QALYA quality adjusted life year. QALY
is used by health economists to com-
pare costs and outcomes of treatment
for various diseases. Each year of life
saved or prolonged is adjusted by a fac-
tor, Q, which takes account of how close
to normal is the individual’s lifestyle
before and after treatment.
Q feverAn uncommon illness causing
symptoms similar to influenza. Q fever
occurs throughout the world. It is caused
by the rickettsiaCOXIELLI BURNETTI, and
may be contracted by inhaling dust con-
taminated with faeces, urine, or birth
products from infected animals. Rarely,
it may be spread by tick bites.
Symptoms develop with sudden onset
about 20 days after infection, and include
a high fever, severe headache, muscle
and chest pains, and a cough. A form of
pneumoniathen occurs. In some cases
hepatitisor endocarditis may develop.
Less than 1 per cent of cases are fatal.
After diagnosis is confirmed by a
blood test, treatment is with antibiotic
drugs. There is an effective vaccine.
quackeryA false claim to have the abil-
ity to diagnose and treat disease.
quadrantectomy A surgical procedure
that involves the removal of tissue in
one quadrant of a breast in order to
treat breast cancer. (See also lumpec-
tomy; mastectomy.)
quadriceps muscleA muscle with 4 dis-
tinct parts that is located at the front of
the thigh and straightens the knee. The
most common disorder of the quadriceps
is a haematomacaused by a direct blow.
quadriparesisWeakness of the mus-
cles in all 4 limbs and the trunk. (See
also quadriplegia.)
quadriplegiaParalysisof all 4 limbs and
the trunk. (See also paraplegia.)
quarantineThe isolation of a person or
animal recently exposed to a serious in-
fectious disease. The aim is to prevent
the spread of a disease by infected, but
symptomless, people or animals.
Quarantine procedures are now less
commonly necessary due to the reduced
incidence of most serious infectious
diseases and the availability of vaccina-
tionsfor many of them.
quickeningThe first fetal movements
felt by a pregnant woman, usually after
about 18 weeks’ gestation.
quinineThe oldest drug treatment for
malaria. Quinine is now used mainly to
treat strains of malaria that are resis-
tant to other antimalarial drugs. Large
doses are needed, and there is a high
risk of adverse effects, including head-
ache, nausea, hearing loss, ringing in
the ears, and blurred vision.
Quinine is commonly prescribed in
low doses to help prevent leg cramps at
night; adverse effects are rare.
quinolone drugsA group of antibiotic
drugs, often called antibacterials, that
are used to treat bacterial infections.
Quinolone drugs are derived from
chemicals, rather than living organisms.
Examples include norfloxacin, ciproflox-
acin, and ofloxacin.
Quinolones are used in the treatment
of a wide range of conditions, including
urinary tract infections, acute diarrhoeal
diseases (such as that caused by sal-
monella infections), and enteric fever.
Their absorption is reduced by antacids
containing magnesium and aluminium.
Quinolones should be used with cau-
tion in patients with epilepsy, during
pregnancy and breast-feeding, and in
children and adolescents. Side effects
include nausea, vomiting, diarrhoea,
headache, sleep disorders, dizziness,
rash, and blood disorders.
quinsyAn abscess in the soft tissue
around the tonsils, which is also known
as a peritonsillar abscess.QALY QUINSY
Q