Patho Test 1 Week 3 Flashcards
Why is the human body a hospitable site for bacteria to grow and flourish?
Because of its sufficient nutrients and appropriate condition of temp and humidity
What is a symbiotic relationship?
Both humans and microorganisms benefit
What is an example of a symbiotic relationship?
Normal flora of the human gut are provided nutrients from food and in exchange produce enzymes that facilitate digestion and use of more complex molecules found in the human diet, provide antibacterial factors that prevent colonization by pathogenic microorganisms, and produce usable metabolites (vit k)
What are possible strategies of microbial treatment to limit antibiotic resistant strains?
consistent, proper hand hygiene, maintenance of a clean environment, use of barrier where appropriate, and prompt identification of patients at high risk of colonization with transmissible microorganisms.
What is the prevention strategy for the US to address emerging infections?
Surveillance & response, applied research, Prevention and Control, and Infrastructure
What is the role of surveillance and response ?
detect promptly, investigate, and monitor emerging pathogens, the disease they cause, and the factors influencing their emergence
What is the role of applied research?
integrate lab science and epidemiology to optimize public health practice
What is the role of prevention and control?
enhance communication of public health info about merging diseases and ensure prompt implementation of prevention strategies
What is the role of infrastructure?
strengthen local, state, and federal public health infrastructures to support surveillance and implement prevention and control programs
Give examples of emerging infections
West Nile Virus, SARS, Influenza, Hanta Virus, Resistant Microbes, and Influenza A/H1N1 - 2009
When and where did WNV emerge?
NY in 1999
WNV has moved from NY to _____?
almost all of the continental U.S., 7 Canadian provinces, and throughout Mexico and parts of the Caribbean
What is the etiology of WNV?
infected mosquito & infected bird, transfusions, transplants, maternal-child. Not through touch (contact) or airborne
True or False, most people with WNV are asymptomatic ?
TRUE, 70 to 80% are asymptomatic
What are the clinical presentations of WNV?
Fever, headache, fatigue, skin rash on trunk, swollen lymph glands, and eye pain
What are the 3 severe forms of the WNV?
West Nile (WN) Meningitis, WN Encephalitis, WN Poliomyelitis
When the CNS is affected, what are 2 clinical presentations?
febrile headache and encephalitis
What does SARS stand for?
Severe Acute Respiratory Syndrome
Describe the impact that SARS has had locally and globally
originated in Southern China in end of 2002, crossed into Hong Kong in Feb 2003. In days, it lead to Viet Nam, Singapore, Canada, Germany, and beyond. Nov 2002 to July 2003, more than 8,098 SARS cases, 774 deaths in 26 countries ( majority in the Western Pacific)
What are the clinical Presentations of SARS?
high fever, headache, discomfort, body aches, mild respiratory symptoms at outset, diarrhea, a dry cough, and pneumonia
What are the 3 types of Influenza?
Seasonal/ Common flu, Avian Influenza (or bird) flu (AI),and Pandemic Influenza
Describe the difference between Seasonal and Pandemic Influenza
Season flu is a resp. illness that can be transmitted person to person. Most people have some immunity and a vaccine is readily available. Pandemic influenza is a virulent flu that causes a global outbreak/pandemic of serious illness. Because there is little natural immunity, the disease can spread easily from person to person
What is the Avian Influenza caused by?
it is caused by influenza viruses that occur naturally among wild birds
True or False, low pathogenic AI is deadly to domestic fowl and humans
False, Highly pathogenic is deadly, whereas Low pathogenic AI is common in birds and causes few problems
Which subtype of AI are healthcare providers most concerned with and why?
H5N1 b/c its virulent, is being spread by migratory birds, can be transmitted from birds to mammals & humans, and the virus continues to evolve. Since 2003, there have been numerous cases reported, but no human to human contact YET.
What are the clinical presentations of Avian Influenza?
fever, cough, sore throat, muscle aches, eye infections, pneumonia, acute respiratory distress, viral pneumonia
What is another name for Hanta Virus?
Hanta Pulmonary Syndrome (HPS)
What is HPS and how is it contracted?
HPS is a potentially deadly disease transmitted by infected rodents through urine, droppings, or saliva. Humans can contract the disease when they breathe in the aerosolized virus
Describe the impact Hanta Virus has had locally and globally
First recognized in 1993 and has since been identified throughout the U.S. Outbreaks of hantaviral disease have been associated with changes in rodent pop. densities, which may vary across time, both seasonally and from year to year
What are the clinical presentations of HPS?
Fever, myalgia, N&V, cough, dizziness, arthralgia, SOB, rhinorrhea, and sore throat
MDR TB, MRSA, VRE, VISA, And VRSA are all examples of what?
Resistant Microbes
______ can lead to the destruction of the normal flora, allowing the selective overgrowth of antibiotic-resistant strains of pathogens that had previously been kept under control
Overuse of antibiotics
True or False, 3.7% of new cases and 20% of previously treated cases are estimated to have MDR-TB
True. 3.7% of new cases and 20% of previously treated cases are estimated to have MDR-TB
Extensively drug-resistant TB (MDR-TB plus resistance to second-line injection) has been identified in how many countries?
84
E.coli O157:H7 was first recognized as a cause of illness in 1982 during an outbreak of _________
severe blood diarrhea
What was the source of contamination of the E.coli outbreak in1982?
Undercooked ground beef
Describe some of the recent E.coli outbreaks
package spinach source, raw clover sprouts, and a beef E.Coli outbreak in 2009
What does a phase 6 declaration mean?
a global pandemic
Describe the impact that Influenza A/H1N1 had on the world in 2009
43-83 million H1N1 cases,192,000 - 398,000 H1N1 hospitalizations, and 8,720-18,050 deaths
True or False, Influenza has been completely eradicated worldwide
False, the disease does not go away, it comes back and can not be contained to one geographic area
A patient wants to know when the flu season begins and ends. What should you tell them?
The flu season starts in October or November and peaks from December to March
How might you educate a patient on the transmission of Influenza?
It is spread person to person via small particle aerosols that can get into the respiratory tract. It can survive on surfaces for small amounts of time and can be spread this route if it gets into the nasal mucosa before it loses its infectivity
A patients comes into your community clinic presenting with the following signs and symptoms… Fever, myalgia, headache, ocular symptoms, dry cough, and nasal discharge. What is most likely the diagnosis?
Uncomplicated Influenza A
What are the Pulmonary Complications, Sequelae seen in Influenza A?
Croup in children (a cough that sounds like a seal, difficulty breathing, stridor), primary influenza virus pneumonia, and secondary bacterial infections
What are the non-pulmonary complications associated with Influenza A?
cardiac failure, encephalopathy, Reyes Syndrome, Guillain-Barre Syndrome
Define Attenuation
The weakening of a microbe so that it can be used in a live vaccine
What is a conjugate vaccine?
a vaccine in which proteins that are easily recognizable to the immune system are linked to the molecules that form the outer coat of disease-causing bacteria to promote an immune response
True or False, conjugate vaccines are designed only for adults over 18
False, conjugate conjugate vaccines are designed primarily for very young children because their immune systems can not recognize the outer coats of certain bacteria
What is a DNA/Naked DNA vaccine?
a vaccine that uses a microbe?s genetic material, rather than the whole organism or its parts, to simulate an immune response. (Tb, SARS, HIV)
What is an inactivated “killed” vaccine?
a vaccine made from a whole viruses or bacteria that has been inactivated with chemicals or heat
______ is a vaccine that uses one or more components of a disease-causing organism, rather than the whole, to stimulate an immune response
Subunit vaccine
What is the technique by which genetic material from one organism is inserted into a foreign cell or another organism in order to mass-produce the protein encoded by the inserted genes called?
Recombinant DNA Technology
_______ is a vaccine made using recombinant DNA technology to engineer the antigen molecules of the particular microbe
Recombinant Subunit Vaccines
True or False, vaccines that use modified viruses or bacteria to deliver genes that code for microbial antigens to cells of the body are called Toxoids
False. Correct answer is Recombinant Vector Vaccines.
Diphtheria and tetanus are notorious examples of what?
Toxoids
What is the controversy surrounding toxoids?
The growth of the bacterium is not dangerous, but the protein toxin that is liberated by it is. Treating the toxin with, for example, formaldehyde, denatures the protein so that it is no longer dangerous, but retains some epitopes on the molecule that will elicit protective antibodies.
What is the Diphtheria vaccine?
is an inactivated form of diphtheria toxin (toxoid); part of DTap
True or False, H. influenzae type b (Hib) vaccine is an extracted bacterial antigen conjugated to a protein carrier
TRUE
What type of vaccine is used for Hep A?
inactivated virus
What type of vaccine is used for Hep B?
recombinant viral protein
What type of vaccine is used for Influenza?
injected inactivated virus
Which vaccines are attenuated live viruses, part of MMR combined vaccine?
Measles & Mumps
True or False, the polio vaccine us an inactivated toxin & contains other bacterial agents and is part of Dtap combined vaccine
FALSE. Correct answer is Pertussis, Whooping Cough
What is the difference between the children and adult Pneumococcal vaccine?
Children: vaccine is a protein conjugate with 7 different capsular antigens; Adult: vaccine is a mixture of 10 extracted capsular polysaccharides
True or False, the polio vaccine is an activated virus
False, the polio vaccine is an inactivated virus vaccine
The Rotavirus and Varicella Zoster (Varicella) vaccine are both examples of what kind of vaccine?
Attenuated live virus
Rubella is apart of which combined vaccine?
MMR combined vaccine
Which vaccine contains the live vaccine virus?
smallpox
____ vaccine is an inactivated from of the ____ toxin (toxoid) and is apart of what?
Tetanus, Tetanus, DTAP
Describe medical issues surrounding vaccines
possibility of eradicating infections, pain and redness at injection site, fever, allergic reactions to vaccine ingredients, infection associated with attenuated viruses in immondeficient individuals.
What is thimerosal and why is it a concern regarding vaccines?
It is a mercury containing compound that has been used as a preservative in vaccines. Has been removed from all vaccines in 2001, with the exception of the influenza vaccine.
Describe the political issues surrounding vaccines
Controversies over the efficacy, safety, and morality of compulsory immunization stem from the longstanding tension between two, sometimes divergent, goals: protecting individual liberties and safeguarding the public?s health
Describe the economic issues surrounding vaccines
Every dollar spent on immunization saves 6.30 in direct medical costs, with an aggregate savings of 10.5 billion. When including indirect costs to society – a measurement of losses due to missed work, death and disability as well as direct medical costs – the CDC notes that every dollar spent on immunization saves 18.40, producing societal aggregate savings of 42 billion
Identify 5 substances used in bioterrorism
Anthrax (Bacillus anthracis), Smallpox (variola major), Botulism (clostridium botulinum toxin), Plague (Yersinia pestis) E. coli, water safety threats (cholera), emerging infectious diseases (Hanta virus)
After a major disaster, what are some acute physical issues your patient may present with?
gastroenteritis or viral syndromes
True or False, More than one half of acute post-disaster health issues are illnesses
True. Ex: self-limited viral syndromes (i.e. pneumonia, diphtheria, colds), gastroenteritis
Approximately ____ of acute post-disaster health complaints are injuries (cuts, abrasions, sprains, fractures)
one-fourth
True or False, routine items post major disasters include refills, wound checks, and splinting
TRUE
Describe acute mental issues post major disasters
emotional liability, negative emotions, cognitive dysfunction & distortions (reduced concentration, confusion), physical symptoms (headache, tension, fatigue), and behaviors negatively impacting interpersonal relationships ( irritability, distrust, withdrawal)
When will acute psychological distress resolve?
weeks to several months, can persist up to one year
