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57 Cards in this Set

  • Front
  • Back
Infection
Invasion of the body tissue by a microorganism and their proliferation there
Assymptomatic
Microorganism produces no clinical evidence of disease
Disease
A detectable alteration in normal tissue function
Chain of Infection
-Infectious agent: microorganism
-Reservoir: the normal location for the pathogen
-Portal of exit from the reservoir:
-Mode of transportation: Direct (physical) and indirect (ingestion) contact, air and dust, fomites, arthropod (bites) and accidental (needle sticks) inoculation.
-Portal of entry: GI tract, blood and blood derivatives, respiratory tract, wounds
-Susceptible host:
Natural Immunity
-Nonspecific response to a foreign invader
-Physical barriers: skin, mucus membranes, chemical
Acquired Immunity
-Specific response to a foreign invader
-Involves the immune system responding to a specific foreign antigen
-Includes humoral and cellular response
-Acitve or Passive
Acitve Acquired Immunity
-Antibodies produced in the body in response to an infection
-Long lasting
-Natural or artificial
Natural Active Acquired Immunity
-Formed in the presence of an active infection: chicken pox, hep A
-Lifelong
Artificial Active Acquired Immunity
-Immunized with vaccines or toxoids and stimulates antibody production
-Lifelong though may require a booster
Passive Acquired Immunity
-Antibodies are produced by another source
-Short acting
-Natural (breast milk) or artificial (hep A)
Natural Passive Acquired Immunity
-Antibodies transferred naturally from immune mother to infant at birth or through breast milk
Artificial Passive Acquired Immunity
-Immune serum from another source transferred by injection
-Exp: hep A
Immunizations
-Important to health promotion
-Many adults not adequately immunized
-Adult immunizations include:
*hep B
*Influenza
*Diptheria/Tetanus
*Measles, Mumps, Rubella (MMR)
Inflammmatory Response
-Chemical medications are released in response to tissue injurt or organisms to:
*Control blood loss
*Wall of organism
*Activate phagocytes
*Promote scar formation and tissue regeneration
Inflammatory Response
-Local: redness, swelling, pain, heat, and loss of function
-Systemic: increased body temp, fatigue, increased WBC, and swollen lymph nodes
Contact Transmission
-Prevent transmission of organism through direct or indirect contact
-Herpes, Diptheria, Staph, Hep A, and wound infection
-Private room
-Glove and gown worn
-Door can be open
-Direct: skin-to-skin
-Indierct: skin-to-object (MRSA, lice, scabbies)
Droplet Transmission
-Prevent transmission of large molecular organisms (>5microns)
-Diptheria, Pertussis, Strept throat, Scarlet fever, Meningitis, Rubella, Influenza, SARS
-Private room
-3ft distance or wear mask w/glasses
-Door allowed to be open
-Coughing, sneezing, talking droplets can travel up to 3 feet
Responsibilities of the CDC
-Prevent the transmission of communicable diseases
-Collect data
-Updating recommendations
-Publishes the Mortality and Morbidity Report
-Disease Surveillance
-Research
Cardinal signs of inflammation
-Redness
-Pain
-Swelling
-Heat
-Loss of function
Four stages of the infectious process
-Incubation: time between contact and onset of signs and symptoms
-Prodromal period: the period between the earliest symptoms and the onset of a rash or fever
-Illness period: the onset of the disease
-Convalescent period: recovery phas
Airborne Transmission
-To prevent transmission of small particles (<5 microns)
-Negative air pressure room
-Door closed
Particulate respiratory mask tight fit (orange)
Anti-Infective Agents
-Treatment and prophylaxis of variuos bacterial agents
-Mechanisms of action:
*inhibits cell wall synthesis
*alters plasma membranes
*inhibits protein synthesis
*inhibits synthesis of essential metabolites
-Mode of action:
*bactericidal or bacteristatic (inhibit new growth)
*not active against viruses and fungi
-Spectrum:
*broad or narrow
*divided into categories depending on the chemical similarities and anitmicrobial spectrum
Pharmacological Management
-Antibacterial:
*broadest group
-Antiviral:
*inhibits viral DNA replication
-Antifungal:
*inhibits mycotic (fungal) infections
Toxic Shock Syndrome
-Caused by a toxin of Staph A. when in the bloodstream in susceptible individuals
-55% of menstrating women
-Associated with tampon use
S/S and Tx of Toxic Shock Syndrom
-Sudden fever
-Decreased b/p
-Headache
-Diarrhea
-Red rash on palms of hands and soles of feet
-Fluids and antibiotics
Stapphylococcal
-Normal flora of skin and respiratory tract
-Usually nonpathogenic but can cause serious infections
-Cause of nosocomial UTI and endocardititis
-Pathogenic staph in 30% of health people
-Contact precautions
Streptococcal
-Virulent and contagious
-Causes of Scarlet fever, strept throat, and impetigo
-GAS
Coccidioidomycosis
-Fungal infection
-Indiginous to San Joaquin Valley
-Valley Fever
-Inhalation of spores into lungs after rainfall
-Rainfall increases growth
-Sunlight inhibits growth
-Dx is made by skin test
-Tx is Amphotercin B
-Very toxic
-Hypersensitivity reactions
-Phlebitis
-Renal changes
-Hypokalemia
-Standard precautions
Clostridium Difficele
-Anarobic Spore forming organism
-Common nosocomial causing diarrhea
-Easily spread
-Usually starts within 48 hours after antibiotic therapy started
-Vancomycin: drug of choice
-Contact precautions
MRSA
-Methicillin Resistant Staph
-Contagious form of staph not susceptible to penicillin
-Caused by misuse of antibiotics
-Requires isolation until 2 negative cultures
-Vancomycin drug of choice
-Contact isolation
VRE
-Vancomycin Resistant Enterococcus
-Gram positive
-Normal Flora of GI tract
-20 fold increase since 1989
-VRE may serve as a reservoir of genes coded for vanco resistance that can be transferred to staph
-Penicillin used but no cure
Lyme Disease
-Multi-system disorder caused by Borrelia Burgdorferi organism carried by the TICK
-Identified in the 1970s
-Progresses in stages
-Starts with skin lesion and progresses to cardiac and neurological abnormalities
Tuberculosis
-A chronic infection caused by the tubercle bacillus
-Identified in the 1900s
-A leading cause of death/responsible for 3 million deaths per year
-TB was on the decline until 1985, increased d/t:
*AIDS
*Homelessness
*Poverty
*Drug abuse
*Alcohol abuse
Tuberculosis
-Droplet nuclei gains into upper lobes of lungs and multiples
-Spread by cough, sneeze, speaking
-4-5 weeks without treatment the germs are numerous and spreads to the blood stream
-Immune system is stimulated
-Droplet isolation
S/S Tuberculosis and Screening
-Fatigue
-Weight loss
-Anorexia
-Low grade temperature, night sweats, long lasting cough
-Screening:
*Intradermal Mantoux Test
*Purified Protein Derivative (PPD)
*Read in 48 hours
*Those exposed wil have a + reaction:
~>5mm + HIV + or recent close contact
~>10mm + if from high risk group
~>15mm + for all others
*+ skin test does not mean active TB
*Sputum is the only definitive Dx
*AFB sputum obtained in arm, need 3 consecutive specimens
*Chest X-Ray used for screening only
Tuberculosis Classification
-0 = no TB
-1 = TB exposure, no disease
-2 = TB exposure, and + PPD
-3 = TB disease, + sputum, + skin
-4 = History of TB disease
-5 = TB suspect (3 months)
Tuberculosis Treatment
-Medications: Rifampin, Isoniazid
-Chemotherapy (medications)
-6 months to 1 year
-2 months of of daily INH, RIF, ENH
-4 months twice daily
-up to 1 year of 2 drugs twice daily
-Reduces the risk of developing active TB
-Recent skin test converter
-Pediatric with know close contact
-High risk
-6 months of INH only
Tuberculosis Medications
-Isoniazid (INH):
*Side effects: peripheral neuritis, hepatoxicity, hypersensitivity, and optic neuritis
-Rifampin (RIF):
*Side effects: hepatitis, febrile reaction, GI disturbance, peripheral neuropathy, and hypersensitivity
-Ethambutol:
*Side effects: skin rash, GI disturbances, malaise, peripheral neuritis, optic neuritis
-Streptomycin:
*Side effects: audiotoxicity, nephrotoxicity, hypersensitivity
-2nd line drugs:
*Ethionamide
*Capreomycin
*Kanamycin
*Pyrazinamide
*Para-aminosalicylic acid (PAS)
Hepatitis
-Infects the liver
-Many people do not have and S/S but may have serious or fatal complications
like cirrhosis, liver CA, chronic liver disease
-5-10% become carriers
-5 types
Types of Hepatitis
-Hep A: fecal/oral
-Hep B: serum
-Hep C: non A non B
-Hep D: delta
-Hep E: enteric
Heptatis A
-Fecal/oral
-Ingestion of contaminated foods
-poor sanitation
-Day care centers
-Incubation: 15-19 days
-Vaccine available
Hepatitis B
-Blood and body fluids
-Sexually transmitted
-Needles
-Incubation: 28-165 days
-Vaccine available
-10% carrier status
Hepatitis C
-Non A, Non B
-Needle stick
-Blood transfusion
-Mother to baby
-Incubation: 15-120 days
-S/S can occur up to 30 years after exposure
-No Vaccine
Hepatitis D
-Delta
-Needle sticks
-Sexually transmitted
-Must have Hep B to get Hep D
-Incubation: 21-140 days
-High carrier rate
-Vaccine for Hep B
Hepatitis E
-Enteric
-Poor santitation
-Water
-Not seen in the US
-Incubation: 15-65
-Unknown immunity
Hepatitis Protection
-Blood borne pathogen
-Universal precautions
-Hep B vaccine
Causative Organism
The types of organism that cause infection are bacteria, rickettsiae, viruses, protozoa, fungi, helminths
Reservoir
Any person, plant, animal, substance, or location that provides nourishment for microorganisms and enables further dispersal of the organism
Mode of Exit
The organism must have a mode of exit from the reservoir. Organisms exit through the respiratory tract, the GI tract, the genitourinary tract and the blood
Route of Transmission
Is necessary to connect the infectious source with its new host. Organisms may be tramsmitted through sexual contact, skin-to-skin contact, percutaneous injection, or infectious particles carried through the air
Carrier
A person who carries, or transmits an organism and who does not have apparent signs and symptoms of infection
Susceptible Host
For infection to occur a host must be susceptible (not possessing immunity to a particlular pathogen)
Portal of Entry
Is needed for the microorganism to gain access to the host
Colonization
Microorganisms present in or on a host, without host interference or interaction and without eliciting symptoms in the host
Infectious Disease
The state in which the infected host displays a decline in wellness due to the infection
Microbiology Report
Usually shows:
*the smear and stain
*the culture and organism identification
*the antimicrobial susceptibility (sensitivity)
CDC and OSHA
-CDC goal: disease reduction
-OSHA goal: reduction of risk exposure
-CDC Regulations: optional
-OSHA Regulations: mandatory