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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
What 3 tests can you use to investigate suspected TB with sputum?
AFB - Acid fast bacilli sputum stain - shows if infection Liquid culture Gene probe/PCR - for resistance + specificificty
26
If someone has no sputum but is suspected of TB, what could you do to diagnose?
Bronchoscopy Plural biopsy Mediastenoscopy
27
Name 2 ways you can test for latent TB
Mantoux skin test | IGRA - Interferon gamma release assay
28
A positive mantoux test (>6mm) could mean one of 4 things, what are they?
Active TB Latent TB BCG vaccination atypical non TB mycobacterium
29
Why in some ways in IGRA better than mantoux testing for latent TB?
It isn't positive with BCG vaccine | very specific
30
For non-resistant pulmonary TB, what drug regime is used?
2 months - Rifampicin, Izoniazid, pyrazinamine, ethambutol | 4 months - Rifampicin + isoniazid
31
What are the brand names of the drugs used in TB?
2 months - Rifater + ethambutol | 4 months - Rifinah
32
What monitoring is needed during TB treatment?
LFTs + Renal function | Eyesight (ethambutol can cause colour blindness + restrict visual fields)
33
What is anaemia?
Reduction in quantity of oxygen carrying pigment, haemoglobin, in the blood
34
What is haemoglobin made from?
essential metalloprotein | tetramer of Haem + 4 globin chains (2 alpha, 2 beta)
35
What is different about foetal haemoglobin?
They have greater affinity to O2 Contain 2 alpha and 2 gamma/foetal globin subunits after 6 months becomes adult
36
What are the symptoms of anaemia?
Tireness, breathlessness, palpitations, pallor, poor resistance to infection
37
What are the signs of anaemia?
``` Pallor Koilonychia glossitis Angular stomatis peripheral oedema ```
38
What are the 2 types of anaemia?
Microcytic and macrocytic
39
What causes macrocytic anaemia?
B12/folate deficiency, or DNA replication interferance
40
Why does B12/folate deficiency cause a macrocytic anaemia?
There is less DNA, so cells can't divide as much, so less devisions occur before the RBC matures, so each is bigger
41
What causes Microcytic anaemia
Iron deficiency, or insufficient globin chains
42
Why does iron deficiency cause microcytic anaemia?
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
What type of anemia do you have in sickle cell?
Microcytic
44
What is sickle cell?
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
Why do you get bone pain in sickle cell?
The sickle cells can occlude small vessels in the bone
46
What is dactylitis
Painful inflammation of the fingers
47
What is B Thalyssaemia?
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
Why can you get bone hypertrophy in B thalyssaemia?
Breakdown of RBCs causes an EPO drive, which stimulated expansion of the marror and bone hypertrophy
49
What management is given in b thylassaemia?
Repeated blood transfusions + iron chaelation
50
What is an intermediate host of a parasite?
Where the parasite develops
51
What is a definative host of a parasite?
Host where an adult/sexually mature parasite lives
52
What are protozoa?
Protista kingdom, most require host to complete part of lifecycle Classified by locomotion and region of infection
53
What are the 4 classes of protozoa?
Amoebas Flagellates Ciliates Apicomplexans (sporozoans)
54
What features do amoebas have?
Move by pseudopodia - cytoplasmic projections | Feed by phagocytosis
55
What are the features of flagellates?
Move by flagella | 2 body forms - metamonads + tryanosomes
56
What are the features of ciliates?
Feed and move via rows of cilia | Rarely effect humans
57
What are the features of apicomplexans?
obligate intracellular pathogens No means of locomotion Apical complex forms for attachement
58
Give examples of amoebas
Amoebiasis / amoebic dysentry - intestinal
59
Give examples of Flagellates
Giardiasis - intestinal, in stools, v common Trichomoniasis vaginalis - urogenital, most common non viral STD African sleeping sickness Chagas Leishmaniasis - blood + tissues infection
60
Give examples of ciliates
Balantidum coli - rarely affects humans
61
Give examples of Apicomplexans
Maleria - plasmodium spp. Toxoplasmosis - bloof and tissue Cryptosporidiosis - intestinal, life threatening in AIDS
62
What are vectors?
Organisms that transmit pathogens from 1 infected person/animal to another often biting invertebrates
63
What is the vector of the bubonic plague (yersinia pestis)
Flea
64
What is the vector of Chagas disease (trypanosoma cruizi)?
Triatomine bug
65
How do you get Chagas disease? What does it cause?
Bug bits + poos on skin, you itch, parasite enters Can have 20-30 yr chronic phase Causes heart failure, purple swelling on face
66
What vector transmits dengue (flavivirus)
Aedes mosquito
67
What does dengue cause?
Rash like measles, fever, headache, bone pain, ? haemorrhagic
68
What vector transmits Lyme disease?
Tick
69
What transmits rabies?
Dog
70
What transmits Leishmaniasis?
Sandfly
71
What does leishmaniasis cause?
Ulcers, fever, enlarged spleen + liver
72
What vector transmits maleria?
Anopheles mosquito
73
What species of protozoa cause maleria?
Plasmodium falciform p. vivax p. ovale p. malarae
74
What vector transmits onchoceriosis?
Black fly
75
What is a more common name for onchoceriosis?
River blindness ( become blind so see black - black fly!)
76
What vector transmits african sleeping sickeness?
Tetse fly
77
What vector transmits Typhus / spotted fever (rickeltisia)
Lice / ticks
78
What vector transmits yellow fever (flavivirus)
aedes mosquito
79
What are helminths?
parasitic worms
80
What are the 3 groups of helminth?
Cestodes (tapeworms) Trematodes (Flukes) Nematodes (Round worms)
81
Give examples of cestode species
Toxocariasis Echinococcosis Taeniasis
82
Give examples of tramatode species
Schistosomiasis - vector
83
Give examples of nematode species
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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