infectious disease Flashcards
(41 cards)
1
Q
objectives
A
- define specific terminology associated with infectious diseases
- identify and discuss the epidemiological and psychosocial aspects, pathophysiology, and methods of transmission of infectious diseases
- discuss the clinical manifestations, treatment, and prevention of common infectious diseases
2
Q
infectious diseases
A
- infectious diseases are illnesses caused by pathogenic organisms (pathogens), such as bacteria, viruses, fungi, protozoa, and parasites
- most are non-life threatening
- communicable diseases are responsible for most occupationally acquired illness
- protect yourself!
3
Q
regulatory line of defense
A
- centers for disease control and prevention (CDC) ->
- office of the surgeon general (OSG) ->
- food and drug administration (FDA) ->
- occupational safety and health administration (OSHA) ->
- state department of public health ->
- local agencies - public health agency, fire dept, EMS, emergency management, hospitals, and labs (FIRST LINE OF DEFENSE)
4
Q
CDC
A
-Atlanta, georgia
-give guidance treatment mechanisms
-guidance on protection mechanisms
-guidance on how to come into contact with infectious patients
-not global -> its local
-just the US
-ex. masks, hazmat suits
-centers for disease control and prevention (CDC)
-chief US agency responsible for tracking and prevention morbidity and mortality associated with infectious disease
-CDC in Atlanta, Georgia, is the chief agency responsible for tracking and preventing morbidity and mortality associated with infectious disease. It’s the most visible epidemiologic agency in the international medical community.
The CDC monitors national infectious disease data and distributes this information liberally to all healthcare providers and to the community through the internet (www.cdc.gov) and in publications.
5
Q
OSHA
A
- safety in the workplace
- go to hospitals, work places, clinic
- daily work habits
- part of deptarment of labor
- occupational safety and health administration
- disposal of sharps
- hand washing techniques
- oversees compliance, enforcement, inspection, tracking and reporting related to infection control practice
- establishes guidelines for prevention of transmission of airborne and bloodborne pathogens, and post-exposure protocols in occupational settings.
- specifies which personal protective equipment (PPE) must be available in given occupational setting and dictates how employees must be educated on its use in order to protect themselves from the hazards they are likely to encounter during their normal work
- RYAN WHITE CARE ACT
6
Q
FDA
A
- food and drug administration
- responsible for ensuring the safety of prescription and over-the-counter drugs and medical devices, including those associated with transmission of infectious disease, such as indwelling catheters.
7
Q
office of the surgeon general (OSG)
A
-oversees the U.S. Public Health Service and spearheads risk reduction activities, such as promoting childhood immunization, ensuring public preparedness for bioterrorist attacks, and addressing disparities in rates of infectious disease and access to treatment among various racial, ethnic, and socioeconomic patient population groups.
8
Q
world health organization (WHO)
A
- coordinates worldwide disease prevention efforts for member of the UN by providing leadership on global health issues and technical and logistical support for health research
- WHO staff work side by side with governments and other partners to ensure the highest attainable level of health for all people
9
Q
ryan white care act
A
- OSHA
- each agency must have a designated infection control officer
- deals with ex. employee is stuck by a needle
10
Q
epidemic
A
- greater than expected incidence of a disease occurring in a certain area or occurrence of disease in area(s), where it does not usually occur
- Usually due to organism that has mutated in a way that either has enabled it to evade the immune system or has made it more virulent
11
Q
pandemic
A
- Epidemic that sweeps the globe
- 3 influenza pandemics in the last century
- COVID-19 (Coronavirus)
12
Q
chain of infection
A
- reservoir/host
- portal of exit
- transmission
- portal of entry
- host susceptibility
13
Q
breaking the chain
A
- universal precautions/standard precautions
- proper use of PPE
- hand washing (proper hand hygiene) *** -> most important
- vaccination/immunization programs
- preventing sharps injuries
- self-sheathing needles
- needleless IV systems
- readily available sharps containers
- proper cleaning/decontaminating
- promptly reporting exposures
14
Q
physiologic response to infections
A
- respiratory
- circulatory
- genitourinary
- integumentary
- special circumstances -> geriatric and obese
15
Q
hepatitis C
A
- leading cause of chronic liver disease and the #1 indication for liver transplants
- generally a slow, progressive disease that causes severe liver damage over time
- needle sharing
- 85% of cases become chronic
- NO VACCINE
- spread PARENTERAL
- four million Americans and 200 million persons worldwide are infected
- most common chronic blood borne infection and leading cause of liver transplantation in the US
- slow acting- 2 week -6 month onset -> chronic
16
Q
hepatitis C transmission
A
- transmitted through sharing IV needles
- prior to 1992, receiving blood products
- tattooing or body piercing
- needle stick injury
- sexual contact
- organ transplantation
- NO VACCINE
- spread PARENTERAL
17
Q
hepatitis C treament
A
- ensure universal precautions are followed
- treatment is primarily supportive
- 24 weeks course of interferon A are moderately effective with a combination of antiviral drugs
- avoid agents known to cause liver damage, such as ETOH and NSAIDs
- screen for complications
- if liver failure develops, transplant is only real option
- NO VACCINE
- spread PARENTERAL
18
Q
meningococcal meningitis
A
- caused by Neisseria meningitis, a gram-negative diplococcus bacterium
- only causes disease in humans
- active infection is almost always due to spread from colonization of nasopharynx
- progresses rapidly over 24 hours
- classic triad: fever, nuchal rigidity, and altered mental status (AMS), but headache is also common
- petechiae and palpable purpura (not always)
- stiffness and tiredness
- very contagious
19
Q
assessment of nuchal rigidity: Kernig’s sign
A
- technique:
- place patient supine
- flex the hip and knee 90 degrees
- keep the hip immobile while extending the knee
- positive sign:
- it suggests irritation of meninges
- the patient resists extending the knee -> may be +
- patient has pain in the hamstrings
20
Q
assessment of nuchal rigidity: Brudzinski’s sign
A
- technique:
- place patient supine
- keep the trunk against the stretcher
- touch the chin to the chest (flex neck)
- positive:
- it suggests irritation of meninges
- the patient involuntary flexes hip
21
Q
treatment of meningococcal meningitis
A
- is it bacterial or viral?
- rapid antibiotic therapy is key to outcome
- do not delay for CT and/or difficult lumbar punctures (LP)
- corticosteroids
- supportive care as indicated
- universal precautions
- antibiotic prophylaxis for close contacts and health care providers (this is the ONLY cause of meningitis that needs prophylaxis)
22
Q
mumps
A
- caused by RNA-type virus
- covered by standard childhood immunizations but some sporadic outbreaks in recent years
- fever, malaise, myalgias, headache, then parotitis (swelling of parotid glands)
- complications include meningitis, encephalitis, orchitis/oophoritis, hearing loss
- all other body systems may be involved
- contagious - droplet
23
Q
mumps treatment
A
- isolation with droplet precautions
- highly infectious and spreads rapidly
- incubation period of 14-18 days
- supportive care
- analgesics and antipyretics
- fluids as needed
- cold packs to inflamed areas
24
Q
H1N1 influenza
A
-Influenza A type virus with components of two swine, one human, and one avian strain
First detected in March 2009 in Mexico with subsequent pandemic
-Higher attack rate, morbidity, and mortality than typical for seasonal flu among younger persons and pregnant women
-Majority of deaths still in those with co-morbidities
-Spread via airborne and surface droplets
-Incubation period is about 2 days
-Contagious period is from 1 day before symptom onset until fever resolves; longer in immunocompromised patients
25
H1N1 treatment
- standard precautions with droplet precautions
- airway management as indicated
- supportive care
- IV fluids
- analgesics/antipyretics
- anti-viral therapy per current CDC guidelines:
- severe or complicated disease
- pregnant women
- age <5 or >65 years
26
sepsis from MRSA: MRSA define
- Methicillin-resistant Staphylococcus aureus
- Gram positive bacterium resistant to certain antibiotics
- Hospital-acquired strains more virulent than community acquired
- Recent admission and IV are risk factors
- Cellulitis (infection of the skin or the fat and tissues that lie immediately beneath the skin, usually starting as small red bumps in the skin).
- Boils (pus-filled infections of hair follicles)
- Abscesses (collections of pus in under the skin).
- Sty (infection of eyelid gland).
- Carbuncles (infections larger than an abscess, usually with several openings to the skin), and impetigo (a skin infection with pus-filled blisters).
- spread to almost any other organ in the body -> severe symptoms develop
- MRSA that spreads to internal organs can become life-threatening.
- Fever, chills, low blood pressure, joint pains, severe headaches, shortness of breath, and "rash over most of the body
27
sepsis from MRSA: sepsis defined
- Systemic inflammatory response to infection
| - Potential for hemodynamic collapse, ARDS, and multi-organ system failure
28
Sepsis from MRSA treatment
- universal precautions
- airway management
- resuscitate with aggressive, large volume IVF
- check glucose
- consider vasopressor agents -> to raise BP
- in hospital, will require specific antibiotic therapy and continued resuscitation and supportive care
29
summary
- Infectious disease requires knowledge of:
- Specific terminology
- Epidemiological and psychosocial aspects, pathophysiology, and methods of transmission of infectious diseases
- Clinical manifestations, treatment, and prevention of common infectious diseases
30
hepatitis A
- Most common type of hepatitis in the US
- Commonly transmitted through fecal-oral route
- signs and symptoms include vomiting, diarrhea, fever, or abdominal discomfort
- Recommended vaccine
- Treated with IV fluids
- Hand-Washing is key
- spread FECAL, ORAL, PARENTERAL, SEXUAL
- VACCINE -> YES
31
hepatitis B
- According to the WHO, 240 million people infected with chronic hepatitis B
- Transmitted through exposure to blood and blood products, sexual contact, or perinatal exposure (mom to fetus)
- Common causes include IV drug use from needle sharing, shared razors, and acupuncture
- signs and symptoms include flu like symptoms and jaundice of the skin and eyes
- Required vaccine in US within 12 hours of birth
- jaundice*
- spread PARENTERAL and SEXUAL
- VACCINE -> YES
32
rubeola (measles): childhood diseases
- resides in the mucus of the nose and throat of the infected person
- airborne illness requiring droplet precautions and hand washing
- signs and symptoms include high fever, blotch red rash and presence of Koplik spots
- treatment is supportive with hydration
- prevention as part of MMR vaccine
33
mumps: childhood disease
- Acute, communicable and systemic disease
- Transmission through droplets or direct contact with saliva of infected person
- signs and symptoms include a fever, swelling and tenderness of the parotid salivary glands affecting one or both sides of the neck
- Treatment is supportive with analgesics and antipyretics
- Prevention as part of MMR vaccine
34
rubella (german measles): childhood diseases
- found in respiratory secretions
- transmission by direct contact with nasopharyngeal secretions of infected persons
- signs and symptoms include low grade fever, rash, and swollen lymph glands behind the ears and at the base of the skull
- treatment is supportive
- prevention as part of MMR vaccine
35
multidrug-resistant organisms: methicillin-resistant staphylococcus aureus (MRSA)
- community acquired (prevalent in nursing homes)
| - signs and symptoms include deep abscesses to bones, joints, heart valves, and bloodstream
36
multidrug-resistant organisms: vancomycin-resistant enterococci (VRE)
- resistant to antibiotics
- found in patients with UTI or bloodstream infections
- signs and symptoms unusual urine color or odor, fever, chills, or wound infections
37
multidrug-resistant organisms: clostridium difficile (C-diff)
- caused by antibiotic therapy and unwashed hands by healthcare providers
- infection usually is the stool
- signs and symptoms include diarrhea that has a foul odor and abdominal pain
38
treatment for all includes handwashing practice
- methicillin-resistant staphylococcus aureus (MRSA)
- vancomycin-resistant enterococci (VRE)
- Closterium difficile (C-diff)
39
conclusions
- who are the regulatory agencies and what are their roles
- epidemic vs. pandemic
- routes of transmission- how can this be prepared
- scenarios- understand the diagnosis behind each scenario
- know the signs and symptoms for each infectious disease presented in the cases
- HEPATITIS- know the different types and the transmission routes as it pertains to each -> what are the treatment plans for each
- CHILDHOOD DISEASE- MMR vaccine -> signs and symptoms specific to each infectious disease as it relates to MMR
- MULTIDRUG-RESISTANT ORGANISMS- classic signs and symptoms pertaining to the various classifications
40
LOOK AT HEPATITIS CHART
**
41
Hepatitis D
- spread FECAL, ORAL, SEXUAL, (parenteral?)
| - VACCINE -> YES (same as hep b vaccine)
