Mock paper 1

Question 1

who were experiments in blood transfusions performed by?

Answer 1

James Blundell in 1819

Question 2

how were transfusion’s carried out?

Answer 2

with the donor being directly connected by a tube to the recipient

Question 3

what were the problems with the early uses of blood transfusions?

Answer 3

blood clots as soon as it leaves the body and so the tube became blocked up
the blood of the donor was sometimes rejected by the recipient because they were not compatible
there was a danger of infection from unsterilized equipment

Question 4

when were blood groups discovered?

Answer 4

Karl Landsteiner in 1901

Question 5

how was the problem of infection solved?

Answer 5

by aseptic surgery which was invented by Joseph Lister in the 1860’s through the use of carbolic acid after hearing about the germ theory in 1865
the use of antiseptics immediately reduced death rates from as high as 50% in 1864-66 to around 15% in 1867-70

Question 6

how were blood transfusions used in WW1

Answer 6

used at base hospitals from 1915
a syringe and tube used
extended to casualty clearing stations from 1917
a portable blood transfusions kit was close to the front line invented by a doctor called Geoffrey Keynes

Question 7

how did the discovery of sodium citrate benefit blood transfusions?

Answer 7

it prevented blood clotting so that blood could be stored outside of the body in 1915

Question 8

regarding blood transfusions what was discovered in 1916

Answer 8

it was discovered that adding a citrate glucose to blood allowed it to be stored for up to four weeks

Question 9

what was used in the battle of Cambrai in 1917

Answer 9

blood was stored in glass bottles at a blood bank and used to treat badly wounded soldiers throughout the battle

Question 10

what was stage one of the chain of evacuation

Answer 10

stretcher bearers
advance on no mans land at night or during a break in fighting to collect the dead and wounded. Each battalion had 16 stretcher bearers and it took 4 men to carry a stretcher

Question 11

what was stage 2 of the chain of evacuation

Answer 11

Regimental Aid Post - RAP
always close to the front line and the battalion regimental medical officer was in the RAP. He identified those who were lightly wounded and those soldiers who needed more medical attention

Question 12

what was stage 3 of the chain of evacuation

Answer 12

field ambulance and dressing station
a field ambulance was a large mobile medical unit with medical officers, support and staff and from 1915 some nurses.
The dressing stations was where medical emergency treatment was given to the wounded and they were about a mile behind the front line and here a system of triage was set up where the men where separated depending on injury

Question 13

what was stage four of the chain of evacuation

Answer 13

the casualty clearing station - CCS
the first large and well equipped medical unit that the wounded would experience. The CCS contained x ray machines and wards with beds and they were located in tents or huts about 10 miles from the conflict

Question 14

what was stage 5 of the chain of evacuation

Answer 14

the base hospital was usually a civilian hospital or converted building and soldiers would arrive by train, ambulance, canal because the journey was more comfortable and they had operating theatres x-ray departments and areas for gas poisoning. From the base hospital most patients were sent back to Britain in hospital train which has being converted.

Question 15

what was there in regards to help of the wounded in war by November 1915

Answer 15

there was 250 motor ambulances in France and ambulance trains were also introduced to carry up to 800 casualties. Ambulance barges were also used to carry the wounded along the river Somme.

Question 16

discuss the underground hospital at Arras?

Answer 16

During the battle of Arras during April-May 1917 160,000 soldiers were killed and over 7000 were injured in the first three days despite this the evacuation route worked and in 1916 the existing tunnels and quarries were extended. They created an underground town for soldiers to live in with running water and electricity and a hospital with 700 beds and operating theatres

Question 17

discuss the RAMC

Answer 17

Royal Army Medical Corps
all medical officers belonged to the RAMC the membership increased from 9000 in 1914 to 113,000 in 1918 as the number of wounded grew. |Doctors had to learn quickly about conditions and wounds they has never faced before.

Question 18

discuss the FANY

Answer 18

First Aid Nursing Yeomanry founded in 1907 by a soldier who hoped they would be the nursing cavalry to help the wounded in battle
Initially the nurses on the front line were the well-trained Queen Alexandra’s nurses and the government turned away volunteer nurses. However this attitude changed as the number of wounded increased
volunteers worked as professional theatre nurses to floor scrubbers
they helped as ambulance drivers and nurses once the British army changed their policy towards volunteers in 1916
they also carried supplies to the front line and drove motorised kitchens to supply food

Question 19

what was triage

Answer 19

a system of splitting the wounded into groups according to who needed the most urgent attention

Question 20

what was set up in 1123

Answer 20

St Bartholomew’s Hospital in London and at first it specialised in the treatment of poor, pregnant women

Question 21

what was set up in 1247

Answer 21

St Mary’s of Bethlehem was established and specialised in the treatment of “poor and silly” people

Question 22

what did many towns have

Answer 22

leper houses outside their walls their walls or “hospitality” places for travellers

Question 23

what were almshouses in the medieval period

Answer 23

small hospitals set up to provide a home for the old and those unable to work who might otherwise have had to live on the streets and beg for a living

Question 24

what was the routine of care in a hospital in the medieval period

Answer 24

you rang the doorbell in medieval hospitals
went to a chapel
the bath - the nuns or sisters took your clothes and boiled them then baked them in an oven
you then went into clean sheets overnight

very few hospitals employed either physicians or surgeons
most care carried out by nuns and elderly women
the main treatment was prayers
most monks and nuns had an excellent knowledge of herbal remedies

Question 25

what was the problem in 1914

Answer 25

there were no motor ambulances and the horse-drawn carriages were unable to cope with the large number of casualties

Question 26

how did attitudes in the 18th century change

Answer 26

there became more hospitals as funding increase because in 1700 there were only 5

Question 27

what were hospitals like by the 1900 in the industrial period

Answer 27

different wards split up infections from surgery needing
operating theatres
specialist departments with new equipment and space for certain procedures
cleanliness now important - clean up germs using antiseptics and by 1900 focused on preventing germs
doctors common
trained nurses lived nearby
new ideas adopted quickly
everyone competing for most modern with best doctors and donations
now a place where the sick were treated

change in role had forced a change in the way hospitals were built and run

Question 28

the first public health act

Answer 28

1848
cities were encouraged to set up Boards of Health and provide clean water supplies. However it was not compulsory so many cities didn’t do it

Question 29

the second public health act

Answer 29

1875
cities now forced to improve sanitary conditions by:
- providing clean water to stop spread of disease
- disposing of sewage to avoid pollution
- building public toilets
- employing a public officer of health to monitor conditions and outbreaks of disease
- creating street lighting

Question 30

mass vaccinations

Answer 30

the government introduced compulsory vaccinations throughout the 20th century including diphtheria in 1942 and polio in 1950
these vaccination campaigns were funded by the government to ensure that they were widespread

Question 31

government legislation

Answer 31

the government passed laws to ensure healthy living conditions like the clean air acts and the health act

Question 32

clean air acts

Answer 32

1956 and 1968

passed to prevent smog caused by air pollution

Question 33

health act

Answer 33

2006

made illegal to smoke in all enclosed workplaces

Question 34

government lifestyle campaigns

Answer 34

aimed to prevent illness themselves through education and by promoting healthier lifestyles

• advertising campaigns that warm against the dangers to health from binge drinking and drug use
• encouraging people to eat more healthily and get more exercise
• Change4life campaign

Question 35

what happened during the medical renaissance

Answer 35

new ideas began to influence medicine and slowly replaced old beliefs
Protestantism spread across Europe and the Catholic church was less able to promote its beliefs and control medicine as a more secular society developed, scientific discoveries were made in both medicine and beyond

Question 36

secular

Answer 36

no connected with religious or spiritual matters

Question 37

what explanations about the cause of disease continued between the medieval and renaissance period

Answer 37

• miasma theory continued and became more widespread during epidemics
• influence of the church as during epidemics like the great plague religious causes were still influential
• supernatural: from 1500 astrology was less popular but during epidemics people wore charms still as protection from evil spirits

Question 38

what explanations about the cause of disease changed between the medieval and renaissance period

Answer 38

• the decline of the influence of the church as now most believed that God did not send disease
• the theory of the four humours as it got discredited and was not believed by physicians by the end of 17th century but because patients understood it, it continued to be used to diagnose illness until this time
• urine analysis was no understood that it was not linked to ill health and no longer used to diagnose illness

there was a move away from old ideas but they were not replaced

Question 39

animalcules

Answer 39

a new idea in the renaissance that little animals were the cause of disease developed after they could be seen by newly invented more powerful microscopes even though the images were not clear

Question 40

Thomas Sydenham

Answer 40

well-respected doctor during the 1660-1670
he was important in moving medicine away from the ideas of Hippocrates and Galen
believed in close observation of patients, noting down detailed descriptions and then looking for specific remedies to treat the disease rather than relying on medical books
His book Observationes Medicae was used for two centuries

Question 41

when is the renaissance period

Answer 41

1500-1700 a revival of ideas and an enlightenment period

Question 42

epidemic

Answer 42

a widespread occurrence of an infectious disease in a community at a particular time

Question 43

printing press

Answer 43

1470

• ideas spread quicker
• language translation
• communication
• quick

Question 44

advances in surgery between 1700-1900

Answer 44

surgery in the eighteenth century was dangerous with risks of pain, infection and bleeding

1847 James Simpson discovered chloroform as an anaesthetic but doctor had to be careful with it because the dosage had to be carefully controlled
Hannah Greener died from an overdose when having her toenail removed. Chloroform continued to be used and was given royal blessing when in 1853 Queen Victoria used it during the birth of her son

The problem of infection was overcome in 1865 by Joseph Lister who used carbolic acid to clear bacteria from the wounds of patients - antiseptic surgery

Lister’s ideas faced opposition because the medical profession took time to understand the germ theory and carbolic spray was unpleasant to use, it dried the skin of surgeons and left a bad smell.

From 1890 aseptic surgery was used

Question 45

what are the modern day advances in surgery

Answer 45

development of new machinery since then 1900 improved treatments in hospitals

• radio and chemotherapy to target and shrink tumours growing inside the body
• dialysis to wash the blood of patients with kidney failure
• prosthetic limns to replace those lost for example by soldiers in war
• keyhole surgery to prevent cutting into a patients body