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2 Infection Notes (Lectures) > Chronic Disease > Flashcards

Chronic Disease Flashcards

1
Q

How do chronic diseases link to infections?

A

They can predispose to specific infections:

  • Can change structure/function of tissue–> effect on interaction between patient and microorganism
  • Altered presence of micro-organisms- consequences of treatment
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2
Q

What is Cystic Fibrosis?

A
  1. Autosomal recessive condition
  2. Defect- transmembrane conductance regulator (CTFR) gene- in exocrine glands- codes for cAMP regulated chloride channel
  3. Reduces secretion of Cl-
  4. More water reabsorbed
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3
Q

What complications does cystic fibrosis cause?

A
  1. Lungs- colonisation and infection w./ various organisms
  2. Pancreas- pancreatitis, diabetes, malabsorption
  3. Intestines- thick secretions- bowel obstructions in newborns
  4. Liver- cirrhosis
  5. Reproductive system- infertility
  6. Sinus-infections
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4
Q

Why are patients more suceptible to infections?

A

Compromised innate immune system:

  • Mucus=dehydrated + thick
  • Clearance of organisms= impaired

=Reduced ciliary action

=Airway remodelling

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5
Q

Name some infections that CF patients are particulary susceptible to.

A
  • H influenzae
  • Staph aureus
  • Pseudomonas aeruginosa
  • Burkholderia cepacia
  • Atypical Myobacteria, Candida albicans, Aspergillus fumigatus
    *
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6
Q

Why are CF patients particullary susceptible to Pseudomonas aeruginosa infections?

A

CF causes biofilms as:

  • Damages local epithelium- cycle of inflammation
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7
Q

What steps can be taken to prevent respiratory infections developing in cystic fibrosis patients?

A
  1. Encourage mucus clearance (chest physiotherapy, nebulisers, bronchodilators)
  2. Steroids- reduce inflammation
  3. Prophylactic antibiotics- prevent colonisation
  4. Good hand hygiene
  5. Good nutrition
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8
Q

Why are patients with diabtetes more susceptible to infections?

A
  1. Microvascular and macrovascular disease–> poor tissue perfusion+increased infection risk
  2. Neuropathy- diminished sensation- unnoticed skin ulcers/cuts (breach innate immunity
  3. Hyperglycaemia- impairs humoral immunity (ie neutrophil and lymphocytes functions)
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9
Q

What infections are diabetes patients particularly susceptible to?

A
  • Cellulitis
  • UTIs
  • Malignant otitis externa
  • Respiratory infections
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10
Q

Why is cellulitis commonly found in diabetic patients?

A

Hyperglycaemia, imparied sensation, reduced perfusion

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11
Q

If a patient with diabetes presents with a foot ulcer, what actions should be taken?

A
  1. Identify infection-swab for culture
  2. Assess severity of infection:
    1. Blood markers (FBC, CRP)
    2. Foot X-ray (osteomyelitis)
    3. Renal function (U&Es)
  3. Check Glycaemic control (BM/HbA1c)
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12
Q

How should diabetes patients be manged with relation to developing cellulitis? (5)

A
  1. Treat infection if present
  2. Maintain good glycaemic control
  3. Regular foot checks
  4. Good foot care
  5. Reduced CVS risk factors
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13
Q

Why are UTIs common in diabetic patients?

A
  1. Diabetic neuropathy- defects in bladder emptying (stasis)
  2. Glycosuria- increase bacterial infections

(Causative organisms: E coli, pseudomonas aeruginosa)

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14
Q

What investigations should be carried out for UTIs in diabetic patients?

A

Urinanalysis:

  • Glycosuria
  • Nitrites+leucocytes

Sepsis screen

FBC, CRP etc

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15
Q

What is malignant otitis externa?

A

External ear infection

Spreads from EXTERNAL AUDITORY CANAL to adjacent soft tissue/bone

Caused by pseudomonas aeruginosa

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16
Q

How does a patient with malignant otitis externa present?

A

Severe ear pain

17
Q

Why are respiratory infections more likely to occur in diabetic patients?

A

Hyperglycaemia: impair neutrophil function

Can have altered perfusion

18
Q

Name some examples of respiratory infections which can be acquired particularly in Diabetic patients.

A
  1. Streptococcus pneumoniae
  2. Haemophilus influenzae
  3. Staphylococcus aureus
19
Q

What causes COPD?

A
  • Chronic inflammatory response to inhaled irritants
  • Primarily mediated by neutrophils and macrophages
20
Q

Why are patients with COPD more susceptible to infections?

A
  • Local overeactivity- inflammation damages airways
  • Emphysema-breakdown lung tissue
  • Obstructive bronchitis, damage to cilia
  • Increased mucus production
21
Q

What infections are patients with COPD more susceptible to?

A
  1. Pneumonia
  2. H.influenzae
  3. Ps. aeruginosa

2 Infection Notes (Lectures) (6 decks)

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