). 63. The joint effort of the World Health Organization and UNEP in studying environmental hazards is known as   A. Ecosystem Health Initiative B. Health and Ecosystem Linkage Initiative C. Ecosystem Health Linkage Initiative D. Health and Environment Environment Linkages I nitiative nitiative emorize.   Health. M emorize.

And. ENVIRON M  E MENT.   NT. Linkages. Initiative.

64. Death from Diarrheal diseases diseases is an indicator of t his priority risk identified by the Initiative on:   A. Climate change B. Vector-borne diseases C. Toxic substances D. W ater, ater, health and ecosystems E. Urban environment I cannot find the exact phrase in the past cor explaining why choice D is the answer, but I  guess that is the answer because Diarrheal diseases are usually borne out of Water. For nos. 65-69, pls. Memorize!



65. Unintentional poisoning of 355, 000 ± Climate change (choice B) ~ i don¶t know why this is the answer   66. Lead exposure 230, 000 ± T oxic substances oxic substances (choice C) 67. Malaria 1.2 million/dengue ± Vector -borne -borne diseases (choice E) 68. Respiratory diseases at 1.6 million ± million ± I ndoor ndoor air pollution and household energy (choice D) 69. Road traffic injuries ± Urban environment (choice A) 70. Based on the NSCB 2006 Millennium Development Goals Progress chart regarding malaria, the Philippines is likely to:  A. Not reach target for malaria B. Reach target malaria C. Remain standstill I don¶t have a source for this   so sorry if I can¶t explained it. But probably, choice B is the answer because in M illennium illennium Development Goals, reached naman lagi. Ata..hehe. 71. From the same source, for MDG Goal 7 (Ensure environmental sustainability, Target 7C, Halve by 2015, the proportion of population without sustainable access to safe drinking water and improved sanitation), the Philippines is likely to:   A. Remain standstill B. Reach target  C. Not reach target  Again.   72. The Multiple-Exposure-Multiple Effect Model (MEME) used for Children¶s Illness and Environment study is known in your current project as the tool   A. Community Diagnosis B. Problem Investigation C . Problem tree D. A and B E. B and C In a problem tree, there are multiple exposures that can lead to multiple effects. 73. Water-borne diseases are examples of ___ Environmental Hazards: raditional   A. T raditional  B. Modern C .  A and B D. None of the above Traditional ± waterborne diseases (ex. Typhoid, Cholera), food safety  odern ± avian flu, bovine spongiform encephalopathy, industries, emissions, spillage M odern The answer is probably both because Water-borne diseases could also arise from industries and spillages (?)

74. The follow f ollowing ing is/are examples of Modern Environmental Hazards:  A. Noise pollution B. Pesticide soil contamination contamination C . Radioactive contamination D. Mad C ow¶s ow¶s Disease E.  All of the above See no. 73   75. The framework for the Philippine National Environmental Health Action Plan has four  components EXCEPT  A. SWATOF¶S issues, challenges and strategies B. Multiple stakeholders C .  Advocacy campaigns D. Convergence ± MDG, MDG, International agreements, National National Objectives Objectives for Health E. Environmental Health Country Country Profile and Data Sheet  Again, I don¶t have a source for this (sori nmn   ). I-memorize nyu nlng... Occupational Health: (items 76 ± 100) For nos. 76 ± 80, pls. Memorize!  at sori wla akons source neto, hulaan nlng nten bket gnun sgot ahaha :D 76. Water ± Department of  I nterior nterior and Local Government (choice Government  (choice B) ~ feeling ko kaya DILG kse ung mga bodies of water is sakop or managed by the Local Government (hula lang :p) 77. Air ± Department of Environment and Natural Resources (choice C)~ obviously :p 78. Occupational Health ± Department of Labor (choice Labor  (choice A) 79. Food ± Bureau of Food and Drugs (choice E) 80. Sanitation ± Department of Health (choice D) 81. Which of the following statements is/are true?  A. The workplace is a safe safe environment environment B.  About 30-50% of workers report hazardous exposures exposures individual s spend one-third of their their adult life in such such hazardous work  C . Many individuals environments D. All statements are true E. B & C  are true Choice A is wrong because the workplace is a ha zardous environment. 82. Occupational health is an important strategy to: mprove the overall quality of life of individuals and society   A. I mprove B. Ensure the health of workers ontribute positively to productivity, quality of products, work motivation and job C . C ontribute satisfaction D.  All of the above Digest. Absorb. 83. The National Objectives for Health 2005-2010 in the Philippines aims to: disability , mortality from adverse occupational conditions  A. Reduce morbidity, disability, B. Establish an occupational health information system system in 10% 10% of municipalities municipalities and cities cities C . Establish occupational health programs at the local level  D. All of the above above are correct E.  A & C  are correct  I can¶t find the exact phrase in the handouts explaining why choices A & C are the only  answers. P ls ls digest and absorb nalang   84. Work places include the following:  A. Hospitals and clinics B. C all all centers Semi-conduct or and garment factories factorie s C . Semi-conductor D. Streets E.  All of the above Workplace refers to the office, premises or worksite, where the workers are habitually  employed and shall include the office or place where the workers who have no fixed or  definite work site (e.g. the streets), regularly report for assignment in the course of their  employment. 85. The elements of Occupational Health are the orker, job, tool, work environment  environment   A. W orker, B. Task, act, employee, work environment C. Employer, employee, union, factory

D. Work environment, environment, task, tool, employer  Worker Genetic composition Physical constitution Psychological characteristic Disease susceptibility

Tool Biochemical designs specifications

Task or job and  Application Software design Change Training Job satisfaction Rest breaks Shift works Support systems Management system

Working environment Physical condition Biomechanical Furniture/equipment

86. An Occupational Health Program in a company can be developed through collaboration among the  A. Industrial hygienist, employer, safety engineer  B. Industrial hygienist, hygienist, safety engineer, engineer, sanitary inspector  C. Industrial physician, physician, industrial industrial hygienist hygienist and safety safety inspector  D. I ndustrial ndustrial physician, industrial hygienist, safety engineer  OH P ROGRA ROGRAM  (DIAGRAM  ) Industrial P hysician hysician

OH P ROGRA ROGRAM  Industrial Hygiene

Safety Engineer 

87. Occupational health is considered to be a multidisciplinary activity aiming at and promotion promotion of health of workers  A. Protection and B. Enablement of workers to conduct socially socially and economically economically productive productive lives and  to contribute positively to sustainable development  promotion of healthy and safe safe work, work environments and  C . Development and promotion work organizations organizations D.  All of the above rinciples P rinciples

of Occupational Health and Safety: Occupational health is considered to be multidisciplinary multidisciplinary activity aiming at: 1. Protection and promotion of health workers by: reventing and controlling occupational diseases and a ccidents P reventing Eliminating Eliminating occupational factors and conditions hazardous to health and safety at  work  2. Development and promotion promotion of healthy and safe safe work, work environments and  work organizations organizations 3. Enhancement of physical, physical, mental and social social well-being well-being of workers and support for the development and maintenance of their working capacity, as well as professional and  social development at work  4. Enablement of workers to conduct socially and economically economically productive productive lives and  to contribute positively to sustainable development  88. Health hazards in the workplace are  A.  Also referred to as environmental factors, agents or stresses B. Etiologic agents of occupational diseases lassified as physical, chemical, biological and ergonomic  C . C lassified D.  All of the above E.  A & B only  Digest. Absorb. M emorize. emorize.   Classification of Health Hazards in the W orkplace (diagram) hysical P hysical

Chemical  Workplace Health Hazards

Biological

Ergonomic 

89. The junior intern on-duty at the Emergency Room just finished extracting blood from a pregnant woman in labor when she accidentally punctured her hand while recapping the needle. What potential hazard was she exposed to?

  A. B. C . D.

Chemical hazard Ergonomic hazard Biological hazard  Physical hazard

Chemical hazard ± include substances used and/or generated as raw materials, intermediate  products, finished products and waste product; occur in the solid, liquid and gaseous state; each chemical is documented through a M aterial aterial Safety Data Sheet ( M  S MSDS)   DS) Ergonomic hazard ± related to the fit between a worker and his job, to achieve optimum efficiency and productivity; design of work and workplace should consider human factors,  physical, mental and emotional capacities of people BIOLOGICAL HAZARD ± DEAL WITH LIVING ORGANIS M S WHICH HAVE BEEN FO U ND ND TO TRANS M  I  T DISEASE TO M  AN OR TO AFFECT HIS HEALTH ADVERSEL Y  (since the JI  MIT was pricked by a needle used to extract blood which could have living organisms that can transmit disease to man) hysical hazard ± involve contact w ith various forms of energy; environmental conditions in a P hysical workplace 90.

Threshold limit values (TLVs):  A.  Are occupational exposure limits B. Refer only to airborne concentrations of substances substances guidelin es in the control of workplace health hazards C . Serve as guidelines D.  A & C  are correct  E. All are correct TLVs -

occupational exposure limits serve as guidelines in the control of workplace health hazards refer to airborne concentrations of substances AND represent conditions under  which it is believed that nearly all workers may be repeatedly exposed day after  day without adverse health effects

For nos. 91-92: AMIX, a semi-conductor manufacturing company, with 2,500 employees hired you as their Occupational Health Physician. One of the problems identified by the management is absenteeism due to sickness. Based on the clinic census, Influenza ranks no. 1 in the illnesses list. 91.

Which is the most appropriate environmental/health hazard control measure in this case?  A. Prevention B. Shielding C. Isolation D. Treatment Basic P rinciples rinciples to the Control of Environmental and Occupational Health: 1. Prevention ± is eliminating effects of or exposure to a hazard (as to this case, prevention from Influenza) 2. Shielding ± is setting setting up of physical barriers barriers between the source of the problem or hazard  and man 3. Isolation ± is separating the hazard from man in terms of either distance distance or time to  prevent or minimize contact  4. Treatment - involves measures to terminate terminate the the existence existence of a hazard hazard through destruction or inhibition with the aid of physical, chemical or biological agents 5. Substitution ± is the use of other materials, products, activities, processes/operations, processes/operations, methods, machines, and other equipment instead of hazardous ones; ³modification´ 

92.

As the physician, what should be your best recommendation mmunization against flu   A. I mmunization B. Treat patients patients with with signs and symptoms symptoms of flu C. Provision of of Vitamin C tablets tablets daily by the company D. Use of face mask Choice A is for  P ROTECTION. ROTECTION. Choice B is for treatment, and Choice D is for shielding.

93.

Giving oral medicine against Malaria before travelling to Palawan is an example of what environmental control   A. Substitution B. Prevention C. Treatment D. Shielding See no. 91   prophylaxis is for prevention.

94.

Based on the levels of control which is least effective   A. Engineering control B. Administrative Administrative control

C .

Use of Personal Protective Protecti ve equipment  Engineering control ± requires physical changes in the workplace environment; use of  substitution, isolation and ventilation   Administrative control ± includes setting up policies, rules/regulations, safe work   practices, changes in the workplace organization ersonal protective equipment ( PP  E) ± include devices that can protect worker from P ersonal PP E) head to foot; ³last resort´ type of protection or control; merely set up a barrier between the worker and the hazard²hazard is NOT eliminated 

95.

Newer pesticides which are less hazardous than organochlorines are now being utilized in agriculture. This is an example of    A. Shielding B. Isolation C . Substitution D. Prevention See no. 91   organochlorines organochlorines are being substituted by newer, less hazardous pesticides.

96.

Which statement is true regarding Occupational Healt? he promotion and maintenance of the highest degree of physical, mental and   A. T he social well-being of workers in all occupations B. I t adapts work to people, and people to their jobs C . I t prevents departures from health and control risks D.  All of the above Digest. Absorb.  

97.

Industrial hygiene involves: he anticipation, recognition, evaluation, and prevention and control  A. T he environmental factors or stresses which may affect the health of the worker  B. Focus on the human factors C. The treatment of workers D. All of the above

of 

Choice B is wrong because Industrial Hygiene focuses more on ENVIRON M  E MENTAL   NTAL factors, and choice C is wrong because it is NOT for treatment of workers but for anticipation, recognition, evaluation, and prevention and control of environmental factors or stresses which may affect the health of the worker  98.

Rule 1960 pertains to the Occupational Health Services: Possess all of the additional qualifications qualifications required under the rule (such as training in Basic  C ourse ourse in Occupational Medicine or Basic Occupational Safety  and Health T raining) raining) B. Every employer is required to provide his workplace workplace with medical and dental  services, emergency medicines and dental facilities Health Practitioner refers only to the the physician duly licensed licensed to C . Occupational Health  practice his or her profession in the Philippines D. ³Occupational Health Health Practitioner´ Practitioner´ refers to the physician, nurse, nurse, engineer, dentist  dentist  or chemist duly licensed to practice his or her profession in the Philippines E.  All of the above

 A.

emorize. M emorize. 99.

Digest. Absorb.  

The health hazard associated with Caisson¶s disease is   A. Noise B. C hange hange in barometric pressure C. Cotton dust D. Coal dust emorize.   M emorize.

100. Tina is a 24 year old female who works for eight hours as a teller in the tollway. The potential hazard/s in her work station are  A. Physical hazard  B. Ergonomic hazard  hemical hazard  C . C hemical D.  A & B E.  All of the above See no. 89   ~END

OF EVALS 5 RECON ~