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BDS 2 BAMS > Infection > Flashcards

Infection Flashcards

1
Q

what are the 6 chains of infection

A 
infectious agent
reservoir
portal of entry
portal of exit
transmission
susceptible host
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2
Q

give an example of an endotoxin and exotoxin

A

endotoxin - lipopolysaccharide wall

exotoxin - proteases

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3
Q

what is a fomite

A

an area that a microbe can survive between reservoirs - keyboards, worktops

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4
Q

what is the incubation period and what is the relevance

A

where a person is infected but not showing clinical symptoms - dont realise they are. a long incubation period allows for more transmission

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5
Q

what is colonisation

A

where a patient has high levels of the microbe but is showing no signs of infection. no symptoms or clinical onset - staph aureus in nose

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6
Q

what is the difference between an endogenous and exogenous infection

A

endogenous - infectious agent comes from within, just in a different place - mutans in pulp
exogenous - infectious agent comes from an external source

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7
Q

what is the RO

A

risk of transmission, if 1 case can cause 1 case - high risk of transmission, likely to cause an outbreak

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8
Q

describe hepatitis A

A

RNA virus, lives in contaminated water, transmission via faecal-oral route - seafood can be contaminated. causes an acute infection, more common in developing countries

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9
Q

how can hepatitis A be detected

A

serology - antibodies (if enough time has passed since infection) or antigens
or antigens detected in faeces

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10
Q

what is the viral load

A

number of viral particles per ml of blood - high suggests highly transmissible

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11
Q

what is the viral structure of hepatitis B

A

double stranded DNA genome, protein coat with surface antigens, a core antigen beneath the surface

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12
Q

what are the 3 main routes of transmission of hepatitis B

A

blood borne - intravenous drug user, healthcare worker
sexual - homo and hetero
mother to baby

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13
Q

why is hepatitis b concerning in a baby

A

more likely to cause chronic disease - cirrhosis or liver cancer

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14
Q

what is the difference in disease in hepatitis b in endemic and non-endemic areas

A

endemic - acute disease mainly, with recovery - only 5% of chronic disease
non-endemic - common in children and 95% have chronic disease

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15
Q

describe hepatitis C

A

RNA virus, blood borne from human flavivirus, no vaccine available but effective treatments, subclinical infection can result in chronic disease - 60%

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16
Q

how is hepatitis D a defective virus

A

can only replicate protein coat if hepatitis B is present

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17
Q

what is the difference between co infection and super infection

A

co-infection - infection of hepatitis b and d at same time

super infection - hepatitis b infection, then get d infection

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18
Q

explain the virology of HIV

A

RNA virus, enters cells and converts to DNA. Then everytime the cell replicates, DNA replicates and proteins made. these can be released to then infect more cells. infects CD4 cells - reduces numbers, less able to fight infections

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19
Q

describe the primary infection of HIV

A

virus enters CD4 cells and reduces numbers - may have flu like symptoms

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20
Q

describe the latent infection of HIV

A

body is managing to control the virus, dont realise you have it for 2-15 years. control is lost, allows CD4 numbers to drop and patient to develop more infections

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21
Q

what infections are indictive of HIV

A

kaposi’s sarcoma, candidiasis, hairy leukoplakia, non-hodgkin lymphoma

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22
Q

what does HIV cause

A

acquired immunodeficiency syndrome

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23
Q

how is HIV transmitted

A

blood transfusion, IV drug user, unprotected sex

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24
Q

what is HIV PrEp

A

pre-exposure prophylaxis, given to HIV negative patients who are high risk for catching HIV, keeps virus from establishing a permanent infection

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25
Q

what is the aim of treatment of HIV

A

reduce viral load to stop developing AID

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26
Q

who are high risk individuals for HIV

A

sex workers, IV drug users, gay men

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27
Q

define sepsis

A

organ dysfunction due to excessive inflammatory response to infection

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28
Q

what differentiates sepsis from an infection

A

organ dysfunction

29
Q

what is SIRS

A

systemic inflammatory response syndrome - high or low body temperature, increased respiratory rate, increased heart rate, increased white blood cell count

30
Q

why can SIRS not be used alone to diagnose sepsis

A

it doesnt account for organ dysfunction, just systemic inflammation and at risk for sepsis

31
Q

what is used to diagnose sepsis

A

SOFA - involves lab tests but can do a quick one - a score higher than 2 suggests sepsis - need medical intervention
reduced blood pressure, increased respiratory rate and a score of less than 15 on Glasgow coma scale

32
Q

what is the difference for those with a pre-existing organ condition on the qSOFA

A

they start at a score of 1 already - only need 1 more thing to suggest sepsis

33
Q

what is the glasgow coma scale

A

measures motor response, verbal response and eye response - fully working is 15, anything lower than this requires intervention

34
Q

what causes sepsis

A

any infection. some are more virulent so more likely to cause infection - LPS
some people are more susceptible - immunosupressed

35
Q

describe the pathophysiology of sepsis

A

tissue damage - cytokines and chemokines - increase vascular permeability - macrophages enter area
fail to resolve damage or infection - increase of cytokines - more tissue damage - failure to localise infection - hyperinflammation
also have suppression of immune response - apoptosis, dysfunctional dendritic cells - removal of b and t cells
results in organ dysfunction

36
Q

why is sepsis important in dentistry

A

dental infection has ability to become systemic and cause sepsis, dentist can notice symptoms of disease

37
Q

what is spoulding’s classification

A

classifies surfaces and determines what level of disinfection is required

38
Q

what are the classifications of spoulding

A

critical - enters normally sterile surfaces, periodontal scaler or forceps. requires sterilisation
semi-critical - enters intact mucous membrane, handpiece or mirror - high level disinfection
non-critical - enters intact skin, light cure - low level disinfection
minimal risk - not in contact with intact skin - dental chair - low level disinfection

39
Q

what are the different surfaces in dental setting

A

housekeeping surfaces - not normally in contact during procedure, require low level disinfection - walls, floor
clinical contact surfaces - in contact, either direct or via aerosol, splatting or dentist gloved hand - drawer, worktops

40
Q

what is the difference between detergent and disinfectant

A

detergent - dont know efficacy, how well it actually works

disinfectant - kills all bacteria, only leaves spores, but requires contact time

41
Q

what is the difference between a microbiome and a biofilm

A

microbiome - collection of microbes in the human body
biofilm - microbes on one surface, not everywhere has one - gut and oral cavity
skin has microbiome but not biofilm

42
Q

what are some examples of microbes being introduced to the human body

A

giving birth - naturally, through birth canal, baby accumulates several bacteria
lactation - breast milk, contains sugars that bacteria can feed off
weaning off milk to solid food

43
Q

why do we require microbes in the body

A

production of vitamins - k and b12
to prevent colonisation of more harmful bacteria - competes for resources and prevents attachment of c diff for example
stimulates cell growth

44
Q

what are firmicutes

A

bacteria that have been linked to obesity. may have something to do with how energy is sourced from food - more firmicutes, more over weight

45
Q

how could firmicutes be used in treatment

A

may be useful to do a faecal transplant - remove firmicutes from gut microbiome and may reduce obesity - change the way they store energy

46
Q

how can the biofilm contribute to oral disease

A

some people have a biofilm composed of more sacchrolytic bacteria - thrive off of carbohydrates and acid producing - they are more likely to develop caries if their oral hygiene is poor - develops quicker

47
Q

what biofilm is protective of caries

A

proteolytic - bacteria doesnt produce as much acid so more protective. however, is more indicative of periodontal disease. if their oral hygiene is poor - more likely to develop perio disease

48
Q

what are the two ways in which microbial growth can be controlled

A

physical - heating up in hot temperatures its kills microbes - autoclave
chemical - disinfectant or anti septics

49
Q

what is the difference between antiseptic and disinfectant

A

disinfectant has a high concentration of chemical to kill microbes on surfaces. anti-septics are used to target microbes and protect hosts, used on skin and mucous membranes

50
Q

what are the mechanisms of action of disinfectants and antiseptics

A

target proteins or enzymes - functionality
target membrane to cause lysis - alters osmolarity
target processes - oxidising agents

51
Q

give an example of a disinfectant/antiseptic for each mechanism of action

A

chlorohexidine - alters osmolarity
iodophor - denatures proteins
hydrogen peroxide - oxidising agent

52
Q

what are the mechanisms of action of antibiotics

A

target protein synthesis
target dna transcription
attack cell wall

53
Q

how do antibiotics target protein synthesis

A

by binding to ribosome subunit, inhibiting it and preventing protein building - tetracyclin

54
Q

how do antibiotics attack cell wall

A

penicillin - attacks cross linking of peptidoglycan, causes it to fall apart. cell membrane then exposed - osmosis altered and cell lysis

55
Q

how do antibiotics inhibit dna transcription

A

by inhibiting dna gyrase - dna cannot unwind for transcription

56
Q

how can resistance to antibiotics develop

A

misuse of antibiotics - not finishing courses, taking them when not required. antibiotics work in a specific way - can change the shape of ribosome and antibiotic is no longer effective. or sometimes it is just thrown back out by cell

57
Q

why might we want to manipulate the immune system

A

to promote a response - vaccines, immunosupressed

to suppress a response - autoimmune disease, chronic inflammation

58
Q

what are the 5 stages of an infectious disease

A

pre-vaccine, vaccine coverage, loss of confidence, resumption of confidence, eradication

59
Q

what diseases have a vaccine

A

polio, diptheria, hep B, measles mumps and rubella

60
Q

what is the aim of a vaccine

A

stimulate an immune response, resulting in the production of IgG antibodies, providing immunological memory and immunity in a second exposure

61
Q

what are different types of vaccine

A

live attenuated, inactive, subunit

62
Q

what is a live attenuated vaccine

A

the infection has been genetically modified to make it weaker, injected and can replicate in tissues. generates a strong immune response but can result in disease in the immunosupressed. MMR

63
Q

what is an inactive vaccine

A

the microbe has been killed before injection, cannot replicate in tissues. much safer but not as good immunity, may require several rounds - polio

64
Q

what is a subunit vaccine

A

when parts of the microbe are taken and injected - proteins e.g. - hepatitis b

65
Q

what can be added to a vaccine

A

adjuvant - intra muscular, forms a granuloma, keeps the vaccine at the site of injection, prevents it from being dispersed - increase immune response

66
Q

what are the considerations for a caries vaccine

A

strep mutans has been severely linked - could vaccinate against this so it is removed from oral environment. but thought more the interaction of host and bacteria causes disease, not kosch’s postulate. also completely preventable and not life threatening

67
Q

what drugs can be used to suppress immune system

A

corticosteroids, non-steroidal anti-inflammatory, methotrexate (disease modifying anti-rheumatic drugs)\ and biological therapy - anti tnf’s

68
Q

what treatment is normally given for rheumatoid arthritis

A

methotrexate, but normally start to develop resistance so biological therapy is used in conjunction

BDS 2 BAMS (12 decks)

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