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N116 > Infection > Flashcards

Infection Flashcards

1
Q

infection

A

invasion and multiplication of microorganisms in body tissues

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2
Q

pathogen

A

disease causing micro organism

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3
Q

normal flora

A

microorganisms that live in or on the body w/o causing disease

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4
Q

sepsis

A

presence of pathogens in blood or other tissues throughout the body

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5
Q

virulence

A

capacity of a microorganism to cause disease (degree of pathogenicity)

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6
Q

opportunistic

A

microorganism that normal does not cause disease but will if there are the right conditions

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7
Q

epidemiology

A

study of distribution, cause, and control of disease in human population

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8
Q

descriptors of infection

A 
location
duration
source
endemic infection
epidemic infection
pandemic infection
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9
Q

location

A

localized vs disseminated vs systemic infection

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10
Q

duration

A

acute vs chronic

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11
Q

source

A

hospital acquired
health care acquired
community acquired
primary vs secondary infection

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12
Q

endemic infection

A

always present in a community usually at a low

almost constant frequency

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13
Q

epidemic infection

A

increases cases of a specific infection at a specific time and place which exceeds the predicted number of new cases

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14
Q

pandemic infections

A

infections that spread to other countries

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15
Q

factors for infection

A 
communicability 
infectivity 
virulence 
pathogenicity 
portal of entry 
toxigenicity
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16
Q

communicability

A

ability to spread from person to person and cause disease

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17
Q

infectivity

A

ability of pathogen to invade and multiply in the host

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18
Q

virulence

A

capacity of pathogen to cause disease

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19
Q

pathogenicity

A

ability of an agent to produce disease

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20
Q

portal of entry

A 
route by which a pathogen infects the host 
direct contact
inhalation
ingestion 
bites from an animal or insect
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21
Q

toxigenicity

A

ability to produce soluble toxins or endotoxins

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22
Q

immune responses to bacterial invasion

A
  • B lymphocytes are activated = production of antibodies
  • T lymphocytes are activated = phagocytosis
  • complement system activated to enhance overall responses
  • bacteria release endo/exotoxins which damage cells of the host and initiate inflammation response
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23
Q

factors that influence the bodies ability to fight infections

A 
age 
nutrition
immunoglobulins 
WBC
organ function 
circulation
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24
Q

transmission of of viral diseases

A

aerosal
infected blood
sexual contact
vector

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25
Q

immune deficiencies

A

failure of immune mechanisms
primary (congenital) immunodeficiency - genetic
secondary (acquired) immunodeficiency - caused by another illness

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26
Q

treatment for immunodeficiencies

A 
gamma-globulin therapy (IVIg)
stem cell transplantation 
transfusion of erythrocytes 
bone marrow transplant 
mesenchymal stem cell injection 
gene therapy
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27
Q

manifestations of inflammation

A

redness
heat
edema
pain

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28
Q

manifestations of systemic symptoms

A 
fever
fatigue 
malaise 
cough 
diarrhea
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29
Q

empiric therapy

A

treatment of an infection before specific culture information has been reported or obtained

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30
Q

definitive therapy

A

antibiotic therapy tailored to treat organisms identified with cultures

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31
Q

prophylactic therapy

A

treatment with antibiotics to prevent an infection

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32
Q

broad spectrum antibiotics

A

effective against a wide variety of different microbial species
effective against gram +, - and anaerobic
overuse contributes to resistance

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33
Q

narrow spectrum antibiotics

A

effective against a smaller group of microbes or only the isolated species

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34
Q

bactericidal

A

kill bacteria

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35
Q

bacteriostatic

A

slows bacterial growth

allows bodys natural defences to destroy bacteria

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36
Q

four most common mechanisms of antibiotic action

A
  1. interfere with bacterial cell wall synthesis
  2. interfere with protein synthesis
  3. interfere with replication of nucleic acids
  4. antimetabolite action that disrupts critical metabolic reactions inside the bacterial cell wall
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37
Q

superinfections

A

microorganisms normally present in body are destroyed by antibiotics

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38
Q

C. diff

A

gram + bacillus
hospital acquired from antibiotic use
antibiotics remove normal flora and allow c. diff to colonize

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39
Q

manifestations of C. diff

A 
watery, foul smelling diarrhea 
abdominal cramping 
dehydration 
electrolyte loss
fever
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40
Q

evaluation for c. diff

A

test stool

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41
Q

c. diff treatment

A

treated with antibiotics
- vancomycin
- flagyl
probiotics

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42
Q

steps in drug selection

A
  1. make diagnosis
  2. obtain cultures and/or specimen
  3. make microbial diagnosis using lab results
  4. select drug based on the results of sensitivity or usual susceptibility
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43
Q

4 types of penicillin

A

narrow spectrum
narrow spectrum/penicillinase resistant
broad spectrum
extended spectrum

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44
Q

penicillin action

A

inhibit bacterial cell wall synthesis

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45
Q

penicillin indications

A

acute chronic bronchitis, sinusitis, UTIs, pharyngitis, pneumonia, meningitis, skin bone and joint infections, stomach infections, blood and valve infections, gas gangrene, tetanus, anthrax and sickle cell anemia in infants

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46
Q

penicillin contraindications

A

known allergy

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47
Q

side effects of penicillin

A

diarrhea, stomach cramps, mouth sores, vaginitis, convulsions, decreased output

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48
Q

adverse effects of penicillin

A

penicillin allergy, antibiotic-associated pseudomembranous colitis

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49
Q

half life of penicillin

A

0.5-2 hours

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50
Q

duration of action of penicillin

A

4-8 hours depending on the type of penicillin

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51
Q

dosing frequency of penicillin

A

BID (twice a day) Q4H, Q8H, Q12H

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52
Q

route of excretion of penicillin

A

kidneys

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53
Q

aminoglycosides and penicillin

A

additive

more effective killing bacteria

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54
Q

NSAIDS and penicillin

A

compete for binding sites

more free and active penicillin (could be harmful)

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55
Q

oral contraceptives and penicillin

A

decrease effectiveness

may decrease efficacy of contraceptive

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56
Q

warfarin (coumadin)

A

increases metabolism

penicillin may increase metabolism of warfarin, decreasing its effect

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57
Q

cephalosporins

A

treatment of choice for gram - infections

5 generations

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58
Q

5 generations of cephalosporins

A 
first (cefazolin, cephalexin)
second (cefuroxime)
third (cefixime, ceftriaxone)
fourth (cefepime)
fifth (ceftraroline)
59
Q

cephalosporins action

A

bactericidal

interfere with bacteria cell wall and bind to the same penicillin binding proteins inside bacteria

60
Q

cephalosporins indications

A

primary therapeutic use for gram - infections and people who cannot have penicillin
same indications as penicillin

61
Q

cephalosporins contraindications

A

allergic to penicillin people may also react to cephalosporins

62
Q

adverse effects of cephalosporins

A 
similar to penicillin
if taken with alcohol may cause:
severe vomiting
weakness
blurred vision 
severe hypotension
63
Q

half life of cephalosporins

A

1-4 hours

64
Q

duration of action of cephalosporins

A

4-24 hours depending on type

65
Q

route of excretion of cephalosporins

A

most via kidneys

some are 30% in bile and 70% in urine

66
Q

tertacyclines

A

effective against large number of gram -/+ organisms

67
Q

action of tetracylines

A

bactereiostatic effect and inhibits protein synthesis in susceptible bacteria

68
Q

indications for tetracylines

A

syphilis, rocky mountain spotted fever, typhus, cholera, lyme disease, ulcers caused by H. pylori, chlamydial infections

69
Q

contraindications for tetracyclines

A

pregnant and nursing women, children under 8, allergy, renal impairment

70
Q

adverse effects of tetracyclines

A 
discolouration of teeth in young children 
photosensitivity 
alteration in intestinal flora
diarrhea
colitis 
super infections
coagulation irregularities 
exacerbate systemic lupus
71
Q

half life of tetracyclines

A

6-22 hours

72
Q

duration of action of tetracyclines

A

6-12 hours

73
Q

route of excretion of tetracyclines

A

kidneys and feces

74
Q

macrolides

A

safe alternative to penicillin
drug of choice for fewer diseases
may be bacteriostatic or bactericidal in high enough doses

75
Q

macrolides action

A

binds to ribosomal subunit inside bacterial cell and prevents bacterial protein synthesis needed to grow

76
Q

macrolides indications

A

various infections of upper and lower respiratory tract, skin and soft tissue infections
whooping cough, Legionnaire’s disease, strep infections, haemophilus influenza, mycoplasma pneumonia and chlamydia, HIV/AIDS, PUD

77
Q

macrolides contraindications

A

hepatic disease (metabolized in the liver), caution in pregnancy and breastfeeding

78
Q

macrolides adverse effects

A

seizures, dysrhythmias, hepatotoxicity, nausea, vomiting, abdominal cramping and diarrhea, angioedema

79
Q

macrolides half life

A

1-12 hours

80
Q

macrolides duration of action

A

6-24 hours

81
Q

macrolides route of excretion

A

mainly by bile, also in urine

82
Q

aminoglycosides

A

treatment of aerobic gram - bacteria, mycobacteria and protozoans

83
Q

aminoglycosides action

A

bactericidal

inhibits bacterial protein synthesis and causes synthesis of abnormal proteins

84
Q

aminoglycosides indications

A

serious systemic infections caused by aerobic gram - bacteria, pneumonia, bacterial meningitis, endocarditis, pericarditis, abdominal infections

85
Q

aminoglycosides contraindications

A

not good for long term use due to toxic effects, pregnancy category D, caution with infants and elderly, drug allergy

86
Q

aminoglycosides adverse effects

A

headache, dizziness, vertigo, skin rash, fever, neuromuscular blockade, ototoxicity, nephrotoxicity

87
Q

aminoglycosides half life

A

2-4 hours

88
Q

aminoglycosides duration of action

A

6-12 hours

89
Q

aminoglycosides route of excretion

A

kidneys

90
Q

fluoroquinolones

A

four generations
active against gram - bacteria
later generations more effective against gram +

91
Q

fluoroquinolones actions

A

bactericidal

alters DNA

92
Q

fluoroquinolones indications

A

kills susceptible strains of gram -/+ bacteria

93
Q

fluoroquinolones contraindications

A

caution with children, do not use in pregnancy or lactation, caution with epilepsy, alcoholism, cerebral arteriosclerosis, drug allergy

94
Q

fluoroquinolones adverse effects

A

nausea, vomiting, diarrhea, dysrhythmias, liver failure, dizziness, headache, sleep disturbances, QT prolongation, ruptured tendons/tendonitis, fever, chills, tinnitus

95
Q

fluoroquinolones half life

A

2-20 hours

96
Q

fluoroquinolones duration of action

A

12-24 hours

97
Q

fluoroquinolones route of excretion

A

kidneys

98
Q

sulfonamides

A

used in combination with other drugs to treat UTI’s

99
Q

sulfonamides action

A

bacteriostatic

inhibits growth by preventing synthesis of folic acid

100
Q

sulfonamides indications

A

UTI’s, upper respiratory tract infections, used with other drugs to treat malaria, e. Coli, Klebsiella, staphylococcus aureus

101
Q

sulfonamides contraindications

A

pregnancy, lactation, infants less than 2 months, caution with kidney disease, drug allergy

102
Q

sulfonamides adverse effects

A

formation of crystals in urine, hypersensitivity reactions, nausea, vomiting, fatal blood abnormalities (rare)

103
Q

sulfonamides half life

A

5-12 hours

104
Q

sulfonamides duration of action

A

4-12 hours

105
Q

route of excretion

A

mainly kidneys

106
Q

clindamycin (Dalacin C)

A

treats gram +/- infections when other drugs are not effective

107
Q

Vancomycin (PMS-vancomycin)

A

treat gram + infections

most effective drug against MRSA

108
Q

Linezolid

A 
first new drug in a class known as Oxazoildinones 
effective against MRSA
109
Q

UTI

A

inflammation of urinary epithelium that is caused by bacteria from the gut flora
can include bladder, kidneys, urethra or prostate

110
Q

upper UTI

A

kidney and pelvis

111
Q

lower UTI

A

urethra, prostate, bladder

112
Q

manifestations of UTIs

A 
dysuria (painful urination)
frequency 
urgency 
nocturia 
foul smell 
hematuria 
pyuria (excess mucous and white cells in urine)
confusion
back pain
anorexia
fever
113
Q

mycostatin used for

A

fungal infections of vagina, oral, skin, scalp and nails

114
Q

fungal infection agents action

A

inhibit ergosterol synthesis causing cell membranes to become leaky

115
Q

fungal infection agents indications

A

wide spectrum of activity against fungi that invade humans

116
Q

fungal infection agents contraindications

A

caution with renal impairment, liver function or sever bone marrow suppression

117
Q

non-malarial protozoan infections action

A

binds with DNA and degrades the structure inhibiting synthesis

118
Q

non-malarial protozoan infections indications

A

treatment of amebiasis, toxoplasmosis, giardiasis, trichomoniasis

119
Q

non-malarial protozoan infections contraindications

A

alcoholics, first month of pregnancy, blood diseases, diseases of the CNS, caution in children

120
Q

helminthic infections

A

parasitic worms

121
Q

pharmacotherapy of helminthic infections

A

not indicated for all infections because parasites often die without reinfecting the host

122
Q

complications from helminthic infections

A

physical obstructions of the intestine, malabsorption, increased risk for secondary infection and severe infections

123
Q

“symptoms” of helminthic infections

A

as worms die patients may have abdominal distension, diarrhea or abdominal pain

124
Q

treatment of viral infections

A

most viruses don’t need treatment, risk for adverse effects

drug therapy can be used to prevent infection or alleviate symptoms

125
Q

influenza

A

viral infection of the epithelial cells within the airway

126
Q

influenza impairs

A

cilia, mucous, and antibodies

127
Q

influenza causes

A

epithelial cells to die
results in necrosis and sloughing of dead cells
leads to upper respiratory tract infection or pneumonia

128
Q

manifestations of influenza

A 
cough
sore throat 
nasal congestion/drainage
shortness of breath
chills
fever
body aches
weakness 
malaise (feeling of uneasiness)
129
Q

acute otitis media

A

common infection in infants and children

infection and inflammation of middle ear

130
Q

acute otitis media causes

A

tubes become blocked, preventing secretions from draining
creates negative pressure within middle ear space
nasopharyngeal secretions move to middle ear

131
Q

acute otitis media manifestations

A 
ear pain
fever
irritability
inflamed tympanic membrane 
fluid in middle ear 
difficulty eating or sleeping 
tugging at ear
132
Q

acute otitis media treatment

A

symptom management
antibiotics
placement of tympanostomy tubes

133
Q

antiretroviral agents

A

used to treat HIV/AIDS

6 groups

134
Q

antiretroviral agents not recommended for patients with

A

renal, hepatic disease, seizure disorders, pregnant or lactating individuals, patients who are dehydrated or have an electrolyte imbalance

135
Q

vancomycin-resistaant Enterococcus

A

antibiotic resistant organism
resistant to B-lactam antibiotics and vancomycin
typically seen in UTI’s

136
Q

primary prevention

A 
vaccinations 
hygiene 
   - personal hygiene
   - food hygiene
   - patient care hygiene
137
Q

countermeasures

A 
infection control measures 
antimicrobials 
antibiotic resistance 
vaccines 
passive immunotherapy
138
Q

infection control measures

A 
waste disposal 
water treatment and contamination prevention 
food safety 
insect control
safe insecticides
139
Q

antimicrobials

A 
bacteriocidal vs bacteriostatic 
inhibit cell wall synthesis 
damage cytoplasmic membrane 
alter metabolism of nucleic acid 
inhibit protein synthesis 
modify energy metabolism
140
Q

antibiotic resistance

A

genetic mutations
inactivation of antibiotic
modification of target molecule
increasing active efflux of antibiotic

141
Q

antibiotic resistance caused by

A

lack of compliance with therapeutic regimen

overuse

142
Q

vaccines

A

biological preparations of weakened or dead pathogens or recombinant viral protein
long lasting immunity

143
Q

passive immunotherapy

A

preformed antibodies

144
Q

secondary prevention

A

most common infection screening:

  • STI in high risk groups
  • TB in high risk groups

N116 (11 decks)

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