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CD of other body systems Flashcards

DHF, Chicken pox, Malarian, Leptospirosis (68 cards)

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1
Q

A mosquito-borne illness that occurs in tropical
and subtropical areas of the world.

A

DENGUE FEVER

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2
Q

DENGUE FEVER other name

A

AKA: Breakbone fever

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3
Q

DENGUE HEMORRHAGIC FEVER CA:

A
  1. Dengue Virus 1, 2, 3, 4
  2. Chikungunya Virus
  3. O’nyong’nyong Virus

GENUS:
Flaviviridae
FAMILY:
Flavivirus, renamed in 2023 to Orthoflavivir

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4
Q

DENGUE HEMORRHAGIC FEVER MOT

A

Bite of the Aedes Aegypti
Female mosquito → vector

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5
Q

CHARACTERISTICS OF THE FEMALE
MOSQUITO:

A
  • Day biting (3 pm)
  • Low flying (elementary pupils)
  • Stagnant water (Rubber tires, vases, empty can)
  • Urban area

DLSU

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6
Q

DHF IP:

A

6-7 days

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7
Q

DHF DIAGNOSTIC TEST:

A

Tourniquet / Rumpel leads / Capillary Fragility
Test

  1. Get the BP (120 /80) [120 – 80]
  2. Inflate the BP cuff midway between the SBP and
    DBP
  3. Inflate the BP – 100 mm/Hg and let it stay for 2-
    3 minutes
  4. Deflate the cuff and make an imaginary box, 1
    inch below antecubital fossa
  5. Count the number of petechiae (rashes)
    (+) tourniquet test = 20 or more petechiae
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8
Q

3 STAGES OF DHF:

A

I. Febrile / Invasive (1-3 days)
II. Toxic / Hemorrhage Stage (4-7 days)
III. Convalescence / Recovery (8-10 days)

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9
Q

I. Febrile / Invasive (1-3 days)

A
  1. Fever (40C or 104F) / chills
  2. Arthralgia, Malaise
  3. Nausea and vomiting, loss of appetite
  4. Headache / abdominal pain
  5. Rash which appears on the 3rd day
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10
Q

II. Toxic / Hemorrhage Stage (4-7 days)

A
  1. Signs of bleeding
  2. Epistaxis, gum bleeding, melena, narrow
    pulse pressure, hypotension, weak and
    thready pulse
    Note: Diet: Avoid dark-colored foods and
    beverages (mask s/sx of bleeding)
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11
Q

III. Convalescence / Recovery (8-10 days)

A
  1. Regains appetite
  2. BP normalizes
  3. Generalized flushing
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12
Q

GRADE LEVELS OF DHF: (+) tourniquet, fever, headache,
abdominal pain, and other s/sx (no bleeding)

A

Level 1:

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13
Q

GRADE LEVELS OF DHF: Signs of spontaneous bleeding:
epistaxis, gum bleeding, melena, rashes

A

Level 2

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14
Q

GRADE LEVELS OF DHF: Signs of spontaneous bleeding:
Signs of circulatory collapse
(hypotension, narrowed pulse pressure, weak
and thready pulse, tachycardia, tachypnea)

A

Level 3

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15
Q

GRADE LEVELS OF DHF: Signs of profound shock

A

Level 4

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16
Q

NURSING MANAGEMENT:

A
  1. Ice packs (placed on forehead → epistaxis)
  2. TSB (fever)
  3. Increase Fluid Intake (3-4 L, ↑Circulating
    Blood Volume)
  4. Monitor Vital Signs (↓BP, ↑PR, ↑RR)
  5. Diet: ↑carbohydrates, ↑protein, ↑Vit C, ↑fiber
  6. Clean surroundings
  7. Bed rest
  8. Avoid constipation → rectal bleeding
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17
Q

MEDICAL MANAGEMENT:

A
  • Oresol – homemade solution composed of a
    pinch of salt, 4-6 teaspoons of sugar mixed to 1
    liter of water
  • Acetaminophen: for fever
  • Codeine: severe headaches and for myalgia
  • No aspirin (anticoagulant = ↑bleeding)

Virus directly affects the blood vessels → vascular
permeability / plasma leakage → thrombocytopenia
→ ↓platelet count (N: 150, 000 – 450, 000) → prone
to bleeding
Use tawa-tawa (can ↑platelet)

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18
Q

DHF VACCINES:

A
  1. Dengvaxia, 2016
  2. Qdenga vaccine, 2022
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19
Q

Contraindication for both vaccines:
1. Dengvaxia, 2016
2. Qdenga vaccine, 2022

A
  1. AIDS / HIV
  2. Immunosuppression
  3. Chemotherapy
  4. Corticosteroid
  5. Pregnancy
  6. Breastfeeding
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20
Q
  1. Dengvaxia, 2016
    * Dosage:
    * Route:
    * Storage:
    * Discard reconstituted vaccine if not used
    * within:
    * no of Doses:
    * Interval:
A
  1. Dengvaxia, 2016
    * Dosage: 0.5 ml
    * Route: Subcutaneous
    * Storage: body of ref, +2 to +8C
    * Discard reconstituted vaccine if not used
    * within 30 mins
    * # of Doses: 0, 6, 12 months
    * Interval: 6 months apart
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21
Q

Qdenga vaccine, 2022
* 2 Dosage:
* Interval:
* Route:
* Interval:

A
  1. Qdenga vaccine, 2022
    Dosage: 0.5 ml
    Dose: 2 doses
    Interval: 3 months
    Route: SQ
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22
Q

CHICKEN POX Other name:

A

Varicella

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23
Q

Varicella CA:

A

Human Alpha Herpes Virus 3

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24
Q

HICKEN POX
- Other name: Varicella IP:

A

13-17 days
Macule (flat) → Papule (elevated) → Vesicle (fluidfilled)
→ Scab
Highly communicable until the scabs have crusted
over

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25
CHICKEN POX MOT:
* Droplet * Contact * Airborne (possible)
26
CHICKEN POX DX TEST:
Vesicular Fluid Test 1. Get a sample from the vesicle 2. Add staining reagent 3. Viewed under a microscope Tzanck Smear 1. Get a sample from scab 2. Scrape a sample tissue (scalpel) 3. Place in glass slide 4. Add reagents 5. Viewed under microscope
27
Chicken pox (Varicella) s/sx:
1. Irritating rash 2. Fever 3. Anorexia / Loss of Appetite 4. Headache 5. Malaise 6. Coryza
28
CHICKEN POX Pattern:
Macule (flat) → Papule (elevated) → Vesicle (fluid-filled) → Scab
29
CHICKEN POX Distribution:
Centripetal – starts with the hidden / covered areas (chest, trunk, scalp)
30
Chicken pox (Varicella) MANAGEMENT:
1. Antipyretics - fever 2. Lukewarm bath – relieve pruritus 3. Baking soda – 1 cup and soak for 15-30 mins – relieve pruritus 4. Mittens for infants / children
31
- Protozoan infection / parasitic
MALARIA
32
MALARIA vector
Female Anopheles mosquito ## Footnote Parasites travel to the liver (target organ) where they nurture and reproduce Bloodstream → liver → mature & reproduce
33
MALARIA Most common complication:
Malarial cachexia
34
Malarial cachexia Characterized by:
1. Jaundice 2. Anemia 3. Splenomegaly 4. Hepatomegaly 5. Emaciation (thinning and weakness) ## Footnote * May happen after 3 days * Prolonged, continued, and uncontrolled malaria
35
MALARIA 5 CA
Parasites (protists) 1. Plasmodium Falciparum – most malignant Drug resistant: Chloroquine / Aralen Alternative drug: Sulfadoxine 2. Plasmodium malariae 3. Plasmodium vivax 4. Plasmodium ovale 5. Plasmodium knowlesi
36
Female Anopheles mosquito CHARACTERISTICS:
- Night biting (9pm – 3 am) - High flying - Free flowing - Rural areas
37
MALARIA MOT:
Vector-borne (bite of the female anopheles mosquito)
38
MALARIA IP:
10-12 days
39
Stages of MALARIA
A. Cold Stage B. Hot Stage C. Wet Stage
40
MALARIA s/sx: A. Cold Stage
1. Quivering / Shivering 2. Chills 3. Chatter teeth
41
MALARIA s/sx: B. Hot Stage
1. High fever that reaches up to 40C or 104F (Acetaminophen is preferred; TSB to promote heat loss by evaporation) 2. Reddened eyes and skin 3. The skin is warm to touch
42
MALARIA s/sx: C. Wet Stage
1. Diaphoresis (prone to DHN)
43
Malaria Paroxysm Plasmodium vivax / Plasmodium ovale – happens every__ Plasmodium malariae and Plasmodium falciparum – every__
Malaria Paroxysm Plasmodium vivax / Plasmodium ovale – happens every 2 days Plasmodium malariae and Plasmodium falciparum – every 3 days
44
Malaria DX TEST:
Peripheral Blood Smear ## Footnote Get a sample of blood from the pt particularly at the height of fever (Hot Stage)
45
Peripheral Blood Smear 2 Types:
1. Thick smear 2. Thin smear
46
quantitative; count number of parasites present in the blood
Thick smear
47
qualitative; identify the specific causative agent / parasite that is present in the blood
Thin smear
48
6 RECOMMENDED ANTI-MALARIA DRUGS:
1. Chloroquine (Aralen) 250 mgs 2. Quinine 3. Sulfadoxine 4. Tetracycline 5. Artemisinin 6. Mefloquine
49
with Pyrimethamine (after 1st trimester, organogenesis); P. falciparum
Sulfadoxine
50
given during emergency situations; epidemic
Quinine
51
taken 1-2 weeks before entering an endemic area (Palawan) until 8 weeks On pregnancy and endemic areas (safe)
Chloroquine (Aralen) 250 mgs
52
2. Quinine given during emergency situations; epidemic WOF: neurologic toxicity:
1. Confusion 2. Disorientation 3. Muscle weakness 4. Seizures (worst adverse reaction) 5. Coma (worst adverse reaction)
53
RECOMMENDED ANTI-MALARIA DRUGS:
1. Chloroquine (Aralen) 250 mgs: taken 1-2 weeks before entering an endemic area (Palawan) until 8 weeks On pregnancy and endemic areas (safe) 2. Quinine given during emergency situations; epidemic WOF: neurologic toxicity: * 1. Confusion * 2. Disorientation * 3. Muscle weakness * 4. Seizures (worst adverse * reaction) * 5. Coma (worst adverse * reaction) Children 5 mg/kg once a week 3. Sulfadoxine – with Pyrimethamine (after 1st trimester, organogenesis); P. falciparum 4. Tetracycline – oral liquid suspension: infant / children – use straw to prevent permanent staining of teeth 5. Artemisinin 6. Mefloquine
54
MALARIA MANAGEMENT:
1. TSB, antipyretics – promote heat loss by evaporation 2. Increase fluid intake – 3-4L/day 3. Monitor VS - temperature 4. Bed rest – pt is weak / fatigue 5. Iron-rich foods – possible anemia
55
PREVENTION: clearing of vegetation
On-stream clearing
56
PREVENTION: construction of bioponds
On-stream seeding ## Footnote - Larvivorous fish: tilapia - 2-4 fish/sqm: immediate impact - 200-400 fish/ha: delayed effect
57
PREVENTION: Avoiding peak biting hours:
9pm to 3 am
58
PREVENTION: the typing of domestic animals (horses, carabao, cows); place near dwelling houses to drive away mosquito
Zooprophylaxis
59
5 PREVENTION:
1. On-stream clearing – clearing of vegetation 2. On-stream seeding – construction of bioponds 3. Avoiding peak biting hours: 9pm to 3 am 4. Zooprophylaxis 5. Planting of neem tree
60
Rodent: mice → urine/stool contains bacteria that causes leptospirosis
LEPTOSPIROSIS
61
LEPTOSPIROSIS Other names:
1. Weil’s disease 2. Mud fever 3. Trench fever 4. Flood fever 5. Spiroketal Jaundice 6. Japanese Seven Day Fever
62
LEPTOSPIROSIS CA:
Leptospira interrogans ## Footnote CLASSIFICATION: Bacteria, gram (-), spiral shaped bacteria
63
LEPTOSPIROSIS IP:
5-14 days (7-19 days)
64
LEPTOSPIROSIS MOT:
Direct inoculation
65
PHASES of LEPTOSPIROSIS
A. Anicteric Phase B. Icteric Phase
66
A. Anicteric Phase sx:
1. Fever / chills 2. Headache 3. Nausea and vomiting 4. Anorexia (Loss of appetite) 5. Myalgia 6. Diarrhea
67
B. Icteric Phase s/sx:
1. Jaundice (damaged liver/spleen) 2. Renal failure 3. Meningitis 4. Myocarditis
68
Leptospirosis DOC:
1. Penicillin: 2M units 2. Tetracycline: 100mg

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