16. Infectious Diseases - Pathologies Flashcards
1
Q
What are systemic symptoms of infectious diseases?
A
Fever
Fatigue
Headache
Nausea
2
Q
What are local signs of infectious diseases?
A
Pain Swelling Redness Warmth Purulent exudate
3
Q
What is a possible complication of an infection?
A
Sepsis (septicaemia)
4
Q
What is sepsis?
A
When a pathogen infects the blood
5
Q
What can sepsis lead to?
A
Multi-organ failure
6
Q
Who is more at risk of developing sepsis?
A
Over 75s <1 yrs Alcoholics Diabetics Chemo patients Those on steroid treatment
7
Q
What are the symptoms of sepsis?
A
Lethargy Nausea/vomiting Abdominal pain Diarrhoea Coughing
8
Q
How can infectious diseases be tested?
A
Culture/staining
Blood tests
Stool tests
Radiography
9
Q
What kind of infections can blood tests detect?
A
Bacterial e.g. leukocytosis
Viral e.g. leukopenia
High erythrocyte sedimentation rate (ESR)
10
Q
What is leukocytosis?
A
High leukocyte count
11
Q
What is leukopenia?
A
Low leukocyte count
12
Q
Cellulitis: definition
A
Bacterial infection of the skin creating inflammation of dermal/subcutaneous layers
13
Q
Erysipelas: definition
A
Bacterial infection of the skin creating inflammation of dermis/upper subcutaneous layer
Well defined edge
14
Q
Cellulitis/Erysipelas: aetiology
A
Bacterial - Staphylococcus aureus. Infections can enter the skin through minor trauma, eczema (itching), IV drug abuse, ulcers
Streptococci bacteria in subject’s own nasal passages
15
Q
Cellulitis/Erysipelas: signs and symptoms
A
Very red, inflamed skin
Fever, malaise
16
Q
Cellulitis/Erysipelas: diagnostics
A
Microbe analysis
Clinical presentation
17
Q
Cellulitis/Erysipelas: allopathic treatment
A
Antibiotics
18
Q
Impetigo: definition
A
Very contagious bacterial skin infection
Common in infants/young adults
19
Q
Impetigo: aetiology
A
Staphylococcus aureus
Haemolytic streptococci
20
Q
Impetigo: signs and symptoms
A
Pustules with round, oozing patches and golden-yellow crusts that grow larger each day
Affects mostly exposed areas - hands/face
Skin folds - particularly armpits
21
Q
Impetigo: allopathic treatment
A
Antibiotics
22
Q
Oral Candidiasis: definition
A
Superficial fungal yeast infection of mucous tissues
23
Q
Oral Candidiasis: aetiology
A
Candida albicans
Often presents after broad spectrum antibiotics
Immune-compromised patients
24
Q
Oral Candidiasis: signs and symptoms
A
White plaques
Dysphagia
Reduced appetite
25
Oral Candidiasis: complications
Can become systemic in immune-compromised patients - deposits on organs
26
Oral Candidiasis: allopathic treatment
Antifungals - topical/oral
| these can impact liver function/damage local skin
27
Genital Candidiasis: definition
Very common fungal infection of the genitals
28
Genital Candidiasis: aetiology
```
Not sex-related (opportunistic)
Immune-compromised patients
Antibiotic treatment
Diabetes mellitus
Pregnancy
Immune system disorders
```
29
Genital Candidiasis: signs and symptoms
Vaginal/genital itch, discomfort, irritation
| Thick, clumpy discharge (cottage cheese)
30
Genital Candidiasis: diagnostics
Physical exam
| Fungal culture/analysis
31
Genital Candidiasis: allopathic treatment
Antifungals - topical/oral
| these can impact liver function/damage local skin
32
Lyme Disease: aetiology
Bacterium - borrelia, transmitted by tick bites
33
Lyme Disease: signs and symptoms
Different bacterial strains cause different clinical manifestations (differences between Europe and USA)
Circular pink/red rash at site of tick attachment that radiates over 5cm away
Flu-like symptoms - can lead to neurological disease, cardiovascular disease and arthritis if not treated
34
Lyme Disease: allopathic treatment
Antibiotics
35
Diphtheria: definition
Highly contagious upper respiratory tract infection affecting primarily the nose and throat
36
Diphtheria: aetiology
Bacterial - Corynebacterium diphtheriae (gram positive), transmitted by droplets
37
Diphtheria: signs and symptoms
Sore throat and fever
Grey membrane (necrosis) grows across the tonsils, pharynx, nose (impairs breathing)
Enlarged cervical lymph nodes
38
Diphtheria: complications
Exotoxins cause endothelial necrosis by inhibiting protein synthesis
Can cause myocarditis and paralyse diaphragm
The membrane can block the airways
39
Diphtheria: allopathic treatment
Medical emergency
Anti-toxins
Antibiotics
Respirator
40
Scarlet Fever: definition
Infectious disease resulting from exotoxins released by Streptococci pyogenes bacteria
Usually occurs in children (90% <10yrs)
41
Scarlet Fever: pathophysiology
Bacteria secrete haemolytic enzymes and exotoxins (damage capillaries which both cause red rash)
42
Scarlet Fever: aetiology
Streptococci pyogenes bacteria (haemolytic streptococcus)
43
Scarlet Fever: transmission
Droplets
44
Scarlet Fever: incubation time
3-4 days incubation
45
Scarlet Fever: signs and symptoms
Sore throat, fever, scarlet rash (blanches under pressure)
Haemorrhagic spots on palate
First 2 days - white tongue with red papillae
After this - more raw/red
46
Scarlet Fever: allopathic treatment
Antibiotics
47
Cold Sores: definition
Viral infection causing small blisters around mouth/on lips
48
Cold Sores: pathophysiology
When immunity is low, the virus migrates along the nerve (often the trigeminal) to the skin/mucosa around mouth causing tingling/burning sensation
49
Cold Sores: aetiology
Herpes simplex virus (Type I)
Stress
Drugs - steroids
Trauma, local infections, sunlight exposure
50
Cold Sores: transmission
Direct contact or indirect - saliva
51
Cold Sores: signs and symptoms
Commonly asymptomatic
Tingling, itching, burning sensation around the mouth
Small, fluid filled sores that appear most commonly on lower lip
52
Cold Sores: allopathic treatment
Antiviral cream - acyclovir
53
Who is mainly affected by chicken pox?
Mostly affects children (90%)
54
Chicken Pox: aetiology
Varicella zoster virus (part of herpes family)
55
Chicken Pox: transmission/incubation time
Droplets into upper respiratory tract mucosa
Direct contact
2-3 weeks incubation
56
Chicken Pox: signs and symptoms
Prodromal fever and malaise
Vesicular eruptions on the skin appear over 3-5 days mostly on head/truck.
Itchy
Infective 2 days before rash until all lesions at 'crusting'
57
Chicken Pox: complications
Infection because of scratching
Encephalitis
Viral pneumonia
58
Chicken Pox: allopathic treatments
None
59
Shingles: definition
Infection by the varicella zoster virus following chicken pox infection
60
Shingles: aetiology
Varicella zoster virus - travels down infected nerve causing neuritis (nerve inflammation) in an immune-compromised individual
61
Shingles: signs and symptoms
1-2 days before rash - burning, itching, tingling
Eruptive phase - skin lesions similar to chicken pox (affecting head/face), causing severe dermatomal pain, altered sensation and vesicular rash
62
Shingles: allopathic treatment
Antiviral cream - acyclovir
63
Whooping Cough: definition
Bacterial infection with characteristic coughing attacks where there's a desperate attempt to breathe in
64
Whooping Cough: aetiology
Bacterial - Bordetella pertussis
65
Whooping Cough: signs and symptoms
Initial 1-2 weeks flu like symptoms
Then, a cough that doesn't respond to usual cough medication
Cough gets worse and presents with attacks (for 3-6 weeks)
66
Whooping Cough: complications
Pneumonia
Rib fracture
Death
67
Tuberculosis: definition
Systemic infection
| Granulomatous disease
68
Tuberculosis: pathophysiology
Macrophages in the lungs engulf the bacteria and carry them to the hilar lymph nodes
Some organisms can spread to distant areas
80% of cases the granulomas formed will be eliminated by the immune system. If not, the bacteria can become active immediately, later, or may remain dormant
Can affect lungs but also CNS, lymph, circulation, genitourinary, bones, joints, skin
69
Tuberculosis: transmission
Droplets
Inspiration of dust
Dry excretions
Contaminated milk
70
Tuberculosis: signs and symptoms
Pulmonary TB: fever, chronic cough, purulent/bloody sputum, night sweats, severe malaise, weight loss, anorexia
71
Tuberculosis: diagnostics
Blood tests - high ESR, leukocytosis
| X-rays, other imaging
72
Tuberculosis: allopathic treatment
Antibiotics for 6 months
73
Measles: definition
Acute and very infectious viral disease mainly in children
74
Measles: aetiology
Measles virus
75
Measles: transmission/incubation
Droplets
| 11 days incubation
76
Measles: signs and symptoms
3-5 days - non-specific cold symptoms
Koplik spots - small grey spots on oral mucosa opposite molar teeth
Eruptive phase - measles-like rash that initially begins on face/forehead
Rash fades within 1 week (contagious 4 days before and after rash)
77
Measles: complications
Middle ear infection
Pneumonia
Encephalitis
78
Measles: allopathic treatment
No specific treatment
79
Mumps: definition
Acute, viral infection causing swelling of the parotid/salivary glands
80
Mumps: aetiology
Mumps virus
81
Mumps: signs and symptoms
```
Feeling unwell
Fever
Head and joint pains
Swollen parotid glands
First one then both sides
```
82
Mumps: complications
After puberty, about 30% of males get testicular inflammation
83
Rubella: definition
Rare, harmless viral infection
84
Rubella: signs and symptoms`
Sore throat, fever, headache
Petechiae on hard palate
Pink rash with small macules that starts on face and behind ears
85
Rubella: complications
Abnormal foetal development
| Miscarriage
86
Viral Hepatitis: definition
Acute viral infection of the liver
87
Viral Hepatitis: aetiology
Hepatitis virus (types A, B, C, D, E)
88
Viral Hepatitis: transmission
A/E - faecal-oral
| B/C/D - blood, other bodily fluids
89
Viral Hepatitis: signs and symptoms
1. Pre-icteric stage - malaise, diarrhoea
| 2. Icteric stage - jaundice, pale stools, dark urine, pruritic skin, enlarged liver, impaired blood clotting
90
Viral Hepatitis: diagnostics
Blood test - liver function
91
Viral Hepatitis: complications
Chronic liver disease - cirrhosis, liver cancer
92
Viral Hepatitis: allopathic treatment
Limited - antiviral therapy
| Hep B vaccine in vulnerable groups
93
HIV (Human immunodeficiency virus): definition
An STI which attacks the immune system
| Retrovirus - a double-strand RNA virus
94
AIDS (Acquired immune deficiency syndrome): definition
Later stages of HIV when the immune system is severely impaired and life-threatening
95
HIV (Human immunodeficiency virus): pathophysiology
HIV binds to CD4 receptors
Viral envelope and cell membrane fuse and viral RNA enters the cell
Converted by 'reverse transcriptase' enzyme into viral DNA
Using integrase, it integrates into the host cell DNA
Viral DNA forces the host cell to produce viral RNA and proteins
Assembles in cytoplasm and buds off
As viral load goes up, T-cell count goes down
Can mutate, destroys CD4 cells leading to immune compromise
96
HIV (Human immunodeficiency virus): transmission
Primarily through blood and semen (unprotected anal sex)
Low risk with saliva and vaginal secretions
NOT transmitted by casual contact
Risk of transmission during pregnancy/breastfeeding
Increase in heterosexual transmission
6-7% intravenous drug use
97
HIV (Human immunodeficiency virus): signs and symptoms
1. Initial stages - 1-6 weeks after infection
50% asymptomatic
Flu/glandular fever-like sore throat, fever, malaise, muscle/joint pain, swollen lymph nodes
Negative antibody (IgG tests) but viral RNA high
2. Late stage - huge reduction in CD4 count and rise in viral load
Severely impaired immune function
Opportunistic infections
Fatigue, anaemia, anorexia
Neurological disease with no other cause
Peripheral neuropathy
Neutropenia, thrombocytopenia
Dementia
Cognitive/motor dysfunction
98
HIV (Human immunodeficiency virus): diagnostics
Blood tests - antibodies
99
HIV (Human immunodeficiency virus): opportunistic infections CD4 <500
Herpes infections
Candidiasis
Kaposi's sarcoma
100
HIV (Human immunodeficiency virus): opportunistic infections CD4 <200
Toxoplasmosis, pneumonia
101
HIV (Human immunodeficiency virus): opportunistic infections CD4 <50
Severe mycobacterium infection
| HIV dementia
102
HIV (Human immunodeficiency virus): prognosis
Increased with highly active anti-retroviral therapy (HAART)
| Anti-retrovirals increases life expectancy but causes a variety of adverse effects due to high toxicity from the drugs
103
Dysentery: definition
Infection of the intestines that causes diarrhoea containing blood or mucus
104
Dysentery: aetiology
Bacteria - shigella
| Amoebic(protozoa) - via faecal-oral contamination
105
Dysentery: signs and symptoms
Diarrhoea - watery stools with mucus and blood
| Cramping, possible nausea/vomiting
106
Dysentery: diagnostics
Stool microscopy
107
Dysentery: complications
Dehydration - dangerous in small children, infants, pregnancy and elderly
108
Dysentery: allopathic treatment
Antibiotics - anti-parasitic or anti-bacterial
| Rehydration - fluid and mineral replacement
109
Malaria: definition
Tropical infectious disease spread by anopheles mosquitos
| 5 million affected each year
110
Malaria: pathophysiology
Infected female anopheles mosquito bites human
Plasmodium parasites taken up by liver, proliferate and mature. Can lie dormant for up to a year
Spread to erythrocytes and proliferate further. Symptoms begin i.e. fever
Infected cells burst and spread infection
Protozoan gametes are formed and are taken up by another mosquitos during blood meal
111
Malaria: 3 stages of life cycle
1. Mosquito
2. Human liver
3. Erythrocytes
112
Malaria: aetiology
```
Plasmodium species (5 types) - protozoa
Spread by vector/host mosquito
```
113
Malaria: signs and symptoms
Cyclical fever - chills, then fever, followed by extreme sweating and then shivering
Headache, fever, malaise, arthralgia, nausea, vomiting, diarrhoea, anaemia
Splenomegaly, hepatomegaly, jaundice
114
Malaria: complications
Death
| Relapses
115
Malaria: allopathic treatment
Quinine/chloroquine
| Preventative drugs
116
Chlamydia: definition
Very common sexually transmitted infection
| Common <25s
117
Chlamydia: aetiology
Bacterial - Chlamydia trachomatis
118
Chlamydia: incubation
Several weeks incubation
119
Chlamydia: signs and symptoms (males)
50% asymptomatic
Milky white/yellow discharge from penis
Epididymitis
Urethritis
120
Chlamydia: signs and symptoms (females)
80% asymptomatic
Yellow vaginal discharge
Dysuria
121
Chlamydia: diagnostics
Urine
Cervical
Urethral swab tests
122
Chlamydia: complications
Pelvic inflammatory disease
| Risk of infertility
123
Chlamydia: allopathic treatment
Antibiotics
124
Gonorrhoea: definition
Common bacterial STI
125
Gonorrhoea: aetiology
Bacterial - Neisseria gonorrhoea - infects epithelium of GU tract, rectum, pharynx, conjunctiva
126
Gonorrhoea: transmission
Direct - oral, anal, genital sex
| Mother to baby during birth
127
Gonorrhoea: signs and symptoms (male)
90% symptomatic
Yellow penile discharge
Dysuria
128
Gonorrhoea: signs and symptoms (female)
```
50% asymptomatic
Yellow vaginal discharge
Dysuria
Irregular vaginal bleeding
Lower abdominal pain
Pain during sex
```
129
Gonorrhoea: diagnostics
Swab culture of urethra, throat, cervix/rectum
| Presumptive on-the-spot diagnosis often made
130
Gonorrhoea: complications
Permanent complication (particularly women) if untreated
PID
Infertility
131
Gonorrhoea: allopathic treatment
Antibiotics
| Abstain from sexual activity until all clear
132
Genital Herpes: aetiology
Herpes simplex virus (Type II)
133
Genital Herpes: transmission
Direct contact - sexually transmitted
134
Genital Herpes: signs and symptoms
Always symptomatic
After initial infection the viruses move to sensory nerves where they remain latent
Painful vesicles, then shallow ulcers
135
Genital Herpes: allopathic treatment
Antiviral cream - acyclovir
136
Syphilis: definition
Chronic, contagious systemic disease
137
Syphilis: aetiology
Bacterial - Treponema pallidum
138
Syphilis: transmission
Enters body via damaged skin or mucous membranes
Sexual contact
Pregnancy
139
Syphilis: signs and symptoms
1. Hard, painless ulcer on infection point. Heals and becomes asymptomatic
2. Flat, erythematous rash (v. contagious), potentially covering whole body. Not itchy. Lasts several weeks
3. Latent stage - no symptoms but untreated person may remain infectious for up to 2 years
4. Years later if left untreated can lead to chronic gummas (granulomas), neurological syphilis, cardiovascular syphilis
140
Syphilis: allopathic treatment
Penicillin
| Avoid sex until all clear
141
Genital Warts: aetiology
Human papillomavirus (HPV)
142
Genital Warts: incubation
Up to 6 months incubation
143
Genital Warts: signs and symptoms
Soft, fleshy projections
Cauliflower-like masses
Small pointed masses
Flat lesions on vagina, cervix, penis
144
Genital Warts: allopathic treatment
Surgery
Laser
Cryotherapy
