Midterm 2 Flashcards
In what time period and from what did TB arise from?
The Neolithic
Derived from cattle
Causative agent of TB
Mycobacterium tuberculosis
Is TB an endemic, epidemic, or pandemic?
Endemic
What is the iconic symbol of TB
Chest x Ray
Why was TB believed to be hereditary
Because it was often passed from older family members to younger children
TB mode of transmission
How was this proved
Droplet
Riley proved by exposing cages of guinea pigs to either treated air or untreated air from TB wards
3 stages of TB disease process
Primary (childhood TB)
Reactivation disease (cavities TB)
Reinfection
Details of primary TB
Occurs in children
Minor, many non-specific symptoms which are misdiagnosed
Slips into latency
Details of cavitation TB
10% of latent TB cases will reactivate
Caused by aggressive IR that destroys lung tissue creating cavities
Causes coughing, sneezing
Mycobacterium tuberculosis generally affects _______
The lungs (pulmonary TB)
Explain the granuloma response of pulmonary TB
Appears as swollen lymph nodes
Macrophage eat TB, normally joins with lysosomes for granuloma enzyme response
If the macrophage doesn’t join with lysozyme, it calcifies and can be felt as a hard mass in the lungs
Symptoms of pulmonary TB
Fever and Night sweats Fatigue due to disease related anemia Appetite and weight loss Severe cough with haemoptysis Cavities in the lungs
Risk factors for TB infection
Duration of exposure Frequency of coughs Concentration of droplets in air Small/ enclosed spaces Inadequate air flow
Risk factors for TB disease
Strain of bacterium Effectiveness of IR - genetics - nutrition - other infections (immunocompromised)
Explain extrapulmonary TB
Causes by m. Bovis
Affects lymph nodes, kidneys, bones and joints
Often gets into bone tissue via infected blood
Causes a hump back by infecting vertebra
Transmission via unpasteurized cows milk or meat
What was Canada’s first TB sanatorium called?
Muskoka cottage sanatorium
What is a bug box?
Boxes that TB patients would spit mucus into so that they wouldn’t spread it on the ground or swallow it to their own digestive tract
What was the Brompton TB sanatorium (England) treatment method?
Graduated labour (worked in gravel pits)
Who is Dr. William Dock?
TB physician, studied the effects of gravity.
Argued that when we position our bodies upright, there is a high oxygen supply and lack of blood flow to the apex region of the lungs
Said that laying down increase blood flow and reduces oxygen concentration
What is artificial pneumothorax?
Intentionally collapsing certain parts of one lung
What is thoracoplasty?
Removing ribs to allow for the compression of the lungs
What was the golden age of TB?
1930s
Who invented the drug streptomycin?
Waksman
Syphilis:
Bacteria name
Shape
Motility
Treponema pallidum
Spirochete
Extremely motile (corkscrew movements)
Syphilis transmission
Direct contact with a sore on genitalia/ mouth
In utero via placenta (congenital syphilis)
Affects of congenital syphilis
Increased risk of stillbirth/ early infant death
Developmental delays
Saber shin tibia (infection and developmental issues in legs and face)
2 ways to screen for syphilis
Microscopy Blood sample (looking for antibodies - Wassermann test)
What drug is used to treat syphilis?
Penicillin
Stages of syphilis (time periods)
Primary stage:
- incubation period = 21 days
- lasts 3-6 weeks
Secondary stage
Latent stage
- early latent = within 1 year of infection
- late latent = after 1 year of infection
- can last 3-39 years
Tertiary stage
- until death
Symptoms of primary syphilis
Single or multiple sores at site of inoculation
Symptoms of secondary syphilis
Rash on palms and feet
General symptoms + patchy hair loss + periostitis
Symptoms of tertiary syphilis
Organ and skeletal damage: Paralysis Perhaps death Dementia Inability to coordinate muscles Numbness Gradual blindness
Which stages of syphilis are NOT infective?
Late latent and tertiary
When was the Winnipeg outbreak of syphilis?
What was the 3 methods they used?
2003
Condoms, coasters, posters
What disease is historically know as a disease of blame?
Syphilis
Evidence for syphilis from the old world
Confusion with “venereal leprosy” Medieval Essex woman: 25-50 yo Bones show signs of syphilis Lived prior to new world connections BUT have to prove that It’s actually syphilis bacteria, and that acidic soil didn’t cause bone appearance
Evidence for syphilis from the new world
Thought to be imported from the new world to the old world, no reports of syphilis in old world
Old treatments of syphilis
Cupping and bleeding
Mercury treatment
Pyrotherapy
Side effects of mercury treatment of syphilis
Black teeth
Degenerative neurological disorder
Who invented pyrotherapy?
Julius Wagner-Jauregg
What is pyrotherapy
Infecting syphilis patients with malaria (plasmodium vivax)
Induced high fever which Kills the syphilis bacteria, then treat malaria with Quinine
What was the first condom made of?
Pig intestine
What percentage of people are immune to leprosy?
90-95%
Incubation period of leprosy
2-20 years
Early stage symptoms of leprosy
Light patches on skin, with tingling or numbness
Fluid filled nodules
Leprosy bacterium causes _____ and _______
Loss of sensory and motor function
True or false: leprosy can cause blindness
True
Lepers had to carry a _______ to announce their presence
A bell
Leprosy:
Bacterium name
Shape
Distinctive feature
Mycobacterium leprae
Rod shaped
Waxy coat
What temperature does M. Leprae favour?
30°C
Where does M. Leprae reside in the body?
Cooler areas: Nerves of the hand and feet Nose Skin Anterior part of eye
What is the difference between paucibacillary and multibacillary leprosy?
Paucibacillary = milder, fewer bacteria Multibacillary = more aggressive, more bacteria
Other name for paucibacillary leprosy?
Tuberculoid leprosy
Other name for multibacillary leprosy?
Lepromatous leprosy
What causes a person to have multibacillary leprosy instead of paucibacillary leprosy?
Lower hydrogen peroxide production in macrophages
What drug is used to treat leprosy?
Dapsone (derived from dyes)
Leprosy transmission
Most widely believed to be direct contact
BUT
Bacteria can survive up to 35 hours outside host, so indirect contact and vector borne are possible
Most likely via droplet transmission
What is slit skin sampling, what disease is it associated with?
Going to deeper tissues
Leprosy
Leprosy numbers today
Over 1 million persist
0.5 million new each year
Movement of leprosy around the world
India China Mediterranean (Alexander the great) Europe Africa
When were lazarettos established?
Middle Ages Europe (13th century)
True or false:
TB infections make leprosy cases worse
False - TB infections improve resistance to leprosy
Name 2 lazarettos in Canada
D’arcy island (BC)
Tracadie (NB)
