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DPT 724 Pathophysiology > Lecture 4 Outline: Infectious Diseases > Flashcards

Lecture 4 Outline: Infectious Diseases Flashcards

1
Q

Overview of Infectious Diseases

A
  • from 1950 until 1980 the management of communicable infectious diseases was well under control
  • in 1970s and 80s new infectious agents appeared: via combo of environmental disruption and human mobility (increased gene mobility)
  • emergence of antibiotic-resistant organisms
  • resurgence of long-standing diseases (i.e. tuberculosis)
  • new infectious agents appeared
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2
Q

Signs and Symptoms of Infectious Disesases

A
  • blood composition: increased number or change in type of leukocytes
  • change in mentation in older adults: confusion, memory loss, difficulty concentrating
  • fever
  • abscess
  • rash with fever
  • red streaks radiating from an infection site
  • inflamed lymph nodes
  • joint effusion
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3
Q

Fever

A
  • can be associated with non-infectious event
  • normal temp regulated by hypothalamus-can cause hypothalamus to reserve heat and increase heat production
  • pyrogens: above 104 degrees (delirium, convulsions, irreversible cell damage)
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4
Q

Abscess

A
  • localized infection and inflammation with purulent exudate (what contain pus)
  • combo of leukocytes, dead organisms, and necrotic tissue (pus)
  • rupture: drainage into other tissues spreading infection
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5
Q

Rash With Fever

A
  • maculopapular eruptions-microbes penetratelayer of skin (i.e. measles)
  • nodular lesions (i.e. pseudomonas)
  • diffuse erythema (i.e. scarlet fever)
  • vesiculobullous eruptions (i.e. herpes zoster)
  • petechial purpuric eruptions (i.e. CMV)
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6
Q

Red Streaks

A
  • radiate from infection site (aka blood poisoning)
  • moe in direction of regional lymph nodes
  • may be associated with lymphangitis
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7
Q

Inflamed Lymph Nodes

A
  • palpable in cervical axillary or inguinal areas
  • overlying skin may be erythematous and warm due to infections
  • metastatic sites for cancer:common in supraclavicular and inguinal nodes
  • usually hard and fixed to underlying tissue, no tenderness usually but swollen
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8
Q

Joint Effusion

A

-fluid gets into interstitial fluids and causes swelling

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9
Q

Definition and Overview of Infection

A
  • process in which organisms establishes a parasitic relationship with its host involving reproduction of microorganism
  • tissue-destroying microorganisms enter and multiply in body
  • may take form of minor illnesses or result in life-threatening condition called sepsis
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10
Q

Steps of Infection

A
  • transmission can have more than one outcome: pathogen contamination of body surface only, subclinical infection: no evident symptoms, clinically apparent infection: host-parasite interaction causes obvious injury, one or more clinical symptoms present, called infectious disease
  • incubation period: period between pathogen entering host and appearance of clinical symptoms
  • latent infection: occurs after microorganism has replicated, but remains dormant or inactive in host
  • period of communicability: time period when organism can be spread
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11
Q

Viruses

A
  • smallest organisms
  • completely dependent on host cell (no metabolic capability)
  • made up of DNA or RNA nucleus
  • not susceptible to antibiotics
  • viral infections develop when normal inflammatory and immune response fail: inner capsule releases genetic material
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12
Q

Bacteria

A
  • well defined cell wall
  • one-celled organisms with no true nucleus and reproduce by cell division
  • pathogenic bacteria contain cell-damaging proteins
  • exotoxins: released during cell growth
  • endotoxins: released when bacterial cell wall decomposes
  • both of the above cause fever and aren’t affected by antibiotics
  • shape classification: cocci (spherical) bacilli (rods) spirilla or spirochetes (spiral)
  • gram positive or negative or acid-fast
  • motile or nonmotile
  • tendency for capsulation but can be encapsulated or not
  • sporulating or nonseparating
  • aerobic or anaerobic (most human flora is anaerobic)
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13
Q

Fungi

A
  • part of human body’s normal flora
  • fungal diseases in humans called mycoses
  • infection usually mild unless systemic or compromised immune system
  • reproduce asexually and contain nucleus
  • classification: yeast and mold
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14
Q

Parasites

A
  • common in rural or developing areas
  • organisms that live on or inside another organism
  • enter through mouth or skin, depend on host for food and protection or harm the host
  • ex: helminths (tapeworms)
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15
Q

Prions

A
  • proteins without nucleic acids
  • transmitted from animals to humans and cause rapidly progressive deteriorating state
  • ex: mad cow disease-rare form of dementia, from beef infected with bovine spongiform encephalopathy, infects CNS leading to myelin destruction and neuronal loss
  • symptoms: myoclonic jerking, ataxia, aphasia, vision disturbances, paralysis
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16
Q

Chain of Transmission

A
  • pathogen
  • reservoir
  • portal of exit
  • mode of transmission
  • portal of entry
  • host susceptibility
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17
Q

Chain of Transmission: Pathogen

A
  • any microorganism that has capacity to cause disease

- virulence: potency of pathogen in producing severe disease

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18
Q

Chain of Transmission: Reservoir

A
  • environment in which organism can live and multiply such as animal, plant, soil, food, or other organic substance or combo of substances
  • carrier: maintained environment that promotes growth, multiplication, and shedding of parasite without exhibiting sides of disease (hepatitis)
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19
Q

Chain of Transmission: Portal of Exti

A
  • place from which parasite leaves reservoir
  • site of growth of organism
  • secretions, fluids, feces, open lesions
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20
Q

Chain of Transmission: Mode of Transmission

A
  • contact: direct (physical contact of microorganism with host) or indirect (passive transfer from intimate intermediate object-fomite)
  • airborne: disease-causing organism usually less than 5 microns capable of floating on air current for hours; then inhaled by host
  • droplet: larger particles greater than 5 microns that fall out within 3 feet of source
  • vehicle: infectious organism transmitted through common source (food/water) to many potential susceptible hosts
  • vectorborne: involves insects and/or animals that act as intermediaries between two or more hosts (ticks)
  • nosocomial infections: infections acquired during hospitalization (~5%)
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21
Q

Chain of Transmission: Portal of Entry

A

-site where pathogen may enter a new host

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22
Q

Chain of Transmission: Host Susceptibiltiy

A

-variable depending on many factors

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23
Q

Clostridium difficile (C Diff): Overview, Etiology, Transmission, and Risk Factors

A
  • bacterial infection
  • cause of nosocomial and community based diarrhea
  • occurring exclusively in presence of exposure to antibiotics (wipes out intestinal flora)
  • primarily in health care facilities and transferred via fecal-oral route
  • non human reservoirs include water, raw veggies, and animals
  • most common mode of transmission is patient to patient via contaminated hands of healthcare workers
  • can also spread through bedpans, tubes, urinals, bed rails, call bells, etc
  • happens a lot in old people because they have decreased stomach acid
  • classically associated with use of antibiotic clindamycin (cleocin)
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24
Q

Clostridium difficile (C Diff): Pathogenesis, Clinical Manifestations, Medical Management, Prevention

A
  • change in protective flora of enteric system induced by antibiotics allow growth and toxin production (toxins A and B)
  • clinical manifestations: persistent diarrhea following antibiotic consumption, elevated WBC count, abdominal pain, cramping, or tenderness, nausea and vomiting, fever
  • diagnosis and Rx: stool culture, assay to detect toxins in stool, prompt discontinuation of antibiotic agent, oral vancomycin if not responding
  • prevention: hand hygiene, barrier precautions, environmental disinfection, and antimicrobial stewardship
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25
Q

Lyme Disease: Definition, Overview, Incidence, Pathogenesis

A
  • infectious multi-systemic disorder caused by bacterium (spirochete) carried by deer ticks
  • incidence: most prevalent vector-borne infectious disease in US, >90% of cases come from mid-atlantic, northeastern, and northcentral regions
  • pathogenesis: infected tick injects spirochete-laden saliva into bloodstream or deposits fecal matter on skin; after incubating 3-32 days spirochetes migrate outward causing an inflammatory response (rash); disseminates to other skin sites or organs through the blood or lymph (may survive for years in joints)
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26
Q

Lyme Disease: Clinical Manifestations

A
  • varied symptoms mimicking those of many other diseases
  • stage 1: early localized state within days: EM (erythema migrans) is a red, slowly expanding bull’s eye rash (not everyone develops this) resolves spontaneously in ~4 weeks; flu-like symptoms
  • stage 2: disseminated infection (weeks to months), if not treated may spread to NS, heart, and joints; neurologic symptoms: 15% of cases first to arise, manifested as aseptic meningitis, cranial nerve palsies, peripheral neuropathy, may improve or resolve if untreated; lyme arthritis (in ~50% of diagnosed cases): unilateral inflammation and swelling in large joints
  • stage 3: late persistent (weeks to months)-60% get here if didn’t get early treatment, intermittent arthritis with marked pain and swelling occurs 6 weeks to several years after tick bite, usually only 1 or a few joints are affected-50% of people not treated progress to this stage
27
Q

Lyme Disease: Medical Management

A
  • diagnosis: CDC criteria, blood tests, Ab titers
  • treatment: oral antibiotics (amoxicillin), NSAIDS and other drugs for arthritis pain as appropriate
  • prognosis: good if treated early with antibiotic therapy
  • no natural immunity that develops here
28
Q

Staphylococcal Infections: Overview, Incidence, Risk Factors, Pathogenesis

A
  • most common bacterial pathogens on skin
  • leading cause of nosocomial and community acquired infections
  • survives on fomites (surfaces)
  • most common cause of infections
  • S. aureus very virulent: about 90% of strains penicillin resistant and 50% to methicillin
  • risk factors: spreads by direct contact, most common route of transmission is thought to be open wounds or from contact with a carrier: poor hand washing, poor personal hygiene, sharing personal items etc; most frequent site for colonization are nares; surgical, burn, and diabetic patients very susceptible
29
Q

Staphylococcal Infections Pathogenesis

A
  • s. aureus cannot invade through intact skin or mucous membranes
  • virulent pathogen secreting membrane-damaging enzymes and toxins
  • bones, joints, kidney, lung, and heart valves are most common sites of s. aureus infections
  • MRSA: common in health care and athletic settings, overuse of antibiotics has fed increase in MRSA infection not resistant to vancomycin
30
Q

Staphylococcal Infections: Clinical Manifestations, Medical Management

A

-starts out as small red bumps that resemble pimples, boils or spider bites consistent with folliculitis
-infection usually produces suppuration and abscess formation: can remain confined to skin or burrow deep in body to cause life-threatening infections
-consumption of toxins in contaminated food cause food poisoning
-diagnosis: culture from pus drainage is diagnostic, antibiotic sensitivity testing is important
-treatment: drainage of abscesses, administration of antibiotics
=prevention: good hand hygiene is most effective, follow contact precautions when working with patients
-prognosis: good with treatment unless antibiotic resistance is present; sepsis, infective endocarditis, visceral abscesses, and osteomyelitis are potentially lethal
-SIFTT: anyone with active infection should not be discharged fro IP setting, same germicidal cleaning measures required as in hospital setting cause spread by direct contact

31
Q

Streptococcal Infections: Group A

A

-GAS
-s.pyogenes is prototypical GAS: two categories of diseases supportive and non-supportive
-typically transmitted via contact with respiratory droplets or after contact with clients who have infected secretions
types of GAS infections: streptococcal pharyngitis strep throat, scarlet fever, impetigo, erysipelas, necrotizing fasciitis, streptococcus pneumoniae

32
Q

Streptococcal Pharyngitis (Strep Throat)

A
  • incubation 1-5 days
  • symptoms include pain with swallowing and fever
  • diagnosis: throat culture or rapid diagnostic kits
  • treatment: antibiotics with supportive measures
33
Q

Scarlet Fever

A
  • usually follows untreated streptococcal pharyngitis in children aged 2-10
  • caused by a release of a pyogenic toxin
  • presentation: sore throat, fever, strawberry tongue (white coated tongue with red papilla)
  • rash first appears on upper chest, then spreads to extremitites
34
Q

Impetigo

A
  • usually caused by GAS but other streptococci or staphylococci species may be involved
  • usually in children 2-5
  • produces small molecules that develop into vesicles that become pustular and encrusted
  • does not typically cause pain or fever
  • scratching spreads infection and may progress into lymphangitis or cellulitis
  • treatment should cover both streptococci or staphylococci species
35
Q

Erysipelas

A
  • type of cellulitis usually affecting face and legs

- red, shiny, and swollen in appearance with well demarcated margins between normal and infected skin

36
Q

Necrotizing Fasciitis

A
  • invasive infection of fascia: destroys tissue by releasing toxins; usually in legs
  • infection spreads rapidly causing edema and tenderness
  • characterized by thrombosis of blood vessels passing between skin and deep circulation, producing skin necrosis
  • skin breaks down and bullae form that contain thick dark fluid cutaneous gangrene occurs
  • can affect any part of body, but is most common on extremities, especially legs
  • immediate surgery with aggressive debridement is mandatory and usually requires multiple procedures along with intensive antibiotics to save muscles and limbs
37
Q

Streptoccoccus Pneumoniae

A
  • group B
  • transmission by direct contact or inhalation of droplets of respiratory secretions
  • most common cause of community acquired pneumonia and death by a vaccine-preventable bacterial disease
  • most common cause of meningitis in adults, infants, and toddlers
  • clinical manifestations: fever, chills, pleuritis with pleuritic chest pain, dyspnea with productive cough or purulent sputum; diseases spreads rapidly over 24-48 hours
  • mortality rate is high without treatment
  • diagnosis: lab exam of sputum, CSF, or blood and culture of organisms
  • treatment: antibiotics, vaccine for adults and young children and infants
  • prevention: rate has decreased in young children with vaccines as well as adults
38
Q

Gas Gangrene: Definition and Overview

A
  • Group B
  • rare but severe and painful
  • usually follows trauma or surgery
  • gangrene is death of body tissue associated with loss of vascular supply followed by bacterial invasion and putrefaction
  • occurs in wounds infected by anaerobic bacteria, leading to gas production and tissue breakdown
  • spreads rapidly to adjacent tissues and can be fatal within houts of onset
39
Q

Gas Gangrene: Pathogenesis, Clinical Manifestations

A
  • anaerobic conditions necessary, but rare in humans; produced only in presence of extensive devitalized tissue
  • skin darkness
  • thick discharge with foul odor and sometimes gas bubbles
  • produces myositis and anaerobic cellulitis affecting only soft tissue
40
Q

Gas Gangrene: Medical Management and SIFTT

A
  • diagnosis: anaerobic cultures of wound drainage and radiographs showing gas in tissues
  • treatment: surgery to debride surface necrotic tissues, amputation may be necessary
  • prognosis: 20% of cases in extremities will be fatal, poorer prognosis with abdominal wall, uterus or bowel
  • watch for: cool skin, pallor or cyanosis, sudden severe pain, sudden edema and loss of pulses; be prepared for foul odor; use sterile technique, double bag drainage and dressings, no special cleaning required after discharge
41
Q

Pseudomonas: Overview and Pathogenesis

A
  • group B
  • one of most common hospital or nursing home-acquired pathogens
  • associated with pneumonia, wound infections, urinary tract disease, and sepsis in debilitated people
  • thrives on moist environmental surfaces
  • among most antibiotic-resistant bacteria
  • pathogenesis: produces array of proteins, which allow it to attach to, invade, and destroy host tissue, while avoiding host inflammatory and immune defenses; many strains produce proteoglycan that surrounds bacteria, protecting them from mucociliary action, complement, and phagocytes
42
Q

Pseudomonas: Clinical Manifestations and Medical Management

A
  • vascular thrombosis and hemorrhagic necrosis particularly in lungs and skin
  • causes infections of respiratory tract, bloodstream, CNS, skin and soft tissues, bones and joints of body
  • diagnosis: isolate organism
  • treatment: antibiotics; debridement/drainage of infected wound
  • prognosis: good for local infections, septicemic pseudomonas associated with high mortality rate
43
Q

Viral Infections

A
  • bloodborne viral pathogens

- herpes

44
Q

Bloodborne Viral Pathogens

A
  • hepatitis B and C and HIV are greatest concern for HCW

- prevented by following standard precautions

45
Q

Herpesviruses: Incidence, Etiolgy, Risk Factors, and Pathogenesis

A
  • subclinical primary infection is more common than clinically symptomatic illness
  • each type persists in latent state for rest of one’s life
  • incidence, etiology, and risk factors: 70% of americans over 12 have HSV-1 which causes cold sores; 1/5 have HSV-2, the principal cause of genital herpes; more common in women
  • pathogenesis…
  • both types can infect eyes and other organs
  • initial infections often asymptomatic, although minor localized vesicular lesions may be evident: makes patient a carrier susceptible to recurrent attacks
  • primary infection occurs when virus enters peripheral sensory nerves and migrates along axons to sensory nerve ganglia in CNS (usually via break in mucous membrane)
  • may be latent for years
  • stress, heat, cold, menses, fever, lack of sleep, or even sun exposure can cause virus to travel back down sensory nerves to surface of body (outbreak)
46
Q

Herpesviruses: Clinical Manifestations and Medical Management

A
  • HSV-1 (first episode) primarily affects skin and mucous membranes: cold sores, mouth sores, symptoms usually resolve 3-14 days
  • HSV-2 most often acquired through sexual contact, sores usually crust over and heal in 1-3 weeks; ulcers on genital area, buttocks, urethra, or bladder; c/o tingling in involved area, malaise, dysuria, and dyspareunia
  • severe illness in immunocompromised patients
  • diagnosis: clinical diagnosis usually insensitive, so cultures of vesicular fluid is standard lab test (Ab test)
  • treatment: no immunization available, anti-viral drugs can minimize recurrences
  • prognosis: good
47
Q

Herpes Zoster-Varicella Zoster Virus: Incidence and Pathogenesis

A
  • 10-20% of population develops secondary form resulting in herpes zoster or shingles
  • local disease brought about by reactivation of same virus, varicella-zoster virus (VZV) that causes systemic disease called varicella (chicken pox)
  • causes significant pain, adults over 50 yo and individuals that are immunocompromised are at risk
  • pathogenesis: VZV has capacity to persist in body (in sensory nerve ganglia) as latent infection; acute inflammation of dorsal root ganglia; enters through respiratory tract and conjunctiva; mechanism for reactivation of VZV unknown
48
Q

Herpes Zoster-Varicella Zoster Virus: Clinical Manifestations

A
  • after 2-4 days, severe, intermittent, or continuous, deep pain may occur as well as chill and low-grade fever
  • after pain starts, small, red, nodular lesions begin to erupt on painful areas-they change rapidly into pus or fluid filled vesicles
  • shingles can occur on face, trunk, and limbs-most often involves trunk or area of 5th cranial nerve (face)
  • vesicular lesions occur unilaterally in the distribution of a specific dermatome supplied by a dorsal root: can lead to postherpetic neuralgia (PHN) (pain in area of recurrence that persist after the lesions have resolved)
49
Q

Herpes Zoster-Varicella Zoster Virus: Medical Management and SIFTT

A
  • diagnosis: clinical symptoms, lab test from vesicular fluid
  • treatment: bedrest until fever has gone down, keep skin clear, antihistamines or creams for itching, antiviral meds
  • prognosis: recovery from varicella infection usually results in lifetime immunity
  • prevention: varicella vaccine recommended for children at 12-18 months before age 13 if they have not had chickenpox; zostavax for adults 60 and older
  • SIFTT: adults with shingles are infectious to persons who have not had chickenpox; susceptible healthcare workers with significant exposure to varicella should be relieved from direct client contact from day 10-21 after exposure…if workers develop chickenpox, varicella lesions must be crusted before they return to direct client contact; neither heat nor ultrasound should be used on person with shingles because these modalities can increase severity of person’s symptoms
50
Q

Infectious Mononucleosis: Overview, Incidence, Pathogenesis, Medical Mangement

A
  • primarily affects young adults and children
  • both genders affected equally
  • spreads by oral-pharyngeal route most likely in saliva
  • “kissing disease”
  • caused by Epstein-Barr virus
  • pathogenesis and clinical manifestations: HA, profound fatigue, myalgia, abdominal discomfort, hepatomegaly, increased lymphocytes and monocytes, enlarged spleen (may cause referral of pain to upper left quadrant), splenic rupture (person with infectious mononucleosis should avoid trauma)
  • diagnosis: physical assessment, lab tests, positive heterophil (monospot) test
  • treatment: rest and supportive care, no specific intervention alters or shortens the disease process
  • prognosis: excellent, virus can live indefinitely in B lymphocytes so reactivation can occur
51
Q

Cytomegalovirus (Herpes Virus Type 5)

A
  • commonly occurring DNA herpesvirus
  • frequently increases with age: 4/5 adults older than 35 have it, few symptoms for majority of people
  • etiologic and risk factors: transmitted by human contact
  • pathogenesis and clinical manifestations: spreads via lymphocytes or mononuclear cells and causes inflammatory reactions
  • in normal adults, infection is usually asymptomatic
  • diagnosis: culture or serologic ID of virus antigens
  • treatment: relief of symptoms, pharmacologic treatment in immunocompromised individuals
  • prognosis: poor for those with transplanted organs or immunocompromised states
52
Q

Viral Respiratory Infections

A
  • influenza

- respiratory syncytial virus (RSV)

53
Q

Influenza

A
  • influenza viruses A and B cause human influenza epidemics usually appearing each winter
  • mode of transmission: person to person by inhalation of aerosolized virus or direct contact
  • incubation period is ~1-4 days
  • vaccination: recommended before beginning of each flu season for: people over 50, diabetics, renal dysfunction, nursing home residents, people with chronic lung or heart disease, immunosuppression, HCW’s, pregnant women–associated with reduced hospital rates
  • genetic mutations very common
  • antiviral agents help decrease duration and severity of S&S: antibacterial antibiotics are used only for bacterial complications
  • good prognosis unless you get bacterial or viral pneumonia
54
Q

Respiratory Syncytial Virus (RSV)

A
  • virus that infects lungs and breathing passages
  • causes pneumonia, bronchiolitis, and tracheobronchitis in infants and very young children
  • in adults it appears as a mild respiratory tract infection and tracheobronchitis
  • signs include low-grade fever, tachypnea, nasal congestion, coughing, sore throat, earache, fever, and wheezing
  • transmitted by respiratory secretions (via large droplets) during close contact or on fomites or hands (incubation period 4-5 days)
  • diagnosis: culture of nasopharyngeal secretions
  • treatment: hydration, humidification of inspired air, ventilatory support as needed
  • only viral disease that has its maximum impact very early in life
55
Q

Anthrax

A
  • infection of skin, lungs, or GI tract: bacillus anthracis spores (transmitted by contaminated animals, animal products, hides, and soil)
  • inhaled spores enter lymph nodes
  • S&S (incubation up to 14 days) red-brown bump on skin-turns into black scab, swollen lymph nodes, nausea, vomiting, fever, muscle ache, and HA, respiratory problems, shock and coma
56
Q

Botulism

A
  • paralytic illness: endotoxin-clostridium botulinum acts at NMJ prevention ACh release and blocking neural transmission; inadequately cooked, contaminated foods
  • S&S (12-36 hours after digesting food): initially, dry mouth, sore throat, weakness, dizziness, vomiting, and diarrhea
  • cranial nerve impairment, weakness and muscle paralysis follows
57
Q

Legionnaires Disease

A
  • infection caused by Legionella pneumophila
  • inhalation of organism from A/C units, water faucets, showerheads, humidifiers, and contaminated respiratory equipment
  • S&S (most people don’t get sick; occurs in middle aged or older): dry cough, fever, purulent sputum, myalgia, GI distress, pneumonia, and CV collapse (those with weakened immune systems)
  • no indication it’s transmitted from person to person
  • most likely transmitted via inhalation or aspiration
58
Q

Leprosy

A
  • infection caused by mycobacterium leprae
  • respiratory transmission leads to systemic infection with progressive cutaneous lesions that attack PNS
  • lesions on skin, pharynx, nose, larynx, eyes, muscle weakness, paralysis
59
Q

Rabies

A
  • acute CNS infection transmitted by animal bite
  • virus replicates in striated muscle cells and spreads along nerve pathways to SC and brain where it replicates again and moves into other tissues
  • prodromal (early warning signs) symptoms: local and radiating pain, burning, pruritus, and tingling at bite site as well as HA, nausea, sore throat, excessive salivation
  • excitation phase: about 2-10 days after S&S being, intermittent hyperactivity, anxiety, apprehension, fever, shallow respirations, altered level of consciousness
  • hydrophobia: about 50% of patients get this which causes forceful, painful pharyngeal muscle spasms that expels fluid from the mouth, swallowing problems cause frothy drooling, seizures, and cardiac arrhythmias
  • treatment: no Rx after symptoms appear; post exposure-4 does immune globulin
60
Q

Rocky Mountain Spotted Fever

A
  • infection caused by Rickettsia rickettsii carried by dermacentor ticks
  • multiply within endothelial cells: leads to thrombosis and leakage of RBCs
  • S&S: fever, HA, myalgia, nausea, vomiting, rash develops (wrist, ankle, and spreads to trunk)
61
Q

Rubella

A
  • german measles
  • produces distinctive 3 day rash and enlarged lymph nodes
  • transmitted through contact with blood, urine, stool, or nasopharyngeal secretions from infected person: communicable from ~10 days before rash appears and ~5 days after
  • mildly itchy rash that usually begins on face and spreads rapidly, covering trunk and extremity within hours
  • rash usually disappears on 3rd day: rapid appearance and disappearance distinguishes it from rubeola
  • treatment: antipyretics and analgesics for fever and joint pain
  • primarily affects skin and lymph nodes
62
Q

STDs: OVerview, Incidence, Etiologic and Risk Factors

A
  • 19 million Americans contract STD each year
  • 1/4 sexually active people carry STD other than HIV
  • syphilis has steadily increased since 2000 particularly in black men and men who have sex with men
  • gonorrhea has reached all time lows
  • chlamydia and HPV are epidemic
  • 45 million people have chronic genital herpes with 1 million new cases every year
  • 1.1 million Americans have HIV/AIDS with 42,000 new cases per year
  • etiology: 25% of all STD’s occur in people 25 years old and younger
  • multiple sex partners, partner with know risk factor, sharing needles, blood transfusion between 77 and 84
63
Q

STDs: Pathogenesis, Clinical Manifestations, Medical Management

A
  • caused by bacteria, viruses, or occasionally parasites
  • manifestations vary according to STD
  • prevention: abstinence and or mutually monogamous sexual relationship; proper condom use can reduce transmission
  • testing: recommended chlamydia testing for sexually active adolescents and women every 6 months
  • older women at high risk with history of previous infection

DPT 724 Pathophysiology (18 decks)

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