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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
Antiseptics
inhibit microorganism growth & reproduction on inanimate objects, but safe enough to be used on surfaces of living tissue -static
26
Disinfectants
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
27
Sterilization
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
28
Spread of C. Difficile
spread by active bacillus or spores spores --> contact transfer from bad handwashing of HCP (direct). Equipment (indirect)
29
How can PTs decrease C. Difficile transmission?
Contact plus precautions Appropriate hand hygiene (alcohol doesn't kill spores) Dedicate equipment to pts STerilize equipment with bleach
30
Definition of Staph
bacterial genus in 2 groups aureus, non-aureus
31
Characteristics of S. aureus
found in environment can cause skin infections, pneumonia, meningitis, sepsis #1 cause of nosocomial pneumonia, wound infections
32
Where are staph found?
found on skin and in anterior nares of healthy people (normal flora)
33
Bacteremia staph aureus
come from self usually
34
How is staph spread?
direct and indirect contact can live on surfaces for 2-6 months
35
MRSA
s. aureus strain resistant to some antibiotics
36
Change in MRSA precautions
now doing standard precautions w/history of MRSA decreases falls, pressure injuries, increases pt satisfaction
37
Pathogenesis of staph
cannot invade intact skin or mucous membrane iatrogenic factors uses exotoxins to detroy host tissue
38
Clinical Presentation of staph
depends on site of infection fever, malaise, chills common in skin, bones, joints, heart valves
39
Diagnosis and treatment of staph
culture of organism from abscess, drainage, blood treatment includes drainage and ABX
40
Prognosis of staph
good with treatment, unless antibiotic strain
41
Furuncles & carbuncles
infection of skin/subcutaneous tissues by s. aureus
42
Furuncle
boil, infection of hair follicle and adjacent subcutaneous tissue hard, painful nodules local inflammation purulent exudate face, neck, armpits, buttocks, thighs
43
Carbuncle
several furuncles that develop close together, local and deep skin infection deep abscess, painful, multiple openings nape of neck/back
44
Pathogenesis of furuncles/carbuncles
person to person or autoinfection
45
Treatment of furuncles/carbuncles
topical or oral antibiotics warm compresses incision/drainage
46
Prevention of furuncles/carbuncles
good personal hygiene
47
Impetigo definition
superficial vesiculopustular infection of skin, found on arms, legs caused by staph or strep
48
Transmission of impetigo
HIGHLY contagious direct or indirect
49
Risk factors for Impetigo
infants/small children crowding multiple skin breaks poor hygiene warm, humid weather skin-skin sports
50
Presentation of Impetigo
intesne itching and burning (pruritis) brown sugar legion face, mouth arms lymph nodes swelling
51
Treatment of Impetigo
self-limiting to 2-3 weeks topical ABX on lesions antipruritis for itching do not scratch
52
Prevention of Impetigo
good personal hygiene standard and contact precautions disinfect all pt surfaces
53
Group A strep (GAS) types
Impetigo Strep throat Rheumatic Fever Necrotizing fasciitis
54
Group A strep definition
bacteria found in throat and skin most are mild illnesses, can become severe
55
Risk factors for GAS infections
chronic illnesses, long term glucocorticoids
56
Rheumatic fever
acute inflammatory complication from GAS infection lesions in connective tissues of joints, heart, CNS, subcutaneous most cases are 5-15 years of age
57
Pathogenesis of rheumatic fever
in some, follows a previous GAS infection hypersenitivity type 2 (immune system attack the host)
58
Long term complcations of acute rheumatic fever
disease--> damage to valves of heart, causes stenosis death reccurrent cases due to memory cells
59
Common presentation of acute RF
polyarthritis carditits chorea
60
Treatment of RF
ABX during, later on for prophylaxis notify HCPs about history before treatment of other conditions
61
Pseudomonas aeruginosa
aerobic, motile, gram-negative bacterium moist environment grows at 37° opportunistic pathogen, most common nosocomial
62
Presentation of Pseudomonas aeruginosa
affect any part of body progresses raidly to sepsis sweet, fruity odor
63
Treatment of Pseudomonas aeruginosa
ABX surgery for removal of local tissue
64
HCPS & Pseudomonas aeruginosa
handwashing is most important clean and disinfect reservoirs (like pools, respiratory equipment) possibly ABX resistant
65
Lyme disease
caused by bacterium (borrelia burgodorferi) transmitted by tick multisystem disorder
66
Epidemiology
northeast and midwest late spring-summer most prevalent vectorborne infectious disease
67
Pathogenesis of lyme disease
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
Diagnosis of lyme disease
history of exposure to ticks and rash S/S ( the great imitator) immunoassy --> takes about 2-3 weeks
69
Initial presentation of lyme disease
bull's eye rash fadees in 3-4 weeks behind the knee is common flu like S/S
70
Late presentation of lyme disease
intermittent nonerosive inflammatory arthritis neurologic complications --> bell's palsy
71
Treatment
ABX
72
Prognosis of Lyme Disease
2-4 week course of ABX anyone can be reinfected some have persistent symptoms
73
Post-treatment Lyme Disease syndrome (PTLDS)
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
Prevention of lyme disease
reduce exposure to ticks avoid areas with them keep them over your skin check skin, clothes, pets
75
PT and lyme disease
caution patients to not overuse joints w/arthritis, during flare ups differential diagnosis is key make sure to SCREEN for lyme disease
76
Antibiotic resistance
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
Common ABX resistant organisms
MRSA VRE MDR-TB
78
MRSA
methicillin -resistant staph aureus
79
VRE
vancomycin-resistant enterococci
80
MDR-TB
multiple-drug-resistant mycobacterium tuberculosis
81
Herpes
8 members of herpes virus family cause human disease most of us have HSV-1
82
HSV-1
orofacial infection, usually lips can affect genitals 50% of us are seropositive at time of puberty
83
HSV-2
genital infection painful, watery blisters can affect face
84
HSV-4
epstein-barr infectious mononucleosis virus, EBV mono
85
Pathogenesis/Transmission of Herpes
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
Triggers for reactivation
stress, increased sun exposure, facial injuries, viral infections, ABX, arginine (chocoalte, peanuts, walnuts)
87
Clinical presentation of Herpes
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
Treatment of Herpes
no cure. immune system destroys active but cannot destroy latent antiviral drugs Lysine: supplement commonly used to compete with arginine
89
Prevention of HSV1 and HSV2
condoms secual abstinence antivirals and condoms together measures to decrease reactivation
90
Herpetic whitlow
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
HSV 3
varicella zoster virus primary VZV infection results in chickenpox very contagious, childhood disease VZV remains dormant in CNS, can reactivate to cause shingles
92
Pathogenesis and Transmission of HSV-3
direct contact with skin sores, indirect contact with contaminated items, droplet, airborne infected can spread 1-2 days before rash appears
93
Clinical presentation of chickenpox
headache, low grade fever, malaise, anorexia rash serous exudate
94
Complications of chickenpox
penumonia enchpahlitis bacterial infections reye's syndrome
95
Chiceknpox treatment
topicals to relieve itching pain meds isolation, cool room acyclovir --> high risk cases
96
Shingles
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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