Infection in compromised host

Question 1

define immunocompromised

Answer 1

disruption of specific defence of an organ humeral or cellular

Question 2

what are 5 types of innate defences

Answer 2

skin 
mucous membrane 
lungs 
proteins - interferons, complement 
flora in gut

Question 3

what type of people are more commonly immunocompromised

Answer 3

elderly or neonates
pregnant
malnourished

Question 4

what is the second line of defence after the skin

Answer 4

neutrophils

Question 5

what are the two types of neutrophil defects

Answer 5

qualitative

quantitate

Question 6

what are the qualitative defects of neutrophils

Answer 6

chemotaxis - rare congenital - inadequate signalling

Question 7

what are some causes of quantitative defects of neutrophils

Answer 7

chemo, bacterial infections

fungal infections

Question 8

what is neutropenia

Answer 8

lack of neutrophils

less than 0.5x10^9

Question 9

what is a pseudomona and what is the treatment

Answer 9

bacteria infection from soil
lethal in neutropenic patients
antipseudoomonal penecillin with gentamicin

Question 10

give an example of a congenital T cell deficiency

Answer 10

hypogammaglobulinaemia

T helper dysfunction

Question 11

what are the two types of acquired T cells deficiency

Answer 11

drugs - ciclosporin after transplantation, steroids

viruses - HIV

Question 12

which type of opportunistic bacterial pathogens target T cell deficient patients

Answer 12

listeria monocytogenese (dairy products)
mycobacteria (TB)

Question 13

which type of opportunistic viral pathogens target T cell deficient patients

Answer 13

HSV
CMV
VZV

Question 14

which type of opportunistic fungal pathogens target T cell deficient patients

Answer 14

candida spp

crypto coccus spp

Question 15

which type of opportunistic protazoan/parasitic pathogens target T cell deficient patients

Answer 15

cryptosporidium parvum - oocysts shed by catches / humans - faecal oral

toxoplasma gondii - from cats - mainly risk of pregnant women with cats

Question 16

what are the characteristics of hypogammaglobulinaemias, causes and treatment

Answer 16

low antibodies 
congenital - x linked 
acquired - multiple myeloma 
encapsulated bacteria - s. pneumonia 
parasitic - giardia lambita 

immunoglobulin long term

Question 17

complement deficiency leads to what types of infection

Answer 17

from encapsulated bacteria
N. meningitiids
S. pneumonia

Question 18

what are the infection risks of a splenectomy

Answer 18

spleen is a source of complement and antibody producing b cells

risks to - Strep. Pneumonia, influenza B, n. menin, malaria
plasmodium falciparum

Question 19

how do organ transplant causes immunodeficiency

Answer 19

anti-rejection treatment - surprises cell mediated immunity and CD8 intervention

Question 20

what are the 5 stages of transplant infection

Answer 20

initial disease 
surgery and admission 
organ receipt 
opportunistic infection during initial immunosuppression 
later opportunistic infection

Question 21

what are the general principles of management of immunocompromised patients

Answer 21

prevention of infection
hand washing
aseptic technique
vaccines

Question 22

why should you be cautious with vaccines in immunocompriised patients

Answer 22

can’t use live vaccines in T cell deficient patients