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2 Principles of Disease > Lecture 5 > Flashcards

Lecture 5 Flashcards

1
Q

General signs/symptoms of infectious diseases

A

fever, chills, malaise
enlarged lymph nodes
specific S/S for each system

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2
Q

What is the PT role when a pt has an infectious disease?

A

medical screening
direct treatment
know when to refer out

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3
Q

Aging and immune system

A

thymus involution, altered T cell-mediated immunity, increased autoantibody production

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4
Q

Infections are ________ in older adults

A

under-reported

poor historians
absent/poorly localized pain
absence of fever

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5
Q

What are considerations for PT with older populations?

A

altered mental status
recognize incrased risk of infection
recognize increased risk of AI disease
alert other HCPs of early S/S

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6
Q

Colonization of Organisms

A

microorganisms present i host tissue, not causing symptomatic disease
person may be a carrier, able to transmit organism to others

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7
Q

Incubation period

A

period between pathogen entering host and appearance of clinical symptoms

end of incubation period = disease symptoms start

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8
Q

Latent infection

A

microorganism has replicated, but remains dormant or inactive

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9
Q

Broad categories of pathogens

A

Viruses
Mycoplasmas
Bacteria
Protoza
Fungi
Prions

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10
Q

Viruses

A

composed of RNA or DNA nucleus and covered by proteins
can only replicate by invading host cell
extremely difficult to destroy by pharmacological interventions

HIV, herpes

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11
Q

Mycoplasmas

A

pneumonia

self-replicating bacteria that lack a cell wall
several species are pathogenic in humans

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12
Q

Bacteria

A

staph, strep

single-celled microorganisms with well-defined cell walls
classified by different properties

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13
Q

Protozoa

A

Giardia

single celled eukaryotes with cell membranes (not cell walls)

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14
Q

Fungi

A

Tinea
eujaryotic organisms: digest food externally and absorb nutrients into its cells

mycosis = fungal disease

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15
Q

Prions

A

Creutzfeldt-Jakob disease, scrapie, BSE

proteinaceous infectious particle
infectious protein structure that converts normal host proteins into abnormally structured form

cause transmissble spongiform encephalopathy diseases, all are untreatable and fata diseases

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16
Q

Chain of transmission

A

Pathogen
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host

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17
Q

Modes of entry

A

ingestion, inhalation, injection, mucous membrane, transplacental

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18
Q

Portal of exit

A

area form which pathogen leaves reservoir, usually corresponds to entry into next host

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19
Q

Transmission

A

contact, droplet, airborne, vehicle, vectorborne

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20
Q

Breaking chain of infection

A

cleaning and disinfection
Standard and Transmission based precautions
vaccinations

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21
Q

Disease prevention practice for HCPs

A

Active immunization
handwashing
observer all pts for infection
standard precautions
isolation/transmission based precautions
avoid high risk when you have infection

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22
Q

Standard Precautions

A

assume all pt blood and bodily fluids are infectious

hand hygiene, respiratory hygiene, PPE, equipment and environmental cleaning

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23
Q

Transmission-based precautions

A

contact
contact plus
droplet
contact and droplet
airborne

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24
Q

Choosing which product to clean equipment

A

risk of infection
resistance of pathogen
microbial load
mixed populations
amount of gross stuff present
concetration of pathogen
time/temp

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25
Q

Antiseptics

A

inhibit microorganism growth & reproduction on inanimate objects, but safe enough to be used on surfaces of living tissue

-static

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26
Q

Disinfectants

A

inhibit or kill various microorganisms on nonliving objects in environment; should NOT be used on living tissue
ex: micro-kill one germicidal alcohol wipes

-cidal

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27
Q

Sterilization

A

use of physical or chemical means to kill all microbial life, including highly resistant bacterial endospores (dormant, non-reproductive structures made by a small number of bacteria)

wound care

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28
Q

Spread of C. Difficile

A

spread by active bacillus or spores

spores –> contact transfer from bad handwashing of HCP (direct). Equipment (indirect)

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29
Q

How can PTs decrease C. Difficile transmission?

A

Contact plus precautions
Appropriate hand hygiene (alcohol doesn’t kill spores)
Dedicate equipment to pts
STerilize equipment with bleach

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30
Q

Definition of Staph

A

bacterial genus in 2 groups
aureus, non-aureus

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31
Q

Characteristics of S. aureus

A

found in environment
can cause skin infections, pneumonia, meningitis, sepsis
#1 cause of nosocomial pneumonia, wound infections

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32
Q

Where are staph found?

A

found on skin and in anterior nares of healthy people (normal flora)

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33
Q

Bacteremia staph aureus

A

come from self usually

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34
Q

How is staph spread?

A

direct and indirect contact
can live on surfaces for 2-6 months

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35
Q

MRSA

A

s. aureus strain resistant to some antibiotics

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36
Q

Change in MRSA precautions

A

now doing standard precautions w/history of MRSA
decreases falls, pressure injuries, increases pt satisfaction

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37
Q

Pathogenesis of staph

A

cannot invade intact skin or mucous membrane
iatrogenic factors

uses exotoxins to detroy host tissue

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38
Q

Clinical Presentation of staph

A

depends on site of infection
fever, malaise, chills
common in skin, bones, joints, heart valves

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39
Q

Diagnosis and treatment of staph

A

culture of organism from abscess, drainage, blood
treatment includes drainage and ABX

40
Q

Prognosis of staph

A

good with treatment, unless antibiotic strain

41
Q

Furuncles & carbuncles

A

infection of skin/subcutaneous tissues by s. aureus

42
Q

Furuncle

A

boil, infection of hair follicle and adjacent subcutaneous tissue
hard, painful nodules
local inflammation
purulent exudate
face, neck, armpits, buttocks, thighs

43
Q

Carbuncle

A

several furuncles that develop close together, local and deep skin infection
deep abscess, painful, multiple openings
nape of neck/back

44
Q

Pathogenesis of furuncles/carbuncles

A

person to person or autoinfection

45
Q

Treatment of furuncles/carbuncles

A

topical or oral antibiotics
warm compresses
incision/drainage

46
Q

Prevention of furuncles/carbuncles

A

good personal hygiene

47
Q

Impetigo definition

A

superficial vesiculopustular infection of skin, found on arms, legs

caused by staph or strep

48
Q

Transmission of impetigo

A

HIGHLY contagious
direct or indirect

49
Q

Risk factors for Impetigo

A

infants/small children
crowding
multiple skin breaks
poor hygiene
warm, humid weather
skin-skin sports

50
Q

Presentation of Impetigo

A

intesne itching and burning (pruritis)
brown sugar legion
face, mouth arms
lymph nodes swelling

51
Q

Treatment of Impetigo

A

self-limiting to 2-3 weeks
topical ABX on lesions
antipruritis for itching
do not scratch

52
Q

Prevention of Impetigo

A

good personal hygiene
standard and contact precautions
disinfect all pt surfaces

53
Q

Group A strep (GAS) types

A

Impetigo
Strep throat
Rheumatic Fever
Necrotizing fasciitis

54
Q

Group A strep definition

A

bacteria found in throat and skin
most are mild illnesses, can become severe

55
Q

Risk factors for GAS infections

A

chronic illnesses, long term glucocorticoids

56
Q

Rheumatic fever

A

acute inflammatory complication from GAS infection
lesions in connective tissues of joints, heart, CNS, subcutaneous
most cases are 5-15 years of age

57
Q

Pathogenesis of rheumatic fever

A

in some, follows a previous GAS infection
hypersenitivity type 2 (immune system attack the host)

58
Q

Long term complcations of acute rheumatic fever

A

disease–> damage to valves of heart, causes stenosis
death
reccurrent cases due to memory cells

59
Q

Common presentation of acute RF

A

polyarthritis
carditits
chorea

60
Q

Treatment of RF

A

ABX during, later on for prophylaxis
notify HCPs about history before treatment of other conditions

61
Q

Pseudomonas aeruginosa

A

aerobic, motile, gram-negative bacterium
moist environment
grows at 37°
opportunistic pathogen, most common nosocomial

62
Q

Presentation of Pseudomonas aeruginosa

A

affect any part of body
progresses raidly to sepsis
sweet, fruity odor

63
Q

Treatment of Pseudomonas aeruginosa

A

ABX
surgery for removal of local tissue

64
Q

HCPS & Pseudomonas aeruginosa

A

handwashing is most important
clean and disinfect reservoirs (like pools, respiratory equipment)
possibly ABX resistant

65
Q

Lyme disease

A

caused by bacterium (borrelia burgodorferi)
transmitted by tick
multisystem disorder

66
Q

Epidemiology

A

northeast and midwest
late spring-summer
most prevalent vectorborne infectious disease

67
Q

Pathogenesis of lyme disease

A

bacteria lives in mice and squirrels
transmitted via tick
risk is very low if tick is attached for less than 24 hrs
incubation period –> 3-32 days

68
Q

Diagnosis of lyme disease

A

history of exposure to ticks and rash
S/S ( the great imitator)
immunoassy –> takes about 2-3 weeks

69
Q

Initial presentation of lyme disease

A

bull’s eye rash fadees in 3-4 weeks
behind the knee is common
flu like S/S

70
Q

Late presentation of lyme disease

A

intermittent nonerosive inflammatory arthritis
neurologic complications –> bell’s palsy

71
Q

Treatment

A

ABX

72
Q

Prognosis of Lyme Disease

A

2-4 week course of ABX
anyone can be reinfected
some have persistent symptoms

73
Q

Post-treatment Lyme Disease syndrome (PTLDS)

A

completed ABX w/resolution of symptoms, for a new set to return and last for 6 months

pain, fatigue, difficulty concentrating
S/S consistent with fibromyalgia, chronic fatigue

74
Q

Prevention of lyme disease

A

reduce exposure to ticks
avoid areas with them
keep them over your skin
check skin, clothes, pets

75
Q

PT and lyme disease

A

caution patients to not overuse joints w/arthritis, during flare ups
differential diagnosis is key
make sure to SCREEN for lyme disease

76
Q

Antibiotic resistance

A

ability of bacteria to mutate and survive ABX
inappropriate use of ABX causes resistance to occur faster, all ABX use causes selective pressure

happens faster when ABX are used frequently, especially low doses over long periods of time

77
Q

Common ABX resistant organisms

A

MRSA
VRE
MDR-TB

78
Q

MRSA

A

methicillin -resistant staph aureus

79
Q

VRE

A

vancomycin-resistant enterococci

80
Q

MDR-TB

A

multiple-drug-resistant mycobacterium tuberculosis

81
Q

Herpes

A

8 members of herpes virus family cause human disease
most of us have HSV-1

82
Q

HSV-1

A

orofacial infection, usually lips
can affect genitals
50% of us are seropositive at time of puberty

83
Q

HSV-2

A

genital infection
painful, watery blisters
can affect face

84
Q

HSV-4

A

epstein-barr infectious mononucleosis virus, EBV
mono

85
Q

Pathogenesis/Transmission of Herpes

A

via direct skin contact with infected person. Do NOT need symptoms to be infectious

primary infection: enters PNS and moves along axons to sensory gangloa
latency: viral DNA is maintained in sensory neurons
Reactivation: trigger allows virus to travel back down nerves

86
Q

Triggers for reactivation

A

stress, increased sun exposure, facial injuries, viral infections, ABX, arginine (chocoalte, peanuts, walnuts)

87
Q

Clinical presentation of Herpes

A

prodromes: early symptoms indicting an outbreak will soon happen
HSV 1 = one or clister of fluid filled blisters
HSV 2 = small, painful grouped lesions.

88
Q

Treatment of Herpes

A

no cure. immune system destroys active but cannot destroy latent
antiviral drugs
Lysine: supplement commonly used to compete with arginine

89
Q

Prevention of HSV1 and HSV2

A

condoms
secual abstinence
antivirals and condoms together
measures to decrease reactivation

90
Q

Herpetic whitlow

A

herpes infection around fingernail. occupational risk for HCPs

more common in children, comes from sucking thumbs
unprotected exposure to infected secretions of pt
pain/burning of digit, edema, erythema

wear gloves to prevent

91
Q

HSV 3

A

varicella zoster virus

primary VZV infection results in chickenpox
very contagious, childhood disease
VZV remains dormant in CNS, can reactivate to cause shingles

92
Q

Pathogenesis and Transmission of HSV-3

A

direct contact with skin sores, indirect contact with contaminated items, droplet, airborne
infected can spread 1-2 days before rash appears

93
Q

Clinical presentation of chickenpox

A

headache, low grade fever, malaise, anorexia
rash
serous exudate

94
Q

Complications of chickenpox

A

penumonia
enchpahlitis
bacterial infections
reye’s syndrome

95
Q

Chiceknpox treatment

A

topicals to relieve itching
pain meds
isolation, cool room
acyclovir –> high risk cases

96
Q

Shingles

A

herpes zoster
reactivation of earlier infection

dermatome rash
later symptoms are post-herpetic neuralgia

vaccine available, only PREVENTS, does not TREAT

2 Principles of Disease (7 decks)

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