GHS Final Exam

HIV

Human Immunodeficiency Virus

Attacks the immune system by destroying specialized white blood cells needed to fight infection

(THIS IS CONTAGIOUS)

AIDS

Acquired immunodeficiency syndrome

Illnesses occurring due to the destruction of immune system cells by the HIV virus

(NOT CONTAGIOUS)

Common ways to get HIV/AIDS

• HIV infection can be passed through

  • Blood

  • semen

  • vaginal fluids

  • breast milk

  • Sharing needles

  • Unprotected sex

  • Breastfeeding

  • Blood transfusions

Methods one can take to protect themselves from HIV/AIDS

Don’t share needles

ensure sterilized tattooing

Safe sex; condoms

Do not share hygiene products

HIV infection has 3 stages

1. Primary infection

2. Asymptomatic Period

   1. Clinical latency

3. AIDS

How does COVID-19 impact a HIV+ person?

Health

Risk of dying from COVID-19 is double

Since HIV has more severe outcomes that compromise the immune system, resulting in higher simultaneous medical conditions

Beyond

COVID-19 lockdowns Disrupted testing

Steep drops in treatment diagnoses /referrals

Primary Infection of HIV

Commonly infection is not known right away

takes about 2-6 weeks after infection

Symptoms include:

• Headache

• Fatigue

• Sore throat

• Fever

• Rash

• Swollen Lymph nodes

Clinical Latency of HIV

Symptoms goes away but the virus remains in the body and can still be transmitted. This stage can last for several years.

During this time, the virus is killing CD4 cells and slowly destroying the immune system.

AIDS

CD4 T-cell number drops below 200

A person becomes at a higher risk of dying from another disease, such as the flu or cold, due to a compromised system.

Opportunistic infections

Infections that occur more often or are more severe in people with weakened immune systems

More than half of the current cases of HIV and half of new cases of HIV worldwide occur in females. Why

1. 2X as likely to acquire HIV from heterosexual sex
2. Women generally marry at younger ages
3. More likely to be the victims of sexual violence

Women tend to become infected with HIV at younger ages than men

What are the Prevention method

1. Enhanced WASH

2. Water treatment in risk areas

3. Hand washing

4. Vaccinate

Sporozoites

Parasite stage that infects humans

Tuberculosis

A disease that typically affects the lungs

• Caused by bacteria
Mycobacterium tuberculosis

2 types of Tuberculosis

1. Pulmonary TB

2. Extrapulmonary TB

Pulmonary TB

• Airborne

• Released into the air
  (cough, speak, sneeze)

• Nearby person breaths it in

Extrapulmonary TB

Typically, not infectious
• Hard to diagnose

Ways of Transmission Pulmonary TB

Speaking

Coughing

Singing

What is often a driver of TB transmission and why?

Poverty and economic status

How?

• Poor living conditions with overcrowding (easy spread)

• Lack of access to treatment

• Poor nutrition

Latent Tuberculosis

When infected, the immune system will attack the bacteria by quarantining. If the quarantine is effective, the infection is then considered

• Bacteria is inactive

• No symptoms

• Can’t spread TB

• Will test positive for TB

How does TB attack?

Slowly destroys the tissues and leaves in their place a thick cheesy substance

- If in the lungs it will causes holes

What is the link between TB and HIV

TB is the leading cause of death in people w/HIV

• HIV+ are 30x more likely to develop TB

What is TB an example of?

An opportunistic infection

What is another name for TB Disease?

Wasting disease; the disease is wasting away of the body

What is the main symptom of Cholera?

Acute watery diarrhea (Rice Water Diarrhea)

Cholera

the bacteria doesn’t directly attack but instead releases toxins

What is the recipe for ORS?

6 teaspoons of sugar

A half teaspoon of salt

1 liter of water

What place has Malaria disproportionately affected globally?

Africa, with 90% of all cases & deaths occur in sub-saharan Africa

Gametocytes

Parasite stage that mosquitoes take in

How to tell if a mosquito is a malaria mosquito vector?

First, identify the gender; this is done by looking at the antenna (Males have bushy antennas, whereas females don’t)

The female transmits the disease.

1. Palps

   • The length of the palps are the same length as the mouthparts

2. Resting Stance

   • Rest at a 45-degree angle

     • Butt pointed towards the sky

What groups or demographic are at the highest risk for severe malaria complications and/or death?

Children Under 5 & Pregnant Women

Interventions for Malaria

Artemisinin

• From the Sweet wormwood plant

Long-Lasting Insecticide-treated Nets

• Typically lasts up to 3-5 years

• Not a definite answer, but a solid temporary solution

Indoor Residual Spraying

• Coating walls/other surfaces of a house with a residual insecticide

What is the most common cause of malaria?

P vivax

P.vivax (and P.ovale also) results in

relapsing malaria

Relapsing malaria

After recovery from malaria, it returns and causes additional attacks without reinfection

• can happen months/years later

• can happen several times

Neglected Topical Diseases (NTDS) derive from

1. Bacteria

2. Viruses

3. Parasites

Two types of disease-causing parasites

1. Protozoa

   • Single-celled organism

   • Often lives in water

2. Helminth

   • multicellular worm that lives inside the body of its host

What disease is Protozoan

Malaria

Helminth Location

Definitive host
• Animal host in which a parasite
reaches sexual maturity and
reproduces.

• This is the parasites “goal”

ntermediate host
• Animal host in which an
immature parasite develops but
does notdoes not reach sexual maturity

Vectorborn Infection a result og

Human → Insect → human cycle

or

Animal → insect → animal cycle

Flaviviruses

RNA viruses found in arthropods
(primarily ticks and mosquitoes) can infect humans

Romana’s sign

Swelling in eyelid

Chagastic Megacolon

Extreme bloating of the colon; contispation which

Dengue fever (DF) is also known as

break-bone fever

due to extreme pain in joints

2 main mosquitos transmit this virus

Aedes aegypti

Aedes albopictus (Also known as the Asian tiger mosquito)

Aedes albopictus (Asian tiger mosquito) are most active

diurnal - active during the daylight hours

4 serotypes (strain)

1st infection - Symptoms

2nd infection - Often severe Dengue

• Death (hemorrhagic fever, shock)

West Nile Virus

Typically a disease in birds but can and will effect humans

Most people asymptomatic:

• Severe: encephalitis

• weakness

• coma

• vision loss

• death

Lymphatic Filariasis

Transmitted by mosquitoes which transmit microscopic roundworms (filarial Nematodes)

Immense swelling in legs

Immense swelling in the scrotum for men

Two different types of Trypanosomiasis

1. HAT (African Sleeping Sickness)

2. Chagas Disease

HAT (Human African Trypanosomiasis)

Also known as Sleeping Sickness

Symptoms of the 1st stage

• Fever

• severe headaches/fatigue,

• swollen lymph nodes

• aching muscles and joints

Symptoms of the 2nd stage

• invades the central nervous system
  - Confusion, personality changes, other neurologic

Two key eye worm diseases

Onchocerciasis

Loa Loa

Chagas Disease

Triatomine Bug defecates

Signs

• Ramona’s sign

• Diseases of poverty

Symptoms: Initially mild and become
chronic and deadly after many years

- Heart rhythm abnormalities; sudden death
- A dilated heart that doesn’t pump blood well
- A dilated esophagus or colon (megacolon)

Onchocerciasis

• Big lumps in skin; produce juvenile worms called Microfilaria

• Intense itching which may change the appearance of the skin

  • (kinda like a vitiligo effect) leopard skin

  • lumps

• If enter eyes, may cause blindness

Treatment

• Ivermectin (3mg)

Loiasis (Loa Loa)

Transmitted by deer fly

Symptoms

• Intense itching

• Painful swelling

• If enter eyes, may lead to blindness

Treatments

• DEC

Dracunculiasis

Transmitted by drinking water with infected copepods (water bugs)

Treatment

• Only way to remove is to twist slowly with a stick

Zika Virus

• transmitted by Aedes mosquitoes

• can also be sexually transmitted

mainly affects mothers and their infants

• linked to microcephaly (decrease in head shape)

Yellow fever

Spread by infected aedes mosquitos 

Named after the jaundice (yellow color of the skin) from an infection

Two Cycles of Yellow fever

• Urban- spread between humans and mosquitoes in populated areas,  

• Sylvatic- spread between mosquitoes and wild animals, generally in monkeys 

Neonate

a newborn within first 28 days after birth

Infant

a baby between birth and their 1st birthday

Preterm birth

the delivery of a baby before the 37th week of pregnancy

A typical pregnancy is about 40 weeks long

In resource-limited settings, survival
of preterm babies is enhanced by?

Skin-so-skin contact of mother/newborn
- Frequent breastfeeding
- Early discharge from the hospital

Breastmilk contains

Colostrum

which all needed nutrients, water, digestive enzyme

Neonatal Survival

• Beings with universal access to prenatal care

• Labor and delivery care should be provided by skilled birth attendants

• After birth, routine care for newborns

• Clinical treatment for breathing difficulties, signs of infection, jaundice, other problems

Reproductive rights

The freedom of women & their partners to decide how many children they want

Without interference from governments/others

1st Trimester

Hyperemesis gravidarum

• severe nausea and vomiting in early pregnancy that causes severe dehydration & significant weight loss

Ectopic pregnancy

• fertilized egg implants in fallopian tubes/another location outside the uterus

2nd/3rd Trimester

Placenta previa

• the placenta covers
  part/all of the cervix, causing bleeding

Placental abruption

• placenta separates
  from the uterine wall prior to delivery

Causes of Maternal Mortality

Preeclampsia

• Worsening hypertension in the final months of pregnancy

Family Planning

The process by which both
women/men make informed decisions about

• How many children they want to have

• How many years apart they want pregnancies

• Actions they will take to achieve these goals

Family Planning Methods

1. Abstinence- refraining from sexual contact

2. Contraception - intentional prevention of pregnancy through a variety of measures

3. Fertility Treatment - mechanisms that assist the pregnancy process (conception/infertility)

Birth spacing

time period after the birth
of a child before conceiving the next child

What is the optimal time period between childbirth (for birth spacing)

two years

Spacing Benefits

Women/Children are usually healthier
when women have fewer pregnancies

• Malnutrition from weaning (older child)

• Increased risk of low birthweight
  as well as preterm birth (younger child)

Economic benefits as well

• Work productivity → resources

What is the correlation between gross national income per capita and % of deaths from NCDs

Higher gross national income per capita is
associated with a higher % of deaths from NCDs

Based on the diseases who do you think is most at risk for death NCDs?

Older population

• 70 and older

• Is this true for low income countries (yes because people typically build immunity from communicable diseases and will most likely die from )

The risk of NCD is

most common cause of death for older adults in every country

Example of NCDs

Heart disease / other cardiovascular diseases

• Cancers

• Chronic respiratory diseases

• Diabetes

NCDs also called

“Diseases of affluence”

Diseases of affluence is contrast to

“Diseases of poverty”

• Infectious diseases/undernutrition

Lifestyle diseases

disease that can be prevented through the behavior change

Behavior change

• Process of adopting healthier habits & maintaining the practices

Diabetes

chronic condition that affects how your body turns food into energy

Insulin

Allows glucose (sugar) into cells

lack of insulin results in Sugar staying in your bloodstream

3 types of diabetes

Type 1

• Not preventable

• Body does not create enough insulin

Type 2

• Preventable

• Body does not create enough insulin OR develops insulin resistance

Gestational

• Pregnancy related

Treatment?

• Have the baby

• Resolves after delivery

Diabetes Results

Heart disease

• Kidney disease/failure

• Blindness

• Nerve damage

• Diabetic neuropathy

• Foot ulcers

• May lead to amputation

Common CVDs

• Heart attacks

• Strokes

• Arrhythmia

• Hypertension

Where is the Overall CVD mortality rate highest and why?

In high-income countries.

WHY?
- Have the highest proportion of older adults

Ischemic heart disease and it’s effects

Ischemia is a reduced supply of oxygenated blood

Often a result of atherosclerosis

• Thickening of the artery walls which carry blood from the heart to the heart muscle

Stroke

brain cells die from lack of oxygen

2 common causes of strokes

1. Ischemia (reduced blood flow to brain)

2. Hemorrhage

Symptoms of Stroke

• Weakness on 1 or both sides of the face/body

• Vision issues, loss of balance, severe headache

• Trouble speaking/understanding

• Confusion

Cancer

• abnormal cells reproduce
  uncontrollably within the body

  
  • Often invading nearby tissues and
  spreading to other parts of the body

Apoptosis

Cell programmed death

This is what normal cells go through to eliminate the chance of cancer

Cancer cells vs Normal Cells

Normal cells are genetically stable and will die after some time (Apoptosis)

Cancer cells are genetically UNSTABLE & undergo unlimited reproductive cycles
(no apoptosis)

Risk factors for Cancer

Tobacco use increases risk of cancers

• Environmental hazards induce cellular damage

• Air pollution, residential radon, arsenic, etc.

• Occupational exposure to
  carcinogens damages cells

• Unhealthy diet, obesity,
  physical inactivity may
  impair cellular function

Cancer Prevention

Detection at an early stage through screening

What virus did we skip over in the Spillover documentary? 

Nipah virus