Global health

Question 1

Indoor pollution

Answer 1

More prevalent in developing countries-
Those who rely on biomass like wood and coal to meet domestic energy needs.

Leads to many adverse health effects:
COPD
Lung cancer
Low birth weight
Childhood illness

Question 2

Pneumoconiosis

Answer 2

Disease that shows inflammation and fibrosis due to inhalation of dust.

Includes:
Silicosis
Asbestos
Coal dust

Question 3

Global silicosis

Answer 3

Silicosis rates have dropped in US and Europe due to less reliance on rocks.

Increasing exposure in developing economies like in Brazil.

Question 4

Asbestosis in Europe

Answer 4

Asbestos is outlawed in Europe.

There is still a lag time due to past exposures.

Question 5

Mesothelioma

Answer 5

Cancer of the mesothelium- lining of many internal organs.

Commonly seen in the pleura.

Associated with exacerbation of asbestosis.

Question 6

Intersections of HIV

Answer 6

TB and other pulmonary infections.

Emphysema

Question 7

MDR-TB

Answer 7

Multi-drug resistant TB

Occurs when TB organism is resistant to rifampicin and isoniazid

Question 8

Injectable second-line drugs

Answer 8

In XDR-TB, TB organism has to be resistant to any one of these drugs:

Amikacin
Kanamycin
Capreomycin

Question 9

XDR-TB

Answer 9

Extensively resistant TB

TB organisms must be resistant to:
Isoniazid
Rifampicin

Any fluoroquinolone

At least one injectable second-line drug.

Question 10

Causes of MDR-TB

Answer 10

Poor quality and supply of drugs

Poor leadership of TB programmes

Non-Compliance

Incorrect prescription

Poor diagnostics

Question 11

7 countries with 64% of global TB cases

Answer 11

India

Indonesia

China

Philippines

Pakistan

Nigeria

South Africa

Question 12

Standard treatment for TB- Initial phase

Answer 12

2 months:

Isoniazid

Rifampicin

Pyrazinamide

Ethambutol

Question 13

Standard treatment for TB- Continuation phase

Answer 13

4 months

Isoniazid

Rifampicin

Question 14

MDR-TB treatment

Answer 14

At least 5 drugs from groups A-D3 + high dose of isoniazid/ethambutol.

Administered for 9-12 months

Question 15

Eligibility criteria for latent TB screening programme

Answer 15

1. Born or spent more than 6 months in high TB incidence country. (150 per 100K)
2. Entered UK within the last 5 years.
3. Aged 16-35
4. No history of TB or LTBI
5. Not previously screened