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Semester 2 PM Exam 1 > Clinical Implications of Infection > Flashcards

Clinical Implications of Infection Flashcards

1
Q

Infection Define

A

invasion of and multiplication of microorganisms within the tissue of the host
requires that the pathogen be able to adhere to; colonize or invade the host cells
EXPOSURE TO PATHOGEN DOES NOT EQUAL INFECTION

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2
Q

Types of pathogens

A

Bacteria
Virus
Fungus
Parasites

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3
Q

Host Defenses

A
  1. Skin barrier
  2. Biological - normal flora
  3. Chemical - pH
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4
Q

Routes for spread of infection

A

blood
lumph
tissue planes

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5
Q

Types of damage

A

Localized
Widespread
Invasive

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6
Q

Localized Damage

A

occurs at the site of injury and may spread to surrounding tissue
Damage is related o intensity of inflammatory response
- bacteria is usually more localized than virus or parasite

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7
Q

Widespread Damage

A

release of endotoxins causes damage at the site of entry and a distance from entry point
Degree of spread depends on pathogen, condition of host, entry site
Viruses take over host cell function –> widespread

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8
Q

Invasive Damage

A

cellular alterations occur
Loss of host cell function
Viral or parasitic

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9
Q

Factors that inc risk of infection

A 
Impaired nutritional status
Dehydration
Age
Renal and Hepatic dysfunction
Immune sys function
Vascular condition of host tissue
Poor sanitation
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10
Q

Impaired nutritional status

A

Dec macrophage func
T lymph func is depressed
Antibody production is less sens
Overall not a good inflammatory response

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11
Q

Dehydration

A

Inc core temo
changes in HR responses
Changes in resp

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12
Q

Age

A

Dec in function of mechanical barriers

Inc risk of pathologies that alter biological and chemical barriers

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13
Q

Metabolic cost of infection

A

inc basal metabolic rate and energy consumption

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14
Q

Fever - Metabolic consequence

A

Ant hyp is sens to endogenous pyrogens –> these are released by cells involved in host defense –> thought to have pos effect on course of infection

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15
Q

For every 1 degree celcius rise in temp…

A

there is a 13% inc in the BMR

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16
Q

Low and high grade fever

A 
Low = >98.6 to 102
High = > 102
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17
Q

Fever and PT

A

Dont work with patients who hace a high grade temp - functional things ok

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18
Q

Metabolic consequence - protein metabolism

A

inc with fever
body needs the proteins to fight infection
normal mechanisms for energy are inhibited with acute infections

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19
Q

Metabolic consequences - mineral metabolism and acid/base balance

A

Initially NA and H20 retention occur - not peeing
Then during convalescent phase diuresis occurs
Acid/base imbalance may occur - not problem if hsort course but can become issure if infection is severe or prolonged

20
Q

Metabolic consequence - immune system

A

lymphocytes - inc # of them

21
Q

Metabolic consequence - hematologic system

A

Inc CO demand (inc BMR)

Severe acute infection and in chronic there will be bone marrow effects –> dec RBCs and Inc WBCs

22
Q

course of infection is dependent on

A

pathogen and condition of the host

23
Q

Chronic infections

A

initial stages are the same as acute
s/s wax and wane
No quick resoluation
Hep is Ex

24
Q

Latent Infections

A

s/s subside as they do in acute infections but reappear again later
Chicken pox –> shingles

25
Q

Secondary acute infection

A

follow primary infections that have left the host susceptible - allows for pathogen entryway

26
Q

Subclinical infection

A

does not reach prodromal stage
Pathogens have colonized though
Can be transmitted

27
Q

Bacteremia

A

Transient presence of pathogens in the blood as result of localized infection
Tends to not produce s/s

28
Q

SIRS

A

Systemic Inflammatory Response Syndrome
Systemic inflammatory response to a wide variety of severe clinical insults manifests by 2 or more of following conditions:

29
Q

Conditions for SIRS

A

Temp higher than 100.4 or less than 96.8
HR higher than 90
RR higher than 20 or PaCO2 less than 32
WBC higher than 12000 or less than 4000

30
Q

Septicemia

A

Repid multiplication of and prolonged presence of pathogens within the blood
Significant s/s may be present

31
Q

CLinical features of septicemia

A

Headaches, lethargy, apprehension, fever, hypotension, rigors, petechial hemorrhages

32
Q

Septic Shock

A

Circulatory failure with inadequate tissue perfusion

Sever infection can lead to septicemia which will trigger a systemic inflammatory cascade leading to septic shock

33
Q

Hemodynamic changes with septic shock

A

 Low systemic vascular resistance
 Low central venous pressure and pulmonary artery occlusion pressure
 CO is high
 Myocardial depression with low ejection fraction
 SV is maintained by ventricular dilation and CO is inc by tachycardia

34
Q

Clinical s/s septic shock

A 
	Fever
	Nausea, vomiting
	VD
	Bounding pulse
	Hypotensive
	Coagulopathies 
	Coma
	Jaundice
35
Q

Tests and Measures for Dx of infection

A

Physical exam - vitals, skin rashes, lymphadenopathy, hepatosplenomegaly
CBC, Urinalysis, chest x-ray, blood culture

36
Q

Bactericidal drugs

A

destroy pathogen

37
Q

Bacteriostatic drugs

A

inhibit growth

38
Q

Blind (wide spectrum) therapy

A

havent done analysis of what pathogen is

39
Q

Penicillan

A

active agents
effect the wall of bacteria
can be cidal or static
about 15% of pop is allergic

40
Q

Cephalosporin

A

broader rang of action than Pen
Inhibit cell wall synthesis
nephrotoxicity can be problem

41
Q

Sulphoamide

A

bacteriostatic
inhibits microbial folic acid synthesis
allergies

42
Q

Tetracycline

A 
inhibits protein syn
limited use
resistance develops
used secondary to pen allergy
effects bones and teeth
43
Q

Erythromicin

A

inhibits protein synth
bacteriostatic
similar to pen
used mainly in resp, skin, and GU infections

44
Q

MRSA

A

is a gram positive cocci
 A healthcare associated infection
 healthcare environment puts pt at risk od MRSA
 Highly resistant
 Primary antibiotic used to treat is vancomycin
 Can produce septic shock and is highly transmittable

45
Q

VRE

A

 Enterococci are part of the normal GI flora
 Common infections include skin, urinary tract, meningitis, endocarditis, bacteremia
 Healthcare associated infection

Semester 2 PM Exam 1 (7 decks)

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