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401 1st Exam > n402 2nd test > Flashcards

n402 2nd test Flashcards

1
Q

whats is the difference of placenta previa vs. placenta abruptio

A 
placenta previa:
- quiet and sneaky
- external bleeding
- anemia = to blood loss
- shock equal to blood loss
- toxemia- absent
- pain only in labor
- uterine tenderness- absent
- uterine tone - soft and relaxed
- uterine contour- normal
placenta aburptio:
- sudden & stormy
- external or concealed
- dark venous
- anemia and shock= greater than apparent blood loss
- toxaemia may be present
pain- severe and steady
uterine tenderness- present
- firm to stony hard
- may enlarge
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2
Q

pinworms

A

transmission:
- contact through fingernails.
- can live up to 2 wks outside the body.
- can be airborne - shake bed sheets
incubation:
- from contact with eggs to 1-2 mo
communicability period:
- as long as female worms present& producing eggs
symptoms:
- intense itchiness around vagina and anus.
onset to resolution:
- get rid of eggs

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3
Q

syphilis:

A

incubation:
- person to person direct contact with syphilitic chancre (painless ulcer)
- occurs during vaginal anal and oral sex
- vertical transmission
incubation:
- if infected for less than a year and is dx.
- 1-13 wk (usually 3-4 wks)
communicability period:
- primary secondary and early latent stages.
-tertiary can be cardiovascular aneurysm
symptoms:
1. primary stage: painless chancre
2. secondary stage: systemic symptoms: rash over trunk 6-12 wk
3. latent stage: no symptoms.
(the great imitator because many possible symptoms which look like other diseases
onset to resolution
abx. but can’t undo damage.

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4
Q

hpv

A

transmission
- contact with infected genital skin, mucosal membranes or bodily fluid thru anal sex and oral.
incubaiton
- 2-3 months
communicability period:
- during acute and persistent infection.
- genital warts look like a cauliflower. (vagina cx and vulvula or penis. or oral
symptoms:
- itchy with discharge or bleeding or painful sex. van spread to cancer
- sometimes no S&S
onset to resolution
- most are gone within 2 years or other complications

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5
Q

rubeola (measles)

A

transmission:
- airborne
- direct contact with nose and throat secretions with infected person.
incubation period:
- fever develops 7-8 days after exposure and 14 days rash
communicability period:
- 5 days before - to 4 days after rash appears
symptoms:
- fever cough runny nose, watery eyes,
- SMALL RED SPOTS WITH WHITE/ BLUISH CENTERS IN MOUTH
-dusky red blotchy rash that begins over face.
- rash begins 3rd- 7th day (illness lasts 4-7 days.
- KOPLIK spots on ducal mucosa
- BLOTCHY RASH 3-7 DAYS
- LEUKEMIA OR SYSTEMIC INFECTION

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6
Q

capylobacterium

A

transmission:
- contaminated food or water or infected animals (kitties dogs)
incubation period: 2-4 days
symptoms:
- mild to severe diarrhea, and bloody, nausea, fever and vomit
onset to resolution
roughly one week or 3 weeks to resolve

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7
Q

HSV2

A 
transmission:
- sexually transmitted during close skin or mucus membranes contact with infected person
- mom to baby
incubation period:
2-21 days
period of communicability
- females sores on vag, cx or anus, 
males: penis, thigh lumps or oral
- greatest risk when active
symptoms:
- mild to severe burning itching
- flu like symptoms
- painful lesions that can be ulcerative, scabbed or blister
- dysuria, or purulent bloody vaginal discharge
onset to resolution
- ulcerative lesions may persist for 4-15 days
- lifelong risk
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8
Q

gonorrhoea: inflamed urethra, cx, and dysuria, or no symptoms

A

transmission: via vaginal anal oral or vertical
incubation :
1-5 days
communicability period:
- onset until 7 days post tx.
symptoms:
- asymptomatic or mild
- males: symptoms burning when void, GREEN DISCHARGE FROM PENIS, SWOLLEN LYMPH NODES. IRRITATED, RED PENIS HEAD
- females: dyspareunia, GREEN/ YELLOD DISCHARGE itchy soreness. bleeding between periods

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9
Q

chlamydia: urethra and cx infection

A 
transmission:
- vaginal oral anal and vertical
incubation
2-6wkss
communicability: months to years
symptoms:
- ASYMPTOMATIC
OR 
- women: abnormal discharge and pyuria and bleeding
men: discharge from penis, dysuria, and swelling 
- both: rectum bleeding or discharge. 
onset to resolution: abx therapy
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10
Q

norovirus

A

transmission:
- contact with stool or vomit. or contaminated.
- consume infected food and drink
droplet in air (inhale)
-incubation:- 24-48h
communicability: ill till 48h after diarrhea stops
symptoms:
-NV, Diarrhea, abd cramping, fever headache muscle ache
onset to resolution:
1-2days

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11
Q

hand foot and mouth:

A

transmission: contaminated air, contact with nose and throat secretions,
incubation period: 3-6 days
period of communicability:
- 7-10 days virus can be in stool for 4 wks after start of illness
symptoms:
- small grey blisters on hand foot and mouth
onset to resolution 7-10 days

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12
Q

roseola infantum

A

transmission: direct droplet and airborne contact
incubation: 10 days
communicability: during high fever or before rash develops
symptoms: raised red rash on trunk after 3-4 days of high fever which spreads to rest of body
(fever ** )
onset to resolution: 5-15 days

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13
Q

scarlet fever

A

transmission: direct contact: nose and throat, airborne,
incubation:
1-3 days
period of commuincability
10-21 days (for tx with abx- 1 day).symptoms: red rash like sunburn chest stomach to rest of body and swollen face and strawberry tongue
resolution- 3-21 days

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14
Q

salmonella:

A

transmission:
-eating contaminated food, animal fruit veggies, not wash hands.
-feces from pets
incubation:12-36h
communicability:
- throughout course of infection 5-7 days. self limiting
symptoms: fever, ha, diarrhea, ncramps
onset to resolution:5-7 days after initial symptoms have started.

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15
Q

giardiasis:

A

transmission: fecal oral route (WATERBRONE)
incubation period: 7-10 days
communicability: until tx
symptoms: daihrea weight loss, poor absorption of food, PALE GREASY STOOLS. or asymptomatic
onset to resolution: 3-25 days

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16
Q

goals of communicable disease control

A
  1. to decrease occurrence spread and complications

2. eliminate and eradicate vaccine preventable disease

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17
Q

active vaccines

A

contain whole or fractionated microorganisms:

- killed or attenuated.

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18
Q

killed/ inactive vaccine

A
  • dead so doesn’t replicate in the body so can’t cause the disease
  • ex) INFLUENZA, HPV TETANUS, TDAFF
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19
Q

live/ attenuated (weakened vaccine)

A

no longer capable of causing disease but does replicate in the body.
- can get mild symptoms, delayed response
-ex) MMR VARICELLA ROTATRIX/ ROTAVIRUS.
-CANT GIVE TO IMMUNOCOMP, OR PREGO WOMEN OR IF HAD LIVE VACCINE WITHIN 4 WK (CAN GIVE ON SAME DAY)
OR RECEIVE BLOOD WITHIN 4 WK)
- OR ACTIVLEY SICK

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20
Q

toxoid: active

A

protect against injury from bacterial toxins but are not bacteriocidal
ex) botulism toxoid. - so its tohe takin produced by the bacteria that is a problem

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21
Q

immune globulins: passive

A

rhogam, hep b rabies varicella. so are these the antigens

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22
Q

first 48 h after any vaccine can have a response

A

antipyretic and cold compress. if longer than bad.

can’t give any vaccine if sick.

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23
Q

VARICELLA*

A

transmission: direct contact with lesions or oral secretions or by airborne route
incubation: 10-21 days (usually 14-16)
communicability: 1-2 days before onset of rash until all lesions are crusted over
symptoms
- fever sore throat headache malaise
-RASH: RED MACULAR/ PAPULAR THEN VESICLES ARE ITCHY . new rash appears over 2-4 days, vesicles break leaving open sores which crust over
progression of rash:1ST ON BODY SCALP AND FACE THEN TO LIMBS.
onset to resolution- 10 days

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24
Q

impetigo

A

moist purulent yellow crusted sores surrounded by redness

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25
Q

rubeola

A

dusky red blotch / rash spreading down from face

26
Q

rubella

A

slightly raised red PINPOINT rash spreading behind ears to face and down

27
Q

roseola infantum

A

RAISED RED RASH ON TRUNK AFTER ¾ DAYS HIGH FEVER SPREAD TO REST OF BODY

28
Q

5th disease

A

raised red rash first appear on cheeks

29
Q

hand foot and mouth

A

small greyish blisters in mouth palm and soles

30
Q

prevention & tx:of STI

A
  1. abstinence
  2. limit # of partners. (and delay because when women are young their cells have more affinity for STI other morbidities (HIV DM more susceptible)
  3. use condoms
  4. immunizations hep b and his
    TX:
    1.regular checkups and 2. medications
  5. contact tracing.
31
Q

contact tracing: aims

A
  1. to prevent spread of infection

2. to minimize the impact of the infection through treatment measures

32
Q

TB natural hx

A

transmission: inhalation, almost always airborne and person to person , aerosolized ingestion
greatest risk vulnerability: TB and SDOH: if low SES, crowded poor ventilation etc.
incubation: 4-6 wks. 5% latent develop active within 2 y. 5% later in life.
communicability: highly infectious during active phase
screening: TST CXR sputum IGRA
S&S:
- fever night sweats weight loss, loss of appetite fatigue, and symptoms where its activated (usually lungs)
–> cough for 2-3 wks and sometimes hemoptysis, CP SOB
pain swelling and dysfunction wherever you have it.

33
Q

TB

A

wh do we screen: immigrants and foreigners and travellers.

FN communities, ppl who worked in FN communities, anything institutionalized crowded poor ventilation

34
Q

TB prevention and TX

A

prevention:
1. general : adequate appropriate housing and nutrition
2. specific: do screening
tx:
latent TB: tb skin test. possible isoniazid for 9mo
active TB:
1. isolate and have person wear mask until negative sputum
2. 1st line and second line meds - year of cult pills and vitae’s b6 (stomach pain. and DOT (blood tests as well)

35
Q

Influenza pandemic

A

global epidemic which results from a new viral subtype. new virus and ppl have no immunity. this would be a shift. complete change in virus and happens q 10-40y. abrupt sudden change of influenza type A- (which is h1n1 and from birtds)
(pandemic and epdiemic) -. WE HAVE NO VACCINE FOR THIS. MAJOR CHANGES SUCH AS emergence of new subtypes

36
Q

effective planning against the influenza pandemic. or epidemic:

A

plan:

  1. minimize spread of virus,
  2. minimize serious illness and death
  3. curtail societal disruption.
37
Q

antigenic drift

A

minor antigenic changes- yearly epidemics and regional outbreaks

38
Q

epidemic

A

i.e.) type A large epidemic
the occurrence of a greater number of cases of a disease an injury or condition other than expected in a particular area or group (ex) if one disease was considered previously eliminated in that area

39
Q

pandemic:

A

WIDESPREAD EPIDEMIC- EBOLA.
global disease outbreak. his aids. is a global pandemic
geographically widespread.
SARS

40
Q

endemic:

A

disease with a constant presence in a particular popualtion/ geographical area. community acquired pneumonia.
constant presence of a disease in a particular population or geographical area
ex) pertussis in the us

41
Q

INFLUENZA

A 
transmission: viral respiratory infection
airborne respiratory droplet
incubation 1-4 dyas
ha, chill cough, muscle ache. 
symptoms 7-10 days. 
type b regionalized outbreak- endemic
vs type a large epidemic.
42
Q

who is most at risk for influenza and other disease

A

prego, indigenous, weakened immune, chronic disease

43
Q

3 categories of ppl who qualify for influenza vaccine

A
  1. vulnerable
  2. care for vulnerable
  3. front line workers.
44
Q

what to ask someone before you vaccinate?

A
  1. influenza can lead to viral bacteria pneumonia or death or develop GBS
    did u have a rx last time
    do u have allergies
    side effects to expect- might feel achy or fever- within 48h
    obtain informed consent. say the vaccine and stay for 15 min incase rx. (anaphylaxis)
    common side effects:
    anaphylaxis: tightening of airway, severe allergic rx, chapel permeability bv out of circulatory system.. unconscious. red and warm and swelling. raspy voice, wheezing. difficult laboured rapid breathing NV diarrhea. irritable anxious thready pulse and low bpusually happens within first 15mind
45
Q

common side effect faint and anxiety….

sometimes with faint - tonic clonic. look at loc and pulse and resps.

A

fainting- loss of blood flow to brain b/c of psych or emotional stimuli, will see skin pale cool and clammy pulse regular pulse slow breathing shallow or faster. cool and clammy
anxiety: psychological tx to fight or flight freeze
pale cool calmly pulse elevated and rapid breathing and hyperventilate nauseated.

46
Q

vaccine safety

A
  1. cold chains
  2. knowledge about
    - contraindications: allergic rx
    - routine precautions
    - ORS
    - informed conset
    vaccine administration
    - 3 checks 7 rights
    - reconstitution and drawing up
    -site selection
    - anaphylaxis, post vaccine supervision and vaccine associated adverse events.
47
Q

surveillance of CD at health unit level- primary prevention

A

ongoing collection & analysis of data to ID problems or trends.
detection of cases, outbreaks and epidemics.
- implementation of policies or interventions to prevent the spread of the disease
active surveillance- go get the data
reportable disease- passive surveillance

48
Q

cd investigation follow up - secondary prevention

A
  • case reported
  • dx- lab confirmed and clinical symtpoms
  • contact index case- and contact tracing
  • chemoprophylaxis - use of drug to prevent disease
  • follow up
49
Q

barriers to communicable disease control

A
  1. globalization & urbanization- creation of big cities and +++ ppl harder to control spread. and people visit other places
  2. natural disaster- destroys health infrastructure and makes ppl vulnerable and destroys food safety and houses causing crowded environments
  3. environmental changes: water sources, drought food instability and malnutrition
  4. cost of vaccines and public education and HR: vaccine is $ and need to spend money educating the public to eliminate misconceptions and HR: paying public health nurses. and education and advertisements
  5. public opinion
  6. anti immunization movements
50
Q

**Barriers to effective prevention and control of CD

A
  1. INTERNATIONALLY:
    - globalization
    natural disasters and environmental changes
  2. nationally
    NATIONAL IMMUNIZATION STRATEGY CONTINUE TO DEVELOP.
    FEDERAL PROVENICAL AND TERRITORIAL RESPONSIBILITIES FOR HC- ARE UNCLEAR RE: VACCINATIONS.
  3. provincially: COST OF VACCINES, PUBLIC EDUCATION, HR TO ADMINISTER THE PROGRAMS IS TO $$
  4. locally: PUBLIC OPINION. ANTI IMMUNIZAITON SENTIMENT (advertisements and education)
51
Q

*** attitudes towards immunization

A
  1. UNINFORMED BUT EDUCABLE:want information, chance of positive outcome is high.
  2. MISINFORMED BUT CORRECTABLE: typically have not been presented with the other side of the argument; may need time to consider new information and will return to cling
  3. WELL -READ AND OPEN MINDED:well informed and want help differentiating information
  4. CONVINCED AND CONTENT: don’t usually come to CHC discussion is usually not productuvie
  5. COMMITTED AND ZEALOUS: not open to information that is not consistent with their perspective; no point in entering into a discussion
52
Q

risk/ benefit communication

A

listen:
- assess attitudes towards immunization
- ID specific parent concerns
- tailor information to these concerns
recognize parental concerns are legitimate:
- adverse events are associated with vaccines
provide context:
-disease are less frequent not gone
- educate about potential consequences: comparative risk of disease vs vaccine events.
- provide examples of re-emergence disease
refute misinformation:
- be current on most recent anti-immunization claims
- be familiar with various web site and respond with reliable data
provide valid information and additional resources
- refer parents to credible sources
recognize that it is an individual decision: immunizations are not compulsory in canada
make a clear recommendation: ppl look to hcp for advice and recommendations

53
Q

communication and immunization

A

concise language correct info compassion consistency and creativity

54
Q

communicable disease control & level of prevention

A 
primary prevention of CDC programs:
- educate on effects of smoking
- admin vaccination
-safe food handelling
-ed public re: CDC
secondary:
- screen for TB
-offer HIV testing
-contact tracing
tertiary:
-initate and monitor therapy. i.e.) blood glocusoe. 
DOT for cats with TB and AIDS
55
Q

what surveillance

A

contacts and sources in outbreaks of pertussis the school or daycare
collecting reportable information pertaining to notifiable communicable disease
providing morbidity and mortality statistics to public and media
- detect changes in frequency or distribution. - surveys, mortality an morbidity, and individual case investigation and epidemic reporting nd demographic and enviornmental data.

56
Q

examples of primary prevention cdc programs

A

educate on effects of smoking, admin vaccine, safe food handling, ed public re cdc, talk about # of ppl infected and common symptoms and community resources, evaluate condom use or abstinence (educational sessions in schools and businesses)

57
Q

examples of secondary prevention prgorams

A

screening for disease to ensure early ideniticantion and tx and teaching and cousnelling
contact tracing: aimed at controlling communicable disease
population level intervention
maintain confidentiality
For TB test notify family and close contacts
person and location of partners

58
Q

tertiary prevention- monitoring with care

A

cats with TB- DOT
if preamtrually stop they’ll get abx resistance
cats with HIV and AIDS taking meds- monitor physical and emotional health status
resources and maintain infection control standards and reduce risky behaivours
manage symtpomatic illness, diarrhea skin break down and nutrition
use gloves and masks and hand washing

59
Q

what level of prevention is surveillance

A

surveillance: contacts and sources in outbreaks of pertussis in schools or day care, TB contact tracing. collecting reportable infromation pertaining to notifiable communicable disease providing morbidity and mortality statistics to public via media.

60
Q

what is harm reduction

A

a realistic public health approach aimed at reducing the adverse health, social and economic consequences of at risk activities ex) insight and dry grad

61
Q

3Rs of immunization

A
  1. routine: tetanus polio measles hep b etc
  2. required for protection in the country you are visiting. (yellow fever, cholera, meningococcal)
  3. recommended- hep a (indigenous, typhoid)

401 1st Exam (3 decks)

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