Summary All tasks & lectures: the important things extensively summarized/discussed
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Course
PGZ2024 Disease And Prevention (PGZ2024)
Institution
Maastricht University (UM)
Per task and college an overview of everything you need to know.
All important aspects of the tasks and lectures are appointed. In short: everything you need for your exam.
PGZ2024 Disease and Prevention
Summary of Cases and Lectures
Contents
General ..........................................................................................................................................................................3
Lecture 1 Introduction to course .........................................................................................................................3
Lecture 3 Introduction to genetics ......................................................................................................................4
Vaccines ..........................................................................................................................................................................5
Lecture 2 Prevention by vaccination ...................................................................................................................5
Case 1 Petition ..........................................................................................................................................................7
Tuberculosis ............................................................................................................................................................... 11
Lecture 4 Tuberculosis ........................................................................................................................................ 11
Case 2 The Asparagus Field ................................................................................................................................ 14
Emerging infections .................................................................................................................................................. 18
Lecture 5 (Re-)emerging infections ................................................................................................................... 18
Case 3 The “new normal” .................................................................................................................................... 20
Cardiovascular disease ............................................................................................................................................ 23
Lecture 6 CV-risk management & prediction models .................................................................................. 23
Case 4 Recommendations for the Minister .................................................................................................... 24
Cystic fibrosis.............................................................................................................................................................. 27
Lecture 7 Prenatal diagnosis & pre-implantation genetic diagnostics ..................................................... 27
Case 5 To test or not to test? ............................................................................................................................. 29
Down syndrome ........................................................................................................................................................ 31
Lecture 8 Down syndrome & ethics of prenatal testing .............................................................................. 31
Case 6 To test or not to test? ............................................................................................................................. 34
Cancer .......................................................................................................................................................................... 35
Lecture 9 Cancer screening ............................................................................................................................... 35
Case 7 Tennis Friends .......................................................................................................................................... 42
Alzheimer .................................................................................................................................................................... 46
Lecture 10 Dementia ........................................................................................................................................... 46
Case 8 Alzheimer’s disease: just part of ageing? ........................................................................................... 49
Colorectal cancer....................................................................................................................................................... 51
Lecture 11 Colorectal cancer survivors ........................................................................................................... 51
Case 9 The challenge of colorectal cancer survivorship .............................................................................. 55
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,Diabetes....................................................................................................................................................................... 57
Lecture 12 Diabetes self-management ........................................................................................................... 57
Case 10 Taking care of yourself ......................................................................................................................... 60
Chronic low-back pain .............................................................................................................................................. 61
Lecture 13 Chronic low back pain..................................................................................................................... 61
Case 11 Chronic back pain ................................................................................................................................. 65
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,General (Lecture 1 + 3)
Lecture 1 Introduction to course
Public health = preventing disease, prolonging life, and promoting health through the
organized efforts of society
- Health protection = management of environmental, food, toxicological and
occupational safety
- Disease prevention = minimizing the burden of diseases and associated risk factors
through prevention efforts
- Health promotion = enabling people to increase control over and improve their
health through social and environmental interventions
Disease prevention differentiates two categories:
- Infectious diseases → communicable
- Chronic diseases → non-communicable
➔ Transition from infectious to chronic diseases
o Development in society have led to changes in the prevalence of risk factors
o Medical and scientific progress has led to improved
detection/screening/treatment
Successes of public health are not always visible → especially in primary prevention: disease is
being prevented and is for that reason not present/prevalent = prevention paradox
Disease characteristics determine which preventive measure is possible and will likely be
most effective:
- Development + risk factors
- Symptoms + diagnosis
- Treatment + prognosis
- Consequences on QoL and participation
Types of prevention:
Prevention by stage of disease:
➢ Primary prevention – no disease
➢ Secondary prevention – subclinical disease
➢ Tertiary prevention – diagnosed disease
Prevention by target group:
➢ Universal (low risk) – general population
➢ Selective (medium-risk) – population at risk
➢ Indicated (high-risk) – early symptoms
3
, Lecture 3 Introduction to genetics
Mendel’s First law: Factors (genes) that determine phenotype come in pairs!
- Monohybrid cross = crossing for one characteristic
- Dihybrid cross = crossing for two characteristics
Law of independent assortment = if you have two characteristics, they never show up in
gametes together (so in this case: not a mixture of green and yellow, but or green or yellow)
→ but there are some exceptions
o Incomplete dominance
▪ Homozygous dominant (flower colour: white)
▪ Heterozygous (flower colour: pink)
▪ Homozygous recessive (flower colour: red)
o Co-dominance
▪ Heterozygous = both alleles are being present (flower colour: white +
red)
Dominant inheritance: a generation is usually not ‘skipped’: in each generation appear
disease
Recessive inheritance: in each generation appear “carriers”
X-linked inheritance:
Male: always Y from father → 50% chance of disease
Female: X from mother and X from father → 50% of being carrier
The anatomy of the genome
DeoxyriboNucleic Acid
- Adenine (A) + Thymine (T)
- Guanine (G) + Cytosine (C)
Every cell has 22 chromosome pairs and 2 sec chromosomes (XX or XY): diploid
Exception are gametes (egg/sperm): haploid
Genes code for proteins → Proteins determine phenotype
The physiology of the genome
Replication = DNA to DNA
Step 1: The enzyme helicase unwinds and separates the 2 DNA strands
Step 2: The enzyme primase attaches ‘primers’ on the 2 separated DNA strands
‘Primers’ are small pieces of complementary RNA:
Step 3: The enzyme polymerase binds to the separated DNA strands
Step 4: The enzyme polymerase completes, from primers onward, the DNA strands (from 5’ to 3’)
For every ‘A’ (old strand) a ‘T’ (new strand) and vice versa
For every ‘C’ (old strand) a ‘G’ (new strand) and vice versa
➔ Result: DNA replication is ‘semi-conservative’: Every daughter-DNA helix contains both an old and a
new DNA strand
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