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JG Year 2 > 201 International Health > Flashcards

201 International Health Flashcards

0
Q

What is Brock’s syndrome?

A

Right middle lobe atelectasis (collapse) in TB secondary to lymphadenopathy. It causes the middle bronchus to become ‘slit-like’ in appearance

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1
Q

What is erythema nodosum a clinical sign of?

A

TB

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2
Q

What are the 3 main symptoms of TB?

A

Fever and night sweats (50%)
Cough (50%)
Weight loss (50%)

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3
Q

What type of bacteria is mycobacterium tuberculosis?

A

Obligate aerobe

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4
Q

In which cells do M. Tuberculosis proliferate in?

A

Macrophages

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5
Q

Where is the primary infection of M. tuberculosis commonly found?

A

Sub pleural in the mid to upper zones

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6
Q

What are the radiological features of a pt with TB?

A

Necrosing granulomas
Hilar lymphadenopathy

I.e. Ghon complex

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7
Q

What are the drugs of choice for the 1st 2 months of a primary TB infection?

A

Rifater (Rifampicin, isoniazid, pyrazinamide)

Ethambutol

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8
Q

What is the treatment following 4 months of the 6 month treatment of primary TB?

A

Rifinah (Rifampicin and isoniazid)

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9
Q

Why should LFTs be monitored in patients with TB on treatment?

A

S/E of treatment drugs cause hepatotoxicity

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10
Q

What are the side effects of Ethambutol in the treatment of TB?

A

Visual effects - loss of vision, eye pain, red-green colour blindness

Should perform regular visual acuity testing etc

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11
Q

How long should a meningitis TB pt be treated for?

A

12 months - add in steroids

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12
Q

How much of the population of sub Saharan Africa are thought to be exposed to TB?

A

100%

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13
Q

Which type of TB is the neonatal vaccination of TB effective against?

A

Meningitis TB

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14
Q

What could be detected in a sputum AFB?

A

Mycobacterium tuberculosis

Non TB mycobacterium

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15
Q

What is auromine rhodamine staining used to visualise?

A

Mycobacterium

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16
Q

What is injected in a Mantoux test?

A

PPD - purified protein derivative of tuberculin

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17
Q

What is IGRA used to test for?

A

Latent TB infection - measures the interferon gamma released by T-cells.
Highly sensitive

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18
Q

What is the lifetime risk of reactivation of TB?

A

10%

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19
Q

What is the lifetime risk of contracting TB?

A

0.1%

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20
Q

What is miliary TB?

A

Uncontrolled dissemination of M. tuberculosis throughout blood stream

21
Q

What is Bedaquiline used to treat?

A

MDRTB

22
Q

Which nucleus is disinhibited in decorticating posture?

A

Red nucleus in rostral midbrain - supplying flexor muscle of the upper limb - therefore pts have disinhibited flexion of the arms

23
Q

Protein synthesis of which chromosomes makes haemoglobin?

A

α genes = chromosome 16

β genes = chromosome 11

24
Q

Why is there microcytic anaemia in low Hb?

A

Hb conc involved with cell division, when less Hb, more division and smaller cells

25
Q

What is the inheritance of sickle cell?

A

AR

26
Q

What are the features of sickle cell?

A

Obstruction of microvasculature, tissue infarction leading to acute pain, chest syndrome, stroke…

27
Q

Where is the mutation in sickle cell?

A

Point mutation of β chain of Hb

28
Q

Why is splenomegaly a feature of thalassaemia?

A

Point mutation of the β and α chains of Hb so solubility of haemoglobin affected. Increased end cell fragility - spleen tries to compensate with increase haematopoesis

29
Q

What is the estimated concentration of Hb if the packed cell volume (PCV) is 21%?

A

Estimated Hb = PCV x10 / 3

= 70g/L

30
Q

Definition:

The organism in which the adult or sexually mature stage of the parasite

A

Definitive host

31
Q

Definition:

The organism in which the parasite lives during a period of its development

A

Intermediate host

32
Q

How do amoebas mobilise?

A

Extend cytoplasmic projections - pseudopodia

34
Q

Definition:

Organism which transmit pathogens rom one infected animal to another

A

Vectors

35
Q

What is the vector for Chagas disease?

A

Triatomine bug

36
Q

Which disease does Yersinia pestis cause?

A

Bubonic plague

37
Q

Which vector carries Onchocerca volvulus?

A

Black fly

38
Q

Which disease is caused by Trypanosoma brucei and what is the vector?

A

Sleeping sickness - tsetse fly

39
Q

Which of the following affects blood and tissues?

  1. Cryptosporidium spp
  2. Trichuris trichuria
  3. Trypanosoma cruzi
  4. Enterobius vermicularis
A
  1. Trypanosoma cruzi - Chagas disease
40
Q

What type of microorganism causes African sleeping sickness?

A

Protozoa - Tichomonas brucei

41
Q

What are the initial S&S of African sleeping sickness?

4 listed

A
  1. Fever
  2. HA
  3. HA
  4. Itching
42
Q

What are the later S&S of African sleeping sickness - once the protozoa has crossed the BBB?
(5 listed)

A
  1. Changes in behaviour
  2. Confusion
  3. Sensory disturbance
  4. Poor coordination
  5. Disturbance of sleep cycle
43
Q

What investigation is performed to determine disease progression?

A

LP

44
Q

Which stage of African sleeping sickness is treated by:
Pentamidine (for gambiense)
Suramin (for rhodisiense)

A

1st stage - i.e. lower toxicity

45
Q

Why are Melarsoprol, Eflorinthine , Nufurtimox + eflorinthine used to treat the 2nd stage of African sleeping sickness?

A

They are able to cross the BBB

46
Q

How is Trypanosoma cruzi transported into the host blood stream?

A

Triatomine bug bites skin of human and defaecates close by. Bite is scratched by the host and protozoa are able to enter in through the broken skin.

47
Q

What percentage of people are chronically affected by African sleeping sickness?

A

30%

48
Q

How long does the acute phase of Chagas disease last?

A

~ 2 months

49
Q

Where do the parasites of Chagas disease reside in during the chronic phase?

A

Heart myocardium

50
Q

What is the long term consequences of a Trypanosoma cruzi infection?

A

Sudden death or HF caused by progressive destruction of the heart muscle

51
Q

What are Benznidazole and Nifurtimox used to treat?

A

Chagas disease

JG Year 2 (28 decks)

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