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Zeynep Tekin Tas Flashcards

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1
Q

Standard Precautions

A

 Hand hygiene  Use of personal protective equipment (PPE)  Respiratory hygiene  Environmental controls (cleaning and disinfection);  Waste management  Packing and transporting of patient-care equipment, linen and laundry, and waste from
isolation areas  Prevention of needle-stick or sharps injuries

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2
Q

Hands are not visibly soiled ->

A

using an alcohol-based hand rub, or by
washing hands with soap and water, and drying them using a single-use
towel

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3
Q

Hands are visibly dirty or soiled with blood or other body fluids 

A

washed thoroughly with soap and water

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4
Q

5 moments for hand hygiene

A

1-before touching a patient
2-before clean/aseptic procedure
3-after body fluid exposure risk
4-after touching a patient
5-after touching patient surrounding

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5
Q

Putting on PPE

A

Ö M G E
-ÖNLÜK
-MASK
-GÖZLÜK YADA YÜZ KORUYUCU
-eldiven

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6
Q

Remove PPE

A

E G Ö M
-eldiven
-gözlük
-önlük
-maske

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7
Q

DROPLET PRECAUTIONS

A

Droplet precautions are appropriate for protection against droplets larger than 5 μm in size,
which are spread through close respiratory or mucous membrane contact with respiratory
secretions
**• SARS-CoV
• Bordetella pertussisa
• Influenza virus
• Adenovirus
• Rhinovirus
• Mycoplasma pneumoniae
• Group A Streptococcus
• Neisseria meningitidis
• Haemophilus influenzae
• Corynebacterium diphtheriae
• Mumps virüs
• Parvovirus B19

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8
Q

Gastroenteritis

A

the inflammation of the mucus membranes of the gastrointestinal tract and
is characterized by diarrhea or vomiting

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9
Q

**Which pathogens cause most of infectious gastroenteritis cases
And give example

A

Viral like:rotavirus(the most in young children ), norovirus(most common cause of medically attended), adenovirus, and astroviruses

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10
Q

**Which pathogen is responsible for severe cases of infectious diarrhea?

A

Bacterial :
Nontyphoidal Salmonella, Campylobacter, and Shigella

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11
Q

Which organism associated with poultry and common cause of travelers diarrhea in asia with postinfectois arthritis and Guillain -barre syndrome

A

Campylobacter jejuni

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12
Q

Most common cause of travelers diarrhea

A

E.coli

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13
Q

Most common cause of dysentery

A

Shigella spp.

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14
Q

**Which organism is more presents persistent or cronic diarrehea

A

Parasitic:Giardia, cryptosporidium, and E. Histolytica

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15
Q

Diarrhea of small bowel origin

A

typically w ate ry, of large volume, and associated with abdominal cramping, bloating, and
gas.

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16
Q

 Diarrhea of large intestinal origin

A

requent, regular, small volume, and often painful bowel movements. Fever and bloody
or mucoid stools are common, and red blood cells and inflammatory cells can be seen routinely on stool microscopy

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17
Q

bacterial causes of visibly bloody diarrhea

A

shigella, campylobacter, and
salmonella species.
E.coli

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18
Q

Stool test

A

-Antigen testing
-Enzyme immunoassay
-Polymerase chain reaction (PCR) of stool (multipathogen molecular panels )
-Fecal lactoferrin

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19
Q

**Red flags of diarrhea

A

Severe volume depletion/dehydration  Abnormal electrolytes or renal function  Bloody stool/rectal bleeding  Weight loss  Severe abdominal pain  Prolonged symptoms (more than one week)  Hospitalization or antibiotic use in the past three to six months  Age 65 or older  Comorbidities (eg, diabetes mellitus, immunocompromised)  Pregnancy

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20
Q

**empiric antibiotic therapy

A

 Acute, nonbloody diarrhea (non-travel-associated), not administering empiric antibiotic therapy
 Severe illness (fever ≥38.5°C [101.3°F], hypovolemia, ≥6 unformed stools per 24 hours, severe
abdominal pain)
 Features of inflammatory diarrhea (bloody diarrhea, small volume mucous stools, fever)
 High-risk host features (age ≥70 years, cardiac disease, immunocompromising condition, inflammatory
bowel disease, pregnancy)

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21
Q

** HIV can be transmitted by:

A

-sexual contact
-sharing needles
-mother to baby

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22
Q

**HIV not transmitted by

Study These Flashcards
A

-air or water
-saliva,sweat,tears,or closed mouth kissing
-insects or pets
-sharing toilets,food,drinks

23
Q

Chronic HIV infection

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A

– Chronic infection, without AIDS – AIDS, characterized by a CD4 cell count <200 cells/microL or the presence of any
AIDS-defining condition – Advanced HIV infection, characterized by a CD4 cell count <50 cells/microL

24
Q

Symptomatic acute HIV infection is
characterized by

Study These Flashcards
A

fever, lymphadenopathy, sore
throat, rash, myalgia/arthralgia, diarrhea, and
headache (often described as a
mononucleosis-like illness)

Diagnosis :
 Anti-HIV is negative  p24 antigen test is positive (from day 14)  If infection is strongly suspected and the p24 antigen test is negative, quantitative
HIV RNA should be measured by PCR (from day 10)  Treatment should be started immediately; with treatment prognosis is better as a
consequence of increased number of CD4 cells and decreased viral load

25
NON-AIDS DEFINING DISEASES IN THE EARLY STAGE OF SYMPTOMATIC HIV INFECTION
 Constitutional symptoms> 1 month fever or diarrhea  Oral aphthae  Vaginal candidiasis, persistent, frequent and difficult to manage  Oral hairy leukoplakia  Herpes zoster, two episodes or> 1 dermatome  Peripheral neuropathy  Bacillary angiomatosis (bartonella)  Cervical dysplasia  Cervical carcinoma in situ  Idiopathic thrombocytopenic purpura  Unexplained fever, weight loss, malasise, headache  Recurrent or persistent oropharyngeal or vulvovaginal candidiasis and oral hairy leukoplakia  Seborrheic dermatitis  Bacterial folliculitis, particularly due to Staphylococcus aureus, is also common
26
Dermatological findings in HIV infection
-Acute Retroviral Syndrome -Seborrheic Dermatitis -Staphylococcal folliculitis -kaposi's sarcoma -herpes zoster -viral warts -tinea pefis and onychomycosis
27
**Vaccination in HIV
 Hepatitis A and B vaccines  Influenza vaccine  Pneumococcal vaccine (conjugated and polysaccharide)  HPV vaccine  Meningococcal vaccines  Diphtheria, tetanus, pertussis vaccine  Polio vaccine  Measles, rubella, mumps and chickenpox vaccine  Zoster vaccine: VZV IgG positive elderly
28
Laboratory Testing In HIV
Renal function Hepatic function Glucose and lipid profile Urine pregnancy test Childbearing potential patiernts Bone mineral density testing
29
 The primary targets of the HIV
dendritic cells in the mucosa of the genital tract The dendritic cells then transport HIV into lymph nodes, where the virus infects lymphocytes  The receptors of the virus are the CD4 molecules on the surface of T lymphocytes  HIV destroys these CD4 cells, weakening a person’s immunity
30
-Vaccination is indicated for those without evidence of immunity, unless the patient has evidence of severe immunosuppression (a CD4 count <200 cells/microL) -Prophylactic antibiotics for primary prevention of opportunistic infections should be given to patients with CD4 cell counts <200 cells/microL
31
POST EXPOSURE PROPHYLAXİS (PEP) is required
Parenteral or mucosal contact with infected body fluids (blood, body fluids containing blood, genital secretions, CSF, amniotic fluid, peritoneal, synovial, pericardial and pleural fluid)
32
POST EXPOSURE PROPHYLAXİS (PEP) is not required:
Contact with body fluids that are not at risk of transmission (tears, saliva without blood, urine and sweat)
33
Airborne transmission
occurs when particles are created from desiccation of suspended droplets (<5 μm in size) and disseminated as airborne droplet nuclei
34
**what are airborne precautions organisms
• M tuberculosis • Rubeola (measles) • Variola (smallpox) • Middle East respiratory syndrome (MERS) • VZV, primary or disseminated
35
CONTACT PRECAUTIONS
Contact precautions are intended to prevent transmission of infectious agents spread by direct or indirect contact with patients or their environments
36
Contact precautions Or MDRO
• Methicillin-resistant S aureus • Vancomycin-intermediate S aureus • Vancomycin-resistant S aureus • Vancomycin-resistant Enterococcus • Extended-spectrum β-lactamase–producing organisms • Carbapenem-resistant Enterobacteriaceae • Multidrug-resistant S pneumoniae • C difficile • SARS-CoV • Herpes simplex virus (HSV), VZV • RSV • Acute viral conjunctivitis • Rotavirus • Scabies • Parainfluenza
37
Antibiotic prophylaxis (AP) refers to:
the prevention of infection complications using antimicrobial therapy -primarily (initial) -secondary (recurrence) -prevent inf by eliminating a colonizing organism
38
What is the most common indication for anti microbial use
Surgical
39
Antimicrobial prophylaxis is justified for most clean-contaminated procedures **The use of antimicrobial agents for dirty procedures or established infection is not classified as prophylaxis; rather, it represents treatment for presumed infection
40
What are skin flora organisms
streptococcal species, Staphylococcus aureus, and coagulase-negative staphylococci
41
Clean-contaminated procedures
predominant organisms include gram-negative rods and enterococci in addition to skin flora
42
General Principles Of Surgical Antimicrobial Prophylaxis
-bactericidal, nontoxic, and inexpensive and have in vitro activity against the common organisms that cause postoperative wound infection after a specific surgical procedure -bactericidal, nontoxic, and inexpensive and have in vitro activity against the common organisms that cause postoperative wound infection after a specific surgical procedure -Vancomycin and fluoroquinolone infusions should be started 90 to 120 minutes before surgical incision because these require at least 1 hour to infuse -The duration of AP for most procedures should not exceed 24 hours, with the exception of cardiac surgeries, in which antibiotics may be continued for up to 48 hours -The majority of preoperative prophylactic antibiotics are administered intravenously (IV)
43
........is used most often for surgical prophylaxis in patients with no history of beta-lactam allergy or of MRSA infection
(Cefazolin) -In patients requiring only cefazolin for preoperative surgical prophylaxis, (clindamycin or vancomycin )are often used as alternatives for those with significant allergies to the medication -Redosing antibiotics due to significant blood loss or dilution during surgery are other considerations being studied at this time
44
Surgical prophylaxis
Cefazolin Ciprofloxacin Clindamycin Metronidazole Vancomycin
45
**Rheumatic Fever
is associated with tonsillopharyngitis caused by the group A β- hemolytic streptococci, may result in carditis with or without valvulopathy **Preferred: -Penicillin G benzathine (1.2 million U IM every 4 week) -Penicillin V(Preferred)(250 mgr orally twice daily) • Macrolides (Erythromycin/Clarithromycin (250 mgr orally twice Daily) /Azithromycin) (who are allergic to penicillin)
46
Primary AP for Rheumatic Fever
appropriate treatment of group A streptococcal tonsillopharyngitis
47
Secondary AP ofRF
prevents recurrent episodes of RF
48
RECURRENT CELLULITIS
• Patients with lymphedema or severe venous insufficiency of their extremities are at increased risk of recurring β-streptococcal cellulitis • Typically, more than 2 or 3 episodes per year should occur before AP is initiated -Recurrent pyogenic skin infections caused by Staphylococcus aureus, including methicillin-resistant S aureus (MRSA), may be managed by encouraging good -penicillin G&V
49
MENINGOCOCCAL DISEASE
• Antimicrobial prophylaxis for meningococcal diseases should be offered to close contacts of sporadic cases of Neisseria meningitidis infection (headaches,altered mental status,photophobia,phonophobia,stiffness,high fever) Tx:Rifampin 600 mg orally every 12 h for 2 day or, • Ciprofloxacin 500 mg orally for 1 dose (adults) or, • Ceftriaxone 250 mg IM once
50
Urinary Tract Infection
• Non-pregnant women with recurrent (≥3 per year),uncomplicated urinary tract infections • Other patients who may be considered for prophylaxis of frequent UTIs • Pregnant women • Persons with spinal cord injuries • Persons with neurogenic bladders, • Renal transplant recipients, • Men with chronic bacterial prostatitis Tx:trimethoprim
51
SPONTANEOUS BACTERIAL PERITONITIS
• Ampirical oral or parenteral antimicrobial treatment of patients with cirrhosis and upper gastrointestinal (UGI) bleeding reduced the incidence of bacterial infections and was associated with shortened hospital stays and reduced rates of overall mortality, mortality from bacterial infections, and rebleeding • Aerobic gram-negative organisms and streptococci are the most frequent causes of this infection Tx(ascites and UGI bleeding) :ceftriaxone
52
BITE WOUND INFECTION
• These infections can lead to septic arthritis, tenosynovitis, severe soft tissue infection, or sepsis • The microbiology of dog and cat bite infections is typically polymicrobial and includes Pasteurella species as the most common isolate, followed by staphylococci, streptococci, and anaerobes Tx:Amoxicillin-clavulanate 875 mg orally twice daily for 3-5 day
53
PERTUSSIS
Pertussis (whooping cough), an upper respiratory tract infection caused by Bordetella pertussis, is associated with prolonged bouts of coughing that may last 1 to 6 weeks *tx:Azithromycin 500 mg orally day 1, then 250 mg per day on days 2-5
54
***Crimean-Congo Haemorrhagic Fever
-causes severe viral haemorrhagic fever outbreaks. -The virus is primarily transmitted to people from ticks and livestock animals. Human-to-human transmission can occur resulting from close contact with the blood, secretions, organs or other bodily fluids of infected persons. • In high risk contacts • Percutaneous injury • Mucosal/impaired skin contact with infected body fluids • < 1m contact without any precaution • In prophylaxis, Ribavirin 4 x 500 mg/day for 7 days , po is recommended

Infection (3 decks)

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