VRL INFCTNS Flashcards
● severe acute respiratory illness.
● Saudi Arabia in 2012
MIDDLE EAST RESPIRATORY SYNDROME (MERS-CoV)
What is the ETIOLOGIC AGENT OF MERS-CoV?
MERS-Coronavirus
What is the MODE OF TRANSMISSION OF MERS-CoV?
Close contact with infected person
What is the INCUBATION PERIOD OF MERS-CoV?
5 to 6 days, but can range from 2 to 14 days
What are the SIGNS AND SYMPTOMS OF MERS-CoV?
-FEVER
-COUGH
-SHORTNESS OF BREATH
-DIARRHEA
-NAUSEA AND VOMITING
What are the DIAGNOSTIC EXAMS for MERS-CoV?
● Polymerase chain reaction (PCR)
● ELISA
● Polymerase chain reaction (PCR) -
CONFIRMATORY TEST (used to detect viral RNA)
● ELISA-
SCREENING TEST used to detect the presence and concentration of specific antibodies
that bind to a viral protein.
What is the MEDICAL MANAGEMENT for MERS-CoV?
● Currently NO VACCINE is available to treat
MERS-COV
● TREATMENT IS SUPPORTIVE and based on a person’s
clinical condition
What are the PREVENTION for MERS-Cov?
● Wash hands often with soap and water for 20
seconds or use alcohol-based sanitizers
● Cover nose and mouth with tissue when coughing
or sneezing, then throw tissue in the trash.
● Avoid touching the eyes, nose and mouth with
unwashed hands.
● Avoid personal contact such as kissing or sharing
cups or eating utensils with sick people.
● Clean and disinfect frequently touched surfaces
such as doorknobs and toys
is a serious, potentially life-threatening viral infection
SEVERE ACUTE RESPIRATORY SYNDROME (SARS)
caused by the_____________ family, the SARS
associated coronavirus (SARS CoV).
Coronaviridae
● Symptoms related with the lower respiratory tract
● Initially discovered in China
● Characterized by a phase of cytokine storms
SEVERE ACUTE RESPIRATORY SYNDROME (SARS)
What are the SIGNS AND SYMPTOMS OF SARS?
● Fever 38 °C
● Fatigue
● Headaches
● Chills
● Myalgias
● Malaise
● anorexia
Less common features include the following:
- Sputum production
- Sore throat
- Coryza
- Nausea and vomiting -Dizziness
- Diarrhea
Stage 2 is the lower respiratory tract phase and is
characterized by:
● Dry cough
● Dyspnea
● Progressive hypoxemia in many cases
● Respiratory failure that requires mechanical
ventilation
What are the DIAGNOSTIC TESTS for SARS?
● PULSE OXIMETRY
● BLOOD CULTURES
● SPUTUM GRAM STAIN AND CULTURE
- To lure out other infection
●VIRAL RESPIRATORY PATHOGEN TEST- influenza test A and
B viruses and respiratory syncytial virus
- Lure out types of viral infection
● LEGIONELLA AND PNEUMOCOCCAL URINARY ANTIGEN
● WBC-decreased
●Mild hyponatremia and hypokalemia
●Elevated lactate dehydrogenase alanine
aminotransferase and hepatic transaminase
●Elevated creatine kinase level -Serum antibodies to
SARS-CoV in single serum specimen
●RT-PCR (reverse transcriptase polymerase chain
reaction)
●CHEST REDIOGRAPH - interstitial infiltrates
MEDICAL MANAGEMENT for SARS:
● CORTICOSTEROIDS
- Decrease mucus production
● ANTIVIRAL AGENTS (Ribavirin)
● PROTEASE INHIBITORS (Lopinavir, Ritonavir)
● INTERFERON
● MONOCLONAL ANTIBOIDES- emergency prophylaxis,
neutralizes virus activity in vitro and in vivo *
Intravenous immunoglobulin (IVIG)
● NITRIC OXIDE
● GLYCYRRHIZIN - inhibits vitro replication of the virus
● VACCINE- phase 1 clinical trial 2004
What is the ETIOLOGIC AGENT of SWINE FLU (H1N1)?
INFLUENZA A VIRUS SUBTYPE H1N1
What is the MODE OF TRANSMISSION of SWINE FLU (H1N1)?
CLOSE AND DIRECT CONTACT WITH INFECTED PERSON
What is the INCUBATION PERIOD of SWINE FLU (H1N1)?
ranges from 1 to 4 days with an average
of 2 days up to 7 days
-It is a type A influenza virus that affects pigs.
-It can pass to humans through contact or air contamination
SWINE FLU (H1N1)
What are SIGNS AND SYMPTOMS of SWINE FLU?
-COUGH
-FEVER
-SORE THROAT
-STUFFY OR RUNNY NOSE
-BODY ACHE
-HEADACHES
-CHILLS
-FATIGUE
What are DIAGNOSTIC TESTS for SWINE FLU?
-PCR
-RAPID ANTIGEN OR ANTIBODY IMMUNOASSAYS
-VIRAL CULTURE
What is the MEDICAL AND TREATMENT MANAGEMENT for SWINE FLU?
● Antipyretic
● Analgesics
● Increased fluid consumption
● Bedrest
● Antiviral agents (Oseltamivir/ Zanamivir
● Isolation
● Vaccination - Influenza virus vaccine trivalent
(Fluzone, Flucelvax)
● Influenza virus quadrivalent (Afluria Quadrivalent,
Fluarix)
What is the PREVENTION AND PRECAUTION for SWINE FLU?
● Seek medical care if suspected with H1N1
● Isolate patient immediately in a negative pressure
air handling
● Wash hands frequently
● Wear face mask
● Social distancing or avoid large gatherings
● Routine cleaning and disinfection
● Pre-exposure prophylaxis
What is the MODE OF TRANSMISSION of EBOLA VIRUS?
Direct contact with blood or bloody fluids, objects of a person infected with ebola and infected animals.
What is the INCUBATION PERIOD of EBOLA VIRUS?
2 to 21 days after exposure to Ebola, but the average is 8 to 10 days.
What are the SIGNS AND SYMPTOMS of EBOLA VIRUS?
● Fever
● Severe headache
● Muscle pain
● Weakness
● Lack of appetite Internal bleeding
● Fatigue
● Diarrhea
● Vomiting
● Abdominal pain
● Unexplained hemorrhage
What is the MEDICAL MANAGEMENT of EBOLA VIRUS?
● Symptoms of Ebola and complications are treated
as they appear
→ Palliative Care
● Provide intravenous fluids and balancing
electrolytes in the body
● Maintain oxygen status and blood pressure
→ There is hemorrhagic bleeding, so if there is
blood loss we need to monitor oxygen stat & bp.
● Treat other infections if they occur.
● ERVEBO - First US FDA approved vaccine
(December 2019)
What are the DIAGNOSTICS TESTS for EBOLA VIRUS?
Within a few days after symptoms begin:
- Antigen-capture enzyme-linked
- immunosorbent assay (ELISA) testing
- lgm ELISA
- Polymerase chain reaction (PCR)
- Virus isolation
Later in disease course or after recovery
● IgM and IgG antibodies
Retrospectively in deceased patients
● Immunohistochemistry testing
● PCR
● Virus isolation
● also known as benign prostatic hyperplasia
● proliferation of the cellular elements of the prostate.
BENIGN PROSTATIC HYPERTROPHY
How to PREVENT EBOLA VIRUS?
● Practice careful hygiene
● Do not handle items that may have come in contact
with an infected person’s blood or body fluids
● Isolate patients with Ebola from other patients.
● Practice proper infection control and sterilization
measures
● Wear appropriate personal protective equipment
● Notify health officials if had direct contact with blood
or body fluids of a person who is sick with Ebola
What are the CLINICAL MANIFESTATIONS of BENIGN PROSTATIC HYPERTROPHY?
● Urinary frequency
● Urinary urgency
● Nocturia
● Hesitancy
● Incomplete bladder emptying Straining
● Decreased force of urine stream
● Dribbling
What are the RISK FACTORS of BENIGN PROSTATIC HYPERTROPHY?
-AGING PROCESS
-HORMONAL IMBALANCE (estrogen, androgen)
What is the MEDICAL MANAGEMENT for BENIGN PROSTATIC HYPERTROPHY?
● PHARMACOLOGIC MANAGEMENT:
● Terazosin (Hytrin) - A1-adrenergic receptor blocker.
Relaxes bladder sphincter.
● Finasteride (Proscar) - Inhibits 5-alpha red.
Reduction of glandular hyperplasia
● Balloon dilation - To relax smooth muscle of the
bladder neck and prostate
● Immediate catheterization
● Watchful waiting - To monitor disease progression
What are the DIAGNOSTIC TESTS for BENIGN PROSTATIC HYPERTROPHY?
● Digital rectal examination
● Urinalysis
● Urine culture
● Prostate-specific antigen (PSA) Serum electrolytes
● Blood urea nitrogen (BUN)
● Ultrasonography (patient w/ full bladder)
● Endoscopy of the lower urinary tract
● Cystoscopy
● Renal biopsy
What is the SURGICAL MANAGEMENT for BENIGN PROSTATIC HYPERTROPHY?
● TURP (Transurethral Resection of the Prostate)
● Open prostatectomy
● Transurethral incision of the prostate (TUIP)
● Transurethral microwave therapy (TUMT)
● Transurethral needle ablation of the prostate
(TUNA)
● Prostatic stents
● Laparoscopic prostatectomy
What is the NURSING MANAGEMENT POST-OPERATIVE for BENIGN PROSTATIC HYPERTROPHY?
● Increase oral intake of client
● Maintain patency of continuous bladder irrigation
(cystoclysis)
● Practice asepsis
● Use sterile saline to prevent water intoxication
● Prevent thrombophlebitis
● Monitor for bleeding
● Post removal of catheter- observe for urinary
retention
● Teach Kegel’s exercises
● Avoid giving client anticholinergic agents
● Instruct client to avoid the following after discharge:
● Vigorous exercises
● Heavy lifting
● Straining
● Prolonged sitting and standinG
● Crossing the legs
an Infection of the female reproductive organ
PELVIC INFLAMMATORY DISEASE (PID)
What is the ETIOLOGIC AGENT of PID?
POLYMICROBIAL, but the common pathogens are
-N. Gonorrhoea and
-Chlamydia
What are the RISK FACTORS of PID?
● Having sex under 25 yrears old
● Multiple partners
● Sex without any protections (condoms)
● Recently having intrauterine device (IUD) infected =
foreign body can cause infection
● Douching
● History of pelvic inflammatory disorder
What are the CLINICAL MANIFESTATIONS of PID?
● Asymptomatic until infection become severe
Additional Notes: some women with PID don’t have
symptoms, they are called asymptomatic until the
infection becomes severe
● Pain in lower abdomen (most common symptom)
● Pain in pelvic area
● Fever (temp above 38 °C = fever is sign of
infection)
● Painful sex
● Painful urination
● Irregular bleeding
● Increased of foul smelling vaginal discharges
● Tiredness
● Vomiting
● Fainting
What are the DIAGNOSTIC TESTS for PID?
● Pelvic examination
● Cervical culture
● Urine test
● Pelvic ultrasound
● Endometrial biopsy
● Laparoscopy
What is the MEDICAL MANAGEMENT for PID?
(common brand named antibiotics)
● Azithromycin
● Cephalosporin
● Ceftriaxone
● Doxycycline
● Clindamycin
● Metronidazole
● Unasyn
● Probenecid
What are the LONG TERM COMPLICATION of PID?
● Infertility
● Ectopic pregnancy:occurs when a fertilized egg
implants and grows outside the main cavity of the
uterus.
● Chronic pelvic pain
● Tubo-ovarian abscess
How to PREVENT PID?
● Teach client to practice safe sex (condom or
abstain)
● Screen for sexually transmitted infections
● Avoid douches
Additional Notes:
○ Normal flora of vaginal discharges =
Lactobacilli which helps fight off infections.
○ Lactic acid it produces also acts as a
chemical barrier.
○ Too much douching = flora may also be
killed or disappear.
● Teach clients to wipe from front to back after -
wiping back to front may spread bacteria from anus
to vagina and urethra which can lead to infection
