Infectious Disease (NOT DONE: Stopped at side Pseudomonas)

Classify the signs, symptoms, and clinical manifestations of infectious diseases to determine the impact on pt/client management across various health care settings

fever

chills

sweating

malaise

nausea and vomiting

confusion

What are common systemic signs and symptoms

rash

red streaks

inflamed lymphnodes

joint effusion

What are signs and symptoms of infection?

Changes in immune system function as we age + co-morbidities

Skin more easily damaged

implanted devices

Confusion is the more defining symptom in the elderly community

Care facilities increase risk of exposure

how does aging impact our ability to fight infectious disease?

pathogen

microorganism or substance capable of producing disease

infection

process where organism establishes parasitic relationship with host

How it is transmitted and how easily it transmits

environment conducive to transmission

Susceptibility of the human host

Development of infection/disease depends on?

contaminate body surface and destroyed by 1st line of defense

subclinical infection without symptoms producing detectable antibody response

development of clinical apparent infection

What are the three outcomes of infections?

incubation period

time between pathogen entering host and appearance of clinical symptoms

latent infection

occurs after microorganism has replicated but remains dormant or inactive in the host, comes when the person is stressed

communicability

diseases may pass or be carried from one person to another directly or indirectly

contamination

infection

intoxication

How do pathogens cause disease?

viruses

bacteria

rickettsiae

fungi

protozoan

helminthes

yeast

what are some examples of pathogens

congenital

endogenous

exogenous

what are sources of infections

endogenous

internal environment is causing the problem

exogenous

external environment is causing the problem

Physical contact (direct vs indirect)

inhalation

ingestion

injected

How do exogenous pathogens enter into the body

primary (infected food)

secondary (infected food handlers)

What are the two types of ways that ingestion can allow exogenous pathogens in

Carriers = was a cook who wasn’t sick or exciting symptoms but transmitted typhoid to other individuals

What is the “Typhoid Mary” demonstrating with hospital infections?

antibiotic resistance

Now we have sicker pts with widespread antibiotic resistance

Could happen because every illness was given an antibiotic whether it was warranted or not. So bacteria was able to build a resistance

What are super infections?

1st - intact body surfaces

2nd - acute inflammation

3rd - lymphatics

4th - immune system

What are the 4 lines of defense

1st line of defense

barrier to infection

powers of decontamination are: mechanical, biological, chemical

can be damaged by maceration

2nd line of defense

fluid and cellular exudates

depends on local damage

if pathogen produces little to no tissue damage, may slip through

not every bug has the same reaction in the body

3rd lines of defense

lymphatics

area drains here

swollen lymph nodes

body’s way of containing infection

4th line of defense

immune system

in blood stream

lymphatics drain here

Pathogen causes local tissue damage

gets by first line of defense, causes inflammation which helps contain it, usually ends in lymphatics, limited spread

Pathogen does not cause local tissue damage

Gets by 1st line defense, gets by 2nd line of defense because no tissue damage and doesn’t cause an inflamed state. Gets by 3rd line of defense. 4th line of defense resulting in bacteremia and specitemia.

bacteremia

in blood without symptoms

septicemia

in blood with severe symptoms

Diphtheria

contained at tonsils, but toxin results in nerve and heart damage

Tetanus

at site of infection

toxin causes CNS and muscle damage

Spasms, paralysis, death, “lock jaw”

Avirulent

not very strong

virulent

very strong

Pathogenic Bacteria Characteristics

Tropism

Simple reproduction

rapid reproduction

Tropism

certain bacteria like certain parts of the body

gram stain and morphology

What are the two types of bacteria classifications

gram positive (purple)

Gram negative (pink)

What are the two type of gram stains?

cocci (spherical shaped)

Bacili (rod shaped)

What are the types of morphologies

diplococci - pairs

staphylococci - grapes

Streptococci - strands

What are the types of cocci shapes

Staphylococcus

a bunch of grapes

naturally located on skin and mucus membranes

pyogenic with localized lesions

spread by direct contact

can survive on inanimate objects for an extended period of time

Health acquired

you got it in a health care facility

community acquired

you got it out in the community

could be fatal but most cases respond to treatment (antibiotics)

What is staphylococcus prognosis

proper hand hygiene and environmental management

don’t be a carrier, clean your equipment and prevent the spread

What are the PT implications for staphylococcus?

Streptococcus

gram positive pairs or chains

mouth, intestinal tract, respiratory tract

spread by ingestion or respiration

spreading inflammation

group A - strep throat

group B - neonatal streptococcal infections

strep pneumonia

What are examples of streptococcus

Pseudomonas

gram negative rods

common hospital and nursing home acquired pathogens

Thrives in moist environments especially swimming pools, whirlpool tubs, respiratory therapy equipment, sinks, flowers, and endoscopes/bronchoscopes

Lentivirus (retrorvirus family)

Human Immunodeficiency virus (HIV) is what type of virus?

Prevention

What is the CDC focued on with the medical management of HIV?

nucleic acid tests, antigen/antibody tests, and antibody tests

What is the testing algorithm for diagnosis of HIV?

medications for HIV

Do not cure but promote healthier lives and longer life expectancy

Used to prevent it from advancing to aids

Reduce risk of transmission

Pt Implications for HIV

Infection control strategies

preventing transmission in health care/athletic settings

Post exposure prohylaxis

assisting with management of impairments and functional limitations related to chronic HIV infection, its co morbidities and/or opportunistic infections

Taylor treatments that take HIV into account

Provide custom exercises and pain management programs

Help people w/advanced HIV prevention, reduce, or delay movement and functional problems

Empathy