chapter 23: diseases of the cardiovascular and lymphatic systems

Question 1

target diseases

Answer 1

sepsis and septic shock, brucellosis, plague, lyme disease, malaria

Question 2

lymphatic drainage collects in

Answer 2

thoracic duct (aka alimentary duct) and drains into blood stream at the left brachiocephalic vein between the left subclavian and left internal jugular veins

Question 3

blood is normally

Answer 3

sterile, but small number of microbes is not a big problem

Question 4

sepsis: nosocomial invasion common due to interventions involving

Answer 4

medical devices (catheters, IVs, breathing tubes, etc.)

Question 5

sepsis: blood-bourne _____ and ____ defenses…

Answer 5

cellular (phagocytes), soluble (complement), plus iron restriction (transferrin), check growth of microbes; if defenses fail, microbes can proliferate

Question 6

sepsis

Answer 6

systemic inflammatory response syndrome (SIRS)

Question 7

septicemia

Answer 7

actue illness associated with pathogens in blood stream

Question 8

sepsis is the result of

Answer 8

infection-associated inflammatory mediators bring released in the blood, although the source of the etiology is not necessarily blood

Question 9

sepsis symptoms

Answer 9

fever, rapid heart or respiratory rates, elevated white blood cell count; release of iron from RBCs by microbial action can stimulate microbial growth

Question 10

lymphangitis

Answer 10

red streaks up appendages indicative of inflamed lymph vessels; often associated with sepsis or septicemia; can occur if there is a local infection and then it enters the vasculature of the lymphatic system

Question 11

if body cannot quickly control infection and resulting SIRS, the condition….

Answer 11

rapidly progresses to shock and death

Question 12

symptoms of sepsis

Answer 12

brought on largely by release of proinflammatory cytokines in response to infection; fever, chills, accelerated breathing and heart rate, drop in blood pressure, organ failure

Question 13

Severe sepsis signs

Answer 13

drop in blood pressure and organ failure

Question 14

final stage of sepsis

Answer 14

when low blood pressure can no longer be controlled=septic shock, survival chances of septic shock are very low

Question 15

90% of adults and 70% of children who developed sepsis had

Answer 15

a health condition that may have put them at risk

Question 16

sepsis occurs most often in people

Answer 16

65+ years of age or younger than 1 year; weakened immune systems, or with chronic medical conditions (ex: diabetes)

Question 17

if an infection is not treated properly….

Answer 17

even healthy people can develop sepsis

Question 18

four types of infections are often associated with sepsis

Answer 18

lungs, urinary tract, skin, and gut

Question 19

common germs that can cause sepsis

Answer 19

Staph aureus, E. coli, and some types of strep

Question 20

septic shock most frequently caused by

Answer 20

gram negative bacterium

Question 21

outer envelope of gram neg bacteria contain

Answer 21

lipopolysaccharide (endotoxin) which itself can induce ALL of the symptoms of septic shock, 1 nanogram is sufficient to cause symptoms

Question 22

___ of all hospital deaths due to sepsis

Answer 22

1/3

Question 23

____ ____ is crucial as is ____ to reduce effects of endotoxin

Answer 23

antibiotic therapy, treatment

Question 24

Xigris

Answer 24

a drug that reduces clotting associated with septic-mediated organ failure

Question 25

brucellosis

Answer 25

undulant fever; world's most common zoonosis, Middle East is an endemic region

Question 26

Brucella

Answer 26

small, aerobic, gram negative coccoid-rod shaped bacterium

Question 27

3 common species of brucella

Answer 27

abortus (cattle), suis (swine), melitensis (goats and sheep-most common and dangerous human pathogen)

Question 28

brucellosis is highly ...

Answer 28

infectious, dangerous to handle, easily aerolized and highly transmissible

Question 29

brucellosis transmission

Answer 29

- eating undercooked meat or consuming unpasteurized/raw dairy products (infected animals have infected dairy) - breathing in the bacteria (inhalation), greater risk for people who work in laboratories with brucellosis. - bacteria enters body through skin wounds or mucous membranes (when come into contact with infected animal

Question 30

incubation period of brucellosis

Answer 30

1-3 weeks, duration can be quite long (weeks-months)

Question 31

symptoms of brucellosis

Answer 31

fever (rising and falling, thus undulant), malaise, night sweats, muscle aches

Question 32

treatment for brucellosis

Answer 32

combination antibiotic therapy for several weeks; doxycyclin and rifampin for 6-8 weeks

Question 33

malaria

Answer 33

a parasitic disease, affects 108 countries of tropical/semitropical world, central african bearing 98% of malarian deaths, about 1 million deaths per year

Question 34

malaria prevention

Answer 34

mosquito control and mosquito netting

Question 35

malaria prophylaxis/treatment

Answer 35

chloroquine, malarone for chlorine resistant

Question 36

plague

Answer 36

bubonic plague, disease of rodents, transmitted by bite of flea; man is accidental host of plague

Question 37

lung involvement leads to...

Answer 37

highly transmissible and virulent form; mortality of pneumonic plague is nearly 100%

Question 38

chain of events of transmission of plague

Answer 38

flea feeds on infected rodent, flea becomes occluded; upon next feeding, flea regurgitates stomach contents including Y. pestis into bite of new host; organism travels through lymphatic system, capsule prevents phagocytosis, enters blood stream, lungs, etc.

Question 39

etiologic agent of plague

Answer 39

Yersinia pestis, gram neg facultative bacterium, member of Enterobacteriaceae

Question 40

buboes

Answer 40

swollen lymph nodes, usually in groin or under arms, extremely painful; skin becomes dark and black due to hemorrhaging

Question 41

which antibiotics are effective on plague

Answer 41

streptomycin and tetracylcine

Question 42

Lyme disease progression and lack of rash preceding symptoms suggested

Answer 42

tick-bourne disease

Question 43

etiologic agent of lyme disease

Answer 43

Borrelia burgdorferi-spirochete

Question 44

___ ____ are most important reservoir for disease, ___ also for maintaining the disease, though less likely to harbor the ticks most likely to carry disease

Answer 44

field mice, deer

Question 45

human pick up ____

Answer 45

ticks usually nymphs, immature ticks; go unnoticed usually bc of size

Question 46

symptoms of lyme disease

Answer 46

first=rash at bite site; red area that clears at center as it expands to final diameter of about 15 cm; flu-like symptoms in 2-3 weeks as rash fades, antibiotics taken at this stage are very effective

Question 47

if not treated, lyme disease enters second stage

Answer 47

heart involvement, irregular heart beat, chronic neurological symptoms, incapacitation, facial paralysis, meningitis, encephalitis

Question 48

in third phase of lyme disease

Answer 48

months or years after infection, arthritis in some patients, similar long term effects as syphilis (another spirochete)

Question 49

malaria symptoms

Answer 49

fever, shaking chills, flu-like symptoms and anemia

Question 50

malaria caused by

Answer 50

parasite Plasmodium, results from the bite of infected Anopheles mosquito

Question 51

4 major forms of malaria

Answer 51

P. vivax, P. ovale, P. malariae, P. falciparum

Question 52

P. vivax

Answer 52

benign malaria, widely distributed due to fact that it can develop at lower temps in mosquito- most prevalent form of disease

Question 53

P. ovale and P. malariae

Answer 53

relatively benign, restricted geographically

Question 54

P. falciparum

Answer 54

most dangerous form, malignant malaria, left untreated= mortality 50%, children most susceptible to death, high degree of RBC lysis, thus anemia is significant

Question 55

parasites of malaria multiply inside

Answer 55

RBCs, lyse within 48 to 72 hours, infecting more RBCs.

Question 56

first symptoms of malaria

Answer 56

occur 10 days to 4 weeks after infection, though they can appear as early as 8 days or as long as a year after infection. then symptoms occur in cycles of 48-72 hours

Question 57

mosquito carries

Answer 57

sporozoite form in saliva; within 30 minutes enters liver, sporozoites in liver undergo schyzogony (multiple asexual fissions) release about 30,000 merozoites into blood stream; merozoites infect RBCs, schyzogonize in blood cells, RBCs lyse and release new merozoites

Question 58

___ released with merozoites

Answer 58

toxic compounds, causing paroxysms (recurring intensification of symptoms) chills and fever that characterize malaria

Question 59

fever with malaria reaches

Answer 59

40 degrees C

Question 60

people especially at risk for sepsis in hospitals because

Answer 60

organism has opportunity to easily reach patient's blood stream, compromised host, organisms are well adapted to hospital environment ie; antibiotic resistant

Question 61

bubonic plague cannot be transmitted by

Answer 61

humans, only by fleas

Question 62

Pneumonic plague can be transmitted by humans becasue

Answer 62

this is the secondary stage, infection has reached lungs and aerosols are now in play

Question 63

the flea acts as a _____ for plague

Answer 63

vector

Question 64

lyme disease rash is different from ringworm rash

Answer 64

it's smooth