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Flashcards in The Home Guard Deck (34)
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1

Define the 'normal flora'.

The wide range of organisms that live on the body without causing disease (usually).

2

Define endogenous infection.

An infection whose source is within the body.

3

Define exogenous infection.

An infection whose source is a tranmitted organism.

4

What is the meaning of commensal or non-commensal?

Pathogen or non-pathogen 

5

What is a pathogen?

An organism capable of causing disease.

6

Mucus and cilia capture organisms and remove them from the respiratory tract. This is part of the innate immune system What could compromise this?

  • Loss of ciliary function (e.g. Kartagener's syndrome).
  • Thick mucus as in cystic fibrosis. 
  • BOTH lead to chronic bronchial sepsis.
  • Some organisms which cause this are:
    • S. aureus
    • H. influenzae
    • P. aeruginosa
    • M. cattarhalis
    • M. abscessus
  • Intubation bypasses the system which is designed to prevent pathogens from entering so could also compromise this defence mechanism. 

7

The flushing action of urinary flow removes organisms. This is part of the innate immune system. How could this immune defence be compromised?

  • Many urinary pathogens have specialised adherence mechanisms.
  • Obstruction to the urinary flow can lead to stasis and urosepsis. 
  • Obstruction can be caused by:
    • Catheters
    • Congenital malformations
    • Pregnancy
    • Prostatic enlargement 
    • Stones 
    • Tumours 
  • Cathaters damage the epithelial lining. A big bag of urine full of bugs which can eventually travel back up the cathater can compromise.

8

The skin is a physical barrier to pathogens. This is part of the innate immune system. How could this be compromised?

  • Breaching the skin opens a route for infection.
  • Some causes of this are:
    • IV therapy
    • Canulae
    • Central venous lines
    • Arterial lines
    • Chest drains 
    • Post-operative drains
  • This can take skin organisms into the body.
  • They can use this as a route for invasion.
  • It causes local sepsis and septicaemia.

9

The stomach acid kills infected pathogens. This is part of the innate immune system. How could this be compromised?

  • The stomach acid reduces the infective dose making intestinal infection less likely.
  • Reducing stomach acid allows colonisation and infection at lower infective doses.
  • The impact varies depending on the organism's infective dose.
  • Some causes are:
    • Antacids 
    • H2 antagonists
    • Proton pump inhibitors
  • Some relevant organisms are:
    • Salmonella
    • Shigella
    • C. difficile
    • Resistant gram negatives

10

The vagina has a low pH as a result of lactobacilli which prevents colonisation by pathogens. This is part of the innate immune system. How could this be compromised?

  • Mixed flora in the vagina prevents colonisation. 
  • Replacement by potential pathogens leads to vaginitis.
  • Some causes are:
    • Antibiotic use
    • Age-related - becomes more common with age because the flora depletes with age.
  • Some relevant organisms are:
    • Candida spp.
    • Trichomonas vaginalis

11

Which patients will be affected by S. mitis?

S. mitis does not cause disease unless the patient is immunocompromised. These patients can become septic.

12

What can be caused by S. oralis?

Endocarditis

13

What can be caused by staphylococcus aureus?

  • Skin sepsis
  • Septicaemia
  • Acute endocarditis
  • Osteomyelitis

14

What can be caused by staphylococcus epidermidis?

  • Endocarditis
  • Local sepsis
  • Septicaemia

15

What can be caused by candida albicans?

  • Candidaemia
  • Endocarditis

16

What can happen to the lower bowel following:

  • perforation of hollow viscus
  • intestinal obstruction
  • penetrative injury
  • pancreatitis
  • cholecystitis?

  • Perotinitis 
  • Abscess formation 
  • Septicaemia
  • Fistula formation 

17

Describe colonisation resistance.

  • A theoretical concept
  • Bacterial products inhibit other organisms (e.g. free fatty acids from anaerobes)
  • Competition of binding sites limits competition
  • Disruption of colonisation resistance allows pathogens or resistant organisms to gain a foothold.
  • Some causes:
    • Intensive therapy unit
    • Antibiotic therapy (especially targeting anaerobes)

18

What are the important points surrounding air and water supply in hospitals?

  • Managed airflow is potentially infecting patients. 
  • Complex water supply allowing pathogens to lurk 
  • Multiple patients
  • Immunologically vulnerable patients
  • Transmissible organisms are concentrated

19

Which pathogens travel by airborne transmission?

  • S. aureus 
  • S. pyogenes 
  • M. tuberculosis
  • S. pneumoniae
  • Respiratory viruses
  • Legionella

20

Which pathogens are transmitted by direct contact?

  • S. aureus
  • Enterobacteria
  • Pseudomonas
  • Vancomycin resistant enterococci (VRE)

21

What are the relevant organisms and consequences of these associated with IV canulation?

  • Organisms:
    • Coagulase negative staph
    • S. aureus
    • Gram-negativie bacilli
    • Yeasts
  • Consequences:
    • Septicaemia
    • Endocarditis

22

What are the infection consequences associated with surgery?

  • Predisposition
    • Tissue trauma
    • Ischaemia
    • Leak of intestinal contents
  • Consequences
    • Local infection 
    • Abscess
    • Septicaemia

23

What are the infection consequences associated with urinary catheter?

  • Urinary stasis
  • Bacterial colonisation
  • Consequences:
    • Urinary infection 
    • Systemic infection

24

What are the relevant organisms and consequences associated with gastrointestinal infection?

  • Antibiotic-associated diarrhoea
  • C. difficile
  • Norovirus
  • Food poisoning

25

What are the predisposing factors and consequences of a skin infection?

  • Predisposition:
    • Surgery
    • Stasis
    • Burns
  • Consequences
    • Local infection
    • Colonisation by resistant bacteria

26

What are the organisms associated with spelectomy?

  • S. pneumoniae
  • H. influenzae type b
  • Plasmodium falciparum
  • Babesia spp.
  • Removal of the spleen causes increased risk of pneumococcal sepsis.

27

What are the organisms associated with complement deficiency?

  • Neisseria spp.
  • S. pneumoniae

28

Which infections can be commonly caused by streptococcus pneumoniae?

  • Lower respiratory tract infection 
  • Meningitis

29

Which infections can be commonly caused by haemophilus influenzae?

  • Bacteraemia

30

Which type of infection is commonly caused by cryptosporidium?

  • Intestinal infection