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MICRO 121 > review > Flashcards

review Flashcards

1
Q

4 things for handwashing**:

A

4 things for handwashing**:
1. before initial patient contact
2. Before an aseptic procedure
3. After body fluid exposure risk (after procedure)
4. After patient/patient environment contact
- remember PPE, get risk of gloves after one task, wear barriers

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2
Q

Hepatitis B Virus Diagnostic Testing:**

A

Hepatitis B Virus Diagnostic Testing:**
Serology testing for HBV antigens and HBV antibodies
Diagnostic test uses antigens (from virus) and antibody production (from host response)

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3
Q

Treat all patients if they have:

A

Bloodborne pathogens
Infectious/drug resistant organisms

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4
Q

Chain of Transmission:

A

Infectious agents: what’s spreading
Reservoirs: where is it found?
Susceptible hosts: who is susceptible?
Portal of exit: how does it go from person to person?
Portal of entry: how did it get into/on the person?
Modes of transmission: how was it transmitted?

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5
Q

Routes of Transmission:

A

Routes of Transmission:
Respiratory: airborne, droplet
Parenteral (anywhere other than mouth): needle-stick injuries, abrasions

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6
Q

Vaccine induced immune response

A
  • 1st/Primary Response: IgM develops relatively quickly, then IgG much later, takes 7-14 das to mount a response
  • 2nd/Secondary/Anamnestic (Memory) Response: (Post vaccine, actual exposure): HUGE and FAST IgG response, smaller IgM; takes 1-2 days after exposure and lasts sort-of forever may need a booster
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7
Q

live attenuated vaccine

A

live organism that is significantly weakened
VZV, MMR

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8
Q

inactivated vaccine

A

killed, completely dead
not as immunogenic
HAV, Influenza

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9
Q

polysaccharide vaccines

A

needs frequent boosters
streptococcus, neisseria, pneumococcus

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10
Q

toxoid vaccines

A

strong immune response bc toxins are naturally immunogenic
tetanus, diphtheria

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11
Q

subunit vaccines

A

uses small portions of pathogen put together and presented as an antigen to us
bordetella pertussis, prevnar

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12
Q

Recombinant Vector Vaccines (DNA Vectors)

A
  • DNA viral vector with DNA spliced into it
  • viral DNA that produces viral proteins and put into a vector
  • vector enters body; shit loads of viral proteins are made
  • sueper good target practice but also super experimental
    HBV, malaria
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13
Q

how do vaccines work

A
  1. antigen or foreign protein of a pathogen is presented to host
  2. host mounts an antibody/t-cell/both response to protein components of pathogen
  3. viral proteins aren’t great at eliciting strong IR, need proteins carried on adjuvants which potently initiate immune response
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14
Q

passive immunization

A

temp protection, given there’s no time to develop antibodies through active immunity

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15
Q

Hepatitis

A

general term, clinical presentation “inflammation of liver”
we focus on the viruses
5 types: ABCDE; ABC is focused, D is Africa/Middle East, E is sea

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16
Q

Hep A Presentation

A

telltale is jaundice
can be completely asympt, can cause disease, fever, nausea, debilitating vomiting

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17
Q

Hep A diagnosis

A
  • ALT liver enzyme means you should get a Hep test
  • Detecting HAV IgM in serum = early antibodies, acute infection
  • Detecting HAV IgG in serum = later antibodies
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18
Q

Hep A prevention

A

no vaccine

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19
Q

Hep B transmission

A

sexually
parenteral (iv)
perinatal

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20
Q

hep c pathogenesis

A

acute phase
chronic
cirrhosis
liver transplant

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21
Q

HBsAg

A

surface antigen (ur infected)

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22
Q

HBsAB

A

surface antibody (immune)

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23
Q

HBcAB (IgM)

A

core antibody early
were infected more recently, still an acute infection, started developing an immune response

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24
Q

HBcAB (IgG)

A

core antibody later
infected a while ago; could be in past or chronic stage

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25
Q

HBeAg

A

Envelope Antigen
Virus actively replicating and you are infectious

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26
Q

HBeAB

A

Envelope antibody
body is stopping virus from replicating

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27
Q

prevention of HBV

A

vax
antivirals
liver transplant - for liver failure

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28
Q

bacteremia

A

presence of bacteria in bloodstream

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29
Q

primary bacteremia

A

ONLY in blood

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30
Q

secondary bacteremia

A

blood AND other sites

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31
Q

transient bacteremia

A
  • bacteria enters blood but immune sys can handle it
  • no symp
  • not clinically signif
32
Q

intermittent bacteremia

A

(more common than continuous)
bacteria comes from EXTRAvascular source
(wound, UTI, GI perforation)

33
Q

continuous bacteremia

A

bacteria consistently from INTRAvascular source
(biofilms from IV line, endocarditis)

34
Q

bacteremia diagnosis

A

collect blood in culture bottles, DON’T refrigerate, send to lab ASAP
rapid cultures help ensure early antibiotic therapy and decrease hospital stay

35
Q

Common causes of issues with blood cultures**

A
  1. inadequate skin preparation; clean top of bottle AND skin to prevent contaminants from skin
  2. improper volume of blood taken: collect 8-10 mL per bottle, collect 3-4 bottles (4 if >70 pounds or older than 15)
  3. not take from right sites: two sites; site #1 and #2 each 1 anaerobic and 1 aerobic bottle; if doing 3 bottles don’t do 2nd anaerobic bottle
  4. improper number of bottles
  5. improper timing; take before antibiotic initiation, 10-20 min btwn sites
  6. issues with pediatric patients; <35 lbs take ped’s bottles with 1-3 mL in each bottle
36
Q

likely a blood culture contaminant if

A

coagulase neg staph, prop acne, gram +’ve bacilli in ONE bottle

37
Q

possible pathogen for blood culture

A

same organism diff times >1 bottle and >1 set
- staph aureus, gram neg bacilli (e. coli), bacillus anthracis, c. diff
OR
multiple bottles of coagulase negative staph, prop acne, gram positive bacilli

38
Q

epidemic impetigo

A
  • epidermal eruptions of flacid pustules around mouth and nose (highly contagious lesions, rupture and form thick honey coloured crust)
  • superficial, epidermis
  • streptococcus pyogenes (group a strep), staphylococcus aureus
  • treatment: Abx w/o culture if not healing/complicated take culture
    Risk Factors: day care/school, breaks in skin
39
Q

erysipelas

A
  • infection of deeper skin layers
  • may b source of bacteremia
  • causes inflammation
  • dermis
  • streptococcus pyogenes (group a strep)
40
Q

cellulitis

A
  • deeper infection
  • may cause bacteremia
  • subcutaneous layers of skin
  • staphylococcus aureus, streptococcus pyogenes, pseudomonas aeruginosa, gram neg bacilli
  • follows local infection/trauma
41
Q

furuncles

A
  • infected sebaceous gland
  • always treat staphylococcus aureus
  • treatment: cloxacillin (unless MRSA)
42
Q

decubitus ulcers

A
  • bed sore colonized with mixed potential pathogens and non pathogens
  • complete breakdown of the skin therefore deep layers
  • often skin flora or GI flora organisms
  • treatment: nursing care
43
Q

types of surgical wounds

A

clean = no contamination
clean contaminated = clean would but in area w bacterial colonization
contaminated = wound is close to high prevalence of organisms
dirty/infected = wound in site with existing infection

44
Q

bites

A
  • know what kind of bite
  • complications: cellulitis, abscess, deep tissue infection
45
Q

fasciitis

A
  • rapidly progressing cellulitis with EXTENSIVE NECROSIS of subcut tissue resulting in injection of inner fascia
  • organisms: toxin producing agents; streptococcus pyogenes
  • rapid clinical diagnosis with gram stain and culture for confirmation
46
Q

dermatophyte infection

A
  • fungal infection of hair, skin, or nails (ringworm, dandruff, athletes foot)
  • caused by yeast or dermatophytic fungi or tinea/ringworm
  • diagnosis: clinical, skin/nail scraping sent for calcofluor stain +/- fungal culture
  • treatment: topical antifungals
47
Q

scabies

A
  • female microscopic mite that burrows into skin and lays eggs causing inflammatory reaction
  • diagnosis: clinical; can see the tracks/migratory patterns of mites, immunological reaction to eggs causing inflammation, very easily spread bc patient shed mice
48
Q

scabies

A
  • female microscopic mite that burrows into skin and lays eggs causing inflammatory reaction
  • diagnosis: clinical; can see the tracks/migratory patterns of mites, immunological reaction to eggs causing inflammation, very easily spread bc patient shed mice
49
Q

lice

A

head lice

50
Q

crabs

A

pubic lice

51
Q

herpes simplex virus

A
  • cold sores (HSV 1)
  • genital (HSV 1 or 2)
  • organism HSV type 1 and 2
  • direct contact transmission; kissing, sex
  • diagnosis: clinical, also possible genital viral culture
  • treatment: antiviral drugs
52
Q

varicella zoster virus

A

chicken pox or shingles
- respiratory spread to blood than to skin
- healthcare workers test for immunity, live vaccine

53
Q

Conjunctivitis (pink eye)

A
  • infection/inflammation of conjunctiva
  • organisms: organisms in upper resp tract are most common
    bacteria: strep pneumo
    virus: adenovirus
    neonates: chlamydia trachomatis
    diagnosis: gram stain and culture
    treatment: abx if bacterial, supportive care if viral, antivirals if HSV
54
Q

otitis externa

A

infection of OUTER ear
typically caused by environment: swimmers ear, prolonged antibiotic use
diagnosis: only do culture and sensitivity if extensive/severe
treatment: dry the area, topical Abx after enviro is cleaned out/dried

55
Q

otitis media

A

infection of INNER ear
blocked eustachian tubes therefore no draining of normal secretions and no pressure regulation
organisms: often pathogens of URTI; bacteria: streptococcus pneumoniae, haemophilus influenzae
viral: RSV, influenza
diagnosis: otoscope
treatment: Abx

56
Q

pharyngitis

A

majority caused by viruses
viruses:
- epstein Barr
- adeno
- influenza
bacteria:
- streptococcus pyogenes = STREP THROAT
- chlamydia
diagnosis: throat swab
treatment: penicillin
complication: endocarditis

57
Q

tracheobronchitis

A

croup, laryngitis, bronchitis
viruses: RSV, influenza, parainfluenza
bacteria: bordetella pertussis (whooping cough)

58
Q

tracheobronchitis: influenza

A

fall and winter, in the tropics = yr round
virulence factors: paralyze cilia, antigenic drift and shift
diagnosis: NP swab or wash, virus culture, PCR

59
Q

tracheobronchitis: parainfluenza

A

croup in children
bronchitis in older children/adults
clinical unless hospitalized

60
Q

tracheobronchitis: RSV

A
  • bronchiolitis (inflammation of bronchus)
    fall and winter
  • diagnoses: NP swab or wash, rapid antigen detection, virus culture, PCR
    complication: pneumonia
61
Q

whooping cough

A

bordetella pertussis (gram neg) that infects resp epithelial cells
starts w mild URTI: cough
leads to uncontrollable coughing followed by a WHOOP and vomiting
PCR of NP swab
prevention: DTaP vaccine

62
Q

pneumonia

A

inflammation and infection of lungs
acute onset, fever, SOB, productive cough
types: community acquired, ventilator associated, hospital acquired

63
Q

community acquired pneumonia

A

streptococcus pneumoniae (most common), haemophilus influenzae (2nd most common)
diagnosis: blood culture, PCR

64
Q

ventilator associated pneumonia

A

translocated from URT to LRT via tube
- pseudomonas aeruginosa, MRSA
diagnosis: blood cultures, suctioning

65
Q

tuberculosis

A

mycobacterium tuberculosis
- transmission from airborne droplets from coughing, sneezing, speaking
- culture, TB test
infection control: neg pressure, private room
6-9 month treatment

66
Q

cystitis

A

bladder infection

67
Q

pyelonephritis

A

kidney infection

68
Q

urethritis

A

urethra inflammation

69
Q

how to UTI’s happen

A
  1. organisms from rectum/perineal region translocate to urethra
  2. normal flora typically protect against this (lactobacillus)
  3. if UTI untreated = urosepsis
70
Q

asymptomatic bacteriuria

A

NOT AN INFECTION, colonization of bacteria
do we treat it? NO
if they have a catheter: change catheter and re-assess

71
Q

uncomplicated UTI’s

A

healthy adults
non-preg

72
Q

complicated UTI’s

A

structural or functional urinary tract abnormalities
preg women
catheters

73
Q

diagnosis of UTI’s

A

urine dipstick *if positive and sympt present=UTI, if neg=further testing
urine culture and sensitivity - midstream

74
Q

interpreting urine culture results

A

1 organism growing - that’s responsible

of colonies of organism 1> # of colonies of organism 2: organism 1 is causing UTI

3 diff bacteria” most likely contaminated
if bacteria not growing a lot (<10 colonies): prob not a UTI

75
Q

treatment of UTI’s

A

high dose antibiotics x3 if UNCOMPLICATED
frequent urination
cranberry juice?
DON’T overhydrate

76
Q

Types of vaginitis

A

bacterial - microscopy
candidiasis/yeast infection
trichomonas vaginitis

MICRO 121 (19 decks)

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