T1- Inf Dz of Heart Flashcards
(108 cards)
1
Q
What is a major function of the cardiovascular system?
A
provides tissues with oxygen and nutrients and carries away carbon dioxide and waste products
2
Q
The cardiovascular system moves blood in a ____ circuit.
A
closed
3
Q
What organ is divided into two halves, each half divided into an upper and lower chamber?
A
the heart
4
Q
What covers the heart?
A
pericardium
5
Q
What are the three layers to the wall of the heart (from outer to inner)?
A
outer - epicardium
middle - myocardium
inner - endocardium
6
Q
What is a one-way passage that returns fluids from the tissues to the cardiovascular system?
A
the lymphatic system
7
Q
The cardiovascular system is highly protected, however, if microbes do invade what do they gain access to?
A
every part of the body
8
Q
bloodstream infections = _________.
A
systemic infection (often with the suffix -emia)
9
Q
What systemic infection can lead to septic shock?
A
septicemia
10
Q
What are the defenses in the bloodstream?
A
leukocytes
11
Q
T/F: The cardiovascular and lymphatic systems both contain normal biota.
A
FALSE!! - Some microorganisms may be present transiently (filtering out of tissues) but they do NOT colonize the systems in the healthy state.
12
Q
A patient came into the ED while Jen was the PA on call. The patient felt like they were having a heart attack. Along with this symptom, the patient presented with petechiae over the upper half of his body, fever, abnormal heartbeat, abdominal pain and was anemic. What is the first diagnosis Jen should suspect?
A
Endocarditis
13
Q
inflammation of the endocardium = _____.
A
endocarditis
14
Q
When a patient presents with endocarditis, where does the infection usually occur?
A
in the valves of the heart
15
Q
What is the causative organisms of acute endocarditis?
A
Staphylococcus aureus, Streptococcus pyogenes, S. pneumoniae, Neisseria gonorrhoeae
16
Q
What is the most common mode of transmission of acute endocarditis?
A
parenteral
17
Q
What is the virulence factor of both acute and subacute endocarditis?
A
attachment
18
Q
What is the culture performed to confirm diagnosis of both acute and subacute endocarditis?
A
blood culture
19
Q
What can be done to prevent acute endocarditis?
A
aseptic surgery or injections
20
Q
What treatment is recommended for both acute & subacute endocarditis?
A
PCN, or vancomycin plus aminoglycoside - but surgery may be necessary
21
Q
What are the distinctive features of acute endocarditis?
A
acute onset with high fatality rate
22
Q
What is the causative organism for subacute endocarditis?
A
Alpha-hemolytic streptococci
23
Q
What is the most common mode of transmission of subacute endocarditis?
A
endogenous transfer of normal biota to bloodstream
24
Q
How can subacute endocarditis be prevented?
A
prophylactic antibiotics before invasive procedures
25
What is the distinctive feature of subacute endocarditis?
slower onset that acute endocarditis
26
35-yr old WM comes to the ED presenting with 102 degree fever, shaking chills, GI symptoms, BP of 80/60, RR of 20, respiratory alkalosis and apparent altered mental state. What is the most likely diagnosis?
septicemia
27
What are the causative organisms of septicemia?
bacteria or fungi
28
What is the most common modes of transmission of septicemia?
parenteral or endogenous transfer
29
What are the virulence factors of septicemia?
cell wall or membrane component
30
What is used to determine the diagnosis of septicemia?
blood culture
31
What is used to treat septicemia?
broad-spectrum antibiotic until identification and susceptibilities tested
32
What are the 3 possible manifestations of plague?
Pneumonic plague
Bubonic plague
Septicemic plague
33
What plague is respiratory disease?
pneumonic plague
34
What plague is has bacterium injected through a flea bite, enters the lymph and is filtered by a lymph node, infection causes inflammation and necrosis of the node?
bubonic plague
35
What plague results in a swollen lesion called a bubo, usually in the groin or axilla?
bubonic plague
36
what is the incubation period of bubonic plague? ending with the onset of fever, chills, HA, nausea, weakness, and tenderness of the bubo
2-8 days
37
Which plague is when the case progresses to massive bacterial growth in the blood?
septicemia plague
38
What is the causative organism of plague?
Yersinia pestis
39
What is the most common mode of transmission of plague?
vector, biological; also droplet contact and direct contain with body fluids
40
What is the virulence factor of plague?
capsule, yop system, plasminogen activator
41
What is the prevention of plague?
flea and or animal control; vaccine available for high-risk individuals
42
What is the treatment of plague?
streptomycin or gentamicin
43
What is sometimes called rabbit fever, because it has been associated with outbreaks of disease in wild rabbits?
Tularemia
44
What is the pathogen of concern on the lists of bioterrorism agents for Tularemia?
Francisella tularensis
45
Most frequent arthropod vector is tick bites
Tularemia
46
Symptoms to __ include Headache, backache, gever, chills, malaise and weakness.
Tularemia
47
Treatment of Tularemia?
Gentamicin or streptomycin
48
What is a nonfatal disease that evolves into a slowly progressive syndrome that mimics neuromuscular and rheumatoid conditions?
Lyme Disease
49
What are the early symptoms of Lyme Disease?
Rash at the site of tick bite, Other sxs: fever, HA, stuff neck and dizziness
50
What are the second stage of symptoms of Lyme DIsease?
cardiac and neurological symptoms develop
51
What is the Causative agent of Lyme Disease and the most common mode of transmission?
Borrelia burgdorferi
Vector, biological
52
What are the virulence factors and diagnosis of Lyme Disease?
Antigenic shifting, adhesins
ELISA for Ab, PCR
53
What is the treatment of Lyme Disease?
Doxycycline & or amoxcillin for 3-4 weeks, also cephalosporins and pencillin
54
Infectious mononucleosis is majority caused by __
Epstein-Barr virus (EBV)
55
What is the most of the remainder caused of infectious mononucleosis?
cytomegalovirus (CMV)
56
What are the symptoms of mono?
Sore throat, high fever, and cervical lymphadenopathy
May exhibit a gray-white exudates in the throat, skin rash, and enlarged spleen and liver
Sudden leukocytosis and Fatigue
57
What is the incubation period of mono?
30-50 days
58
What is the treatment for Mononucleosis?
Supportive care. This disease is most common in teens, and there is no known way to prevent this from occurring.
59
Viruses from what four families cause hemorrhagic fever disease?
1. Arenaviridae
2. Filoviridae
3. Flavivridae
4. Bunyaviridae
60
This hemorrhagic fever will disrupt the blood-clotting system.
Yellow fever.
61
What are symptoms/complications of yellow fever?
Fever, HA, muscle pain
| -Progressing of disease will lead to oral hemorrhage, nosebleed, jaundice, liver and kidney damage.
62
Which type of fever causes severe pain in muscles and joints?
Dengue Fever
This can progress to dengue hemorrhagic shock syndrome, otherwise, it is typically a mild condition.
63
These two types of viruses cause similar symptoms. In the earliest stages, it will often manifest a rash on the trunk of the patient.
Ebola and Marburg.
patients will bleed from their orifices, mucous membranes and experience massive internal and external hemorrhage.
64
Patients who recover from this hemorrhagic fever typically suffer from deafness.
Lassa Fever.
65
Although most patients are asymptomatic with Lassa Fever, what are some symptoms a patient might have?
Chest pain, hemorrhaging, sore throat, back pain, vomiting, diarrhea, encephalitis.
66
List the non-hemorrhagic fever diseases.
1. Brucellosis
2. Q Fever
3. Cat-Scratch Disease
4. Trench Fever
5. Ehrlichioses
6. Rocky Mountain Spotted Fever
67
This type of fever is on the CDC list of possible bioterror agents.
Brucellosis
Symptoms include: fluctuating pattern of fever accompanied by chills, profuse sweting, HA, muscle pain and weakness.
68
Your patient has an abrupt onset of fever, chills, HA, myalgias (muscle ache), with rash. What is this non hemorrhagic fever?
Q fever.
Can be complicated by pneumonitis, hepatitis, endocarditis.
69
Your patient will not notice symptoms until 1-2 weeks after infection. On exam, you notice cluster of small papules at the site of inoculation. Due to the infection being active for weeks, you notice lymph node swelling. What is the likely diagnosis?
Cat Scratch Disease.
- Only about 1/3 of patients experience a high fever with this disease.
70
This disease has highly variable symptoms. Your patient might come in complaining of leg pain, specifically in the tibial region. They will also have a macular rash present on exam. What is the likely diagnosis?
Trench Fever
HA and chills are other symptoms which might be reported.
71
This is characterized by an acute afebrile state associated with HA, muscle pain and RIGORS.
HGA and HME
72
A patient comes into your clinic with sustained fever, chills, headache and muscular pain. 2-4 days after these symptoms begin, a distinctive spotted rash appears. What is the appropriate nonhemorrhagic fever associated with this presentation?
Rocky Mountain Spotted Fever (RMSF)
Severe untreated cases: enlarged lesions merge and become necrotic
73
What is the causative organism of Rocky Mountain Spotted Fever? What is the most common mode of transmission? Treatment?
Rickettsia rickettsii
Biological vector (tick)
Doxycycline
74
What is the causative organism of Trench fever? Mode of transmission? Treatment?
Bartonella quintana
Lice
Doxycycline or erythromycin
75
What is the causative organism of Cat Scratch Disease? Mode of transmission? Treatment?
Bartonella henselae
Parenteral (cat scratch or bite)
Azithromycin
76
What is the causative organism of Q fever? Mode of transmission? Treatment?
Coxiella burnetti
Airborne, direct contact, food-borne
Doxycycline
77
What is the causative organism of Brucellosis? Mode of transmission? Treatment?
Brucella abortus or B. suis
Direct contact, airborne, parenteral (needlesticks)
Doxycycline (plus gentamicin or streptomycin)
78
What is the world's most dominant protozoan disease?
Malaria
79
Your patient describes onset of symptoms including malise, fatigue, nausea with intermittent diarrhea. They then state symptoms progress to bouts of chills, fever and sweating. What is the possible diagnosis?
Malaria.
- Symptoms occur at 48-72 hour intervals.
- the interval, length and regularity of symptoms reflect the type of malaria.
80
Most common mode of transmission for Malaria?
Biological vector (mosquito).
Prevention by mosquito control, use of bed nets, not vaccine. You can treat prophylactic with antiprotozoal agents.
81
What is the main treatment options for one infected with Malaria?
Choloquine, mefloquine, artemisinin
82
What are the most common forms of Anthrax?
Cutaneous and pumonary.
Other, less common, types include gastrointestinal and anthrax meningitis.
83
What is the causative organism of Anthrax?
Bacilllus anthracis.
Mode of transmission is typically through air, soil, indirect contact (animal hides), vehicle (food).
84
What is the best way to prevent Anthrax?
Vaccine for high-risk population, postexposure antibiotic prhphylaxis.
You will treat with Doxycycline, cipro, penicillin.
85
______ = retrovirus; hybrid virus-genetic sequences from two separate monkey SIVs
Human immunodeficiency virus
86
____ = disease; spectrum of clinical disease associated with HIV infection.
AIDS - acquired immunodeficiency syndrome
87
Symptoms of AIDS is directly tied into what two things?
1. The level of virus in the blood
| 2. The level of T cells in the blood
88
What are the symptoms associated with the initial infection with HIV?
vague, mononucleosis-like symptoms that soon disappear (initial high levels of virus)
--within days, about 50% of the T helper cells with memory for the virus are destroyed
89
A period of asymptomatic infection of HIV occurs that varies in length from ______ to _____ years. What happens to T cells during this time?
2 to 15 years
- -During this period the number of T cells in the blood is steadily decreasing
- -Once T cells reach low enough levels, symptoms of AIDS ensue
90
What are the initial symptoms of AIDS?
fatigue, diarrhea, weight loss, and neurological changes
91
What are some other symptoms as AIDS progresses?
1. Opportunistic infections or neoplasms
2. Severe immune deregulation, hormone imbalances, metabolic disturbances
3. Pronounced wasting of body mass
4. Protracted fever, fatigue, sore throat, and night sweats
5. Lesions in the brain, meninges, spinal column, and peripheral nerves
92
What is the causative organism of HIV infections & AIDS?
Human immunodeficiency virus 1 or 2
93
What are the most common modes of transmission for HIV infection and aids?
direct contact (sexual)
parenteral (blood born)
vertical (perinatal or via breast milk)
94
What are the virulence factors associated with Human immunodeficiency virus 1 or 2?
Attachment
Syncytia formation
Reverse transcriptase
High mutation rate
95
What do you do to culture/diagnose HIV infection and AIDS?
avoidance of contact with infected sex partner, contaminated blood, breast milk
96
What is the treatment for HIV infection and AIDS?
HAART (reverse transcriptase inhibitors plus protease inhibitors) Fuzeon, nonnucleoside RT inhibiotors
97
What is the causative agent of Adult T-Cell leukemia?
HTLV-1
98
What is the causative agent of Hairy-Cell Leukemia?
Possibly (HTLV-II)
99
What are the most common modes of transmission for HTLV-1 in adult T-Cell Leukemia?
Unclear-
| blood borne transmission implicated
100
What are the most common modes of transmission for Hairy-Cell Leukemia?
unclear-
| blood borne transmission implicated
101
What are the virulence factors associated with HTLV-1 in Adult T cell leukemia & Hairy Cell Leukemia (Possible HTLV-2)?
induction of malignant state
102
how do you culture/diagnose adult & hairy t-cell leukemia?
differential blood count followed by histological examination of excised lymph node tissue
103
How can you prevent t-cell leukemia?
CANTTTTTTT
104
What is the treatment for t-cell leukemia?
antineoplastic drugs, interferon alpha
105
What is the most common mode of transmission of AIDS in the USA?
Male to Male sexual contact
106
_____ = a general name for atleast four different malignant diseases of the WBC forming elements originating in the bone marrow.
-some acute, some chronic
Leukemia
107
What two cases of leukemia are considered viral?
Adult T-cell leukemia by HTV-1
| Hairy cell leukemia by HTLV-II
108
WHat are the signs & symptoms of t-cell leukemia?
easy bruising or bleeding, paleness, fatigue, and recurring minor infections
