Public Health State Exam Questions 2015-2017.

A - Preventive medicine
1. Lener J et al: Medical hygiene. Prague - Czech Republic: Vydavatesltví Karolinum;
1997. pp 1-128.
2. Varkey P: Mayo clinic preventive medicine and public health board review. Edited by
Prathibha Varkey. New York - United States: Mayo Clinic Scientific Press - Oxford
University Press; 2010. pp 111-232.
3. Brázdová Z, Fiala J: Dietary guidelines in the Czech Republic. Brno: Acta Facultatis
Medicae Universitas Masarykianae; 1998.
4. Bonita R, Beaglehole R, Kjellström: Basic epidemiology. 2nd edition. Geneva -
Switzerland: World Health Organization; 2006. pp 145-161.
5. www.who.int (information not found in the books).
A1. Aetiology of diseases and the influence of the environment.

A2. Ecology and today’s environment.

A3. Chemicals in the environment and health.

A4. Psychosocial factors and health.

A5. Air quality and health.

A6. Water quality and health.

A7. Waste materials and health.

A8. Electromagnetic radiation and health.

A9. X-ray departments and workplaces using radioactive substances in the health care
system.
A10. Working conditions and health, hazardous workplaces.

A11. Housing and health.

A12. Noise and health. Give the tolerated ranges of noise and give some examples of noises
and their frequencies. How to interpret an audiogram? Prevention.
A13. Smoking / nicotine and its immediate, short-term and long-term effects to the health
in childhood and adults (give examples). Second hand / third hand smoke. Pregnancy
vs smoking. Foetus vs smoking.
A14. Dependence on tobacco. Principles of smoking cessation. Withdrawal symptoms.

A15. Alcoholism and its immediate, short-term and long-term effects to the health (give
examples). Pregnancy vs alcohol.
A16. Drugs and their effects to the health (give examples). Pregnancy vs drugs. Dependence
1
 rate of some drugs.
A17. Health risks associated with diet.

A18. Assessment of nutritional status.

A19. Dietary consumption.

A20. Dietary guidelines / recommendations.

A21. Nutrition in emergency situations.

A22. Nutrition in developing countries. Famines.

A23. Breastfeeding. Breastmilk. Health effects for the baby. Breastfeeding in HIV-positive
women. Breastfeeding vs smoking, heroin.
A24. Define each type of vegetarians (vegans, fruitarians, lacto-vegetarians, lacto-ovo
vegetarians, pesce-vegetarians, pollo-vegetarians, flexitarians.).
A25. Recommended daily intake of vitamins, minerals and proteins.

A26. Diseases caused by vitamins, minerals and proteins (excess or deficit). Name the most
common sources for each one.
A27. Overweight, obesity, eating disorders. Symptoms, health consequences. BMI and
other anthropometric indices.
A28. Principles of slimming diets. What kind of food would you recommend to your patient
in order to reduce 10 Kg within 6 months? Jo jo effect.
A29. Nutritional needs during pregnancy and breastfeeding. Multiple micronutrient
supplementation.
A30. Hospital dietary service.

A31. Epidemiology, aetiology and prevention of coronary heart disease.

A32. Epidemiology, aetiology and prevention of hypertension.

A33. Carcinogenesis. Epigenetic mechanisms in carcinogenesis.

A34. Epidemiology, aetiology and prevention of lung cancer.

A35. Epidemiology, aetiology and prevention of stomach cancer.

A36. Epidemiology, aetiology and prevention of colorectal cancer.

A37. Epidemiology, aetiology and prevention of breast cancer.

2
A38. Epidemiology, aetiology and prevention of uterine cancer.

A39. Epidemiology, aetiology and prevention of urinary system cancer.

A40. Epidemiology, aetiology and prevention of skin cancer.

A41. Epidemiology, aetiology and prevention of obesity.

A42. Epidemiology, aetiology and prevention of allergies.

A43. Epidemiology, aetiology and prevention of osteoporosis.

A44. Epidemiology, aetiology and prevention of decay.

A45. Epidemiology, aetiology and prevention of anaemia.

A46. Health programs recommended by the WHO.

A47. Child development, possible influence of living conditions.

A48. Health protection in babies during their first year of life.

A49. Health protection in school children.

A50. Occupational hygiene (Entry, periodic and exit medical examinations). What should
be emphasised in each one of these?
A51. Occupational hygiene vs prevention of musculoskeletal diseases. Active pauses (give
examples). Ergonomic workplace (define it and give examples).
A52. Occupational hygiene vs entry and periodic medical examination vs patients with:
coronary heart disease, stroke, varicose veins, carpal tunnel syndrome). Measures.
A53. Occupational hygiene vs driving license. Which examinations should be performed?
Restrictions.
A54. Risk workplaces: occupational and work-related diseases (characteristic and
differences). Duties for management, workers, physicians. Principles of „Healthy
office, factory“.
A55. Health risks of shift works or works at night.

A56. Toxicology in prevention - principles for development of safe limits. Problems with
extrapolations of experimental results to real human exposure.
A57. Metabolisms of xenobiotics. Genetic polymorphisms.

A58. Ways of xenobiotics/metabolites excretion. Biological tests of exposure (including tests

for evaluation of genotoxicity.

3
 B - Epidemiology of infectious diseases.
1. Bakoss P, Baška T, Bazovská S, Kmety E, Maďar R et al: Compendium of
epidemiology. Edited by Pavol Bakoss. Bratislava - Slovak Republic: Comenius
University Bratislava; 1999. pp 3-138.
2. Stone DB, Armstrong WR, Macrina DM, Pankau JW: Introduction to epidemiology.
Dubuque, IA - USA: Brown & Benchmark Publishers; 1996. pp 22-63, 115-150.
3. Farmer R, Lawrenson R, Miller D: Epidemiology and public health medicine. 5th
edition. Oxford - U.K.: Blackwell Publishing; 2004. pp 7-13, 91-126.
4. Bonita R, Beaglehole R, Kjellström: Basic epidemiology. 2nd edition. Geneva -
Switzerland: World Health Organization; 2006. pp 117-131.
5. www.who.int (information not found in the books).
6. www.cdc.gov (information not found in the books).
7. http://ecdc.europa.eu/en/Pages/home.aspx (information not found in the books).
B1. Chain of infection - epidemic process. The importance of environmental and social
circumstances, intensity levels of the process of spreading.
B2. Presence of a source of infection. The importance of various clinical forms of a
disease, infectiousness at each stage of a disease, carriers of pathogenic
microorganisms from the epidemiological point of view.
B3. Infection transmission. Phases of transmission, effects of environmental factors,
resistance in microorganisms, main routes of transmission, special ways of
transmission.
B4. Susceptibility of the population to the infections.

B5. The vaccination schedule according to CDC and WHO.

B6. The current epidemiological situation in the Czech Republic. Epidemiological

surveillance.
B7. Decontamination, theoretical principles of sterilization and disinfection.

B8. Epidemiological characteristics of intestinal infections caused by viruses and

prevention of their spreading.
B9. Epidemiological characteristics of intestinal infections caused by bacteria and
prevention of their spreading.
B10. Epidemiological characteristics of viral airborne infections and prevention of their
spreading.
B11. Epidemiological characteristics of bacterial airborne infections and prevention of
their spreading.
B12. Epidemiological characteristics of blood-borne and prevention (measures and
prophylaxis) of their spreading.
B13. Epidemiology of hepatitis. Types and aetiology. Incubation and contagiosity /
virulence. Diagnosis and prevention (measures and prophylaxis) of their spreading.
B14. Epidemiology of HIV. Aetiology. Incubation and contagiosity / virulence. Diagnosis
and prevention of their spreading. Pregnancy and breastfeeding vs HIV.
Epidemiologic measures while treating HIV patients.
B15. Animals as sources of infection.

4
B16. Nosocomial infections. Definition. Aetiology. Prevention. Treatment. Epidemiology
and surveillance of nosocomial infections.
B17. Departments of infectious diseases in hospitals. Quarantine and isolation measures for
infectious patients.
B18. Hospital waste management. Hospital laundry.

B19. Bedside care units in hospitals.

B20. Infections of skin and superficial mucous membranes. Epidemiological characteristics

and preventive measures for their transmission.
B21. Infections as occupational diseases and their prevention.

B22. Travel-related infections and their prevention (measures and prophylaxis).

B23. Principles of safe manipulation with biological materials. Sharp injuries. Work out a
schedule for prophylactic measures in case a health service worker has been wounded
with a contaminated object.
B24. Work out a proposal of epidemiological precautions for the local surgery department,
which should be taken in the case of an incidental hospitalization of a patient with
tuberculosis.
B25. Work out a GP’s operation schedule in case of a probable alimentary infection
outbreak in clients of the local company’s canteen / restaurant.
B26. Vertical transmitted infections (TORCH complex). Definition and aetiology. Routes of
infection. Diagnosis, treatment and prevention - Precautions needed to prevent
hepatitis B vertical transmission at a maternity hospital.
B27. Work out epidemiologic regulations for the haemodialysis unit.

B28. Being the head of the intensive care unit, suggest, how to check if the epidemiologic
regulations are being followed.
B29. Work out the principles of safe manipulation with the aids and instruments for
operative intervention, a) for one-use material b) for material which can be used
repeatedly.
B30. Suggest how to treat a patient with a deep wound at a surgery department (with
regard to tetanus prophylaxis).
B31. Describe the procedure and treatment for animal bites (GP and emergency
department).
B32. Work out preventive and repressive precautions against the spreading of influenza.

B33. Describe the procedures to be followed by a GP assessing a person who would like to
work in a canteen, restaurant or anything related with food manipulation. (Diagnosis,
prophylaxis and treatment).
B34. Highly infectious diseases in the last 15 years. Bioterrorism. Preparation and
planning.
B35. Infectious in developing countries and their prevention (measures and prophylaxis).

5
 C - Public health.
1. Study materials for public health and healthcare administration (20 chapters).
2. Bonita R, Beaglehole R, Kjellström: Basic epidemiology. 2nd edition. Geneva -
Switzerland: World Health Organization; 2006. pp 1-62, 83-113, 165-176.
C1. Health (definition by WHO, aspects, measuring).

C2. Prevention (importance, levels, methods, problems). Screening and screening test.

C3. Epidemiological methods. Epidemiological studies (observational and experimental,

give examples how and when these studies are used). Potential errors in epidemiology.
C4. Mortality and morbidity as health indexes. Death rates. Life expectancy.

C5. Disease frequency - Incidence vs prevalence. Factors influencing them. Cumulative

incidence, case fatality. Relative risk, attributable risk.
C6. Causation in epidemiology (single and multiple causes). Factors in causation.

C7. Health system (General information, accessible healthcare, quality, sustainable costs
and financing, value for money, etc.).
C8. Health system needs (need, demand and use). Variations in utilisation rates. Inverse
care law.
C9. Equity in healthcare system.

C10. Sources of finance for health care.

C11. Health system financing.

C12. Financial management.

C13. Health economics (definition and its importance).

C14. Economic evaluation.

C15. Cost-of-illness studies (COI).

C16. Cost-minimisation analysis (CMA).

C17. Cost-effectiveness analysis (CEA).

C18. Cost-utility analysis (CUA).

C19. Cost-benefit analysis (CBA).

C20. Public health law in Europe - The role of law in society and healthcare legislation.
6
C21. Health impact assessment.

C22. The measurement of patient satisfaction.

C23. Reforming healthcare - The Ljubljana Charter.

C24. The basics of evidence based medicine - How to read a public health paper.

C25. The Tallinn Charter: Health Systems for Health and Wealth.

C26. WHO - General information (when it was established, structure, financing, etc.).

C27. Epidemiology, health policy and planning.

D - Healthcare management and administration

Seminar papers in the subject’s vault VLZP11XX.
D1. Ward rounds (Aim, quality factors, main complications and their impact on patients,
confidentiality, etc.).
D2. Communication between medical personnel and patients / relatives. (Commons
mistakes, recommendations, etc.).
D3. Medical documentation (Medical records, gold standard, etc.).

D4. Medical malpractice (Definition, common mistakes and how to avoid them,
consequences, etc.).
D5. Patient complaints (Definition, common mistakes and how to avoid them,
consequences, etc.).
D6. Patient safety (Common mistakes and how to improve them, etc.).

D7. Risk of harm to patients (Most common risks, patient’s fall, etc.).

D8. Patient identification - (Identification methods, standardising wristbands, right

patient-right treatment, etc.).
D9. Aggression and violence against hospital staff. (Regulations, what to do, common
cases, recommendations, etc.).
D10. Patient consent to treatment (patientsʼ rights, patientsʼ refusal, legal issues, etc.).

D11. Hand washing and hospital staff. (Adequate technique, common mistakes,
measurements of prevention, etc.)
D12. WHO surgical safety checklist.

D13. Dress code and personal presentation / hygiene of hospital staff.

7
D14. Bullying in medicine - Specialist / teachers vs residents and medical students. Sexual
harassment among personnel and towards patients. Verbal and physical aggression /
violence inside hospitals. Preventive measurements. How to deal with these problems.
European Union Legislation.
D15. Common mistakes in surgical theatres vs legal claims. Costs related. Personnel vs
hygiene, hand washing - theory vs practice. Give clinical examples of surgical
mistakes.
D16. Important aspects in pre-operative, operative and post-operative health care.
Patient’s education on his/her disease / possible treatments and possible outcomes.
Information given to patient before discharge vs readmissions.
D17. Individual patient’s preferences vs goals for treatments vs outcomes. Treatment of
choice. Family and patient participation in the medical decision-making process.
Availability of physician specialists. Nurse competency.
D18. Written vs electronic documentation. Cut and paste information into clinical
documentation. What is it written in the medical documentations has truly being
performed? - Pressure on doctors to have a complete medical documentation vs time
given to every patient by hospital management. Manipulation of clinical
documentation. Give clinical examples of such situations.
D19. Legal claims vs defensive medicine. Unnecessary / excessive care. Medical practice
before 2000 and now. It is the legal pressure on doctors influencing patient medical
treatment? Common examples.
D20. Medical claims vs hospital quality of surgical care. Definitions, costs related. General
information. Clinical / case examples. Costs of some claims in European Union
countries and USA.
D21. Medical negligence / malpractice claims (Definition, general information, most
common causes, consequences, costs related. Good medical practice. Guidelines.
Standard of care. Measurements to reduce medical negligence / professional
malpractice claims.).
D22. Nosocomial infections vs PC keyboards, stethoscopes, sphygmomanometers, mobile
phones, pencils, hospital charts, etc. Common flora found in such items. Preventive
measures. Provide statistics in European Union countries and USA. It is preferable to
use surgical scrubs or personal attire inside hospital premises?
D23. Nosocomial infections vs white coats, ties, jewellery, wrist watches, others. Which
countries already banned these items - These policies did improve the prevalence and
incidence of nosocomial infections? - provide statistics in European Union countries
and USA. It is preferable to use surgical scrubs or personal attire inside hospital
premises?
D24. Does expanding nurse autonomy affect / decrease quality of healthcare delivered?
District nurses in the UK. Nurses vs prescription of medicines. Increasing nurse’s
autonomy vs legal claims.
D25. Nurses’ and doctor’s arrogance towards patients. Courtesy of hospital employees.
Lack of ethics. Patient’s privacy. Confidentiality breach. Staff personnel presentation.
Patient complaints. Common mistakes.
D26. Nursing documentation / medical documentation. What should be the minimum
information required. Documentation vs legal claims. Common mistakes in clinical
documentation. Incomplete medical documentation. Documentation tracking. Access
to medical documentation. Confidentiality. Shredding.
D27. Patient complaints and their use to improve quality of provided services. The cost
commons patient complaints. How to deal with such complaints. Average response
8
 times for such complaints. Corrective measures - disciplinary actions. Give examples
of the most common patient complaints in European Union countries and USA.
D28. Patient satisfaction. Hospital food {taste and temperature}, hospital rooms, waiting
lists - give the 10 most common surgical / medical diagnosis and their waiting time for
treatment in European Union countries and USA. Waiting time for outpatient
departments. Average waiting time in emergency departments.
D29. Patient’s bill of rights and obligations. Have personnel the right to refuse or accept a
patient? Availability and continuity of healthcare. Privacy. Confidentiality. Clinical
research. The dying patient. Transplantation.
D30. Personnel and equipment vs nursing / medical performance. Reducing number of
hospital it is cost-effective? Quality of health care in terms of costs. Cost-efficiency
and cost-utility vs quality. Waiting times for most common imaging examinations
(RX, CT scan, MRI, Doppler, US, etc.) in European Union countries and USA.
D31. Professional liability insurance vs legal claim - (Types of insurances. Errors &
omissions. Malpractice / negligence insurance. Coverage. Costs related. Civil /
criminal law vs professional liability. Statistics in European Union countries and
USA.).
D32. Provider major problems - unnecessary / inappropriate / excessive care.
Fragmentation and poor coordination of health care delivery. General information
and give the most common examples on surgical / medical units.
D33. Quality of health care vs legal claims vs burn-out syndrome in personnel. (General
information, most affected specialities, time to develop the burn-out syndrome,
description of symptoms).
D34. Quality of health care vs personnel satisfaction - (It is still medical profession
attractive? Work load vs responsibility vs fatigue vs stress vs salaries in comparison
with other fields. Personnel frustration. Suicide risk among healthcare personnel.
Medical practice before legal claim became more frequent. Specialities more wanted
and less wanted in European Union countries and USA).
D35. Quality of health care I - (Definition, general information, history of quality in health
care, how it is assessed and which parameters are under evaluation. Quality of health
care indicators, etc.).
D36. Quality of health care II - (Health care accreditation systems - Joint Commission
International / Det Norske Veritas, ISO norms / standards in health. National Safety
and Quality in Health Service Standards. Total Quality Management. General
information, requirements to obtain / lose the accreditation. Benefits of the
accreditation, costs related with it.).
D37. Quality of health care III - (Measures to assess the quality of health care. Approaches
for improving outcomes and patient satisfaction. Patient feedback. Provide general
information and give common examples).
D38. Quality of health care V - (Assessment of patient’s satisfaction. Attitude of personnel
towards the patient. Availability of personnel. Hospital environment / facilities vs
cleanliness, smoothness of admission / discharge, etc.).
D39. Quality of health care vs nurses / medical training (General information. Time of
training, hours of work per week in European Union countries and USA. Personnel
continuous education and training. Work under supervision. General information
and give examples. Postgraduate medical education. Board examinations in European
Union countries and USA).
D40. Reducing length of stay in hospital vs quality of healthcare (Definitions, average
hospital stays for the 10 most common surgical / medical diagnosis before 2000 and
after 2010. Economic point of view of reducing hospitalization length - pros and cons.
9
 Hospitalization and home. District nurses.).
D41. Re-sterilization of medical devices and single use devices - Theory and practice.
Which are the most common re-sterilized devices. Reuse of single-use medical devices.
Devices and medicines with expired date. Gloves and masks re-sterilization.
D42. Risk management. Definition. Incident reporting - Dos and don’ts. Patient safety.
Medication errors - Five rights to minimize the risk. Patient falls - statistics in
European Union countries and USA, prevention measures. Strategies to reduce
malpractice claims. Incidents costs related.

10