Week 7- Infectious Disease 1 Flashcards
The study of microscopic organisms, such as bacteria, viruses, archaea, fungi and protozoa
Microbiology
This discipline includes fundamental research on the biochemistry, physiology, cell biology, ecology, evolution and clinical aspects of microorganisms, including the host response to these agents
Microbiology
True or false: We are continually exposed to vast array of microorganisms
True
True or false: Natural systems are not weakened or altered by ecologic stresses
False
(they are weakened)
___________ organisms spread quickly without adequate precautions
Resistant
True or false: Health care professionals must remain vigilant toward preventing disease
True
Examples of immunization efforts
MMR, poliomyelitis, Hepatitis B
PT undoubtedly deal with patients on a __________ basis who are undergoing treatment for infectious diseases
Routine
Infections must be treated effectively to allow full recovery and enable the patient to __________ during physical rehabilitation
Progress
True or false: Infections in the respiratory tract, kidneys, gastrointestinal (GI) tract, and other organs and tissues must also be resolved so that the patient can fully engage in exercise and other rehabilitation interventions
True
True or false: As PTs we do not have to present infection and control of transmission during our service
False
Signs and symptoms of infectious diseases
-Fever and chills
-Sweating
-Malaise
-Nausea
-Vomiting
-Increased number of leukocytes or change in the types of leukocytes
Elevated WBC count
Leukocytosis
Decreased WBC count
Leukopenia
The most abundant WBC type is the __________
Neutrophil
True or false: Leukopenia is a result of bone marrow disease, radiation, or medications, including chemotherapy
True
Leukopenia __________ the risk for patients becoming infected
Increases
A reduction of the neutrophil count
Neutropenia
Range for WBCs
5000-10000/mm3
Blood count for leukocytosis (trending upward)
> 10000/mm3
Blood count for leukopenia (trending downward)
<4000/mm3
Normal fever temperature
98.6 F-99.5 (average of 98.6 F)
Temperature regulating center
Hypothalamus
This causes the set-point of the hypothalamic thermostat to rise
Pyrogens
The rise in the set point of the hypothalamic results in activation of the hypothalamus to…
Conserve heat and increase heat production
A change in body temperature is a characteristic __________ symptom of infectious disease
Systemic
True or false: Fever does not accompany non-infectious causes such as inflammatory, neoplastic, and immunologically mediated diseases
False
(it does)
Fever patterns
Intermittent
Remittent
Sustained or continuous fever
Recurring/relapsing
Some people with serious infection do not initially develop fever but instead express…
Become tachypneic and confused
Develop hypotension
True or false: Rupture of an abscess and drainage into other tissues can spread the infection
True
List other examples of signs and symptoms of infectious diseases
Rash with fever
Red streaks
Inflamed lymph nodes
Joint effusion
True or false: Older adults are more susceptible to infectious diseases
True
Older adults experience increased __________ and __________ (especially in the frail debilitated older adult)
Morbidity
Mortality
Changes in cell-mediated or T-cell function in aging
-Decrease in the number of naive T cells
-Increase in the number of memory T cells
-Slower to respond and requires a stronger stimulus
Extrinsic factors apart from the immune system can lead to __________ susceptibility to infection in the older adult
Increased
True or false: Extrinsic factors apart from the immune system do not lead to increased susceptibility to infection in the older adult
False
(can lead)
Ways infectious diseases can affect the older adult
-Atrophic skin is more easily damaged
-Decreased cough and gag reflexes make it more difficult to control secretions
-Decreased bronchiolar elasticity and mucociliary activity
-Denture associated infections
-More likely to have an implanted device
Symptoms of infectious diseases in older adults are often _______, ________, or ________
Vague
Blunted
Atypical
True or false: In aging, older adults can have more serious infections with little or no fever because of an impaired thermoregulatory system or masking effects of drugs
True
Lower threshold of temperature for infection in older adults
99-100 F
True or false: Infectious disease symptoms in aging are not vague, blunted, or atypical
False
(they are)
Older adults may have more serious infections with little or no fever because of an impaired ___________ or masking effects of ____________
Thermoregulatory system
Drugs
True or false: A higher threshold of temperature for infection should be used in aging adults
False
(lower)
An organism that establishes a parasitic relationship with its host
Infection
Infection begins with transmission of an…
Infectious organism
A pathogen may _________ the body surface and be destroyed by first-line defenses such as intact __________ or ___________ that prevent further invasion
Contaminate
Skin, mucous membrane
True or false: A sub-clinical infection may occur in which no apparent symptoms are evident other than an identifiable immune response of the host (antibodies levels increase)
True
A clinically apparent infection in which the host-parasite interaction causes obvious injury and is accompanied by…. This outcome is called….
One or more clinical symptoms
Infectious disease
The period between the pathogen entering the host and the appearance of clinical symptoms
Incubation period
____________ herald the end of the incubation period
Disease symptoms
Occurs after a microorganism has replicated but remains dormant or inactive in the host, sometimes for years
Latent infection
True or false: The host does not harbor a pathogen in sufficient quantities to be shed at any time after latency and toward the end of the incubation period
False
(the host may harbor)
Time period when an organism can be shed
Period of communicability
True or false: An asymptomatic host can still transmit a pathogen
True
Types of organisms
-Viruses
-Mycoplasmas
-Bacteria
-Rickettsia
-Chlamydiae
-Protozoa
-Fungi
-Helminths
-Mycobacteria
-Prions
___________ begins with the transmission of a pathogen to the host
Infection
Successful transmission depends on a…
Pathogenic agent
Reservoir
Portal of exit from the reservoir
Mode of transmission
Portal of entry into the host
Susceptible host
Sequence of events in infections
Chain of transmission
Also called pathogenic agents
Pathogens
Pathogens are microorganisms that have the capacity to cause _______ (arouse a pathologic response) in the ______
Disease
Host
Two factors that influence the likelihood of a pathogen producing infectious disease and the type of disease produced
Characteristics of the organism
Susceptibility of the host
True or false: Pathogens are ineffective parasites because they stimulate a disease response, which may harm the host and eventually kill the pathogen
True
The ability of the organism to induce disease
Pathogenicity
Pathogenicity depends on…
-The organism’s speed of reproduction in the host
-The extent of damage it causes to tissues
-The strength of any toxin released by the pathogen
The potency of the pathogen in producing severe disease
Virulence
Virulence is measured by…
Case of fatality rate (# of people who of the disease divided by the number of people who have the disease)
They do not cause disease in people with intact host defense systems but can clearly cause devastating disease in people with severe defects in host defense mechanisms
Opportunistic pathogens
An environment in which an organism can live and multiply
Reservoir
Human and animal reservoirs can be ___________ or __________ carriers of the pathogen
Symptomatic
Asymptomatic
A _______ maintains an environment that promotes growth, multiplication, and shedding of the parasite without exhibiting signs of disease (e.g., hepatitis
Carrier
The place from which the parasite leaves the reservoir
Portal of exit
Examples of portal of exits
-Secretions and fluids (respiratory secretions, blood, vaginal secretions, semen, tears)
-Excretions (urine and feces)
-Open lesions
-Exudates (pus form an open wound or ulcer)
-HIV has more than one portal of exit
Knowledge of the __________ is essential for preventing transmission of a pathogen
Portal of exit
Modes of transmission
-Contact transmission
-Airborne transmission
-Droplet transmission
-Vehicle transmission
-Vector borne transmission)
Types of contact transmission
Direct contact
Indirect contact
Inanimate and intermediate objects
Fomites
True or false: Telephone, sphygmomanometer, bedside rails, tray tables, countertops, and other items that come into direct contact with the infected person
True
Small particles (less than 5 μm) that they are capable of floating on air currents within a room and remain suspended in the air for several hours
Airborne transmission
Examples of airborne transmission
Tuberculosis, chickenpox, rubeola measles
Larger particles (greater than 5 μm) than airborne particles
Droplet transmission
True or false: Droplet transmission remain suspended in the air
False
(they don’t; they fall out within 3 ft of the source travel only a short distance)
Occurs when infectious organisms (e.g., salmonellosis) are transmitted through a common source (e.g., contaminated food, water, and intravenous [IV] fluid) to many potential susceptible hosts
Vehicle transmission
Involves insects and/or animals that act as intermediaries between two or more hosts
Vector-borne transmission
A pathogen may enter a new host by…
Ingestion (GI tract)
Inhalation (respiratory tract)
Bites
Injury of the skin
Microbes commonly enter through contact with ___________ and, less frequently, ____________
Mucous membranes
Transplacentally
Host susceptibility
-Biologic and personal characteristics
-Immunosuppressive agents and corticosteroids
-Inadequate or absent hand hygiene
-Presence of underlying medical disorders
-Breaches of body integrity
Lines of defense
-1st line of defense (includes microbial antagonism of normal flora of microorganisms)
-2nd line defense (inflammatory process)
-3rd line of defense (immune system)
Goal of control of transmission
To break the chain of transmission at the most cost-effective point(s)
Ways to break the chain of transmission
-Education for everyone
-Isolation and barriers
-Comprehensive immunizations
-Prophylactic antibiotic therapy
-Improved nutrition, living conditions, and sanitation
-Avoiding risk taking behaviors
-Correction of environmental factors (proper handling and disposal of secretions, excretions, and exudates; isolation of infected clients and quarantine of contacts)
These type of precautions assume any person may be contagious
Standard precautions
True or false: All clients receiving therapy are not asymptomatic hosts during the period of communicability
False
(may be asymptomatic)
Infectious or safe wastes?
-Blood and components
-All disposable sharps (used or unused)
-Urine, stool, or emesis if visibly contaminated with blood
-Vaginal secretions
-Semen
-Cerebrospinal fluid
-Synovial fluid
-Pericardial fluid (mediastinal tubes)
-Amniotic fluid
Infectious wastes
Infectious or safe wastes?
-Cotton balls, band-aids
-Gloves (latex and latex-free), masks, or other personal protective devices
-Nasal secretions
-Sputum
-Feces
-Urine
-Vomitus
-Tears
-Sweat
Safe wastes
Formerly known as nosocomial infections
Healthcare associated infection
The infections that develop in hospitalized persons or persons admitted to a health care facility that were not present before admission
Healthcare associated infection (HAI)
Most healthcare-associated infections (HAI) are caused by…
Pneumonia, GI tract infection, and surgical site infections
True or false: HAI can result in prolongation of hospital stays, increase in cost of care, and significant morbidity and mortality
True
Causes of HAI
-The frequent use of invasive devices for monitoring or therapy
-The increased use of immunosuppressants and antibiotics
-More colonization and infection by multidrug-resistant organisms
-Greater debilitation and severity of illness of hospitalized clients who acquire these infections
-Lack of hand hygiene predispose people to such infections and superinfections
-Central line–associated bloodstream infections (CLABSIs)
-Catheter-associated urinary tract infections (CAUTIs)
-Ventilator-associated pneumonia (VAP)
-Surgical site infections (SSIs)
_____________ is the easiest and most effective means of preventing HAIs and must be done _______, even when gloves are used
Hand hygiene
Routinely
