The Home Guard Flashcards

1
Q

Define the ‘normal flora’.

A

The wide range of organisms that live on the body without causing disease (usually).

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2
Q

Define endogenous infection.

A

An infection whose source is within the body.

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3
Q

Define exogenous infection.

A

An infection whose source is a tranmitted organism.

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4
Q

What is the meaning of commensal or non-commensal?

A

Pathogen or non-pathogen

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5
Q

What is a pathogen?

A

An organism capable of causing disease.

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6
Q

Mucus and cilia capture organisms and remove them from the respiratory tract. This is part of the innate immune system What could compromise this?

A
  • Loss of ciliary function (e.g. Kartagener’s syndrome).
  • Thick mucus as in cystic fibrosis.
  • BOTH lead to chronic bronchial sepsis.
  • Some organisms which cause this are:
    • S. aureus
    • H. influenzae
    • P. aeruginosa
    • M. cattarhalis
    • M. abscessus
  • Intubation bypasses the system which is designed to prevent pathogens from entering so could also compromise this defence mechanism.
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7
Q

The flushing action of urinary flow removes organisms. This is part of the innate immune system. How could this immune defence be compromised?

A
  • Many urinary pathogens have specialised adherence mechanisms.
  • Obstruction to the urinary flow can lead to stasis and urosepsis.
  • Obstruction can be caused by:
    • Catheters
    • Congenital malformations
    • Pregnancy
    • Prostatic enlargement
    • Stones
    • Tumours
  • Cathaters damage the epithelial lining. A big bag of urine full of bugs which can eventually travel back up the cathater can compromise.
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8
Q

The skin is a physical barrier to pathogens. This is part of the innate immune system. How could this be compromised?

A
  • Breaching the skin opens a route for infection.
  • Some causes of this are:
    • IV therapy
    • Canulae
    • Central venous lines
    • Arterial lines
    • Chest drains
    • Post-operative drains
  • This can take skin organisms into the body.
  • They can use this as a route for invasion.
  • It causes local sepsis and septicaemia.
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9
Q

The stomach acid kills infected pathogens. This is part of the innate immune system. How could this be compromised?

A
  • The stomach acid reduces the infective dose making intestinal infection less likely.
  • Reducing stomach acid allows colonisation and infection at lower infective doses.
  • The impact varies depending on the organism’s infective dose.
  • Some causes are:
    • Antacids
    • H2 antagonists
    • Proton pump inhibitors
  • Some relevant organisms are:
    • Salmonella
    • Shigella
    • C. difficile
    • Resistant gram negatives
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10
Q

The vagina has a low pH as a result of lactobacilli which prevents colonisation by pathogens. This is part of the innate immune system. How could this be compromised?

A
  • Mixed flora in the vagina prevents colonisation.
  • Replacement by potential pathogens leads to vaginitis.
  • Some causes are:
    • Antibiotic use
    • Age-related - becomes more common with age because the flora depletes with age.
  • Some relevant organisms are:
    • Candida spp.
    • Trichomonas vaginalis
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11
Q

Which patients will be affected by S. mitis?

A

S. mitis does not cause disease unless the patient is immunocompromised. These patients can become septic.

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12
Q

What can be caused by S. oralis?

A

Endocarditis

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13
Q

What can be caused by staphylococcus aureus?

A
  • Skin sepsis
  • Septicaemia
  • Acute endocarditis
  • Osteomyelitis
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14
Q

What can be caused by staphylococcus epidermidis?

A
  • Endocarditis
  • Local sepsis
  • Septicaemia
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15
Q

What can be caused by candida albicans?

A
  • Candidaemia
  • Endocarditis
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16
Q

What can happen to the lower bowel following:

  • perforation of hollow viscus
  • intestinal obstruction
  • penetrative injury
  • pancreatitis
  • cholecystitis?
A
  • Perotinitis
  • Abscess formation
  • Septicaemia
  • Fistula formation
17
Q

Describe colonisation resistance.

A
  • A theoretical concept
  • Bacterial products inhibit other organisms (e.g. free fatty acids from anaerobes)
  • Competition of binding sites limits competition
  • Disruption of colonisation resistance allows pathogens or resistant organisms to gain a foothold.
  • Some causes:
    • Intensive therapy unit
    • Antibiotic therapy (especially targeting anaerobes)
18
Q

What are the important points surrounding air and water supply in hospitals?

A
  • Managed airflow is potentially infecting patients.
  • Complex water supply allowing pathogens to lurk
  • Multiple patients
  • Immunologically vulnerable patients
  • Transmissible organisms are concentrated
19
Q

Which pathogens travel by airborne transmission?

A
  • S. aureus
  • S. pyogenes
  • M. tuberculosis
  • S. pneumoniae
  • Respiratory viruses
  • Legionella
20
Q

Which pathogens are transmitted by direct contact?

A
  • S. aureus
  • Enterobacteria
  • Pseudomonas
  • Vancomycin resistant enterococci (VRE)
21
Q

What are the relevant organisms and consequences of these associated with IV canulation?

A
  • Organisms:
    • Coagulase negative staph
    • S. aureus
    • Gram-negativie bacilli
    • Yeasts
  • Consequences:
    • Septicaemia
    • Endocarditis
22
Q

What are the infection consequences associated with surgery?

A
  • Predisposition
    • Tissue trauma
    • Ischaemia
    • Leak of intestinal contents
  • Consequences
    • Local infection
    • Abscess
    • Septicaemia
23
Q

What are the infection consequences associated with urinary catheter?

A
  • Urinary stasis
  • Bacterial colonisation
  • Consequences:
    • Urinary infection
    • Systemic infection
24
Q

What are the relevant organisms and consequences associated with gastrointestinal infection?

A
  • Antibiotic-associated diarrhoea
  • C. difficile
  • Norovirus
  • Food poisoning
25
Q

What are the predisposing factors and consequences of a skin infection?

A
  • Predisposition:
    • Surgery
    • Stasis
    • Burns
  • Consequences
    • Local infection
    • Colonisation by resistant bacteria
26
Q

What are the organisms associated with spelectomy?

A
  • S. pneumoniae
  • H. influenzae type b
  • Plasmodium falciparum
  • Babesia spp.
  • Removal of the spleen causes increased risk of pneumococcal sepsis.
27
Q

What are the organisms associated with complement deficiency?

A
  • Neisseria spp.
  • S. pneumoniae
28
Q

Which infections can be commonly caused by streptococcus pneumoniae?

A
  • Lower respiratory tract infection
  • Meningitis
29
Q

Which infections can be commonly caused by haemophilus influenzae?

A
  • Bacteraemia
30
Q

Which type of infection is commonly caused by cryptosporidium?

A
  • Intestinal infection
31
Q

Which type of infection is commonly caused by campylobacter?

A
  • Intestinal infection
32
Q

Which infection type is caused by complement deficiency of C7-C9?

A

Neisseria infections

33
Q

Which infections are associated with complement deficiency in the alternative pathway?

A
  • S. pneumoniae infection inclusing:
    • meningitis
    • septicaemia
34
Q

Why and how does neutrophil deficiency occur?

A
  • Common in cancer treatment and bone marrow transplant.
    • Causes inability to respond to bacterial and fungal infections.
    • Gram negative bacteraemia and pulmonary aspergillus infections are a particular problem.
    • Patients require isolate until neutrophils recover.
  • Congenital deficiencies exist:
    • Chronic infections with S. aureus.