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Lucy Knox - Year 2 > 201 - Global Burden of Disease > Flashcards

201 - Global Burden of Disease Flashcards

1
Q

What is an NTD?

A

Neglected tropical disease - needs more resources to get it under control/research/drugs

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2
Q

In high income countries, what type of diseases do people die from?

A

Chronic diseases

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3
Q

In low income countries, what type of diseases do people die from?

A

Infectious diseases

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4
Q

The age profile of deaths is different between high and low income countries - in high income x% of deaths are over x?

A

70% over 70

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5
Q

The age profile of deaths is different between high and low income countries - in low income, x% of deaths are under x?

A

40% under 14

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6
Q

What are the 3 most common causes of death in children under 5 worldwide?

A

Neonatal - 37%
Pneumonia - 19%
Diarrhoea - 17%

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7
Q

What is the Maternal Mortality Ratio in developed and developing countries?

A 
Developed = 14
Developing = 290
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8
Q

What are DALYs?

A

Disability adjusted life years

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9
Q

How do you calculate DALYs?

A

Years life lost + years lost to disability

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10
Q

What bacterium cause TB?

A

Mycobacterium Tuberculosis (99%)
Mycobacterium bovis
Mycobacterium africanum

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11
Q

What are the features of TB bacterium?

A

Obligate aerobe
Acid Fast Bacillus
Capable of intracellular survival

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12
Q

How is TB transmitted?

A

Cough dropplets

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13
Q

After exposure to TB what % become infected?

A

30%

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14
Q

What response is initiated in TB when a person is infected?

A

Th1 response - causes type IV hypersensitivity + necrotising granulomas

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15
Q

What % of asymptomatic TB will become latent infection?

A

95%

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16
Q

What % of asympotomatic TB will become active TB?

A

5%

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17
Q

What are the clinical features of active TB?

A

Fever, chest pain, cough, fatigue, rash…

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18
Q

What signs are seen in TB?

A

Erythema nodosum
Pleural effusion
Phyclenular conjunctivitis

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19
Q

On CXR, what might you see with someone with TB?

A

1/3 have pleural effusion
They may have pulmonary infiltrates
They may have hilar lymphadanopathy

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20
Q

TB can be reactivated while it is latent, what can be a factor in causing reactivation?

A 
Age
Malignancy
HIV
Drugs
CRF - Chronic renal failure
DM - Diabetes melatus
Alcoholism
Malnutrition
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21
Q

What are the features of TB reactivation?

A

Night sweats
weight loss
Haemoptysis?

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22
Q

What is miliary TB?

A

Uncontrolled dissemination through the blood

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23
Q

What might you see on CXR in miliary TB?

A

Millet seed signs

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24
Q

What protects you from ever getting miliary TB?

A

BCG vaccination

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25
Q

What 3 tests can you use to investigate suspected TB with sputum?

A

AFB - Acid fast bacilli sputum stain - shows if infection
Liquid culture
Gene probe/PCR - for resistance + specificificty

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26
Q

If someone has no sputum but is suspected of TB, what could you do to diagnose?

A

Bronchoscopy
Plural biopsy
Mediastenoscopy

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27
Q

Name 2 ways you can test for latent TB

A

Mantoux skin test

IGRA - Interferon gamma release assay

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28
Q

A positive mantoux test (>6mm) could mean one of 4 things, what are they?

A

Active TB
Latent TB
BCG vaccination
atypical non TB mycobacterium

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29
Q

Why in some ways in IGRA better than mantoux testing for latent TB?

A

It isn’t positive with BCG vaccine

very specific

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30
Q

For non-resistant pulmonary TB, what drug regime is used?

A

2 months - Rifampicin, Izoniazid, pyrazinamine, ethambutol

4 months - Rifampicin + isoniazid

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31
Q

What are the brand names of the drugs used in TB?

A

2 months - Rifater + ethambutol

4 months - Rifinah

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32
Q

What monitoring is needed during TB treatment?

A

LFTs + Renal function

Eyesight (ethambutol can cause colour blindness + restrict visual fields)

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33
Q

What is anaemia?

A

Reduction in quantity of oxygen carrying pigment, haemoglobin, in the blood

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34
Q

What is haemoglobin made from?

A

essential metalloprotein

tetramer of Haem + 4 globin chains (2 alpha, 2 beta)

35
Q

What is different about foetal haemoglobin?

A

They have greater affinity to O2
Contain 2 alpha and 2 gamma/foetal globin subunits
after 6 months becomes adult

36
Q

What are the symptoms of anaemia?

A

Tireness, breathlessness, palpitations, pallor, poor resistance to infection

37
Q

What are the signs of anaemia?

A 
Pallor
Koilonychia
glossitis
Angular stomatis
peripheral oedema
38
Q

What are the 2 types of anaemia?

A

Microcytic and macrocytic

39
Q

What causes macrocytic anaemia?

A

B12/folate deficiency, or DNA replication interferance

40
Q

Why does B12/folate deficiency cause a macrocytic anaemia?

A

There is less DNA, so cells can’t divide as much, so less devisions occur before the RBC matures, so each is bigger

41
Q

What causes Microcytic anaemia

A

Iron deficiency, or insufficient globin chains

42
Q

Why does iron deficiency cause microcytic anaemia?

A

There is less haemoglobin, in RBC development haemoglobin conc must be high enough, so when low Hb, it has to divide many times to get the right concentration - so smaller RBCs

43
Q

What type of anemia do you have in sickle cell?

A

Microcytic

44
Q

What is sickle cell?

A

An autosomal recessive condition, point mutation on Hb alpha.
Causes abnormal RBCs that becoem a sickle shape when deoxygenated, these are rigid and can occlude vessels

45
Q

Why do you get bone pain in sickle cell?

A

The sickle cells can occlude small vessels in the bone

46
Q

What is dactylitis

A

Painful inflammation of the fingers

47
Q

What is B Thalyssaemia?

A

Common inherited disorder
Defects in alpha or beta globin chains, which causes an inbalance and insolubility - fragile RBC
Reduced RBC lifespan - anaemia and splenic crisis

48
Q

Why can you get bone hypertrophy in B thalyssaemia?

A

Breakdown of RBCs causes an EPO drive, which stimulated expansion of the marror and bone hypertrophy

49
Q

What management is given in b thylassaemia?

A

Repeated blood transfusions + iron chaelation

50
Q

What is an intermediate host of a parasite?

A

Where the parasite develops

51
Q

What is a definative host of a parasite?

A

Host where an adult/sexually mature parasite lives

52
Q

What are protozoa?

A

Protista kingdom, most require host to complete part of lifecycle
Classified by locomotion and region of infection

53
Q

What are the 4 classes of protozoa?

A

Amoebas
Flagellates
Ciliates
Apicomplexans (sporozoans)

54
Q

What features do amoebas have?

A

Move by pseudopodia - cytoplasmic projections

Feed by phagocytosis

55
Q

What are the features of flagellates?

A

Move by flagella

2 body forms - metamonads + tryanosomes

56
Q

What are the features of ciliates?

A

Feed and move via rows of cilia

Rarely effect humans

57
Q

What are the features of apicomplexans?

A

obligate intracellular pathogens
No means of locomotion
Apical complex forms for attachement

58
Q

Give examples of amoebas

A

Amoebiasis / amoebic dysentry - intestinal

59
Q

Give examples of Flagellates

A

Giardiasis - intestinal, in stools, v common
Trichomoniasis vaginalis - urogenital, most common non viral STD
African sleeping sickness
Chagas
Leishmaniasis - blood + tissues infection

60
Q

Give examples of ciliates

A

Balantidum coli - rarely affects humans

61
Q

Give examples of Apicomplexans

A

Maleria - plasmodium spp.
Toxoplasmosis - bloof and tissue
Cryptosporidiosis - intestinal, life threatening in AIDS

62
Q

What are vectors?

A

Organisms that transmit pathogens from 1 infected person/animal to another
often biting invertebrates

63
Q

What is the vector of the bubonic plague (yersinia pestis)

A

Flea

64
Q

What is the vector of Chagas disease (trypanosoma cruizi)?

A

Triatomine bug

65
Q

How do you get Chagas disease? What does it cause?

A

Bug bits + poos on skin, you itch, parasite enters
Can have 20-30 yr chronic phase
Causes heart failure, purple swelling on face

66
Q

What vector transmits dengue (flavivirus)

A

Aedes mosquito

67
Q

What does dengue cause?

A

Rash like measles, fever, headache, bone pain, ? haemorrhagic

68
Q

What vector transmits Lyme disease?

A

Tick

69
Q

What transmits rabies?

A

Dog

70
Q

What transmits Leishmaniasis?

A

Sandfly

71
Q

What does leishmaniasis cause?

A

Ulcers, fever, enlarged spleen + liver

72
Q

What vector transmits maleria?

A

Anopheles mosquito

73
Q

What species of protozoa cause maleria?

A

Plasmodium falciform

p. vivax
p. ovale
p. malarae

74
Q

What vector transmits onchoceriosis?

A

Black fly

75
Q

What is a more common name for onchoceriosis?

A

River blindness ( become blind so see black - black fly!)

76
Q

What vector transmits african sleeping sickeness?

A

Tetse fly

77
Q

What vector transmits Typhus / spotted fever (rickeltisia)

A

Lice / ticks

78
Q

What vector transmits yellow fever (flavivirus)

A

aedes mosquito

79
Q

What are helminths?

A

parasitic worms

80
Q

What are the 3 groups of helminth?

A

Cestodes (tapeworms)
Trematodes (Flukes)
Nematodes (Round worms)

81
Q

Give examples of cestode species

A

Toxocariasis
Echinococcosis
Taeniasis

82
Q

Give examples of tramatode species

A

Schistosomiasis - vector

83
Q

Give examples of nematode species

A

Enterobiasis - pin worm
Onchocerciasis (river blindness)
Lumphatic filariasis - wucheria bancrofti, w. brugia
Ascariasis
Trichuriasis
Hookworm disease - anclostoma necator americanas
Strongyloidiasis

Lucy Knox - Year 2 (17 decks)

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