General Knowledge Flashcards
What are some modifiable risk factors of pneumonia?
Inadequate oral care
Aspiration of oral secretions
Reduced mobility
Malnutrition
Poor glucose control/diabetes
Smoking
Unvaccinated status
What are some non-modifiable risk factors of pneumonia?
Age, chronic lung disease, neurological impairment, meds used to suppress CNS.
Which tests are used in the detection of C.diff?
NAAT to detect the presence of the organism, EIA to detect the presence of toxin A or B.
Which groups are most likely to experience complications from influenza?
Children under 2, adults 65+, pregnant women, obese persons, patients with underlying medical conditions.
Which influenza is most likely to cause global pandemics?
Influenza A, because the strains frequently mutate in both their animal and human reservoirs and resist eradication.
Which influenza virus causes annual epidemic disease with a milder clinical illness?
Influenza B.
What disease is erythema migrans a clinical symptom of?
Lyme disease - it begins at the site of the tick bite 7-14 days after tick detachment.
What symptoms are common in early disseminated Lyme disease?
Skin lesions smaller than erythema migraines and uniformly erythmatous, flulike symptoms (malaise, fatigue, headache, fever, chills, myalgia, arthralgia).
Mild hepatits, splenatomegaly, sore throat, nonproductive cough, testicular swelling, conjunctivitis and regional and generalized lymphadenopathy may occur, along with CNS involvement (facial palsies, -itises). Cardiac involvement in less than 10% of people.
What are the symptoms of late disseminated Lyme disease?
Joint pain and swelling - migratory arthralgia followed by intermittent attacks of arthritis lasting from days to months.
Some people develop chronic, potentially erosive arthritis.
Late neurologic Lyme disease is now rare, but left untreated patients may develop encephalomyelitis, peripheral neuropathy, or encephalopathy.
How do we test for Lyme disease?
History of tick bite and residence or travel in an endemic area is sufficient without testing.
Burgdorferi can be cultured from skin lesions, but test is not readily available.
Serologic testing may not show positive results until 2-6 weeks. IgM antibodies will show between 2-4 weeks and IgG will show after 6 weeks.
What caused the incidence of TB to increase in the US in the late 1980s / early 1990s?
The HIV epidemic.
What additional precautions are used for Mycobaterium tuberculosis?
Airborne precautions.
What additional precautions are used for influenza?
Droplet precautions.
What percentage of people develop active TB after exposure to M. tuberculosis?
5% in the first 2 years. If it doesn’t develop then, there is a 5-10% chance it will develop sometime after that.
What are the characteristics of primary TB?
Usually asymptomatic, with a few patients developing fevers, cough, or erythema nodosum (an inflammatory condition characterized by inflammation of subcutaneous fat tissue, resulting in painful red/blue lumps or nodules that are usually seen symmetrically on both shins, on the thighs, arms, and elsewhere.).
Patients with HIV can develop progressive dissemination at this time.
What are the characteristics of post primary TB?
Productive cough, fevers, night sweats, infiltrates on the lower lobes, cavitation on chest x-rays. Resp symptoms last more than 2-3 weeks. Pulmonary TB can have hemotypsis, weight loss, chest pain, weight loss, malaise, and debilitation.
Patients with HIV may be atypical, with a military/disseminated pattern, lower lobe infiltrates or normal chest x-rays.
What is extrapulonary TB?
TB which presents in less common organs, such as lymphadenitis, pleural, pericardial, or peritoneal involvement, meningitis, the spine, the genitourinary tract, etc.
How is TB diagnosed?
Chest x-ray, sputum collection x 3ea. 8 hours apart for AFB staining and culture.
Pediatric patients may need gastric washings as they swallow their sputum.
For extra pulmonary TB, the involved tissue biopsy or fluid should be submitted for mycobacterial culture and AFB staining.
What should we do if TB is diagnosed in a patient not initially suspected of having TB and not on appropriate precautions?
Establish infectious period.
List contacts.
Test close contacts with TST or BAMT as soon as possible, and again after 8-10 weeks. If there are any conversions or positive results, contacts with lesser degrees of exposure should be tested.
Name two parasites transmitted by direct contact with infected persons?
Scabies and lice.
How is scabies transmitted?
Through direct contact with infected persons: less frequently through contact with clothing or bedding.
What is the incubation period of scabies?
As little as 10 days but typically 4-6 weeks.
How does scabies present?
Typical presentation is intense pruritis (itchiness), usually more severe at night. 2/3 people have burrow-type pruritic lesions.
How does crusted (Norwegian) scabies differ from regular scabies?
Presents as a crusty, scaly dermatitis usually of the hands and feet. Highly contagious due to large numbers, itching is minimal.
