Infectious Disease Process Flashcards
Interleukin - 2
Produced by CD 4 cells
Growth stimulator for T cells
Enhances activity of NK cells
What is interleukin 1 (IL-1)
Produced by many cell lines in the cellular immune system
Originally described as endogenous pylon - induces fever
Stimulates the differentiation if primitive T lymphocytes to specific T cell lines
Increases the production of other cytokines
Increases chemotaxis of macrophages
Interleukin 4
Produced by all T cells and mast cells
Stimulates growth of T and B lymphocytes, mast cells, & eosinophils
Interleukin-6
Produced ny macrophages, T & B lymphocytes
Promotes B lymphocyte differentiation
Causes proliferation of T lymphocytes
Causes differentiation of cytotoxic T lymphocytes, macrophages, and neutrophils
Induces fever
INH-a and INF B
Termed type I interferons
Produced by circulating WBC and fibroblasts
Interfere with the reproduction of viruses within infected cells
INF-y
Produced by activated T lymphocytes
Inhibits virus growth
Tumor necrosis factor (TNF)
Produced by macrophages
Causes involution and death of tumor cells
Causes protein catabolism in host with loss of muscle mass
Lymphotoxin
Similar to TNF
Promotes inflammation
Stimulates neutrophils
Granule yet macrophage colony stimulating factor (GM-CSF)
Produced by many cell lines
Stimulates reproduction of all granule the and macrophage cell lines
Granulocyte colony-stimulating factor (G-CSF)
Produced by many cells of the reticule endothelial system and vascular endothelium
Stimulates reproduction if granulocyte cell lines.
Monk the colony stimulating factor ( M-CSF)
Produced by many reticule endothelial cell lines
Stimulates reproduction of monocytes
Humoral immune system
IgG
Develop in a few weeks Provide long term immunity to a pathogen Major circulating and Extra vascular antibody immune response longest lived
Immunoglobulin M IgM
First reacting antibody to fight off infection
First line of defense
Present for only 6 months after exposure
IgA
Principle secretory antibody
Resides in mucous membranes
Found in saliva, breast milk, tissue of bladder, prostate, GI tract
IgD
Present on the surface of lymphocytes
Determines antigen specificity
IgE
Allergy
Releases large quantities of histamine & other inflammatory substances
What is aerobic
Microbes that must have oxygen to grow.
What is anaerobes ?
Microbes that grow without oxygen
What is facultative anaerobes?
Will use oxygen if present, but still grow I the absence of oxygen
What bacteria can penetrate the epithelium of the conjunctiva?
Neisseria gonorrhoeae, neisseria meningitidis, streptococcus pneumonia, listeria monocytogenes, corynebacterium Diphtheriae
What specimens are not appropriate for anaerobic cultures
Sputum Rectal swab Nasal or throat culture Urethral swab Voided urine
What is Virulence
Ability to invade and create disease in a host
Mast cells
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
What is a monocyte
Monocyte is the largest leukocyte which is a white blood cell
50% of monocytes are stored in the spleen
Quickly respond to infection & inflammation
What is a neutrophil
First to arrive at the site of an infection
most abundant phagocyte
they inhibit the growth of bacteria or fungus
What is an eosinophil
Active and killing bacteria and parasites
they also can cause tissue damage during allergic reaction
What is the basophil
They are activated by pathogen and release histamine
important defense against parasites
Play a role in allergic reactions (such as cause asthma)
Maternal passive immunity
Antibody mediated immunity IgG passed from mom to placenta
Antibodies disappear between 6-12 month
Transfer of IgA antibodies in breast milk
What is antiserum injection
Passive immunity is acquired using antiserum injection-
Injection contains antibodies form by a person or animal
provide immediate but short-term protection against an example is hepatitis exposure or tetanus antitoxin
What are parasites
Ectoparasites
Protozoa
Helminths
Detected by microscopic examination
Name the ectoparacites
Infestations are common in the community
Can spread in healthcare facility
Scabies, bedbugs, lice
What are Protozoa
Unicellular free loving eukaryotic organisms
Community health problems (not typical in health care facilities)
Giardiasis
Toxoplasma
Giardiasis
What is helminths
Parasitic worms
Roundworms
Tapeworms
Flatworm
Anthrax
Paused by bacillus anthracis biological agent Occupational contact or infected animals Incubation hours to 7 days typically 48 hrs Contact precautions Treatment with penicillin, Cipro
Aspergillosis
Fungal disease in resp tract of birds/mammals
Diagnosed by intradermal or scratch test
Days to weeks incubation
No precautions
Treated with corticosteroids.
Brucellosis mediterranean fever
Signs and symptoms fever headache weakness profuse sweating chills depression weight loss and aching
Incubation 5 to 60 days
use contact precautions
Chickenpox
Herpes virus, varicella Fever, maculopaoular skin eruptions, Incubation 2-3 weeks Chickenpox- airborne isolation, Disseminated zoster - s
Cholera
Infection of small intestine Watery stools Incubation 5 days Contact precautions 50% die is not treated within hours
Conjunctivitis pink eye
Hemophilia influenza epidemic, streptococcus pnemoniae, neisseria meningitis
Incubation 24-72 hours
Contact precautions
Hemorrhagic fever (break bone fever)
Infectious tropical disease caused by dengue virus
Incubation 3-14 days
Diphtheria
Corynebacterium Diphtheriae
Bacterial disease up involving pharynx
Incubation 2-5 days
Ehrlichiosis
Transmitted by a tick
Fever, chills, malaise, headache, muscle joint pain, headache
Standard precautions
Treat with tetracycline
Erythema infectious fifth disease
Childhood disease slapped cheek and lazy exanthema
Human parvovirus
Incubation 4-20 days
Droplet precautions
Hep A
Jaundice, fatique, and pain, loss of appetite, nausea
Incubation 15-50 days
Fecal / oral route
HAVRIX vaccination
IgM antibody appears first and then declines
Hep B
Jaundice, fatigue, and pain, loss of appetite, nausea.
HBSAG found in the blood 1-2 months after exposure
Incubation 45-180 days
Anti- HBc IgG life time marker for HBV infection
Hep C
70% asymptomatic Anti- HCV can be detected in 4-24 weeks Incubation 2 weeks to 6 months Transmission - blood, sexual, perinatal Standard precautions Treat INF2b and ribavirin
Hep D
Occurs with confection with HBV Detection of HDV Low incidence in US Incubation 2-8 weeks HDV not sexually transmitted hep B vaccination provides immunity
Hep E
Non enveloped particle of The Calcivirus family
Usually a benign disease
Incubation 15-64 days
Fecal oral route for transmission
Histoplasmosis
Systemic primary lesions in lung
Incubation 3-17 days usually 10 days
Standard precautions
Hiv
Fever, malaise, lethargy, anorexia, nausea, headache, sore throat
ELISA measures antibody response
Western blot is confirmatory test
Detected 3 weeks to 6 months after exposure
Incubation 1-3 months
Influenza
Types A B C
Symptoms include fever headache sore throat cough a Myalgia
Strains of flu are described by their geographical site of isolation the culture number and the year of isolation
Incubation period is 1 to 3 days
droplet precautions
Legionnaires disease
Symptoms include anorexia malaise headache rapid rise and fever with chills nonproductive cough abdominal pain diarrhea
Incubation period is 2 to 10 days. standard precautions
mortality is about 39%
Lyme disease
Borerelia buefdorferi
Incubation 3-32 days
ELISA testing
Malaria
Symptoms include fever chills sweats cough diarrhea respiratory distress headache shock renal and liver failure, encephalopathy, cerebral edema, coma, death
Incubation period is 7 to 14 days if it’s a blood it’s two months
quinine is a treatment
Measles rubella which is red measles
Signs and symptoms include fever conjunctivitis cough spots red blotchy rash which begins on the face
Diagnostic and testing includes and IgM antibodies which are present 3 to 4 days after the rash
Airborne isolation
treatment can include me you know globin and IG
Bacterial meningitis
Sudden fever, headache, N, V, stiff neck, convulsions,
Test CSF appears cloudy, test for blood cells, leukocyte, cell count, protein ^ sugar
Neisseria meningitis - treat with Cipro.
Viral meningitis
Occurs in July, August, sept
<40 y.o.
No mental impairment
Viral cultures of CSF
Haemophilus influenzae
Usually associated with Otis media or pharyngitis.
Causes bacteria meningitis
deafness occurs in 50%
Incidence has decreased since HIb vaccination
Mononucleosis (Epstein Barr disease)
Human game herpesvirus
Fever, sore-throat, splenomegly, lymphadenopathy
IFA test for IgM & IgA
Incubation 4-6 weeks
Mumps
Fever, swelling, tenderness of salivary glands
Incubation 12-25 days avg 18
DROPLET from 9 days past onset of swelling
Treatment - none
Pediculosis LICE
Infested hair is fluorescent under UV light
Incubation 7-10 days
Contact precautions
Ectoparasites - scabies, bedbugs, lice
Pertussis
Bortella pertussis Cough has a crowing or high pitched sound Diagnosed by NP culture Incubation 6-20 days Droplet for at least 5 days
Plague (pestis)
Fever, chills, malaise, myalgia, nausea, sore throat, headache
Dx by bipolar staining, FA test,
Incubation 1-7 days
Droplet precautions for 72 hours until abx
Clothing will be infested with fleas use insecticides
Poliomyelitis
Poliovirus (enterovirus types 1,2,3
Flaccid paralysis. Fever, malaise, headache, nausea. Vomiting. Muscle pain, stiffness of neck
Dx: virus in stool, CSF, oral secretions
Incubation 3-35 days, average 7-14 days
Contact precautions
rabies
Virus rhabdovirus of genus Lyssavirus Vizsla encephalomyelitis, sudden onset of apprehension, headache, fever, malaise, Sensory changes, DX: brain tissue Incubation 9 days to 7years Contact precautions Intensive medical care
Rocky Mountain spotted fever
Sudden onset Fever, malaise, deep muscle pain, severe headache, maculopaoular rash on extremities include palms and soles of feet, petechiae, and hemorrhages,
Incubation 3-14 days
Standard precautions
RSV respiratory syncytial virus
Bronchiolitis & pneumonia in infants and children under 1 year
DX - virus antigens viral RNA
Isolation contact and droplet
Rubella- German measles
Togavieidae, genus rubivirus
Maculopaoular rash resembles measles, headache, malaise, conjunctivitis,
Incubation 14-23 days, average 16-18 days
Droplet for 7 days after rash development
SARS
Cornponavirus SARS CoV
Fever 100.4, headache, body ache, mild respiratory symptoms
Incubation 10 days
Droplet and contact precautions
Scabies
Sarcoptes scabies Mite penetrates the skin Diagnosed by skin scrapping Incubation 2-6 weeks Contact precautions for 24 hours after treatment
West Nile virus
80% asymptomatic
Fever, myalgia, rash, nausea, vomiting, anorexia, malaise,
DX: test for CSF 8 days after symptoms IgM
Incubation 3-14 days
Standard precautions
Yellow fever
Sudden onset Fever, chills, headache, backache, generalized muscle pain, nausea , vomiting,
Incubation 3-6 days
Standard precautions
Protect from Mosquitos
What do natural killer cells do?
Do not destroy microbes, but destroy the compromised host cd,lx such as tumor cells or virus infected cells
Not part of inflammatory response
Active immunity
Host had an immunological response and produces cells that response
Host produces own antibodies
Active immunity persists for a long time - years
Passive immunity
Humoral immunity
Host receives antibodies from another source. (Mom to baby 6-12 months)
Immunity is short lived months/weeks
Anti-serum injection
IVIG pooled human immunoglobin (Kelli)
