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Final exam review questions 1. 2. 3. 4. 5. Name a disease that is endemic in some areas and epidemic in others.

(cholera) Malnutrition is correlated with the prevalence of which disease? (cholera) What is rice water? (diarrhea caused by cholera) What is miasma? (bad air, formerly believed to cause disease) Why is cholera an indicator of social development? (it is preventable with good nutrition and clean drinking water) 6. How did Florence Nightingale use miasma theory to better the health of soldiers in the Crimean war? What did she actually do? (she cleaned up the smell in the hospital, actually removing many of the germs) 7. Which was invented first, the flush toilet or the modern sewer system? (flush toilet) 8. What was Joseph Bazalgettes contribution to public health? (he engineered the sewer system of London, reducing the risk of cholera and other water-borne diseases) 9. What did John Snow discover? (cholera was spread through contaminated water; evidence for contagion theory) 10. Why did Max Joseph von Pettenkofer drink culture fluids of cholera? What happened to him? (To prove that cholera wasnt spread through contaminated water; he did not get cholera because he was well-fed and healthy) 11. Gerbils are illegal pets in California because they can carry what disease? (tuberculosis) 12. Pasteurization of milk was invented to control the spread of what disease? (tuberculosis) 13. Relative to other bacteria, is the reproductive rate of Mycobacterium tuberculosis fast or slow? For this reason, what nickname has the disease received? (slow; consumption) 14. What is the first antibiotic to be discovered and widely used? When did this happen? (penicillin; 1940s, WWII era) 15. What is peptidoglycan? What types of bacteria produce a great deal of this compound? (a component of the cell wall; gram positive bacteria) 16. What are the three ways that antibiotic resistance can appear in bacteria? Define each. (Transformation bacteria uptake pieces of DNA from the environment; conjugation plasmid transfer between bacteria; transduction viral delivery of genetic information from one bacteria to another) 17. What is the R-plasmid? (a bacterial plasmid that contains resistance genes for numerous types of antibiotics) 18. Name one disease that is currently zoonotic. Name one that was probably originally zoonotic but no longer is. (rabies, Lyme, bubonic plague, etc; tuberculosis, HIV, most others) 19. Yersinia pestis causes what bacterial disease? (bubonic plague) 20. What is a bubo? (swollen lymph node) 21. What are the two theories about the cause of the Black Death in the 14th century? (bubonic plague transmitted by fleas; something (viral?) transmitted between people, like a hemorrhagic disease) 22. What disease outbreak may have been caused by the pessimism and hedonism in the wake of the Black Death? (syphilis) 23. What are some of the assumptions in the most basic SIR model? (no vector, instantaneous incubation period, microparasite, direct human to human transmission, short time scale relative to human lifespan, random mixing of people)

24. Rank in order of greatest to least R0: smallpox, measles, influenza, chicken pox, Ebola. (measles>chicken pox>smallpox>influenza>Ebola) 25. How was eradication of smallpox accomplished in areas like rural Bangladesh, where people are hard to reach by public health campaigns? (ring vaccination) 26. What is the most contagious known disease? (measles) 27. Bell's Palsy is a symptom of which disease? (Lyme disease) 28. The leprosy-causing bacteria can only be cultured on the foot pad of a nine-banded armadillo. This is an example of a short-coming of which set of postulates? (Koch's) 29. How many times does a tick feed in its life? (three times: as larva, nymph, and adult) 30. The bites from which life stage of the tick pose the greatest threat for humans to contract Lyme disease? (nymphal; larvae are always uninfected, and adult bites are easily detected so treatment can occur early) 31. What adaptation did the Vibrio cholerae bacteria undergo to allow the El Tor strain to cause a cholera epidemic in Peru? (bacteria survive dormant in the plankton (copepods), transported by ballast water from China, infect shellfish who filter-feed, and contaminate ceviche) 32. What was the cheap and easy cholera-prevention tool that Rita Colwell proposed? (filtration of water through cloth) 33. How did the Bolivian revolution and land reform indirectly cause an outbreak of Machupo virus, or Bolivian hemorrhagic fever? (peasants owned the landcattle companies pulled out of the areapeasants turned to subsistence agriculturepeasants clear landmice invade housesmouse urine infects humans with Machupo virus) 34. What other virus is spread in mouse urine in the US? (Hantavirus, or Sin Nombre) 35. Why is war linked with typhus fever outbreaks? (crowding of soldiers and reduced hygiene lead to louse infestations, which vector the disease) 36. What biological agent causes Mad Cow Disease? How is it spread between cows? (a prion, or misshapen protein that perverts other proteins and causes them to clump together; when cows are fed rendered cow parts they acquire the prion) 37. How did workers in Germany become infected with the Marburg virus? (contact with infected monkeys = spillover) 38. What is so scary about the Reston Ebola virus, which was discovered in 1989 in macaques in Reston, VA? (it is airborne and has extremely high mortality) 39. Can you get an iatrogenic infection from visiting your grandmother in the hospital? Why or why not? (no, you need to undergo a medical procedure for it to be iatrogenic, otherwise it is just nosocomial) 40. Name that superbug: This infection kills more people than AIDS. (MRSA methicillin resistant Staphylococcus aureus) 41. What is DOTS and how does it work? (Directly observed treatment shortcourse treatment for Tb that involves watching people take their antibiotic does for 6 to 8 months) 42. Which of the following diseases is studied at BSL 3? BSL 4? Ebola, Hantavirus, SARS, anthrax, HIV (BSL 3: SARS, anthrax; BSL 4: Hantavirus, Ebola; BSL 2: HIV) 43. How many times has HIV jumped from primates to humans? (at least 2, up to 5) 44. What is HAART? (Highly active antiretroviral treatment AIDS treatment) 45. What is apoptosis, and how does HIV use it to kill T-cells? (programmed cell death; T-cells recognize that they are infected and kill themselves)

46. Who is the definitive host of the Plasmodium parasite that causes malaria? (the mosquito, where the sexual reproduction occurs) 47. Why dont we have malaria in the U.S.? (We eliminated it by draining swamps and spraying with DDT) 48. During the Spanish-American war of 1898, what killed 469 people? What killed 2,000 people? (combat; disease, mostly malaria) 49. Who first discovered parasites in the blood of people with malaria? (Charles Laveran) 50. Who first confirmed that malaria and yellow fever were transmitted by mosquitoes? (Walter Reed) 51. What did the US Army do to control malaria and yellow fever during the Panama Canal project? (fumigate every building with sulfur, oil the surface of water to kill larvae, quarantine infected people in screened structures, protect workers from mosquitoes) 52. Why is malaria hard to eradicate? (animal reservoirs, vectors, no vaccine, no lifelong immunity, mosquito resistance to DDT, parasite resistance to drugs, political issues with DDT, association with poverty) 53. What are the two most likely candidates for the next disease to be eradicated? (polio and guinea worm) 54. What is the causal agent of polio? (a virus) 55. Why did epidemics of paralysis caused by polio increase in the 1900s? (increased sanitation decreased childhood exposure decreased immunity more likely to get paralytic infections as an adult) 56. Who created the polio vaccine? (Jonas Salk) 57. What is the difference between antigen drift and antigen shift? Which one is more likely to cause an influenza pandemic? (drift = small changes; shift = major change in antigens; antigen shift can cause pandemic) 58. What killed 50-100 million people worldwide in 1918? (Spanish influenza pandemic) 59. Which people were most susceptible to death during the Spanish influenza pandemic? Which people are most susceptible to death by non-pandemic flu? (young adults; the very old and very young) 60. What animal acts as the conduit by which bird flus get to humans? (pig; reassortment of human and bird flus occurs in pig cells coinfected with both) 61. Which has a higher mortality: Ebola or a non-pandemic flu? Which has a higher morbidity? (Ebola has higher mortality, non-pandemic flu has a higher morbidity; pandemic flu has high mortality and morbidity)

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