40Human diseases

πŸ“š
COMMUNICABLE DISEASES
β–’ Definition: Diseases caused by pathogens
β–’ Pathogens:
  • β€’
    Bacteria
  • β€’
    Viruses
  • β€’
    Fungi
  • β€’
    Protozoans
  • β€’
    Helminthes
πŸ“š
VIRAL DISEASES
β–’ Classification:

Table 1: Viral Diseases by Tissue Tropism

Type
Mainly affects
Examples
Dermotropic viral diseases
Skin
Herpes simplex, smallpox / variola, chickenpox / varicella, measles / rubeola, rubella / German measles, mumps
Viscerotropic viral diseases
Blood + visceral organs
Yellow fever, dengue fever, chikungunya, hepatitis, AIDS
Pneumotropic viral diseases
Respiratory system
Influenza, swine flu, common cold, SARS
Neurotropic viral diseases
Central nervous system
Rabies / hydrophobia, polio / poliomyelitis
β–’ Hepatitis:
❖ Treatment:
  • β€’
    Ξ±-interferon
  • β€’
    Lamivudine
πŸ“š
AIDS / ACQUIRED IMMUNODEFICIENCY SYNDROME
β–’ Synonym: Slim disease
β–’ Introduction:
  • β€’
    Pandemic disease
  • β€’
    Concentrated epidemic in Nepal
  • β€’
    First case reported in USA β†’ 1981
  • β€’
    First case reported in Nepal β†’ 1988
  • β€’
    Estimated cases in Nepal β†’ 60,000
β–’ Agent:

Table 1: HIV

Feature
Point
Agent
HIV / Human Immunodeficiency Virus
Common type
HIV-1
Other type
HIV-2
Virus type
Retrovirus
Enzyme
Reverse transcriptase β†’ RNA to DNA
Immunity affected
Cell-mediated immunity
Main target cells
Helper T-cells / CD4 cells
CD4:CD8 ratio
Normal 2:1 β†’ altered to 1:2
β–’ Mode of Transmission:

Table 1: HIV Transmission

Mode
Key points
Chance
Sexual contact
Most common mode; heterosexual route most common by number; homosexuals at higher risk
0.01–1%
Blood contact
Infected blood transfusion; IV drug users; hemophiliacs; surgeons at higher risk
>90%
Vertical transmission
Mother to baby during delivery + breastfeeding
>30%
β–’ HIV Concentration in Body Fluids:

Table 1: HIV in Body Fluids

Level
Fluids
High concentration
Blood, breast milk, semen / vaginal fluid, pus
Low concentration
CSF, amniotic fluid
Highly unlikely transmission
Sweat, tears, saliva, urine
β–’ Clinical Stages:

Table 1: Clinical Features of HIV/AIDS

Stage
Features
Acute viral stage
Flu-like symptoms β†’ common cold, fever, sore throat
Window period
Antibody test negative but transmission possible; 2 weeks–2 months
Asymptomatic stage
Antibody test positive; no specific symptoms except generalized lymphadenopathy
AIDS-related complex / ARC
Uncontrolled diarrhoea >1 month; unknown fever >1 month; >10% weight loss within 6 months
End stage / AIDS
Opportunistic infections; tuberculosis common
β–’ Tumours in AIDS:
  • β€’
    Kaposi's sarcoma
  • β€’
    Non-Hodgkin's lymphoma
β–’ Diagnosis:

Table 1: HIV Diagnosis

Test type
Test
Screening test
ELISA / Enzyme-Linked Immunosorbent Assay
Confirmatory test
Western blotting
β–’ Treatment:
❖ HAART: Highly Active Anti-Retroviral Treatment
❖ Drugs:
  • β€’
    Zidovudine
  • β€’
    Nevirapine
  • β€’
    Saquinavir
β–’ Important Day: World AIDS Day β†’ 1st December
πŸ“š
BACTERIAL DISEASES
β–’ Classification:

Table 1: Bacterial Diseases by Transmission

Type
Examples
Airborne bacterial diseases
Scarlet fever, Q fever, diphtheria, pertussis, meningitis, tuberculosis, pneumonia
Waterborne + foodborne bacterial diseases
Typhoid fever, botulism, bacterial dysentery / shigellosis, cholera
Soilborne bacterial diseases
Anthrax, tetanus / lockjaw / trismus, gas gangrene
Arthropod-borne bacterial diseases
Bubonic plague, endemic relapsing fever, rickettsial diseases
Contact bacterial diseases
Leprosy, trachoma, bacterial conjunctivitis / pinkeye
Sexually transmitted bacterial diseases
Syphilis, gonorrhoea, chlamydia, chancroid
β–’ Rickettsial Arthropod-borne Diseases:
  • β€’
    Rocky Mountain spotted fever
  • β€’
    Typhus β†’ epidemic typhus + endemic typhus
  • β€’
    Trench fever
πŸ“š
TUBERCULOSIS / KOCH'S DISEASE
β–’ Introduction:
  • β€’
    44,000 people develop active TB every year
  • β€’
    20,000 β†’ infectious pulmonary TB
  • β€’
    5,000–8,000 deaths per year
  • β€’
    45% of total population of Nepal infected
  • β€’
    Can affect all organs except hair + nails
  • β€’
    Generally affects lungs β†’ pulmonary tuberculosis
β–’ Risk Factors:
  • β€’
    HIV / immunocompromised state
  • β€’
    Malnutrition
  • β€’
    Overcrowding
  • β€’
    Poverty
  • β€’
    Carpet industry
  • β€’
    Smoking
  • β€’
    Alcoholism
  • β€’
    Diabetes mellitus
  • β€’
    Corticosteroid use
β–’ HIV Relation: Leading cause of death in HIV patients
β–’ Causative Agents:

Table 1: TB Agents

Organism
Disease / Host
Mycobacterium tuberculosis
Human TB
Mycobacterium bovis
Animal / bovine TB
Mycobacterium avium
Seen in immunocompromised / cancer patients
β–’ Important Points:
  • β€’
    Agent discovered by Robert Koch
  • β€’
    Acid-fast bacilli / AFB-positive bacteria
  • β€’
    Not detected by Gram stain
β–’ Incubation Period: 3 weeks–3 months
β–’ Mode of Transmission:
  • β€’
    Droplet infection
  • β€’
    Infected cow milk β†’ bovine TB
β–’ Clinical Features:
  • β€’
    Evening rise of temperature
  • β€’
    Night sweats
  • β€’
    Low-grade fever
  • β€’
    Hemoptysis / blood in cough
  • β€’
    Chronic cough
  • β€’
    Chest pain
  • β€’
    Anorexia / loss of appetite
  • β€’
    Weight loss
  • β€’
    Fatigue
β–’ Lesions:

Table 1: TB Lesions

Term
Meaning
Ghon focus
Primary subpleural granulomatous lesion; often mid-upper zones
Ghon complex / Primary complex
Ghon focus + adjacent lymphatics + hilar lymph nodes
Ranke complex
Fibrosis + calcification of Ghon complex
β–’ Diagnosis:
  • β€’
    Chest X-ray
  • β€’
    AFB test / Ziehl-Neelsen test
  • β€’
    Sputum culture β†’ 3 consecutive morning samples
  • β€’
    Mantoux test
  • β€’
    PCR
β–’ Treatment Drugs:

Table 1: Anti-TB Drugs

Drug
Key point
Pyrazinamide
P
Rifampicin
R; red secretions β†’ sweat, urine
Isoniazid
I; peripheral neuritis due to vitamin B6 / pyridoxine inhibition
Ethambutol
E; only bacteriostatic drug
Streptomycin
S; injectable
β–’ DOTS:
  • β€’
    Directly Observed Treatment Short-course
  • β€’
    Launched in Nepal β†’ April 1996
  • β€’
    Intensive phase β†’ 2 months
  • β€’
    Continuation phase β†’ 6 months
β–’ Vaccine: BCG / Bacillus Calmette-GuΓ©rin β†’ prevents childhood TB
β–’ Important Notes:
  • β€’
    TB Day β†’ 24th March
  • β€’
    SAARC TB Centre β†’ Bhaktapur, Nepal
  • β€’
    National TB Centre β†’ Bhaktapur, Nepal
πŸ“š
TYPHOID FEVER / ENTERIC FEVER
β–’ Causative Agent: Salmonella typhi
β–’ Agent Features:
  • β€’
    Gram-negative bacillus
  • β€’
    Humans are the only host
β–’ Incubation Period: 10–14 days
β–’ Mode of Transmission: Faeco-oral route β†’ contaminated food + water
β–’ Clinical Features:
  • β€’
    High-grade fever / step-ladder fever
  • β€’
    Constipation / diarrhoea
  • β€’
    Nausea + vomiting
  • β€’
    Rose spots on trunk + chest after 1st week
  • β€’
    Rose spots β†’ seen in about 30% cases but specific
  • β€’
    Headache
  • β€’
    Relative bradycardia
  • β€’
    Relative neutropenia
β–’ Diagnosis by Week:

Table 1: Typhoid Diagnosis

Week
Test
1st week
Blood culture
2nd week
Widal test / antigen-antibody test
3rd week
Stool culture
4th week
Urine culture
Most sensitive
Bone marrow examination; not practical in most cases
β–’ Treatment:
  • β€’
    Ciprofloxacin
  • β€’
    Chloramphenicol
  • β€’
    Amoxicillin
β–’ Notes:
  • β€’
    Called enteric fever because it affects small intestine
  • β€’
    Peyer's patches affected
  • β€’
    Peyer's patches concentrated in ileum
  • β€’
    Chronic carriers + latent stage β†’ bacteria in gall bladder + biliary tree
  • β€’
    Typhoid Mary β†’ chronic carrier
πŸ“š
FUNGAL DISEASES
β–’ Introduction:
  • β€’
    Fungal diseases = mycoses
  • β€’
    Can affect many body organs
  • β€’
    Ringworm + athlete's foot β†’ skin
  • β€’
    Cryptococcosis + histoplasmosis β†’ lungs
  • β€’
    Candidiasis β†’ oral cavity, intestinal tract, skin, vaginal tract, other locations
  • β€’
    Weak immune system predisposes to pathogenic fungi
β–’ Examples:
  • β€’
    Cryptococcosis
  • β€’
    Candidiasis
  • β€’
    Dermatophytosis
  • β€’
    Pneumocystis pneumonia
  • β€’
    Aspergillosis
  • β€’
    Ergotism
πŸ“š
PROTOZOAN DISEASES
β–’ Giardiasis:
❖ Agent: Giardia lamblia / Old man of intestine
❖ Habitat: Duodenum + upper jejunum
❖ Mode of Transmission: Faeco-oral route
❖ Incubation Period: 3 weeks
❖ Special Features:
  • β€’
    Lacks mitochondria
  • β€’
    Lacks Golgi apparatus
  • β€’
    Dimorphic β†’ trophozoite + cyst
❖ Clinical Features:
  • β€’
    Abdominal pain
  • β€’
    Fatty diarrhoea / steatorrhoea
  • β€’
    Nausea
❖ Diagnosis: Cyst detection in stool
❖ Treatment:
  • β€’
    Metronidazole
  • β€’
    Tinidazole
  • β€’
    Secnidazole
  • β€’
    Albendazole
❖ Notes:
  • β€’
    Commonest cause of diarrhoea in adults
  • β€’
    Rotavirus β†’ most common diarrhoea cause in children
  • β€’
    Common where food hygiene is poor β†’ hostel, cafeteria
πŸ“š
HELMINTHIC DISEASES
β–’ Ascariasis / Roundworm:
❖ Agent: Ascaris lumbricoides
❖ Agent Features:
  • β€’
    Parasitic roundworm
  • β€’
    Largest nematode
  • β€’
    Largest intestinal parasite
❖ Habitat: Human small intestine β†’ jejunum
❖ Mode of Transmission: Ingestion of embryonated eggs through contaminated food / water
❖ Infective Stage: Embryonated eggs
❖ Incubation Period: 1–2 months
❖ Clinical Features:
  • β€’
    Abdominal pain
  • β€’
    Constipation
  • β€’
    Passing worm in stool / vomit
  • β€’
    Intestinal obstruction
  • β€’
    Ulcer
  • β€’
    Cough
  • β€’
    Obstructive jaundice
  • β€’
    Loeffler's pneumonia if larva reaches lungs
  • β€’
    Malnutrition
❖ Diagnosis:
  • β€’
    Stool examination
  • β€’
    Egg β†’ bile-stained
  • β€’
    Egg shell β†’ thick, irregular albuminous mammillated coat
  • β€’
    Abdominal X-ray / imaging
  • β€’
    Eosinophil count
❖ Treatment:
  • β€’
    Mebendazole
  • β€’
    Piperazine
  • β€’
    Albendazole
  • β€’
    Thiabendazole
❖ Notes:
  • β€’
    Most common helminthic / worm infection in Nepal
  • β€’
    Direct human-to-human contact transmission impossible
πŸ“š
NON-COMMUNICABLE DISEASES
β–’ Examples:
  • β€’
    Diabetes mellitus
  • β€’
    Arthritis
  • β€’
    Gout
  • β€’
    Cardiovascular diseases
  • β€’
    Cancer
πŸ“š
CANCER
β–’ Introduction:
  • β€’
    Cancer word from Greek karkinos = crab
  • β€’
    Major dreaded disease + cause of death worldwide
  • β€’
    Normal cells show contact inhibition
  • β€’
    Cancer cells lack contact inhibition
  • β€’
    Uncontrolled growth β†’ neoplasm / tumour
  • β€’
    All cancers β†’ uncontrolled growth + division of cells
  • β€’
    Oncology = study of cancer cells
β–’ Tumour Types:

Table 1: Benign vs Malignant Tumour

Feature
Benign tumour
Malignant tumour
Growth
Slow
Fast
Organization
Well organized + capsulated
Disorganized + non-capsulated
Metastasis
Absent
Present
Suffix
Usually -oma
Usually carcinoma / sarcoma
Damage
Little damage; localized
Invades + damages surrounding tissues
β–’ Malignant Tumour Types:

Table 1: Major Malignant Tumours

Type
Origin
Examples / Sites
Carcinoma
Epithelial tissue
Skin, mucous membrane, breast, lungs, pancreas, stomach
Sarcoma
Connective tissue / primitive mesoderm
Osteosarcoma, bone tumour, muscle tumour, lymph nodes
β–’ Other Cancer Terms:

Table 1: Cancer Terms

Term
Meaning
Glioma
Cancer of glial cells of CNS
Melanoma
Cancer of pigment cells of skin
Leukaemia
Unchecked proliferation of blood cells + bone marrow precursors
Adenoma
Cancer of glands
Myoma
Cancer of muscle tissue
Lymphoma
Cancer of lymphatic tissue
Hodgkin's lymphoma
Lymphatic cancer with uncontrolled lymphocyte growth
β–’ Causes of Cancer:
❖ Radiations:
  • β€’
    Ionizing radiation β†’ X-rays, gamma rays
  • β€’
    Non-ionizing radiation β†’ UV rays
  • β€’
    Cause DNA damage
❖ Carcinogens:

Table 1: Carcinogens & Target Tissues

Carcinogen
Target tissue
Soot
Skin + lungs
Coal tar / 3,4-benzopyrene
Skin + lungs
Cigarette smoke / N-nitrosodimethylene
Lungs
Mustard gas
Lungs
Nickel + chromium
Lungs
Aflatoxin
Liver
Vinyl chloride
Liver
Cadmium oxide
Prostate gland
Diethylstilbestrol / DES
Vagina
❖ Cancer Susceptibility Factors:
  • β€’
    Familial / hereditary factors
  • β€’
    Smoking
  • β€’
    Chemical + environmental factors
  • β€’
    Viral factors
  • β€’
    Alcohol
  • β€’
    Dietary factors
  • β€’
    Physical irritants / chronic abrasion
β–’ Oncogenic Viruses:

Table 1: Human Oncoviruses

Virus type
Oncogenic virus
Cancer
DNA tumour virus
Human papilloma virus / HPV
Cervical + penile cancer
DNA tumour virus
Epstein-Barr virus / EBV
Burkitt's lymphoma
DNA tumour virus
Herpes virus 8 / HHV-8
Kaposi's sarcoma
DNA tumour virus
Hepatitis B virus / HBV
Hepatocellular carcinoma
RNA tumour virus
Hepatitis C virus / HCV
Hepatocellular carcinoma
RNA tumour virus
HTLV-1
Adult T-cell leukaemia
RNA tumour virus
HTLV-2
Cervical cancer
❖ Notes:
  • β€’
    Viruses cause specific cancers in animals
  • β€’
    Viruses responsible for about 20% of human cancers
  • β€’
    Cancer-causing viruses = oncogenic viruses
  • β€’
    Oncogenic viruses carry viral oncogenes
  • β€’
    Cellular oncogenes / proto-oncogenes can produce cancer
β–’ Cancer Warning Signs:
  • β€’
    Rapid weight loss without apparent cause
  • β€’
    Scab / sore / ulcer not healing within 3 weeks
  • β€’
    Mole enlarging / bleeding / itching
  • β€’
    Severe recurrent headaches
  • β€’
    Difficulty in swallowing
  • β€’
    Persistent hoarseness
  • β€’
    Coughing blood-stained sputum
  • β€’
    Persistent abdominal pain
  • β€’
    Change in shape / size of testes
  • β€’
    Blood in urine without painful urination
  • β€’
    Change in bowel habits
  • β€’
    Lump or change in breast shape
  • β€’
    Bleeding / discharge from nipple
  • β€’
    Vaginal bleeding between periods / after menopause
β–’ Common Cancers:
  • β€’
    Men β†’ lung cancer commonest
  • β€’
    Women β†’ breast cancer commonest
  • β€’
    Women β†’ followed by large intestine + rectum cancer
  • β€’
    Breast cancer almost absent under age 25
β–’ Detection & Diagnosis:
  • β€’
    Early detection = life-saving
  • β€’
    Biopsy β†’ tissue section stained + examined microscopically
  • β€’
    X-ray
  • β€’
    CT / Computed Tomography
  • β€’
    MRI / Magnetic Resonance Imaging
  • β€’
    Histopathology of tissue, blood, bone marrow
β–’ Treatment:

Table 1: Cancer Treatment

Treatment
Main point
Surgery
Tumour removed wherever possible
Radiotherapy
Kills cancer cells while protecting normal surrounding tissue
Chemotherapy
Stops cancer-cell division / more toxic to cancer cells
Immunotherapy
Ξ±-interferon activates immune system to destroy cancer cells
❖ Chemotherapy Examples:
  • β€’
    Cisplatin
  • β€’
    Catharanthus roseus β†’ vincristine + vinblastine
  • β€’
    Vincristine + vinblastine used in leukaemia
❖ Side Effects:
  • β€’
    Hair loss
  • β€’
    Anaemia
πŸ“š
SOCIAL DISEASES
β–’ Examples:
  • β€’
    Alcoholism
  • β€’
    Tobacco-smoking
  • β€’
    Drug abuse
πŸ“š
ALCOHOLISM
β–’ General:
  • β€’
    Most commonly abused substance in world β†’ alcohol
  • β€’
    Most commonly abused substance in Nepal β†’ smoking
  • β€’
    Ethyl alcohol = colourless liquid produced by fermentation of sugar by yeast
  • β€’
    Alcohol used clinically as antiseptic + solvent
  • β€’
    Alcohol acts as drug even in small amounts
β–’ Alcohol Content:

Table 1: Alcohol by Volume

Drink
Ethyl alcohol
Beer
5%
Wine
10%
Whisky
40%
β–’ Absorption & Metabolism:
  • β€’
    Alcohol needs no digestion
  • β€’
    Rapidly absorbed by gut mainly stomach
  • β€’
    Enters bloodstream within minutes
  • β€’
    Carried to liver
β–’ Liver Metabolism: Alcohol β†’ acetaldehyde β†’ acetic acid β†’ carbon dioxide + water
β–’ Liver Damage:
  • β€’
    Alcohol β†’ fat synthesis in liver
  • β€’
    Extra fat ↓ enzyme + structural protein production
  • β€’
    Fatty liver syndrome
  • β€’
    Cirrhosis β†’ liver cells replaced by fibrous tissue
  • β€’
    Hepatitis
  • β€’
    Liver cancer
β–’ Effects:

Table 1: Effects of Alcohol

Level / System
Effects
Low level
Facial flushing, talkativeness, increased social confidence
Skin
Facial flushing; constant in heavy drinkers
Brain + CNS
Disturbed thinking, irritability, reduced self-control, slurred speech, drowsiness, difficulty standing
CNS action
Depressant; reduces anxiety, tension, inhibitions
Cerebellum
Ataxia / loss of balance
Liver
Fatty liver, hepatitis, cirrhosis, liver cancer
Heart + circulation
Coronary heart disease, hypertension, heart failure, stroke
Reproductive system
Low dose ↑ confidence; high dose β†’ impotence
Water metabolism
↓ ADH β†’ ↓ water reabsorption β†’ ↑ urine output
β–’ Vitamin B1 Effect:
  • β€’
    Alcohol disturbs thiamine / vitamin B1 metabolism
  • β€’
    Wernicke's encephalopathy
  • β€’
    Korsakoff's psychosis
β–’ After Effects:
  • β€’
    Dehydration
  • β€’
    Thirst
  • β€’
    Dry tongue
  • β€’
    Hangover
β–’ Marker: Gamma-glutamyl transferase / GGT increases in alcoholism
πŸ“š
TOBACCO-SMOKING
β–’ Tobacco:
  • β€’
    Dried leaves of Nicotiana tabacum
  • β€’
    Dried leaves of Nicotiana rustica
  • β€’
    Family β†’ Solanaceae
  • β€’
    Originated in America
  • β€’
    Smoked by Red Indians
  • β€’
    >6800 chemicals in tobacco smoke
β–’ Nicotine:
❖ Role:
  • β€’
    Addictive substance in tobacco
  • β€’
    Acts as tranquilizer
  • β€’
    Stimulates adrenaline release β†’ high blood pressure
  • β€’
    Highly toxic
❖ Effects:
  • β€’
    Cramps
  • β€’
    Vomiting
  • β€’
    Diarrhoea
  • β€’
    Dizziness
  • β€’
    Confusion
  • β€’
    Tremors
  • β€’
    Stimulates nerve impulses
  • β€’
    Muscle relaxation
  • β€’
    Increased heart rate
  • β€’
    Pregnancy β†’ foetal growth retardation
β–’ Tobacco Chewing: Mouth cancer common among tobacco chewers
β–’ Tobacco Smoke Contents:
  • β€’
    Carbon monoxide
  • β€’
    Polycyclic hydrocarbons β†’ carcinogenic
  • β€’
    Tar
β–’ Harmful Effects of Smoking:

Table 1: Smoking Effects

System
Diseases / Effects
Respiratory system
Lung cancer, bronchitis, emphysema
Cardiovascular system
Coronary artery disease, peripheral vascular disease
Lung airways
Smoke particles irritate airways β†’ excess mucus secretion
Alveoli
Alveolar wall damage + coalescence β†’ reduced lung efficiency
Dependence
Physiological dependence + withdrawal symptoms
πŸ“š
DRUG ABUSE
β–’ Introduction:
  • β€’
    Drug = chemical substance altering body function
  • β€’
    French drogue = dry herb
  • β€’
    Drugs may prevent / cure disease when medically prescribed
  • β€’
    Repeated misuse can cause drug dependence / addiction
β–’ Drug Dependence:

Table 1: Forms of Drug Dependence

Type
Meaning
Physical dependence
Drug needed to maintain bodily comfort; stopping causes withdrawal
Psychological dependence
Drug needed for mental / emotional comfort; withdrawal may be severe
β–’ Psychotropic / Mood-Altering Drugs: Act on brain β†’ alter behaviour, consciousness, perception
πŸ“š
SEDATIVES & TRANQUILIZERS
β–’ General:
  • β€’
    Depress brain activity
  • β€’
    Act on cerebral cortex, midbrain, hindbrain
  • β€’
    Reduce anxiety
  • β€’
    Induce drowsiness / sleep
β–’ Sedatives:
  • β€’
    Produce calmness, relaxation, drowsiness
  • β€’
    High dose β†’ sleep
  • β€’
    Important sedative-hypnotics β†’ barbiturates
β–’ Barbiturate Examples:
  • β€’
    Nembutal
  • β€’
    Seconal
  • β€’
    Tuinal
  • β€’
    Amytal
β–’ Tranquilizers / Anxiolytics:
  • β€’
    Reduce tension + anxiety without inducing sleep
  • β€’
    Examples β†’ benzodiazepines, chlorpromazine, phenothiazine
πŸ“š
OPIOIDS / NARCOTICS
β–’ Opium:
  • β€’
    Obtained from unripe seed pods of poppy plant Papaver somniferum
  • β€’
    Analgesic / painkiller effect
  • β€’
    May reduce anxiety + tension
  • β€’
    Lowers blood pressure + breathing rate
  • β€’
    Opium derivatives β†’ codeine, morphine, heroin
  • β€’
    Narcotic β†’ narco = sleep
β–’ Opium Derivatives:

Table 1: Opioid Derivatives

Drug
Point
Codeine
Milder than morphine; used medically in cough syrup
Morphine
Sleep + dream-inducing properties
Heroin
Highly addictive and dangerous narcotic
Brown sugar
Diacetylmorphine hydrochloride; stronger analgesic than morphine
β–’ Dependence: Repeated narcotic use can cause addiction; abrupt discontinuation in heavy addiction causes severe withdrawal
πŸ“š
STIMULANTS
β–’ Introduction:
  • β€’
    Temporarily ↑ mental alertness
  • β€’
    ↑ self-confidence
  • β€’
    ↑ excitement
  • β€’
    Mood elevators
  • β€’
    Increase nerve activity by initiating noradrenaline release
β–’ Mild Stimulant:
❖ Caffeine:
  • β€’
    Present in coffee, tea, chocolate, colas
  • β€’
    Stimulates nerve-cell metabolism
  • β€’
    ↑ alertness
  • β€’
    ↓ fatigue + boredom
  • β€’
    ↑ heart rate
  • β€’
    ↑ blood pressure
  • β€’
    ↑ urine formation
❖ Caffeinism:
  • β€’
    Due to very large coffee intake
  • β€’
    Symptoms β†’ insomnia, high blood pressure, increased body temperature
  • β€’
    Withdrawal β†’ headache, irritability
β–’ Strong Stimulants:

Table 1: Strong Stimulants

Drug group
Examples / Source
Effects
Amphetamines
Benzedrine, Dexedrine, Methedrine
Similar to epinephrine; burst of energy; overcomes fatigue
Cocaine
Alkaloid from Erythroxylon coca
Interferes with dopamine transport; severe toxicity possible
Crack
Purified cocaine
Can cause seizures + cardiac arrest
πŸ“š
HALLUCINOGENS / PSYCHEDELIC DRUGS
β–’ Introduction:
  • β€’
    Also called psychedelic drugs
  • β€’
    Examples β†’ LSD, marijuana, mescaline, psilocybin
  • β€’
    Strong effect on cerebrum + sense organs
  • β€’
    Cause fantasy / false temporary happiness
  • β€’
    Alter thoughts, feelings, perceptions
β–’ LSD:
  • β€’
    Lysergic acid diethylamide
  • β€’
    Dangerous hallucinogen
  • β€’
    Synthesized from lysergic acid produced by ergot fungus Claviceps purpurea
  • β€’
    Ergot fungus parasitic on cereal grains e.g. rye
  • β€’
    Initial effects β†’ weakness, dizziness, nausea
  • β€’
    Later β†’ distortion of time + space
β–’ Marijuana:
  • β€’
    Active chemicals β†’ tetrahydrocannabinols / THC
  • β€’
    THC highest in hashish
  • β€’
    Hashish = concentrated resinous exudate from marijuana plant
  • β€’
    Smoke irritates lungs
  • β€’
    Regular use may cause bronchitis
  • β€’
    Temporarily reduces sperm production
  • β€’
    May cause abnormal sperm
  • β€’
    Causes hallucination, forgetfulness, reduced mental agility
β–’ Indian Hemp Preparations:
  • β€’
    Ganja
  • β€’
    Bhang
  • β€’
    Charas
  • β€’
    Hashish
β–’ Other Hallucinogenic Plants:
  • β€’
    Atropa belladonna
  • β€’
    Datura
πŸ“š
HIGH-YIELD RECALL

Table 1: Communicable + Non-Communicable Disease One-Liners

Fact
Answer
Communicable disease agents
Bacteria, viruses, fungi, protozoans, helminthes
Dermotropic viral diseases
Skin
Viscerotropic viral diseases
Blood + visceral organs
Pneumotropic viral diseases
Respiratory system
Neurotropic viral diseases
CNS
AIDS agent
HIV
HIV type common
HIV-1
HIV enzyme
Reverse transcriptase
HIV target
CD4 / Helper T-cells
CD4:CD8 in AIDS
2:1 β†’ 1:2
HIV screening test
ELISA
HIV confirmatory test
Western blot
World AIDS Day
1st December
TB agent
Mycobacterium tuberculosis
TB discoverer
Robert Koch
TB stain
Ziehl-Neelsen / AFB
TB not detected by
Gram stain
TB vaccine
BCG
TB Day
24th March
Ghon complex
Ghon focus + hilar lymph nodes
DOTS Nepal launch
April 1996
Typhoid agent
Salmonella typhi
Typhoid route
Faeco-oral
Typhoid fever pattern
Step-ladder fever
Typhoid test 2nd week
Widal test
Typhoid chronic carrier site
Gall bladder + biliary tree
Giardia habitat
Duodenum + upper jejunum
Giardia infective forms
Trophozoite + cyst
Adult diarrhoea commonest cause
Giardiasis
Child diarrhoea commonest cause
Rotavirus
Ascariasis agent
Ascaris lumbricoides
Ascaris habitat
Jejunum
Ascaris infective stage
Embryonated egg
Commonest worm infection in Nepal
Ascariasis
Cancer study
Oncology
Cancer key defect
Loss of contact inhibition
Spread of cancer
Metastasis
Epithelial cancer
Carcinoma
Connective tissue cancer
Sarcoma
Cervical cancer virus
HPV
Burkitt lymphoma virus
EBV
Kaposi sarcoma virus
HHV-8
Liver cancer viruses
HBV + HCV
Cancer diagnosis gold method
Biopsy
Cancer immunotherapy
Ξ±-interferon
Alcohol metabolism
Alcohol β†’ acetaldehyde β†’ acetic acid β†’ COβ‚‚ + water
Alcohol CNS action
Depressant
Alcohol affects balance via
Cerebellum
Alcohol ↓ hormone
ADH
Alcohol marker
GGT
Tobacco plant
Nicotiana tabacum / Nicotiana rustica
Tobacco family
Solanaceae
Addictive substance in tobacco
Nicotine
Tobacco smoke carcinogens
Polycyclic hydrocarbons + tar
Drug dependence types
Physical + psychological
Caffeine withdrawal
Headache + irritability
Opium plant
Papaver somniferum
Cocaine plant
Erythroxylon coca
LSD fungus source
Claviceps purpurea
Marijuana active chemical
THC
Q1.
On which date is World Tuberculosis Day celebrated? [IOM]
Q2.
World health day is celebrated in : [BPKIHS 2012]
πŸ“…BPKIHS 2012
Q3.
World tobacco day is celebrated in : [BPKIHS 2012]
πŸ“…BPKIHS 2012
Q4.
Prolonged use of alcohol in excess leads to [IOM - 2004]
πŸ“…IOM - 2004
Q5.
Paraplegic refers to paralysis of [MOE-2063]
πŸ“…MOE-2063
Q6.
SAARC Tuberculosis Center is present in: [IOM]
Q7.
Which of the following diseases is considered to be the Koch's disease? [IOM]
Q8.
Rifampicin is used to cure [IOM - 2000]
πŸ“…IOM - 2000
Q9.
Isoniazid is the drug for the disease: [IOM]
Q10.
Most common helminthic/worm infestation in Nepal [IOM -1992]
πŸ“…IOM - 1992
Q11.
Infective form of Ascariasis is: [IOM]
Q12.
In different surveys done in primary schools of Kathmandu valley, majority of the children were found to be infested with: [IOM]
Q13.
Ascariasis is caused by [KU 2010]
πŸ“…KU 2010
Q14.
Which of the following statements about Ascaris infestation is incorrect? [IOM -1998]
πŸ“…IOM - 1998
Q15.
All are true for Ascariasis except [IOM -1997]
πŸ“…IOM - 1997
Q16.
The commonest worm infestation in school children in Kathmandu is: [IOM]
Q17.
Which of the following drugs is used in ascariasis? [IOM - 1992]
πŸ“…IOM - 1992
Q18.
In an stool examination, eggs of a worm are found. The egg is bilestained and the egg shell is thick with irregular albuminous coat which is mammillated. The stool may contain: [IOM ]
Q19.
Anemia may be caused by [KU 2012]
πŸ“…KU 2012
Q20.
The causative agent of AIDS is [IOM - 1992]
πŸ“…IOM - 1992
Q21.
Which of the following has a high risk of getting AIDS? [IOM 1992]
πŸ“…IOM 1992
Q22.
Who among the following has the highest probability of infection with AIDS? [IOM 1992]
πŸ“…IOM 1992
Q23.
Tattoo may lead to transmission of [IOM 1996]
πŸ“…IOM 1996
Q24.
The major group of cells depleted in AIDS is: [IOM]
Q25.
In AIDS patient, which one is common? [IOM]
Q26.
Which of the following cells does the AIDS virus attack? [IOM - 1995]
πŸ“…IOM - 1995
Q27.
Recent study done among intravenous drug users in Kathmandu valley revealed that 70% of them are HIV positive. What will be your priority programme to prevent further transmission of HIV among the drug users? [IOM]
Q28.
HIV virus can be transmitted by all except: [IOM]
Q29.
The seroconversion test of AIDS occurs positive at about [IOM - 1996]
πŸ“…IOM - 1996
Q30.
The incorrect statement about AIDS is [IOM - 1998]
πŸ“…IOM - 1998
Q31.
The disease caused by virus is [MOE 2069]
πŸ“…MOE 2069
Q32.
Which disease is transmitted by faeco-oral route? [BPKIHS 2012]
πŸ“…BPKIHS 2012
Q33.
Causative agent of Typhoid in humans is: [MOE 2069]
πŸ“…MOE 2069
Q34.
Salmonella typhi mainly affects [KU 2009]
πŸ“…KU 2009
Q35.
Typhoid is the disease in which there is the infection of [IOM-2005]
πŸ“…IOM-2005
Q36.
Coffee contains a substance which stimulates the nervous system called [MOE 2009, IOM - 1995]
πŸ“…MOE 2009β€’IOM - 1995
Q37.
PAP smear examination is used in the detection of [IOM - 2003]
πŸ“…IOM - 2003
Q38.
A 17-year-old obese girl developed wrinkles in face, armpit and thigh. What could be the probable cause? [IOM - 1995]
πŸ“…IOM - 1995
Q39.
Which of the following is a narcotic? [IOM]
Q40.
Which of the following is not a psychoactive drug? [IOM]
Q41.
Sense of well being, alertness and confidence is accelerated by [IE - 2001]
πŸ“…IE - 2001
Q42.
Alcohol absorption in our body is mainly from: [IOM - 2003]
πŸ“…IOM - 2003
Q43.
A man will die if he drinks more than .... ml of pure methanol. [IOM - 1993]
πŸ“…IOM - 1993
Q44.
.... harbors highest percentage of female smokers in the world. [IOM]
Q45.
Smoking is the causative factor of [IOM-2003]
πŸ“…IOM-2003
Q46.
Addiction of cigarettes is mainly due to [IOM 1996]
πŸ“…IOM 1996
Q47.
The elevated level of the enzyme..in serum is found particularly in chronic alcoholics. [IOM]
Q48.
Chronic alcohol use may harm the following part of our body: [IOM]
Q49.
HIV invades [IOM-2014]
πŸ“…IOM-2014
Q50.
Alpha-interferon and lamivudin are used in treatment of: [IOM-2014]
πŸ“…IOM-2014
Q51.
Fatty liver syndrome is due to: [IOM-2014]
πŸ“…IOM-2014
Q52.
Constriction of pupil and low respiratory rate is caused by [BPKIHS -2013]
πŸ“…BPKIHS -2013
Q53.
Which disease is also known as consumption disease [BPKIHS-2014]
πŸ“…BPKIHS-2014
Q54.
PEP in HIV refers to: [BPKIHS -2014]
πŸ“…BPKIHS -2014
Q55.
Typhoid in human being is caused by: [IOM-2013]
πŸ“…IOM-2013
Q56.
Zeil-Neil test is used for: [BPKIHS -2016]
πŸ“…BPKIHS -2016
Q57.
Hensen's disease is: [BPKIHS -2016]
πŸ“…BPKIHS -2016
Q58.
Barbiturates and benzodiazepine are examples of: [IOM-2015]
πŸ“…IOM-2015
Q59.
Mycolic acid is present in: [BPKIHS -2016]
πŸ“…BPKIHS -2016
Q60.
Causative agent of typhoid in human is : [MOE 2012]
πŸ“…MOE 2012
Q61.
Sarcoma is the cancer of [MOE 2014]
πŸ“…MOE 2014
Q62.
When TB is associated with AIDS: [KU 2014]
πŸ“…KU 2014
Q63.
Which of these following is correct? [KU 2013]
πŸ“…KU 2013
Q64.
DOTS stands for [KU 2011]
πŸ“…KU 2011
Q65.
Mycobacterium causes [KU 2011]
πŸ“…KU 2011