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*CIC Studying > Infectious Disease Process (22 questions) > Flashcards

Infectious Disease Process (22 questions) Flashcards

24 Exam questions

1
Q

Characteristics of bacteria

A

Free-living; single celled organisms; multiply through replication and cellular division; contain DNA, ribosomes, membrane and cell wall

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2
Q

What bacteria/organisms can penetrate the epithelium of the conjunctiva or cornea?

A

Neisseria gonorrhoeae, Neisseria meningitidis, Streptococcus pneumoniae, Listeria monocytogenes, Corynebacterium Diphtheriae.

For all others, a breach in the protective epithelial barrier or mucous membranes must occur.

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3
Q

What specimens are not appropriate for anaerobic cultures

A

Anaerobes are commonly found on
mucous membranes and other sites such as the vagina and oral cavity.
Therefore, specimens likely to be contaminated with these organisms
should not be submitted for culture.

Sputum
Rectal swab
Nasal or throat culture
Urethral swab
Voided urine

Anaerobic culture should be used for:Blood, transtracheal aspirate, spinal fluid

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4
Q

What is Virulence

A

Ability to invade and create disease in a host. Ability to grow and multiply.

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5
Q

1st element virulence

A

ability of organism to survive in external environment during transit between hosts

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6
Q

2nd element virulence

A

mechanisms for transmission to new host

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7
Q

Antigen

A

Any substance that the immune system can recognize and can thus stimulate an immune response

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8
Q

Antibody

A

(Immunoglobulin) protein that is produced by B cells that tightly bind to the antigen of an invader, tagging the invader for attack or directly neutralizing it

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9
Q

T cell (T lymphocyte)

A

A white blood cell that is involved in acquired immunity and that may be one of three types: helper, killer (cytotoxic), or regulatory.

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10
Q

B cell (B lymphocyte)

A

a WBC that produces antibodies specific to the antigen that stimulated their production

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11
Q

What is a neutrophil

A

First to arrive at the site of an infection
most abundant phagocyte
they inhibit the growth of bacteria or fungus
quickly enter tissues and phagocytize pathogens- phagocytosis (engulf and ingest particles of nutrients or bacteria)
bands = immature WBC (elevated in serious infection)

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12
Q

Monocytes

A

Largest Leucocyte (WBC)
cells of chronic inflammation, “late comers” to infection

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13
Q

Mast cells

A

Located in connective tissue and mucous membranes
When activated Excrete histamine and heparin
Histamine dilates blood vessels and causes neutrophils and macrophages to the site (characteristic signs of inflammation)

A cell in tissues that releases histamine and other substances involved in inflammatory and allergic reactions.

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14
Q

Lymphocyte

A

WBC responsible for acquired (specific) immunity, including producing antibodies (by B cells), distinguishing self from oneself (by T cells), and killing infected cells and cancer cells (by killer T cells).

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15
Q

Leukocyte

A

WBC such as a monocyte, neutrophil, eosinophil, basophil or a lymphocyte (B cell or T cell)

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16
Q

What is an eosinophil

A

WBC - Active and killing bacteria and parasites
they also can cause tissue damage during allergic reaction. Important in hypersensitivity rxn.

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17
Q

Cytokines

A

Proteins that are secreted by immune and other cells that acts as the immune systems messendgers to help regulate an immune response

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18
Q

What is the basophil

A

WBC activated by pathogen and releases histamine (substance involved in allergic rxn)
Produces substances that attract other WBC (neutrophils and eosinophils) to a trouble spot
important defense against parasites
Play a role in allergic reactions (such as cause asthma)

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19
Q

Co- infection for Hep B

A

Hepatitis D. Only occurs among people infected with Hep B. Uncommon in US. Transmitted through contact with infectious blood.

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20
Q

HIV/AIDS

A

affects CD4 cells or T cells, compromising immune system to fight off infection
*Transmission: body fluids (most commonly during unprotected sex)
*no cure, tx with antiretroviral improves survival
* prevention= standard precautions, risk reduction, med adherence

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21
Q

HIV/AIDS exposure

A

Western Blot detects antibody 1-3 months after exposure.

Incubation: 1-3 months

ELISA positive 3 weeks to 6 months (rare) after exposure are rare.

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22
Q

Hepatitis D

A

Co-infection with Hepatitis B Incubation: 2-8 weeks Transmission bloodborne not usually sexual Standard Precautions

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23
Q

Influenza

A

*Incubation 1-4 days (avg 2), shed day prior sx onset through 5-10 days.
* Influenza A= predominant cause epidemic. Influenza B also causes epidemics but clinical illness is usually milder.
*Droplet Precautions (includes eye protection) for 7 days after illness onset or 24 hours after the resolution of fever and respiratory symptoms, whichever is longer. extended for children and immunocompromised patients who might shed virus for longer periods. AGP’s: N95 and AIIR (if available)

because droplets do not remain suspended in the air and generally travel only
a short distance (≤1 meter) through the air. Contact with respiratory-droplet
contaminated surfaces is another possible source of transmission.

In recent years, influenza A and B
strains also have been named according to the city or state and year of their
initial isolation, for example, A/Texas/36/91 (H1N1) or B/Hong Kong/330/2001.

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24
Q

Lyme Disease

A

Borrelia burgdorferi. Incubation 3-30 days after tick bite.

characteristic skin rash
called erythema migrans (annular lesions that burns and itches)

Standard Precautions. Most common New England, Mid Atlantic, Upper Midwest and northern Cali

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25
Bacterial Meningitis
CLOUDY CSF, increase WBC, increased protein, decrease glucose. Determined based off of exam of CSF. Appearance is cloudy- presence of significant concentration of WBC's, RBC's bacteria and/or protein. WBC is increased if untreated bacterial meningitis.
26
Meningitis
Meningococcus Neisseria meningitidis Gram negative diplococcus Droplet Precautions until 24 hrs effective antbx Prophylaxis for exposed HCWs
27
Viral meningitis
More prevalent during late summer Most often seen in ages <40 yrs Standard Precautions Recovery usually without sequelae CSF lymphocytes without organisms
28
Pertussis
Whooping Cough Incubation: 7-10 days. Onset = Catarrhal stage: 1-2 weeks. Paroxysmal coughing that can last 1-6 weeks (up to 10). Droplet Precautions until 5 days effective antbx
29
Scabies
incubation 4-6 weeks (early as 10 days). Sx= burrow-type pruritic (itchy) lesions on hands, webs of fingers, wrists and exterior surfaces of elbows and knees, outer surfaces of feet, armpits, butt and waist. Contact precautions until 24 hours after topical tx.
30
Facultative anaerobe
Utilize O2 if present but still grow in absence of O2
31
Hep C
found in blood and certain body fluids Incubation average 45 days antibody detected between 4-24 weeks after onset there is NO vaccine to prevent HCV infection
32
Hep B
found in blood and certain body fluids incubation average 90 days HBsAG (hep B surface antigen) found in serum 1-2 months post exposure Prevention= vaccination HbsAg- current or chronic HBV HbsAb- recovery or immunity to HBV Anti-Hbc-current or previous HBV infection Thom Anti-Hbc IgM- recent acute infection
33
Hep A IgM Antibodies detectable
within 3 weeks of exposure 5-10 days post exposure ? IgM antibodies to HAV (IgM anti-HAV), which are used to diagnose acute HAV infection, are detectable within 3 weeks of exposure and are present at the onset of jaundice gG anti-HAV is also detectable at onset of jaundice and remains positive lifelong, indicating immunity to HAV. Hep A= fecal-oral average incubation= 28 days Prevention= vaccination
34
Biofilm
Any group of microorganisms in which cells stick to each other on a surface. Also referred to as "slime", generally composed of extracellular SNA, protein and polysaccharides. Prevents water-soluble elements (ABX and Disinfectants) from reaching pathogens
35
Gram stains are first step to classify organism as gram- pos or gram- neg. The determinant factor for gram stains are cell well components of
Peptidoglycans
36
Good gram stain specimen will have
<10 epithelial and >25 PMN. Bad= large epithelial (ex: oral contamination - spit)
37
Bacteria
Free living, single celled organisms, multiply through replication and cell division, cell contains DNA, ribosome membrane and cell wall
38
Gram + cocci in clusters
Staphylococcus. Most common = staph aureus (MRSA, MSSA) and staph epidermis (coag-neg)- both leading causes of CLABSI
39
Gram + cocci in pairs or chains. Normally found in GI tract
Enterococcus. Most common commensals in human intestines: enterococcus faecalis and enterococcus faecium. Another example =VRE
40
Gram + cocci in chains. Normally found in genital tract and alimentary canal (mouth, pharynx, esophagus, stomach, intestine, anus)
Streptococcus. Most Common= Streptococcus pneumoniae (lancet shaped gram +), and strep pyogenes aka "Group A strep"
41
Gram + rods
Baciullus species, clostridium species, diphtheroid bacillus, Corynebacterium species and listeria species
42
Gram - rods
Enterobacteriaceae (Enteric- E. Coli, klebsiella pneumoniae, Serratia marcescens, Enterobacter cloacae, proteus mirabills) and Non- Enteric: Pseudomonas aeruginosa, Acinetobacter bahmannii , Neisseria meningitis, legionella, Haemophiles influenzae, steno
43
Reproduce by spore formation
Fungi
44
Fungi labeled as two different groups based on appearance of colony formed
Yeast (creamy)- reproduce by budding Molds (fuzzy) spread by spores
45
Yeast species
Candida albicans: normal GI/skin flora Candida auris: frequent with LTC pt with catheter. Often multidrug resistant
46
Long branching filaments of calls called hypae
Mold Examples: Aspergillus (construction) Rhizopus (soil, environment, dressings) Stachybotrys - black mold found after water damage
47
Obligate intracellular parasites that require living host cells to grow and reproduce
Viruses. Contains DNA or RNA
48
not living germs, proteins without RNA or DNA
Prions Ex: CJD
49
Bacteria that may have + AFB smear, but don't need isolation
Nocardia, Actinomyces, Rhodococcus, Legionella micdadei or cysts of Cryptosporidium species.
50
Community acquired pna (CAP) quality measure for those 65 or order
Screen for pneumococcal vax and administration before discharge, if necessary
51
immunocompromised status
* Neutropenia (absolute neutrophils count <500/mm3) * Leukemia or lymphoma * HIV with CD4 count <200 * Splenectomy * Early post-transplant * On cytotoxic chemotherapy * On high-dose steroid therapy: >40 mg prednisone or its equivalents (>160 mg hydrocortisone, >32 mg methylprednisolone, >6 mg dexamethasone, >200 mg cortisone) daily for >2 weeks
52
most common ESBL-producing pathogens.
E. coli and Klebsiella pneumoniae, which confer resistance to all β-lactam drugs except the carbapenems
53
Mechanical barriers to infection include
skin, mucous membranes, and tears. Movement due to cilia or peristalsis helps to keep air passages and the gastrointestinal tract free from microorganisms. The trapping effect of mucus that lines the respiratory and gastrointestinal tract helps protect the lungs and digestive systems from infection. Chemical factors include fatty acids in sweat that inhibit the growth of bacteria. Lysozyme and phospholipase found in tears, saliva, and nasal secretions can break down the cell wall of bacteria and destabilize bacterial membranes. The low pH of sweat and gastric secretions prevents growth of bacteria
54
The most common opportunistic bacterial infections associated with cell-mediated immunity dysfunction are primarily intracelluar pathogens that include:
* Listeria monocytogenes * Salmonella spp. * Mycobacterium spp., including M. tuberculosis * Nocardia (N. asteroides, others) * Legionella pneumophila, other species of Legionella * Rhodococcus equi * Pseudomonas pseudomallei
55
All viruses are obligate intracellular parasites. Obligate intracellular parasitic bacteria include
Chlamydia, Rickettsia, Coxiella, and certain species of Mycobacterium. Epidemic typhus and Q fever Intracellular parasites are parasitic microorganisms that are capable of growing and reproducing inside the cells of a host. Obligate intracellular parasites cannot reproduce outside their host cell, meaning that the parasite’s reproduction is entirely reliant on intracellular resources.
56
Spores
Resistant to Abx. The function of a spore is to permit the cell to survive unfavorable conditions such as extremes of temperature or moisture. Spores become dormant at these times; they do not multiply in adverse conditions. Instead, the spore protects the bacteria until favorable conditions occur, at which time the bacteria can begin to multiply. Spores are usually formed by Grampositive bacteria.
57
Staphylococcus aureus
Food poisoning with most rapid onset (as little as 30 min, but usually 1-6 hours) Staphylococcal toxins are resistant to heat and cannot be destroyed by cooking. Foods at highest risk of producing toxins from Staphylococcus aureus are those that are made by hand and require no cooking. Some examples of foods that have caused staphylococcal food poisoning are sliced meat, puddings, pastries, and sandwiches. Staphylococcal toxins are fast acting, sometimes causing illness in as little as 30 minutes after eating contaminated foods, but symptoms usually develop within 1 to 6 hours. Patients typically experience several of the following: nausea, retching, vomiting, stomach cramps, and diarrhea.
58
Most common bacterial foodborne illness
salmonella, clostridium perfringes and campylobacter
59
Salmonella
Foodborne illness (bacterial). Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts 4 to 7 days, and most persons recover without treatment. Associated Foods: Contaminated eggs, poultry, unpasteurized milk or juice, cheese, contaminated raw fruits and vegetables (alfalfa sprouts, melons). S. typhiepidemics are often related to fecal contamination of water supplies or street-vended foods.
60
Clostridium perfringens toxin
Foodborne illness (bacterial) Incubation: 8-16 hr Food Associated: Meats, poultry, gravy, dried or precooked foods, time- and/or temperature-abused food Duration: 24-48 hr
61
Campylobacter
Foodborne illness (bacterial) Incubation: 2-5 days Associated Foods: Raw and undercooked poultry, unpasteurized milk, contaminated water Duration: 2-10 days
62
Toxoplasma gondii
Foodborne illness (parasitic) Incubation: 5-23 days Flu like sx Associated Foods: Accidental ingestion of contaminated substances (e.g., soil contaminated with cat feces on fruit and vegetables), raw or partly cooked meat (especially pork, lamb, or venison). Passed from mother (who acquired acute infection during pregnancy) to child Duration: months
63
Listeria monocytogenes
Foodborne illness (bacterial) Incubation: 9–48 hr for gastrointestinal symptoms, 2–6 wk for invasive disease At birth and infancy. Can cause pre-mature birth Associated Foods: Fresh soft cheeses, unpasteurized or inadequately pasteurized milk, ready-to-eat deli meats, hot dogs Duration: variable
64
norovirus
Foodborne illness (viral) Incubation: 12–48 hr Associated Foods: Shellfish, fecally contaminated foods, ready-to-eat foods (salads, sandwiches, ice, cookies, fruit) touched by infected food workers. Duration: 12–60 hr
65
Exotoxin
Secreted by bacteria, specifically gram positive. Are heat inactivated, neutralized by specific antibody and may have enzymatic activity
66
Endotoxin
Complexes of bacterial proteins, lipids and polysaccharides that remain firmly within bacteria. Surface components of gram negative bacteria that resist inactivation of heat, only partially neutralize by antibody and have capability of interacting with host system to set off cascade of responses that can cause fever, swelling, pain, shock, vascular leaking
67
Most common organism contamination for TPN
Candida With strict adherence to aseptic compounding technique, contamination of the total parental nutrition (TPN) solution is rarely the cause of sepsis. TPN can foster microbial growth. Organisms that have been reported to proliferate in TPN include fungi (Candida albicans or Malassezia furfur); Gram-positive bacteria (coagulase-negative Staphylococcus, Staphylococcus saprophyticus, or Staphylococcus epidermidis); and Gramnegative bacteria (Escherichia coli or Pseudomonas aeruginosa) bacteria.
68
gram - that causes chronic gastritis in humans and most common cause of ulcers
H. Pylori
69
Gram neg rod, can cause serious pneumonia. Known Reservoir is air conditioner cooling towers
Legionella pneumophilia
70
Gram neg rod/bacilli, can cause serious infections in ICU patients. Can be very resistant
Acinetobacter baumannii
71
Enteric gram net rod. Can cause UTI’s. Known to produce carbapenemase
Klebsiella pneumoniae
72
Gram positive cocci in clusters. Can cause CLASI and prosthetic infections
Staphylococcus epidermidis
73
Lancet shaped gram positive diplococci. Can cause pneumonia
Streptococcus pneumoniae
74
Gram negative diplococci. Normal flora of the respiratory tract but can cause
Meningitis Neisseria meningitis
75
Gram negative rod which is considered normal flora in GI tract
E. Coli
76
Mold found in soil, outdoor and indoor air. Have been associated with outbreaks related to construction
Aspergillus
77
Good specimen (not saliva) the gram stain should show
Fewer than 10 epithelial cells
78
Chicken pox/herpes zoster-varicella/shingles
sudden onset slight fever, skin eruptions that are macupapular for hours, vesicular for 3-4 days then granular scab *incubation is 2-3 weeks *Iso chicken pox= Airborne/contact *iso zoster = standard unless disseminated then contact. Iso until scabbed.
79
Incubation period scabies
4-6 weeks Can be as short as 10 days
80
Types of bacterial meningitis
Haemophilus influenzae type b (HIB) Pneumococcus (strep pneumo) Meningococcus (Neisseria)
81
Pathogen that is active and reproduces, but requires livings cells to do so
Virus
82
HbsAg
Current or chronic HBV
83
HbsAb
Recovery or immunity to HBV
84
Anti-Hbc
Current or previous HBV infection
85
Anti Hbc IgM
Recent acute HBV infection If also AbsAg+ = acute infection Distinguishes acute from chronic infection

*CIC Studying (9 decks)

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