Module 3 - Chapter 10 - Infection Flashcards
What is the most significant cause of complications and death in people with malignant disease?
Infection
Why are advanced malignancies highly immunosuppressive?
Advanced malignancies are highly immunosuppressive due to the immunosuppressive effects of both the disease itself and the radiotherapy and chemotherapy used in its treatment.
When does the risk of serious microbial infection increase in individuals with cancer?
The risk of serious microbial (bacterial and fungal) infection increases when the absolute granulocyte count falls below 500 cells per microlitre.
How can surgery impact an individual’s resistance to infection in the context of cancer?
Surgery can lower resistance to infection in cancer patients because the removal of large quantities of tissue, along with factors like hemorrhage, dead spaces, and poor tissue perfusion, can create favorable sites for infection.
What are some factors that contribute to hospital-related infections in cancer patients?
What are some factors that contribute to hospital-related infections in cancer patients?
What factors related to age can predispose individuals with cancer to infection?
Age-related factors include declining immunological functions, general debility, immobility, and nutritional inadequacies, all of which reduce immunocompetence in cancer patients.
How can the tumor itself contribute to infection risk in cancer patients?
Tumors can lead to nutritional derangements, create favorable conditions for microbial growth (e.g., obstruction, effusion, ulceration), cause debility and immobility, and result in immune defects, including humoral and cellular deficiencies.
What immune-related issues are associated with leukemias in cancer patients?
Leukemias often result in inadequate granulocyte production (impaired phagocytosis), thrombocytopenia (bleeding risk), and may lead to late effects like chronic lung disease from Pneumocystis carinii pneumonia during therapy.
How do lymphomas and other mononuclear phagocyte malignancies affect the immune system?
These malignancies can lead to humoral and cellular immune defects, including anergy and altered immunoglobulin production. In children, splenectomy can increase susceptibility to infection as a late effect.
What are some reasons why surgical treatment can increase infection risk in cancer patients?
Surgical procedures can interrupt the body’s first lines of defense, cause hemorrhage, decrease tissue perfusion, create dead spaces, and devitalize tissues, especially in lengthy and radical surgeries. Surgery can be “dirty” in cases involving bowel or infected areas. Older patients, long preoperative hospitalization, prior adrenocorticosteroid therapy, and remote infections are additional risk factors. Nutritional derangements, lymph node dissection, fistulae, and bronchopleural fistulae can also contribute to infection risk.
