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Flashcards in Midterm 2 Deck (63):
1

In what time period and from what did TB arise from?

The Neolithic
Derived from cattle

2

Causative agent of TB

Mycobacterium tuberculosis

3

Is TB an endemic, epidemic, or pandemic?

Endemic

4

What is the iconic symbol of TB

Chest x Ray

5

Why was TB believed to be hereditary

Because it was often passed from older family members to younger children

6

TB mode of transmission
How was this proved

Droplet
Riley proved by exposing cages of guinea pigs to either treated air or untreated air from TB wards

7

3 stages of TB disease process

Primary (childhood TB)
Reactivation disease (cavities TB)
Reinfection

8

Details of primary TB

Occurs in children
Minor, many non-specific symptoms which are misdiagnosed
Slips into latency

9

Details of cavitation TB

10% of latent TB cases will reactivate
Caused by aggressive IR that destroys lung tissue creating cavities
Causes coughing, sneezing

10

Mycobacterium tuberculosis generally affects _______

The lungs (pulmonary TB)

11

Explain the granuloma response of pulmonary TB

Appears as swollen lymph nodes
Macrophage eat TB, normally joins with lysosomes for granuloma enzyme response
If the macrophage doesn’t join with lysozyme, it calcifies and can be felt as a hard mass in the lungs

12

Symptoms of pulmonary TB

Fever and Night sweats
Fatigue due to disease related anemia
Appetite and weight loss
Severe cough with haemoptysis
Cavities in the lungs

13

Risk factors for TB infection

Duration of exposure
Frequency of coughs
Concentration of droplets in air
Small/ enclosed spaces
Inadequate air flow

14

Risk factors for TB disease

Strain of bacterium
Effectiveness of IR
- genetics
- nutrition
- other infections (immunocompromised)

15

Explain extrapulmonary TB

Causes by m. Bovis
Affects lymph nodes, kidneys, bones and joints
Often gets into bone tissue via infected blood
Causes a hump back by infecting vertebra
Transmission via unpasteurized cows milk or meat

16

What was Canada’s first TB sanatorium called?

Muskoka cottage sanatorium

17

What is a bug box?

Boxes that TB patients would spit mucus into so that they wouldn’t spread it on the ground or swallow it to their own digestive tract

18

What was the Brompton TB sanatorium (England) treatment method?

Graduated labour (worked in gravel pits)

19

Who is Dr. William Dock?

TB physician, studied the effects of gravity.
Argued that when we position our bodies upright, there is a high oxygen supply and lack of blood flow to the apex region of the lungs
Said that laying down increase blood flow and reduces oxygen concentration

20

What is artificial pneumothorax?

Intentionally collapsing certain parts of one lung

21

What is thoracoplasty?

Removing ribs to allow for the compression of the lungs

22

What was the golden age of TB?

1930s

23

Who invented the drug streptomycin?

Waksman

24

Syphilis:
Bacteria name
Shape
Motility

Treponema pallidum
Spirochete
Extremely motile (corkscrew movements)

25

Syphilis transmission

Direct contact with a sore on genitalia/ mouth
In utero via placenta (congenital syphilis)

26

Affects of congenital syphilis

Increased risk of stillbirth/ early infant death
Developmental delays
Saber shin tibia (infection and developmental issues in legs and face)

27

2 ways to screen for syphilis

Microscopy
Blood sample (looking for antibodies - Wassermann test)

28

What drug is used to treat syphilis?

Penicillin

29

Stages of syphilis (time periods)

Primary stage:
- incubation period = 21 days
- lasts 3-6 weeks

Secondary stage

Latent stage
- early latent = within 1 year of infection
- late latent = after 1 year of infection
- can last 3-39 years

Tertiary stage
- until death

30

Symptoms of primary syphilis

Single or multiple sores at site of inoculation

31

Symptoms of secondary syphilis

Rash on palms and feet
General symptoms + patchy hair loss + periostitis

32

Symptoms of tertiary syphilis

Organ and skeletal damage:
Paralysis
Perhaps death
Dementia
Inability to coordinate muscles
Numbness
Gradual blindness

33

Which stages of syphilis are NOT infective?

Late latent and tertiary

34

When was the Winnipeg outbreak of syphilis?
What was the 3 methods they used?

2003
Condoms, coasters, posters

35

What disease is historically know as a disease of blame?

Syphilis

36

Evidence for syphilis from the old world

Confusion with “venereal leprosy”
Medieval Essex woman:
25-50 yo
Bones show signs of syphilis
Lived prior to new world connections
BUT have to prove that It’s actually syphilis bacteria, and that acidic soil didn’t cause bone appearance

37

Evidence for syphilis from the new world

Thought to be imported from the new world to the old world, no reports of syphilis in old world

38

Old treatments of syphilis

Cupping and bleeding
Mercury treatment
Pyrotherapy

39

Side effects of mercury treatment of syphilis

Black teeth
Degenerative neurological disorder

40

Who invented pyrotherapy?

Julius Wagner-Jauregg

41

What is pyrotherapy

Infecting syphilis patients with malaria (plasmodium vivax)
Induced high fever which Kills the syphilis bacteria, then treat malaria with Quinine

42

What was the first condom made of?

Pig intestine

43

What percentage of people are immune to leprosy?

90-95%

44

Incubation period of leprosy

2-20 years

45

Early stage symptoms of leprosy

Light patches on skin, with tingling or numbness
Fluid filled nodules

46

Leprosy bacterium causes _____ and _______

Loss of sensory and motor function

47

True or false: leprosy can cause blindness

True

48

Lepers had to carry a _______ to announce their presence

A bell

49

Leprosy:
Bacterium name
Shape
Distinctive feature

Mycobacterium leprae
Rod shaped
Waxy coat

50

What temperature does M. Leprae favour?

30°C

51

Where does M. Leprae reside in the body?

Cooler areas:
Nerves of the hand and feet
Nose
Skin
Anterior part of eye

52

What is the difference between paucibacillary and multibacillary leprosy?

Paucibacillary = milder, fewer bacteria
Multibacillary = more aggressive, more bacteria

53

Other name for paucibacillary leprosy?

Tuberculoid leprosy

54

Other name for multibacillary leprosy?

Lepromatous leprosy

55

What causes a person to have multibacillary leprosy instead of paucibacillary leprosy?

Lower hydrogen peroxide production in macrophages

56

What drug is used to treat leprosy?

Dapsone (derived from dyes)

57

Leprosy transmission

Most widely believed to be direct contact
BUT
Bacteria can survive up to 35 hours outside host, so indirect contact and vector borne are possible

Most likely via droplet transmission

58

What is slit skin sampling, what disease is it associated with?

Going to deeper tissues
Leprosy

59

Leprosy numbers today

Over 1 million persist
0.5 million new each year

60

Movement of leprosy around the world

India
China
Mediterranean (Alexander the great)
Europe
Africa

61

When were lazarettos established?

Middle Ages Europe (13th century)

62

True or false:
TB infections make leprosy cases worse

False - TB infections improve resistance to leprosy

63

Name 2 lazarettos in Canada

D’arcy island (BC)
Tracadie (NB)