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Exhibition design for St George’s University of London Pathology
Museum• This power point presentation contains work
currently displayed in the Pathology Museum at St George’s University of London.
• The audience: The exhibition was designed as an educational tool for A -Level, ‘Access to Medicine students’ and Medical students at St George’s.
• The exhibition: – Topic: TB– Method: Questions listed in the pamphlet, (see
word document) act to guide students through this interactive exhibition.
– Content: a poster (see subsequent slides), x-rays (mounted on a light box),‘handling specimens’ and specimen pots from the Pathology Museum collections (lungs, brain, liver, kidneys and a half skeleton).
– Each of the specimens pertains to the mode of disease suffered by the patient: ‘Sarah’ .
• See subsequent slides for exhibition content.
The pamphlet
(back and front)
Spec
imen
B
TB w
ith
'col
d ab
sces
s'
form
atio
n in
dor
sal
spin
e
A ‘c
old
absc
ess’
dest
roye
d se
vera
l of S
arah
’s ve
rtebr
ae,
caus
ing
them
to c
olla
pse,
be
nd a
nd fu
se to
one
ano
ther
, re
sulti
ng in
seve
re c
urva
ture
of
her
spin
e.
Spec
imen
C
Cere
bral
tub
ercu
lom
a - T
B m
enin
giti
s.
Whi
te g
ranu
lom
atou
s les
ions
in
side
the
brai
n ca
use
it to
be
com
e in
flam
ed a
nd sw
olle
n.
The
resu
ltant
incr
ease
in
intra
cran
ial p
ress
ure
acco
unts
fo
r Sar
ah’s
seve
re h
eada
ches
, na
usea
and
vom
iting
.
TB Q
uest
ions
How
is M
. tub
ercu
losis
tran
smitt
ed?
Whe
re is
prim
ary
infe
ctio
n es
tabl
ished
? W
hat i
s a tu
berc
ulou
s gra
nulo
ma?
Wha
t trig
gers
seco
ndar
y in
fect
ion?
How
doe
s TB
spre
ad th
roug
h th
e bo
dy?
Can
TB
be c
ured
?
Com
pare
the
spec
imen
s in
the
cabi
net
with
the
hand
ling
spec
imen
s on
the
tabl
eLo
okin
g at
the
lung
s
In li
fe o
ur lu
ngs a
re th
e sit
e of
gas
eous
exch
ange
.
Sque
eze
spon
ge 1
- im
agin
e th
is to
be
what
a
heal
thy
hum
an lu
ng fe
els l
ike.
Desc
ribe
the
text
ure
and
appe
aran
ce?
How
does
it re
late
to a
hea
lthy
lung
?
How
woul
d th
e pr
esen
ce o
f a g
ranu
lom
a aff
ect t
he lu
ng? (
Hint
– fe
el lu
ng 2
)
The
hip
join
t
Desc
ribe
the
appe
aran
ce o
f the
dise
ased
hip
?
Com
parin
g it
with
the
mod
el o
n th
e ta
ble,
ho
w wo
uld
Sara
h’s m
ovem
ent b
een
affec
ted
in li
fe?
The
spin
e
Can
you
see
the
‘S’-s
hape
of t
he sk
elet
on’s
spin
e.
Wha
t has
hap
pene
d to
the
infe
cted
ve
rtebr
ae?
How
may
this
have
effe
cted
Sar
ah’s
mov
emen
t in
life?
The
brai
n
Iden
tify
the
tiny
tube
rcle
s.
Spec
imen
ETB
of t
he lu
ngs
This
is M
iliary
tube
rcul
osis
- tin
y Gr
anul
omas
, res
embl
ing
mille
t see
ds, t
hrou
ghou
t the
lu
ng, c
ausin
g th
e po
rous
tis
sue
to h
arde
n. In
flam
mat
ion
woul
d ha
ve c
ause
d th
e su
rroun
ding
cap
illarie
s to
rupt
ure,
acc
ount
ing
for
Sara
h’s v
iole
nt, b
lood
stai
ned
coug
h.
TU
BER
CU
LOSI
S
The
Path
olog
y M
useu
m
D
isco
ver t
he w
orld
of
in
fect
ious
di
seas
e
Int
rodu
ctio
n
TB is
hig
hly
cont
agio
us.
It
curre
ntly
affe
cts o
ne th
ird o
f th
e W
orld
’s po
pula
tion.
Th
is m
akes
it o
ne o
f the
one
of
the
Wor
ld’s
mos
t im
porta
nt
infe
ctio
us d
iseas
es.
6,
500
case
s are
repo
rted
ever
y ye
ar in
the
UK.
TB
is c
ause
d by
Myc
obac
teriu
m
tube
rcul
osis.
Be
fore
the
disc
over
y of
St
rept
omyc
in in
the
1950
’s TB
was
in
cura
ble.
To
day
TB is
a c
ontro
llabl
e, b
y va
ccin
atio
n an
d cu
rabl
e by
Co
mbi
natio
n Th
erap
y un
der
Dire
ctly
Obs
erve
d Th
erap
y (D
OT).
Tube
rcul
osis
Th
e im
porta
nce
of T
B to
day
Ho
w TB
is tr
ansm
itted
Pr
imar
y in
fect
ion
Gr
anul
oma
form
atio
n
Seco
ndar
y in
fect
ion
Di
ssem
inat
ion
Sy
mpt
oms
Cu
re
Lea
rn m
ore
abou
t:
Cas
e st
udy:
Sar
ah F
inne
gan
Sara
h Fi
nneg
an w
as a
dmitt
ed to
St
Geor
ge’s
Hosp
ital,
on D
ecem
ber t
he 4
th
1945
(age
d 19
yea
rs),
with
a fe
ver,
seve
re
ches
t pai
n an
d a
viol
ent,
bloo
d st
aine
d co
ugh.
She
had
lost
wei
ght a
nd w
as su
fferin
g fro
m
diar
rhoe
a an
d pa
infu
l, fre
quen
t urin
atio
n.
Upo
n ex
amin
atio
n Sa
rah
was p
ale,
re
stle
ss, s
weat
ing,
and
com
plai
ned
of p
ain
in h
er c
hest
, bac
k an
d he
ad.
Ther
e wa
s a
larg
e sw
ellin
g ov
er h
er ri
ght h
ip.
Ches
t x-
ray,
cer
ebro
-spi
nal fl
uid
(CSF
), bl
ood
and
sput
um sa
mpl
es sh
owed
that
Sa
rah
was s
uffer
ing
from
syst
emic
TB,
spec
ifica
lly T
B m
enin
gitis
– in
flam
mat
ion
of
the
brai
n.
With
out e
ffect
ive
antib
iotic
trea
tmen
t, Sa
rah’
s hea
dach
es in
crea
sed
in fr
eque
ncy
and
seve
rity.
Sad
ly, S
arah
slip
ped
into
a
com
a an
d di
ed, f
our w
eeks
afte
r ad
miss
ion.
*Sar
ah F
inne
gan
is a
fictit
ious
cha
ract
er
On th
e ba
lcony
: Pap
worth
Hos
pita
l - A
TB
Sana
toriu
m
Why is TB an important disease to study? TB currently infecting ‘one third of the World’s population (2)’. The World Health Organisation (WHO) has ‘declared TB a public health emergency’ (4).
TB is highly contagious - if left untreated, each infected person will pass TB on to ‘between 10 and 15 people every year’ (7).
TB is not limited to the Developing World. Today, in the UK, over ‘6,500 cases are reported each year.’ (5)
For this reason TB is a ‘notifiable disease’ – by law an incident of TB must be reported to Governmental and Medical authorities to ensure effective treatment and control.
Most importantly - today, TB is both curable and controllable. But, less than 50 years ago, before the discovery of the antibiotic Streptomycin, this was not the case.
Follow the story of Sarah Finnegan to learn more about the transmission, Infection, control and cure of TB.
A Case Study: Sarah Finnegan
She had lost a considerable amount of weight, was suffering from diarrhea and painful, frequent urination.Upon examination Sarah was pale, restless, sweating, and complained of pain in her chest, back and head. There was a large swelling over her right hip.Tests• A chest x-ray • A cerebro-spinal fluid (CSF) sample, taken by lumbar puncture.• Blood sample was taken.• Sputum sample taken.Upon admission, Sarah was given a course of streptomycin. Initially her condition improved, but after a number of weeks Sarah’s headaches became more frequent and severe. Unable to combat the TB that had infected her brain, sadly, Sarah slipped into a coma and died, four weeks after admission.Sarah Finnegan is a fictitious character inspired by the specimens on display in the Pathology Museum. Examine the display specimens to see how Sarah's body may have been affected by TB
On December the 4th 1941 at 21:34, Sarah Finnegan*, aged 19 years, was admitted to St George’s Hospital with a fever (37.8ºC), severe chest pain and a violent cough.
Specimen B
TB with 'cold abscess' formation in dorsal spine
A ‘cold abscess’ destroyed several of Sarah’s vertebrae, causing them to collapse, bend and fuse to one another, resulting in severe curvature of her spine.
Specimen C
Cerebral tuberculoma - TB meningitis.
White granulomatous lesions inside the brain cause it to become inflamed and swollen. The resultant increase in intracranial pressure accounts for Sarah’s severe headaches, nausea and vomiting.
Specimen E
TB of the lungsThis is Miliary tuberculosis - tiny Granulomas, resembling millet seeds, throughout the lung, causing the porous tissue to harden. Inflammation would have caused the surrounding capillaries to rupture, accounting for Sarah’s violent, blood stained cough.
Poster depicting mode of infection in TB