Modern Medicine Flashcards
All 55 cards in this deck
What were mobile X-ray units used for on the Western Front in the First World War?
They were set up close to the front to identify shrapnel fragments so they could be removed before the wound became infected.
Why was a blood bank created before the Battle of Cambrai (1917)?
In anticipation of heavy casualties, so transfusions were available to stop soldiers dying from blood loss.
Who discovered blood groups, and in what year?
Karl Landsteiner, in 1901.
How were the earliest blood transfusions in the First World War carried out?
With a syringe and tube, donor-to-patient with the donor present, to stop the patient going into shock from blood loss.
Which researchers found ways of storing blood during the First World War?
Lewisohn (sodium citrate stopped blood clotting, 1915), Weil (refrigerated citrated blood, 1915), and Rous and Turner (a citrate-glucose solution that kept blood for weeks, 1916).
Why was storing blood a problem before the First World War?
Blood clotted very quickly once outside the body, so it could not be kept.
Who discovered x-rays, and when?
Wilhelm Roentgen, in 1895.
Give two lifestyle factors now known to affect a person's health.
Smoking and poor diet (also alcohol and lack of exercise).
When was the NHS set up, and what did it provide?
- Treatment from GPs and hospitals funded by taxes and free at the point of delivery, so accessible to all.
Give two examples of high-tech surgical treatment in modern hospitals.
Organ transplants and keyhole (or robotic) surgery.
Name two government lifestyle campaigns used to prevent illness in modern Britain.
The '5 a day' healthy eating campaign and anti-smoking / stop smoking campaigns.
What did Alexander Fleming discover in 1928?
Penicillin — he noticed a mould killing the bacteria in a Petri dish in his laboratory at St Mary's Hospital, London.
What was the contribution of Florey and Chain to penicillin?
From 1939 at Oxford they purified penicillin and proved it worked on patients (Albert Alexander, 1941), then won funding to mass produce it.
Why was penicillin mass produced from 1942–44?
The US government funded drug companies to make it for wounded troops after America entered the war; by D-Day (1944) there was enough for all Allied casualties.
What was the second magic bullet, who developed it, and when?
Prontosil, developed by Gerhard Domagk in 1932. It cured some types of blood poisoning, and its active ingredient (a sulphonamide) was later used against pneumonia.
Why have antibiotic-resistant bacteria become a problem?
Overuse of antibiotics has allowed bacteria to evolve resistance (e.g. MRSA), so some infections are now hard to treat.
Why did Fleming not develop penicillin further after publishing his findings in 1929?
He had no funding to continue, and he did not believe penicillin would work inside a living body.
Why was penicillin hard to produce in large amounts at first?
The mould made only tiny amounts of the drug, so one patient needed vast quantities, grown slowly in many containers, which was costly.
When did British drug companies begin mass-producing penicillin, and why not earlier?
- British factories were too stretched by war production to take it on, so in 1941 Florey had turned to American drug companies instead.
Who shared the 1945 Nobel Prize for Physiology or Medicine for penicillin?
Alexander Fleming, Howard Florey and Ernst Chain.
Who set up the blood bank used at the Battle of Cambrai (1917)?
Oswald Hope Robertson, an American army doctor. He stored 22 units of blood in advance and used it to treat wounded men suffering from shock.
Who led advances in plastic surgery for soldiers with facial wounds?
Harold Gillies, at the Queen's Hospital in Sidcup, Kent, who used skin grafts to rebuild damaged faces.
Give one problem with early x-ray machines.
Any one: the machines were bulky and hard to move; patients could suffer radiation burns or hair loss; exposures took a long time, so patients had to keep very still.
What impact did the mass production of penicillin have on the pharmaceutical industry?
It grew rapidly into a huge, profitable industry, with companies investing in research to find new drugs, e.g. streptomycin (1944) for tuberculosis.
What was the thalidomide tragedy?
A drug given to pregnant women for morning sickness around 1957–61 caused about 10,000 babies to be born with deformed limbs. It led to far stricter drug testing and licensing.
Give two alternative treatments used in Britain today.
Any two: acupuncture, homeopathy, herbal remedies, osteopathy, hypnotherapy.
True or false? Antibiotics can be used to treat viral infections such as flu.
False. Antibiotics only kill bacteria, and using them when they are not needed helps bacteria become resistant.
Give one way chance played a part in the discovery of penicillin.
Mould spores blew into Fleming's laboratory and landed on a Petri dish he had left out — and he happened to notice that the bacteria around the mould had been killed.
Who carried out the first successful human heart transplant, and when?
Christiaan Barnard, in South Africa in 1967. The patient, Louis Washkansky, lived for 18 days.
What is keyhole surgery?
Surgery carried out through very small cuts using fibre-optic cameras and tiny instruments, so patients recover more quickly.
How are lasers used in modern surgery?
Instead of a scalpel, for very precise cutting and for sealing blood vessels, e.g. in eye surgery.
What is radiation therapy used to treat?
Cancer — radiation is aimed at tumours to destroy the cancer cells.
When was the British National Blood Transfusion Service set up?
1938, building on the advances in transfusion and blood storage made during the First World War.
What was the Thomas (Army Leg) Splint used for in the First World War?
It held a broken leg extended and raised so the bone could mend, cutting deaths from leg wounds. It is still used today.
Who was Charles Booth and what did his survey show?
A businessman whose Life and Labour of the People in London (1889) showed about 35% of people in London's East End lived in poverty, caused by low wages, illness and old age.
Who was Seebohm Rowntree and what did his survey show?
A York businessman whose Poverty: A Study of Town Life (1901) found about 28% of people in York lived below the poverty line, too poor to stay healthy.
Why was the Boer War (1899–1902) important for public health?
About 40% of volunteers were rejected as unfit to serve, alarming the government about the nation's health and helping to bring about the Liberal social reforms.
What did the 1906 Education (Provision of Meals) Act do?
It allowed local councils to provide free school meals for poor children, paid for out of the rates.
What did Part 1 of the National Insurance Act 1911 provide?
Insured workers paid weekly contributions and in return received free treatment from a doctor and sick pay (10 shillings a week for men) for up to 13 weeks. Their families were not covered.
What did evacuation during the Second World War reveal about public health?
City children arrived in the countryside dirty, underfed and ill, which shocked people and increased support for government action on poverty and health.
What were the 'Five Giants' identified in the Beveridge Report (1942)?
Want, disease, ignorance, squalor and idleness.
True or false? NHS treatment has been completely free ever since it was created.
False. Charges for prescriptions, dental care and glasses were brought in during the early 1950s because the NHS cost far more than expected.
Give two issues facing healthcare in Britain in the 21st century.
Any two: an ageing population; the rising cost of new drugs and treatments; lifestyle diseases such as obesity; choosing what the NHS should fund.
True or false? Albert Alexander, the first patient treated with penicillin by Florey and Chain in 1941, made a full recovery.
False. He improved dramatically but the supply of penicillin ran out and he died.
True or false? The main obstacle to successful transplant surgery was the patient's immune system rejecting the new organ.
True. Transplants only became routinely successful once immunosuppressant drugs were used to prevent rejection.
True or false? In the early 1950s Richard Doll's research showed a link between smoking and lung cancer.
True. It alerted people to the need to change their lifestyle and led to government action on smoking.
True or false? The Beveridge Report of 1942 was unpopular with the British public.
False. It was a bestseller, selling over 100,000 copies in its first month, and people expected the government to act on it.
True or false? The NHS was created by Churchill's Conservative government.
False. Labour, led by Clement Attlee, won the 1945 election and set up the NHS in 1948, with Aneurin Bevan as Minister of Health.
Who worked out the structure of DNA, and when?
Francis Crick and James Watson at Cambridge in 1953, helped by Rosalind Franklin's X-ray images. Understanding DNA later led to genetic screening and gene therapy.
Who was Archibald McIndoe?
A New Zealand-born plastic surgeon, a cousin of Gillies, who treated badly burned RAF airmen at East Grinstead in the Second World War, using skin grafts and penicillin; his patients formed the Guinea Pig Club.
What was the first whole organ to be transplanted successfully, and when?
A kidney, in the USA in 1954; the first in Britain was in 1960.
What did the Liberal government introduce in 1908 for the elderly?
Old age pensions, paid from taxes to poorer people over 70 (up to 5 shillings a week).
What did the Liberals introduce in 1907 for schoolchildren's health?
School medical inspections; free treatment for the illnesses they found followed later, from 1912.
How did government act on housing after the First World War?
The 1919 Housing Act made councils build homes for working families ('homes fit for heroes'), and large-scale slum clearance followed in the 1930s.
Give one concession Aneurin Bevan made to win doctors over to the NHS.
Any one: hospital consultants could keep treating private patients, including in 'pay beds' in NHS hospitals; GPs stayed self-employed, paid for each patient on their list rather than becoming salaried state employees.