Part 6 Flashcards
Service Learning
Involves students in community service activities and applies the experience to personal and academic development resulting in equal benefit for both the student’s learning and action in the community
Pedagogy definition
The art and science of teaching using an array of teaching strategies because there is no universal approach that suits all situations to support intellectual engagement and connectedness and prommote wellbeing of students, teachers, and community
Public Health
The science and art of preventing disease, prolonging life, and promoting health through organized efforts and informed choices of society, organizations, public and private communities, and individuals
Epidemic/outbreak
Occurence in a community or region of cases of an illness, specific health related behavior, or other health related event clearly in EXCESS of normal expectancy. Both terms are used interchangeably, however epidemic usually refers to a larger geographic distribution
Pandemics definition and history
Pandemic is seen throughout the world
- 1918 500 million infected around world (spanish flu)
- 2009 19000 deaths from influenza outbreak
- 1955 Polio vaccine development
- HIV decrease in 20% since 2001
Public health approach steps (4)
1) Surveillance - what is the problem
2) Risk factor identification - what is the cause
3) Intervention evaluation - What works to fix while considering cultural and practical barriers
4) Implementation - How do you do it
John Snow
Father of modern epidemiology, studied outbreak of cholera cases in 1854 to determine what factors were contributing to that disease process
Health determinants (4) and their percentages
- Genes and biology (5%)
- Health behaviors (20%)
- Social or societal characteristics (50%)
- Health services or medical care (25%)
4 Types of disease prevention
1) Primary - prevention of a disease before it happens (Immunizations, etc.), health promotion
2) Secondary - treatment of complications of a disease to prevent it from worsening or progressing (B-blockers, drug therapy), pre-symptomatic diagnosis and treatment
3) Tertiary - Assistance mitigating an already established bad outcome (OT, PT, rehab), disability limitation, preventing CKD in diabetics
4) Quaternary - Avoidance of unnecessary medical interventions (error in medicine)
Sensitivity
Ability of a test to identify all individuals who actually are positive, including false positives (example of all spirochetes opposed to specifically syphilis)
Specificity
Ability of a test to differentiate between individuals who are positive and negative, such as ignoring false positives
The greatest predictor of health is ____, and the greatest predictor of that is _____
socioeconomic status, education
Reliability vs validity
Reliability is ability of a measure to get the same results each time regardless (precision), validity is the accuracy of the results to their truth
3 Levels of evidence
Level A - meta-analysis, high quality randomized, controlled trials that considers all important outcomes, using comprehensive search strategies Always followed
Level B - Other evidence, well designed, nonrandomized clinical trial, quantitative systematic review with well substantiated conclusions, Almost always followed
Level C - Consensus/expert opinion, only sometimes used
Level D - against providing intervention in an asymptomatic patient because the harms outweigh the benefits
Staph aureus
- Gram +
- Pustules, boils, abscess, cellulitis (red swollen skin affecting lower leg), scalded skin syndrome (babies and children), food poisoning, TSS
- Anti staph PCN or 1st gen cephalosporin
Staph epidermidis grap type, common infection type, and treatment
- Gram +
- Surgical wound infections, medical procedural infections, - Part of normal flora, causes infection on prosthetic implants as it attaches to the plastic
- Vancomycin (has resistance to PCNs)
Strep pyogenes
- Gram +
- impetigo (often in children or daycares), erysipelas (bright aised lesions on skin), pharyngitis, scarlet fever (strawberry tongue), pneumonia, cellulitis and necrotizing fasciitis (flesheating disease), TSS, acute glomerulonephritis (antibody complexes in kidney), Rheumatic fever
- PCN’s
- important human pathogen capable of producing infections and post infection diseases
Viridans strep gram type, common infections it causes, antibiotics to treat
- Gram +
- S. mutans, S. salivarius, S. Sanguis, cause dental caries and bacterial endocarditis
-Beta lactams, IV meds depending on type
Strep pneumoniae gram type, common infections it causes and treatment
- Gram +
- 80% of cases of bacteria pneumonia, also meningitis, otis media, septicemia
- B Lactams, sometimes IV needed
Enterococci gram type, common infections caused, treatment
Gram pos cocci part of normal fecal flora, can persist on fomites for a long time, common cause of nosocomial infections, sensitive to synergistic combo of B-lactam and aminoglycosides, except some resistant, including other classes like VRE
Niesseria gonorrhoeae gram type, diseases caused, treatment
- gram -
- Cause gonorrhea,, PID, and sterility in females
- ceftriaxone
Niesseria meningitidis gram type, diseases caused, treatment
- gram -
- Cause contagious spinal meningitis, hemorrhagic rash
- IV ceftriaxone
One key differentiatior between niesseria meningitidis and niesseria gonorrhoeae is the latter….
….does NOT produce a capsule
Moraxella catarrhalis gram type, common infections it causes, treatment
- Gram -
- Infection of respiratory system, middle ear, eye, CNS, joints
- Treatment depends on results of sensitivity testing
Bacillus anthracis gram type, disease caused, treatment
- gram +
- anthrax (woolsorter’s disease - inflammation, edema, hemorrhage), Normally found in livestock
- PCN
Clostridium perfringens gram type, diagnosis, treatment
- Gram +
- Enterotoxin, food poisoning, gangrene, shock
- IV zosyn
Zosyn (piperacillin and tazobactam) drug class and use
a combo of a penicillin and a beta-lactamase inhibitor used for serious infections given IV
Clostridium tetani gram type, common disease caused, treatment, note about organism
- Gram +
- Tetanus exotoxin causing tetanus
- IV metronidazole
-spores have tennis racket appearance
Clostridium botulinum gram type, disease caused, treatment
- Gram +
- Botulinin toxin resulting in paralysis/paresis
- antitoxin treatment
Clostridium difficile gram type, common diseases caused, treatment
- Gram +
- Cytopathic exotoxins from antibiotic induced pseudomembranrous colitis
-oral vancomycin
Lipopolysaccharide (LPS)
virulence factor released by gram neg bacteria causing inflammation in tissues by inducing cells to secrete proinflammatory mediators (cytokines, prostaglandins)
E. coli gram type, common diseases caused
- gram -
- UTI, gastroenteritis
Klebsiella pneumoniae gram type and common diseases it causes
- gram -
- pulmonary disease, nosocomial UTI, epidemic diarrhea of newborn
Serratia marcescens gram type and common infections caused
- gram -
- Nosocomial UTI, bacteriemia, lower respiratory tract infections
Vibrio cholerae gram type, common diseases caused, treatment
- gram neg
- Human cholera diarrhea syndrome
- fluid resuscitation and antibiotics sometimes including macrolides, fluorquinolones, or tetracyclines
Helicobacter pylori gram type, diseases caused, treatment, notes about it
- gram -
- acute gastritis and gastric ulcers, chronic gastritis
- triple therapy (clarithromycin, amoxicllin and PPI) or quadruple therapy (metronidazole, tetracycline, PPI, and bismuth subsalycylate
- releases urease to protect self from stomach acid
Bacteroides fragilis gram type, common infections, treatment and fun fact
- gram -
- Peritonitis, gynecologic infections, endocarditis
-Often metronidazole - may acount for 99% of fecal flora
Pseudomonas aeruginosa gram type, common infections, treatment
- gram -
- nosocomial infections from long term antibiotic treatment
- often zosyn, fluorquinolones orally
Haemophilus influenzae gram type, common infections caused, treatment
- gram -
- respiratory and meningeal infections in children
- ampicillin or chloramphenicol
Haemophilus ducreyi gram type, disease caused, treatment
- gram -
- chancre on genitals (soft unlike syphilis)
- Bactrim
Bordatella pertussis gram type, disease caused, treatment
- gram - coccobacilli
- whooping cough (three stages, catarrhal stage cough, paroxysmal stage explosive cough, convalescent)
- tetracyclines, macrolides
- vaccine available
Chlamydia trachomatis gram type, disease caused, treatment
- gram neg
- trachoma leading to blindness, inclusion conjunctivitis, genital infections, venereal disease
- tetracycline
- sexual activity very similar to gonorrhea
Chlamydia psittaci gram type, disease caused, treatment
- gram neg
- pneumonitis frquently carried by bird feces
- tetracycline
Rickettsia rickettsii grma type, disease caused, treatment
- gram -
- rocky mountain spotted fever (maculopapular rash,) high fever
- tetracycline
- transmitted via ticks
Cornyebacterium diphtheriae gram type, disease caused, treatment
- gram +
- diptheria (sore throat, neck swelling, airway closur)
- antitoxins
- immunization is part of DPT vaccine
Timeline day 0 (embryonic age)
- Day 0 is fertilization forming a zygote in distal third of fallopian tube
- Division into morula (ball of cells will become placenta and embryo, each cell is totipotential)
- Division into blastocyst (blastocele (cavity) containing embryoblast, trophoblast at other pole form placenta)
Timeline week 1 (embryonic age)
-up to week 1 implantation on uterine wall of blastocyst
All or nothing concept of pregnancy
During the first 3 weeks any insult will result in immediate miscarriage, or there will be no impact on the wellbeing of the fetus, no in-between
Timeline week 2 (embryonic age)
- Bilaminar disk formation, evolution of embryoblast to bilaminar blastocyst with cell layers epiblast and hypoblast (primitive ecto and endoderms) sandwiched between 2 cavities - amniotic cavity and yolk sac
- Trophoblast divides into cystotrophoblast (inner single cell layered) and syncytiotrophoblast (thicker outer layer releases hGC to prevent menstruation)
“I just missed my period, what is embryonic age and gestational age?”
Week 2 embryonic age, week 4 gestational age