Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
34 Cards in this Set
- Front
- Back
|
Neisseria Gonorrhoeae
|
Gram - / diplococci/ likes humid atmospheres with CO2 in 35º-37ºC temp.//oxidizes glucose.
Diognosis/TESTING--Gram stain of urethral specimens is accurate for symptomatic males only! Thyer Martin agar//choclate with antibiotic agar is selective to pathogenic strands of nisseriae -Nucleic acid amplification assays(best test) |
|
|
Neisseria Gonorrhoeae
|
-2 to 5 day incubation/Purulent discharge form involved site.
-95% of men have acute SX -primary infection is cervix on women -SX- Vaginal discharge dysuria, abdominal pain, salpingitis, tubovarian abscesses,eptopic pregnancy, and PID...gonococcal opthalmia in newborns. |
|
|
Gonoccoccemia
|
Sisseminated infections with septicemia. Infection of skin and joints occur in 1-3% of infected woman (will occur if continuly undetected/untreated)
SX--fever, migratory arthralgias, suppurative arthritis, and a pustular rash on an erythematous base(on extremities)--leading cause of purulent arthritis in adults. |
|
|
Meningococcemia
|
N. Meningitidis(gram- diploc)
Septicemia (Meningococcemia) -Life threatening if untreated -thrombosis of small blood vessels and multi organ involvment. -Small petechial skin lesions on trunk and lower extremities -intervascular coagulation with shcok -bilateral destruction of adrenal glands(Waterhouse-Friderichsen syndrome) --also can me mild chronic septicemia where even after days or weeks only symptoms are low fever, arthritis and petechial skin lesions. <good Antibiotic response> |
|
|
N. Meningitidis
|
-if seen on gram test as a gram negative diplococci within polymorphonuclear leukocytes then positive result is Reliable. All negative results in woman and asymptamatic men must be comfirmed with a culture.
|
|
|
Hepititis A vacine is called
|
A vacine = Harvix
A and B vacine = Twinrix Hep A causes an ACUTE INFECTION after infection body should have immunity. -Fecal oral transmission |
|
|
Hepititis B C
|
Call chronic disease
|
|
|
Hep B and C
|
Hepatocellular carcinoma
and cirrosis |
|
|
Rotovirus
|
Doubled-stranded RNA, doubled-shelled capsid, no envelope
95% children by 3-5 years of age ELISA/ latex agglutination IgA antibodies -causes viral --double shelled capsid/no envelope. Resists harsh envioirments. |
|
|
Urinary Tract Infection
(Perdesposing Factors) |
=Most infections are ascending, but some can spread through the blood such as TB or staph aureus
E. Coli is most common cause of urinary infections= -Obstruction: enlarged prostate, kidney stone, weaker detrusor muscle (causes pooling of urine where bacteria grow) - post void residual: urine left over after micturition, can be up to 50 cc but only a few cc’s is enough to cause an infection. -Neurogenic bladder:don’t get sensation that need to urinate or muscles will not contract. May pass urine without realizing it.; MS effects nerves, starts to demyelinate, and cause neurogenic bladder; also with diabetic patients, spina bifida, paraplegic patients, cauda equinism – affects continence. -Vesicoureteral reflux:common in young girls-urine goes back up into ureter and kidney-hydronephrosis -Diabetes:if blood glucose over 160 or 200, glucose will get into urine; bacteria can easily grow in the urine if it contains glucose -Catherization:foreign body fosters growth of bacteria -Uncircumcised male: Easy for bacteria to hide adn grow -Sexual Intercourse-non-sterile, friction can make skin more susceptible to infection, spermicides and diaphragms increase risk |
|
|
UTI Symptoms in woman-
|
(URETHRA 4CM)
- frequent urination, - urgency - burning - suprapubic pressure - bladder spasm (doesn’t hurt at first but start having pins and needles sensation at urethra later during flow) -could also be pelvic inflammatory disease; test cervix by moving it – Chandelier test – will cause pain if inflamed = PID |
|
|
UTI Symptoms in men
|
(URETHRA IS 20CM)
-complain of penile discharge -hesitancy or decreased urinary flow -Urgency -can also get prostatitis – which can be felt during palpation during DRE – digital rectal exam (the posterior portion of prostate) and will cause pain. -PROTECTIVE FACTOR:Prostate secretes zinc which has an antibiotic effect |
|
|
Diferential Diagnosis of UTI's
|
Women- Pelvic Inflamatory Disease/// STD's
Men: >60: Prostatitis/prostatic hypertrophy Younger men: STD's//wouldn’t give a urine specimen bc could wash away the bacteria. |
|
|
Neisseria Gonorrhoeae
|
Gram - / diplococci/ likes humid atmospheres with CO2 in 35º-37ºC temp.//oxidizes glucose.
Diognosis/TESTING--Gram stain of urethral specimens is accurate for symptomatic males only! Thyer Martin agar//choclate with antibiotic agar is selective to pathogenic strands of nisseriae -Nucleic acid amplification assays(best test) |
|
|
Neisseria Gonorrhoeae
|
-2 to 5 day incubation/Purulent discharge form involved site.
-95% of men have acute SX -primary infection is cervix on women -SX- Vaginal discharge dysuria, abdominal pain, salpingitis, tubovarian abscesses,eptopic pregnancy, and PID...gonococcal opthalmia in newborns. |
|
|
Gonoccoccemia
|
Sisseminated infections with septicemia. Infection of skin and joints occur in 1-3% of infected woman (will occur if continuly undetected/untreated)
SX--fever, migratory arthralgias, suppurative arthritis, and a pustular rash on an erythematous base(on extremities)--leading cause of purulent arthritis in adults. |
|
|
Meningococcemia
|
N. Meningitidis(gram- diploc)
Septicemia (Meningococcemia) -Life threatening if untreated -thrombosis of small blood vessels and multi organ involvment. -Small petechial skin lesions on trunk and lower extremities -intervascular coagulation with shcok -bilateral destruction of adrenal glands(Waterhouse-Friderichsen syndrome) --also can me mild chronic septicemia where even after days or weeks only symptoms are low fever, arthritis and petechial skin lesions. <good Antibiotic response> |
|
|
N. Meningitidis
|
-if seen on gram test as a gram negative diplococci within polymorphonuclear leukocytes then positive result is Reliable. All negative results in woman and asymptamatic men must be comfirmed with a culture.
|
|
|
Hepititis A vacine is called
|
Harvix
A and B Twinrix Hep a causes an ACUT INFECTION AND THEN HAVE Fecal oral transmission |
|
|
Hepititis B C
|
Call chronic disease
|
|
|
Hep B and C
|
Hepatocellular carcinoma
and cirrosis |
|
|
Rotovirus
|
Doubled-stranded RNA, doubled-shelled capsid, no envelope
95% children by 3-5 years of age ELISA/ latex agglutination IgA antibodies -causes viral --double shelled capsid/no envelope. Resists harsh envioirments. |
|
|
Urinary Tract Infection
(Perdesposing Factors) |
=Most infections are ascending, but some can spread through the blood such as TB or staph aureus
E. Coli is most common cause of urinary infections= -Obstruction: enlarged prostate, kidney stone, weaker detrusor muscle (causes pooling of urine where bacteria grow) post-void residual – urine left over after micturition, can be up to 50 cc but only a few cc’s is enough to cause an infection -post-void residual -Neurogenic bladder -Vesicoureteral reflux:common in young girls-urine goes back up into ureter and kidney-hydronephrosis -Diabetes -Catherization -Uncircumcised male -Sexual Intercourse |
|
|
UTI Symptoms in woman-
|
(URETHRA 4CM)
- frequent urination, - urgency - burning - suprapubic pressure - bladder spasm (doesn’t hurt at first but start having pins and needles sensation at urethra later during flow) -could also be pelvic inflammatory disease; test cervix by moving it – Chandelier test – will cause pain if inflamed = PID |
|
|
UTI Symptoms in men
|
(URETHRA IS 20CM)
-complain of penile discharge -hesitancy or decreased urinary flow -Urgency -can also get prostatitis – which can be felt during palpation during DRE – digital rectal exam (the posterior portion of prostate) and will cause pain. -PROTECTIVE FACTOR:Prostate secretes zinc which has an antibiotic effect |
|
|
Diferential Diagnosis of UTI's
|
Women- Pelvic Inflamatory Disease/// STD's
Men: >60: Prostatitis/prostatic hypertrophy Younger men: STD's//wouldn’t give a urine specimen bc could wash away the bacteria. |
|
|
Urine Specimen Collection
|
-First morning vs. random
-clean-catch -midstream -straight cath: not out of bag -indwelling caths, -suprapubic aspiration- (20cc)long needle through stomach into bladder -nephrostomy tube collections Tin- Kol bag- use on toddlers-goes around entire genital region (boric acid perserves collection) |
|
|
Urinalysis
|
Ketones-in diabetics or if pt is dehydrated
-Positive leukocyte, nitrate, and protein indicates specimen needs to be cultered --UA-dipstick result---spin---in tube—supernutent at top and concentrate sediments at bottom-look at sediment microscopy for cells, bacteria, casts, sperm, mucus, trichomonas and quantitate |
|
|
Culture of Urine bacteria
|
Usually on SBA and MAC plates (Mackonkey plate)
Mackonkey –U see E. coli and other gram-negative agents; distinguishes btwn lactose fermentors and nonfermentors --SBA – can detect swarming Proteus or gram-positive causative agents; Staph saprophyticus – most common in sexually active females; also grp B strep and diptheroids !!.01cc Calibrated loop is used to plate – so any colony that grows represents 1000 col/.01cc urine; -whole plate full means greater than 100,000 colonies per cc. --3 colonies per .01 means infection |
|
|
UTI Prevention and Treatment
|
-Patient needs to be educated on proper hygeine—(to prevent self contamination with wiping)
-urination after sexual intercourse -Prophylatic antibiotics: bactrim = trimethiprim/sulfa), = Macrobid (nitrofurantoin) = Keflex (cephalexin) -can be taken to prevent UTI’s |
|
|
UTI SIGNS! (NOT SYMPTOMS)
|
Signs (objective):
- dark, malodorous (with odor) urine; + leukocytes +/- nitrite + protein with >50 WBC per field and 3+ bacteria colonies -Tenderness on palpation -Nausea/Vomiting/Fever/Chills with flank pain = pylonephritis symptoms -Fever -increased WBC, tachycardia, - + CVA (costovertebral) - tenderness = pylonephritis signs --Degree of pyuria does NOT necessarily correlate with severity of symptoms |
|
|
Organisms
|
(#1 cause = Escherichia coli)
-Enterobacteriacae-Klebsiella, Proteus species (urinary stones), Pseudomonas, Enterobacter, Serratia -Enterococcus, Staph epidermidis: Seen in hospital settings more often because normal skin flora gets into cathater. -Staph saprophyticus-sexually active women ++(Proteus-creates urease which can make some patients more prone to kidney stones |
|
|
Urethritis
pertainting to(UTI) |
Men vs. women
Gonococcal-Neisseria gonorrhoeae Nongonococcal-Chlamydia trachomatis (Rare viral and parasitic causes of UTI too) |
|
|
Rare causes of UTI's
|
-Adenovirus-hemorrhagic cystitis
-Hantavirus- infects capillary blood vessels in kidney -Schistosoma haematobium-inflammation of the bladder |
