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
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
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
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)
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
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)
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
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
9
Q
Cold Vs. Flu
A
- Very similar infections in terms of S&S
~ Sudden, severe fatigue is a good
marker for the flu
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
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
12
Q
Pharyngitis: S&S
A
- Sore throat
- Headache
- Fever
- Chills
- Appears similar to URI except probably less:
~ Nasal congestion
~ Cough
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
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
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
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)
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)
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
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
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
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.
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)
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
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
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
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)
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
