Disease managment Flashcards
disease
Infectious diseases
Significantly contribute to the mortality in
- Elderly
- Immunosuppressed
- Chronic disease states
How microorganisms cause disease?
* Humans harbor a complex ecosystem of microflora.
* Attenuation of normal host- defense healthy”
microbial flora to cause pathologic infections.
* Non-commensal organisms with a wide range
of virulence.
* Highly infectious microbes produce disease in
healthy individuals.
Bloodborne Diseases:
*HIV/AIDS.
*Hepatitis B and C.
Bacterial:
– “Staph” skin infection.
– Pneumonia.
– Urinary tract infection.
– Anthrax
– Botulism
Viral:
– Influenza, or the flu.
– Respiratory infections.
– Diarrhea.
– Chickenpox, measles,
mumps.
- Fungi:
– Candidiosis, Aspergillosis.
Parasitic: Malaria
Infectious diseases definition
- Disease: A pathological condition of body parts or tissues by an identifiable group of signs and symptoms.
- Infectious disease: Disease caused by an infectious agent such as bacteria, virus, fungi, protozoa that can be passed on to others.
- Infection: Occurs when an infectious agent enters the body and begins to reproduce; may or may not lead to disease.
- Pathogen: An infectious agent that causes disease.
- Host: An organism infected by another organism.
- Virulence: The relative ability of an agent to cause rapid and severe
disease in host.
Phases of infectious disease
1. Incubation period: time between infection and
the appearance of signs and symptoms.
2. Prodromal phase: mild, nonspecific symptoms
that signal onset of some diseases.
3. Clinical phase: a person experiences typical
signs and symptoms of disease.
4. Decline phase: subsidence of symptoms.
5. Recovery phase: symptoms have disappeared,
tissue heal and the body regains strength.
Classification of disease
By duration
*Acute: develop and runs its course rapidly
*Chronic: develops more slowly and it usually less severe may
persist for a long, indefinite period of time.
*Latent: characterized by periods of no symptoms between
outbreaks of illness.
By location
*Local: confined to a specific area of the body
*Systemic: a generalized illness that infect most of the body
By timing
*Primary: initial infection in the previously healthy person
*Secondary: infection that occurs in a person weakened by primary infection
Modes of disease transmission
Contact: direct: handshake, kissing, sexual intercourse, bites
Indirect: drinking glasses, toothbrush, toys, punctures
droplet: droplets from sneezing (1 meter)
Vehicle transmission:
Airborne: dust particles
waterborne:streams,swimming pools
Foodborne: poultry, seafood, meat
Vector transmission: Mechnanical: on insect bodies, flies, roaches
Biological: lice ,mites,mosquitoes, ticks
Types of diseases
Genetic, Biological, Physical Chemical
Epidemics of
* Plague in India
* Avian (H5N1) influenza in Hong Kong
* Ebola haemorrhagic fever in central Africa
* Nipah virus (niv) infection in Malaysia and Singapore
Plague: AKA Black Death
*Yersinia pestis causes plague. from rodents to
human by aerosols or fleabites.
*2 main clinical forms of plague infection:
*Bubonic plague: most common and
characterized by painful swollen lymph nodes or ‘buboes’.
*lymph node then becomes inflamed, tense and painful => ‘bubo’.
*Inflamed lymph nodes can turn into open sores filled with pus.
*Pneumonic plague :or lung-based plague, most
virulent form of plague.
Anthrax
*Bacillus anthracis causes anthrax in human.
*prevalant in animals having contact with
spore-contaminated soil.
*Human in contact through exposure to contaminated animal
products or powdered spores (called as a biologic weapon)
suffer from anthrax.
*3 major syndromes:
-Cutaneous: painless, pruritic papules that become
edematous vesicles (lymphadenopathy & lymphangitis)
followed by a black eschar.
-Inhalation: flu like symptoms rapidly leads to sepsis, shock,
and frequently death.
-GI: by eating contaminated meat, causes severe, bloody
diarrhoea and often death.
Small pox
* acute contagious disease by the Variola virus
* high fever which may be recurrent.
* malaise (general feeling of unwellness)
* widespread skin rash – flat spots which change into raised
bumps then firm fluid filled blisters which then scab
* severe headache.
* backache.
* abdominal pain.
* vomiting.
* diarrhoea
Influenza
*Acute contagious disease
*respiratory tract infection but symptoms throughout the
body.
*Seasonal causes epidemics with low fatality. More deadly during
pandemics and occur several times.
*Rapid onset, chills, fever, malaise/fatigue, headache, sore throat
, cough, nasal congestion, & GI symptoms
TYPES OF DISEASES CONTINUED
Viral Hemorrhagic Fever
are infectious diseases.
severe, life-threatening illness.
*can damage the walls of tiny blood vessels, making them leak,
and hamper the blood’s ability to clot internal bleeding.
Early signs and symptoms :
Fever, Fatigue, weakness or general feeling of being unwell, Dizziness,
Muscle, bone or joint aches, Nausea and vomiting, Diarrhoea
Some viral hemorrhagic fevers include:
1.Dengue
2.Ebola
3.Lassa
4.Marburg
5.Yellow fever
Severe symptoms include:
Bleeding under the skin, in internal organs, or from the mouth, eyes
or ears, Nervous system malfunctions, Coma, Delirium, major organ
failure
Tularaemia
* AKA “rabbit fever,” caused by bacterium Francisella tularensis.
* typically found in animals, especially rodents, rabbits,
and hares.
a rural disease and has been reported in all U.S. states except Hawaii.
* Symptoms: Rapid onset, fever, dyspnoea , headache, malaise,
cough, hemoptysis (coughing up blood).
Botulism
* Clostridium botulinum a bacterium
produces dangerous toxins (botulinum toxins) under
low-oxygen conditions.
* Botulinum toxins block nerve functions and can lead to respiratory and muscular paralysis.
* Foodborne botulism is a serious, potentially fatal
disease.
* Improperly processed food, homemade canned,
preserved or fermented foodstuffs are a common
source of foodborne botulism. Symptoms: fatigue, weakness, blurred vision, difficulty in swallowing and speaking, descending muscle paralysis and respiratory failure
Malaria
*Plasmodium falciparum causes severe malaria.
*Plasmodium vivax, Plasmodium ovale, and Plasmodium malariae =>
various types of disease causing vectors.
*Malaria infection begins when an infected female Anopheles mosquito bites a person, injecting Plasmodium parasites, in the form of sporozoites into the bloodstream.
*The sporozoites pass quickly into the human liver.
*The sporozoites multiply asexually in the liver cells over the next 7 to 10 days,
causing no symptoms.
*In an animal model, the parasites, in the form of merozoites are released from the liver cells in vesicles, passes through the heart, lungs, and settle within
lung capillaries.
*The vesicles disintegrate, free the merozoites to enter the blood
phase of their development.
*In the bloodstream, the merozoites invade red blood cells
(erythroctes) and multiply again until the cells burst. Then they invade more erythrocytes. This cycle is repeated, causing fever
each time parasites break free and invade blood cells.
*Some of the infected blood cells leave the cycle of asexual
multiplication. Instead of replicating, the merozoites in these cells
develop into sexual forms of the parasite, called gametocytes that
circulate in the blood stream.
*When a mosquito bites an infected human, it ingests the
gametocytes, which develop further into mature sex cells called
gametes.
*The fertilized female gametes develop into actively moving ookinetes
that burrow through the mosquito’s midgut wall and form oocytes
on the exterior surface.
*Inside the oocyst, thousands of active sporozoites develop. The oocyst
eventually bursts, releasing sporozoites into the body cavity that
travel to the mosquito’s salivary glands.
*The cycle of human infection begins again when the mosquito bites
another person
Disease management, diseases caused by:
Factors influencing health:
1. Genetic disorders- deficiencies a child born with/defect child inherit
2. Infections
3. Life style- food & water, rest & exercise, habits
DISEASE:Any condition which interferes with normal functioning of the body and impairs the
health
Types of Diseases:
I. Congenital Disease- inborn disease/genetically inherited
II. Acquired Disease- after birth & non- inheritable
Congenital Disease:
1. due to gene mutation. Eg. Color blindness
,Haemophilia
2. due to chromosomal mutation Eg.- Down’s syndrome, Klinefelter’s syndrome
Acquired Disease:
1. Communicable or infectious diseases- air, water, food, physical
contact or vectors (Bacteria, Virus, Protozoa, Helminth, Fungus etc.)
2. Non- communicable or non- infectious diseases- Deficiency disease (Diabetes), Degenerative (Arthritis),
*Disease management: a system of coordinated heath care
interventions and communications for patients where self-care efforts can be implemented.
helps individuals work with healthcare providers to manage their condition and prevent complications.
prevent complications.
Improvements in quality of care and patient outcomes =>successful disease management
Infectious diseases caused by:
*Bacteria. one-cell organisms => strep throat, urinary tract infections,
tuberculosis.
*Viruses. Even smaller than bacteria, => multitude
of diseases => common cold to AIDS.
*Fungi.
*Parasites.
Common Infectious Diseases
*Chickenpox.
*Common cold
*Diphtheria.
*Giardiasis.
*HIV/AIDS.
*Influenza (flu)
lifestyle diseases
primarily based on the day
to day habits of people.
Lifestyle diseases include
* atherosclerosis
* heart disease
* stroke
* obesity
* type 2 diabetes
* hypertension
* smoking and alcohol, drug abuse diseases
*colon cancer, and
*premature mortality
CHRONIC DISEASE
affects every aspect of a person’s life.
ex: physical, mental health, family, social life,
finances, and employment
.
shorten a person’s life.
such as asthma, diabetes require regular monitoring to prevent disorders from progressing to life-threatening
Chronic disease management:
essential to both
improving health outcomes of poor individuals and
costs in health care system.
10 steps for coping with a chronic condition
* prescription for info.
* Make your doctor a partner in care.
* Build a team.
* Coordinate your care.
* Make a healthy investment in yourself.
* Make it a family affair.
* Manage your meds.
* Beware of depression
*Eat Healthy => delay, and manage heart disease, type 2 diabetes, and other chronic diseases.
*Regular Physical Activity=> manage chronic diseases.
*Avoid Alcohol.
*Get Screened.
*Get Enough Sleep
Vaccines and immunisation
* Diseases can be now prevented- vaccines and immunisation
* A vaccine =>a biological preparation that provides active acquired
immunity to a infectious disease.
* Vaccines - eradicate smallpox, polio, diphtheria, pneumonia and
tetanus
* Through Biotechnology => newer and safer
vaccines.
* Discovery of antibiotics and various other drugs => effectively treat infectious diseases
DISEASE GROUPS, and control of diseases
Diseases can be grouped
Food & water borne diseases:
* Proper hygiene: clean body; clean drinking water, food
* Proper public hygiene: proper disposal of waste and excreta;
periodic cleaning and disinfection of water reservoirs, pools, cesspools and
tanks and observing standard practices of hygiene in public catering.
- Eg.- Typhoid (Salmonella typhii), Amoebiasis (Amoeba) and Ascariasis (Ascaris)
Air borne diseases:
*Close contact with infected person & their belongings should be
avoided
*Personal hygiene => imp to prevent diseases
*Eg.- Pneumonia and Common cold
Vector borne diseases:
*Controlling/eliminating vectors and their breeding places.
*Avoid stagnation of water
regular cleaning of household coolers, use mosquito nets
* fishes like Gambusia in ponds that feed on mosquito
larvae, spray insecticides in ditches, drainage areas ,swamps, etc.
*Doors and windows > wire mesh => no mosquitoes.
, Aedes & Culex mosquitoes, Houseflies
*Malaria, Filariasis, Dengue and Chikungunya
Prevention or control of Diseases
* maintenance of
personal/public hygiene
Cancer
Cancer => malignant tumor,
group of diseases
involving abnormal cell growth with the potential to invade or spread
to other parts of the body
* Considered as major cause of death
* Due to its severity process of Oncogenic transformation of cells, its
treatment and control => intense areas of research => bio and medicine
* Cancer can be induced by external factors- Carcinogens
Causes of Cancer:
Normal cells =>cancerous neoplastic cells by physical,
chemical and biological agents.
These agents = carcinogen.
* Physical agents: ionizing radiation like X-rays, gamma rays non- ionizing
radiations like UV-rays.
* Chemical agents: Tobacco smoke, sodium azaide, Methyl ethane
sulphonate.
Biological agents:
* Cancer causing viruses called oncogenic viruses have a gene called
viral oncogenes, induce transformation of neoplastic cells.
* Cellular oncogenes (c-onc) or proto oncogenes in normal cells, when
activated lead to oncogenic transformation of the normal cells
Mechanism transformation to cancerous cell:
*Cell growth and differentiation is highly controlled and regulated
NOT in cancerous cell
*Normal cell show a property- Contact inhibition- inhibits
uncontrolled growth
*Cancer cells appears to have lost this property. thus cancerous cells just continue to divide giving rise to masses of cells
= tumors.
TYPES OF TUMOR
Benign tumors:
* Normally remain confined to their original location
* Do not spread to other location.
* Cause little damage
Malignant tumors:
* Mass of proliferating cells called neoplastic/tumor cells.
* cells grow very rapidly.
* Invade and damage surrounding tissues.
* cells actively divide and grow; also starve the normal cells.
* Cancerous cells escape from the site of origin and moves to distant place
by blood, wherever they get lodged make the normal cell cancerous. => metastasis.
Four main types
Carcinomas. begin in the skin or the tissue that covers the surface of internal organs and glands.
Sarcomas. begin in the tissues that support and connect
the body.
Leukemias. cancer of the blood.
Lymphomas and Myelomas: Cancer of immune system
Allergy
hypersensitivity disorder of immune system in which exaggerated response of the immune takes place to certain antigens in the environment
* Substance which induce allergy- Allergen (mites in dust, pollens,
animal dander)
* Antibodies produced- IgE
- Symptoms: Sneezing, watery eyes, running nose and difficulty in breathing.
- Reason: Release of chemicals like histamine and serotonin from
the mast cells - Diagnosis: Injecting small dosage of possible allergens & reactions are observed
- Drugs anti-histamine, adrenalin and steroids- quickly reduce the
symptoms of allergy - Protected environment- lowered immunity thus more & more people are now sensitive to allergens
Aquired Immuno Deficiency Syndrome
- disease caused due
to deficiency of immune system - Disease/ syndrome- acquired during the lifetime of an individual indicating that it is not a congenital disease (at birth or inherited)
- 1st in 1981 & last 25 years- 25 M killed
Causative organism:-
* Human Immuno deficiency Virus (HIV)- retrovirus, i.e RNA
virus having RNA genome enclosed by protein coat
Modes of Transmission of HIV infection:
(a)sexual contact with infected person
(b)by transfusion of contaminated blood and blood products
(c)by sharing infected needles => intravenous drug abusers
(d)from infected mother to her child through placenta
high chance of AIDS
*Individuals with multiple sexual partners,
individuals who require repeated blood transfusions and
It takes few months to few years (5- 10 years)- between infection &
appearance of AIDS symptoms
Symptoms:
*HIV attacks Helper T lymphocyte- reduction of Helper T lymphocyte which cause severe Cellular immuno- deficiency
*Bouts of fever, Diarrhoea & Weight loss
*Highly susceptible to Mycobacterium, viruses, fungi, parasites
*Infected person => more infections
Diagnosis & Treatment:
*Diagnostic test for AIDS- enzyme linked immuno-sorbent assay(ELISA)
*Treatment of AIDS with anti-retroviral drugs- partially effective
*Drugs can only prolong the life of the patient but cannot prevent death, which is inevitable
Prevention of AIDS:
*Educating people to generate awareness among them
* National AIDS Control Organization (NACO) and
* other non-governmental organization (NGOs)
*WHO has started a number of programs to prevent the spreading of HIV infection
which includes- Making blood (from blood banks) safe from HIV, ensuring the use of only disposable needles and syringes in public and private hospitals and clinics,
free distribution of condoms, controlling drug abuse, advocating safe sex and promoting regular check-ups for HIV in susceptible populations
immunity
Immunity
* The foreign agents could be pathogens/foreign substance => disease in host
* ability of host to fight against disease causing organism
Types of Immunity
* Innate Immunity- from birth & is not pathogen specific
- Immediate, maximum response
No build up memory (no lasting immunity)
- Acquired Immunity- not from time of birth & is pathogen specific; Immunity is
conferred based on memory that immune system have for that pathogen - lag time before max response
- immunological memory (“memory cells”)
Natural: contact with disease(Active)
Passive(Placenta, mothers milk)
Artificial
Active:
vaccine
Passive:
Immune serum, eg hepatitis shot
Detection of Cancer
Biopsy and histopathological study
tissue and blood and bone marrow tests for increased cell counts (leukemias);
b)Biopsy of a piece of the suspected tissue cut into thin sections is stained and examined
under microscope ( histopathological studies) by a pathologist
Radiography like X-rays, CT (computerizedtomograph)
a)used to detect cancers of the internal organs
b)Computed tomography uses X-rays to generate a 3D image of the internals
of an object
MRI (magnetic resonance Imaging):
a)uses strong magnetic fields and non-ionising radiations to accurately detect pathological
and physiological changes in the living tissue
Antibodies against cancer-specific antigen:
a) Antibodies against cancer-specific antigens are used for detection
of certain cancers genes- person is advised to prevent exposure
Treatment:
Surgery:(removal of cancer cells )
Radiotherapy: Destruction of cancer cells using radiation
Chemotherapy: destruction of cancer cells using drugs (anti cancer agents )
Pandemic Management Platform
- contact Tracing command center automation
- Location History
Managment - Risk Assessment for individual
- Health Assessment Screening Bot
- QnA bot
- Mass surveillance Over edge
- Quarantine time
- E-Pass Verification API,
- Pandemic Analytical Models
Telemedicine
WHO defines as ‘The delivery of health care services, where distance is a critical factor, by all health care professionals using IT tech for the
exchange of valid info for diagnosis, treatment
and prevention of disease and injuries, research and
evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities.
TELEHEALTH
delivery and facilitation of health and health-related
services => medical care, provider and patient
education, health information services, and self-care via telecommunications and digital communication
Who can be associated with Telemedicine ?
REGISTERED MEDICAL PRACTITIONER
=> a person who is enrolled in the State Medical Register or
the Indian Medical Register under the Indian
Medical Council Act 1956.’ [IMC Act, 1956]
*Patient management approach combining various IT for monitoring patients at distance.
*IT application domains in health care include telemedicine and home telecare.
*Chronic health conditions such as
pulmonary
conditions, diabetes, hypertension, and cardiovascular
diseases,
are preventable or highly treatable.
*majority of all
healthcare spending — could be saved with
better preventative care and disease management .
*Telepsychiatry, teleradiology, teledermatology, and
teleophthalmology.
*Provides specialist consultation to distant communities, rather than to provide a tool for self-management of chronic disease.
Home telecare moinitoring:
providing care in a home setting => supporting the patient
*used in a more restrictive
sense and use of audio, video, and other tech to
monitor patient status at a distance
Tools for Telemedicine
Telephone, video, devices connected over LAN, WAN, Internet, mobile or
landline phones, Chat Platforms, internet based digital platforms
systems like Skype/ email/ fax etc.
classified into 4 types
1.mode of communication
2.timing of the info transmitted
3.the purpose of the consultation and
4.the interaction between the individuals involved—be it RMP-to-patient / caregiver, or RMP to RMP.
USE OF TOOLS WHERE PEOPLE can take their own measurements, automatically transmitted to doc
ALSO:
Home monitoring with interactive television
telemedicine in Karnataka
and adv and dis of telemedicine
Project in 2001
and the project was initiated by (ISRO).
*first phase =>in the district hospitals
*Expert medical advice was given by specialists
coordinated by
Karnataka State Remote Sensing Applications Centre
(KSRSAC)
uses the Indian Remote Sensing Satellite
for monitoring and managing resources.
*connected to super-speciality hospitals from
major cities via INSAT satellites => link
btw the patients and medical experts.
customised software integrated with computer hardware and diagnostic instruments=> joined to Very Small Aperture Terminal (VSAT) at every location.
TELEMEDINCE
Advantages
*Real-time data
*Decreased hospitalizations
*Actionable alerts
*Early identifications can be reported
*Client satisfaction
Disadvantages
*Reducing the number of complications remains
inconsistent across chronic illnesses
*Very few have reported resulting changes in
medication regimens and quality of life
*Clinical effects reported in several cardiac studies
were often minimal and inconclusive
