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Y1&2 Medicine Zoe Veary > IMMUNE & HAEM 201 International Health > Flashcards

IMMUNE & HAEM 201 International Health Flashcards

1
Q

What is the causative organism of TB?

A

Mycobacterium tuberculosis

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2
Q

How can humans catch TB cattle and what bacteria is it?vb

A

Drinking unpasteurized milk containing mycobacterium bovis

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3
Q

Why does TB prefer the upper lungs?

A

Greater oxygenation here TB is an obligate aerobe

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4
Q

How does TB resist destruction?

A

Strong cell wall with a waxy layer

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5
Q

What happens once TB bacilli settle in the upper alveoli?

A

They cause parenchymal inflammation

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6
Q

Why do some people not contract a TB infection when exposded?

A

Low bacterial load and sufficient innate immunity

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7
Q

What type of hypersensitivity reaction is there to TB exposure and what does it result in?

A

Type 4 - granuloma formation

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8
Q

Describe a Ghon focus in TB

A

Granuloma - central nectrotic area surrounded by calcification

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9
Q

What is Miliary TB?

A

When TB is diffusely spread throughout the lung

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10
Q

What systemic diseases can arise from a TB infection?

A 
Miliary TB
Brain abscess
Meningitis
Osteomyelitis of the spine
pericarditis with effusion
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11
Q

Why may a TB infection cause lobar collapse?

A

Infection spreads to mediastinal lymph nodes which can enlarge and compress the bronchi

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12
Q

What are some long term lung complications from TB?

A

Bronchiectasis or emphysema

Reactivation - bronchopneumonia

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13
Q

What are the clinical features of TB?

A 
primary infection may be asymptomatic/flu like
Erythema nodosum or keratoconjunctivitis
Night sweats
chest pain
cough +/- haemoptysis
Swollen lymph nodes
Weight loss
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14
Q

What investigations can be done to check for TB?

A

Sputum culture may show acid fast bacilli (highly contagious at this point|)
Bacterial culture
Mantoux test

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15
Q

What can cause a false positive in the Mantoux test?

A

BCG or nonTB mycobacterium exposure

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16
Q

What test can look for latent TB disease?

A

Interferon gamma release assay

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17
Q

What is the treatment for non resistant TB?

A

2 months Rifater (rifampicin, isoniazid and pyrazinamide) + ethambutol
or
4months Rifinah ( rifampicin and isoniazid)

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18
Q

Which parasite causes African Sleeping sickness and what is its vector?

A

African Typanosomiasis and carried by Tsetse flies

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19
Q

What is the brief replication cycle for African sleeping sickness?

A

Bacilli taken up by flies, reproduce asexually in gut, attach to salivary glands and transferred to human during a blood feed (can cross the BBB)

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20
Q

What parasite causes Chagas disease and what is its vector?

A

American Trypanosomiasis carried by triatomine bugs

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21
Q

What is the brief replication cycle for Chagas disease?

A

Triatomine bugs live in housing, the bacilli taken up by bug which moves through GIT to rectum. Bug bites human who when scratches the bite allows this faeces to enter skin

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22
Q

How do people develop chagas disease? Slow or fast onset?

A

Fast onset - acutely unwell

23
Q

How do you treat chagas disease?

A

nifurotimox and benzimidazole

24
Q

What parasite is transferred through Water Snails?

A

Schistosomiasis

25
Q

Where does schistosomiasis travel to in the body?

A

Liver via portal bein

26
Q

How do you treat a schistosomiasis infection?

A

Praziquantel

27
Q

Which paraside causes bubonic plague?

A

Yesinnia Pestis

28
Q

Which parasite causes elephantiasis?

A

Lymphatic filiarisis

29
Q

Which parasite causes river blindness?

A

Onchocerciasis / round worm

30
Q

What parasite causes anal itching commonly in children?

A

Enterobiasis - pinworm/threadworm

31
Q

What are the general abx for treating nematode infections?

A

mebendazole, albendazole and ivermectin

32
Q

How do RBC differentiated from normoblastic nucleated cells to their mature form?

A

Via action of EPO derived from the kidney which causes them to become anucleate

33
Q

Where is haemoglobin synthesised?

A

Mitochondria of developing RBC

34
Q

What shape are mature RBC’s

A

Biconcave disks

35
Q

What is the general structure of Hb?

A

Haem group + globin chain

4 in total

36
Q

What is haem made up of?

A

Iron and a protoporphyrin

37
Q

How is iron transported in the blood?

A

Bound to transferrin

38
Q

What are the different types of haemoglobin?

A

HbA - two alpha, two beta globin chains (most abundant)
HbA2 - two alpha, two delta
HbF - two alpha, two gamma

39
Q

What is vitamins are required for complete differentiation and DNA replication in RBC’s?

A

Vitamin B12 and folic acid

40
Q

How generally do haemoglobinopathies affect RBC’s?

A

Change the globin chain production or structure therefore changing the solubility of Hb
This makes the RBC more fragile, therefore decreasing the lifespan

41
Q

What are the main clinical outcomes of having a haemoglobinopathy?

A

Anaemia, splenic crises - increased EPO production and haematopoetic tissue expansion

42
Q

How do patients with a homozygous beta thallasaemia usually present?

A

Early in life with failure to thrive, severe anaemia and hepatosplenomegaly

43
Q

How do you treat a homozygous beta thallasaemia?

A

Regular blood transfusions, folic acid and desferrioxamine

44
Q

What is desferroxiamine used for?

A

prevent/treating iron overload

45
Q

What may a patients blood film show with a heterozygous beta thallasaemia?

A

Hypochromic, microcytic rbc’s - mild anaemia

46
Q

What is the cause of sickle cell anaemia?

A

A single base mutation changing adenine to thymine

47
Q

What happens to RBC’s in sickle cell?

A

Some RBC’s have HbS which is insoluble and cant carry oxygen. It polymerises changing the flexibility of the cell - sickle shaped. It can’t move through microcirculation

48
Q

What may be seen in a patient with homozygous sickle cell anaemia?

A

Acute pain from tissue infarction
Pulmonary hypertension
Cardiomyopathy
Splenomegaly

49
Q

What blood disorder would have microcytic cells, low MCV and high iron levels?

A

Sideroblastic anaemia

50
Q

What blood disorder would have microcytic cells, low MCV, normal/high iron and abnormal levels of foetal and A2 haemoglobin?

A

A haemoglobinopathy

51
Q

What blood disorder would have macrocytic cells, with high mcv, megaloblastic cells?

A

B12/folate deficiency

52
Q

What is a megaloblastic cell?

A

An immature RBC containing a nucleus but larger than a normoblast due to insufficient DNA synthesis

53
Q

What may cause macrocytic, high MCV and normoblastic RBC’s?

A

Alcohol/Hypothyroidism

54
Q

What indicates that there is a haemolytic anaemia/blood loss?

A

Macrocytic, high MCV, normoblastic cells but with a high reticulocyte count

Y1&2 Medicine Zoe Veary (60 decks)

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