Patho CH 5: Infection Flashcards
1
Q
A state of cellular, tissue, and organ destruction resulting from invasion by microorganisms
A
infection
2
Q
With infection, harmful microorganisms have penetrated
A
3 lines of defense
3
Q
multi-drug resistant microbes formed from
A
overuse or incomplete use of antimicrobial drugs
4
Q
pathogens mechanisms for causing disease
A
-Direct destruction of host cell by pathogen
-Interference with host cell’s metabolic function
-Exposing host cell to toxins produced by pathogen
5
Q
potential disease causing capacity of pathogens
A
pathogenicity
6
Q
factors affecting pathogenicity
A
Antigenic variability
Pathogenic defense mechanisms
Coinfection
Superinfection
Virulence
Infectivity
Toxigenicity
Antigenicity
7
Q
microorganisms that live on or within the body in nonsterile areas, such as the skin, mucous membranes, bowel, rectum, or vagina, without causing harm.
A
Resident flora
8
Q
potency of the pathogen indicated by the ratio of the number of cases of disease in a population compared with the number of people exposed to the microorganism.
A
Virulence
A more virulent microorganism is one that causes severe disease in a large proportion of those exposed to the microorganism.
9
Q
proportion of exposures needed to cause infection in an individual based on the pathogen’s ability to enter, survive in, and multiply in the host.
A
Infectivity
A more infective organism is one that takes one exposure, takes hold, multiplies, and causes disease in the host.
10
Q
ability of the pathogen to produce harmful toxins that increase host cell and tissue damage
A
Toxigenicity
11
Q
level to which a pathogen is viewed by the host immune system as foreign.
A
Antigenicity
Those with low antigenicity can readily elude immune mechanisms and continue to survive in the host.
12
Q
process of eluding the human host defenses and is often a result of altering the antigens present within or on the surface of the microorganism.
A
Antigenic variability
This means that many infectious microorganisms can escape human host defenses through slight genetic variations unrecognized by the host.
These mutations are responsible for much of the infectious disease burden throughout the world.
13
Q
simultaneous occurrence of hosting two or more pathogens
A
Coinfection
Certain pathogens, such as those that cause chlamydia and gonorrhea, are more likely to be transmitted and to coexist in the host. Coinfection presents a greater challenge to the immune system.
14
Q
an infection that arises in addition to one that is already present
A
Superinfection
Superinfection often results from compromised host defenses and over proliferation of resident flora.
15
Q
Obligate parasite
A
require host for metabolism and reproduction
16
Q
Facultative parasites
A
may live on host but can survive independently
17
Q
bacteria
A
single celled microorgansims
18
Q
aerobic bacteria
A
require oxygen for growth
19
Q
anaerobic bacteria
A
do not require oxygen
20
Q
“match drug with the bug”
A
treat specific bacteria without harming host cell
cultures
21
Q
stain turns purple
ex:
A
gram postive
ex: staph, pneumonia, C.diff
22
Q
stain turns red
ex:
A
gram negative
ex: gonorrhoea, H.pylori, E. coli
23
Q
Bacteria can survive outside the human host and can infect and reinfect if not destroyed.
A
Independent survival
24
Q
Bacteria stimulate an inflammatory and immune response that will destroy surrounding host tissues in an effort to rid the body of the invader.
A
Stimulation of inflammatory response
25
Encapsulated bacteria are adherent and highly resistant to phagocytosis.
Bacterial capsule
26
The presence in the Gram-negative bacterial cell wall activates the plasma protein systems.
inflammatory mediators to be released, leading to a massive inflammatory response
Endotoxin
This in turn can result in a state of septic shock accompanied by severe diarrhea, fever, and leukocytosis.
27
survive in a latent state and are resilient to environmental extremes and lack of nutrients.
endospores
28
released into the surrounding tissues that cause local or systemic injury to the host
exotoxins
29
cannot replicate outside of host cell
virus
30
chronic viral infections are caused by
acute infection not provoking a strong immune response
31
chronic viral infection promoted by these 4 host factors
1. The size of the virus that is inoculated into the body
2. The process of viral replication
3. The viral genotype
4. Host susceptibility
32
dormant
latency
33
Phases of life cycle chlamydiae
1. The metabolically inactive elementary body enters the body, attaches to, and internalizes the host cell.
2. The elementary body becomes metabolically active and transforms into a reticulate body, which takes over the host cell.
3. The chlamydiae are then capable of replication.
4. Each replicated pathogen goes through the life cycle, causing epithelial cell necrosis.
34
both bacteria and virus
Rickets and Chlamydia
35
unicellular fungi
yeasts
36
multicellular fungi
molds
37
cause disease only in a host with a compromised immune system.
Opportunistic pathogens
38
softening and breaking down of tissues
maceration
39
lesions are white and resemble cottage cheese attached to an erythematous oral cavity; these lesions bleed easily and can be painful if scraped
In oral candidiasis
40
irregular and changing shape without a cell wall
protozoa
41
transmission of protozoa
sexual contact
contamination
insect
42
infection that are spread from person to person
often through blood
communicable disease
43
infectious agent possibilities
bacteria
fungi
virus
rickettsiae
protozoa
44
reservoir possibilities
people
equipment
water
45
portal of exit possibilities
excretions
secretions
skin
droplets
46
means of transmission
direct contact
ingestion
fomites
airborne
47
portal of entry posibillities
mucous membranes
GI
GU
respiratory tract
broken skin
48
susceptible hosts posibillities
immunosupressed
diabetes
surgery
burns
elderly
49
holding tank
reservoir
50
passage for microorganism to leave reservoir
portal of exit
51
mechanism of transference from the reservoir to the portal of entry
mode of transmission
52
As a mode of transmission, ___ implies physically touching or otherwise coming in contact with the reservoir.
Ex:
Direct contact
Examples: touching the blood or body fluids of an infected person, kissing, or sexual intercourse. This mode can also involve close contact by touching another person or a surface in the environment that is holding the pathogen.
53
Larger respiratory particles, produced by sneezing, coughing, or talking, can pass through the air from the reservoir to the host.
Droplet transmission
For droplet transmission to occur, generally the host must be within 3 feet of the reservoir. The heavy droplet particles usually drop to the ground beyond this distance. Most respiratory illnesses are spread through droplet transmission.
54
Smaller respiratory particles can remain suspended in the air and are subject to:
Airborne transmission
The particles can remain in the area of the reservoir for an extended period. Infection can be transmitted to a person who enters this area and breathes the air. Tuberculosis (TB) and varicella (chicken pox) are examples of respiratory diseases spread through airborne transmission.
55
vehicle that harbors the pathogen and carries it to the host.
vector
56
access point for microoraganism into the host
Ex:
portal of entry
EX: mucous membranes, eyes, RT, GU, GI, placenta
57
phases of acute infection and meaning
1. Exposure: Exposure is contact with the pathogen through any of the modes of transmission.
2. Incubation: The incubation phase extends from exposure to the onset of any signs or symptoms. During the incubation period, the individual often has no idea that they have been exposed to, or will develop, the illness. With communicable disease, it is often during this incubation period that transmission of microorganisms to others is greatest. For example, chickenpox has an incubation period of 7 to 21 days from exposure to recognizable signs and symptoms.
3. Prodrome: The prodrome phase involves the onset of vague, nonspecific signs and symptoms, including fatigue, low-grade fever, nausea, weakness, and generalized muscle aches. This phase is often described as feeling “under the weather.” The specific signs and symptoms related to the disease have not yet emerged.
4. Clinical illness: The clinical illness phase represents the signs and symptoms specific to the disease. Often, the accurate medical diagnosis is applied more confidently during this time. In many cases, the immune response peaks or treatment is initiated and the body is able to overcome the pathogen.
5. Convalescence: The convalescence phase extends from waning clinical manifestations to full recovery from the disease. Fatigue is a common concern during this time of recovery.
58
acute infection clinical manifestations
local and systemic
local infection is usually manifested by
pain
heat
redness
swelling
lymph node enlargement and tenderness
site-dependent loss of function
purulent
Systemic manifestations include
fever
malaise
weakness
anorexia
headache
nausea.
59
labs to detect infection and why
WBC = leukocytosis (increase) and leukopenia (decrease)
serum antibodies = antibodies indicate antigen
cultures = positive = microorganism
sensitivities = find treatment
60
infection treatment drug and MOA
antimicrobials
destroy pathogens or decrease microorganism growth
61
influenza transmission
respiratory droplets
62
influenza pathophysiology
-infected epithelial necrosis
-viral
-Reassortment: gradual change in genetic composition during replication in human host
63
influenza CM
Fever
Body aches
Weakness
Malaise
Cough
Sore throat
Nasal congestion/drainage
Shortness of breath
Chills
64
Influenza diagnostic criteria
H&P
abrupt onset, severe body aches, fever,
anorexia, headache, malaise, and a dry cough.
rapid viral assays
65
Influenza treatment
-prevention
-systomatic care - hydration, pain
-antiviral drugs - reduce duration
66
viral hepatitis transmission
fecal-oral
direct contact with blood/body fluids
67
viral hepatitis patho
Acute or chronic inflammation of the liver caused by infection with one or more hepatitis viruses
68
chronic hepatitis types
B,C,D
69
vaccine for hepatitis types
A,B
70
Major roles of the liver
Bile secretion
Bilirubin metabolism
Blood storage
Clotting factor synthesis
Nutrient metabolism
Metabolic detoxification
Mineral and vitamin storage
71
responsible for bile secretion
hepatocytes
72
function of bile
fat emulsification and absorption
73
Nursing consideration for administering meds to liver disease patient
meds metabolize in the liver and can circulate at high levels too long
74
bilirubin accumulation
jaundice
75
liver disease marked by jaundice
icterus
76
viral hep CM
fatigue
anorexia
low grade fever
clay stool
dark urine
yellow sclera
77
viral hepatitis DC
H and P
viral antibody test!!!!!
Labs (urine bili, serum bili, clotting time)
78
Viral hep treatment
prevention
symptomatic care
antiviral drugs
low fat diet
79
TB patho
most prevalent and deadly infectious disease worldwide
human only reservoir
lungs primary site of infection
80
TB cause
M. tuberculosis
81
TB transmission
airborne droplets
very small and gets through barriers
82
TB CM
90% of those infected are asymptomatic
In 10% with progressive primary disease:
Malaise
Weight loss
Fatigue
Anorexia
Low-grade fever
Night sweats
Severe chronic productive cough with hemoptysis (bloody sputum)
Site-specific
83
contaminent through an effective cellular immune response
asymptomatic primary TB
84
multiplication and development of aggressive, symptomatic disease
progressive primary TB
85
latency with future multiplication or reinfection leading to aggressive, symptomatic disease
secondary TB
86
TB DC
Tuberculin skin tests
Chest radiograph (Ghon complex)
Sputum culture
Sputum nucleic acid amplification
87
TB treatment
Vaccinations
Transmission prevention
Isolation in private room
Negative air pressure
Droplet precautions (masks, respirators)
Antimicrobials
Isoniazid
Rifampin
Pyrazinamide
Ethambutol or streptomycin
Directly observed therapy (watch take medicine)
BCG vaccine
88
UTI patho
ascending infection of urinary tract
cell necrosis
89
UTI cause
E.coli
90
UTI CM
Dysuria
Urgency
Frequency
Hematuria
Cloudy (purulent) urine
91
UTI DC
History and physical examination
Urinalysis and urine culture (increased WBC, hematuria)
Leukocyte esterase dip test (pus in urine)
92
UTI treatment
antibiotic drugs
increased fluid intake
93
acute pyelonephritis patho
bacterial infection of kidneys (e.coli)
94
acute pyelonephritis risk factors
Urinary obstruction (renal calculi)
Incomplete bladder emptying, causing urine stagnation
Frequent intercourse, irritating urethra
Exposure to sexually transmitted infections
Hormonal changes, reducing ureteral peristalsis
95
acute pyelonephritis CM
Fever
Costovertebral angle pain
Nausea or vomiting
Dysuria
Urinary frequency, hesitancy, or urgency
Lower abdominal pain
Blood in urine
96
acute pyelonephritis DC
Presence of symptoms
Urinalysis and microscopic evaluation
Urine culture
Imaging studies
97
AP treatment
Intravenous fluids
Antibiotics
Analgesics
Surgery (remove obstruction)
98
bacterial meningitis patho
inflammation of meninges of the brain and spinal cord
Bacteria proliferate in CNS
Exudate damages and obstructs CNS structures, leading to reduced oxygen to the brain
99
BM cause
N. meningitidis
100
BM transmission
respiratory droplet
101
main functions of the meninges
1. Protect the brain and spinal cord from injury
2. Provide blood supply to the skull and brain tissue
3. Allow for the flow of cerebral spinal fluid
102
BM CM
Rapid and severe onset
Severe headache
Photophobia
Nuchal rigidity (stiff neck)
Decreased alertness
Loss of consciousness
Changes in mental status
Vomiting
Seizures
Fever
Leukocytosis
Anorexia
103
BM DC
History and physical examination
Kernig sign - pain with knee pulled to chest and chin
to chest
Brudzinski sign - knees involuntarily flex when
neck flexed
Blood cultures
CSF analysis and cultures
104
treatment fo BM
Vaccination
Antibiotics
Corticosteroids - inflammation
Fluids
Treatment of close contacts
105
Tinea patho
Group of fungal infections
Dermatophyte attaches to and produces thickening of keratinized cells
106
tinea transmission
direct contact
107
tinea: ”ringworm”
Corporis (body)
108
tinea: hypopigmentation
Versicolor (skin)
109
tinea: hair loss/breakage
Capitis (scalp)
110
tinea: maceration between and around toes
Pedis (feet)
111
tinea: erythema, itching
Cruris (groin)
112
tinea: nail thickening, discoloration
Unguium (nails)
113
tinea DC
History and physical examination
Microscopic examination
Fungal cultures
Wood light examination - UV light shows glowing
114
tinea treatment
Prevention
Proper hygiene
Avoidance of contact with those infected
Antifungal drugs (topical and oral)
115
malaria patho
Transmitted by mosquito
Incubation period of 1 month from exposure
Currently eradicated in United States
Worldwide, >1 million deaths per year
Common in children from sub-Saharan Africa
116
malaria cause
infection with Plasmodium protozoa
117
malaria CM
Headache
Shivering and chills
High fever!!!!
Excessive sweating
Cough
Fatigue
Malaise
Joint/muscle aching
118
malaria DC
History of travel to an endemic area
Physical examination
Laboratory testing
Peripheral blood smears
119
malaria treatment
Prevention
Avoiding mosquitoes
Using a bed net during sleep
Wearing long-sleeve clothing
Using insect repellants (with DEET)
Antimalarial drugs
(Quinolines
Antifolates
Artemisinins
Antimicrobials)
Antipyretics
*multiple drugs must be used - no single drug works*
120
prescense of microorganisms in blood
severse blood infection
septicemia
121
septicemia occurs when infection enters from
skin
lungs
kidneys
bladder
122
septicemia first sign
delirium
123
sepsis caused by
septicemia
124
sepsis causes
inflammation through body
125
inflammation from sepsis causes
blood clots blocking oxygen
126
common infections leading to septicemia
UTI
lung infections
kidney infections
abdominal infections
127
disorders of synthesis and storage functions from liver failure
glucose
proteins
lipoprotein cholesterol
bile salts
128
hepatitis A transmission
fecal-oral
129
hepatitis B transmission
infected blood or bodily fluid
130
hepatitis C transmission
infected blood
131
lab testing for malaria
peripheral blood smears
