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Pathology Exam 1 > Infectious Disease > Flashcards

Infectious Disease Flashcards

1
Q

What is the immune systems three lines of defense?

A

physical, mechanical and biochemical barriers

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2
Q

What are physical barriers?

A

tightly woven epithelial cells

skin, lining of GI system etc.

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3
Q

What are mechanical barriers?

A

cough, sneeze, vomiting, urine

cilia in respiratory tract helps cough stuff out

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4
Q

What are the biochemical barriers?

A

substances secreted by epithelial cells that trap and/or destroy pathogens
Ex.) mucus, perspiration saliva etc.

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5
Q

What is normal bacteria flora?

A

nonpathogenic bacteria that colonize areas of body

help break down food in GI tract

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6
Q

What are the 2nd and 3rd line of immune defense

A

2- inflammatory response

3- immune response, adaptive immunity

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7
Q

What is the first step of inflammatory response?

A

Vascular response which is the body sensing the wound

characterized by redness, heat, swelling and pain

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8
Q

What do chemicals at the site of injury do to control process?

A
  1. limit and control process to injured tissue
  2. prevent infection and further damage by contamination of pathogens
  3. elicit a specific response to a pathogen (ex. influx of macrophages and lymphocytes)
  4. prepare area for healing
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9
Q

What if inflammatory response doesn’t work?

A

autoimmune disease

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10
Q

What three systems does the inflammatory activate?

A

complement, clotting and Kinin

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11
Q

What is the complement system?

A

this is the control center of IP

increases the immune system function

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12
Q

What is the clotting system?

A

using fibrin it forms a fibrinous meshwork at the site of injury or inflammation

prevents spread of infection, keeps pathogens at site, stops bleeding

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13
Q

Kinin system

A

this is why we have pain at a cellular level

primary role is to assist the inflammatory process

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14
Q

What is Bradykin?

A

it is an inflammatory mediator the most common one

cause vessel dilation, acts with protasglandin to produce pain

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15
Q

What is the immune response?

A

fighting pathogens when physical and chemical barriers have been breached and INFL response has begun

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16
Q

What are the two types of immune response?

A

Humoral (immunoglobulin) and cell mediated (T- cell)

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17
Q

What is humoral immunity?

A

responsible for extra cellular defense against bacteria and viruses (B cells)

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18
Q

What is cell mediated immunity?

A

responsible for intra cellular defense against intra cellular bacteria, viruses, fungus and cancers

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19
Q

What are the ways to identify infection?

A

wbc count total, antibody count, WBC differential count

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20
Q

What does high neutrophil count usually mean?

A

active phagocytes, mainly bacteria

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21
Q

What does high lymphocytes count usually mean?

A

active in formation of T and B cells, bacteria, fungi and viruses

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22
Q

What does high monocyte count usually mean?

A

end up as macrophages (inflammatory response)

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23
Q

What does high eosinophil count usually mean?

A

active against parasites

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24
Q

What does high basophil count usually mean?

A

releases histamine

25
Q

What is a Gram’s stain?

A

most important stain test in microbiology

positive= violet (strep or staph)

negative= red ( ecoli, meningitis)

26
Q

What is bacteria?

A

single cell microorganisms that grow without help of other cells

cocci- spherical
bacilli- rod shaped

27
Q

What is a virus?

A

organisms made up of DNA/ RNA and are completely dependent on host cell for replication

28
Q

What is a fungi?

A

single cell filament organism ( yeast or mold)

29
Q

What is a rickettsiae?

A

animal pathogens transmitted to humans, require a host for replication

ex. malaria or thyphoid

30
Q

What is the chain of infection?

A
  1. microorganism (bacteria, virus etc.)
  2. source ( human, water, air, med. equipment)
  3. port of exit (secretion, excretion, droplets)
  4. means of transport ( contact, in the air, by vector or bite)
  5. port of entry (mucosa lining, open wound, resp. tract, urinary)
  6. susceptible host
31
Q

What is an inactive infection period?

A

defense of the immune system was succesful, and pt is very asymptomatic however they can still spread or be infected

it can be in incubation period (replicating) or latent (dormant)

32
Q

What is an active infection period?

A

clinical manifestations begin to appear

increases risk of getting active infection with immunocompromised, immunosupressed or opportunistic

33
Q

What are the clinical manifestations during active infection?

A

fever, increased WBC, increased antibody, system specific test findings, fatigue, cough, runny nose, diarrhea

34
Q

What are universal precautions?

A

hand hygiene and barriers when being exposed such as gloves and gowns

35
Q

What is a nosocomial infection?

A

one that is usually acquired in a hospital setting or HAI

most common MRSA, VRE, C-diff

36
Q

MRSA or Methicillin Resistant Staphhylococcus Aureus

A

SA that is resistant to methicillin

found in respiratory tract or skin

person to person or object to person
can survive on object for up to 11 days

isolation room treatment and Vancomycin

PT implications avoid DC and disinfect everything they touch

37
Q

VRE or Vancomycin resistant enteroccoci

A

enterococcus that is resistant to vancomycin

found in GI tract or female genital tract

P2P or O2P can last on object for 4 days to 4 months

isolation and beta-lactams and aminoglycosides

same PT implications as MRSA

38
Q

C- Diff or colostridium difficile

A

spore forming an anaerobic bacillus that only occurs when person is exposed to or in on antibiotics

spores give off toxins that inflame and cause plaque to be formed in the mucosal lining of colon

classic symptom is severe, foul smelling diarrhea, increased WBC

found in human GI tract, stool, water, food and animals

oral -fecal transmission, poor hand hygeine

re-hydration and electrolyte support

39
Q

Bacteremia

A

bacterial invasion of the blood, may resolve or turn to sepsis

most have two positive blood cultures, WBC over 12k with fever, malaise, fatigue and tachycardia

40
Q

Sepsis

A

symtomatic extension of bacteremia within the body can also be fungus related

massive inflammatory response to infection

disrupts the clotting factors, coagulation issues and decreased PLTS leading to bleeding

large amount of endotoxins allow increased permeability of endothelium

41
Q

Diagnostic criteria of Sepsis

A 
Fever over 100.4
hyporthermia under 96.8
HR over 90 tachycardia
RR over 20 tachypnea
PaCO2 under 32 mmHG
WBC count over 12k
Infection
42
Q

Severe Sepsis

A

complicated by organ dysfunction with hypotension

most commonly effects brain, endocardium, kidneys bones and jts

clinical manifestations are specific to organ systems dysfunction

Diag cri: signs of pulm or cardio system involvement plus other system

43
Q

Septic Shock

A

advancement of organ dysfunction as cell death begins to occur

cold shock or warm shock

very low BP
systolic under 90 diastolic under 40

44
Q

Sepsis and PT considerations

A

optimize functional mobility, limit secondary complications such as deconditioning , maintain ROM, edema management

45
Q

What percentage of population is unaware they have HIV?

A

20%

46
Q

Etiology of HIV

A

HIV- retrovirus or HIV 1 or 2

AIDS- caused by HIV infection
diagnosed when CD4+, T lymphocyte count is under 200 and when 1 of 25 aids defining illnesses are present

47
Q

Pathogenesis of HIV

A

mode of trans- blood, semen, and from mother to infant in wound

reverse transcriptions HIV attaches to CD4 receptors and on T4 lymphocytes

found primarily in GI tract, uterine cells and neuroglial cells

48
Q

What is reverse transcription?

A
  1. once bound to CD4 receptor, HIV enters T4 cell
  2. HIV releases viral RNA and then forms viral DNA
  3. viral DNA enters T4 cell nucleus and makes copies of HIV and kills host T4 cell
  4. HIV then leaves T4 cell to look for another CD4 and T4 cells
49
Q

Clinical Manifestations of HIV: asymptomatic stage

A

CD4 count > 500 (normal)
HIV+ via lab tests
flu like symptoms

recover from initial symptoms but viral replication continues for up to 10 years

50
Q

Clinical Manifestations of HIV: early symptomatic

A

CD4 count 200-500
gland enlargement
weight loss, fatigue, NIGHT SWEATS

opportunistic infection can occur like PCP

51
Q

Clinical Manifestations of HIV: Advanced Disease (AIDS)

A

CD4 count less than 200

presence of AIDS defying illness

52
Q

Biggest way to prevent disease?

A

Education, education, education

53
Q

What is HAART?

A

drug cocktail designed to slow down viral replication aka Highly Active Antiretroviral Therapy

54
Q

What is Candidiasis?

A

opportunistic fungal yeast infection

occurs in mouth, throat, vagina

appears as white splotchy spots usually benign but symptomatically troublesome

55
Q

What is cytomegalovirus?

A

opportunistic herpes viral infection

transmitted by almost any bodily fluid therefore 85% of US population have had some form

most commonly effects eyes in pts with AIDS, pt sees “floaters”

CD4 count 50-100

56
Q

What is Kaposi Sarcoma?

A

cancer like disease of vascular tissue caused by human herpes 8

found in saliva and skin but mode of transmission still unclear

manifests as flat, painless. itchless, dry spots varying in color

lesions that progress to inside body become most severe

57
Q

What is wasting syndrome?

A

involuntary loss of body weight (10%) accompanied by diarrhea, fever and/or weakness for 30 days

usually attacks lean body moss rather than fat (catabolizing self)

58
Q

PT considerations with HIV and AIDS pt

A

depends on what system is most affected

holistic approach

energy conservation and pacing will be key

Pathology Exam 1 (7 decks)

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