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HLTB21H3 (100)

Entire Course Study Guide - in CHART format!


Department
Health Studies
Course Code
HLTB21H3
Professor
Anna Walsh

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Disease
Cause/
Transmission
Symptoms
Treatment/Prevention
Origin/Today
Black Plague
- Black
Death
- Universal
Plague
- Great
Pestilence
- Great
Mortality
- Yersina pestis
± a bacillus
- From the rat
flea
(Xenopsylla
cheopis) ± can
survive on
own
- Human flea
(Pulex
irritans)
transferred to
humans from
rats or infect
ppl
- 2-10 days for symptoms to develop
- Bubonic: buboes = large swellings (grapefruit
size), purple/black, filled of pus ± swollen lymph
glands (under armpits, groin)
- Nausea, vomiting, blisters, fever, headache,
delirium, chills, muscle pain
- 4/5 infected ppl died within 8 days of infection
- immortality rate = 90-95% until 1700s
- Pneumonic = affects respiratory system ±
coughing, congestion, bloody cough
- Septicemia = affects blood ± black nails, bleeding
into skin, blood clots, fever, lox BP, diarrhea,
organ failure
- rich fled
- mistaken for Spanish Flu
- EHOLHYHGWREH³*RGVZUDWK´
- flagellants = ppl whipped
themselves to ward of
plague and sin ± spread
disease b/c spilled pus
- diagnosed by examining skin
- scapegoat: Jews, lepers,
foreigners, beggars ±
miasmas (finger pointing)
- Great London Fire in 1665
stopped plague
- Eyam ± city where priest
William Mompesson tried
spreading self-quarantine
- first found in 1346, NW
Caspian Sea
- pandemic in Asia, Middle
East, North Africa, Europe in
18th CE
- lasted 7 years, 5-8 months at a
time in region
- death rate 30-50% in Europe
and Middle East
- FKDQJHG(XURSHVVWUXFWXUHEF
everyone was dying
- flourish in warm weather,
dormant in winter
- exists today: California, Utah,
Arizona, Nevada, New Mexico
- killed almost 75 million, 20 in
Europe alone
Leprosy
- +DQVHV
Disease
- Mycobact-
erium leprae
- spread with
skin contact
(lesions), resp.
droplets,
constant
contact with
infected ppl
- skin lesions and necrosis
- chronic infectious disease
- takes 2-14 days for bacteria to double
- can take 20 years for symptoms to show
- Moller Christensen = found 80% lepers
(hyperimmune) had a facial deformity
characteristic of leprosy ± facies leprosa
- skin lesions, nerve thickening, sensory loss
- showed positive skin smears
- irreversible damage to skin, nerves, eyes
- not highly infectious
- seen in 10-14 and 35-44 years old mostly
- Intermediate (IL) = earliest, mildest, few #
hypopigmented macules (cutaneous lesions), no
sensation loss, can progress or be fought
- Tuberculloid (TT) = large lesions, anesthesia, thick
nerves, can progress to B or L
- Borderline Tuberculloid (BT) = like TT but smaller
lesions and can go up/down levels
- Borderline Borderline (BB) = cutaneous lesions,
smaller but more that TT
- 2 kinds: Paucibacillary (little
bacteria, negative skin
smear, single to 5 lesions)
and Multibacillary (many
bacteria, positive smear or
more than 5 lesions)
- used oils and extracts ±
chaulmoogra in 1940
- Promin used to help treat
leprosy IV injection
- Thalidomide was used but
caused birth defects
- Dapsone and Diason first
used but showed resistance
- MDT = Multi Drug
Treatment used to stop drug
resistance (dapsone,
rifampicin, cofazimine)
- Leprosaria = hospitals for
lepers ± segregated
- lepers wore yellow cloaks
with badges and bells and
had to walk opposite wind
- Dr. Armauer Hansen
discovered in 1873
- First written in Egypt in 1550
BC and then in India in 600
BC
- Prevalence down
- Cured with MDT
- New cases in India, South
Africa, Brazil area
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- Borderline Lepromatous (BL) = numerous lesions,
can be papules, plaques, nodules, and look inverted
µSXQFKHGRXW¶
- Lepromatous (LL) = cannot become less severe,
early nerve involvement can go unnoticed, many
lesions, plaques, nodules, papules, macules, nasal
stuffiness, discharge, bleeding, swelling of leg and
ankles²untreated ± forehead thickens (leonine
facies) and legs, hoarse voice, loss of
eyebrows/eyelashes, sensory loss, nose collapse or
misshapen, eye photophobia (light sensitivity),
glaucoma, ulcer (nodule breakdown), organ
infection (liver and lymph swell), scar nerves and
thicken
- lepers were considered
legally dead ± had no legal
rights excepts that spouse
FDQWUHPDUU\XQWLOWUXO\
dead
Tuberculosis
- first name
was
Phthisis =
disease of
consump-
tion
- White
Plague (b/c
of
complex-
ion)
- acid fast
bacillus:
Mycobact-
erium
tuberculosis
- 30 species
identified ± 15
can cause
disorders like
TB but not
- bovine type
infects ppl
- aerial
transmission:
spread in resp.
droplets =
droplet nuclei
(talk, cough,
sneeze, spit,
sing, and other
resp.
functions)
- droplet
emitted by a
TB individuals
could contain
between 1-3
bacilli
- chronic disease, can linger for months and years
sometimes before appearing
- bacteria rHPDLQVYLDEOHWKURXJKRXWKRVWOLIHWLPH
dormant until resistance fails - indefinite and
variable incubation period
- TB disease = the active form that shows symptoms
and is contagious (10% ppl)
- commonly associated with the lungs and can affect
any tissue or organ in the body
- frequently causes disease in the meninges,
intestines, bones, lymph glands surrounding the
neck, skin, spine, kidneys, and genitals
- acute forms in infants, can be fatal in a matter of
weeks
- acute form: miliary TB ± small, grain like tubercles
are created simultaneously in almost every organ
in the body)
- bovine bacilli ingested through digestive tract
(milk/products) and can cause intestinal disease ±
can lead to pulmonary or military TB
- tubercular meningitis is not chronic, the rest are
- pulmonary TB = most common form: increasingly
frequent and violent cough that produces a purulent
sputum sometimes streaked with blood
- symptoms include fatigue, lethargy, anorexia,
chills, muscular aches, sweating, low-grade fevers
that continue indefinitely
- tubercles = caseous areas: cheesy consistency, can
- Waksman discovered many
antibiotics
- infections went down
because ppl with leprosy
somehow were immune to
TB
- 1944 researchers had
discovered streptomycin ,
proving effective for
inhibiting the disease
- 1946-52: para-amino-
salicylic acid (PAS) and
isoniazid (isonicotinic acid
hydrazide, or INH) effective
when used with
streptomycin
- diagnosis can be made with
a tuberculin skin test (TST)
- treated with DOTS (Directly
Observe Treatment
Shortcourse)
- LIFDQWGLDJQRVHZLWK767
or chest x-ray, Mantoux is
used
- chest x ray only used for
pulmonary TB
- anti-tuberculosis
vaccination: BCG (bacillus
- 1882 Robert Kosh discovered
M. TB
- endemic in Eurasia, North
Africa, and possibly the
Americas (from the Neolithic
period)
- 800 BC affected native
Americans
- 2400 BC found in Egyptian
mummies
- China in 206 BC ± 7 AD, TB
LQDZRPHVOXQJV
- Chinese medical texts
provided detailed treatments of
the disease written in Sui and
Tang dynasties
- development in 18th-20th CE
increased epidemic in Europe,
Americas, Africa and Asia ±
prevalence rates approached
100% of pop in some places of
exposure
- countries with highest TB
mortality rates have been those
with low standards of living,
poor working conditions and
inadequate treatment programs
- 1970s, over 20 nations (all
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- Type I: India
(least virulent
of 3,
susceptible to
disease when
infected with
Type A/B)
- Type A:
Africa, China,
Japan Europe,
North
America
- Type B:
Europe, North
America
become hard as rocks or can liquefy, leaving cavity
(if occurring close to a major blood vessel, can
hemorrhage)
- malnourished and of old age have higher risk with
exposure to bacillus and ppl with HIV
- ZRUOGVSRSLVLQIHFWHGZLWK7%
Clamette-Guerin) =
attenuated form of bovine
bacillus isolated in 1921 by
Clammette and Guerin
- MDRTB = multi-drug
resistance TB (and extra
resistance TB)
- dry tubercle bacilli in dried
sputum presented the
greatest threat
- early treatment: creosote,
carbolic acid solutions, gold,
iodoform, arsenic, and
menthol oil (administered
orally, inhaled, or injected in
lungs), drinking papaya
juice, enemas of sugar gases
- late 19th century: surgical
therapies: pneumothorax, or
collapsed-lung treatments,
and surgical removal of ribs
developing countries) had new
case rates for TB of over 150
per 100, 000 a year
- Luxury Sanitoria for the
wealthy
- Andrew Speaker had TB and
traveled from Prague to
Montreal on a bus
Syphilis
- venereal
disease
(VD)
- Great Pox
of Lues
after King
Louis had
it
- French Pox
- Turkish
disease
- Spanish
disease
- Treponema
pallidum ± a
spirochetal
bacterium
- humans
known to be
the only host
(human
treponema-
toses)
- sexual contact
- mother to
fetus across
placenta at
any stage
(congenital
syph)
- close contact
with early,
open lesions
- chronic, used to be most fatal STD (until HIV)
- HutchLQVRQ¶VWHHWKµVFUHZGULYHWHHWKRI
infected ppl
- many latency periods
- congenital = fetal wastage, neonatal mortality,
infant morbidity, risk to fetus in first 2 years of
infection is high, can die, be stillborn, or be
premature, and secondary lesions can appear at
birth of in 6 months of life
- Primary = T. pallidum penetrates intact mucous
membrane, regional lymphadenopathy
- 2-6 weeks lesions (= chancre) appear on site of
entry
- chancre = single, small, painless ulcer, and on
genitalia (penis, vulva²may have swollen inguinal
lymph nodes, labia, cervix)
- chancre can heal over 2-6 weeks
- Secondary = brief latent stage (6-8 weeks),
generalized lymphadenopathy
- disseminated lesions on skin and internal organs
- mostly disappeared after
WW2 and discovery of
penicillin (1928 by
Alexander Fleming)
- infects a lot of 15-34 years
in 2.6:1 ratio of homo men
to women in 1983
- study: Oslo ± 2VOHU³KHZKR
knows syphilis, knows
PHGLFLQH´
- study: Tuskegee ±
controversial because used
400 infected black men
compared to 200 uninfected
then watched them die
without treatment and
received spinal taps without
anesthetics and no consent,
heavy metal therapy,
received no penicillin or
antibiotics
- diagnosed with simple blood
- FDPHIURPSRHPµSyphilis ±
VLYHPRUEXVJDOOLFXV¶E\
Fracastoro
- began in 1490s in Europe
- 14-µPRUEXVJDOOLFXV¶
- 16-µOXHVYHQHUHD± said
to be French Pox and
contagious sexually
- 17-1850: idea of lues venereal
was destroyed
- 18-1950: became noticed as an
STD
- 1905 isolated germ that caused
syphilis by Schaudim and
Hoffman
- 1906 Fournier confirmed T.
pallidum found in tertiary
syphilis lesions
- 1995 ± 20 million new cases
- 2002 ± 4 times # cases since
1997
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