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communicable disease

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infectious disease capable of spreading from person to person

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parasite

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lives in or on a host deriving benefit

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pathogenicity

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ability to cause disease

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virulence

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pathogen's ability to cause a severe disease

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point-source outbreak

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group of individuals exposed to a single source of infection

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extended-source outbreak

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group of individuals exposed to a single source of infection over an extended period of time

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endemic

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disease that occurs all year long

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pandemic

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epidemic that affects world at the same time

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formites

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inanimate objects that passively transmit pathogens (tpwels, door knobs)

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vector

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living creatures that transmits pathogen

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host factors

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underlying disease, immunity, nutrition, socioeconomic

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agent factors

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pathogenicity, infectiousness, ability to survive in animal/human hosts

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environmental

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temperature, dust, chemicals

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population factors

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herd immunity, the ability of a pathogen to sustain itself

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routes of transmission

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inhalation
direct contact
ingestion
inoculation

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local defenses

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skin
mucosa
gut

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skin

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barrier, sebum (antimicrobial), normal flora

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mucosa

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tears, lysozyme, surface phagocytes, cilia

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gut

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gastric acid, normal flora, bacteriocins, mucosal phagocytes

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innate immunity

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phagocytosis
classical pathway
alternative pathway

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phagocytosis

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neutrophils and macrophages

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classical pathway

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initiated by antigen-bound antibody molecules usually IgG or IgM. Initial enzyme is C1. Proteins bind to cell membrane initiating lysis. May use opsonins.

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alternative pathway

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can operate without antibody interation. It is initiated by the spontaneous hydrolysis of C3. Proteins bind to cell membrane initiating lysis.

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adaptive immune response

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activated by innate immune response mechanisms. Allows a small number of genes to generate a vast number of different antigen receptors.

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lymphoid tissue contains a mixture of B&T lymphocytes

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naive cells
effector cells
memory cells

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naive cells

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that have matures, left the bone marrow of thymus, have entered the lymphatic system, but that have yet to encounter their cognate antigen

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effector cells

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that have been activated by an antigen, and are actively involved in eliminating a pathogen

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memory cells

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the long-lived survivors of past infections

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Humoral - B-lymphocytes develop into clones of antigen producing cells causing _______ antibody production. Become plasma cells which actually _____ the antibodies. Also requires input from helper ___________.

Antibody binding to _______ makes them easy target for phagocytosis. Produce IgA, IgD, IgE, IgG, and IgM.

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increased
produce
T-cells (CD4+)

antigen

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Cellular - T-lymphocytes release _______ and ________: _______ which form pores in the target cell's plasma membrane, allowing ions and water to flow into the infected cell, and causing it to _____. Produce ____ and ____ cells according to antigen.

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perforin
granulysin
cytotoxins
burst
CD8+
CD4+

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successful pathogens

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survive in environment
attachment to host
overcoming defenses
ability to damage host
ability to replicate within host

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manifestations of infectious disease

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fever
inflammation
rashes

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fever

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useful in combating infections
can cause delirium or seizures

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treatment for fevers

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ibuprofen
acetaminophen
aspirin
cooling

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inflammation

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vasodilation
leaking tissue fluids
accumulation of neutrophils/macrophages
release of active aubstances - leukotrienes, lactoferrin, lysozymes, free radicals, oxygen metabolites

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signs of inflammation

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pain
heat
redness
swelling

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detection of inflammation

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C-reactive proteins - activates classical complement pathway

various plasma proteins alpha10antitrypsin

ESR (erythrocyte sedimentation rate) - increases with inflammation

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rashes

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sometimes painful if causes by infectious disease

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clinical assessment of fever:
community acquired

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respiratory
UTI
GI
skin
blood (bacteremia)

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clinical assessment of fever:
fever of unknown orgin

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infections
cancer
autoimmune
endocrine
metabolic
pulmonary emboli

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clinical assessment of fever:
body temperature can varies in adults and ____ in children. Women's ________ ____ can elevate temperature by one degree or more.

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more
menstral cycle

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clinical assessment of fever:
temperature is usually ______ in the evening. It can be raised by physical activity, strong emotion, eating, heavy clothing, medications, high room temperature, and high humidity. This is especially true for ______.

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highest
children

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clinical assessment of fever:
Rectal temperature of ____ and less may be entirely normal. A rectal temperature og _____ or above should always be considered a fever.

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100.4 F
100.5 F

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Most bacteria and viruses that cause infections in people thrive best at ____. Raising the temperature a few degrees can give your body a winning edge. In addition, a fever ______ the body's immune system to make more white blood cells, antibodies, and other infection-fighting agents.

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98.6 F
activates

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clinical assessment of fever:
if unsure, give drugs such as ________ a 3rd generation cephalosporin which has broad spectrum activity against Gram Positive and Gram Negative bacteria.

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ceftriaxone

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never give ____ to children under 16 years (i would place the cutoff at 18 years). May cause ____ syndrome.

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aspirin
Reyes

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Reyes Syndrome

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accumulation of fats (especially in live) and encephalopathy

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clinical assessment of fever:
control of fever:
hyothalamus

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hypothalamus controls several regulatory systems including the control of body temperature, blood pressure, body water, feeding and reproductive activity

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clinical assessment of fever:
control of fever:
some hypothalamic neurons sense changes in temperature, osmotic pressure, glucose and reproductive hormones. These neurons can be affected by fever-producing agents, such as _______ and ________. In addition, some neurons show ________ changes in their firing rates and temperature sensitivities.

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interleukin-1
prostaglandins
circadian

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clinical assessment of fever:
control of fever:
When cold themoreceptors in the skin or from deep thermal receptors send messages to the hypothalamus. ______ is released, its target organ being the anterior lobe of the pituitary gland. When TRH reaches the pituitary gland, it releases ______. The target organ of TSH is the thyroid gland. Upon receiving TSH, the thyroid then produces ______. _______ increases cellular metabolism to make heat.

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TRH (thyroid releasing hormone)
TSH (thyroid stimulating hormone)
thyroxin
thyroxin

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clinical assessment of fever:
other reactions to temperature:
cold

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vasoconstrictions (blood diverted from skin to keep heat)
reduced sweating
skin hairs raised (erector pili muscle contracted)
shivering
increased metabolic rate

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clinical assessment of fever:
other reactions to temperature:
hot

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increased sweating to release heat via water
vasodilation (blood diverted to skin to lose heat)
skin hairs lowered
reduced metabolic rate