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Flashcards in Infection Deck (188)
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30

How does phagocytosis occur?

PRR recognises PAMP
Pseudopods engulph and ingest microbe forming phagosome
Phagosome fuses with lysosome
Microbe digested leaving residual body
Waste discharged from cell

31

How do phagocytes kill the microbes..

Oxidative burst
Lysozymes, lactoferrin, proteolytic enzymes

32

What chemical pathways are involved in second line innate immunity?

Compliment
Cytokines

33

How is complement activated?

Classical pathway - antibody antigen complex
Alternative pathway - cell surface on microbes (e.g. LPS)
Mannose binding lectin - MBL binds to mannose on pathogen

34

What are the active components of compliment? What do they do?

C3a and C5a - chemotaxis
C3b and C4b - opsinisation
C5-C9 - membrane attack complexes

35

What are the effects of macrophage derived chemical in second line innate immunity?

Increase crp
Chemotaxis
Vasodilation
Increase vascular permiability
Increase body temperature

36

What chemicials do macrophages release?

Tnf alpha
Il-1
Il-6

37

In what conditions are second line defences of innate immunity compromised?

Asplenia/hyposplenia
Decreased neutrophils (leukaemia, chemotherapy)
Decreased neutrophil function

38

Define a healthcare related infection

An infection arising from a consequence of healthcare both within and out of hospital

39

How are hospital acquired infections differentiated form normal infections?

An infection that was neither present nor incubating at the time of admission (onset of symptoms >48 hrs after admission

40

What are the most common categories of healthcare related infections? What is the in hospital prevalence..

Gi and utis
8%

41

What can we do to reduced healthcare related infections regarding patient factors?

Screening
Prophylactic treatment
Optimise physical health
Appropriate choice of medications (e.g. Decreased cephalosporins)

42

What can we do to reduced healthcare related infections regarding place factors?

Bed layout with siderooms for high risk patients
Pressure isolation rooms
Sink and toilets accessible and individual in high risk
Sterilisation and decontamination

43

What can we do to reduced healthcare related infections regarding practice factors?

Handwashing
Hospital policies (eg. No relative sitting on beds)
Leadership up to government level - incentives work
Healthcare worker vaccinations
Ppe
Food hygene

44

What are the subdivisions of streptococcus?

Alpha haemolytic - pneumoniae and viridans
Beta haemolytic - pyrogenes
Non haemolytic - enterococcus

45

Diseases from strep viridans

Endocarditis
Dental caries

46

Diseases from strep pyogenes

Necrotising fascitis
Impertigo
Tonsilitis
Scarlet fever

47

Diseases from strep pneumoniae

Pneumonia
Meningitis

48

Diseases from staphylococcus

Boils
Carbuncles
Impertigo
Wound infection

49

Treatment options for staphylococcus infection

Flucloxacillin
Co-amoxiclav

50

Treatments for necrotising fasciitis

Initial broad spectrum like tazocin (pipperacillin and tazobactam)
Once id as strep pyogenes swich to ben pen
Large dose immunoglobulins to neutralise toxins
Antiprotein abx like clindamycin to decrease toxins
Debridment and amputation

51

Why is travel history important?

Different diseases
Different strains (resistance change and change in detecting)

52

What do you need to know about in a travel hx

Where
When
Via anywhere
Doing what
Staying where
Specific risks (sex, animals, swimming)
Preventative measures taken (prophylaxis, vaccinations, bite prevention)

53

What should you do with a suspected travel related infection?

Isolate until you know what it is!
Flag as high risk for lab

54

What are the causes of malaria?

P vivax
P falciparum
P ovale
P malariae

55

What is the characteristic fever of malaria? Which subtype differs?

3 day cycling, malariae is 4 day cycling

56

Symptoms of malaria

Fever 3 day cycling
Headache
Cough
Fatigue
Malaise
Arthralgia
Myalgia

57

What is the usual incubation period for malaria?

1-3 weeks

58

What are the methods of transmission of malaria?

Vector - anaphalies mosquito in endemic region
Cryptic - mosi on a plane arriving at non endemic airport
Haematogenous
Iatrogenic - infected equipment

59

What investigations would you perform in malaria?

Blood smear
Fbc
U and e
Lft
Glucose