Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clin Path > Week 3 > Flashcards

Week 3 Flashcards

1
Q

Define infection

A

When germs enter the body, increase in number, and cause the body to react

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define colonization

A

Presence of pathological organism that is increasing in numbers. However, symptoms may not be displayed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the transmission based precautions?

A

1) Contact precaution: clean hands before entering and after leaving the room, disposable gloves, disposable gown, disinfect equipment
2) Enteric contact isolation: clean hands (soap) before and after, gloves, gown
3) Droplet precaution: clean hands before and after, eyes, nose and mouth covered
4) Airborne precautions: clean hand before and after, n-95 or higher level mask, door to room must remain closed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the aspects of diagnostics?

A

1) culture (blood, mucus, saliva, stool)
2) antigen testing
3) clinical presentation (lab values)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some signs and symptoms of infection?

A

1) fever, chills, enlarged lymph nodes, malaise “not feeling good”, rash, red streaks, joint effusion
2) Cardiac: tachycardia, hypotension
3) Nervous: confusion, stiff neck, headache
4) GI: nausea, vomiting
5) Kidney: flank pain, dysuria, hematuria
6) pulmonary: shortness of breath, lower O2 saturation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Define infectious organisms (bacteria)

A
  • Simple, unicellular
  • Differing shapes
  • Complex wall
  • Stain-gram + or -
  • Aerobic or Anerobic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is Clostridium difficile?

A

(Bacterial) (enteric contact isolation)

  • Often follows a course of antibiotics, detrimental to the normal gut flora
  • Prolific diarrhea with characteristic smell
  • Commonly diagnosed with stool culture
  • Anerobic
  • Metronidazole (Flagyl)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Staphylococcus?

A

(Bacterial)

  • Often present on the skin,
    typical portal of entry
  • Prone to biofilm creation
    on prosthetic implants
  • Prone to abscess
    formation, purulent
    drainage
  • Staph aureus –most
    common cause of septic
    arthritis, osteomyelitis,
    bacterial endocarditis,
    sepsis
  • trimethoprim-
    sulfamethoxazole,
    tetracyclines, and
    clindamycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is MRSA (Methicillin-resistant Staphylococcus Aureus)?

A

(Bacterial) (contact precautions)

IV Vancomycin is the typical
treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is Streptococcus?

A

(Bacterial) (droplet precaution)

  • Streptococcus pyogenes is one of the most
    common bacterial pathogens of any age
  • Gram positive
  • Diverse range of infections
    o Pharyngitis (strep throat)»»»»»»»
    o Scarlet fever»»»»»»»»»»»»
    o Cellulitis
    o Necrotizing fasicitis
    o Rheumatic fever
    o Glomerulonephritis
  • Streptococcus pneumoniae
    o Pneumococcal pneumonia»»»»»»>
    o Otitis media
    o Meningitis
  • Penicillins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is Pseudomonas aeruginosa?

A

(bacteria)
* Opportunistic-burns
* Common HAI
* Pneumonia, wound infections, UTI,
sepsis, meningitis- immunocompromised
* Moist environments
* Variety of antibiotics
* Characteristic Blue-green drainage and smell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is Mycobacterium Tuberculosis?

A

(Bacterial) (airborne precautions)

  • QuantiFERON-TB Gold
    test, others
  • May be latent for long
    periods of time, then
    become active
  • Primarily effects lungs,
    but extra pulmonary TB is
    possible with
    “granulomas” forming in
    other tissues (skeletal)
  • Cough, night sweats,
    fever, fatigue, chest pain
  • Rifampin-
    antimycobacterial
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is Klebsiella (Carbapenem-resistant)?

A

(Bacterial) (contact precautions)

  • Gram negative
    causing urinary,
    wound, respiratory
    and blood stream
    infection
  • Only two remaining
    antibiotics are
    effective: Colistin
    and Tigecycline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is VRE (Vancomycin-resistant Enterococci)2?

A

(Bacterial) (contact precautions)

  • Enterococci are
    normally found
    in intestines,
    female genital
    tract and
    enviornment
  • Resistant to
    vancomycin
  • Daptomycin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is Chlamydiae4?

A

(bacteria)
* Common STD
* Urethritis, burning with urination
* Discharge
* In women can cause pelvic inflammatory disease
* Typically treated with doxycycline or azithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is Rickettsiae Borrelia Burgdorferi?

A
  • Tiny, gram negative bacteria
  • Vector transmission vis lice or tick
  • Borrelia Burgdorderi most commonly
    in the USA
  • Latent onset of symptoms, up to one
    month
  • 5-14 days, bullseye rash
  • Fatigue, chills, headache, arthralgias
  • Aseptic meningitis, cranial nerve
    impairment
  • Lyme’s arthritis, cardiac
    manifestations
  • IV Ceftrioxone or oral doxycycline
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Describe Infectious Organism
(Viruses)

A
  • Very small intracellular parasite
  • Requires a living host cell
  • Protein coat and core of either DNA or
    RNA
  • Note the “shedding” (last phase) where host cell reproduced virus and now they are going out and host cell lysis, highly communicable and can be asymptomatic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is Hep A?

A

(Virus)

“Infectious” “daycare hep”

Fecal-oral transmission
Most recover fully in 4-8 weeks
Vaccine available

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is Hep B?

A

(Virus)

1) Blood borne pathogen, sexually
transmitted, needle sticks,
mother to child
2) Most common cause of chronic
hepatitis
3) Vaccine available

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is Hep C?

A

(Virus)

“Post transfusion”

1) Previously blood transfusion
related, IV drug use
2) 60-70% of chronic hepatitis,
associated with liver cancer
3) No vaccine available

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is Human Immunodeficiency Virus
(HIV)?

A

(Virus)

  • Blood borne pathogen-blood, sexual activity, maternal-child
  • Blood test-viral load
  • Initially, flu-like symptoms, then latency, followed by
    immune destruction (T cells)
  • Multi system involvement:
    o Pain syndromes
    o Lipodystrophic syndrome
    o Neurologic involvement
    o Cardiopulmonary
    o Integumentary
  • Anti-Retroviral treatments
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the characteristic of an opportunistic infection?

A

Takes advantage when the immune system is compromised

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the Herpes types?

A

(Virus) (types 1-8) (type 3: airborne precaution)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Influenza

A

(Virus) (droplet precaution)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is covid 19?

A

(Virus) (airborne precaution)

  • Rapid and PCR testing
  • Variable presentation
  • SARS-CoV-2 Severe Acute Respiratory
    Syndrome
  • Cytokine storm, microthrombosis,
    hypoxemia and ischemia
  • Acute Respiratory Distress Syndrome
    (ARDS) 20% of patients with severe disease
  • Cardiomyopathy 1/3 of patients admitted to
    ICU
  • Acute thromboembolic disease
  • Multiorgan failure
  • Critical Illness Myopathy and
    Polyneuropathy
  • Treatment: Antivirals (Paxlovid,
    Remdesivir), Immune
    Modulators (Tocilizumab)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is Candida Albicans?

A

(Fungi)

  • Single celled
  • Proliferate in dark, warm, moist environments
  • Treatment: Diflucan, Fluconazole
27
Q

What is Plasmodium?

A

(Parasite)

Malaria
* Plasmodium live in the red blood cells
* Headache, fever, chills escalate to
seizures, organ failure, and death.
* Early detection is essential
* Treatment: Antimalarial drugs, often taken
prophylactically if traveling to high-risk
location, Quinine

28
Q

Give examples of Infectious Organism
Macroparasite-Helminths

A

1) pin worms
2) tape worms

29
Q

What is SEPSIS?

A

1) a life threatening organ dysfunction caused by a deregulated host response to an infection or inflammatory response
2) can lead to septic shock

30
Q

What is septic shock?

A
  • A subset of sepsis in which underlying circulatory and cellular abnormalities are
    profound enough to substantially increase mortality
    1) Hypotension
    2) Serum lactate >2
  • > 4 consistent with septic shock and associated with poor prognosis (78%)
31
Q

What is bactermia?

A

“AKA positive blood culture”

Presence of bacteria in blood
Not everyone with sepsis has bactermia
Those with bactermia can develop sepsis

32
Q

How do you detect SEPSIS?

A

SIRS: systemic inflammatory response syndrome
(Any combo of these trigger SIRS alert because it can be the start of sepsis)

1) Temp >38 deg C or <36 deg C
2) HR >90 beats/min
3) Respiratory rate >20 breaths/min
4) WBC >12,000

33
Q

What is the qSOFA?

A

(Used to detect sepsis)

quick sequential (sepsis-related) organ failure assessment
* Altered level of consciousness
* SBP < 100mmHG
* Respiratory rate >22 breaths/min

34
Q

What are the risk factors for sepsis?

A
35
Q

What are the signs and symptoms of sepsis?

A
  • Fever
  • Tachycardia
  • Tachypnea
  • other symptoms depend on location of infection

SEPSIS
S- shiver
E- extreme pain
P- pale (or discolored skin)
S- sleepy, confused, difficult to arouse
I- “I feel like I might die”
S- shortness of breath

36
Q

List the 5 conditions/procedures that increase O2 consumption

A

1) Sepsis (50-100%)
2) sever infection (60%)
3) work of breathing (40%)
4) getting out of bed (40%)
5) chest PT (35%)

37
Q

How do you diagnose sepsis?

A

Biomarkers
* Lactate- found in blood to show systemic tissue hypoperfusion
* C-reactive protein (CRP)- protein produced by liver that indicates rapid increase in acute inflammation and infection
* Procalcitonin (PCT)- released into the blood in response to bacterial infection or tissue injury

Imaging
* Can help determine initial location of infection

38
Q

What is the medical management for sepsis?

A

(Blood lactate issue)
1) hemodynamic stabilization
2) fluids
3) vasoactive drugs (^ BP)

(CRP/PCT issue)
1) infection control
2) antibiotics
3) identify source

39
Q

Describe shock

A
  • Lift-threatening manifestation of circulatory failure
  • Decreased oxygen delivery and increased oxygen consumption
  • Leads to cellular and tissue hypoxia that causes cellular death and dysfunction of vital organs
40
Q

What are the stages of shock?

A

1) injury or infection
2) pre-shock (can be compensated)
3) shock (compensatory mechanism is no longer effective, symptoms begin to present)
4) end organ dysfunction (irreversible without intervention)
5) death

41
Q

What are the types of shock?

A

1) Distributive
* Septic
* Anaphylactic
* Neurogenic
* Endocrine
2) Hypovolemic
* Hemorrhagic
* Non-hemorrhagic
3) Cardiogenic
4) Obstructive

42
Q

Describe septic shock

A

When sepsis symptoms become extreme
It’s a cascade effect
Hypotension -> poor organ profusion -> multisystem organ failure

43
Q

Describe distributive shock

A

1) septic
2) Anaphylactic
* Severe allergic reaction that results in cardiovascular and respiratory distress
* Commonly brought on by drugs, food, insects or latex
3) Neurogenic
* Mostly occurs in trauma to the brain or spinal cord
* Disrupts the autonomic pathways leading to impaired vagal tone
4) Endocrine
* Caused by adrenal failure leading to sudden drop in blood pressure

44
Q

Describe hypovolemic shock

A

Decreased intravascular volume
1) Hemorrhagic
* GI bleed
* Rupture of aneurysms or blood vessel trauma
* Spontaneous bleeding with high INR
2) Non-Hemorrhagic
* Organ losses
* Vomiting, diarrhea, drains, medication induced diuresis, burns, heat stroke

45
Q

Describe cardiogenic shock

A

Caused by intracardiac issues leading to decreased cardiac output and systematic hypoprofusion
* Cardiomyopathies
* Large MI
* Cardiac arrest
* Arrhythmia
* Mechanical
* Insufficiency of valves or aneurysms

46
Q

Describe obstructive shock

A

Caused by extracardiac issues leading to decrease in cardiac output
* Pulmonary
* PE
* Pulmonary HTN
* Mechanical
* Compression of LE causing decreased return to R ventricle
* Large pneumothorax
* Tamponade

47
Q

What are some monitoring tools to use

A

1) APACHE II
* Used in the first 24 hours in ICU
* Possible score of 0-71
* Higher scores associated with increased severity and higher risk of death
2) SOFA
* Sequential Organ Failure Assessment
* Used after 24 hours and beyond
* Higher scores are more predictive of mortality

48
Q

Is bed rest necessary?

A

Yes, but can be detrimental to a multitude of systems if extended (2+ days but can be as little as 2 hours “pressure ulcers”)

49
Q

What are the cardiovascular bed rest complications?

A
  • Increased HR at rest and at all levels of activity
  • Decreased resting and maximum stroke volume
  • Decreased maximum cardiac output
  • Increased risk for venous thrombosis and thromboembolism
  • Decreased orthostatic tolerance
  • Decreased aerobic conditioning
  • Increased venous compliance
50
Q

What are the pulmonary bed rest complications?

A
  • Pneumonia
  • Increased secretions
  • Decreased tidal volume/reduced ventilation
  • Increased respiratory rate
51
Q

What are the skeletal bed rest complications?

A
  • Disuse osteoporosis
  • Decreased muscle mass
  • Decreased muscle strength
  • Decreased muscle endurance
52
Q

What is the integumentary bed rest complication?

A

Pressure ulcers

53
Q

What are the renal bed rest complications?

A
  • Urinary calculi
  • Urinary retention
  • Overflow incontinence
54
Q

What is the GI bed rest complication?

A

Constipation

55
Q

What is the endocrine bed rest complication?

A

Glucose intolerance and insulin insensitivity

56
Q

What is ICU acquired weakness?

A
  • Includescriticalillnessmyopathy(CIM),criticalillnesspolyneuropathy(CIP),or a mixture of both
  • Diagnosismadeincasesinwhichapatientisnotedtohaveclinicallydetected weakness with no plausible cause other than critical illness
  • IncreasingbodyofevidencethatICUAWleadstopoorqualityoflifeand persistent weakness lasting long after ICU discharge
57
Q

What are the risk factors of ICU acquired weakness?

A
  • Prolonged ventilation (as little as 3 days)
  • Sepsis or multiple system organ failure
  • High doses of corticosteroids and neuromuscular blocking agents

(Incidence is difficult to determine due to a wide variety of diagnosis and criteria of research)

58
Q

What is ICUAW pathology

A

1) results from cascade of effects from multiorgan failure
2) ischemia and muscle breakdown for protein use
3) nerve damage from lower O2
4) hyperglycemia results in decreased circulation to peripheral nerves
5) Muscle weakness (as little as 4 days)
6) muscle wasting (as little as 10 days)

59
Q

ICUAW prognosis

A
  • More sever cases -> poor prognosis
  • weakness can persist for months to years after hospitalization
  • poor QOL
  • PICS-postICUsyndrome
  • Collective of physical, mental, and emotional symptoms that continue to persist of discharge form ICU
  • Cognitive symptoms- poor memory, concentration, and problem solving
  • Emotional symptoms- PTSD, anxiety, depression
  • Physical symptoms- fatigue, weakness
60
Q

What is the best way to tackle ICUAW

A

Prevention

61
Q

What does the evidence say regarding ICUAW?

A
62
Q

Describe the ABCDEF bundle

A

(PT can really help in D,E,F)

It represents an evidence based guide for clinicians to approach the organizational changes needed to optimizing ICU patient recovery and outcomes

A- assess, prevent, manage pain
B- both spontaneous awakening trial “SAT” and spontaneous breathing trials “SBT”
C- choice of analgesia and sedation
D- delirium assess, prevent and manage
E- early mobility and exercise
F- family engagement and empowerment

63
Q

When does mobilization begin?

A

1) As soon as the acute crisis is stabilized
2) The patient is trending in the recovery direction
3) The A through F bundle is being applied

Clin Path (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions