Public health 5

So I had public health 5 yesterday. I studied 2 days for it. My examiner was dr. Katalin Szendi. She was very nice, as all examiners appearently are in 3rd and 4th year (hopefully 5th and 6th too). She was fair and passed everyone before me that day, even though every one of us said stupid things.

You draw 2 topics, one from each envelope. I don’t know how the topics are separated into the two envelopes, but some people drew two consecutive topics, so it’s not divided in the middle.

My topics were “16. Epidemiology and prevention of prostate and cervix cancer” and “22. Epidemiology and prevention of asthma”.

16. Epidemiology and prevention of prostate and cervix cancer

I began by explaining the incidence and mean age of onset of prostate cancer. I said that it has low mortality, to which she asked what the 5-year survival rate is. I said 30% (no idea why I said that), and she as like “but you said it has low mortality, 30% is not low”. I corrected myself, first to 50, then 70 and finally 80%, which is correct.

I mentioned the risk factors I had written down. She said that there is at least one more important risk factor related to lifestyle. I guessed diet, which is correct, but she wanted to know what part of the diet increases the risk for prostate cancer. I started to guess red meat, trans fats, saturated fats, salt, but that was not it. She says it’s a type of fatty acid. I started to guess all types of fatty acids I could think of, saturated, monounsaturated, trans fats, but no. I was pretty sure that polyunsaturated fats were not the cause, because they’re healthy, right?

Then she asks me what the remaining type of fatty acid is, to which I say polyunsaturated. She asks me what two types of polyunsaturated fats we have, and when she said that I remembered omega-6 fatty acids, which was correct. She told me to move on to cervical cancer.

I start by saying that the incidence is declining due to screening and prevention, and that the 5-year survival is 20%. I talk about the risk factors I had written down, and she says that there is another important risk factor. I suddenly recall that having many full-term births is a risk factor. She asks the mechanism behind this.

I didn’t know the answer, and I couldn’t think of anything. I came up with a really stupid guess, which in retrospect was obviously wrong. I don’t really know why I said it. Maybe I saw an opportunity to be funny?

“Because having many births is related to having lots of sex?”

The examiner starts laughing hysterically. The co-examiner starts laughing too. The other students in the room also laugh. I laugh at how I could say such a stupid thing.

After a minute straight of laughing, the examiner asks me what happens with the cervix during delivery. “It’s dilated”, I say. “What else?” “It’s physically injured?” “Yes, injury to the cervix makes it more susceptible to HPV infection.”

She asks about which genetic factors are involved. I say BRCA, to which she says yes, but that’s not the most important. I guess the androgen receptor. She says not really, but it has to do with androgens. I guess the 5-alpha reductase enzyme, and she says yes.

She asks about prevention. I mention what I had written down. She asks me what types of vaccines we have. I say that we have the bivalent against 16 and 18, and the quadrivalent against 16, 18, 31 and 33. She says that that’s not correct. I realize the mistake and say 6, 11, 16 and 18. We move on to the next topic.

22. Epidemiology and prevention of asthma

I basically read everything I had written down. She asks me about another primary preventative measure. I half-guess breastfeeding (because I remembered that it was protective against some immune-related diseases), which was correct. She asks me how long it’s recommended by the WHO to breastfeed a child. I guess 1 year, but she says 6 months.

I think she might have asked me one or two more questions but I can’t remember.

She ends up giving me a 4, and says that the dietary risk factors for prostate cancer were was prevented me from getting a 5.

Christmas break

That’s all the exams before christmas for me. I leave for Norway on sunday, and I return the 29th. Hopefully I can relax and recharge during my time at home, so I can be ready to tackle ENT the 3rd (I hate ENT).

Good luck to you and merry christmas!