Treatment Flashcards
1
Q
What was most physicians training based on?
A
Galens ideas
2
Q
When were medical schools set up in universities?
A
During the 12th century
3
Q
Describe a lecture in medieval times
A
Even though a few human dissections were carried out, they were to demonstrate Galena teachings while his book was read aloud by the lecturer, nobody questioned Galen
4
Q
What had Galen believed about religion?
A
He believed in a soul and he said that parts of the body had been created to work together
5
Q
Give 2 reasons why it was difficult to challenge Galens ideas
A
Majority of education and medical training was controlled by the church who approved of Galens ideas and most collections of books were in monasteries
6
Q
Identify the 5 options of where to go for treatment in medieval times
A
Trained physician, apothecary, prayer or pilgrimage, housewife physician, hospital, barber surgeon
7
Q
Give 5 points about a trained physicians work in medieval times
A
Trained at medical school and passed exam, diagnose you using urine and astrological information, administers treatment based on Galen (bloodletting or purging to balance humours) or herbal medicine, consults astrology to determine the best approach to treatment, expensive as you pay for each visit, doesn’t mix medicines you have to get them at the apothecary, might not let blood himself and may direct u to the barber surgeon, male
8
Q
Give 5 points about the apothecary in medieval times
A
Trained but no medical qualifications, mixes various ingredients to produce medicines or ointments for the physician, may make you up their own mixture for a price, cheaper than consulting a physician and then paying the apothecary for the same medicine anyway, probably male
9
Q
Give 7 points about the barber surgeon in medieval times
A
Practices bloodletting, can pull out teeth and lance boils, have a go at basic surgery such as cutting out bladder stones or amputating limbs, used no anaesthetics, low success rate for surgery, not trained or respected by trained physicians, can cut hair
10
Q
Give 3 points about hospitals in medieval times
A
Used for old or specific illnesses such as leprosy and most sick people were looked after at home, run by monks and nuns: Christianity values caring for others, after the reformation in the 16th century some free hospitals were set up in towns funded by charity
11
Q
Give 5 points about the housewife physician in medieval times
A
Knew traditional remedies like sore throats stomach aches or a temperature, able to deal with broken bones and childbirth, used some remedies based on herbs and other plants and others based on charms and spells, could be the lady of the manor who would treat her servants or families living on manor land
12
Q
How was pilgrimage used as treatment in medieval times?
A
People went to a holy shrine in the hope they could be cured of an illness
13
Q
Give 3 facts about women in medicine in medieval times
A
Few female physicians such as Trotula who taught at Salerno medical school in the early 12th century, women not allowed to attend universities which drove them out the medical profession by the 14th century, continued to work as midwives but needed a license from their bishop to show they were of good character and would not encourage illegal abortion
14
Q
Identify 8 treatments in medieval times
A
Bleeding, purging, saying a prayer, holding a lucky charm while being bled to balance humours, powdered unicorn horn, saying a charm as you drank a medicine, using plants that had to be picked at full moon, treatments were based on superstition or four humours
15
Q
How was a urine chart used in medieval times? 5 points
A
Physicians matched patients urine to colours smells and densities on the chart, may taste the urine to see if it was normal, wealthy people sent urine to a physician to see if they were falling ill, this method of diagnosis (uroscopy) fitted the four humours, very white urine was a sign of too much phlegm
16
Q
What did the Arab doctor Al-Razi do in medieval times?
A
Described the difference between smallpox and measles. Before this, all infections with rashes had been put together as one illness
17
Q
Give 3 points about timing the treatment in medieval times
A
Choosing the best time to carry a treatment out required knowledge of astrology as they believed parts of the body were linked to zodiac signs and planets. Zodiac man showed physicians when to avoid treating certain parts of the body. For example when the moon is in Pisces, the feet should not be treated
18
Q
Give 3 facts about bleeding a patient in medieval times
A
Bleeding done by warming a bleeding cup and letting the warmth draw out blood from the cut, leeches sank jaws into patients and draw out blood -this method was still used in the 19th century, bleeding was carried out as a cure to restore the balance of the humours
19
Q
How was purging carried out in medieval times?
A
Purging the stomach was another way to restore the humours. This meant swallowing a mixture of herbs and animal fat to make the person sick or taking a laxative to empty their bowels, sometimes these methods were used at the same time
20
Q
What was the cure for a stye in medieval times?
A
Take onions and garlic, pound them together, take wine and bulls gall, stand for nine nights in a brass vessel, strain mixture in a cloth, apply to stye with a feather. They believed that onion, garlic, bulls gall and copper salts (formed when acetic acid in wine reacts with copper in the brass vessel) killed bacteria
21
Q
Give 5 facts about home remedies in medieval times
A
Honey and plantain were common ingredients for cuts, wounds, dog bites and acted like modern antibiotics, common remedies based on herbs minerals plants and animal parts, remedies written down in books to illustrate each plant and other ingredients the exact quantities required and how to mix up the potion, included prayers to say when collecting the herbs to increase effectiveness of the remedy, some cures combined prayer magic and folklore
22
Q
When did King Charles II have a stroke and how was he treated? 5 points
A
Bled a pint of blood, his shoulder was cut and eight more ounces of blood were extracted by cupping, given an emetic, given multiple purgatives, given enemas
23
Q
Identify 8 ingredients in herbal remedies which were used to treat King Charles II
A
Cinnamon, beet root, licorice, sweet almonds, white wine, melon seeds, nutmeg, ammonia
24
Q
What is an emetic?
A
An agent that makes you vomit
25
What is bezoar stone?
A stone that grows in the stomach of a goat found in the Middle East, thought to be an antidote to poison during the Renaissance
26
What was salt of quinine used for during the Renaissance?
Settling the stomach
27
What is an enema?
A liquid treatment commonly used to relieve severe constipation, the process pushed waste out of the rectum when you cannot do so on your own
28
How did people believe the kings touch could cure them of disease in medieval times and during the Renaissance?
It was believed in England and France that a touch from royalty could heal skin disease known as scrofula or ‘the kings evil’
29
What are 3 changes in treatments between medieval times and the Renaissance?
New herbs from the exploration of the new world, hospitals lost when Henry VIII destroyed the monasteries and were replaced by charity hospitals run by physicians, more purpose built hospitals were developed, child birth became the responsibility of men not women due to the invention of forceps (only men could use complicated tools)
30
Which 13 treatments were the same in medieval times and Renaissance?
Pilgrimage, prayer, fasting, exorcisms/chants/spells, astrology, bleeding, purging, kings touch, herbal remedies, apothecary, wise women, physicians for the rich, barber surgeons
31
What were hospitals policies in medieval times and why?
Care not cure. People thought they may be sinning if they cured people
32
Give 10 points about medieval hospitals
Decline in the standard of hospitals (controlled by church so often only used for the deserving poor), usually for old or specific illnesses such as leprosy, contagious diseases separated which is positive, wards were small rooms which were dark dirty and cramped, disease linked to gods displeasure so condition of hospital is not as important as condition of the patients soul, monks and nuns run hospitals (Christianity values caring for others), some larger hospitals like St Bartholenews in London were set up in 1123, no doctor appointed to st bartholemews but several priests were, beds positioned so patients could see the alter and hospitals had religious statues and stained glass windows, some larger scale hospitals could admit over 200 patients
33
Give 6 points about hospitals in the Renaissance
Larger hospitals with numerous wards, condition of hospitals remained poor due to lack of undertaking about germs, nurses run hospitals on a day to day basis, nursing seen as a disrespectable career, doctors visit to treat the sick, reformation (1535) leads to hospitals linked to monasteries closing so new purpose hospitals begin to develop,
34
Give 7 points about hospitals in the Industrial Age
Conditions in hospitals improve, First Cottage hospital opened in Sussex by 1900 there were 300 of them, 18 voluntary hospitals in London with 4000 but being treated depended on how much money you had, Great Ormond Street Hospital for sick children opens in 1852 with only 10 beds, by 1875 emphasis was on medicine as a science, influence of Florence nightingale and understanding of germ theory in cleaning up hospitals, hospitals designed to be brighter and airier
35
Give 7 facts about modern day hospitals
NHS set up which helps improve the standard of all hospitals, use of technology in hospitals/clean sheets/curtains around beds/handling and recording of medicine/hygenic conditions, all doctors work for NHS so rich do not get better treatment than the poor
36
Give 3 facts about treatment of the sick in roman times
fathers responsible for the health of the family, father could pay for a doctor if he could afford it and if not he could pay local herb experts, herb specialists
37
Identify 4 of Florence Nightingales demands. Why did she demand these things?
300 scrubbing brushes to get rid of dirt near patients, nurses to be organised and respected in order to treat 2000 wounded soldiers effectively, clean bedding, good meals. She said this would mean she could reduce death rates from 40% to 2%
38
Identify 6 things Nightingale did which had an impact on nursing
In 1859 she wrote a book Notes on Nursing which provided basis on training nurses and was translated into 11 languages, raised money to create and establish the Nightingale School for Nurses at St Thomas Hospital in London in 1860, she helped establish a training school for midwives at King’s college hospital London 1861,nursing became a respectable occupation for middle class women, nursing became a profession rather than an unskilled job so the number and skill of nurses grew rapidly
39
Identify 8 things Nightingale did which impacted hospitals
Improved ventilation to make sure patients in hospitals had fresh, clean air to breathe, improved clothing and washing facilities in hospitals for patients, wrote over 200 books on hospital design and organisation, in 1863 wrote Notes on Hospitals which provided basis of hospital design, improved sanitation in hospitals, during the Crimean war she organised care and supplies at Scutari military hospital and emphasised cleanliness and fresh air, hospitals built out of materials which were easy to clean, separate wards ensured infectious patients were kept separate
40
What happened to death rate thanks to Nightingale?
Fell from 42% to 2%
41
Identify a limitation of Nightingales work
She paid little attention to the Germ Theory and continued to associate disease with dirt (miasmas)
42
How did hospitals change by 1900? 8 points
Split up infectious patients from those requiring surgery, operating theatres and specialist departments for new medical equipment, focused on preventing germs from getting in to begin with, doctors and junior doctors were a common sight, trained nurses lived in nearby houses, everybody wanted to have the most modern hospital designs to help attract donations and student doctors, hospitals become a place where the sick were treated not a place just to rest, new ideas adopted quickly
43
Identify the 3 individuals involved in producing the first magic bullet
Emil von Behring, Paul Ehrlich, Dr Sahachrico Hata
44
What was von Behring's role in the development of Magic Bullets?
He developed Koch's work to isolate the antitoxins used by the body to fight diphtheria then found a way to inject them to cure the disease
45
What was Ehrlich's role in the development of Magic Bullets?
He was a member of Koch's team who set up his own research team. He knew certain dyes stained specific microbes and that antitoxins attacked the disease's microbes so tried to combine a dye with other chemicals to find a cure for syphilis - a magic bullet would only attack the disease microbe and not the rest of the body. He researched for several years due to government funding
46
What was Hata's role in the development of Magic Bullets?
In 1909 he joined the research team and reviewed some previous experiments. He discovered that the 606th compound they had tested and dismissed had actually been effective. This treatment was called Salvarsan 606
47
How was the second magic bullet discovered?
In 1932 Gerhard Domagk discovered that a particular red dye was effective against some cases of blood poisoning and he developed the drug Prontosil. Key ingredient was sulphonamide and other sulphonamide drugs were developed to cure pneumonia, meningitis and scarlet fever
48
Why was the discovery of magic bullets so important?
Many people had previously died from simple cuts and wounds so the cure for blood poisoning could save many lives. Treatments had previously been by injection but technological developments in the late 19th century meant pills could be mass produced and the pharmaceutical industry grew rapidly
49
Who did Domagk test Prontosil on?
His daughter after she pricked her finger and was dying from blood poisoning. He had not yet tested it on humans, only on mice
50
Identify 5 factors which contributed to the discovery of magic bullets
Individual genius, science & technology, government, chance, communication
51
Which factor was the most important in contribution to the discovery of magic bullets
Science & technology
52
What did Alexander Fleming (a chemist) discover in 1928?
A culture of bacteria growing in a petri dish had been attacked and killed by an unknown mould growing in the same dish. The mould was penicillin, an excellent antibiotic however he only tested it on bacteria in the lab rather than bacteria in animals
53
When did Fleming publish his findings and what did he do afterward?
1929 but he couldn't get funding to develop his work so returned to his original research
54
What happened with the development of penicillin in 1939?
Howard Florey and Ernst Chain (two scientists working in Oxford) read about Flemings research and set up a team including a range of specialists to develop penicillin although it was difficult to produce
55
How did Florey and Chain test penicillin and what did this show?
in 1940 they tested it on mice, in 1941 they tested it on patients which showed that penicillin acted like a miracle drug on people dying from infection
56
What was an early limitation of penicillin?
There was only a small amount available and the patient died when it ran out
57
How was penicillin produced?
It could not be synthesised from chemicals, it had to be cultured on a broth and exposed to air in order to grow. This used a collection of containers including food tins, bedpans, baths, milk churns and six assistants had to be hired just for this stage
58
Why could no British firm create the technology needed to mass produce penicillin?
Many factories were damaged by bomb raids during ww2 or already working at full capacity producing other drugs needed in the war
59
When did Florey and Norman Heatley (another member of the team) go to the USA and why?
They went there to see if drug companies would fund their research
60
Why did Florey refuse to patent penicillin?
He believed it should be available for everyone.
61
When was the US government willing to fund mass production of penicillin and why?
December 1941 when the USA entered ww2 and knew that many soldiers were likely to die from infection rather than actual injuries so penicillin could save many lives
62
What did Florey discover was the most successful method of purifying penicillin?
Drying the mould at low temperatures. Scientists at chemical company Pfizer in New York used an old ice cream freezer to develop a method of freeze drying which was eventually used for large scale production in 1944
63
What was a limitation of sulphonamides?
Only killed one type of germ whereas penicillin could kill a range of infections in the body at once
64
Identify 3 limitations of penicillin
Fleming discovered it by accident as he didn't clean his petri dish correctly and he was not successful in getting the drug widely publicised, joseph lister was actually the first person to discover penicillin in 1871 but had not realised its potential, Florey and Chain had tested it on a policeman with blood poisoning who died after they ran out of penicillin and they had to recycle the penicillin by taking It out of the patients urine to make more of the drug
65
What did Humphrey Davy accidentally discover and when?
In 1799, inhaling nitrous oxide (laughing gas) made you less aware of pain
66
What did Horace Wells do with nitrous oxide?
Between 1844-45 used it when extracting teeth
67
What did William Morton discover and when?
1846, the gas ether was a longer lasting anaesthetic
68
What was ether first used for in the UK and in the USA?
In an operation to remove a growth from a patient's neck in USA, Robert Liston used it to amputate a leg in Britain
69
Identify 5 problems of ether
Sometimes made patients vomit, irritated lungs of patients so they coughed even when they were unconscious, highly flammable which was dangerous when the only for of artificial light was candles or gas lights, tended to produce deep sleep which could last for days, had to be carried in large heavy glass bottles which were difficult for surgeons to carry around
70
What did a young surgeon in Edinburgh called James Simpson discover and how?
Invited some doctors to his house to experiment with anaesthetics by inhaling vapours from various chemicals. Simpson's wife found them all unconscious so they realised chloroform was extremely effective and did not have negative side effects like ether
71
When did Simpson first use chloroform in an experiment in Edinburgh?
1847
72
When did the use of chloroform become more widespread?
After Simpson came to work in London, after Queen Victoria used chloroform during the birth of her eighth child in 1853
73
What were the 2 issues with chloroform?
Difficult to get the dosage correct. Too little and the patient could still feel pain but too much could be fatal as shown when Hannah Greener (14) died almost immediately after being given chloroform when having an infected toenail removed. Affected the heart
74
What did John Snow create for chloroform and when?
An inhaler which regulated the dosage and reduced number of deaths. 1848
75
Identify 4 reasons some people did not want pain relief
Religious people thought pain relief interfered with God's plan since he told Eve in the bible that childbirth would be painful, anaesthetics were new so their effects were not fully understood, some doctors felt it was easier for a patient to die if they had been unconscious, number of patients who died shortly after operations increased when anaesthetics were used
76
Give 8 facts which suggest the problem of infection became worse after the introduction of anaesthetics
Number of deaths increased 1850-1870 (sometimes called Black Period of surgery), still done in homes and hospital wards, problem of blood loss led to deaths, surgeons wore normal clothes with large amounts of dried blood on, surgeons did not know about germs and infection, students still came to watch, still problem of unhygienic instruments and operating procedures, after surviving an operation patients died a few days later from Gangrene of sepsis
77
Give 2 facts which show some progress in the problem of infection after the introduction of anaesthetics
Do more complex operations which saved lives, surgeons could take longer on operations
78
Difference between local and general anaesthetic
General made the patient completely unconscious whereas local numbed a specific part of the body
79
How was cocaine involved in anaesthetics?
In 1884 it was discovered that cocaine could be used as a local anaesthetic however it was addictive. A more effective version called Novocaine was developed as a local anaesthetic in 1905
80
Between which period did half of the people who had operations die?
1861-1865
81
How did Lister discover carbolic acid? 4 steps
Tried various methods to encourage wounds to heal cleanly without infection but had little success, became interested in Pasteur's work (the idea microbes were responsible for infection in a wound), in 1864 he found that carbolic acid was used in sewage works in Carlisle and it killed parasites, thought carbolic acid could also be used to kill microbes causing infection
82
How did Lister test his theory about carbolic acid?
1865 tested on an 11 year old boy with a compound fracture of his leg (the bone poked through the skin creating an open wound). Lister soaked bandages in carbolic acid and watched the wound carefully - no sign of pus or infection and the bone and wound healed at end of six weeks
83
What 3 things did Lister use a solution of carbolic acid for after testing it on the boy?
Cleaning equipment, wounds, bandages
84
What did Lister announce in 1867?
Wards had been free from sepsis for 9 months
85
What did Lister do in 1877?
Became Professor of Surgery at King's College Hospital in London and carried out an operation on a kneecap under antiseptic conditions which was widely publicised and other surgeons began to copy his methods
86
What were two problems with silk being used as stitches to sew wounds closed?
Silk did not absorb carbolic acid so could not be sterilised, a thread had to be left dangling out of the wound so stitches could be pulled out after the wound healed
87
How did Lister solve the two problems with stitches?
Introduced use of catgut which would be sterilised so reduced chance of infection, developed a form of catgut which dissolved after several days in the body so no thread needed to be left dangling
88
Identify 7 reasons for opposition to aseptic surgery
Some doctors didn't accept the idea microbes caused infection since they couldn't be seen with a microscope, using carbolic solutions slowed down the operation process which led to problems of blood loss, equipment was expensive and heavy, some doctors copied Lister's ideas incorrectly, some surgeons had good results without use of carbolic acid, nurses resented extra work due to emphasis on hygiene, carbolic acid made eczema on Nurse Caroline Hampton's hands worse
89
How was carbolic spray used?
It was drenched on instruments, the patient, the surgeons hands and the air
90
What happened with operations in 1912?
Up to 10 times more operations were taking place than 40 years before and with less infection
91
Who developed steam cleaning after a septic surgery?
Robert Koch in Germany
92
What did William Halstead of America introduce into surgery?
Gloves and masks
93
Give points about poor living conditions and health in the 19th century
Laissez faire government (hands off), malnutrition, back to back housing, low life expectancy for working classes, no voting rights for women, cholera epidemics, industrial diseases like phossy jaw, smog/pollution due to industrial revolution
94
What did Erwin Chadwick's government report 'The Sanitary Conditions of the Labouring Population' suggest and when was it written?
1842 after cholera epidemic. Suggested it would be cheaper if local taxes were used to improve housing and hygiene rather than paying for sick people to be supported in workhouses. His suggestions included: providing access to clean water, removal of sewage and rubbish
95
Why were Chadwick's suggestions criticised by the public? 4 reasons
Laissez faire attitude in society so people believed that the government should not interfere with the lives of ordinary people, water companies thought there may be reductions in their profits, middle class people (who had to pay local taxes) did not see why their money should be taken to provide better living conditions for the poor who did not pay anything, 'dirty party' protesters were angry at the idea the government should insist on piped water and sewers
96
When was the first Public Health Act and who was one of the commissioners?
1848. Erwin Chadwick
97
What did the first Pubic Health Act allow towns to do? 4 things
Set up their own local Board of Health, appoint a local medical officer, organise removal of rubbish, build sewer system
98
Why was the first Public Health Act not very successful? 4 points
It did not force town councils to take action so only one third of towns set up a Board of Health, even fewer appointed a medical officer, terms of the act were only temporary so in 1854 three commissioners had to resign, General Board of Health which it set up was abolished in 1858
99
What is cholera?
Infectious and often fatal bacterial disease of the small intestine, typically contracted from infected water supplies which causes severe vomiting and diarrhoea
100
How many deaths did cholera cause between 1831 and 1832?
26,101
101
How many deaths did cholera cause between 1848 and 1849?
52,293
102
How many deaths did cholera cause between 1853 and 1854?
20,079
103
How many deaths did cholera cause in 1865?
14,378
104
How did Chadwick make cholera worse?
He believed in miasmas so insisted on all human waste being dumped in river Thames then it made its way to the water supply
105
When did Dr John Snow investigate his theory that cholera was spread by infected water?
After an outbreak in London in 1854
106
How did John Snow investigate this theory?
Marked on a map all the deaths in one area and there was a clear concentration of deaths around the water pump on Broad Street. Snow had the handle of the pump removed so water could not be collected and number of deaths fell dramatically
107
Why did parliament slowly become convinced it should take action to improve public health? 4 reasons
Snow proved there was a link between water and cholera, Pasteur showed how disease spread, Snow showed that death rates varied according to water sources from different water companies, after the government collecting statistics on births/marriages/deaths William Farr showed that death rates were much higher in towns/cities than villages
108
Identify 6 limitations of Snow's discovery
Snow could not explain what was causing the disease because germ theory wasn't until 1861 but he was working in 1854, actual germ which caused cholera wasn't discovered until 1883 by this time snow was dead, government refused to act on snow's advice as they didn't want to pay so cholera came back in 1865, Great Stink 1858 caused Parliament to close, many scientists still believed in miasmas
109
What was the Great Stink?
In 1858 the level of the river Thames was so low due to hot weather and the smell of exposed sewage along its banks caused Parliament to close even though sheets soaked in disinfectant were hung at the windows to cover the smell
110
What did the Metropolitan Board of Works agree to after the Great Stink?
Joseph Bazalgette's expensive ideas to build a sewer system in London which took seven years to complete. By 1965 London had 1300 miles of sewers
111
When did working class men in towns get the vote and what did this mean?
1867. Put more pressure on councils to take action. An example would be that in the 1870s Joseph Chamberlain the mayor of Birmingham demolished 40 acres of slums
112
When was the Sanitary Act and what were the key terms?
1866. All towns had to appoint inspectors to check water supply and drainage
113
When was the Artisans Dwelling Act and what were the key terms?
1875. Local authorities were given the power to buy and demolish slum housing
114
When was the second Public Health Act and what were the key terms?
1875. Towns had to appoint Health Inspectors and Sanitary Inspectors; local authorities given powers to enforce regulations on water supplies and sanitation
115
When was the third Public Health Act and what were the key terms?
1878. Consolidated existing laws
116
What 6 things were local councils responsible for by 1875?
Clean water was provided, streets were paved, rubbish was removed, sewers were built, quality of housing was improved, checking quality of food in shops to ensure sand/chalk had not been mixed into flour/bread/sugar and meat had not been dyed to make it look fresh
117
What was the main aim of the NHS?
Bring healthcare to entire nation
118
Identify 13 aspects of healthcare the NHS improved
Maternity and child welfare, health centres, dentists, hospitals, medicines, specialists, family doctors, ambulances, vaccination, home visiting and after care of sick, teaching hospitals, medical research, ran by parliament
119
When was the National Insurance Act and how did it work?
1911. Workers, employers and government paid weekly into a sickness fund. When a worker fell ill he received 10 shillings (50p) a week for up to 26 weeks and he had free healthcare which was paid out of the sickness fund
120
Identify 6 initial problems with the National Insurance Act
Country was damaged and had very little money following WW2, government responsible for 2700 hospitals most of which had been built in 19th century so needed updated, massive waiting times and delays as many more people visited GPs, GP surgeries needed modernised, doctors and surgeons thought they would lose pay as they worked for the government not themselves, most hospitals were in London or the South East which left many people out of reach
121
Identify 6 new technologies in the NHS
Advanced x rays, smaller cheaper machines, robotics, microsurgery, key hole surgery, robotic surgery
122
What treatments were made possible by advanced x rays?
Target and shrink tumours growing inside the body using radiotherapy. Combined with chemotherapy, this is an effective treatment for many types of cancer
123
What treatments were made possible by smaller, cheaper machines?
Dialysis (blood of patients with kidney failure is 'washed' by a machine), heart bypasses (machine performs the functions of the heart). These are more available as machines are more portable
124
What treatments were made possible by robotics?
Better prosthetic limbs, partly in response to number of soldiers surviving bomb attacks in recent wars in Iraq and Afghanistan
125
What treatments were made possible by microsurgery?
First successful kidney transplant made in 1956 in USA between twins. Lungs transplanted in 1963, livers and hearts from 1967. Made possible by improved surgical techniques like microsurgery (reattaching tiny nerve endings and blood vessels)
126
What treatments were made possible by laparoscopic (keyhole) surgery?
Tiny cameras and narrow surgical instruments used so surgeons can operate inside the body through tiny incisions some distance away from the area to be operated on which allows for quicker healing and less trauma to the body
127
What treatments were made possible by robotic surgery?
Surgeons use computers to control instruments inside the body for more precise surgery with smaller cuts. Operations can be performed on a tiny scale where precision is of vital importance like brain surgery
128
Identify 4 problems today with treating disease
Lifestyle factors cause increase in illnesses like heart disease, difficult to develop vaccines against some viruses and different flu vaccines have to be available each year, new diseases keep appearing which do not respond to any chemical treatments, microbes have evolved to beat certain cures
129
When did the government set up the Ministry of Health and why?
1919 to help determine the level of health of people across the country
130
When did the NHS make healthcare free at the point of service?
1948
131
What did the introduction of the NHS make clear?
Hospitals were for treating the sick not places for the elderly to rest like they had been in earlier periods
132
Identify 8 positives of the introduction of the NHS
All health services centralised under the government so they could be regulated easily and people could get all aspects of their healthcare checked for free, maternal mortality continually reduced under the NHS, made women's health a priority so women are now 4 times more likely to consult a doctor than a man, provides healthcare for both the rich and poor, transformed the role of the family doctor, GPs work as teams to provide a range of services, costs less than many other private health systems (6% of national income but USAs private healthcare costs 12%), people seek treatment at an early stage so have better chance of recovery
133
Identify 5 limitations of the NHS
Cost has steadily increased from 500 million GBP in 1950 to over 3500 million in 1990s, prescription charges introduced in 1950s and charges for dentist , lack of money in recent years has left hospital beds unused although there is a need for them, sometimes NHS will refuse costly treatments like cancer drugs as this would drain the budget, people now live longer so are more likely to develop problems needing treatment which costs the NHS more
134
Why is lung cancer so difficult to treat?
Usually by the time the cancer is detected it is already very advanced. Patients often mistake their symptoms for other diseases. There is no national screening programme for lung cancer so patients are not routinely tested to see if they have it which is because tests are not accurate enough to weigh out negative effects of the screening (exposure to radiation during x ray)
135
What is the first stage of diagnosing lung cancer?
Patients are likely to be given a CT scan which creates a more detailed picture of inside the body. Often patients are injected with a dye before the scan so the lungs show up more clearly on the scan
136
What is the second stage of diagnosing lung cancer if it is detected? 2 options
If cancer doesn't look very advanced the patient will be given a PET-CT scan Or the patient is given a bronchoscopy
137
What is a PET-CT scan?
Like a CT scan but a small amount of radioactive material is injected into the body instead of dye which helps doctors identify cancerous cells in the body
138
What is a bronchoscopy?
Uses a tool like an endoscope called a bronchoscope which is passed down into the patient's lungs where it collects a sample of cells for testing
139
What can a doctor do after carrying out tests for lung cancer?
Determine what type of cancer it is and how far advanced it is. This makes it possible to draw up a treatment plan to attack the cancer
140
Identify 4 uses of science/technology in lung cancer treatment
Transplants, radiotherapy, chemotherapy, genetic research
141
How can lung cancer be treated if it is diagnosed early?
Doctors can perform an operation to remove the tumour and infected portion of the lung which can range from removal of just a small piece or of the whole thing
142
What do lung transplants involve and why does this raise ethical issues?
Replacing cancerous lungs with healthy ones from a donor which raises a number of ethical problems if the patient developed lung cancer after smoking for a long period because they chose to ruin their own lungs
143
What does radiotherapy involve?
Concentrated waves of radiation aimed at tumour to try to shrink it. It is administered as beams of radiation directed at the tumour from outside the body or by placing a small piece of radioactive material next to the tumour by using a catheter (very thin tube). Small tumours can be treated this way instead of surgery and larger tumours can be prevented growing any bigger
144
What does chemotherapy involve?
Patients are injected with many different drugs which either shrink the tumour before surgery or prevent the cancer from reoccurring or provide relief from symptoms of lung cancer when surgery is not possible
145
What are lung cancer patients now more likely to be treated using?
A range of strategies. E.g Surgery to remove tumour, radiotherapy and chemotherapy to tackle remaining cancerous cells
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What genetic research is being done about lung cancer?
Studying genes of lung cancer sufferers in order to prescribe more effective treatments. E.g some chemotherapy drugs work better in lung cancer patients whose tumours have a certain genetic mutation. This shows that treatment is more effective when prescribed for the individual. The idea of tailoring treatments to a person's DNA is a growing field in medical research called pharmacogenomics
147
Identify an economic negative and two economic positives of the tobacco industry
By 1985 smoking related deaths cost the NHS 165 million GBP per year. Government earned around 4 billion GBP from the tobacco tax, thousands of jobs related to tobacco industry
148
Identify 2 things the government has done to protect non smokers from the dangers of second hand smoke
2007 put a ban on smoking in all public buildings and workplaces, in 2015 the ban was extended to cars carrying children under 18
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Identify 1 thing the government has done to encourage smokers to quit
Increased taxation on tobacco products
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Identify things the government has done to prevent people becoming smokers
2007 raised the legal age of buying tobacco from 16 to 18, ban on cigarette television advertising in 1965, ban on all tobacco advertising in 2005, campaigns to advertise dangers of smoking by highlighting the effect on pregnant women and number of chemicals in cigarette smoke and diseases related to regular use, education in schools, all cigarette products removed from display since 2012
