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Infectious Diseases 1 > TB > Flashcards

TB Flashcards

1
Q

how did we double the human life expectancy

A

conquering infectious disease

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2
Q

what are the 3 big components of conquering infectious disease

A

1) knowledge of the true method of transmission of disease = Germ Theory (for some disease we can take action - cholera - clean water supplies)
2) development of antibiotics (treat bacterial disease)
3) development of an effective vaccine (prevent disease from spreading

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3
Q

what did John Snow do

A

1850-1900 transmission of Miasma Theory - Germ Theory

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4
Q

name the bacteria that cause Tb

A

Mycobacterium tuberculosis

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5
Q

before antibiotics for Tb

A

millions of people died, no treatment or cure for tb

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6
Q

after antibiotics

A

the disease could be cured

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7
Q

last few years what has happened to Tb

A

increase in the prevalence of drug-resistant Tb = hard to treat >inurable Tb

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8
Q

how many people infected with Tb in the world

A

1/4 of the population infected 1.8 billion people

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9
Q

incidence

A

new cases of Tb = active cases

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10
Q

what countries are most likely to have TB

A

India and China = vast populations

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11
Q

mode of transmission for Tb

A

DIRECT CONTACT = person with active case of Tb: coughs, spits, sneezes, expels droplets with bacteria

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12
Q

what was an attempt to stop the spread of Tb in the past

A

stop people from spitting/coughing in public

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13
Q

if exposed to someone with Tb will you get Tb

A

probably not 1/5 chance

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14
Q

why will you be unlikely to get infected by someone who has Tb

A

of those infected 90% = do not develop active case of tb - still, have Tb bacteria, not multiplying, low number, dormant, not infectious, not symptomatic

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15
Q

what happens to 10% of the population infected

A

immediately develop an active case of Tb = no of bacteria increase and cause problems

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16
Q

what happens to 90% Asymptomatic/latent Tb cases

A

immune system fought bacteria but some still survive = if something changes > later develop Tb

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17
Q

a difference between cholera and Tb

A

Tb = slow disease

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18
Q

changes that cause latent Tb to become active

A
  1. age (older immune system changes)
  2. general welfare (nutrition)
  3. other diseases (AIDS/Cancers)
  4. immunosuppression for cancer therapy
  5. immunosuppression for transplants
  6. stress
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19
Q

if untreated active cases of Tb have a death rate of

A

50% within 2 years

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20
Q

how does Tb affect you

A

inhaling droplets > respiratory system > lung function lost

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21
Q

if you’re vaccinated against Tb what will be the result of a skin test

A

postive skin test - detects if the immune system has mounted response

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22
Q

what are 3 reasons why you can get a positive result for a standard Tb test

A
  1. active case
  2. latent case
  3. had vaccine
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23
Q

1815 how many people died of Tb in England

A

1/4

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24
Q

who did Tb affect

A

rich and poor equally

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25
Q

what kind of disease is Tb, contrast to cholera

A

endemic (cholera = epidemic)

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26
Q

where is Tb more likely and what age group were mostly affected

A

crowded urban cities - prime age of life

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27
Q

can Tb be caused by other species

A

yes in cattle = can affect humans and vice versa

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28
Q

what causes Tb in cattle

A

Mycobacterium Bovis (slow-growing)

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29
Q

what causes Tb in humans

A

Mycobacterium tuberculosis (slow-growing)

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30
Q

a way in which Tb can be transmitted

A

via milk

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31
Q

how do you kill microbes - Louis Pasteur

A

boil them

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32
Q

what happens if you boil milk

A

changes chemistry

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33
Q

what did Louis Pasteur realize

A

raise temp - reach point where you kill microbes before boiling = repeat several times = kill most of microbes (low level = decreases chances of infection)

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34
Q

what years did Louis Pasteur carry out relevant work

A

The 1860s, 1870s, 1880s

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35
Q

vaccine

A

a preparation of killed microorganisms, living attenuated organisms or living fully virulent organisms administered to produce or artificially increase immunity to a particular disease

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36
Q

vaccination

A

administering weakened or dead pathogens to a healthy person or animal, with the intent of conferring immunity against a targeted form of a related disease agent

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37
Q

BCG

A

is a vaccine against Tb that is prepared from a strain of the attenuated (weakened) live Mycobacterium Bovis

38
Q

attenuated

A

reducing the virulence of an organism, usually a virus whilst keeping it viable (can infect a person but the immune system can fight it)

39
Q

what countries use BCG

A

countries with Tb

40
Q

The US and Western European countries do not use BCG, how do they then detect Tb

A

simple test: Tb Skin Test
use a purified protein from Tb (not infectious/bacteria) - recognized by immune system
measure size of the raised area
never seen before = small reaction

41
Q

why do the US and Western European countries do not use BCG

A

because of the low risk of infection

42
Q

how did we develop 2 strains of Tb

A

early human history: single disease only affected cattle, then evolved to affect humans, humans became more abundant - evolutionary event = two different strains

43
Q

asymptomatic

A

individuals affected by the disease but do not show any of the typical symptoms

44
Q

Tb

A

a chronic infectious disease usually caused by mycobacterium tuberculosis in humans

45
Q

how did strain specialized in humans spread

A

human density increased, as people moved to cities

46
Q

where was a common site of breeding for Tb in Victorian England

A

in Debtor’s prison

47
Q

how was Tb exported to different countries

A

people moved from England to colonies > returned back brought Tb with them

48
Q

why did people not think Tb was infectious

A

slow disease - thought it ran in the family

49
Q

when did Robert Koch find a causative agent for Tb

A

1982

50
Q

when did we find out Tb was infectious

A

The 1860s

51
Q

when were antibiotics discovered and by who and what was the first antibiotic

A

1928, Alexander Flemming, penicillin

52
Q

what did we do to treat Tb without antibiotics and why, did it help

A

place people in sanitoriums, get fresh air

50% of people died within 5 years

53
Q

how did Alexander Flemming discover antibiotics

A

knew that bacteria grown in different conditions = show different results
Staphylococcus aureus -grow well in the human body and not room temperature
Fungi - optimum at room temperature
Halo around fungus - fungus producing something killing bacteria - isolated fungi and identified it, substance it produced = penicillin

54
Q

how was penicillin obtained

A

solely from fungal growth

55
Q

how was penicillin develop

A

find fungi that produced most penicillin - need huge culture, stabilize it - go to markets and collect mouldy fruits

56
Q

how did Howard Florey and Ernst Chain contribute to antibiotics and when

A

1930s/1940s

  1. increased productivity by 4 orders of magnitude
  2. developed submerged cultures
57
Q

what do bacteria do and how are they able to

A

grow and divide - continually make cell wall - defence against the extracellular environment/organisms

58
Q

how is bacterial cell wall made

A

PEPTIDOGLYCAN - numerous glycan backbones connected by peptides

59
Q

gram-positive

A

thick wall of peptidoglycan

60
Q

gram-negative

A

peptidoglycan between membranes = defend better, substance don’t reach it easily (outer membrane)

61
Q

how do beta-lactam antibiotics work (include penicillin and derivatives)

A

bacteria make glycan backbones then move to surface - enzyme allows peptide bonding - part of penicillin structure that enzyme recognizes = enzyme binds to penicillin = irreversible

62
Q

effect of penicillin on bacteria

A 
gram-positive = enough kills them 
gram-negative = variable, far less effective
63
Q

did we conquer all infectious diseases with antibiotics

A

no, gram-negative bacteria diseases are not treated

64
Q

bacteria causing infections (wound/following surgery)

A

all gram-positive

65
Q

some gram-positive bacteria form spores which are very resistant, how did Flemming detect this

A

took swatches from soldiers uniform, put them on cultures = clostridium

66
Q

antiseptics

A

kill bacteria

67
Q

how did Flemming show antiseptics don’t work on battlefield wounds

A
  1. two sterile tubes: smooth.cracked
  2. pollute with bacteria
  3. disinfect tubes
  4. apply a culture medium to tubes
    = disinfectant work on smooth surfaces (reach all bacteria) not on rough edges
68
Q

was evolution to antibiotic resistance expected

and how do multicellular/eukaryotic organisms get new info

A

expected but didn’t know the different ways bacteria could acquire new info - bacteria evolve resistance to one antibiotic, may develop for everything that has the same mode of action - (humans only get new genetic info by mutation)

69
Q

different antibiotics have

A

MODES OF ACTION

70
Q

how does natural selection work (penicillin)

A
  1. original population = variation of bacteria
  2. change the environment by adding penicillin - ones that die fist = make least cell wall making enzyme
  3. some bacteria resistant to antibiotic = natural selection population favours this bacteria
    (changing env = favours surviving bacteria)
71
Q

why do antibiotics have trouble reaching mycobacteria

A

thick waxy coat outside layer

72
Q

what year did we antibiotics against all bacteria

A

1950s

73
Q

how do genes for resistance appear

A 
bacteria can acquire new info by 
1. transformation
2.transduction
3. conjugation 
AND MUTATION
74
Q

transformation

A

some bacteria can take up DNA from the environment and incorporate into own genetic sequence

75
Q

competence (for bacteria)

A

the ability of a cell to take up extracellular DNA from its environment

76
Q

transduction

A

the process by which bacterial DNA is moved from one bacterium to another by a virus

77
Q

conjugation

A

transfer of genetic information between bacteria through direct cell-to-cell direct
. plasmids replicate and pass info
. can occur between different species

78
Q

what are some resistance mechanisms of bacteria

A
  1. degrade antibiotics (penicillinase)
  2. make more product
  3. alter antibiotic
    pump out antibiotic
79
Q

where do antibiotics come from

A

not invented, come from the natural world - pencilin came from a fungus
bacteria competing in soil (grow and divide)

80
Q

types of antibiotic misuse

A
  1. inappropriate prescription (antibiotics only kill bacteria, not viruses)
  2. use of broad-spectrum antibiotics - affect range of bacteria (patient, doctor, company = happy ) * all bacteria get affected - some resistant - selected in that population
  3. agricultural use (pigs grew 50% faster)
  4. incorrect use (incomplete course/Tb thicky waxy layer = harder to reach)
  5. water contamination (urinate antibiotics - water sources not regulated)
81
Q

why are we ‘back in the nineteenth century’

A

Tb - strains we can’t deal with > back to sanitariums/accept the transmission of an incurable disease

82
Q

MDR-TB

A

multi-drug-resistant Tb - any strain of Tb that is resistant to both of the two main first-line antibiotic drugs

83
Q

how many antibiotics do you get prescribed for Tb and why

A

cocktail of antibiotics - mutation can develop resistance

84
Q

problems between the first and second-line drugs

A

cost and severe side effects

85
Q

XDR-TB

A

extreme drug-resistant Tb - any strain of Tb that is resistant to both of the two main first-line antibiotic drugs AND two more of the second-line drugs

86
Q

antibiotic resistance strains are a big problem before antibiotics resistant to everything why

A
  1. drugs of last resort - more expensive
  2. inconvenience - drugs may need to be given intravenously and over longer period
  3. side effects - much more severe
87
Q

why are we still heading in the wrong direction

A

no new antibiotics being made

88
Q

antibiotics

A

chemical substance that kills/suppresses the growth of microorganisms

89
Q

antibiotic resistance

A

ability of a microorganism to withstand the effects of an antibiotic

90
Q

latent/dormant infection

A

asymptomatic infection only capable of manifesting symptoms if activated

91
Q

Describe the work of Fleming, and Florey and Chain, and how this work was important

A

Fleming isolated penicillin from a fungus that was killing bacteria, the first antibiotic

Florey and Chain found more productive strains of penicillin to increase productivity

This work allowed widespread use of ABs, reducing mortality from infection in WWII and paving the way for widespread use of ABs throughout the world

Infectious Diseases 1 (4 decks)

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