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IMS TEST 2 > L16 & 17 Infection PART 3 > Flashcards

L16 & 17 Infection PART 3 Flashcards

1
Q

what are the 4 major groups of pathogenic organisms?

A

bacteria
viruses
fungi
parasites

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2
Q

what are 4 popular bacterial pathogens?

A

Staphylococcus aureus
Streptococci
Escherichia coli
Tuberculosis

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3
Q

what are 4 popular viruses?

A

Rhinovirus (common cold)
Influenza
Hepatitis B/C
HIV

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4
Q

what are 2 popular fungal pathogens?

A

candida

tinea

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5
Q

what are 2 popular parasites

A

malaria

hookworm

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6
Q

what is the difference between non-specific and specific symptoms?

A 
non-specific: 
Fever
Sweats, chills, shivers
Rigors
Loss of appetite +/- weight
Aching muscles (myalgia) or joints (arthralgia)

specific:
According to source
Pneumonia – cough, breathlessness, sputum
Meningitis – headache, neck stiffness, photophobia

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7
Q

what information from a history taking could help you formulate a diagnosis?

A

Conditions that make people more susceptible to infection
Past medical history: diabetes, immunodeficiency e.g. HIV
Drug history: steroids, chemotherapy

Lifestyle activities that bring people in to contact with infection
Occupation: healthcare worker, vet, farmer, sex worker
Travel: ask where, when and what did they get up to…?
Recreation: hobbies (e.g. watersports), food (e.g. takeaways/BBQ), injecting drugs
Contacts: people (including sexual partners), animals, insects

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8
Q

in what infection are neutrophil levels elevated?

A

bacterial infection - pneumococcal pneumonia

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9
Q

in what infection are lymphocyte levels elevated?

A

viral infections - glandular fever (Epstein Barr virus)

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10
Q

in what infections are eosinophil levels elevated?

A

parasitic infections - schistosomiasis (bilharzia)

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11
Q

what does C-reactive protein (CRP) test?

A

it is a marker of inflammation

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12
Q

what does U&E test?

A

urea and electrolyte levels (kidney function)

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13
Q

what is lumbar puncture used to test?

A

it is used to examine cerebrospinal fluid for signs of meningitis

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14
Q

What tests do Microbiologists do with the samples you send?

A 
antibody detection
culture
antibiotic sensitivity testing
PCR
antigen detection
microscopy
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15
Q

during microscopy, what can the gram, ziehl-neelson and calcofluor tests be used for?

A

gram - bacteria
ziehl-neelson - TB
calcufluor - fungi

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16
Q

which 3 species can be tested using culture?

A

beta-haemolytic streptococci
salmonella
aspergillus (a fungus)

17
Q

how can we detect organisms that we cannot grow in the lab?

A

identify part of the organism through proteins ie antigens or through DNA/RNA PCR

identify the body’s immune response to the infection through antibodies eg IgM or IgG antibodies

18
Q

give examples of conditions that can be found using antigen testing?

A

legionnaire’s disease (pneumonia) via urine test

rapid hep B via blood test

19
Q

what can DNA/RNA identification be used for and which conditions can be tested?

A

Method of detecting genetic ‘fingerprints’
Identifies unique genetic code sequence for specific infection

meningitis
HIV
hep B and C
respiratory viruses eg flu

20
Q

what is the difference between IgM and IgG antibody testing?

A

IgM:
intitial antibody response appears within a week, usually disappears after few months

IgG:
later antibody response appears 10-14 days.
Test for rising level (titre) in consecutive samples
Persists throughout life (part of immunological memory)
Also useful to test whether you are immune to an infection

21
Q

what are the problems with antibody testing?

A

False positives – cross-reactivity

False negatives – sampled too early/late, immunocompromised patient

Not usually helpful in acute setting

22
Q

what is supportive therapy for treating infections?

A

symptomatic eg paracetamol for fever/aches

dehydration/low bp ‘shock’ - IV fluids

23
Q

what is specific therapy for treating infections?

A

Antimicrobials (= all drugs/chemicals that kill microorganisms)
An antibiotic = “a chemical substance derived from a mould or bacterium that can kill microorganisms and cure bacterial infections”

NOTE:
For many viral infections there is no specific treatment
Some infections are self-limiting – no treatment is required
Antibiotics must be started immediately for serious infections, e.g. meningitis

24
Q

where is penicillin from?

A

derived from mould

25
Q

where is mupirocin from?

A

produced by Pseudomonas fluorescens (bacterium)

26
Q

what are the characteristics of a good antimicrobial? [6]

A

Selective toxicity (effective against microbe without harming host)

Bacteriocidal (= kills the organism) rather than bacteriostatic (= inhibits its growth)

No resistance

Good pharmacokinetics (i.e reach high level in body and stay there, allowing fewer doses/day)

No side effects

Not inactivated by enzymes secreted by microbes, or by the host

27
Q

which areas of the cell do antibacterials target? [7]

A

cell wall synthesis

DNA replication (DNA gyrase)

DNA-dependent RNA polymerase

Protein synthesis (50S inhibitors)

Protein synthesis (30S inhibitors)

cell membrane

folic acid metabolism

28
Q

what are the problems with antimicrobials?

A

Variable spectrum of activity

  • Broad spectrum (kills lots of different organisms)
  • Narrow spectrum (kills few organisms)

Some cannot be given orally

Many cause side effects which can be serious, e.g. anaphylaxis (severe allergy)

Bacterial resistance

  • some antibiotics are now effective against very few organisms, e.g. penicillin
  • some organisms are now resistant to many antibiotics, e.g. MRSA
29
Q

how is a new strain of staph aureus introduced?

A

everytime a new antibiotic is introduced

30
Q

how do you reduce pathogens in the environment generally and in hospital?

A

general:

  • clean drinking water
  • improving sanitation
  • hygienic food preparation

in hospital:

  • cleaning wards, rooms and equipment
  • filtered air in operating theatres
  • Using sterile instruments when operating, taking blood etc
31
Q

what are the different routes of transmission and what are some examples of prevention measure?

A

food/water bourne - sanitation, clean water, food prep hygiene

contact eg MRSA - handwashing, wearing gloves, gowns, masks

airbourne eg TB - isolate infected patient in negative pressure room (that filters out-going air)

vector bourne eg malaria - avoid bites, insect repellent, bed nets, long sleeves

32
Q

how would a potential host protect themselves with prophylactic treatments?

A

antimalarials

antibiotics given to very immunosuppressed patients (bone marrow transplant recipients)

33
Q

what is the difference between passive and active immunisation?

A

Passive (with antibodies) - e.g. chickenpox immunoglobulin

Active (by stimulating the immune system with something which mimics the infection) – e.g. hepatitis B virus surface antigen

34
Q

what does the notification of communicable diseases by the Health Protection (Notification) Regulations 2010 do?

A

From Bacillus anthracis (anthrax) to Yersinia pestis (plague)

Information on infection

Information on patient with infection or suspected infection

Used to identify and prevent outbreaks e.g. food poisoning

Coordinated by Public Health England

IMS TEST 2 (14 decks)

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