Week 201 - International Health

Question 1

What is the TOP cause of death?

Answer 1

High income areas - Cardiovascular Disease

Low income areas - Acute Respiratory Infections

Question 2

What is the most common of cause of maternal mortality?

Answer 2

Haemorrhage (35%) - IV oxytocin after birth to stop it

Question 3

How do you test for TB?

Answer 3

Mantoux skin test (Active/Latent/BCG)

Interferon Gamma Release Assay (IGRA)

Question 4

How do you treat TB?

Answer 4

Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
All FOUR = 2 months
Rif+Iso = 4 months
TB meningitis 12 months therapy + steroids

Question 5

What is miliary TB?

Answer 5

Uncontrolled dissemination of organisms through the blood stream
Associated with milary shadowing on CXR
More insidious and non-specific

Question 6

What is in Rifater?

Answer 6

Rifampicin, isoniazid & pyrazinamide combination

Note: TB drugs may interact with HIV treatment

Question 7

What needs to be monitored in patients receiving TB treatment?

Answer 7

Prior to treat: Kidney+Liver function
LFTs
If ALT x5 normal = stop TB treatment
Visual changes
If treatment RIGHT - sputum smear negative after 2 weeks

Question 8

What type of vaccine is BCG?

Answer 8

Live attenuated M.bovis
0-80% protection for 10-15yrs
Protects agains leprosy and Buruli ulcer

Question 9

What is the mechanism of action of Rifampicin?

Answer 9

Inhibits bacterial DNA-dependent RNA polymerase

S/E- induces P450, ↑LFT, GI disturb., flu syndrome, red urine

Question 10

What is the mechanism of action of Isoniazid?

Answer 10

Prevents synthesis of mycolic acid (activated in liver)

S/E- ↑LFTs, peripheral dysfunction, arthralgia, gout

Question 11

What is the mechanism of action of Pyrazinamide?

Answer 11

Disrupts function of cell membrane

S/E- ↑LFTs, nausea, arthralgia, gout

Question 12

What is the mechanism of action of Ethambutol?

Answer 12

Inhibits production of arabinan (component of cell wall)

S/E- optic neuritis (↓acuity), colour changes or visual field changes

Question 13

What is a DEFINITIVE host?

Answer 13

the organism in which the ADULT or sexually mature stage of the parasite lives

Question 14

What is an Endoparasite?

Answer 14

lives WITHIN another living organism

Question 15

What is an Ectoparasite?

Answer 15

lives on EXTERNAL surface of living organism

Question 16

What are the subgroups of Protozoa?

Answer 16

Amoebas (pseudopodia)
Flagellates (two body forms: Metamonad (Giardia), Trypanosomes (Trypanosoma, leishmania)
Ciliates (Balantidium coli)
Apicomplexans (Plasmodium, Cryptosporidium)

Question 17

What are the three groups of Helminths?

Answer 17

Nematodes
Cestodes
Trematodes

Question 18

What is RED CELL division controlled by?

Answer 18

[Hb]

Question 19

Where does the mutation in Sickle Cell Anaemia lie?

Answer 19

β chain ( glu->val)

Question 20

Where does the mutation in Thalassaemia lie?

Answer 20

α and/or β chain genes

point mutations, deletions, translocations

Question 21

What are the possible causes of microcytic anaemia?

Answer 21

Thalassaemia
Iron Deficiency
Anaemia of chronic disease