Infectious Diseases Chapter 10 Flashcards
Most likely exposure of hepatitis for health care workers
Hepatitis B
Blood spills
Must be cleaned up immediately
CDC and OSHA standards
10:1 water:bleach
Hepatitis B
RNA virus
Transmitted through body fluids, feces, ingestion of contaminated food and drinking water
Lives for several months outside body
Approx 28 day incubation period
Hepatitis A
S/S: loss apetite, fatigue, abdominal pain, vomiting, diarrhea, fever, jt pain, dark urine, clay stools, jaundice
Vaccine is available
Prognosis: good
MI: prevention: chlorinate water, hand washing. Immunoglobulin can help
PT: none, but practice regular hand washing
Hepatitis A
Incidence probably higher that realized
800,000- 1.4 million living with it
If HIV positive or immunosuppressed, risk of contracting is higher
Vaccination available
Virus in blood is viable for up to 7 days
Hepatitis B
Blood borne transmitted through contaminated blood, sexual contact
Mother to baby
Contaminated instruments
Unsafe sex
Blood transfusion
Direct contact with contaminated blood
Hepatitis B
S/S:Loss appetite, N&V, weakness, fatigue, low grade fever, joint and mm pain and aching, possible rash
Prognosis: acute portion resolves in few weeks
Liver returns to normal function
Chronic hepatitis with liver failure
5% adults
95% infants
50% children 1-5 yrs old
Liver cirrhosis and liver cancer rates are higher
Hepatitis B
MI: prevention is best, inhibitor drugs are available (adefovir and entercavir) and antivirals (interferon, limivudine)
Medications help reduce the virus
PT: not directly
Know standard precautions
Hepatitis B
More prevalent in IV drug users
85% of people who contract it develop the chronic form
Etiology: RNA virus transmitted by infected blood: most common in IV drug users and those with multiple sexual partners, can be spread by spread by transfusions, as a nosocomial infx or mother to child during delivery
Hepatitis C
S/S: incubation of 6-7 weeks
can have for years without any outward signs
Once signs appear: may be mild, however can have chronic form for life.
Loss of appetite, fatigue, abdominal pain and tenderness over liver, mm and jt pain
Chronic form: liver cirrhosis in immunosuppressed, liver cancer
Hepatitis C
S/S liver cirrhosis: enlarged liver and spleen, jaundice, mm atrophy, rash, ascites, ankle edema, LE neuropathy
Long term complications with HCV: glomerulonephritis, arthritis, sjogrens syndrome, non-Hodgkins lymphoma, fibromylagia
Hepatitis C
Prognosis: depends on severity
MI: prevention if possible, NO VACCINATION, blood tests: liver function tests, anti-HCV, HCV-RIBA, viral load test, liver biopsy. Medications: antivirals: alpha-interferon, ribavirin. May have liver transplant
PT: may see if have arthritis or fibromyalgia
Hepatitis C
Occurs with extreme alcohol intake
Occasionally from moderate drinking
More common in women
Affects 2 million people in US, more prevalent in 20-60 yr olds
Etiology: most likely genetic factors, malnutrition, immunological factors, other hepatitis
Alcoholic Hepatitis
S/S: pain, tenderness in abdomen, ascites, nausea, fever, loss of appetite, fatigue, excessive thirst, dry mouth, pallor, rapid weight gain, tachycardia, anemia, encephalopathy
Complications: portal htn, varices, bruising and bleeding tendencies, cirrhosis, hepatic encephalopathy
Alcoholic Hepatitis
Prognosis: less severe can recover
If more severe much higher mortality rate
Hepatic encephalopathy: very severe
MI: liver tests: both enzymes and levels of albumin and bilirubin, US, liver biopsy, refrain from alcohol, improve nutrition, weight loss, liver transplant
PT: not indicated
Alcoholic Hepatitis
Sexually transmitted virus
Worldwide health problem
Leading cause of death in Africa
In 2006: 53% homosexual and bisexual men
43% African American men and women
31% heterosexual
12% drug abusers
24-27% WERE NOT AWARE THEY HAD THE DISEASE
Human Immunodeficiency Virus (HIV)
Etiology: blood borne
Undetectable for several weeks
Can go long period with no S/S
Leaves body vulnerable to opportunistic infx
Is an RNA retrovirus
Virus attacks T lymphocytes
Medication cocktails have to be changed because virus becomes drug resistant
Human Immunodeficiency Virus
Etiology:
Can have latent period of 10-15 yrs
Transmit through intimate contact or infected semen (condoms can prevent this)
Hypodermic needles
Mother to child transmission during PG, childbirth, breast milk
Human Immunodeficiency Virus
S/S: flulike symptoms: fever, sweating, diarrhea, HA, jt. or mm pain, fatigue, blurred vision, swollen lymph glands, rash, SOB
Long term symptoms: weight loss, chronic diarrhea, chronic fatigue, progressive weakness, arthritis
Neurological changes: encephalitis, behavioral changes, reduced cognitive function
Human Immunodeficiency Virus
Secondary infections
Pneumocystis carinii, myobacterium avium, Hodgkin’s lymphoma, cytomegalovirus, candidiasis, Kaposi’s sarcoma
Prognosis: no cure
Much improved medical therapy
prevention
Human Immunodeficiency Virus
MI: detection of ______ in blood, CD4-T lymphocyte count < 200/mm3, use of HAART
PT: treat due to mm weakness, atrophy and fatigue, peripheral neuropathy. Work on strength, balance, conditioning, functional mobility with assistive devices….
Human Immunodeficiency Virus
Hospital acquired
Most common agents: streptoccoci, staphylococcus aureus, enterococci, Pseudomonads, Escherichia coli, enterobacter species
Most found in ICUs
Increased likelihood if seriously ill, length of stay, immune compromised, patient to nurse ratio, iatrogenic risk factors
Nosocomial Infections
S/S: fever, rash, fatigue, malaise, tachycardia
Suspected when pt gets fever after entering hospital
Prognosis: double the mortality and mortality
MI: identify the pathogen: blood or fungal cultures, give broad spectrum abx, remove IV or catheter lines if possible, PREVENTION
PT: standard precautions
Nosocomial Infections
