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Musculoskeletal System > Viral diseases > Flashcards

Viral diseases Flashcards

1
Q

What is the normal body temperature range?

A

36.1 - 37.5 degree celcius

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2
Q

What are the two types of thermoreceptors?

A
  1. Peripheral (in skin)

2. Central (in the body core)

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3
Q

Give examples of central thermoreceptors

A
  1. Brain (hypothalamus)
  2. Spinal cord
  3. Abdominal vescera etc.
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4
Q

Where does thermoregulation take place?

A

Hypothalamus

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5
Q

The core temperature is usually lower and less stable? True or false

A

FALSE - the core temperature is usually higher and more stable

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6
Q

The skin temperature is usually lower and less stable? True or false

A

TRUE

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7
Q

When does the core temperature vary?

A
  1. It is lower during sleep (to aid a good night sleep as we sleep better when we are cooler)
  2. Higher when awake
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8
Q

At what temperature are you in hyperthermia?

A

> 38.5 degree celcious

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9
Q

Change in temperature is sensed by …?

A

Thermoreceptors

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10
Q

What is the role of the hypothalamus?

A
  1. Responds to an increase in environmental temperature
  2. Controls core temperature of the body
  3. Responds to a decrease in body temperature
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11
Q

Define homeostasis

A

Homeostasis is a healthy state that is maintained by the constant adjustment of biochemical and physiological pathways.

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12
Q

Describe the mechanism of increasing temperature with thyroid hormones

A
  1. T4 is converted into T3
  2. T3 increases ATP production
  3. More ATP = increase metabolic rate = more heat
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13
Q

What are the two types of thyroid hormones?

A
  1. Thyroxine (T4)

2. Triiodothyronine (T3)

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14
Q

Hyperthyroidism leads to …?

A

Heat intolerance as too much thyroid hormones are produced

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15
Q

Describe the mechanism of increasing temperature via the sympathetic nervous system

A
  1. Catecholamine production is activated
  2. Catecholamine binds to beta receptors in brown fat cells
  3. Brown fat (good fat) - burns calories and generates heat .
  4. Catecholamine also stimulates alpha one receptors which allows vasoconstriction
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16
Q

What is the sympathetic nervous system usually activated by?

A

Flight or fight response

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17
Q

Give 2 examples of a catecholamine

A

Epinephrine and norepinephrine

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18
Q

How does shivering increase the body temperature?

A
  1. Skeletal muscles contract
  2. ATP converted into ADP
  3. Bonds broken = energy release > Exothermic reaction
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19
Q

During hyperthermia, the anterior hypothalamus stimulates …. (1)… which activates the …. (2).

A
  1. Sympathetic cholinergic fibres

2. Sweat glands

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20
Q

How does sweat reduced body temperature?

A
  1. Sweat on skin evaporates from skin

2. Liquid changes to a gaseous state.

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21
Q

Another way the hypothalamus reduces body temperature is by…. ?

A
  1. Vasodilation - more warm blood from core taken to skin surface
  2. Warmth is lost by radiation, convection, conduction
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22
Q

What is heat exhaustion and what does it lead to?

A
  • caused by high temperatures

- can lead to rapid heart beat , dizziness and fainting

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23
Q

What is heat stroke and what does it lead to?

A
  • occurs when body temperature is > 40 degrees celcius > causes excessive vasodilation
  • can lead to confusion, coma and seizures
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24
Q

When does malignant hyperthermia occur?

A

When heat dissipating mechanism are unable to keep pace with the high heat production

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25
Q

Who is more susceptible to heat strokes and why?

A
  1. Infants and children - higher metabolic rate

2. Elderly - pre existing conditions e,g physical and psychological limitations

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26
Q

What are some medications for heat strokes?

A
  1. Beta blockers

2. Diuretics

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27
Q

What are some risk factors for hypothermia?

A
  1. Prolonged cold expose
  2. Impaired thermoregulation
  3. Heat loss
  4. Cold IV fluids
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28
Q

Describe the pathophysiology of fever

A
  1. Fever releases pyrogens e.g IL-1 and TNF
  2. IL-1 signals hypothalamus to increase prostaglandin levels
  3. Prostaglandins increase the set temperature in the hypothalamus
  4. Heat production increases until core temperature reaches new regulated level.
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29
Q

What are the benefits of a high temperature during fever?

A
  1. Increased rate of immune response

2. Compromises growth of microorganisms

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30
Q

How does aspirin reduce a fever?

A

It blocks the synthesis pathway of prostaglandins

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31
Q

What is pyrexia and what is is usually caused by?

A

FEVER, caused by infections, autoimmune diseases etc.

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32
Q

Why do we shiver during fevers?

A

Because there is a difference between the new set temperature and the actual body temperature - so it makes you feel cold (increases heat)

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33
Q

Define herd immunity

A

Resistance to the spread of an infectious disease within a population that is based on pre-existing immunity of a high proportion of individuals as a result of previous infection or vaccination.

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34
Q

What are vaccinations?

A

Active process of developing immunity - results in adaptive immunity

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35
Q

What are the different ways vaccines can be administered?

A
  1. Intramuscularly
  2. Intradermally (into dermis under skin)
  3. Subcutaneously (into fat layer under skin)
  4. Orally
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36
Q

What is adaptive immunity?

A

It is when you produce Memory T and B cells - when infection occurs cells can quickly proliferate and respond

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37
Q

Vaccinations help establish ….. ?

A

Herd immunity

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38
Q

What is passive immunity?

A

When a person gets antibodies made by someone else e.g from breastfeeding/cells in the lab /invitros

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39
Q

How long does passive immunity last for?

A
  • As long as the antibodies last for
40
Q

When is a vaccine considered successful?

A

When it results in a strong antigen specific titer (measures presence and amount of antibodies in blood)

41
Q

Describe the mechanism of vaccines

A
  1. CD4+ helper T-cells produces TNF - alpha, IFN-g and IL -2
  2. CD4+ helper T-cell stimulate activated B- cells
  3. Activated B cells differentiate into plasma cells >IgG, IgA, IgE
42
Q

What are the main types of vaccines?

A
  1. Live attenuated - whole cell vaccine
  2. Inactivated - whole cell vaccine
  3. Subunit - fractionated vaccine (only part of pathogen is used)
  4. Toxoid - fractionated vaccine
43
Q

What are inactivated vaccine s and what do they protect against.

A
  • Pathogen has been killed with heat/formalin
  • humoral/antibody response (plasma cells make antibodies not T-cells)
  • no cellular immunity
  • not as strong as live vaccine (requires boosters)
  • protect against hepatitis A, Polio, Rabies and Influenza
44
Q

What are subunit vaccines?

A
  • contains portions of pathogens (polysaccharides or proteins)
  • usually proteins of different pathogens are attached together - forms conjugate subunit vaccines
45
Q

Why are polysaccharide vaccines not effective in kids <2 years old?

A

Because when T cells help is available, vaccines work better - immune system is still immature and developing
- without T cells, memory B cells cannot be formed

46
Q

What does polysaccharide vaccines protect against?

A
  • Haemophilus influenza Type B
  • Hepatitis B
  • HPV
  • Pertussis
  • Meningitis
  • Pneumonia
47
Q

What are toxoid vaccines?

A
  • vaccines specifically against toxins e.g tetanus and diphtheria toxin
  • usually combined with other subunit vaccines
48
Q

What are some vaccines contraindications?

A
  1. Patient should be healthy
  2. Should not have any previous allergic reactions to past vaccines
  3. Should not be used on individuals with weakened immune system
49
Q

List 5 notifiable diseases

A
  • Cholera
  • Covid 19
  • Pertussis
  • Diphtheria
  • Food poisoning
  • Leprosy
  • Malaria
  • Measles
  • Mumps
  • Acute meningitis
  • Tetanus
  • Tuberculosis
  • Rubella
  • Yellow fever (virus spread through mosquito bites)
50
Q

To support the reporting of the required infectious disease the Public Health England has developed… ?

A

The second generation surveillance system - national surveillance system that hold all the test results

51
Q

What kind of information needs to be acquired when filling out the form to notify the PHE?

A
  • First name and surname
  • Date of birth
  • Gender
  • Postcode
  • Contact information
  • Ethnicity
  • Sample taken date
  • Sample number
  • Sample type
  • Test method e.g PCR
  • Result
  • Result date
  • Name of laboratory
52
Q

What is the process of reporting a notifiable disease?

A
  1. Complete the notification form immediately on diagnosis of suspected notifiable disease (don’t wait for laboratory confirmation)
  2. Consult the PHE notifiable diseases poster
  3. Send the form within 3 days or notify verbally within 24hours is case is urgent
53
Q

What are the 4 common viral infections seen in primary care?

A
  1. Influenza
  2. Human papilloma virus
  3. Herpes viruses
  4. Viral rashes
54
Q

Name 3 common respiratory viral infections

A
  • Adenovirus
  • Influenza A and Influenza B
  • Parainfluenza
  • Rhinovirus
  • Coronavirus
55
Q

How many people did the pandemic influenza infect?

A

50 Million worldwide

56
Q

What are some risk factors for complicated influenza?

A
  • Neurological, hepatic, renal, pulmonary and chronic cardiac disease
  • Diabetes mellitus
  • Severe immunosuppression
  • Age over 65 years
  • Pregnancy
  • Children under 6 months
57
Q

Who are usually first immunised with influenza?

A
  • Primary school children (super spreaders)
  • Healthcare workers and carers
  • Elderly
58
Q

Human Papilloma virus cases a range of human disease? True or false?

A

TRUE

59
Q

What is a serotype?

A

A serologically and antigenically distinct variety of microorganism

60
Q

What can high risk serotypes of HPV cause?

A

Malignancy

  • Cervical cancer
  • Head and neck cancer
  • Penile cancer
  • Anal cancer
  • Vaginal cancer (rare)
61
Q

What is common in HPV?

A

Hnad and foot warts

62
Q

What vaccine protects against 4 serotypes of HPV?

A

Gardasil

63
Q

What viruses are part of the human herpes viruses?

A
  • Herpes Simplex Type 1 and 2
  • Cytomegalovirus
  • Chicken pox and shingles
  • Epstein Barr Virus
  • Human herpes virus types 6, 6A, 7 and 8
64
Q

Once you get infected with a HHV virus, you recover and do not keep it for life. True or False?

A

FALSE

- you keep it for life usually in a dormant form

65
Q

In what HHV does reactivation occur?

A
  • Shingles

- Pityriasis rosea in HHV 6 and 7

66
Q

What is the cytomegalovirus?

A

A genus of viruses in the order herpesvirales

- humans and monkeys serve as natural hosts

67
Q

Cytomegalovirus causes an infection similar to?

A
  • EBV but less pharyngitis or tonsillitis)
68
Q

Where does a serious infection of cytomegalovirus occur?

A

In the immunocompromised

69
Q

FACT

A

70% of sore throats are caused by viral infections including EBV

70
Q

What does Epstein - Barr virus cause?

A
  • Glandular fever

- Initial infection of oral epithelial cells with subsequent spread to B lymphocytes

71
Q

What kind of diseases do Epstein - Barr viruses cause?

A
  • Infectious mononucleosis - acute infections characterized by fever, fatigue, leucocytosis
  • Burkitt lymphoma - undifferentiated B lymphoma of the jaw
  • Nasopharyngeal carcinoma - proliferation of EBV - infected epithelial cells in nasopharynx
  • Central nervous system lymphoma
    Lymphoma = white blood cell cancer - leucocytes grow out of control
    Leucocytosis = increase in leukocytes
72
Q

Human herpes virus type 6 can be isolated from the saliva of about ….. % of adults

A

85%

73
Q

HHV type 6 causes what in children?

A

Roseola infantum - causes high fever and rash

74
Q

What is the % risk of a healthcare facility in the developed world developing an infection

A

10%

75
Q

What are nosocomial bacterial infections?

A

Infections caused by organisms that are resistant to numerous antibotics e.g MRSA

76
Q

What are some Infection Prevention Control Measures in Institutions

A
  • Specialised ventilation (laminar flow)
  • Cleanliness of environment and medical equipment
  • Handling, storage and disposal of clinical waste
77
Q

Give examples of IPC measures for healthcare staff

A
  • Education
  • Hand hygiene
  • Use of PPE
78
Q

Name 2 airbone infections

A

Measles and TB

79
Q

Name two droplet infections

A

Norovirus
C. difficile
Rota virus
MRSA

80
Q

Name 2 direct contact infections

A 
Influenza
Rubella
Plague 
Pertussis 
Diphtheria 
Parvovirus
81
Q

Name 3 prevention and control measures of communicable diseases

A
  1. Immunisation
  2. Interruption of infection transmission e.g quarantine, good hygiene etc.
  3. Rapid diagnosis and treatment of infected individuals
82
Q

What is a needle stick injury?

A

An incident in which the blood of a patient comes into contact with the blood of a healthcare worker

83
Q

What are the three types of exposure in health care settings associated with significant risk from blood or higher risk body fluids

A
  1. When a needle or sharp object breaks the skin
  2. Exposure of broken skin
  3. Exposure of mucous membranes (+ eyes and mouth)
84
Q

What are blood borne viruses?

A

Viruses which can be present in blood or other body fluids - high potential for transmission to another person

85
Q

Examples of blood borne viruses

A

Hepatitis B (HBV)
Hepatitis C (HCV)
HIV
- ranked in the order of most infectious

86
Q

What is the transmission rate for HBV

A

30%

87
Q

What is the transmission rate for HCV

A

3%

88
Q

What is the transmission rate for HIV

A

0.3%

89
Q

What is a post exposure prophylaxis (PEP)

A

Treatment that might be advised to recipient following a risk assessment form a known or high risk HIV or Hepatitis B exposure incident

90
Q

Name 3 infectious fluids could be transmitted during a needlestick injury?

A
  • Blood
  • Amniotic fluid
  • Vaginal secretions
  • Semen
  • Breast milk
  • Cerebrospinal fluid
  • Peritoneal fluid
91
Q

Name 2 non - infectious fluids

A
  • Urine
  • Vomit
    -Saliva
  • Faeces
    (if not visibly blood stained)
92
Q

Describe the immediate management of a needlestick injury

A
  • Bleed, wash and cover

- Inform person in charge of ward/department

93
Q

What should you do if you had a needle stick injury with high risk of HIV

A
  • Attend A&E for assessment with the details of the ‘source’
94
Q

What should you do after the immediate management of a needle stick injury -

A
  • Contact workplace health and wellbeing

- Contact site nurse from operation centre to assess whether A&E assessment is needed

95
Q

What happens to the source of a needle stick injury

A
  1. Gain consent for blood test

2. Arrange for blood test of HIV serology, Hepatitis B surface antigen, Hepatitis C antibodies

96
Q

What is the heat conservative centre in the hypothalamus?

A

Posterior hypothalamic nuclei

97
Q

What is the heat loss centre in the hypothalamus?

A

Preoptic and anterior nuclei

Musculoskeletal System (14 decks)

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