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Pathophysiology & Pharmacology > Infectious Diseases > Flashcards

Infectious Diseases Flashcards

1
Q

Virus

A
  • Forms of Viral Disease
    ~ Kill infected cells
    ~ Interfere with a cell’s function
    > Diarrhea
    ~ Cause cells to Proliferate
    > Warts
    > Causes tumors to form
  • Common
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2
Q

Bacteria

A
  • Forms of Bacterial Disease
    ~ Directly damaging cells by release of
    exotoxins.
    > Initiates inflammatory response.
    ~ Binding to cells.
    > Can trigger inflammatory
    response and resist phagocytosis
  • Hybrid between plant and human cell due to having a cell wall and other structures
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3
Q

Common Cold/URI: Cause and Transmission

A
  • Cause
    ~ Viral infection (coronavirus, rhinovirus)
    > 90% of the Time
    ~ Infects the Respiratory Tract (nose to
    bronchi)
  • Transmission: Direct or indirect contact with sputum and discharges from respiratory system.
  • Coronavirus and rhino virus are specific to the epithelial cells of the respiratory tract.
  • Usually confined to the upper respiratory tract due to the fact that these viruses reproduce well in temps below body temperature
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4
Q

Common Cold/URI: Results in Inflammation of Respiratory Tract

A
  • Does not cause cell death, but histamine would be released and overactive immune response often causes cell damage.
  • Respiratory tract has LT receptors that when activated cause increased mucous production (excess mucous due to excess LT)
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5
Q

Common Cold/URI: S&S and Treatment

A
  • Sneezing
  • Chills (causes vasoconstriction making people feel cold)
  • Sore Throat
  • Nasal Congestion (inflammation or mucous)
  • Non-productive Cough (nothing is coming out)
  • Aches and Pains (PG)
  • Fever (PGE2) (causes vasoconstriction making people feel cold)
  • Treatment: Support and Symptom relief
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6
Q

Influenza (URI): Cause and Transmission

A
  • Cause
    ~ Viral infection (influenza virus)
    ~ Infects the Respiratory Tract (nose to
    bronchi)
  • Transmission: Direct or indirect contact with sputum and discharges from respiratory system.
  • Influenza virus is specific to the epithelial cells of the respiratory tract.
  • Can tolerate a large range of temps so it can spread to the bronchi and lungs (can turn into pneumonia if spread)
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7
Q

Influenza (URI): Cell Response

A
  • Similar to the common cold this virus does not directly damage cells, but over active immune response may.
  • Typical response to chemical mediators occurs with LT’s extra function of increasing mucus production.
  • Cell death diminishes the usual mucous lining and cilia defenses predisposing to secondary bacterial infection
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8
Q

Influenza (URI): S&S and Treatment

A
  • Sneezing
  • Chills (causes vasoconstriction making people feel cold)
  • Sore Throat
  • Nasal Congestion (inflammation or mucous)
  • Non-productive Cough (nothing is coming out)
  • Aches and Pains (PG)
  • Fever (PGE2) (causes vasoconstriction making people feel cold)
  • Treatment: Support and Symptom relief
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9
Q

Cold Vs. Flu

A
  • Very similar infections in terms of S&S
    ~ Sudden, severe fatigue is a good
    marker for the flu
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10
Q

Cold Vs. Flu: Chart

A

Flu Cold

Onset: Sudden Gradual

Cough: Nonprod Hacking
(often severe)
Aches &
Pains/
Weakness: Often Severe Mild

Fever: High Infrequent
(persistent)

Headache: Prominent Rare

Congestion: Sometimes Usual

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11
Q

Pharyngitis: Cause and Transmission

A
  • Inflammation of the pharynx
    ~ Classic sore throat (doesn’t matter
    unless it’s strep)
  • Cause
    ~ Typically a viral infection
    ~ Can be bacterial
    > Strep throat (streptococcus
    bacteria)
  • Transmission: Direct or indirect contact with saliva and nasal discharge
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12
Q

Pharyngitis: S&S

A
  • Sore throat
  • Headache
  • Fever
  • Chills
  • Appears similar to URI except probably less:
    ~ Nasal congestion
    ~ Cough
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13
Q

Strep Throat

A
  • Needs to be referred
  • Triad of
    ~ Red tonsils w/ exudate
    ~ Fever
    ~ Swollen lymph nodes (neck)
  • Streptococcus can cause many illnesses because it is specific epithelial cells and that type of cell is found at multiple sites.
  • Invades and Kills Tissues
    ~ Only form of pharyngitis that should
    be routinely treated with antibiotics.
    ~ Antibiotics probably will not shorten
    illness, but can prevent spread of
    infection and remote disease.
  • Remotely can cause: (can be fatal)
    ~ Rheumatic fever
    ~ Endocarditis
    ~ Post Streptococcus
    Glomerulonephritis
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14
Q

Strep Throat Diagnosis

A
  • Presence or absence of “triad” with exam does not confirm that the cause is or is not strep
  • Microbial culture is the only way to confirm.
    ~ Takes 24-48 hours to get the results.
    ~ Rapid strep test can confirm if
    positive but may not pick it up every
    time
    > Takes 15 minutes or less
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15
Q

Pneumonia: Cause and Transmission

A
  • Cause
    ~ Can be bacterial or viral infection.
    ~ Infects the Lungs
    > Cell death and inflammation result
    in a filling of terminal airways w/
    mucous, exudate, and dead cells
    > Causes a lack of gas exchange
  • Transmission: Direct or indirect contact with sputum and discharges from respiratory system
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16
Q

Pneumonia: S&S and Treatment

A
  • Signs and Symptoms
    ~ Productive Cough (stuff comes out)
    ~ Dyspnea (shortness of breath)
    ~ Fever
    ~ Chest Pain
    ~ Increased Breathing Rate
  • Treatment
    ~ Support
    ~ Antibiotics - If Bacterial
    ~ Removal of Secretions (cough or
    taking a tube to suction it out)
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17
Q

Tuberculosis (TB)

A
  • Refer
  • Infection caused by Myobacterium tuberculosis.
  • Myobacterium is a bacterium with a slightly different structure.
    ~ Has high amount of lipid in its cell
    wall structure.
    ~ Grows more slowly resulting in
    chronic disease.
    > Can be present for years after
    exposure.
    ~ Does not directly kill tissue - causes
    damage by inducing inflammatory/
    immune response. (the problem)
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18
Q

Tuberculosis: Transmission

A
  • Direct or indirect contact with respiratory fluids
  • Typically confined to developing countries.
    ~ In over 90% of those exposed, the
    infection does not cause active
    disease.
    ~ Causes disease in the 10% that don’t
    have effective immune responses
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19
Q

Course of Tuberculosis

A
  • M. tuberculosis makes its way to the lungs and is ingested by macrophages.
  • Macrophages eventually degrade and the foreign antigen is presented allowing for potential immune response.
  • Can go to liver and brain
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20
Q

Latent TB (90%)

A
  • Body mounts an immune response
    ~ T-cells are produced/activated
    ~ Infection stays localized in the lungs
    and local lymph nodes.
    > Lesions form in the lungs at sites
    of infection that are the result of
    the associated immune response.
    (scaring/healing): can show up on
    an X-ray
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21
Q

Active TB (10%)

A
  • Body is unable to mount strong immune response
    ~ Areas of infection in the lungs and
    local lymph nodes become enlarged.
    > Can impinge airways
    ~ Infection can spread to any organ in
    the body.
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22
Q

S&S of Active TB

A
  • Fever
  • Weight Loss
  • Fatigue
  • Night Sweats
  • Chest Pain
  • Pleural Effusion
  • Enlargement of Lymph Nodes
  • Cough/Hemoptysis (coughing up blood)
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23
Q

TB/Tuberculin/Mantoux Test

A
  • Purpose
    ~ Used to Screen: High Risk Populations
    ~ Used to Diagnose: Those showing S/S
    of TB
    ~ Helps to determine both TB infection
    and active TB
  • Procedure
    ~ Components of TB injected under the
    skin.
    ~ Response Is observed 48 to 72 hours
    later
    > Positive = Large Reaction Raised
    Swollen Circle at site
    • Same reaction in persons TB
    infected or with active TB
    > Negative = Minimal No Response
    • If immune system is
    compromised an exposed
    person may appear negative
    • Persons never having TB
    infection or active TB
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24
Q

Activity Recommendations and Respiratory Tract Infections

A
  • Above the Neck
    ~ Can exercise at a tolerated intensity
  • Below the Neck
    ~ No exercise
  • Fever >100
    ~ No exercise
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25
Q

Respiratory Tract Infection and Antibiotics

A
  • “I have yellow/green mucus/phlegm don’t I need antibiotics?”
  • Maybe
    ~ Most Respiratory Infections Are Viral
    = Antibiotics Are Not Effective
    ~ Mucus/phlegm production is a
    reaction to both bacterial and viral
    infection.
    ~ Color is associated with dirt, dead
    cells, dead bacteria/virus.
    ~ Antibiotics needed if infection is truly
    bacterial AND body is unable to
    effectively fight infection
    > Or could be deadly (strep)
    • Prevents pt from getting to
    symptoms that cause death
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26
Q

Epstein Barr Virus Infections

A

-By adulthood most people have been infected by EBV and infection is asymptomatic.
~ Infected persons can develop certain
cancers.
> Burkitt Lymphoma
> B-Cell Lymphoma
> Nasopharyngeal Carcinoma
~ Can develop mononucleosis (mono)

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27
Q

Mononucleosis: Cause and Transmission

A
  • Cause
    ~ Initially infects nasopharyngeal cells
    and B-Lymphocytes.
    ~ EBV then infects the Lymphatic
    System (lymph nodes, spleen, liver)
  • Transmission: Direct or indirect contact with saliva
  • “kissing disease”
28
Q

Mononucleosis: S&S and Treatment

A
  • Long incubation period (30-50 days: months if really bad)
    ~ Sore throat
    ~ Fatigue - can be extreme
    ~ Headache
    ~ Fever
    ~ Swollen lymph nodes, especially in
    neck
  • Treatment - Support and Symptoms Relief (wait it out)
29
Q

Mononucleosis: Return to Activity

A
  • Unable due to symptoms in less than 4 weeks.
  • Complications
    ~ Splenomegaly
    > Enlarged Spleen + Trauma =
    Kerr’s Sign
    • Peak enlargement: 10 days
    after DX
    • Back to normal: Avg of 27
    days
    > Important to be aware of due to
    the possibility of internal bleeding
    ~ Hepatitis
30
Q

Gastrointestinal Infections: Cause & Transmission

A
  • Cause
    ~ Typically a viral infection (rotavirus or
    Norwalk virus)
  • Transmission
    ~ Ingest fecal matter with virus
    ~ Unwashed hands and eating
31
Q

Gastrointestinal Infections: Results

A
  • Virus infects the cells lining the small intestine interfering with the absorption of nutrients
    ~ Results in vomiting (2-3 days) and
    profuse, watery diarrhea (5-8 days)
  • This bacteria is found all around the environment.
    ~ Soil
    ~ Water
    ~ Air
    ~ Clothing
    ~ Dust
    ~ Meat
32
Q

Gastrointestinal Infections: Clostridium Perfringens

A
  • Bacterial infection
    ~ Will cause diarrhea (<24 hrs) and
    abdominal pain
  • This bacteria produces an exotoxin that results in cell death at the lining of the small intestine.
    ~ Contents of cells spill into the lumen.
    ~ Small intestine cannot absorb
    nutrients as well.
33
Q

Gastrointestinal Infections: S&S and Treatment

A
  • Diarrhea
  • Fever
  • Abdominal Pain (usually lower abdominal)
  • Lasts a long time
  • Treatment
    ~ Take an anti-diarrheal and wait
34
Q

Other Clostridial Diseases

A
  • Gas Gangrene
    ~ C. perfringens
    ~ C. novyi
    ~ C. septicum
  • Tetanus
    ~ C. tetani
  • Botulism
    ~ C. botulinum
35
Q

Gas Gangrene

A
  • Most commonly caused when C. perfringens contaminates a wound.
  • Produces a toxin that destroys the membrane if a number of cell types including, muscle cells, leukocytes, and erythrocytes
  • Tissues exposed to this bacteria quickly become necrotic.
  • Tissues liquety and overlying skin becomes stretched over the edema and gas formation. (Gas is a byproduct)
  • Clean wounds to prevent
    ~ Especially feet wounds: shoes are
    dirty, wet, and dark
36
Q

Tetanus

A
  • Infection caused by wound contaminated by Clostridium tetani.
  • This bacteria is present in the soil and lower GI tract of many animals.
  • Produces a toxin that doesn’t allow skeletal muscle to relax
    ~ Results in rigidity
37
Q

Tetanus: S&S

A
  • Early S/S
    ~ Fatigue
    ~ Weakness
    ~ Muscle Cramping
  • Progresses to muscle rigidity
    ~ Starts with muscles of the face.
    (lockjaw)
    ~ Spasm of respiratory and laryngeal
    musculature can lead to death
38
Q

Botulism

A
  • C. botulinum is widely distributed.
  • Infection usually due to improperly canned food that is stored without refrigeration.
    ~ Resistant to boiling and drying.
  • Produces a neurotoxin that resists gastric digestion and is absorbed into the blood stream
    ~ Binds to nerve terminals and inhibits acetylcholine release or binds to the molecule.
    > Results in weakness/paralysis
    > Can result in death.
  • Muscles that help with ventilation can’t relax
39
Q

Psoriasis: Cause

A
  • Cause
    ~ Unknown
    ~ Appears to Have a Genetic Link
    > 1/3 have a family history of
    condition.
    > Not seen in Native Americans
    > Rarely seen in Asians
  • Related Factors
    ~ Stress
    ~ Hormonal Changes
    ~ Change in Climate
    ~ Trauma
40
Q

Psoriasis: S&S

A
  • Thick, Flaky Scaling of the Skin
  • Dry, Cracked and Encrusted
  • Pain, Tingling or Burning
41
Q

Psoriasis: Treatment

A
  • Since there is no cure, symptoms are treated.
    ~ Scale Removal
    ~ Antihistamines
    ~ Oatmeal Baths
    ~ Coal Tar
42
Q

Impetigo: Cause and Transmission

A
  • Cause
    ~ Bacterial infection of the skin (strep)
  • Transmission
    ~ Direct or indirect contact with vesicle
    contents
43
Q

Impetigo: S&S and Treatment

A
  • S&S
    ~ Vesicle Formation
    ~ Vesicles rupture and form yellow
    crust
  • Treatment
    ~ Wash affected areas 2-3 times per day
    with antibacterial soap.
    ~ Topical Ant-Biotic Ointment
    ~ Wash all clothing and linens.
    ~ Avoid Contact With Others
44
Q

Furuncles and Carbuncles: Cause

A
  • Bacterial infection (staph) of one (Furuncle) or many (Carbuncle) hair follicles
  • Bad if it gets into circulatory system
45
Q

Furuncles and Carbuncles: S&S and Treatment

A
  • S&S
    ~ Painful
    ~ Swollen
  • Treatment
    ~ Wash affected areas 2-3 times per
    day with antibacterial soap.
    ~ Hot, Wet Compresses
    ~ Antibiotic Ointment
    ~ Surgical Incision and Drainage
46
Q

Fungal Infections: Cause and Transmission

A
  • Cause
    ~ Exposure to fungus
    ~ Skin in an evironment thats dark, wet,
    and hot (shoes)
    ~ Opportunistic - Infect those with
    compromised immune systems.
  • Transmission
    ~ Direct contact with fungus or spores.
    ~ More likely if skin is damaged of
    abraded.
    ~ More likely if hygiene is poor.
47
Q

Fungal Infections: S&S and Treatment

A
  • S&S
    ~ Fungus eats keratin in skin, nails, and
    hair
    > Skin becomes red, cracked, and
    scaly
    > Itching, burning, and stinging
  • Treatment
    ~ Topical Fungicide
    ~ Oral Medications
    ~ Keep area dry, ventilated and clean.
48
Q

Fungal Infections Types: Tinea Capitis

A

Infection of the scalp

49
Q

Fungal Infections Types: Tinea Corporis

A
  • “Ringworm”
  • Lesions are ring shaped
50
Q

Fungal Infections Types: Tinea Unguium

A
  • Infection of nails
  • Nails become dull, brittle, and thickened
51
Q

Fungal Infections Types: Tinea Pedis

A
  • Athletes Foot
  • Commonly includes intense burning and itching
52
Q

Fungal Infections Types: Tinea Cruris

A
  • “Jock Itch”
  • Often caused by same fungus that causes athletes foot
53
Q

Herpes: Cause

A
  • Infection of the skin and or mucous membrane with herpes simplex virus
  • Results in cell death and associated inflammation
54
Q

Herpes: S&S

A
  • Fever
  • Malaise
  • Burning/Tingling Sensation
  • Vesicle Formation and Ulceration
  • Inflammation of Involved Tissues
55
Q

Herpes: Management

A
  • Treat General Symptoms
  • Avoid Close Contact
  • Anti-Viral Medications
  • Use care with individuals showing signs of herpes and conjunctivitis.
    ~ Corneal scarring
    ~ Leading infectious cause of blindness
56
Q

Herpes Simplex Virus Types

A
  • Both can infect many epithelial tissues or mucus membranes.
  • Most likely to infect if tissues are damaged.
57
Q

Herpes Simplex Virus 1

A
  • Transmitted in oral secretions or open lesions
    ~ “Childhood”
58
Q

Herpes Simplex Virus 1

A
  • Transmitted in genital secretions or open lesions
    ~ “Adulthood”
59
Q

Herpes Simplex Reoccurrence

A
  • Defeated virus follows the course of the sensory nerves in the area and ascends up the axon and lays dormant.
  • Virus can become active again and descend down the axon.
    ~ May cause new outbreak of vesicles.
    ~ May not cause new outbreak of
    vesicles, but virus is still shed in
    secretions
60
Q

Shingles: Cause and Transmission

A
  • Cause
    ~ Re-activation of the Varicella-zoster
    virus, the same virus that causes
    Chickenpox
    ~ Occurs only in people who have had
    chickenpox in the past.
    ~ Why the virus reactivates is unknown.
  • Transmission
    ~ Contact with someone with shingles
    can’t cause re-activation
    ~ Contact can cause chickenpox if
    person has not been infected before
    or vaccinated
61
Q

Shingles: S&S and Treatment

A
  • S&S
    ~ Usually unilateral and follows
    dermatome pattern
    ~ Tingling, Itchiness or stabbing pain.
    ~ Rash of fluid filled blisters.
    ~ Blisters burst and open sores crust
    over.
    ~ Symptoms usually disappear within
    three to five weeks.
  • Treatment
    ~ Manage Symptoms
    > Topical Hydrocortisone
    > Pain Meds
    ~ Anti-Viral Medications
62
Q

MRSA

A
  • Methicillin Resistant Staph Aureus
  • Penicillin was originally effective against staph aureus.
    ~ Penicillin resistant forms survive and
    multiply.
    ~ Methicillin then used.
    ~ Now methicillin resistant forms
    survive and multiply.
    ~ Last resort drugs now used.
63
Q

MRSA: At Risk Populations

A
  • Children attending daycare (close quarters)
  • Prison Inmates (close quarters)
  • Men who have sex with men.
  • Competitive Sports Participants
    ~ Body Shaving
    ~ Turf Burns
    ~ Sharing Whirlpools
    ~ Sharing Towels
    ~ Use of Antibiotics - 10x rate of non-
    athletes
64
Q

MRSA: Management

A
  • Educate athletes on aggressive wound care and hygiene.
  • Surveillance - refer fast
  • Incision/Drain - send for culture
65
Q

Identification of Skin Infections

A
  • The ability to identify quickly so that these infections are treated effectively is a key concern.
    ~ The appearance of these infections
    can vary depending on skin tone.
    > Conditions on darker skin may
    appear to have less erythema/
    redness
    > Lesions on darker skin may
    present with hyper or hypo
    pigmentation

Pathophysiology & Pharmacology (20 decks)

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