WEEK 1 - IDENTIFYING AND MANAGING INFECTION

Question 1

Systemic effects of inflammation - fever/chills

Answer 1

Macrophages and mast cells at the site of infection release cytokines (Interleukin1) which travel to the brain. This information causes a resetting of the bodies thermostat in the hypothalamus to a higher temperature, inducing a fever.

Question 2

Systemic effects of inflammation - Myalgia

Answer 2

Cytokines released from inflamed tissue interacts with muscle cells to alter gene expression. Break down muscle genes go up.

The breakdown of protein in muscle tissue travels to the liver to develop other proteins like WBC, antibodies and complement proteins.

Question 3

Systemic effects of inflammation - Tachypnea

Answer 3

Increased basal metabolic rate requires a greater demand for oxygen.

As a byproduct of more bodily processes occurring during inflammation, more CO2 is a present as it is a byproduct of these processes.

Question 4

Systemic effects of inflammation - headache/anorexia

Answer 4

Similiarly, cytokines interact with the CNS to cause this. The cytokine Interferon induces a headache.

Question 5

Diagnostic investigations indicating systemic inflammation

Answer 5

• C - REACTIVE PROTEIN

A protein released from the liver in response to certain cytokines (present in inflammation).

Normal range: 10mg/L - above this shows inflammation is present

Non-specific - doesn’t show the source of inflammation

• EURETHROCYTE SEDIMENTARY RATING

How quickly RBC settle

Normal range: 0-22mm/hour

Proteins created in the liver to assist in coagulation travel to the site of inflammation via the bloodstream. This causes RBC in the blood to clump together, falling quickly.

Non-specific - doesn’t show the source of inflammation- WBC COUNT

Normal Range: 4500 - 11000 mg/L

Increase WBC production is a sign of infection

Question 6

Pneumonia - pathology

Answer 6

• Pneumonia is an infection of the alveoli that fills them with fluid.
• Macrophages and other WBC work to fight off and destroy the Pneumonic pathogens that enter the alveoli, resulting in an inflammatory response. The by-product of this inflammation is a purulent fluid that fills the alveoli, inhibiting gaseous exchange.
• Patients may be seen to increase breathing rate, in an effort to expel excess CO2 in the lungs, or cough to remove irritating purulent fluid from the alveoli.
• OBSTRUCTIVE LUNG DISEASE - INCREASE COMPLIANCE, DECREASE RECOIL

Symptoms
- - Dyspnea - difficulty breathing, shortness of breath
- Chest pain
- Cough - force out fluid
- Fever

Risk factors
- Smoking - smoking damages the cilia in the trachea. This makes the mucociliary elevator less effective and less likley to remove pneumonic pathogens and fluid by-products from the respiratory tract.
- Genetic - genetic and auto-immune disorders make people more susceptible to pathogens that can cause pneumonia.
- Exposure to infected people
- Age - older people/young children usually have weaker immune systems

treatment
- oral or IV AB.

Question 7

Meningitis - pathology

Answer 7

• Inflammation of the meninges
  
  • Dura, Arachnoid, subarachnoid space and Pia
  • Meningitis commonly occurs in Arachnoid, subarachnoid space and Pia mater.
• Causes
  
  • bacteria (more serious), virus
• Symptoms
  
  • high fever
  • intense headache
  • stiff neck
  • altered mental status, drowsiness, confusion, delerium, hypersensitivity to light
  • in extreme cases, can spread to underlying brain tissue causing loss of sensory and motor function, coma or death.
• more severe in infants and elderly

treatment
- steroids to limit inflammation
- AB

Question 8

SEPSIS (MORE INFO)