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Med-Surg > Infection, Immunity & Inflammation > Flashcards

Infection, Immunity & Inflammation Flashcards

1
Q

How do you break the chain of an infectious agent?

A

Diagnosis and treatment

Adhering to abx

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2
Q

How do you break the chain of portal of entry?

A

Hand Hygiene, PPE, Personal Hygiene

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3
Q

How do you break the chain of the susceptible host?

A

Immunizations, patient education, treatment of underlying disease

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4
Q

How to break the reservoir chain?

A

cleaning, disinfection, sterilization

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5
Q

Airborne precautions

A

measles, varicella, TB
Suspended in air
N95 Mask
Negative air pressure room

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6
Q

Droplet Precautions

A

wear surgical mask

influenza

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7
Q

Contact precautions

A

MRSA, C Diff
gown and gloves
private room

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8
Q

When should you ideally give antibiotics?

A

After obtaining blood cultures

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9
Q

Pneumonia S/S

A

crackles in lungs, malaise, edema

high fever, pleuritic chest pain, chills

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10
Q

Diagnostics for Pneumonia

A

Culture and Sensitivity is pathogen-specific
CRP- indicates inflammation
Sedimentation Rate/ESR- measures rate of fall of erythrocytes =inflammation

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11
Q

What is pneumonia?

A

Acute infection of lungs

Along with influenza is the 8th leading cause of death in the US

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12
Q

3 Ways Pneumonia is caused

A

Hematogenous spread
Inhalation
Aspiration- caused by decreased cough

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13
Q

Other causes of pneumonia

A

Mucociliary mechanism impaired

Chronic diseases suppress immunity

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14
Q

Hospital-acquired pneumonia

A

non-intubated, begins 48 hours/longer after stay at hospital

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15
Q

Why is it useful to classify pneumonia?

A

The causative agents can be a predictor of guide to treatment

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16
Q

What is the initial tx of pneumonia based on?

A

health hx, exam and chest x-ray

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17
Q

Best prevention for influenza?

A

being vaccinated

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18
Q

S/S of influenza

A

mild fever/chills, cough, sore throat
muscle aches/myalgia,
acute symptoms may subside but cough remains

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19
Q

Influenza

A

highly contagious, incubation period of 1-4 days, peak transmission is 1 day prior to symptoms

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20
Q

Influenza A

A

Most common, affects humans & animals, virulent

H & N antigens

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21
Q

Influenza B

A

Affects humans

Regional epidemics

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22
Q

Influenza C

A

Affects humans

Very mild

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23
Q

Who needs the flu vaccine?

A

Immunosuppressed

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24
Q

Tx for flu

A

antivirals (Tamiflu), OTC pain relievers, increased fluids

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25
Q

Tuberculosis

A

1/3 of world’s population has TB

Prevalence has decreased in the US

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26
Q

Etiology of TB

A

aerophilic- causes affinity for lungs
spread via airborne particles
can be suspended in air for minutes to hours

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27
Q

Active TB

A

primary TB

reactivation TB

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28
Q

Latent TB

A

cannot be spread

TB lives but doesn’t grow

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29
Q

TB manifestations

A

Cough becomes frequent: hemoptysis not common, dyspnea is unusual
may present more acutely: high fever, crackles, wheezing
immunosuppressed more challenging to diagnose

30
Q

An induration of 5mm/more is positive in who?

A

HIV infected persons
immunosuppressed
recent contact with someone who has TB

31
Q

An induration of 15mm/more is positive in who?

A

persons with no known risk factors for TB

32
Q

Rifampin

A

treats TB but causes orange colored body fluids

33
Q

Acute care for TB

A

airborne isolation precautions, single-occupancy room with negative air pressure 6-12 airflow exchanges/hr

34
Q

Immunity

A

provides protection from disease

35
Q

Normal physiological process of Immunity

A

1) protects body from invasion
2) removes dead/damaged tissue
3) recognizes & removes cell mutations

36
Q

IgG (Immunoglobulin)

A

primary Ig in blood

37
Q

Exaggerated Immune Response

A

bee sting may cause an allergic rx/ systemic anaphylactic rx

autoimmune responses have this characteristic

38
Q

Innate Immunity

A

neutrophils & monocytes

present at birth

39
Q

Acquired/adaptive immunity

A

attack “non-self” pathogens
development of immunity
sometimes makes errors

40
Q

RA

A

decreased joint space is one symptom
chronic, systemic autoimmune disease
strong genetic component

41
Q

Etiology of RA

A

caused by autoimmunity

autoantibodies develop against IgG’s

42
Q

S&S in joints

A

fatigue, anorexia, wt loss, stiffness
hands & feet- can be lrg joints
stiffness to joints after rest

43
Q

Rheumatoid Factor

A

positive in 80% of cases

44
Q

Acute care for RA

A

emotional support
observe for: fever pattern, fatigue, joint inflammation
record: severity of symptoms, response to therapy

45
Q

Human Immunodeficiency Virus

A

retrovirus that increases immunosuppression

46
Q

Transmission of HIV

A

Contact with blood, sexual contact, perinatal transmission if untreated

47
Q

Pathophysiology of HIV

A

ribonucleic acid virus
*Lymphocytes are WBCs that are main defense
Normal range of T Cells is 800-1200 cells
-immune problems start at <500

48
Q

HIV S&S

A

Acute infection

  • highly contagious 2-4 weeks after infection due to high viral load
  • flu like symptoms that don’t resolve
49
Q

HIV more S&S

A

asymptomatic infection more likely to become AIDS

  • T Cells <200
  • Wasting Syndrome: a loss of 10% body mass
50
Q

Systemic Lupus Erythematosus

A

complex multi-factor disorder

  • genetic
  • hormonal
  • environmental
  • unpredictable course with alternating periods of remission
51
Q

SLE S/S

A 
Skin problems
-vascular skin lesions to sun-exposed areas
Increased susceptibility to infection
cardiopulmonary issues
-pericarditis
-tachypnea
-cough
Weight loss
52
Q

Tx of SLE

A

cannot get live vaccines- varicella
drug therapy includes steriod-sparing meds AKA Methotrexate
Immunosuppressives

53
Q

Dopamine Rash

A

Discoid rash, Oral ulcers, Photosensitivity, Arthritis, Malar Rash, Immuno Markers, Neuro changes, Elevated ESR
Renal, Positive ANA, Serositis, Hematologic

54
Q

Anti-Smith Tests

A

Highly specific for SLE

55
Q

Inflammation

A

an immunologic defense

56
Q

Hyperemia

A

increased blood flow

57
Q

CBC- complete blood count with differential

A

Includes the WBC percentages of neutrophils, bands, lymphocytes, monocytes, eosinophils and basophils

58
Q

Shift to the Left

A

increased percentage of neutrophils or bands is indicative of an early acute infection; an increase in monocytes is a late-stage acute infection

59
Q

Causes of appendicitis

A

No known causes; may be due to obstruction of proximal lumen by fecalith which results in restriction of blood flow and creates pain

60
Q

CAUTION for Appendicitis

A

NO laxatives/enemas, NEVER apply heat to abdomen

61
Q

Complication: Peritonitis S&S

A

high fever, decreased urine output, rigid boardlike abdomen

62
Q

Cholangiogram

A

x-ray procedure done with contrast media to visualize bile ducts

63
Q

Who is at risk for developing glomerulonephritis?

A

those with recent strep, nephrotoxic drug users

64
Q

Manifestations of GN

A

asymptomatic to abrupt onset: irritability, fever, malaise, microscopic hematuria in nearly all cases, edema may progress

65
Q

Pharm therapies for GN

A

Oral glucocorticoids to induce remission

Antihypertensive meds

66
Q

Gross Hematuria

A

Indicated by red-brown urine

67
Q

Indications of GN

A

increased BUN levels, hypertension & increased urine specific gravity

68
Q

Peptic Ulcer Disease

A

erosion of GI mucosa

occur in the GI tract from the esophagus to duodenum

69
Q

Antinuclear antibodies (ANA)

A

a positive test in people with lupus

70
Q

People with SLE may not receive what kind of vaccines?

A

may not receive live vaccines due to immunosuppression- Varicella

71
Q

How do you break the portal of exit chain?

A

Control of aerosols & Splatters
Respiratory Etiquette
Waste disposal

72
Q

How do you break the mode of transmission chain?

A

Food safety
Isolation
Hand hygiene

Med-Surg (5 decks)

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