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class 3 Flashcards

1
Q

Nonpathogenic

A

◦ Usually do not cause disease unless conditions change
◦ Part of normal flora
◦ Often beneficia

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2
Q

Pathogens

A

Disease causing

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3
Q

Pathogens/germs that are disease causing microbes

A

◦ Bacteria and viruses
◦ Chlamydiae, Rickettsiae, & Mycoplasmas
◦ Fungi, Protozoa
◦ Helminths (worms), Prions, Algae

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4
Q

where are rickettsiae found

A

Rickettsiae (gram negative bacteria found in ticks, lice, fleas,
mites)

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5
Q

Pathogenicity

A

the capacity of microbes to cause
disease

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6
Q

Nosocomial infections

A

occur in health care facilities (often spread by direct contact or via contaminated objects). Also referred to as Hospital acquired infections (HAI)

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7
Q

Example of hospital acquired infections

A

C-diff. MRSA, VRE, …(more serious infections), usually resistant to antibiotics

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8
Q

Infection control requires two approaches

A

◦ Standard Precautions used in all
settings with all clients when body fluids
may be exchanged.
◦ Specific Precautions in clients
diagnosed with a particular infection—
these are used in addition to standard
precautions.

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9
Q

Characteristics of bacteria

A

 Unicellular -Single-celled microorganisms
 Rigid cell wall; unlike human cells (no
cell wall) ◦ Gram (+) or Gram (-) cell wall
 Some secrete toxins ◦ Exotoxins (gram +) ◦ Endotoxins (gram -) ◦ Enzymes
 Capable of cell division ◦ Reproduce by binary fission; if rapid a large infection can develop quickly
 Independent survival ◦ Do not require living tissue to survive
 Some can form spores ◦ Encapsulated; survive long time
 Aerobic and anaerobic; indiscrete
nucleus

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10
Q

On a gram negative bacteria, what can the outer membrane stop from entering

A

penicillin

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11
Q

characteristics of binary fission

A
  • very virulent
  • rapid onset of infection
  • fever stops binary fission
  • stops proliferation
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12
Q

what is a bacterial mutation

A

Errors made when duplicating their genetic codes
Occur spontaneously and randomly
This may result in a bacteria that is able to survive in harsher conditions, change the shape of its organelles, or perhaps grow faster
May result in drug resistance for a microorganism

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13
Q

Prevention of Resistant Strains

A

Prevent Infections when possible

Diagnose and treat infections properly

Use antimicrobials wisely

Prevent transmission

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14
Q

viral infections require what to replicate

A

a host cell

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15
Q

host resistance

A

The ability of a host to resist a pathogen
Healthy people can resist infection

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16
Q

what factors can decrease ones host resistance

A

for example infants, homeless people, use of steroids

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17
Q

What is an Opportunistic Infection?

A

an infection caused by pathogens that take advantage of an opportunity not normally available. These opportunities can stem from a variety of sources, such as a weakened immune system

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18
Q

what is virulence and what is it characterized by

A

the degree of pathogenicity of a
specific microbe (A highly virulent microbe
produces disease when present in small numbers)
characterized by
◦ Invasiveness, Adherence, Ability to avoid host defences
◦ Toxicity (Exotoxins and Endotoxins)

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19
Q

exotoxins

A

Exotoxins are proteins released by bacteria into surrounding tissue and has the ability
to inactivate or kill host cells

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20
Q

endotoxins

A

Endotoxins are harmful non-protein chemicals that are part of the outer wall of gram negative bacteria; They cause macrophages to release large amounts of cytokines, causing generalized inflammation, fever, and chills.

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21
Q

Phases of Acute Infection

A

 Exposure- microorganism enters body
 Incubation – time b/t entry into body and clinical signs
 Prodromal- infected person feels unwell
 Acute Period – clinical manifestations peak
 Convalescence – signs subside, return to normal

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22
Q

if sputum is purulent that indicates what type of infection

A

bacterial

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23
Q

id sputum is clear that indicates what type of infection

A

viral

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24
Q

lymphadenopathy

A

swollen lympth nodes

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25
Arthralgia
joint pain
26
Leukocytosis indicates what type of infection
bacterial
27
Leukopenia indicates what type of infection
viral
28
increased neutrophils indicate what
bacterial infection
29
Parasitic & allergic responses are determined by elevated what in the blood
eosinophils
30
neutropenia indicates what type of infection
viral
31
lymphocytosis indicates what type of infection
viral
32
Serous exudate
watery, consists primarily of fluid with small amout of WBC and protein
33
Fibrinous Exudate
thick and sticky with high cell & fibrin content (increase risk of scar tissue)
34
Purulent exudate
think, yellow-green in color, contains more leukocytes & cell debris & microorganisms – indicates infection (pus)
35
Absess
localized pocket of purulent exudate or pus in a solid tissue
36
Hemorrhagic exudate
Damaged blood vessels
37
2 complications of infection
sepsis (infection of blood) chronic infection
38
what is sepsis
 Severe bacterial infection; life-threatening emergency  Uncontrolled & overwhelming inflammatory response: (+++ inflammatory cytokines) circulatory shock  Development of SIRS (Systemic inflammatory response syndrome)  Leads to tissue damage, organ failure, death
39
super bug
Bacteria that are resistant to the majority of antibiotics commonly used today. ◦ Resistant bacteria that cause pneumonia, urinary tract infections and skin infections are just a few of the dangers we now face MRSA, VRSA, VRE, C. diff
40
what can cause super bugs
overuse or missuse of antibiotics
41
Treatment of Infection
Antimicrobial drugs Vaccination Antiviral drugs Antifungal drugs Symptom reduction ◦ Antipyretics ◦ NSAIDs
42
what is Pneumonia
Inflammation of the alveoli and bronchioles Normally our airway distal to the larynx is sterile (no bugs) Caused by: ◦ Bacterial Infections ◦ Viral Infections – inflammation can make pt susceptible to bacterial invasion ◦ Fungal infections – usually only opportunistic
43
what is a secondary infection
a bacterial or viral illness that develops following a first illness. The second infection may develop because a person's immune system is stressed or weakened.
44
both classifications of pneumonia
Typical (bacterial) ◦ Causes inflammation and exudation of fluid in the air-filled spaces of the alveoli Atypical (viral or mycoplasmal) (less symptoms) ◦ Infection of the alveolar septum and interstitium of the lung = interstitial pneumonia ◦ Flu-like symptoms, little exudate within the alveoli
45
Bacterial (Typical) Pneumonia Classification (2)
Lobar ◦ An acute bacterial infection involving a large portion or an entire lobe of a lung Bronchopneumonia ◦ Patchy consolidation with the involvement of more than one lobe ◦ Both have exudate in the alveoli
46
community acquired pneumonia
◦ Infections from organisms in the community, acquired outside of hospital or diagnosed within 48 hrs of admission ◦ Can be bacterial or viral
47
hospital acquired pneumonia
(90% bacterial) [Nosocomial] ◦ Not present on admission to hospital ◦ Develops ≥48 hrs post admission, most are bacterial
48
Ventilator-Associated pneumonia [Nosocomial]
[Nosocomial] Acquired ≥48 hrs post endotracheal intubation
49
Bactericidal
kills bacteria
50
Bacteriostatic
prevents growth and reproduction of bacteria
51
Mechanisms of Antibacterial Agents (4)
 Drugs that damage bacterial cell wall  Drugs that damage cell membrane  Drugs that inhibit protein synthesis  Drugs that inhibit DNA replication or bacterial cell division
52
Mechanisms of Resistance
 Pathogen destroys drug  Pathogen prevents drug entry or pumps drug out of itself  Pathogen alters target site of drug or undergoes mutation or adapts to drug
53
Bacteria change physiology to become resistant by
 Replicating rapidly  Mutating spontaneously and randomly  Acquiring resistance and promoting resistance to other bacteria via conjugation
54
Antibiotics should not be used for
viral infections or coughs
55
Combining antibiotics can decrease what
their effectiveness and promotes resistant strains
56
Empirical therapy
use of broad spectrum antibiotics used before labs or reports come back to report the specific infection
57
Prophylactic therapy
treatment of antibiotics to prevent infection, ex before surgery
58
Therapeutic response
signs and symptoms are improving
59
Sub-therapeutic response
signs and symptoms are not improving
60
Patient factors affect choice of anti-infective
 Host defenses and immune system status  Local tissue conditions – for some infections, it is difficult to get a therapeutic concentration to site of infection  Allergy history and drug hypersensitivity  Pregnancy, age, genetics
61
superinfections
Superinfections (secondary infections) develop when host flora is damaged by antibiotic as nutrients and space become available for pathogens to grow  Host flora being in competition with each other for space and nutrients is called microbial antagonism  Host flora limit space and nutrients for pathogenic bacteria  Broad spectrum antibiotics are more likely to cause superinfections
62
Peptidoglycan molecules form a set of chains called penicillin-binding proteins (PBPs) because
penicillins and related antibiotics bind to them
63
penicillin mechanism of action
Inhibits bacterial cell wall synthesis by binding to penicillin binding proteins (PBPs) – causing lysis the breakdown of the bacteria membrane (destruction)
64
characteristics of penicillin
 Mainly active against grampositive bacteria  Most have narrow spectrum of antimicrobial activity  Widely distributed to tissues  Nearly all are rapidly excreted by kidneys.  Short half-lives  Penicillin's do not kill other cells in the body
65
penicillin allergies
Allergic reactions occur in 0.7 to 4% of cases  Urticaria, pruritus, angioedema  Those allergic to penicillin's have a fourfold to sixfold increased risk of allergy to other β-lactam antibiotics  Cross-reactivity between penicillin's and cephalosporins is between 1 and 18%  Common adverse effects include:  Nausea, vomiting, diarrhea, abdominal pain
66
Cephalosporins mechanism of action, and what they are used for
interferes with bacterial cell wall synthesis (bactericidal action)  Most common adverse effects are allergy, rash, GI complaints  Eliminated by kidneys  Use with caution in nursing mothers and patients with renal impairment
67
Prototype Drug Cefotaxime (Claforan) (class cephalosoporins)
 Therapeutic effects and uses  Third generation cephalosporin with borad spectrum activity against both Grampositive and Gram-negative infections  Infections of the respiratory tract, urinary tract, genital infections, meningitis, septicemia, endocarditis, bone and joint infections  Infection prophylaxis in surgical patients
68
Cefotaxime (Claforan) adverse effects
 Mild diarrhea, abdominal cramps, rash, pruritis, redness, edema  Potential cross-sensitivity with penicillin's if allergies exist – potential anaphylaxis  Seizures
69
Tetracyclines mechanism of action
Are bacteriostatic (inhibit bacterial growth) Inhibit protein synthesis Stop many essential functions of the bacteria
70
what are tetracyclines used for
 Active against both Gram-positive and Gram-negative bacteria  Drugs of choice for Lyme disease, H. pylori ulcers, and chlamydia  bacteriostatic
71
Tetracyclines Adverse Effects
Strong affinity for calcium  Discoloration of permanent teeth and tooth enamel in fetuses and children (under 8), or nursing infants if taken by the mother  May slow fetal skeletal development if taken during pregnancy  Alteration in intestinal flora may result in:  Superinfection (overgrowth of nonsusceptible organisms such as Candida)  Diarrhea  Pseudomembranous colitis
72
Macrolids mechanism of action
inhibits protein synthesis
73
what are Marcrolids used for
 Most effective against Gram-positive bacteria  Alternative drugs for patients allergic to penicillin  Generally, well tolerated and safe  Decrease hepatic metabolism of other drugs thus drug interactions are possible  Bacteriostatic in low doses, can be bactericidal in high doses
74
what macrolids are not well tolerated
erythromycin
75
Prototype Drug Erythromycin (Eryc) therapeutic effects and uses ( marcolide)
 Strep infections (streptococcus pyrogens)  Mild to moderate upper and lower respiratory tract infections  Syphilis & Lyme disease  Gonorrhea & Chlamydia
76
Prototype Drug Erythromycin (Eryc) adverse effects
 Adverse effects  Nausea, vomiting, abdominal cramping  Phlebitis, intense pain at IV injection site  Serious adverse effects  Cholestatic hepatitis  Anaphylaxis  Ototoxicity (hearing loss, vertigo, dizziness)  Cardiotoxicity including palpitations, chest pain, arrhythmias
77
what are Aminoglycosides used for
 Used to kill Gram-negative bacteria such as Pseudomonas spp., Escherichia coli, Proteus spp., Klebsiella spp., Serratia spp.  Often used in combination with other antibiotics for synergistic effects (never used alone to treat gram + infections  Reserved for serious gram neg (-) infections - only given through IV -bacteriostatic
78
Aminoglycosides cause serious toxicities such as
 Nephrotoxicity (renal damage)  Ototoxicity (auditory impairment and vestibular damage [eighth cranial nerve])
79
Prototype Drug Gentamicin (Garamycin) mechanism of action
inhibits protein synthesis
80
Prototype Drug Gentamicin (Garamycin) therapeutic effects and uses ct (aminoglycoside)
 Serious infections caused by aerobic, Gram-negative bacilli  A few Gram-positive bacteria, including some strains of MSRA
81
Aminoglycosides (Gentamycin): Adverse Effects & Interactions
 Ototoxicity and nephrotoxicity are the most significant  Others include:  Headache Paresthesia Fever Superinfections Vertigo Skin rash Dizziness
82
Fluoroquinolones mechanism of action
Block Bacterial DNA Replication
83
what is Fluoroquinolones used for
activity on all Gram -negative bacteria, with some activity on Gram-positive bacteria  Commonly used for urinary tract infections, GI, respiratory and skin infections - good bioavailability and oral absorption
84
Fluoroquinolones adverse effects
 Cartilage toxicity leading to tendon abnormalities  GI toxicity  Hypersensitivity reactions  Nerve damage  Phototoxicity / photosensitivity  Hepatotoxicity  Resistance
85
Prototype Drug Ciprofloxacin (Cipro) therapeutic effects and uses (fluoroquinolone)
 Urinary tract infections  Sinusitis  Pneumonia  Skin, bone, and joint infections  Infectious diarrhea  Certain eye infections
86
what are Sulfonamides used for and mechanism of action
 Active against broad spectrum of microorganisms; classified based on absorption and excretion qualities  Suppress DNA replication by inhibiting synthesis of folic acid (folate) – folic acid is necessary for thymine metabolism  Adverse effects include hypersensitivity reactions, blood abnormalities, nausea, vomiting, anorexia  Some strains are resistant to sulfonamides
87
Prototype Drug TrimethoprimSulfamethoxazole therapeutic uses and effects
 UTI prophylaxis and UTI  Prophylaxis and treatment of p. carinii and shigella  Acute episodes during chronic bronchitis  Off-label for other indications depending on sensitivity of microbe
88
Prototype Drug Vancomycin (Vancocin) therapeutic effects and uses, mechanism of action
 Severe Gram-positive infections resistant to safer antibiotics  Off-label uses for meningitis and antibiotic-induced pseudomembranous colitis  Mechanism of action  Inhibits synthesis of bacterial cell wall
89
Prototype Drug Vancomycin (Vancocin) adverse effects
“red man” syndrome  Flushing, hypotension, tachycardia, rash on upper body  Nausea, rash, fever, chills  Serious adverse effects  Confusion, seizures, and hallucinations  Extravasation leading to tissue necrosis (if IV leaks)  Ototoxicity, Nephrotoxicity  Anaphylaxis
90
Common therapies for UTI (2)
 Sulfonamides  Fluoroquinolones
91
Prototype Drug Nitrofurantoin therapeutic effect and use, mechanism of action
 Therapeutic effects and uses  Uncomplicated acute cystitis, usually for prophylaxis of recurrent UTI  Mechanism of action  Intermediates attack bacterial ribosomal proteins, prevent DNA and RNA synthesis, and prevent protein synthesis, also inhibits cell wall synthesis

patho (6 decks)

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