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192 Cards in this Set
- Front
- Back
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of the dzs affecting the world most that are preventable and cureable are caused by what
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infectious agents
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what is a communicable dz
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infectious dz capable of spreading
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what is a parasite
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org. that lives on or in another org., deriving benefit from it and providing nothing in return
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what is pathogenicity
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ability to cause dz
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what is virulence
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pathogen's power to cause severe dz
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what is infectivity
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ease w/ which a pathogen can spread in a pop.
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who are the hosts for septicemia
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elder, young, immunocompromised
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what is endemic
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dz that occurs commonly all the yr round
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what is pandemic
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epidemic that affects all or most countries in the world at the same time
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what is normal flora
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organisms that are found in a significant portion of the healthy population; may still have the potential to cause disease
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what is infection
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result of invasion by pathogenic microorganisms (note that some use this term synonymously with disease)
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what is colonization
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presence of microorganisms at a site (some infer no damage)
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what is the triad of infectious dzs
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host, infectious agent, environment
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what are common host factors
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socioeconmic factors, nutritional status, previous immunity, underlying dzs, behavioral factors
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what are some common agent factors
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pathogenicity, virulence, ability to survive in host/resevoir organisms, ability to survive in differential environmental conditions, ability to develop resistance to Tx
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what are some common environemental
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T, dust, humidity, use of antibiotics and pesticides
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which epidemuc came out in 2009
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H1N1
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what is reservoir
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The human or animal population or environment in which the pathogen exists, and from whom it can be transferred
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what are the 2 types of tranfer
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vertical, horizontal
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what is zoonosis
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an dz which can spread to humans
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what is a vector
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living creature that can transmit infection from 1 host to another
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what is direct contact
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transmission from the reservoir to the contact
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how are infections transferred during inhalation
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droplets w/ pathogen, aerosols produced by mechanical devices, dusts, animal droplets
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what is transferred through ingestion
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many viruses, enteric pathogens, toxins, fecal-oral transmission
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what is innoculation
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direct introduction to host via a defect in the skin
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what is smaller than bacteria
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viruses
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what does a virus consist of
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piece of DNA or RNA with a protein shell
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what cannot replicate themselves
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viruses
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what are single celled organisms
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bacteria
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are bacteria pro or eukaryotic
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prokaryotic
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what is prokryotic
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lacks nuclear membrane
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how do bacteria replicate
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binary fission
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true or false: protozoa are multicellular
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false/ unicellular
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what are protozoa composed of
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paired chromosomes
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are protozoa pro or eukaryotic
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eukaryotes
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what are eukaryotes
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possess a nucleus
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how do protozoa reproduce
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by sexual or asexual process
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are fungi pro or eukaryotic
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eukaryotic
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what is vertical transmission
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mom to a baby
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what is in the cell wall of fungi
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chitin or cellulose
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what is a helminths
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parasites- large organisms with complex life cycles
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what are the 4 cardinal signs of inflammation during infection
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1. dolor 2. calor 3. rubor 4. tumor
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what is dolor
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pain
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what is calor
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heat
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what is rubor
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redness
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what is tumor
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swelling
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what are the 2 categories of symptoms of infection
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general/systemic vs. local
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when are general/systemic symptoms seen in infection
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in the acute phase
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what are the general/systemic syptoms seen in infection
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high grade spiking fever, chills, flushing, increased pulse rate
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what is functional latecia
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loss of fx caused by inflammation
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what was added to the 4 cardinal symptoms in 1970
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functional latecia
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the cardinal signs of inflammation are what
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the manifestation of local infection
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what are the local signs of infection
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localized redness, heat, producation of swelling or tumors
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if a pt has high fever they should also have what
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tachycardia
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what is seen on the radiography of an infection
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Pulmonary infiltrates
Fibrous thickening of cavity lining Gas and swelling in the soft tissue Radiopaque masses or accumulation of fluid within body cavities and organs |
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what is seen on the labs of an infection
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An elevation in the ESR,
Peripheral blood leukocytosis Alteration in plasma proteins Elevation in gamma globulins Presence of certain reactants such as CRP or Production of type specific antibodies |
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what are mycobacterium
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group of obligate aerobes, rod shaped bacilli that stain weakly (acid alcohol) gram positive
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mycobacteria lepre cause what
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leoprasy
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what type of bacteria has high lipid cell wall content
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atypical mycobacteria (MOTT) and MTB
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what is atypical mycobacteria and MTB recognized by
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growth and response to light
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what are some examples of atypical mycobacteria
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M. kansasii-Marinum, M. Scrofula, MAC complex, M. Fortuitum-Chelonei, M. lepre
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Chlamydiae obligate intracellular parasites closely related to what
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gram negative bacteria
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what are the 3 chlamydial species known to cause dz
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C.trachomatis, C. pneumonia and C. psittaci.
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gram negative bacteria contain what
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endotoxin
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what is endotoxin
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potent inducer of cytokines and are associated with fever, bacteremia, and septic shock
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what are some gram neg. cocci that cause dz to human
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N. menigitidis, N. gonorrhea (diplococci), and Moraxella catarrhalis species.
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what may cause sinusitis, otitis, bronchitis, epiglottis, pneumonitis, cellulitis, arthritis, and endocarditis.
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H. influenzae and other haemophilus species
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what do H. influenzae and other haemophilus species often cause
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sinusitis, otitis, bronchitis, epiglottis, pneumonitis, cellulitis, arthritis, and endocarditis.
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what is one of the more common adult infections caused by H influenzae type b
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pneumonia
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what are enteric bacteria
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large gram neg rods: E. coli, Klebsiella, Serratia, Salmonella, Shigella, Proteus and Enterobacter.
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most psuedomonas infections are what
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nonsocomial
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what is the exception of pseudomonas in respect to socomial vs nonsocomial
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risk of infection in IVDA
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what is is the most commonly encountered nosocomial species
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P. aeruginosa
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P aeruginosa may cause what
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osteomyelitis, Malignant external otitis, CNS infections, and skin-soft tissue infections
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what are the species of gram positive rods
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Anthrax, listeria, Tetanus, C. diphtheria Bacillus cereus and Clostridia
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what are much more common source of infections in particular the streptococci
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gram + cocci
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what are some conditions seen w/ streptococci
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pharyngitis, pneumonia, rheumatic fever, impetigo, and endocarditis.
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what are primarily commensals
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anaerobic bacteria
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what do commensals inhabit
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the skin, mouth, gut, female genital tract
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what usually cause infection when displaced from their normal sites into tissues or closed body spaces e.g lung, CNS, visceral “gut” perforation, bacteremia,or endocarditis
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anaerobic bacteria
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anaerobic bacteria usually cause infection when
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when displaced from normal sites into tissues or closed body spaces
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what are "closed body spaces"
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lung, CNS, gut
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what are the smallest free living organism
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mycoplasma
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mycoplasmas are commonly found where
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in plants, animals, humans
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what are the biologic properties of mycoplasmas
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resistance to beta-lactam antibiotics, and their adhesion to host cells
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the biological properties of mycoplasmas result from what
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lack of cell wall, in they have a cell membrane
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what are rickettsia
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small gram neg. obligate intracellular bacteria
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what will rickettsia cause
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typhus group, RMSP, ehrlichiosis, q fever
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what are the important B and tissue protozoa
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plasmodium (malaria), babesia, toxoplasma, sarcocystis, pneumocystis, leishmania, trypanosoma
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what is enterobius vermicularis and associated dz
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pinworm/enterobiasis
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what is ascaris lumbricoides and associated dz
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roundworm/ascariasis
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what is trichuris trichiura and associated dz
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whipworm/trichuriasis
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what is necator americanus and associated dz
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new world hookworm/ hookworm infection
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what is strongyloides stercoralis and associated dz
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no other name/strongyloidiasis
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how do fungi/ yeast appear in what 2 forms
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rounded, budding (yeast like) vs. hyphae (molds)
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most fungi that are pathogens for humans are what in nature
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saprophytes
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what pathogens virtually never cause dz in the normal host
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cryptococcus, candida, pneumocystis, fusarium
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endemic fungi are more aggressive in who
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immunocompromised
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what are the endemic fungi
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histoplasma, aspergilla
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what spirochetes are of clinical importance
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Treponema (Syphilis)
Leptospira (rat urine) Borrelia(tick-borne) |
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how is mycobacterium identified
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acid fast stain
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how are bacterial organisms identified
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gram stain
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what are the 3 forms of barriers
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mechanical, chemical, biological
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what are the mechanical barriers
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skin, membranes
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what are the chemical barriers
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microcidal molecules; acidic pH
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what is a biological barrier
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commensal microbes
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what are the cells that eat microbes
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Phagocytes (macrophages, dendritic cells)
Pinocytes (neutrophils) |
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what are cells that respond to stress signals
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natural killer cells, phagocytes
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what provides mechanism for memory
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T and B cells
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what is seen in a pt with fever of unknown origin
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1. illness of at least 3 weeks w/ no cause 2. T > 101 (38.3) 3. fever w/out dx after 1 week of eval. in hospital
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the most common cause of fever of unknown origin is what
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infections and multisystemic dz
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what are some multi systemic dzs
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autoimmune disorders and neoplasms
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in what % of fever w/out known origin is undiagnosed
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25%
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what are the demographics of dz in fever of unknown origin
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adults: infectious 25-40%, cancer 25-40%, autoimmune disorders 10-20%; chilren infectious 30-50%, cancer 5-10%, autoimmune 10-20%
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what are the etiologies of infection in fever of unknown origin
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Tuberculosis
Endocarditis GB, HIV. Viral: EBV, CMV. Abscess: liver, spleen, brain, bone |
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what are the etiologies of neoplasms (cancer) in fever of unknown origin
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lymphomas, leukemia, metastatic ca
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what are the etiologies of autoimmune dosoreders
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SLE
Polyarteritis nodosum Giant cell arteritis > sed rate age 50 Polymyalgia rheumatica sed rate and age 50 |
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what are the miscellaneous etiologies of fever of unknown origin
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Thyroiditis
Sarcoidosis Pulmonary emboli Drug fever Factitious fever (self-induced) |
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despite extensive evaluation the dx remains elusive in what % of pts
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10-15%
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of the ppl that have an elusive dx affter extensive evaluation (fever of unknown origin) what % will the fever abate spontaneously
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75%
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what is included in a thorough Hx of a pt w/ fever of unknown origin
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1. Routine Hx/PE
2. Family 3. Occupational, social (sexual practices, IV drug use). 4. Dietary (unpasteurized products, raw meat). 5. Exposures (animals, chemicals) 6. Travel |
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in fever of unknown origin you should document the fever in order to exclude what
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factitious self induced fever
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what complaints usually accompany fever in cases of fever of unknown origin
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tachycardia, chills, piloerection
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what can be a subtle finding in fever of unknown origin
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rash
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what are the adult differentials for fever of unknown origin
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TB, GB, endocarditis, HIV, polyarteritis, SLE
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what are the child differentials for fever of unknown origin
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juvenile rheumatoid arthritis
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what are the diagnostics done for fever with unknown origin
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CBC c Diff, platelet count
Gram stain Blood cultures Cultures of other body fluids Chest x-ray CAT scan of the abdomen and pelvis Gallium or PET scan |
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what are nonsocomial infections
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those not present or incubating at the time of hospital admission and developing 48-72 hours after admission
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what is the easiest/most effective means of preventing a nonsocomial infection
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handwashing
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what are the sources of contamination in hospitals
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intrumenst, fluid, air, meds
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what are the sources of contamination in pt flora
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cutaneous, GI, GU, respiratory
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what are the sources of contamination in med. personnel
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colonized, infected, transient carriers
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what are the sources of contamination in invasive devices
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urinary caths, vascular caths, endotracheal tubes, wounds, endoscopes
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what is the most common etiology of nonsocomial infections
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urinary tract 39%
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what is the least common etiology of nonsocomial infections
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bacteremia 6%
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what are the risk factors for nonsocomial infections
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Endotracheal intubation
Bladder catheter IV catheters (central lines, arterial lines) Hyperalimentation Immunosuppression Operative procedures |
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% whatof patients who enter the hospital free of infection acquire a nosocomial infection resulting in prolongation of the hospital stay, increase in cost of care, significant morbidity, and a what % mortality rate
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5%; 5%
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what are the classes of anti-infectives
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bacteriocidals, bacteriostatics, anti TB, antiviral, antifungal, antiparasitic
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what drugs are in the bacteriocidal class
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penicillins, cephalosporins, Vancomycin, Bacitracin
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what drugs are in the bacteriostatic class
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sulfonamides (Septra, Bactrim), Gentamycin, erythromycin, Biaxin, Zithromax, Tetracycline
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what drugs are in the anti TB class
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Isoniazid, Rifampin, Ethambutol
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what drugs are in the antiviral class
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acyclovir, Zidovudine (AZT), Amantidine
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what drugs are in the antifungal class
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nystatin, fluconazole, clotrimazole
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what drugs are in the antiparasitic class
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flagyl, kwell, quinine
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what are the antipyretics
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Acetylsalicylic acid (Aspirin)
Acetaminophen (Tylenol®) Ibuprofen (Advil®, Motrin®) |
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what are the antiinflammatory agents
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Acetylsalcyclic acid (Aspirin)
Ibuprofen (Advil®, Motrin®) Indomethacin (Indocin®) Naproxen (Anaprox®, Naprosyn®) Ketorolac (Toradol®) Sulindac (Clinoril®) |
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what are the 5 mechanisms of action of antibiotics
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interference w/ cell wall, cell membrane, inhibition of protein synthesis, nucleic acid synthesis, antimetabolic activity inhibiting folic acid synthesis
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what are the fluoroquiniolones
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alatrofloxan, ciprofloxan, gatifloxacin, levofloxacin, lomefloxacin, moxifloxacin, norfloxacin, ofloxacin, trovafloxacin
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what are the antimicrobials/anti-infectives
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Augmentin (Amoxicillin/Clavulanate)
Zosyn ( Piperacillin/Tazobactam) Ticarcillin, Nafcillin, Dicloxacillin Mezlocillin. Oxacillin, Methicillin Pipercillin Cloxacillin Qxacillin |
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what are the different cephalosporins
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1st Generation- kelfex, Ancef
2nd Cefixime, Lorabid 3rd Rocephin, Fortaz 4th Omnicef, Suprax |
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what are the methods to reduce number of infections
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prophylaxis, vaccination, limit contacts, wash hands!!!
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what are standard precautions
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basic preventative measues- all pts/all time:
Gloves for contact except perspiration and intact skin Hand Hygiene Patient Placement Other PPE based upon anticipated exposure Safe Work Practices Environmental measures |
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what is not part of respiratory protection
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surgical mask
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what is the 1st intent in respiratory protection
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preventing wound contamination by infectious droplets from HCW’s respiratory tract
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what is the 2nd use in respiratory protection
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barrier protecting HCW’s nose and mouth from large droplet splashes, sprays of infectious material
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why is a surgical mask not sufficient for respiratory protection
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particles can enter the edge of the mask
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approx. how many influenza associated deaths are seen each year during influenza season
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36,000
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persons over what age account for more than 90% of influenza deaths
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65
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deaths of how many children (0-18) due to influenza were reported in 2007-08
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85
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there is an avg of how many hospitalizations during influenza season each yr
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226,000
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trivalent inactivated influenza vaccine should only be administered how and how are doses separated
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IM; every 4 weeks
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what is the regimin for the zoster vaccine
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Single dose of zoster vaccine for adults 60 years of age and older whether or not they report a prior episode of shingles
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Persons with a chronic medical condition may be vaccinated with a zoster vaccine unless what
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contraindication or precaution exists for their condition
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who is vulnerable to syncope
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adolescents and young adults
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Since February 2005 what three vaccines targeted to adolescents have been licensed
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Meningococcal conjugate (MCV)
Tdap Human papillomavirus (HPV) |
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what is vasovagal response
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syncope
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what are the statistics for HPV vaccine
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15,037 reports
93% classified as non-serious 7% classified as serious 44 deaths reported no common pattern to the deaths the cause of death was explained by factors other than the vaccine |
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HPV vaccine is not approved for who
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those <9 or > 26
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what is adecel
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Tdap
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who is Tdap approved for
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adults, those 11-64
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how is Tdap given
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single dose
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Pneumococcal Polysaccharide Vaccine are Recommended for who
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adults greater than/equal to 65 or adults of any age w/ normal immune system who have chronic illness: CV or pulm. dz, diabetes, alcoholism, cirrhosis, cerebrospinal fluid leak, cochlear implants
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how is hep a vaccine given
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Inactivated whole virus
Pediatric and adult formulations Adult formulations for persons 19 years and older 2 dose series (0, 16-18) |
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what is the minimal interval b/w doses of hep a vaccine
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6 calendar months
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true or false: Hep a vaccine:Not necessary to repeat the first dose if the interval is longer than the recommended 6 to 18 months
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true
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how is the MMR vaccine given
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live attenuated virus,
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MMR vaccine is effective in preventing dz caused by these viruses in what % pts after 1 dose
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95%
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All adults born after what yr should have documentation of at least 1 dose (or other evidence of immunity)
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1956
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Meningococcal Polysaccharide Vaccine (MPSV) - Menomune is approved for who
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persons 2+
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Meningococcal Polysaccharide Vaccine (MPSV) - Menomune is administered how
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sub Q injection
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Meningococcal Conjugate Vaccine (MCV) - Menactra is approved for who
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pts 11-55
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Meningococcal Conjugate Vaccine (MCV) - Menactra is administered how
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IM injection
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if MCV is not available what is an acceptable vaccine
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MPSV
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what are the dzs w/ occupational risk for healthcare workers
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Hepatitis B
Influenza Measles Mumps Rubella Varicella Meningococcal disease (certain laboratory personnel only) |
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if a pt has DM, CVD, COPD, immunodeficient they need what
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PPV23 Flu (TIV)
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of a pt is asplenic they need what
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PPV23 MCV4/MPSV4
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if pt is > or = to 65 they need what
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Flu PPV23
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if the pt is a healthcare worker they need
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Flu, MMR, Hep b, Td/Tdap VZV
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if pt is IVDA/MSM they need what
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Hep a and b
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if th pt is pregnant they need what
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Flu (TIV), Td/tdap
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if pt is a college freashmen they need what
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MCV4/MPSV4, MMR
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what are some common vaccine errors
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Wrong vaccine or wrong diluent
Wrong vaccine dosage Expired vaccine Timing and spacing mistakes Wrong site, route, or needle length |
