16. Infectious Diseases - Pathologies Flashcards

1
Q

What are systemic symptoms of infectious diseases?

A

Fever*
Fatigue
Headache
Nausea

*one of the biggest indicators of infection

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2
Q

What are local signs of infectious diseases?

A

Pain
Swelling
Redness
Warmth
Purulent exudate

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3
Q

What is a possible complication of an infection?

A

Sepsis (septicaemia)

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4
Q

What is sepsis?

A

When a pathogen infects the blood

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5
Q

What can sepsis lead to?

A

Body’s own response causing organ injury
Multi-organ failure

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6
Q

Who is more at risk of developing sepsis?

A

Immuno-compromised:
* Over 75s
* <1 yrs
* Alcoholics
* Diabetics
* Chemo patients
* Those on steroid treatment

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7
Q

What are the symptoms of sepsis?

A

Lethargy
Nausea/vomiting
Abdominal pain
Diarrhoea
Coughing

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8
Q

How can infectious diseases be tested?

A

Culture/staining
Blood tests
Stool tests
Radiography

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9
Q

What can blood tests for infection detect?

A

Leukocytosis: sign of bacterial infection
Leukopenia: sign of viral infection
High ESR*: marker of infection, influenced by inflammation

*erythrocyte sedimentation rate

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10
Q

What is leukocytosis?

A

High leukocyte count

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11
Q

What is leukopenia?

A

Low leukocyte count

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12
Q

Cellulitis: definition

A

Bacterial infection of the skin creating inflammation of dermal/subcutaneous layers

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13
Q

Erysipelas: definition

A

Bacterial infection of the skin creating inflammation of dermis/upper subcutaneous layer
More superficial than cellulitis
Well defined edge

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14
Q

Cellulitis/Erysipelas: aetiology

A

Bacterial - Staphylococcus aureus Infections can enter the skin through minor trauma, eczema (itching), IV drug abuse, ulcers (from diabetes)

Streptococci bacteria in subject’s own nasal passages

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15
Q

Cellulitis/Erysipelas: signs and symptoms

A

Very red, inflamed skin
Cellulitis: mainly limbs
Erysipelas: face and limbs
Fever, malaise

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16
Q

Cellulitis/Erysipelas: diagnostics

A

Microbe analysis
Clinical presentation

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17
Q

Cellulitis/Erysipelas: allopathic treatment

A

Antibiotics
oral/intravenous

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18
Q

Impetigo: definition

A

Very contagious bacterial skin infection
Common in infants/young adults

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19
Q

Impetigo: aetiology

A

Staphylococcus aureus
Haemolytic streptococci
Poor hygiene

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20
Q

Impetigo: signs and symptoms

A

Pustules with round, oozing patches and golden-yellow crusts that grow larger each day
Affects mostly exposed areas - hands/face
Skin folds - particularly armpits

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21
Q

Impetigo: allopathic treatment

A

Antibiotics

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22
Q

Oral Candidiasis: definition

A

Superficial fungal yeast infection* of mucous tissues

*mycosis

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23
Q

Oral Candidiasis: aetiology

A

Often presents after broad spectrum antibiotics
Immune-compromised patients
Skin/mucous barrier and CD4 cells usually enough to protect

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24
Q

Oral Candidiasis: signs and symptoms

A

White plaques
Dysphagia
Reduced appetite

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25
Q

Oral Candidiasis: complications

A

Can become systemic in immune-compromised patients - deposits on organs (systemic candidiasis)

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26
Q

Oral Candidiasis: allopathic treatment

A

Antifungals - topical/oral
eg. Clotrimazol
Can impact liver function/damage local skin

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27
Q

Genital Candidiasis: definition

A

Very common mycosis* of the genitals

*fungal infection

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28
Q

Genital Candidiasis: aetiology

A

Not sex-related (opportunistic)
Immune-compromised patients
* Antibiotic treatment
* Diabetes mellitus
* Pregnancy
* Immune system disorders
* Significant stress

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29
Q

Genital Candidiasis: signs and symptoms

A

Vaginal/genital itch, discomfort, irritation
Thick, clumpy discharge (cottage cheese)

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30
Q

Genital Candidiasis: diagnostics

A

Physical exam
Fungal culture/analysis

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31
Q

Genital Candidiasis: allopathic treatment

A

Antifungals - topical/oral

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32
Q

Lyme Disease: aetiology

A

Bacterium - borrelia, transmitted by tick bites

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33
Q

Lyme Disease: signs and symptoms

A

Different bacterial strains cause different clinical manifestations (differences between Europe and USA)
Circular pink/red rash at site of tick attachment, over 5cm dia*
Flu-like symptoms - can lead to neurological disease, cardiovascular disease and arthritis if not treated

*can take days/weeks to appear

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34
Q

Lyme Disease: allopathic treatment

A

Antibiotics
Lyme can be quite resistant

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35
Q

Diphtheria: definition

A

Highly contagious upper respiratory tract infection affecting primarily the nose and throat

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36
Q

Diphtheria: aetiology

A

Bacterial - Corynebacterium diphtheriae (gram positive*), transmitted by droplets

* secretes exotoxins that cause necrosis

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37
Q

Diphtheria: signs and symptoms

A

Sore throat and fever
Grey membrane (necrosis) grows across the tonsils, pharynx, nose (impairs breathing)
Enlarged cervical lymph nodes

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38
Q

Diphtheria: complications

A

Exotoxins cause endothelial necrosis by inhibiting protein synthesis
Can cause myocarditis and paralyse diaphragm
The membrane can block the airways

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39
Q

Diphtheria: allopathic treatment

A

Medical emergency
Anti-toxins
Antibiotics
Respirator
DPT vaccine

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40
Q

Scarlet Fever: definition

A

Infectious disease resulting from exotoxins released by Streptococci pyogenes bacteria
Usually occurs in children (90% <10yrs)

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41
Q

Scarlet Fever: pathophysiology

A

Bacteria secrete haemolytic enzymes and exotoxins (damage capillaries which both cause red rash)

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42
Q

Scarlet Fever: aetiology

A

Streptococcus pyogenes (haemolytic streptococcus)

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43
Q

Scarlet Fever: transmission

A

Droplets

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44
Q

Scarlet Fever: incubation time

A

3-4 days incubation

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45
Q

Scarlet Fever: signs and symptoms

A

Sore throat, fever, scarlet rash (blanches under pressure)
Haemorrhagic spots on palate
First 2 days - white tongue with red papillae
After this - more raw/red

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46
Q

Scarlet Fever: allopathic treatment

A

Antibiotics

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47
Q

Cold Sores: definition

A

Viral infection causing small blisters around mouth/on lips

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48
Q

Cold Sores: pathophysiology

A

Classical opportunistic virus
When immunity is low, the virus migrates along the nerve (often the trigeminal) to the skin/mucosa around mouth causing tingling/burning sensation

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49
Q

Cold Sores: aetiology

A

Herpes simplex virus (Type I)
Stress
Drugs - steroids
Trauma, local infections, sunlight exposure

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50
Q

Cold Sores: transmission

A

Direct contact or indirect (saliva)
Saliva remains contagious for weeks after symptoms

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51
Q

Cold Sores: signs and symptoms

A

Commonly asymptomatic
Tingling, itching, burning sensation around the mouth
Small, fluid filled sores that appear most commonly on lower lip

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52
Q

Cold Sores: allopathic treatment

A

Antiviral cream - acyclovir

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53
Q

Chicken Pox: definition

A

Highly infectious viral disease, caused by *Varicella-zoster**

*part of Herpes viral family

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54
Q

Who is mainly affected by chicken pox?

A

Mostly affects children (90%)

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55
Q

Chicken Pox: aetiology

A

Varicella zoster virus (part of herpes family)

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56
Q

Chicken Pox: transmission/incubation time

A

Droplets into upper respiratory tract mucosa
Direct contact
2-3 weeks incubation

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57
Q

Chicken Pox: signs and symptoms

A

Prodromal fever and malaise
Vesicular eruptions on the skin appear over 3-5 days mostly on head/trunk.
Very itchy*
Infective 2 days before rash until all lesions at ‘crusting’

*Danger of secondary infection due to skin breakages

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58
Q

Chicken Pox: complications

A

Infection because of scratching
Encephalitis
Viral pneumonia

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59
Q

Chicken Pox: allopathic treatments

A

None

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60
Q

Shingles: definition

A

Infection by the varicella zoster virus following chicken pox infection

Reactivated varicella virus

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61
Q

Shingles: aetiology

A

Varicella zoster virus - travels down infected nerve causing neuritis (nerve inflammation) in an immune-compromised individual
Commonly affects thoracic nerves or trigeminal nerve*

The pattern of neuritis clealy demarcates the nerve(s) affects

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62
Q

Shingles: signs and symptoms

A

1-2 days before rash - burning, itching, tingling
Eruptive phase - skin lesions similar to chicken pox (affecting head/face), causing severe dermatomal pain, altered sensation and vesicular rash

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63
Q

Shingles: allopathic treatment

A

Antiviral cream - acyclovir

64
Q

Whooping Cough: definition

A

Bacterial infection with characteristic coughing attacks where there’s a desperate attempt to breathe in

65
Q

Whooping Cough: aetiology

A

Bacterial - Bordetella pertussis

66
Q

Whooping Cough: signs and symptoms

A

Initial 1-2 weeks flu like symptoms
Then, a cough that doesn’t respond to usual cough medication
Cough gets worse and presents with attacks (for 3-6 weeks)

67
Q

Whooping Cough: complications

A

Pneumonia
Rib fracture
Death

68
Q

Tuberculosis: definition

A

A systemic infection usually caused by pyogenic bacteria - *Mycobacterium tuberculosis**
Chronic, granulomatous disease

*Very aerobic bateria, loves oxygen - hence presence in lungs

69
Q

Tuberculosis: pathophysiology

A

Macrophages in the lungs engulf the bacteria and carry them to the hilar* lymph nodes
Some organisms can spread to distant areas
80% of cases the granulomas formed will be eliminated by the immune system.
If not, the bacteria can become active immediately, later, or may remain dormant
Can affect lungs but also CNS, lymph, circulation, genitourinary, bones, joints, skin

Lymph nodes in the lungs

70
Q

Tuberculosis: transmission

A

Droplets
Inspiration of dust
Dry excretions
Contaminated milk

71
Q

Tuberculosis: signs and symptoms

A

Pulmonary TB: fever, chronic cough, purulent/bloody sputum, drenching night sweats, severe malaise, weight loss, anorexia

72
Q

Tuberculosis: diagnostics

A

Blood tests - high ESR, leukocytosis
X-rays, other imaging, showing up granulomas

73
Q

Tuberculosis: allopathic treatment

A

Antibiotics for 6 months

74
Q

Measles: definition

A

Acute and very infectious viral disease mainly in children

75
Q

Measles: aetiology

A

Measles virus

76
Q

Measles: transmission/incubation

A

Droplets
11 days incubation

77
Q

Measles: signs and symptoms

A

Early phase:
3-5 days - non-specific cold-like symptoms
Koplik spots - small grey spots on oral mucosa opposite molar teeth

Eruptive phase -
measles-like rash that initially begins on face/forehead
Rash fades within 1 week (contagious 4 days before and after rash)

78
Q

Measles: complications

A

Middle ear infection
Pneumonia (alveolic infection)
Encephalitis

Low rate of complications

79
Q

Measles: allopathic treatment

A

No specific treatment
Part of MMR virus

80
Q

Mumps: definition

A

Acute, viral infection causing swelling of the parotid/salivary glands

81
Q

Mumps: aetiology

A

Mumps virus

82
Q

Mumps: signs and symptoms

A

Feeling unwell
Fever
Head and joint pains
Swollen parotid glands
First one then both sides

83
Q

Mumps: complications

A

After puberty, about 30% of males get testicular inflammation

Because mumps virus targets exocrine glands

84
Q

Rubella: definition

A

Rare, harmless viral infection

German measles, RNA virus

85
Q

Rubella: signs and symptoms`

A

Sore throat, fever, headache
Petechiae on hard palate
Pink rash with small macules that starts on face and behind ears

86
Q

Rubella: complications

A

Abnormal foetal development
Miscarriage

87
Q

Viral Hepatitis: definition

A

Acute viral infection of the liver

88
Q

Viral Hepatitis: aetiology

A

Hepatitis virus
(types A, B, C, D, E)

89
Q

Viral Hepatitis: transmission

A

A/E - faecal-oral
B/C/D - blood, other bodily fluids

90
Q

Viral Hepatitis: signs and symptoms

A
  1. Pre-icteric stage - malaise, diarrhoea
  2. Icteric stage - jaundice, pale stools, dark urine (hepatic stasis), pruritic skin, enlarged liver, impaired blood clotting
91
Q

Viral Hepatitis: diagnostics

A

Blood test - liver function

92
Q

Viral Hepatitis: complications

A

Chronic liver disease - cirrhosis, liver cancer

93
Q

Viral Hepatitis: allopathic treatment

A

Limited - antiviral therapy
Hep B vaccine in vulnerable groups

94
Q

HIV (Human immunodeficiency virus): definition

A

An STI which attacks the immune system
Retrovirus - a double-strand* RNA virus

Retrovirus means it converts from RNA to DNA

95
Q

AIDS (Acquired immune deficiency syndrome): definition

A

Later stages of HIV when the immune system is severely impaired and life-threatening

96
Q

HIV (Human immunodeficiency virus): pathophysiology

A

Binds to CD4 receptor on T-Helper cells and macrophages
Viral envelope and cell membrane fuse and viral RNA enters the cell
Converted into viral DNA by ‘reverse transcriptase’ enzyme
Using integrase, it integrates into the host cell DNA
Viral DNA forces the host cell to produce viral RNA and proteins
Assembles in cytoplasm and buds off
As viral load goes up, T-cell count goes down
Can mutate, destroys CD4 cells leading to immune compromise

97
Q

HIV (Human immunodeficiency virus): transmission

A

Primarily through blood and semen (unprotected anal sex)
Low risk with saliva and vaginal secretions
NOT transmitted by casual contact
Risk of transmission during pregnancy/breastfeeding
Recent increase in heterosexual transmission
6-7% intravenous drug use

98
Q

HIV (Human immunodeficiency virus): progression

A
  1. Initial stages - 1-6 weeks after infection
    50% asymptomatic
    Flu/glandular fever-like sore throat, fever, malaise, muscle/joint pain, swollen lymph nodes
    Negative antibody (IgG tests) but viral RNA high
  2. Late stage - huge reduction in CD4 count and rise in viral load
    AIDS diagnosis : CD4 count < 14%
    Severely impaired immune function
    Opportunistic infections
99
Q

HIV (Human immunodeficiency virus): diagnostics

A

Blood tests - antibodies

100
Q

HIV (Human immunodeficiency virus): opportunistic infections CD4 <500

A

Herpes infections
Candidiasis
Kaposi’s sarcoma

101
Q

HIV (Human immunodeficiency virus): opportunistic infections CD4 <200

A

Toxoplasmosis, pneumonia

102
Q

HIV (Human immunodeficiency virus): opportunistic infections CD4 <50

A

Severe mycobacterium infection
HIV dementia

103
Q

HIV (Human immunodeficiency virus): prognosis

A

Increased with highly active anti-retroviral therapy (HAART)
Anti-retrovirals increases life expectancy but causes a variety of adverse effects due to high toxicity from the drugs

104
Q

Dysentery: definition

A

Infection of the intestines that causes diarrhoea containing blood or mucus

105
Q

Dysentery: aetiology

A

Bacterial - shigella
Amoebic (protozoa)
Via faecal-oral contamination

106
Q

Dysentery: signs and symptoms

A

Diarrhoea - watery stools with mucus and blood
Cramping, possible nausea/vomiting

107
Q

Dysentery: diagnostics

A

Stool microscopy

108
Q

Dysentery: complications

A

Dehydration - dangerous in small children, infants, pregnancy and elderly

109
Q

Dysentery: allopathic treatment

A

Antibiotics - anti-parasitic or anti-bacterial
Rehydration - fluid and mineral replacement

110
Q

Malaria: definition

A

Tropical infectious disease spread by anopheles mosquitos that are infected by *plasmodium** species.
5 million affected each year

*protozoan

111
Q

Malaria: pathophysiology

A

Infected female anopheles mosquito bites human
Plasmodium parasites (sporozoites) taken up by liver, proliferate and mature.
Can lie dormant for up to a year
Spread to erythrocytes and proliferate further.
Symptoms begin i.e. fever
Infected cells burst and spread infection
Protozoan gametes are formed and are taken up by another mosquitos during blood meal

112
Q

Malaria: 3 stages of life cycle

A
  1. Mosquito
  2. Human liver
  3. Erythrocytes
113
Q

Malaria: aetiology

A

Plasmodium species
(5 types) - protozoa
Spread by vector/host mosquito

114
Q

Malaria: signs and symptoms

A

Headache, fever, malaise, arthralgia*

nausea, vomiting, diarrhoea, anaemia**

Splenomegaly, hepatomegaly, jaundice**

*joint pain **(caused by excessive haemolysis)

115
Q

Malaria: complications

A

Death (misdiagnosis as flu)
Relapses

116
Q

Malaria: allopathic treatment

A

Quinine/chloroquine (tetracycline)
Anti-inflammatories, anti-pyretics, analgesics
Preventative drugs*

*significant side effects

117
Q

Chlamydia: definition

A

Very common sexually transmitted infection
Common <25s

118
Q

Chlamydia: aetiology

A

Bacterial - Chlamydia trachomatis

119
Q

Chlamydia: incubation

A

Several weeks incubation

120
Q

Chlamydia: signs and symptoms (males)

A

50% asymptomatic
Milky white/yellow discharge from penis
Epididymitis
Urethritis
Dysuria

121
Q

Chlamydia: signs and symptoms (females)

A

80% asymptomatic
Yellow vaginal discharge
Dysuria

122
Q

Chlamydia: diagnostics

A

Urine
Cervical
Urethral swab tests

123
Q

Chlamydia: complications

A

Pelvic inflammatory disease*
Risk of infertility

Infection of uterus and fallopian tubes

124
Q

Chlamydia: allopathic treatment

A

Antibiotics (e.g. erythromycin and tetracycline).

125
Q

Gonorrhoea: definition

A

Common bacterial STI

126
Q

Gonorrhoea: aetiology

A

Bacterial - Neisseria gonorrhoea
Infects epithelium of GU tract, rectum, pharynx, conjunctiva

127
Q

Gonorrhoea: transmission

A

Direct - oral, anal, genital sex
Mother to baby during birth

128
Q

Gonorrhoea: signs and symptoms (male)

A

90% symptomatic
Yellow penile discharge
Dysuria

129
Q

Gonorrhoea: signs and symptoms (female)

A

50% asymptomatic
Yellow vaginal discharge
Dysuria
Irregular vaginal bleeding
Lower abdominal pain
Pain during sex (dyspareunia)

130
Q

Gonorrhoea: diagnostics

A

Swab culture of urethra, throat, cervix/rectum
Presumptive on-the-spot diagnosis often made based on case history

131
Q

Gonorrhoea: complications

A

Permanent complication (particularly women) if untreated
PID
Infertility

132
Q

Gonorrhoea: allopathic treatment

A

Antibiotics
Abstain from sexual activity until all clear

133
Q

Genital Herpes: aetiology

A

Herpes simplex virus (Type II)

134
Q

Genital Herpes: transmission

A

Direct contact - sexually transmitted
Genital-genital
Oro-genital

135
Q

Genital Herpes: signs and symptoms

A

Always symptomatic
After initial infection the viruses move to sensory nerves where they remain latent
Painful vesicles, rupturing to leave shallow ulcers

136
Q

Genital Herpes: allopathic treatment

A

Antiviral cream - acyclovir

137
Q

Syphilis: definition

A

Chronic, contagious systemic disease

138
Q

Syphilis: aetiology

A

Bacterial - Treponema pallidum

139
Q

Syphilis: transmission

A

Enters body via damaged skin or mucous membranes*
Sexual contact
Pregnancy

*very contagious

140
Q

Syphilis: signs and symptoms

A
  1. Hard, painless ulcer* on infection point. Heals and becomes asymptomatic
  2. Flat, erythematous rash (v. contagious), potentially covering whole body. Not itchy. Lasts several weeks
  3. Latent stage - no symptoms but untreated person may remain infectious for up to 2 years
  4. Years later if left untreated can lead to
    * chronic gummas (granulomas),
    * neurological syphilis,
    * cardiovascular syphilis

*Chancer

141
Q

Syphilis: allopathic treatment

A

Penicillin*
Avoid sex until all clear

Without antibiotics can be fatal

142
Q

Genital Warts: aetiology

A

Human papillomavirus (HPV)

143
Q

Genital Warts: incubation

A

Up to 6 months incubation

144
Q

Genital Warts: signs and symptoms

A

Soft, fleshy projections
Cauliflower-like masses
Small pointed masses
Flat lesions on vagina, cervix, penis

145
Q

Genital Warts: allopathic treatment

A

Surgery
Laser
Cryotherapy

146
Q

Oral Candidiasis: natural treatment

A

Anti-candida protocol: Remove carbohydrates that feed yeast, apple cider vinegar, coconut oil, manuka honey, turmeric, garlic, oregano, probiotics and prebiotics, grapefruit seed extract.
Support immune system; e.g. vitamin C, beta glucans.
Herbs (immune and antifungal) internally; homeopathy;
acupuncture.

147
Q

Scarlet Fever: complications

vocal, not on slide

A

Lung and kidney conditions
Rheumatic fever (if untreated)

148
Q

Chicken Pox: natural treatments

A

Herbs (immune and antiviral); acupuncture; nutrition to support immunity and antimicrobial activity; homeopathy.
Itch relief (to prevent further infection):
Oats in a bath, bicarbonate of soda, apple cider vinegar, raw honey, lavender (in licorice creams when no open wound).

149
Q

Poliomyelitis: definition

A

Acute viral infectious disease

150
Q

Poliomyelitis: aetiology

A

Poliovirus (PV)

151
Q

Poliomyelitis: transmission

A

Faecal-oral transmission

152
Q

Poliomyelitis: pathophysiology

A

Targets anterior horn cells of CNS (motor)
Has no cure

153
Q

Poliomyelitis: signs and symptoms

A

90% of polio infections are asymptomatic.
Initially: Fever, fatigue, headache, vomiting, neck stiffness.
In 1% of cases, the virus enters the CNS and causes paralysis.
5 - 10% die from respiratory failure.

154
Q

HIV (Human immunodeficiency virus): signs and symptoms

A

Fatigue.
Anaemia.
Anorexia, diarrhoea, cachexia
(weight loss, muscle wasting).
Neurological disease with no
other cause.
Peripheral neuropathy.
Neutropenia and
thrombocytopenia.
Dementia (HIV dementia).
Cognitive / motor dysfunction.

155
Q

Dysentery: natural treatment

A

Herbs (antimicrobial & immune), oregano oil, probiotics, colon hydrotherapy (removes amoebic cysts).