chn finals

Primary cause of mortality gap between the rich and the poor countries

Communicable disease

What diseases attriubute to 60% of the death toll on communicable disease

• HIV

• MALARIA

• TUBERCOLOSIS

• MEASLES

• DIARRHEAL DISEASE

• ACUTE RESPIRATORY INFECTION

What is the Goal of WHO with communicable diseases

• prevention of disease

• Prevention of disability and death

• Prevention through immunization

Biologic agent capable of causing disease

Pathogen or causative agent

How to eliminate a pathogen

• sterilizing surgical instruments

• Using good food safe Methods

• Provide safe drinking water

• Vaccinating people

• Treating people who are ill

What are the chain of infection

• pathogen

• Reservoir

• Portal of exit

• Mode of transmission

• Portal of entry

• Susceptible host

Any thing or person or place that can house a pathogen

Reservoi

The way the causative agent gets out of the reservoir

Portal of exit

Any mechanism by which a pathogen is spread from a source or reservoir to a person

Mode of transmission

Hole in the skin that allows the infectious agents to get into the body

Portal of entry

Examples of portals of entry

• mouth

• Nose

• Eyes

• Rashes

• Cuts

A person or animal lacking the effective resistance to a particular infectious agent

Susceptible host

Evidence of disease that is experienced or perceived (subjective) noted by patients not an observer

Symptoms

Objective evidence of a disease the physician can observe and measure

Signs

A specific group of signs and symptoms that accompany a particular disease

Syndrome

Number of people in a population who develop a disease during a particular time

Incidence

Number of people in a population who develop a disease regardless when

Prevalence

Any disease caused by invasion and multiplication of microorganisms

Infectious diseases

Disease that easily spreads from one person to another

Contagious disease

What are the diseases based on the behavior of the host

• Infectious disease

• Contagious Disease

Classifications based on the occurrence of a disease

• sporadic disease

• Endemic disease

• Epidemic disease

• Pandemic disease

Disease that occurs only occasionally

Sporadic disease

Disease constantly present in a population, country or community

Endemic disease

Disease acquired in a relatively short period greater than normal number of cases in an area within a short time

Epidemic disease

A disease that occurs world wide

Pandemic disease

Disease that develops rapidly and last a short time

Acute disease

A disease that develops slowly, milder but longer lasting clinical manifestation

Chronic disease

Acute infection that causes the initial illness

Primary infection

Diseased that is caused by an opportunistic pathogen after primary infection

Secondary infection

What are the stages of disease

• incubation period

• Prodromal period

• Period of illness

• Period of decline

• Period of Convalescence

Time interval between the initial infection and the 1st appearance of any signs and symptoms

Incubation period

Stage where early, mild symptoms of disease show

Prodromal period

Stage of the disease where

• overt signs and symptoms of disease

• WBC may increase or decrease which leads to death if not treated

Period of illness

Stage of disease where

• signs and symptoms subside

• Vulnerable to secondary infection

Period of decline

Stage of disease where

• Regain strength and the body returns to its pre disease state

Period of convalescence

The process of the infectious agent moving from reservoir to susceptible host

Mode of transmission

What are the types of contact transmission

• direct contact

• Indirect contact

What are examples of high risk patients

• immunocompromised

• DM

• Surgery

• Burns

• Elderly

How to eradicate the source of Blood borne diseases

• Chemically treated mosquito net

• Larvae eating fish

• Environmental sanitation

• Anti mosquito

• Neem tree

What are examples of a neem tree

• Oregano

• Eucalyptus

It is caused by the dengue virus

Dengue Hemorrhagic Fever

What insect transmits dengue

Aedes Aegypti mosquito

What is the incubation period of dengue

2-7 days

What is the clinical manifestation of dengue in 4 days

Febrile or invasive stage

• which causes high grade fever, headache, body malaise, vomiting and gum bleeding

What happens at the fourth or seventh day of dengue

Toxic or hemorrhagic stage

• abdominal pain

• Bleeding Upper gi tract

• Shock

What happens on the 7th to 10th day of dengue

Convalescence stage

Classification of dengue fever that is

• Dengue fever, saddleback fever plus constitutional signs and symptoms plus positive tourniquet test

Grade 1

Classification of dengue fever that is

• Grade 1 plus spontaneous bleeding, epistaxis (nosebleed), GI, cutaneous bleeding

Grade 2

Classification of dengue which has

• Dengue shock syndrome, all of the signs and symptoms plus circulation failure

Grade 3

Classification of dengue where

• Grade 3 plus irreversible shock and massive bleeding

Grade 4

What type of diagnostic technique is used on dengue

Tourniquet test

It is a presumptive test for capillary fragility

Tourniquet test

What are the laboratory tests that need to be run for a dengue patient

• CBC

• Bleeding parameters

• Serologic test

• Dengue blot

How much IVF do you give a dengue patient that is somewhat stable with hemoconcentration

5-7 ml/kg/hr

How much IVF do you give a dengue patient that is with shock

10-30 ml/kg in less than 20 minutes

How much fresh frozen plasma is needed to be transfused to a dengue patient

15ml/kg x 2-4 hours

How much platelets need to be transfused to a dengue patient

1 unit/ 5-7kg

What nursing intervention do you do to a dengue patient

• paracetamol

• Giving cytoprotectors

• Gastric lavage

• No IM injection

When a dengue patient goes to shock what do you do

Place patient in trendelenburg position

Is a disease that progresses unto a chronic, debilitating and disfiguring disease since the symptoms are unnoticed

Filariasis

Where can you find high rates of filariasis

• bicol

• Samar and leyte

• Davao

What is the causative agent of filariasis

• Wucheria Bancrofti

• Bulgari Malayi

What are the carriers of the Filariasis disease that transmits the disease

Bite of an infected mosquito like

• aedes

• Anopheles

• Mansonia

What are the two biological types of the filariasis

• Nocturnal

• Diurnal

In nocturnal filariasis what time does it usually occur

10pm - 2am

In diurnal filariasis what time does the disease spread

DAYTIME

For acute filariasis how frequent does it show

10 times per year

How long does chronic filariasis last

10-15 years

What diagnostic test need to be ran for Filariasis

• Blood smear

• Immunochromatographic Test

• Presence of microfilaria

• Eosinophil count

What meds are used for Filariasis

• Diethycarbamazine

• Ivermectin

• Paracetamol

• Vitamin B

What meds are used for when a filariasis patient gets an elergic reaction due to DEC

Antihistamine

A zoonotic systemic infection caused by leptospira which is caught through exposure of soil or water contaminated with animal urine

Leptospirosis

What is the causative agent of leptospirosis

Leptospira

What are the two types of leptospirosis

• Anicteric type

• Icteric type

What is the type of leptospirosis that has

• without jaundice

• Manifested by fever and conjuctival infection

• Signs of meningeal irritation

Anicteric type

What type of leptospirosis where

• jaundice, hepatomegaly

• Hepatic and renal manifestation

• Oliguria, anuria which progress to renal failure

• Shock, coma, CHF

• Convalescent period

Icteric type

What type of syndrome is Icteric Leptospirosis

Weil Syndrome

What diagnostic procedure is needed for leptospirosis

• culture

• Blood during 1st week

• CSF from 5th to 12th day

• Urine after 1st week until convalescent period

• LAAT (leptospira agglutination test)

What are the specific treatments of leptospirosis

• penicillin 50,000 units /kg/ day

• Tetracycline 20-49mg/kg/day

What treatment for patients with leptospirosis with renal failure

Peritoneal dialysis

Also known as king of tropical disease

Malaria

What causes malaria

Protozoa Plasmodia

What insect causes Malaria

Anopheles Mosquito or minimus flavire

Where did malaria have heavy tolls

sub saharan africa up to 90%

When does the anopheles mosquito usually bite to cause Malaria

At night

bacteria in Malaria that is described

• more widely spread

• Causes benign tertian malaria

• Chills and fever every 48 to 3 days

Plasmodium vivax

Bacteria in malaria described as

• common in the Philippines

• Causes the most serious type of malaria due to high parasitic density in blood

• Causes malignant tertian malaria

Plasmodium falciparum

Type of bacteria in malaria which is described

• much less frequent

• Causes quartan malaria, fever and chills for 72 hours in four days

Plasmodium malaria

Bacteria from malaria which is described

• rarely seen

Plasmodium Ovale

What is the most characteristic pathology of malaria

• Destruction of red blood cells

• Hypertrophy of the spleen

What are the manifestation stages of malaria

• cold stage

• Hot stage

• Diaphotetic stage

What disease with clinical manifestation of

• fever and chills every 24-36 hours

• Sporulation or segmentation and rupture of erythrocytes in the brain

• Cerebral malaria

• Seizure

Malaria

Disease with clinical manifestation of

• Filarial Fever

Lymphatic inflammation that happens 10 times per year

Filariasis

Inflammation of the lymph nodes

Lymphadenitis

Inflammation of the lymph vessels

Lymphangitis

Swelling of the scrotum

Hydrocele

Temporary swelling of upper and lower extremities

Lymphedema

What are the diagnostic procedures for malaria

• Malaria smear

• Quantitative buffy coat

Treatment for malaria with P. flaciparum

• chloroquine tablet 150mg/base/tab Days 1,2,3

• Sulfadoxine/ Pyrimethamine 500mg/25mg/tab

• Primaquine

What is the treatment for malaria with P. vivax

• chloroquine

• Primaquine