Deck 7: Chronic and Infectious Diseases

Question 1

Which chronic diseases are markedly higher in the Indigenous population than in the non-Indigenous population?

A) Tuberculosis and diabetes
B) Cancer and heart disease
C) Chronic kidney disease and chronic obstructive pulmonary disease
D) All of the above

Answer 1

D

Question 2

Prevalence of chronic diseases - diabetes, heart problems, hypertension, arthritis and some cancers - is

A) significantly higher among Indigenous communities and is increasing.
B) significantly lower among Indigenous communities and is decreasing.
C) significantly higher among Indigenous communities and is decreasing.
D) significantly lower among Indigenous communities and is increasing.

Answer 2

A

Question 3

Which of the following statements about diabetes and Indigenous people is false?

A) Rates are three to five times higher
B) Rates are highest amongst Indigenous women
C) The disease is often detected later
D) There are fewer health complications

Answer 3

D

Question 4

Risk factors contributing towards the development of diabetes among Indigenous groups include which of the following

A) Obesity
B) Smoking
C) Consumption of caribou meat
D) a and b

Question 5

What are the risk factors for type 2 diabetes?

A) Traditional lifestyle
B) Physical inactivity
C) Obesity
D) b and c

Question 6

Diabetes rates are rising in the Indigenous population due to

A) increased education about environmental contaminants in foods.
B) the movement of status First Nations to the cities and towns from their remote reserves.
C) changes in diet from traditional foods to market foods.
D) all of the above.

Question 7

Canadian sources for data on Indigenous health are

A) a realistic look at the health of Indigenous in Canada.
B) overestimates of disease and health conditions.
C) underestimates of disease and health conditions.
D) an unrealistic look at the health of Indigenous in Canada.

Question 8

Infectious diseases

A) led to frequent epidemics among the North American Indigenous peoples before Contact.
B) were rare, but serious threats to Indigenous populations.
C) were endemic among the Iroquois farmers of Eastern Canada.
D) appear to have been unknown before Contact.

Question 9

The predominant pattern of disease among Indigenous people immediately following Contact was

A) infections.
B) injuries.
C) chronic diseases.
D) suicide.

Question 10

The trade centres of the Northern plains were the hub for disease contact and concomitant spread of many epidemics. Which one of the following diseases fulfils the criteria for depopulating epidemics in the Northern plains?

A) Influenza
B) Measles
C) Smallpox
D) Tuberculosis

Question 11

Introduced epidemic diseases caused Indigenous populations to suffer mortality rates as high as

A) 20%
B) 10%
C) 40%
D) 95%

Question 12

Which of the following diseases were introduced to the Americas by European explorers and traders?

A) Smallpox
B) Rubella
C) Common cold
D) All of the above

Question 13

How far did the 1775 to 1782 smallpox extend across North America?

A) Through the English Thirteen Colonies on the East Coast and Mexico
B) No further north than Mexico and the French colonies in Louisiana
C) Everywhere in North America except the Arctic and the Northwest Coast of British Columbia
D) All of the above

Question 14

Of all the impacts of European Contact on the Americas, epidemic diseases were

A) the most insignificant.
B) the most devastating.
C) as important as new trading opportunities that Contact brought.
D) less important than the new weapons, especially firearms, that Europeans brought.

Question 15

The "Thrifty Gene" theory claims that as a population Canadian Indigenous peoples

A) are predisposed towards diabetes.
B) possess a deoxyribonucleic acid (DNA) structure inherently more weighted towards an active lifestyle.
C) are genetically susceptible to cycles of starvation.
D) have the gene for diabetes present in their DNA.

Question 16

Poverty leads to

A) malnutrition/poor diet.
B) overcrowding/unhealthy environment.
C) lack of education.
D) lack of access to medical services.
E) all of the above.

Question 17

Which of the following health issues can be linked to lower incomes?

A) Diabetes
B) Obesity
C) Heart disease
D) Cancer
E) All of the above

Question 18

How can chronic health conditions be caused or exacerbated by lower income?

A) Lower income leads to poor diets and chronic health problems.
B) Travel costs to access medical services can deter lower income patients.
C) Lower income patients are not entitled to the same level of care as higher income patients.
D) a and b

Question 19

The underlying causes, or risk factors, that inform the prevalence of sexually transmitted diseases (STDs) and their persistence in the Indigenous populations include

A) participation in the sex trade.
B) poverty and generational trauma.
C) lack of health services.
D) all of the above.

Question 20

The Indigenous sub-group at greatest risk for contracting hepatitis C is

A) prostitutes.
B) injection drug users.
C) homosexuals.
D) children.

Question 21

Hepatitis C is spread through an exchange of body fluids. Which source poses the greatest risk?

A) Blood
B) Semen
C) Saliva
D) Urine

Question 22

Indigenous peoples are at risk for contracting hepatitis C for all the following reasons except

A) low self-esteem.
B) sharing needles.
C) tattooing.
D) poor nutrition.

Question 23

The most serious STD, and the only one for which adequate national statistics is available in Canada, is

A) chlamydia.
B) syphilis.
C) hepatitis C.
D) Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS).

Question 24

When compared with Canadians, the life expectancy of Indigenous people living with AIDS is

A) shorter.
B) the same.
C) increasing.
D) longer.

Question 25

Which population sub-group constitutes the largest proportion of Indigenous AIDS cases?

A) Young men
B) Young women
C) Pregnant women
D) Homosexual men

Question 26

Most varieties of human papillomavirus (HPV) do not cause visible symptoms (warts), but some are known to cause cancer. They may lead to cancers of the

A) cervix, vulva, vagina and anus in women.
B) cancers of the anus and penis in men.
C) cancers of the head and neck (tongue, tonsils and throat).
D) all of the above.

Question 27

When compared with the general Canadian population, the incidence of cancer among First Nations is

A) less of a problem.
B)more of a problem.
C) decreasing.
D) the same.

Question 28

High rates of lung cancer in the Indigenous population are due to

A) environmental contaminants in the traditional food supply.
B) high rates of smoking.
C) the transition from a traditional to a market diet.
D) poor air quality in Indigenous communities.

Question 29

The Indigenous populace suffer greater rates of renal complications as a result of all of the following except

A) higher rates of diabetes.
B) higher rates of cardiovascular disease.
C) lower referral rates to specialists.
D)higher rates of misuse of medications.

Question 30

What are major risk factors for respiratory disease?

A)Smoking and air pollution
B) Diet and nutrition
C) Genetics and biological inheritance
D) Currently suffering from one or more other chronic diseases

Question 31

Among the Indigenous community, respiratory disease accounts for 85% of hospital admissions of babies and children. The two major risk factors are

A) inadequate sanitation and smoking.
B) poor nutrition and environmental conditions (indoor and outdoor).
C) poor drinking water and poor nutrition.
D) smoking and environmental conditions (indoor and outdoor).

Question 32

First Nations have higher hospitalisation rates due to

A) respiratory diseases.
B) HIV/AIDS.
C) cancer.
D) cardiovascular diseases.

Question 33

The leading cause of death of children aged 28 days to 1 year in the Native American population is

A) pneumonia.
B) drowning.
C) gastroenteritis.
D) diabetes.

Question 34

What is the leading cause of death in HIV/AIDS infected individuals?

A) Cancer
B) Diabetes
C) Heart disease
D) Tuberculosis

Question 35

Tuberculosis was considered a major health risk for the Canadian population until

A) 1900.
B) 1850.
C) 1946.
D) 1974.

Question 36

Tuberculosis can survive in a dormant state in the tissues of an infected person for

A) 3 weeks.
B) 1 year.
C) 5 years.
D) the rest of their life.

Question 37

Before the development of antibiotics, the only effective treatment for tuberculosis

A) was seclusion in a special hospital, known as a sanatorium.
B) collapsing one lung "to rest" it through surgery.
C) a regime of vitamin D supplementation, usually through exposure to sunlight.
D) all of the above.

Question 38

The last Canadian tuberculosis sanatorium to close was in

A) 1903.
B) 1950.
C) 1964.
D) 1973.

Question 39

How prevalent was tuberculosis infection in Canada before World War II?

A) It was very common; most Canadians carried the disease.
B) It was most prevalent in the Indigenous population, but some non-Indigenous people were also infected.
C) It was very rare in Canada before 1939.
D) None of the above.

Question 40

What factors helped tuberculosis to flourish among Indigenous people during the 20th century?

A) Lack of racial immunity
B) Relocation to reserves
C) Genetic susceptibility
D) Poor water quality

Question 41

Very high latent infection rates of tuberculosis in the Indigenous population are directly due to

A) anti-tuberculosis campaigns of the past focusing on the rural and northern populations.
B) emergence of drug-resistant strains of tuberculosis, namely, MDR-TB and XDR-TB.
C) non-compliance of potent cocktails of steroid drugs.
D) sovereignty concerns driving the Inuit anti-tuberculosis campaigns and evacuations.

Question 42

The spirochete bacterium that causes syphilis was

A) present in Indigenous populations and caused frequent outbreaks of syphilis before Contact.
B) introduced to the Americas as a venereal disease by Europeans.
C) brought to Europe as a venereal disease and then reintroduced to the Americas in this new form.
D) brought to the Americas by sailors trading in the Far East.

Question 43

Historically, the most feared STD, and the one which if left untreated kills the infected person over a period ranging from months to years, is

A) chlamydia.
B) syphilis.
C) hepatitis C.
D) HIV/AIDS.

Question 44

Chronic otitis media can cause

A) damage to vision.
B) chronic respiratory syndrome.
C) tissue necrosis.
D) hearing damage.

Question 45

High blood pressure is a risk factor for

A) injury.
B) heart disease.
C) cancer.
D) diabetes.

Question 46

Prevalence of chronic diseases - diabetes, heart problems, hypertension, arthritis and some cancers - is significantly higher among Indigenous communities and is increasing.

Question 47

Indigenous people were relatively disease free in the pre-Contact period.

Question 48

Syphilis follows three stages over time if left unchecked: stage 1 leads to wart-like skin lesion formation, stage 2 sets in with fevers and weight and hair loss and stage 3 leads to degeneration of the cardiovascular or neural system and death.

Question 49

Otitis media is a health issue in the Indigenous population because it is associated with substandard housing.

Question 50

The rate of tuberculosis is higher among Indigenous people compared with the general population because Indigenous people have lower rates of poverty.

Question 51

Everyone who contracts tuberculosis will display signs and symptoms of the disease within 2 years.

Question 52

One out of three Indigenous persons newly diagnosed with HIV is under 30 years of age.

Question 53

HIV/AIDS has a significant impact on Indigenous men, making up 47% of all new HIV diagnoses among Indigenous people.

Question 54

Chronic obstructive pulmonary disease (COPD) is often seen in people addicted to smoking tobacco.

Question 55

Infection of herpes simplex is lifelong as the virus remains latent in the body, emerging regularly as sores on the genital region.

Question 56

Currently, there is a low prevalence of documented respiratory diseases among many Indigenous groups.

Question 57

Prevalence rates of documented infectious diseases - such as HPV, HIV, chlamydia - are currently lower among many Indigenous groups.

Question 58

Lack of racial immunity is the greatest factor in allowing tuberculosis to flourish among First Nations people during the 20th century.

Question 59

The transmission of hepatitis C is only through blood transfusion, sometimes sexual intercourse but more often through shared IV needles.

Question 60

High obesity rates are closely correlated with the transition from a traditional diet to a market diet among rural and remote Indigenous populations.

Question 61

Incidence of chlamydia in the Indigenous population is compounded by late diagnosis, inadequate medical treatment and failure to follow medication schedules.

Question 62

Gonorrhoea, caused by the Neisseria gonorrhoeae bacteria, is spread through any variety of sexual intercourse and is often contracted in isolation of other STDs.

Question 63

Choose either one infectious disease (such as tuberculosis, human immunodeficiency virus, sexually transmitted infections), or one chronic disease (other than diabetes) that is especially problematic among Indigenous people today, and answer the following questions:
a. Which age group and gender are most affected?
b. List and explain three contributing factors for the increased rates of the disease in this population.
c. List and explain how two determinants of health can be modified to improve the health of people with this disease, either in terms of prevention or in terms of treatment.

Question 64

What was the predominant pattern of disease among Indigenous people following Contact? What is it today? Why?

Question 65

The trade routes of the northern plains and boreal forest were the hub for disease contact and concomitant spread of many epidemics. Which diseases fulfil the criteria for depopulating epidemics? Why?

Question 66

What are the trajectories by which an infectious disease spreads through a population? Explain and give examples.