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Infection > Session 10 > Flashcards

Session 10 Flashcards

1
Q

What is a Hickman line? What is it commonly used for? What implications can it have for acquiring infections?

A

Artificial plastic line inserted through the skin and directly into the vascular system

Administration of chemotherapy drugs

Source of entry for microorganisms and an artificial surface within the body for organisms to attach to

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2
Q

What is mucositis? How can it result in increased risk of infection?

A

Painful inflammation of the mucosal membranes in the body

Provides a break in the mucosal barrier

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3
Q

What causes the loose stools seen as a result of treatment with cancer chemotherapy?

A

Normal mucosal lining is eroded, altering the motility of the bowel leading to loose stools

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4
Q

How does chemotherapy affect blood cell levels in the body?

A

Acts on the dividing cells in the bone marrow resulting in a reduction in all blood cell lines

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5
Q

A patient on cancer treatment is an example of an _____________ immune deficiency

A

Acquired

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6
Q

Fungal cell walls are composed largely of…

A

Chitin

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7
Q

Bacterial cell walls are composed largely of…

A

Peptidoglycan

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8
Q

Where do all fungi derive nourishment from? What is this nourishment used for?

A

From a preformed organic carbon source

Growth

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9
Q

Fungi produce enzymes to…

A

Degrade surrounding material making it soluble and able to cross the cell membrane

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10
Q

Aspergillus can be found in ________ in buildings

A

Dust

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11
Q

Does Aspergillus usually affect people with a normal host immune response?

A

No - people with reduced immunity can be at risk

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12
Q

Acute Aspergillus infection commonly infects the…

A

Lungs

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13
Q

What type of organism is Varicella zoster?

A

Virus - part of the Herpes family

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14
Q

Varicella zoster is an example of a _______ virus

A

Herpes

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15
Q

Epstein-Barr virus is an example of a _________ virus

A

Herpes

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16
Q

Varicella zoster has a __________ pattern of infection

A

Latent

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17
Q

What pattern of infection is seen in Varicella zoster?

A

Latent pattern of infection

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18
Q

Varicella zoster causes…

A

CHICKEN POX

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19
Q

Which organism causes chicken pox?

A

Virus - Varicella zoster

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20
Q

Describe the pattern of infection of Varicella zoster

A

Infection of upper respiratory mucosa with virus containing droplets
Virus spreads to regional lymph nodes and replicates
Virus spreads to the liver and spleen
Infection of the skin leads to the appearance of a vesicular rash
Virus enters cutaneous neurones and migrates to ganglia where it enters a latent state.

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21
Q

Name two symptoms of chicken pox

A

Fever

Rash

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22
Q

Varicella zoster initially infects which part of the body?

A

Upper respiratory mucosa

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23
Q

Varicella zoster virus enters _________ where it becomes dormant or enters a latent phase

A

Ganglia

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24
Q

Varicella zoster is kept in check in its latent state by…

A

T cell surveillance

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25
Q

The reactivation of latent Varicella zoster results in which condition?

A

Shingles

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26
Q

What happens in the reactivation of latent Varicella zoster to cause shingles?

A

Viral particles in the dorsal root ganglion travel along the nerve to sensory terminals in the skin. Virus escapes the sensory terminals and invades the skin —> Shingles

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27
Q

Can shingles occur in healthy individuals?

A

Yes

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28
Q

How can infection with Varicella zoster be diagnosed?

A

Clinical picture is usually diagnostic. Fluid can be taken from rash vesicles and the virus detected by PCR

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29
Q

What does PID stand for?

A

Primary Immunodeficiencies

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30
Q

Why is Immunodeficiency a largely unmet clinical problem?

A

There is a large spectrum of PIDs

There is a failure to recognise and diagnose PIDs

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31
Q

What is an immunocompromised host?

A

State in which the immune system is unable to respond appropriately and effectively to infectious microorganisms

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32
Q

Immunodeficiency is due to…

A

A defect in one or more components of the immune system

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33
Q

Name the main two types of Immunodeficiency

A

Primary Immunodeficiency (congenital)

Secondary Immunodeficiency (acquired)

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34
Q

Is a primary Immunodeficiency, congenital or acquired?

A

Congenital

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35
Q

Is a secondary Immunodeficiency, congenital or acquired?

A

Acquired

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36
Q

Primary immunodeficiencies are due to…

A

Intrinsic gene defects

37
Q

What can result from the intrinsic gene defects that cause primary Immunodeficiencies?

A 
Missing protein 
Missing cell (of immune system)
Non-functioning components produced
38
Q

Secondary Immunodeficiencies are due to…

A

An underlying disease/treatment

39
Q

How can underlying diseases/treatments cause secondary Immunodeficiency? (3)

A

Reduced production of immune components
Reduced function of immune components
Increased loss of immune components

40
Q

Infections suggesting an underlying immune deficiency are defined as…

A

SPUR infections

41
Q

What does the mnemonic SPUR stand for?

A

Severe
Persistent
Unusual
Recurrent

42
Q

SPUR describes infections that…

A

Suggest underlying immune deficiency

43
Q

Give four warning signs of PID in children

A

4 or more new ear infections within 1 year
2 or more serious sinus infections within 1 year
Two or months of antibiotics with little effect
Two or more pneumonias within 1 year
Family history of PID

44
Q

Give 4 warning signs of PID in adults

A

2 or more new ear infections within 1 year
2 or more serious sinus infections in 1 year without an allergy
1 pneumonia per year for more than 1 year
Family history of PID

45
Q

Name three limitations of the 10 warning signs for PID

A

Lack of population based evidence

PID patients with different defects/presentations

PID patients with non-infectious manifestations

46
Q

Name the three most common PIDs with regards to their diagnosis

A

CVID - common variable Immunodeficiency
IgA Deficiency
IgG Deficiency

47
Q

What is the most common PID disease by diagnosis?

A

CVID

48
Q

What does CVID stand for?

A

Common Variable Immunodeficiency

49
Q

Onset of PID disease symptoms before 6 months highly suggests which sort of defect is present?

A

T cell

Phagocyte

50
Q

Onset of PID disease symptoms between 6 months and 5 years often suggests which sort of defect is present?

A

B Cell
Antibody
Phagocyte

51
Q

Onset of PID disease symptoms above 5 years of age usually suggests which sort of defect is present?

A

B Cell
Antibody
Complement

(Secondary Immunodeficiency)

52
Q

Give an example of an infection that is commonly associated with complement deficiency

A

Meningitis

53
Q

Give an example of an infection that is commonly associated with phagocytic defects

A

Skin/mucous infections

54
Q

Give an example of a disease that is commonly associated with antibody deficiency

A

Malignancies

55
Q

Give an example of an infection that is commonly associated with T cell defects

A

Opportunistic infections

56
Q

What type of disease is chronic granulomatous disease?

A

Primary Immunodeficiency Disease

57
Q

What results from chronic granulomatous disease?

A

Increased susceptibility to bacterial and fungal infections

58
Q

Name two clinical signs you may see in someone with chronic granulomatous disease

A

Pulmonary aspergillosis

Skin infections

59
Q

Describe some supportive treatments for the management of PIDs (5)

A

Infection prevention
Treat infections promptly and aggressively
Nutritional supplement - e.g. Vitamins A & D
Use UV-irradiated CMVneg blood products only
Avoid live attenuated vaccines in patients with severe PIDs

60
Q

What does SCID stand for? What is it?

A

Severe Combined Immunodeficiency

Combined deficiency of the immune system - both antibodies and T cells missing

61
Q

What is the specific treatment for most PIDs?

A

Immunoglobulin therapy

62
Q

Give two examples of immunoglobulin therapies that can be used in the treatment of PIDs

A

IVIG - intravenous immunoglobulin

SCIG - subcutaneous immunoglobulin

63
Q

What is the usual treatment for SCID?

A

Haematopoietic stem cell therapy

64
Q

Is immunoglobulin replacement therapy a lifelong treatment?

A

Yes

65
Q

What is the goal of using immunoglobulin replacement therapy, with regards to the serum IgG levels?

A

To increase IgG to > 8g/l

66
Q

Secondary immunodeficiencies are due to an underlying disease/treatment. What three things can cause them?

A

Reduced production of immune components
Reduced function of immune components
Increased loss of immune components

67
Q

State 4 conditions that can result in decreased production of immune components and as a result secondary immune deficiencies

A

Malnutrition
Liver diseases
Lymphoproliferative diseases
Splenectomy

68
Q

What is splenectomy?

A

A surgical procedure where the spleen is removed

69
Q

Name three conditions that can result in the need for a splenectomy

A

Infarction
Trauma
Coeliac disease
Autoimmune haemolytic disease

70
Q

What can cause infarction of the spleen resulting in the need for a splenectomy?

A

Sickle cell anaemia

71
Q

Describe the immune functions of the spleen?

A

Important in the clearance of ENCAPSULATED bacteria

Antibody production (IgM - acute, IgG - long term)

Contains splenic macrophages for removal of microbes

72
Q

An asplenic patient will have particularly susceptibilities to which type of bacteria?

A

Encapsulated bacteria

73
Q

Give thee examples of encapsulated bacteria

A

Haemophilus influenzae
Neisseria meningitidis
Streptococcus pneumoniae

74
Q

What does OPSI stand for? What can it lead to? (2)

A

Overwhelming post-splenectomy infection

Meningitis
Sepsis

75
Q

What can be done in the management of asplenic patients? (3)

A

Medic alert bracelet
Penicillin prophylaxis (life-long)
Immunisation against encapsulated bacteria

76
Q

Patients with haematological malignancies have an _____________ susceptibility to infection

A

Increased

77
Q

How can chemotherapy affect neutrophil levels?

A

Reduces them —> chemotherapy induced neutropenia

78
Q

What action would you take in case of suspected neutropenic sepsis?

A

Treat as an acute medical emergency and offer antibiotic therapy immediately

79
Q

Give an example of two conditions that can cause an increased loss/catabolism of immune components and as a result secondary immunodeficiencies

A

Protein-losing conditions

Burns

80
Q

Give two examples of protein-losing conditions

A

Nephropathy

Enteropathy

81
Q

The pattern and type of infections always reflect the nature of immunological defect.

State some factors that can help you recognised and diagnose IDs

A 
Age at presentation 
Sex
Site and frequency of infection 
Type of organism 
Family history
82
Q

VIRUSES and fungi commonly indicate which sorts of IDs?

A

Related to T cell deficiencies

83
Q

BACTERIA and fungi commonly indicate which sorts of IDs?

A

Related to B cell/granulocyte deficiency

84
Q

How would you test for Immunodeficiency? (3)

A

Look for secondary Immunodeficiency
FBC
Tests of humoral immunity (antibody levels)
Tests of cell mediated immunity (lymphocyte count)
Test for phagocytic cells (neutrophil count)
Complement tests

85
Q

How can neutrophil function be tested to see if a patient has chronic granulomatous diseases?

A

Checking for oxidative burst in neutrophils

86
Q

Aciclovir is used for the treatment of…

A

Herpes simplex virus infections

87
Q

Which bacteria commonly causes tonsillitis?

A

Strep pyogenes

88
Q

What is the specific treatment for tonsillitis?

A

Antibiotics - Penicillin V

Infection (10 decks)

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