Infection Flashcards
1
Q
what are interleukins?
A
immunogenic proteins of the cytokine family
2
Q
what are interleukins secreted by?
A
WBCs
3
Q
there are high levels of TH-1 cells in the presence of what?
A
viral and bacterial infection
4
Q
there are high levels of TH-2 cells in the presence of what?
A
allergy reactions
5
Q
what is the lifespan of neutrophils?
A
up to 1 week
6
Q
what are the 3 types of lymphocytes?
A
NK cells, B cells and T cells
7
Q
what is a booster immunization?
A
boost immune memory, promoting active immunity
8
Q
define passive immunity
A
transferred from one person to another (e.g. to fetus from mother via breastmilk, from medications)
9
Q
what are the functions of antibodies?
A
neutralize or mark for destruction (by phagocytic cells)
10
Q
what is the function of T-helper cells?
A
activate B cells and secrete cytokines
11
Q
what are some causes of decreased WBC numbers?
A
- autoimmune diseases
- chronic infection/inflammation
- immunodeficiencies
- drug therapy
- cancer
12
Q
what is DiGeorge syndrome?
A
malformed thymus
13
Q
define virulence
A
the power of a pathogen to produce disease
14
Q
define pathogenicity
A
organism’s ability to evade or overcome body defenses
15
Q
define port of entry
A
mechanism of getting into the body past endogenous defenses
16
Q
what are the 2 mechanisms of infection?
A
- strength in numbers
- toxin production
17
Q
what does the “strength in numbers” principle mean?
A
pathogen needs to be numerous enough to overtake body defenses and cause infection
18
Q
define toxins
A
substances produced by pathogens that protect bacteria from host defenses and increase chance of success in infection
19
Q
define microflora
A
microorganisms present on/in human body
20
Q
define commensalism
A
relationship where the host is not negatively affected by bacteria
21
Q
define mutualism
A
both bacteria and host benefit in a relationship
22
Q
define parisitic
A
relationship where host is negatively affected by pathogen
23
Q
define opportunistic pathogens
A
any microorganism causing disease if an opportunity arises (immunocompromised, elderly, newborn, etc.)
24
Q
what are the 3 main groups of parasites?
A
protozoa, helmiths, arthropods
25
what is the tx for protozoa?
kill before it inhabits liver and multiplies
26
what parasite group does malaria belong to?
protozoa
27
what parasite group does tapeworm belong to?
helmith
28
what parasite group do lice, ticks, mites and fleas belong to?
arthropods
29
what are the 2 groups of fungi?
yeast and mold
30
what is the tx for fungal infections?
antifungals
31
what environment do fungi best thrive in?
dark and moist
32
define retrovirus
a virus that uses RNA for its genetic material
33
what enzyme do retroviruses use to convert RNA into DNA?
reverse transcriptase
34
why don't antibiotics work on viruses?
they have no cell structure, which is what ABX work on
35
what is the treatment protocol for viruses?
* manage symptoms with antivirals
* support immune system
* prophylaxis
36
define biofilms
colonies of bacteria
37
what environment do bacteria best thrive in?
differs by bacteria with specific temperature, oxygen and light conditions
38
which organisms are more contagious when causing infection: bacteria or virus?
virus
39
what are the 2 classifications of bacteria?
1. gram negative
2. gram positive
40
what differs in the cell wall structure of gram + and - bacteria?
gram - have an outer membrane and a thinner peptidoglycan layer
41
what are some modes of entry for pathogens?
* direct contact
* inhalation
* ingestion
42
define nosocomial
infection acquired in the hospital
43
define community acquired
infection acquired outside of hospital
44
what does "-itis" suffix mean?
infected/inflamed body part
| e.g. appendicitis in appendix
45
what does "-emia" suffix mean?
pathogen presence in blood
| e.g. bacteremia - bacteria in blood or fungemia - fungi in blood
46
what are the stages of infection?
1. incubation
2. prodromal
3. acute
4. convalescent
5. resolution
47
what does the DTaP vaccine protect against?
diptheria, tetanus and pertussis
48
what does the MMR vaccine protect against?
measles, mumps and rubella
49
what does the PNEU vaccine protect against?
against 25 pneumococcal pathogens
50
what are the bacterial characteristics of botulism?
gram positive, anaerobic bacteria that produces a toxin blocking Ach
51
what is the treatment for botulism?
antitoxin HBAT
52
what preservative prevents growth of botulism?
potassium nitrate salt
53
what information does a culture test provide us with?
* identification and classification of bacteria
* sensitivity and resistance to antibiotics
54
what is the incubation period of pharyngitis caused by S. pyogenes?
2-4 days
55
what are the s&s of pharyngitis caused by S. pyogenes?
* fever
* sore throat
* headache
* malaise
* enlarged tonsils with exudates
56
what are some diseases at risk of developing after a strep infection?
* glomerulonephritis
* endocarditis
57
what is our treatment for pharyngitis caused by S. pyogenes?
penicillins
58
what vaccinations are required at 2 months old in Canada?
* DTaP
* IPV
* Hib
* PNEU
* MENI
59
what vaccinations are required at 4 months old in Canada?
* DTap
* IPV
* Hib
* PNEU
* MENI
60
what vaccinations are required at 6 months old in Canada?
* DTap
* IPV
* Hib
* PNEU
* MENI
61
what vaccinations are required at 12 months old in Canada?
* MMR
* VAR
* PNEU
62
what vaccinations are required at 18 months old in Canada?
* DTaP
* IPV
* Hib
* MMR
63
what vaccinations are required at 4-6 yrs old in Canada?
* DTaP
* IPV
64
what vaccinations are required during preteen/teen in Canada?
Hepatitis B
65
what vaccinations are required at 14-16 years old in Canada?
* TdaP
* MENI
66
what are the 4 mechanisms of action of antibiotics?
* cell wall synthesis inhibitors
* protein synthesis inhibitors
* nucleic acid inhibitors
* antimetabolites
67
name some examples of cell wall synthesis inhibitors
* penicillins
* cephalosporins
* bacitracin
* vancomycin
68
name some examples of protein synthesis inhibitors
* chloramphenicol
* erythromycin
* tetracyclines
* streptomycin
69
name some examples of nucleic acid inhibitors
* quinolones
* rifampin
70
name some examples of antimetabolites
* sulfanilamide
* trimethoprim
71
what are the 3 main pathways of bacterial resistance?
* mutations occur
* bacteria to bacteria communication
* biochemical mechanisms
72
what is the function of R plasmid?
primary carriers of antibiotic resistance information
73
define transposons
“jumping genes” that carry DNA information between bacterial genetic information
74
define conjugation
the process in which bacteria communicate with one another to pass on antibiotic resistance information
75
what drug does the B-lactamase enzyme break down?
beta lactam antibiotics like penicillin
76
what does the enzyme kinase do?
Modifies and inactivates **aminoglycosides** antibiotics
77
what does the enzyme acetyltransferase do?
Alter and neutralize **chloramphenicol**
78
what are biochemical mechanisms used in bacterial resistance?
* production of enzymes
* receptor-site alteration
* decrease drug uptake
79
how did bacteria build resistance to the drug erythromycin?
bacteria prevent proper binding of erythromycin to receptor sites
80
how did bacteria build resistance to tetracyclines?
alter cell membranes or transport systems to reduce entry of antibiotics
81
what is the mechanism of action of beta-lactams?
inhibit cell wall synthesis
82
what pathogens do penicillins target?
gram + and - bacteria
83
are penicillins broad or narrow spectrum?
can be both
84
what percentage of people allergic to penicillins have a cross-allergy to cephalosporins?
10%
85
name some examples of penicillins from oldest to newest gen
* penicillin G
* methicillin
* ampicillin
* amoxicillin
* piperacillin
86
what is the 1st choice tx for pharyngitis of bacterial cause?
Penicillin V via PO
87
which bacteria is pharyngitis most commonly caused by?
Streptococcus pyogenes
88
what is the 1st choice tx for otitis media of bacterial cause?
amoxicillin by PO
89
which bacteria is otitis media most commonly caused by?
Streptococcus pneumoniae
90
what is the function of beta lactamase inhibitors?
reduce ABX resistance when in combination with ABX
91
co-amoxiclav (Augmentin) is a combination b/w which drugs?
amoxicillin + clavulanic acid
92
co-ticarcillin (Timentin) is a combination b/w which drugs?
ticarcillin + clavulanic acid
93
pip-taz (tazosin) is a combination b/w which drugs?
tazobactam + pipercillin
94
what is the largest ABX class?
cephalosporins
95
what are 1st gen cephalosporins used to treat?
skin infections
96
name some examples of 1st gen cephalosporins
* Cefazolin (Ancef)
* Cephalexin (Kefle)
* Cefuroxime
97
what are 3rd-5th gen cephalosporins used to treat?
infections that cross the BBB such as bacterial meningitis
98
name some examples of higher gen cephalosporins
* Ceftraxione
* Ceftazidime
* Ceftaroline
99
when are carbapenes used?
can be used for broad or focal tx for patient's who are very sick or with pathogens that are complex - not 1st line
100
name some examples of carbapenes
* imipenem
* meropenem
| -penem suffix
101
define aspiration pneumonia
inhalation of foreign body (typically food) triggers infectious process
102
what is the MOA of bacitracin?
cell wall inhibitor
103
Polysporin is a combination b/w which drugs?
bacitracin + polymyxin
104
what infections can we use bacitracin to treat?
* conjunctivitis
* skin/soft tissue lacerations
105
what pathogens does bacitracin target?
both gram + and - bacteria
106
how does **bacterial** conjunctivitis present?
with edema and pus
107
how does **viral** conjunctivitis present?
lacrimation
108
how does **allergic** conjunctivitis present?
edema, lacrimation, itch
109
what is the 1st choice tx for MRSA?
vancomycin
110
what are the s&s of MRSA?
* red or tender skin around wound
* Swollen, painful, oozing boils
* Doesnt get better with typical ABX tx
111
what are **severe** symptoms of MRSA?
* fever
* difficulty breathing
* chills
* chest pain
112
what is the 2nd choice tx for C. difficile?
vancomycin via PO
113
what is the 1st choice tx for C. difficile?
Flagyl via PO
114
which part of the body does C. difficile infect?
GI tract
115
what are the effects of a C difficile infection look like 24 hrs after exposure?
cells of colon lining are still normal
116
what are the effects of a C difficile infection look like 30 hrs after exposure?
* toxin starting to damage cells
* inflammation triggered
* fluid buildup
117
what are the effects of a C difficile infection look like 36 hrs after exposure?
* inflamed cells burt and die
* spores leave via **diarrhea**
118
what are s&s of C. difficile infection?
* fever
* abdominal pain
* severe diarrhea
* blood or pus in stool
119
what is the tx for restoring host flora during antibiotic tx?
probiotics - e.g. lactobacillus acidophilus
120
what is the MOA of lactobacillus acidophillus?
secretes toxic hydrogen peroxide to destroy other bacteria while restoring and protectin gnormal flora
121
what is the best choice for a lactobacillus acidophilus tx?
Bio K+
122
what structures make up the upper respiratory tract?
* nasal cavity
* pharynx
* larynx
123
what structures make up the lower respiratory tract?
* trachea
* primary bronchi
* bronchioles
* alveoli
* lungs
124
what is the expected SpO2?
>92%
125
what is the expected venous saturation?
~75%
126
how many heme groups make up a hemoglobin unit?
4
127
what 2 ways is oxygen transported in the body?
* dissolved in plasma
* bound to hemoglobin as oxyhemoglobin
128
what modes of transmission to respiratory illness travel by?
* airborne
* droplet
129
what are some pathogens that can cause a common cold?
* rhinoviruses
* respiratory syncytial virus (RSV)
* coronaviruses
130
what are the s&s of the common cold?
* nasopharynx congestion (coryza)
* post nasal drip
* sore throat
* headache
* malaise
* maybe otitis media
131
why is otitis media more common in young children?
their eustachin tubes are more straight and horizontal, making it easier for pathogens to travel to the middle ear
132
what are some common transmission modes of the common cold?
airborne, droplets
133
what is the treatment for the common cold?
supportive care
134
what drug classes can we use to relieve symptoms of the common cold?
* antihistamines
* adrenergic agonists
* antitussives
* analgesics
* combination drugs
135
what prophylaxis treatments can we use for the common cold?
* menthol
* vitamin c
* echinacea
* ginseng
136
how does vitamin C improve our immune system?
immunogenic vitamin that boosts immune system and enhances immune cell activation
137
how does echinacea improve our immune system?
increases ability to respond to pathogens by enhancing phagocytosis
138
what are the s&s of coronavirus?
cough, fever, malaise, **SOB, headache, rash**
139
how does a coronavirus rash typically present?
nonpruritic
140
what are some severe complications of coronavirus infection?
* encephalitis
* myocarditis
141
how is coronavirus transmitted?
droplets and contact with contaminated surfaces
142
what are the treatments for coronavirus infection?
depends on severity of case:
* paxlovid via PO
* remdesivir via IV
* tocilizumab via IV
143
paxlovid is a combination between which drugs?
nirmatrelvir + ritonavir
144
what is the mechanism of action of paxlovid?
* protease inhibitor (enzyme required for replication)
* CYP3A inhibitor (inhibits metabolizing enzyme)
145
what is the MOA of remdesivir?
inhibits RNA polymerase, inhibiting RNA transcription to DNA
146
what is the MOA of tocilizumab?
inhibits release of IL-6 antibody, decreasing inflammation
147
what are the characteristics of long COVID?
* must have had COVID infection prior
* presenting with new symptoms post covid
* last a minimum of 4 wks
* syndrome of symptoms with no identifiable illness
148
what are the 3 categories of symptoms of long covid?
* postviral
* neurological/inflammatory
* fatigue and brain fog
149
what is the treatment for long covid?
supportive practices
150
what is rhinosinusitis?
inflammation of nasal passages and sinuses
151
name the sinuses
* frontal
* sphenoid
* ethmoid
* maxillary
152
what is the etiology of rhinosinusitis?
nasal passage inflammation obstructs normal sinus outflow and traps pathogens
153
what is the treatment for rhinosinusitis?
* supportive care (oxygenation, intubation, antiinflammatories)
* antibiotics
154
what is epiglottitis?
Sudden and severe inflammation of supraglottic and pharyngeal areas
155
what are the s&s of epiglottitis?
* mouth breathing
* drooling
* pale
* cyanosis
156
what pathogens cause epiglottitis?
bacterial cause e.g.:
* Hib
* S. pneumoniae
157
what is the tx for epiglottitis?
**empiric antibiotics** (needs to be immediate) and an ET tube if needed
158
how is measles transmitted?
airborne
159
what are the s&s of measles?
* prodromal symptoms
* white spots inside the cheeks
* rash on upper torso or back
160
what are some complications of a measles infection?
* encephalitis
* blindless
* pneumonia
161
what is the target area of viruses?
inside human cell to survive and replicate
162
what virus family causes influenza?
orthomyxoviridae
163
what are the different types of influenza that affect humans?
A, B and C
164
which structures does influenza affect?
upper or lower respiratory tract, or both
165
which population is more likely to contract a lower respiratory influenza infection?
the immunocompromised
166
what are the common s&s of influenza infection?
* profound malaise
* common cold symptamology
* fever
167
what are the s&s of a severe influenza infection?
* diaphoresis
* myalgia
* tachycardia
* hypoxia
168
what are some possible complications of influenza infection?
* sinusitis
* otitis media
* pneumonia
* bronchitis
169
what is the tx protocol for influenza?
* supportive tx (alleviate symptoms, hydrate, O2 supplement)
* antivirals
170
what are some prophylactic strategies for influenza?
* vaccine
* hand hygiene
171
what antiviral drugs do we use to treat influenza?
* oselta**mivir**
* zana**mivir**
172
what is the MOA of oseltamivir and zanamivir?
neurominidase inhibitors - decrease replication release
173
what drug classes can we use to alleviate symptoms of influenza?
* antipyretics
* analgesics
* adrenergic agonists
* antitussives
174
how does bacterial pneumonia differ from viral pneumonia?
in bacterial pneumonia, alveoli full with exudates
175
"typical" pneumonia is typically caused by what class of pathogens?
bacteria
176
"atypical" pneumonia is typically caused by what class of pathogens?
viruses
177
what are some pathogens that cause bacterial pneumonia?
* S pneumoniae
* Haemophilus influenza
* S. aureus
178
what are some pathogens that cause viral pneumonia?
* influenza
* RSV
179
which structure does a pneumonia infection affect?
lower respiratory tract
180
what are the s&s of pneumonia?
* wet cough
* exudates
* fever
* malaise
181
what is the expected SpO2 of an individual with peripheral cyanosis?
<92%
182
what is the expected SpO2 of an individual with central cyanosis?
<85%
183
which areas can we see peripheral cyanosis affect?
* upper and lower extremities
* maybe lips
184
which areas can we see central cyanosis affect?
oral mucosa
185
what are some causes of cyanosis?
* low perfusion due to vasoconstriction, low CO, etc
* low oxygenation due to pathology
186
define hypoxemia
low blood oxygen
187
define organ ischemia
low presence of oxygen in organs
188
what is the treatment for cyanosis?
depends on pathogen but we can use an empiric tx
189
what vaccinations aid in prophylaxis tx of cyanosis?
* Pneumococcal
* Hib
* Influenza
190
what is the MOA of macrolides?
inhibit protein synthesis
191
what are macrolides typically used to treat?
* community acquired adult pneumonia
* gonorrhea
192
name some examples of macrolides
* erythro**mycin**
* azithoro**mycin**
* clarithro**mycin**
193
what is azithoromycin used to treat?
community acquired pneumonia
194
what is aspiration pneumonia?
lung infection that occurs when foreign materials, such as food, liquids, saliva, or vomit, are inhaled into the lungs instead of being swallowed into the esophagus
195
which populations are at risk for aspiration pneumonia?
* immunocompromised
* individuals taking antitussives or drugs with sedation effect
* poisoning
196
which areas does CN IX (glossopharyngeal) innervate?
base of the tongue and back of the throat
197
which cranial nerve creates the gag reflex?
CN IX (glossopharyngeal)
198
which lung lobe are objects and foreign pathogens most likely to end up in?
RML
199
what is the MOA of the drugs nitroimadozoles and rifampin?
inhibit nucleic acid replication and transcription of RNA and DNA
200
which bacterium causes tuberculosis infection?
mycobacterium tuberculosis
201
how is tuberculosis transmitted?
airborne
202
what are the stages of tuberculosis?
* active - bacterium in alveoli
* latent - necrosed lung tissue harbours pathogen but not infectious
* secondary - latent TB becomes active again
203
what are the s&s of tuberculosis?
* malaise
* cough
* anorexia
204
how do we diagnose TB?
* xray
* tuberculin skin test
* blood culture
205
why are blood cultures not decisive when diagnosing TB?
can appear negative even if they have TB because pathogen stays in the lungs and may not be present in the blood
206
why are tuberculin skin tests not decisive when diagnosing **active** TB?
Tuberculin skin test demonstrates existence of immune response NOT active infection
207
what is the tx for tuberculosis?
* isoniazid
* rifampin
* syngery tx or even surgery
208
what is the MOA of isoniazid?
cell wall synthesis inhibitor
209
how does mycobacterium tuberculosis damage lung tissue?
* macrophages attempt to phagocyte bacteria
* immune response forms ghon foci
* necrosis of lung tissue
210
what is ghon foci?
localized granuloma lesions that forms during TB infection
211
what are common side effects of antibiotic use?
* GI effects (nausea, diarrhea, abdominal pain)
* drug to drug interactions (oral contraceptives, NSAIDs)
212
what symptom analysis questions are important when assessing rashes?
* Where did it start first?
* Where did it spread to?
* Is it itchy?
* What type of rash is it? (e.g. papules, nodules)
213
what is acne vulgaris?
the most common type of acne resulting from inflammation of the pilosebaceous gland
214
when is the incidence of acne vulgaris at its highest?
at the age of high androgen hormone levels
214
which gender has a higher incidence of acne vulgaris?
men
215
which bacterium causes acne vulgaris?
propionibacterium
216
which body regions are most commonly affected by acne vulgaris?
* face
* upper torso
217
what is the MOA of retinoids?
vitamin A derivatives that increases epidermal regeneration and decreases sebum production
217
what treatments can we use to treat acne vulgaris?
* retinoids
* antibiotics (tetracyclines)
* estrogens
* good hygiene
* antiinflammatories (e.g. aspirin)
218
what are some examples of retinoid drugs?
* topical creams - Retin-A
* accutane via PO
219
what pregnancy safety category do systemic retinoids fall under?
pregnancy category X
220
which structures are at risk for organ damage when taking systemic retinoids?
* liver
* **skeletal muscle**
221
which tetracycline is used to treat acne vulgaris?
minocyclines
222
what pathogens do tetracyclines target?
gram + and - bacteria
223
name some examples of tetracyclines
* tetra**cycline**
* doxy**cycline**
* mino**cycline**
224
what is a severe side effect of the original tetracycline?
bone deformations
225
how is syphillies transmitted?
by sexual contact
226
what is the treatment for congenital syphillis?
* screening of mother
* treat mother before she gives birth
227
what pathogen causes syphillies infection?
Bacteria: Treponema pallidum
228
what are the s&s of primary syphillis?
* chancre lesion at area of contact
* highly infectious
229
what are the s&s of secondary syphillis?
* **rash at the palms and soles**
* fever
* pharyngitis
* nausea
* conjunctivitis
230
what are the s&s of tertiary syphillis?
* multi and variable organ lesions
* organ failure
231
what pathogen causes gonorrhea infection?
Neisseria gonorrhoeae
232
how is gonorrhea transmitted?
sexual contact
233
what are the s&s of gonorrhea in females?
* abdominal pain
* pain with intercourse
* vaginal discharge
* bleeding
234
what are the s&s of gonorrhea in males?
* infected kidneys
* UTI
* burning sensation with urination
* inflammation of the penile
* swollen testicles
* discharge from penis
235
what is the treatment for gonorrhea?
empiric antibiotic tx with:
* ceftraxione or cefixime
* azithromycin or ciprofloxacin if allergic
236
which cells does HIV target?
T-helper cells of the CD4 type
237
how is HIV transmitted?
sexual contact or blood-to-blood contact
238
what is the "window" period of HIV?
infectious period prior to the original infected person knowing of their infection
239
what is AIDS?
final stage of HIV infection
240
what are the initial symptoms of HIV?
asymptomatic - i.e. none
241
what are the s&s of the 2nd stage of HIV?
* fever
* fatigue
* pharyngitis
* lymphadenopathy
* headache
* **itchy rash**
242
what are the s&s of last stage HIV?
organ failure
243
what is the treatment of HIV?
multidrug tx focusing on interrupting replication
244
post-exposure prophylaxis (PEP) msut be taken within what time frame to treat HIV?
within 72 hrs of exposure
245
what is the administration schedule for PEP?
3 drugs x 28 days administered PO or IM
246
name some polyene antifungals
* Nystat**in** via PO or cream
* Amphoteric**in** via IV
247
name some examples of azole antifungals
* flucon**azole**
* keton**azole**
* bifon**azole**
248
name some examples of allylamine antifungals
* Lamisil (terbinafine) in cream
249
herpes simplex 1 typically affects which area?
oral
250
herpes simplex 2 typically affects which area
genital
251
what is the treatment for herpes simplex?
antivirals (valacyclovir, acyclovir)
252
what is the MOA of valacyclovir and acyclovir?
inhibits viral DNA polymerase to reduce replication
253
what are the s&s of varicella zoster infection (chicken pox) in pediatrics?
* itchy
* malaise
* fever
* rash
254
what are the s&s of varicella zoster infection (chicken pox) in adults?
pneumonia and organ complications
255
what is the treatment for chicken pox?
supportive tx with antihistamines and antipyretics
256
what is the tx for severe chickenpox?
IVIG (IV immunoglobulin)
257
what are some severe complications of shingles?
* neuropathic pain
* meningitis
* major organ damage
258
what is the tx for shingles?
acyclovir
259
what is shingles?
reactivated chickenpox in adults
260
where is CSF produced?
choroid plexus of lateral ventricles
261
where are CSF cultures taken from?
subarachnoid space
262
what is intracranial pressure (ICP)?
pressure inside the skull, within brain tissue and CSF
263
what is a normal ICP in adults?
5-15 mmHg, average 12-13
264
what is the effect of ICP on CPP?
if ICP is high, CPP decreases
265
what is the formula for CPP?
MAP - ICP
266
what is the formula for MAP?
SBP + 2(DBP) /3
267
what is the expected CPP?
60-80 mmHg
268
what is meningitis?
Inflammation of the pia mater, arachnoid mater and subarachnoid space
269
which meningitis is more severe: viral or bacterial?
bacterial
270
what are some common bacterial pathogens causing meningitis?
* S. pneumoniae
* Niseria meningitis
* Hib
271
what are the s&s of meningitis?
* CNS rigidity
* fever
* headache
* **sensitivity to light (photophobia)**
* **confusion/altered mental state**
* **stiff neck**
* **petechial rash**
* **seizures**
272
what is Brudzinski's neck sign?
assessment tool that is positive if hip flexes involuntarily when trying to flex neck
273
what is Kernig's sign?
assessment tool that is positive if unable to extend the leg when the thigh is flexed on the abdomen without extreme pain
274
what is the tx for meningitis?
* antibiotics
* glucocorticoids (dexamethasone) to decrease inflammation
275
what is the MOA of aminoglycosides?
inhibit protein synthesis
276
name some examples of aminoglycosides
* genta**micin**
* strepto**mycin**
* neo**mycin**
* tobra**mycin**
277
what are some risks to using aminoglycosides?
* extremely cytotoxic
* narrow TI, must be closely monitored
278
what is encephalitis?
inflammtion of the brain
279
what is encephalitis most commonly caused by?
viruses, especially HSV-1
280
what is the tx for encephalitis?
acyclovir
281
name some examples of gram - bacteria
* E-coli
* Klebsiella
* Psuedomonsa
* Salmonella
* Hib
* Cholera
* Syphilis
* Gonorrhea
* Nisseria M.
282
what colour does a gram - bacteria stain?
pink
283
name some examples of gram + bacteria
* Staphylococci
* Streptococci (Pneumococci)
* Enterococci
* Listeria
* C-diff
284
what colour does a gram + bacteria stain?
purple
285
define nephrons
functional units of the kidney
286
define glomerulus
bundle of capillaries where filtration begins
287
define Bowman's capsule
cup-shaped sac at the beginning of the nephron that collects filtrate from glomerulus
288
what is filtrate made up of?
* water
* electrolytes
* glucose
* amino acids
* waste products
289
typically how much urine is made in an hour?
37.2 mL
290
typically how much urine is made in a day?
2L
291
what is glomerulonephritis?
inflammation of the glomeruli
292
what are some complications of glomerulonephritis?
* impaired filtration -> proteinuria and hematuria
* reduced urine output
* fluid retention
* high BP
* increased waste product
* risk of kidney failure and chronic illness
293
what are the s&s of UTI?
* Frequent urination
* Burning/pain on urination (dysuria)
* Cloudy urine
* Confusion and weakness
* May see proteinuria or hematuria
294
which structures does a UTI affect?
upper and lower urinary tract, can ascend into kidneys
295
how do we diagnose the causative pathogen of UTI?
urine culture
296
which populations are at risk for higher incidence of UTI?
* hospitalized individuals
* elderly
297
what are some preventative practices for UTI?
* Adequate hydration
* Good hygiene
* Urination after sex
298
what combination drug is typically used to treat UTI?
sulfamethoxazole and trimethoprim (Bactrim, Septra)
299
what is cranberry juice composed of?
* Water (88%)
* Organic acids (including salicylate)
* Fructose
* Vitamin C
300
how does cranberry juice work to prevent infection?
Inhibit the adhesion of E. coli to host cells
301
name some examples of causative pathogens of diarrhea?
* E. coli
* Klebsiella
* Salmonella
* Shigella
302
what are the s&s of an E. coli infection?
* Water diarrhea – sometimes bloody
* Low fever
* Loss of apetite
* Nausea and vomiting
* Stomach pains and cramps
* Fatigue
* Proteinuria and hematuria
* Paling
303
which strain of E coli is associated with HUS?
E. coli H7
304
what are the s&s of E. coli H7 infection?
* Abdominal pain
* Bloody diarrhea
* Fever
* Seizures
* Lethargy
305
what are some severe complications of HUS?
* microangiopathic hemolytic anemia
* thrombocytopenia
* renal insufficiency
306
what is the tx for HUS?
* Mainly supportive
* Dialysis
* IVIG
307
what is the MOA of fluroquinolones?
Inhibit nucleic acid replication and transcription
308
name some examples of fluroquinolones
* ciproflo**xacin**
* levoflo**xacin**
* norflo**xacin**
309
name some examples of nitroimidazoles
* metroni**dazole** (Flagyl)
310
what are fluroquinolones typically used to treat?
* UTI
* GI infection
311
what are nitroimidazoles typically used to treat?
GI infection (e.g. C. difficcile, H. pylori)
312
what is appendicitis?
Inflamamtion of the appendix
313
what causes appendicitis?
fecal impaction, pathogens, torsion (twisting)
314
what are the s&s of appendicitis?
* Acute, sharp, throbbing pain in the RLQ
* Nausea and vomiting
* Fever
315
what does a positive Mcburney's sign mean?
positive sign is when significant pain is elicited by palpating the RLQ → sign of appendicitis
316
what does a positive Rovsing's sign mean?
positive sign is when there is tenderness in the RLQ when palpating the LLQ → sign of appendicitis
317
what is the tx for appendicitis?
laproscopic or open appendectomy
318
what are some prophylaxis drugs for surgical infections?
* Clindamycin
* Lincomycin
319
what is the MOA of Clindamycin and Lincomycin?
Protein synthesis inhibitors
320
what are some surgical complications of appendectomies?
* Pain
* Surgical infection
* Skin infection
* Wound dehiscence (separation)
* Clots
* Paralytic ileus (no peristalsis)
