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Flashcards in Modern medicine Deck (50):
1

What did Alexander Fleming discover in WWI?

That antiseptics seemed unable to prevent infection in deep wounds — he wanted to find something to kill microbes that caused infection.

2

What was the most dangerous microbe?

Staphylococci that caused septicemia (blood poisoning). Fleming became determined to find a way to treat infected wounds.

3

What did he notice when he returned from holiday in 1928?

That a mould -- penicillin —that had grown on one of his petri dishes had killed the staphylococci in the dish. A spore from this mould grown in a room below hi had floated into his laboratory and killed the germs

4

What did Fleming call Penicillin?

An antibiotic — 'destructive of life.'

5

Why didn't many people hear of his work?

He didn't inject penicillin into animals to prove it could kill infection and he did not have the funding to develop the drug.

6

Who began to research penicillin further in 1937?

Howard Florey and Ernst Chain, at Oxford university

7

How did Florey and Chain prove that penicillin killed infection?

They tested it on 8 mice 1940 and then on humans in 1941. When a patient was injected with penicillin, the infection cleared up but if the penicillin ran out, they died. E.G. They tested it on a policeman but he died after 5 days when the drug ran out.

8

What factors helped in the mass development of penicillin?

1) World War Two was a major factor in transforming the
supply of penicillin because huge quantities were
needed to treat soldiers with infected wounds. In
1943, it was used for the first time on allied soldiers in
North Africa.
2) Government funding. Florey met with the US
government who agreed to pay several huge chemical
companies to make gallons of it.

9

What short term impact did penicillin have?

By 1945 250,000 soldiers were being treated. Around 15% of British and US soldiers would have died without it. After the war it helped to teat illnesses like pneumonia, tonsillitis and meningitis. Florey and Chain got the Nobel Prize for medicine in 1945.

10

What other antibiotics followed?

Streptomycin 1944 (treated TB) , tetracycline 1953 (skin
infections), Cortisone 1950 (arthritis), cyclosporine 1970
(prevents body rejecting transplants, IVF treatment 1978.

11

What other drugs followed in the 20th century?

New vaccines to treat polio, tranquilizers, birth control pill, pills for depression

12

What has been the long term impact of the discovery of penicillin?

It led to new antibiotics being discovered as well as huge government sponsored programmes to develop it. This has then led to the pharmaceutical industry having the finance to develop more drugs and fund more research.

13

What negative impact has this had?

Drug companies have sometimes taken short cuts and not tested drugs properly — e.g —Thalidomide led to babies being born with deformities.

14

What examples of alternative medicine are there?

Hydrotherapy, aromatherapy, hypnotherapy and
acupuncture — some are based on old traditional treatments using natural treatments rather than chemicals.

15

What price Charles said about homeopathy in 2006?

He told the WHO that it is 'rooted in ancient traditions that intuitively understood the need to maintain balance and harmony with our minds, bodies and the natural world.'

16

How has the BMA reacted to alternative medicine?

It described homeopathy as 'witchcraft'

17

What are more bacteria becoming
resistant to in the modern day?

Why is this?

Antibiotics.
1) Overuse doctors prescribing them for minor illnesses
2) Effectiveness bacteria evolve and become resistant
3) Patients picking up super bugs in hospital

18

Give an example of a new superbug.

MRSA

19

How did technology help improve surgery in the early 20th century?

1) X-rays: Mobile x-ray machines used in WW1 v— allowed surgeons to identify location of bullet wounds without having to cut bodies open.
2) Splints for broken legs
3) Blood transfusions

20

Who discovered X-rays and what impact did this discovery have?

Wilhelm Roentgen 1895 — refused to patent so their use spread rapidly. Led to x-ray film being used by 1918, CT scans that allow surgeons to see tissue and bone in 3D.

21

Who helped in the area of blood transfusions and what impact did this have?

Karl Landsteiner discovered blood groups allowing
transfusions.
Once anti-coagulants were added to blood it could be
stored for 28 days.

22

How did WW1 impact surgery?

During the war mobile x-ray units were used
Harold Gilles set up a skin graft unit to treat men with
facial wounds. By 1917 the army had set up a special
hospital for facial repairs. Over 5,000 service men
were treated. Gilles was regarded as the pioneer of
plastic surgery.
First blood banks set up in 1915.
The army identified 80,000 men with shell shock.
Hospitals like Craighlockhart were set up used the
talking cure and occupational therapy. Shows progress
in understanding of mental illness.
New techniques developed to repair broken bones —
splints.

23

How did WW2 impact surgery?

Government set up British Blood Transfusion Service
to use blood donors in WW2.

Blood plasma developed in 1940 making it easier to
store and transport blood.

Blood banks in USA and GB in the war.

Penicillin used to prevent infection when treating
pilots with facial wounds

Dwight Harken (US army surgeon) made improvements
to heart surgery by cutting into beating hearts to
remove shrapnel

Sir Archibald Mclndoe improved on Gilles methods of
skin grafting to treat pilots with severe burns
Cataract surgery — Harold Ridley

Healthy diets encouraged as a result of food shortages

Overall war can speed up developments in surgery as
government spend money on research and
techniques

24

How has war hindered medical progress?

Doctors are taken away from normal duties to treat
war casualties
Sometimes medical research is stopped in war time

25

How did surgery progress after WW2?

-Radiation therapy to target cancer
-1952 First kidney transplant took place
-1961 first heart pacemaker
-1967 Dr Christian Barnard undertook the first heart
transplant operation — patient lived for 18 days.
-Hip replacements 1972
-1986 British woman Davina Thompson became the first
heart, lung and liver transplant patient.
-First full face transplant 2008
-Keyhole surgery means surgeons can now perform
operations through very small cuts and using fibre-
optic cameras
-Laser surgery have been increasingly used since 1987

26

What factors have aided surgical developments?

Scientific and technological advances

27

Other medical developments post (after) WW2

• CAT and MRI scans help to aid diagnoses
• Discovery of DNA 1953 have led to huge area of
research in genetics

28

What are some of the medical controversies today?

Some people argue that fertility treatment has gone too far. Also developments in cloning are open to controversy — sheep have been cloned what about humans?

29

Was the government worried about the
health of the nation?

40% of soldiers who had signed up for the Boer War had been unfit to enlist. The government worried this evidence of poverty would harm the economy and strength of the nation.

30

What did Charles Booth discover?

He published the Life and Labour of the people in 1889 and found that 35% of London lived in abject poverty. This began to change people's attitudes towards the poor.

31

What did Seebohm Rowntree find?

His study, Poverty, A study in Town Life, 1901 showed that nearly half the working class people in York lived in poverty. He coined the term 'poverty line.' His work influenced David Lloyd George and William Beveridge.

32

Who wrote Round about a Pound a week in 1913?

Maud Pember.

33

Which political party passed reforms to help the poor?

The Liberal party.

34

Why did they pass reforms?

They were worried about the strength and power of the
country, some politicians like David Lloyd George believed in direct action from the government and they were worried about the appeal of the labour party.

35

What reforms were passed?

• 1906 Free Schools Meals
• 1907 Education Act— medical inspections in schools
• 1908 Children and Young Person's Act - protected children from neglect
• 1908 Old Age Pensions Act — over 70s received pensions provided they had worked all their life
• 1909 Labour Exchanges built (job centres)
• 1911 National Insurance sick and unemployment pay if you paid into the scheme

36

What were the limitations of these reforms?

Poor families could not afford to pay for medical treatment, pensions were limited to those who had worked all their lives and many Conservatives objected to paying for these reforms.

37

What report was introduced during World War Two?

The Beveridge Report, 1942

38

What did the Beveridge report of 1942 state?

It set out proposals for a welfare state and the need to
eliminate the five 'Giant Evils' of Want, Disease, Ignorance, Squalor and Idleness. It said the government should help people who could not help themselves from the cradle to the grave.'

39

Why had WW2 proved the need for such a report?

People were shocked at the health of some of the evacuated children.

40

Which political party did introduce a
welfare state in Britain?

Labour: Clement Attlee was PM

41

What was the NHS?

Introduced in 1948, it brought together hospitals, doctors, nurses, opticians, pharmacists and dentists under one umbrella organisation. Healthcare was free at the point of delivery. Aneurin Bevan was in charge of overseeing the NHS

42

Who opposed the NHS?

Many Doctors and Winston Churchill who said it was a curse on the country'. 10% of Drs only were in favour of it.

43

What happened in 1952 to make the government realize that towns needed cleaning up?

Killer smog over London.

44

What did the government pass to deal
with this?

Clean Air Acts 1956 and 1968.

45

What other measures did the government pass in the 1960's to improve towns and cities?

New towns built such as Milton Keynes and
Letchworth.
Slum clearance. Poor housing was replaced by
'modern' tower blocks. They had central heating,
bathrooms and fitted kitchens.

46

What are the main health problems that people affect today?

Cancer
Heart disease
dementia

47

Why are people more likely to die of these diseases?

Unhealthy lifestyles (diet/exercise)
People living longer
Obesity

48

How could the NHS solve these problems?

Targeting prevention rather than cure. For example, educating people on smoking and exercise

49

What advances in drugs have been made recently?

The Medical Research Council has set up funds to develop new products such as new drugs for AIDS

50

What are the pressures facing the NHS today?

Cost. As people live longer and technology becomes
more advanced, operations and treatment become
more expensive.

It is not completely free now: prescriptions, dental
treatment and dentistry have to be paid for.

Drug companies sell drugs too expensively and the NHS can't afford them leading to increased prices.