Pathology Exam 2

What are causes of Nervous System Disorders?

What are causes of Nervous System Disorders?

• Headache

• Vomiting

• Fever

• Nausea

• Mood Swings

• Weakness

Disturbances in motor & sensory function for Neurological Disorders are?

• Paralysis; weakness

• Seizures

• Stiffness

• Speech Impairment

• Visual Impairment

What are common Diagnostic Test for Neurological Disorders?

• Scans (MRI, CT, angiogram)

• EEG

• Motor Tests

• Sensory Tests

• Cerebrospinal Fluid (CSF) Analysis

• ICP

• Inflammation of the brain tissue

• Commonly carried by mosquitoes

• Cause: fever, headache, back/neck stiffness

• May be caused by bacteria, viruses, or other diseases such as chickenpox or measles

• Commonly treated with Antiviral medication

Encephalitis

• Inflammation of the brain & spinal cord meninges

• Result of viral or bacterial infection

• Inflammation of all 3 Meningeal Membranes (dura, arachnoid, & pia mater)

• Cause: high fever, photophobia, vomiting, severe headache, neck stiffness

• Bacteremia (bacteria in bloodstream)

• Diagnosed by Lumbar Puncture

• Menactra (vaccine)

Meningitis

• Much less prevalent now (vaccine for it)

• Caused by polo virus that can affect nerves

• Enters GI tract, goes to spinal cord, & brain stem, flu-like symptoms (muscular pain & weakness/paralysis)

• Subclinical, nonparalytic, & paralytic forms

• Survivors of paralytic form = “post-polio syndrome”

Poliomyelitis

• Degenerative disease that affects upper & lower motor neurons

• Known as “Lou Gehrig’s Disease”

• Sensory system may remain intact

• Chronic & progressively debilitating (eventually total dependency for mobility

• Death results in 2-5 yrs (respiratory compromise)

• Onset between 40-70 yrs old

• 3x men than women

• No cure

Amyotrophic Lateral Sclerosis (ALS)

• Chronic, progressive demyelination disease of CNS (affects motor & sensory)

• Demyelination plaques impair neural transmission (caused nerves to fatigue)

• Symptoms: weakness, Paresthesia, visual deficits (diplopia, blurred vision), fatigue, poor circulation; unsteady gait, speech deficits, vertigo, spasticity, cognitive changes

• Acute attacks treated with Corticosteroids

Multiple Sclerosis (MS)

• Chronic, progressive disease of CNS

• Affects basal ganglia (deficiency of inhibitory dopamine)

• Affects men more than women; 50s-60s

• Idiopathic

• Tremors at rest, rigidly, akinesia (freezing), bradykinesia (slow movement), postural instability

• Slow speech, fine tremor of hands “pill rolling” motion of fingers, resting tremor progress to intention tremor, infrequent eye blinking, masked face, flexed arms; lack of arm swing, “bent-forward“ posture, Festinating gait

• Medications: Levodopa-Carbidopa

Parkinson’s (PD)

• Loss of mental ability due to loss of brain cells or neurons

• Commonly occurs as the cells degenerate naturally with aging

• Two Types: senile & vascular

Dementia

• Degenerative disorder of the cerebral cortex

• Loss of cholinergic neurons in areas associated w/memory & cognition

• Most common cause of dementia in older adults (aged 70 or older)

• Begins w/slight mental impairment & short-term memory loss, taking up to 10 yrs. to develop into late-stage

• Idiopathic, linked to hereditary, autoimmunity, toxicities, & viruses

• Medication: Donepezil

Alzheimer’s

• “Stroke”

• Usually occurs in people over age 50

• 3rd leading cause of death

• Leading cause of this disease is Smoking

• Sudden impairment of cerebral circulation in one or more blood vessels

• Stroke typically results from cerebral embolism, thrombus, or hemorrhage

• S&S: one sides weakness, paralysis, or Paresthesia (motor or sensory impairment)

• Coordination, proprioceptive, & blurred (left) vision deficits

• Blood thinners, Anticoagulants, Antithrombotics, Thrombolytics

Cerebrovascular Accident (CVA)

• Occlusion of a major vessel

• Embolism (blood clock breaks loose, travels to bloodstream, get lodged in smaller vessel) from heart (atrial fibrillation, myocardial infraction, heart valve issues, carotid artery plaque/stenosis

• Thrombus (blood clot within a cerebral artery

Ischemic

• Bleeding into cerebral tissues

• High BP

• Aging, weakness vessels

• Arteriovenous malformations (AVMs)

Intracerebral Hemorrhage

• Bleeding subarachnoid space

• Aneurysm

• AVM

• Head trauma

• Blood disorder

• Blood thinners

Subarachnoid Hemorrhage

• Usually due to trauma

Subdural Hemorrhage

• Caused by bleeds

• Epidural, Subdural, Subarachnoid

• S&S: dialed pupils, headache, nausea, vomiting, dizziness, increased intracranial pressure, loss of consciousness, hemiparesis, convulsions

• TX: craniotomy & cauterizing of tissue

Hematomas

• An episode of CVA insufficiency

• Associated w/partial occlusion of a cerebral artery by an atherosclerotic plaque or an embolus

• Symptoms: dizziness, limb weakness, numbness, slurred speech, brined or mild loss of consciousness

• This disorder/disease are warning signs of an impending stroke

Transient Ischemic Attack (TIA)

• Chronic brain disease caused by intermittent electrical activity

• Incidence > childhood & elderly

• Recurring seizures (“sudden attacks”)

• ½ of all seizures are idiopathic

• Medications: Antoconvulsive

Epilepsy/Seizures

• Structural defect of the cerebellum & the skill

• Parts of cerebellum protrude downward into spinal canal through the Foramen Magnum

• S&S: dizziness, headaches, muscle weakness or paralysis, lack of sensation, visual deficits, poor balance/coordination

• Type I, II, III

Chiari Malformation

• Primary brain tumors develop from various tissue types within the intracranial cavity

• Manifestations result from increased intracranial pressure

• TX: chemo, radiation, surgery (dependent on type & location of tumor)

• Ex: Glioblastoma Multiform (most aggressive type)

Neoplasms (Brain Tumors)

• Trauma to the brain, neck, & spinal cord from contact forces, & rotational acceleration forces

• Primary Injury (from the blow/right after)

• Secondary Injury (from cardinal signs of inflammation)

• Concussion (head trauma that does not bruise the brain tissue)

• Skull Fractures (broken cranium)

Traumatic Brain Injury (TBI)

• Name is based on the most casual (inferior/downward)

• Partial or complete disruption of spinal cord (MVAs, falls, stabs, gunshot wounds, disc prolapse, vascular insult, complications from osteoporosis or RA)

• Common level injured: C5, C7, T6, T12, L1

• C1-C3 injuries = potentially fatal

• Concerns: weakness/paralysis, ROM limitations/contractures, skin integrity (prone to pressure ulcers), bowel & bladder dysfunction

Spinal Cord Injury (SCI)

• Degenerative changes in peripheral nerves; lead to sensory loss & motor weakness (burning or numbing sensation)

• Caused by: diabetes, alcohol abuse, malnutrition

• Mononeuropathy (single nerve involvement)

• Polyneuropathy (bilateral, symmetrical involvement

• LEs > UEs

Peripheral Neuropathy/Diabetic Neuropathy

• Involvement of nerve roots

• Ex: due impingement

• Due to skeletal changes

• Associated with soft tissue

Radiculopathy

• Affects the 7th cranial nerve (facial nerve)

• Causes one-sided (unilateral) paralysis of face

• S&S: results from interference in motor function

• Idiopathic but linked with viruses, Lyme disease, Menigitis, high BP, DM, hemorrhage, tumor, local trauma, autoimmune disorders, sarcoidosis

• Medications: Analgesics & Corticosteroids

Bells Palsy

• Acute inflammatory demyelination polyneuropathy (AIDP) recovery up to a year or two years

• Progressive muscular weakness which develops rapidly

• Idiopathic, assoc. w/auto-immune attack, can be triggered by infection

• Attacks myelin sheath & axons of cranial & peripheral nerves

• S&S: fever, malaise, nausea, weakness, paralysis, Paresthesia

• Respiratory failure can occur

• Symptoms can progress to several weeks, & recovery can take up to one year

Guillain Barre Syndrome (GBS)

• Chronic, progressive autoimmune neuromuscular disease

• Presences of autoantibodies to the acetylcholine receptor

• Strongly linked w/thymus issues (enlarged)

• Common in eyelids/eye movements; oropharyngeal, facial proximal, & respiratory muscles (ice pack test)

• Symptoms: diplopia, drooping eyelids, (ptosis), difficulty speaking, chewing (esp meat), swallowing

• TX: Thymectomy

Myasthenia Gravis

• New onset of weakness/fatigue occurring about 25 years after recovery from poliomyelitis

• Can affect previously involved muscles or different ones

• S&S: severe long-lasting fatigue, new decrease in functional ability, slow, steady progression of dysfunction, difficulty w/concentration & memory

Post-Polio Syndrome

• Known as Reflex Sympathetic Dystrophy (RSD)

• Abnormal responses of peripheral nerve

• Painful condition which can develop following trauma to a nerve (cauaglia)

• Severe, localized burning pain, allodynia, hyperalgesia, topic skin changes

• Difficult medical & PT management

Complex Regional Pain Syndrome (CRPS)

• Transmit messages from brain

• Corticospinal & corticonuclear tracts

• Ex: lesions in: CVA, TBI, SCI, MS, ALS

Upper Motor Neuron Lesions (UML)

• Transmits messages from brain stem & spinal cord

• Ex: lesions in: MD, poliomyelitis, MG, peripheral neuropathy, GBS, SCI, MS, ALS

Lower Motor Neuron Lesions (LML)

• Morbid sadness, dejection, melancholy, loss of interest in usually pleasurable activities

• Major: single episode of intermittent episodes through life, may be an illness itself, or a symptom of another psychiatric d/o (ex: schizophrenia), average onset in 20’s: Women > Men, most common adult psychiatric disorder

Depression

• Anticipation of a future concern

• Out of proportion to the situation or age inappropriate

• Hinders one’s ability to function normally

• Associated with muscle tension & avoidance behavior

Anxiety

• Cyclical mood swings

• Outburst of energy/activity, flight of ideas, decreased need for sleep, elevated mood, followed by extreme depression

• Each may last days to months

• Frequently accompanied by alcoholism & drug abuse

• >50 % of cases develop < 20, Men = Women

• Meds: Antipsychotics, Anticonvulsants, Antidepressants, Mood Stabilizers

Bipolar Disorder

• The first line of defense against pathogens.

  1. Skin and Mucosal Barriers: Physical barriers to prevent pathogen entry.

  2. Inflammatory Response: Reaction to injury or infection, characterized by redness, heat, swelling, and pain.

• Nonspecific: Treats all invaders the same way.

• No Adaptive Memory: No long-term immunity or memory for future encounters.

Innate Immunity

• Specific defense mechanism developed after exposure to antigens.

  • Specificity: Tailored response to specific invaders.

  • Memory: Enhanced response upon subsequent exposures to the same antigen.

• Types:

• Active Immunity: Acquired through exposure to an antigen, including vaccinations; provides lifetime protection.

• Passive Immunity: Antibodies or sensitized lymphocytes transferred from one person to another (e.g., mother to fetus, breast milk to baby); provides temporary protection.

Acquired Immunity

• A foreign particle or substance that triggers an immune response.

Antigen

• Proteins formed to destroy specific antigens.

Antibodies

• Function: Provide humoral immunity.

• Development: Originate from stem cells in the bone marrow and are present in bodily fluids like saliva and blood.

• Action: Produce antibodies that bind to antigens, neutralizing them.

• Role: Effective against free-floating organisms.

B-lymphocytes (B-cells)

• Function: Provide cell-mediated immunity.

• Development: Mature in the thymus and migrate to affected areas to directly destroy antigens.

• Types:

  • Helper T-cells: Stimulate B lymphocytes and macrophages.

  • Cytotoxic T-cells: Kill infected body cells.

T-lymphocytes (T-cells)

• Involved in engulfing and digesting pathogens and debris.

Macrophages

What are the factors affecting immunity?

• Aging

• Nutrition

• Environmental Exposure

• Trauma

• Medications

• Concurrent Diseases

• Splenectomy

• Stress

• Inherited disorders leading to increased risk of infections, autoimmunity, and cancer.

Primary Immunodeficiency

• Result from external factors such as infections, malnutrition, alcoholism, cancer, diabetes, aging, or medical interventions.

Secondary Immunodeficiency

• Caused by medical treatments.

• Factors: Cytotoxic drugs (chemo), corticosteroids, immunosuppressants, radiation, surgery (e.g., splenectomy).

Iatrogenic Immunodeficiency

• Type: Retrovirus (Types 1 and 2) primarily affecting T cells.

• Transmission: Through bodily fluids (e.g., blood, semen).

• Effects: Progressive immune suppression, affecting CD4 T-helper cells, macrophages, B cells, and CNS.

• Stages:

  • Asymptomatic

  • Early Symptomatic

  • Advanced (AIDS)

• Risk Factors: Risky sexual behavior, blood transfusion.

• Diagnosis: Antibody blood tests, antibody swab tests; antibody development may take up to 3 months.

• Treatment: No cure, but manageable with HAART (highly active antiretroviral therapy), immune system boosters, and lifestyle modifications.

HIV/AIDS

• Definition: Persistent, unexplained fatigue lasting more than 6 months.

• Symptoms: Sore throat, fever, muscle pain, weakness, and increased fatigue exacerbated by activity.

• Suspected Causes: Involvement of CNS, immune system, and hormonal regulation.

• Progression: Muscle weakness, memory issues, significant fatigue leading to functional impairment.

• Management: Emphasis on symptom relief and supportive care.

Chronic Fatigue Syndrome (CFS)

• Conditions: Allergic reactions, anaphylaxis.

• Symptoms: Wheezing, swelling, hypotension, hives, rhinorrhea.

• Common Allergens: Nuts, shellfish, drugs (e.g., aspirin, penicillin).

Type I (Immediate Hypersensitivity)

• ABO blood incompatibility, Myasthenia Gravis.

Type II (Cytotoxic Reactions to Self-Antigens)

• Conditions: Autoimmune disorders like lupus, rheumatoid arthritis.

• Mechanism: Antigen-antibody complexes deposit in tissues, causing inflammation and tissue destruction.

Type III (Immune Complex Disease)

• Conditions: Contact dermatitis, transplant rejection, type 1 diabetes, MS.

• Mechanism: Delayed response by sensitized T lymphocytes, resulting in inflammation and antigen destruction.

Type IV (Cell-Mediated/Delayed Response)

• Characteristics: Affects multiple organs; common symptoms include a butterfly-shaped facial rash, fatigue, and arthritis.

• Treatment: Glucocorticoids and regular exercise.

Systemic Lupus Erythematosus (SLE)

• Characteristics: Chronic muscle pain syndrome with widespread pain, sleep disturbances, and tender points.

• Associated Factors: Anxiety, stress, trauma, steroid withdrawal, infections.

Fibromyalgia

• Characteristics: Autoimmune connective tissue disease with skin thickening and organ fibrosis.

• Symptoms: Raynaud’s phenomenon, esophageal motility issues, joint stiffness.

• PT Intervention: Focus on maintaining ROM, gentle stretching, and use of lotion.

Scleroderma/Systemic Sclerosis

1. Characteristics: Progressive brain degeneration starting in mid-life. Symptoms include mental deterioration and abnormal jerky movements due to neuron deterioration in the basal ganglia.

2. Management: Genetic counseling is crucial. PT interventions focus on fall prevention, safe ambulation, balance and coordination activities, and wheelchair management.

Huntington’s Disease

1. Characteristics: Affects connective tissue leading to skeletal deformities, long and thin body structure, and impacts the eyes, skeleton, arms, cardiovascular system, and joints.

2. Severe Effects: Mitral valve prolapse, aortic valve ring dilatation, and weakness of the aorta and other arteries.

Marfan Syndrome

1. Characteristics: Affects the lungs (blockage of respiratory passages), pancreas (cyst formation), and digestive system (poor absorption). Marked by excessive secretions and early death.

2. Management: Postural drainage techniques to help clear airways.

Cystic Fibrosis

1. Characteristics: Progressive neuromuscular disorder affecting skeletal muscles with symptoms like hypotonia, weakness, scoliosis, and respiratory issues. Normal intelligence but severe impairment.

2. Management: Wheelchair setting systems, functional activity support.

Spinal Muscular Atrophy (“Floppy Infant Syndrome”)

1. Characteristics: Progressive muscle weakness and degeneration, primarily affecting males. First attacks shoulder, hip, thigh, and calf muscles.

2. Sign: Gowers Sign (using hands to stand up).

3. Management: Breathing exercises, balance, strengthening, and wheelchair seating systems.

Duchenne Muscular Dystrophy

1. Characteristics: Bleeding disorder caused by a deficiency of factor VIII. Severe cases lead to spontaneous bleeding in childhood.

2. Management: Address bleeding and clotting issues.

Hemophilia A

1. Types: Occulta, Meningocele, Myelomeningocele.

2. Management: Assistive devices, wheelchair seating systems, pressure relief, family training.

Spina Bifida

1. Characteristics: Increased CSF in the brain, common with myelomeningocele.

2. Management: Ventriculoperitoneal (VP) shunt.

Hydrocephalus

1. Characteristics: Most common chromosomal disorder. Features include mental retardation, growth reduction, distinctive facial features, congenital heart defects, and hypotonia.

2. Management: Focus on stimulating neurological and motor development, addressing hypotonia, hip dysplasia, and atlantoaxial joint instability.

Down Syndrome

1. Characteristics: A group of disorders affecting movement and muscle tone due to brain injury. Causes include hypoxia, congenital abnormalities, or trauma.

2. Types: Spastic, Athetoid, Ataxic, Mixed.

3. Management: Spasticity management (medications, Botox, surgery), therapy interventions (assistive devices, orthotics, communication aids).

Cerebral Palsy

1. Characteristics: Paralysis of the upper extremity due to brachial plexus injury during birth.

2. Management: Nerve grafts, strengthening exercises, and physical therapy.

Erb’s Palsy

1. Characteristics: Congenital muscular torticollis due to SCM muscle contracture, leading to head tilt and rotation.

2. Management: PT for ROM, stretching, strengthening, and manual traction.

Torticollis

1. Characteristics: Abnormality of the acetabulum causing the femoral head to slip out of position.

2. Management: Closed reduction, splinting, or casting.

Congenital Hip Dysplasia

1. Characteristics: Ischemic necrosis leading to femoral head flattening, primarily affecting boys aged 4-10.

2. Management: Surgery, hip spica cast.

Leg-Calve-Perthes

1. Characteristics: Foot deformity with inward turning and downward pointing toes.

2. Management: Early casting or splinting.

Clubfoot (Talipes Equnovirus)

1. Characteristics: "Brittle Bone Disease" with fragile bones and frequent fractures.

2. Management: Address fractures and scoliosis.

Osteogenesis Imperfecta

1. Characteristics: Multiple joint contractures affecting various body parts.

2. Management: Surgical correction and long-term therapy.

Arthrigryosis Multiplex Congenita

• Definition: Permanent drooping of the upper eyelid, usually affecting one eye and can obstruct vision.

• Causes:

  • Weakness of the muscle that raises the eyelid.

  • Weakness of the 3rd cranial nerve.

Blepharoptosis (Ptosis)

• Definition: Inflammation of the conjunctiva (mucous membrane covering the anterior eyeball and lining the eyelids).

• Causes: Bacterial or viral infections, allergic reactions, or chemical irritation.

• Symptoms: Redness, itching, swelling, tearing, light sensitivity.

Conjunctivitis (Pink Eye)

• Definition: Abnormal protrusion of the eyeballs.

• Causes:

  • Enlarged extraocular muscles.

  • Edema of the soft tissue lining the eye orbits.

  • Retrobullar masses.

  • Hyperthyroidism (e.g., Graves' disease)

Exophthalmos (Proptosis)

• Definition: Involuntary, constant movement of the eyes, which may not be noticed by the affected person.

• Effects: Affects visual acuity and balance.

• Causes: Brain tumors, alcohol abuse, congenital defects, Ménière’s disease, multiple sclerosis, cerebrovascular accident (CVA).

Nystagmus

• Definition: Damage to the optic nerve usually due to elevated intraocular pressure (fluid build-up).

• Characteristics: Leading cause of blindness, primarily affects individuals over 60, causes peripheral vision loss.

• Symptoms: Slow visual changes, headache, nausea, vomiting, photophobia, eye pain.

Glaucoma

• Definition: Cloudy or opaque area of the eye lens, develops slowly.

• Characteristics: Most common cause of age-related visual loss, progressively reduces visual acuity.

• Associated Factors: Diabetes mellitus, medications, UV radiation, alcohol, poor nutrition.

Cataracts

• Definition: Damage to retinal blood vessels affecting the light-sensitive lining of the back of the eye.

• Characteristics: Leads to retinal detachment, usually occurs 8-10 years after diabetes diagnosis.

• Early Symptoms: Floaters, blurred vision.

Diabetic Retinopathy

• Definition: Progressive deterioration of the macula of the retina, leading to loss of central vision.

• Characteristics: Most common cause of reduced vision in the US, develops slowly in both eyes.

• Risk Factors: White females, smokers, low dietary intake of carotenoids.

Macular Degeneration

• Definition: Elevation (separation) of the retina from the choroid in the eye.

• Initial Symptoms: Light flashes, floaters.

• Characteristics: Occurs suddenly and without pain, usually due to aging changes in the vitreous chamber.

Retinal Detachment

1. Definition: Refractive error due to an irregularly shaped cornea causing light rays to be focused unevenly.

2. Treatment:

   • LASIK (laser surgery).

   • PRK (photorefractive keratectomy).

   • Permanent intraocular contact lenses.

Astigmatism

1. Definition: Light entering the eye is focused behind the retina, causing impaired near vision.

2. Characteristics: Normal far vision, impaired near vision.

3. Cause: Eyeball is abnormally short from front to back.

Hyperopia (Farsightedness)

1. Definition: Age-related farsightedness due to the lens's inability to focus quickly.

2. Characteristics: Gradual loss of muscle elasticity in the eye.

3. Treatment:

   • Contact lenses or glasses.

   • Not improved by laser surgery.

Presbyopia

1. Definition: Refractive error where light rays are focused in front of the retina, causing blurry distance vision.

2. Characteristics: Normal near vision, blurry far vision.

3. Cause: Eyeball is abnormally long front to back.

Myopia (Nearsightedness)

1. Definition: Inability of the eyes to look in the same direction simultaneously, often resulting in diplopia.

2. Treatment:

   • Glasses, eye surgery.

   • Early treatment is more effective.

Strabisums

• Definition: Perception of abnormal noises not produced by external stimuli, such as ringing or buzzing in the ears.

• Characteristics: May be constant, intermittent, unilateral, or bilateral.

• Causes: Vascular abnormalities, neuromuscular disorders, impacted cerumen, medications, stimulants.

Tinnitus

• Definition: Illusion of motion, a disorder of vestibular function.

• Characteristics: May feel that the environment is moving around them (objective vertigo) or that they are moving (subjective vertigo).

• Causes: Most cases are due to peripheral vestibular disorders.

Vertigo

• Definition: Vertigo triggered by changes in head position.

• Characteristics: Accompanied by nystagmus.

• Cause: Displaced crystals of calcium carbonate (otoconia) in the ear canal.

• Examples: Rolling, supine to sit, tipping head up or down.

Benign Paroxysmal Positional Vertigo (BPPV)

• Definition: Affects the inner ear with symptoms including tinnitus, hearing loss, fullness in the ear, and vertigo.

• Characteristics: Usually affects individuals aged 40-60.

• Possible Causes: Family history, immune disorders, migraines, infections, head trauma, premenstrual edema.

Meniere’s Disease

Head trauma that does not physically bruise the brain tissue.

Concussion

More seriously physical bruising of the brain tissue.

Contusion

What are the S&S of Infectious Diseases?

• Fever and Chills

• Malaise (general feeling of discomfort)

• Nausea/Vomiting

• Increased WBCs (white blood cells)

• Altered Mental Status (AMS)

• Inflammation; rash/streaks

• Enlarged Lymph Nodes

1. Description: Anaerobic, spore-forming bacillus; causes nosocomial and community-based diarrhea.

2. Transmission: Fecal-oral route, especially after antibiotic exposure.

3. Symptoms: Persistent diarrhea, elevated WBCs, possible fever.

4. Treatment: Discontinue current antibiotic; switch to Flagyl. Requires contact precautions.

5. Prevention: Proper antimicrobial use and handwashing (60 seconds).

Clostridium Difficile (C. diff)

1. Description: Leading cause of nosocomial and community-acquired infections.

2. Transmission: Direct contact; enters through open lesions/trauma.

3. Symptoms: Abscess formation, fever, chills, malaise.

4. Treatment: Antimicrobials resistant except Vancomycin.

5. Note: Antimicrobial gel recommended.

Methicillin-Resistant Staphylococcus Aureus (MRSA)

1. Conditions: Pharyngitis, scarlet fever, impetigo, necrotizing fasciitis.

2. Transmission: Direct contact, droplet, airborne, foodborne.

Group A: Streptococcus Pyogenes

1. Conditions: Neonatal pneumonia, meningitis, sepsis.

2. Transmission: Can be transmitted from mother to baby during birth.

Group B: Streptococcus Agalactiae

1. Conditions: Pneumonia, otitis media, meningitis, sepsis.

2. Treatment: Antibiotics, pneumococcal vaccine.

Streptococcus Pneumoniae

1. Description: Common nosocomial infection, aggressive.

2. Conditions: Pneumonia, wound infections (fruity odor), sepsis, CNS infections, UTI, bone/joint infections.

3. Transmission: Moist environments like hydrotherapy tanks and pools.

4. Treatment: Antibiotic therapy.

Pseudomonas

1. Transmission: Contact with body fluids, feces, contaminated food/water.

2. Symptoms: Vomiting, loss of appetite, fatigue, pain, diarrhea, joint pain, jaundice.

3. Prognosis: Good; no medication or PT intervention needed.

Hepatitis A (HVA)