Test 6 Supplemental
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- How does gonnorhea cause sterility in females?
- Obstruction of fallopian tubes
- What is the therapeutic action of zidovudine (AZT)?
- inhibits or slows replication of virus
- Most common complication of HIV/AIDS?
- pneumocystis carinii pneumonia
- What STD can be tested for by blood?
- Syphilis
- A patient with Mononucleosis should avoid damage to what organ?
- Spleen
- How is Hep A transmitted?
- fecal/oral route
- How is Hep C transmitted?
- blood and body fluids
- Which healthcare worker is most at risk for contracting Hep C?
- Phlebotomist
- What is the first sign of Syphilis?
- painless chancre
- What is the hallmark sign of UTI?
- frequency
- What is the purpose of the Mantoux test?
- To test large populations for exposure to TB
- Med to treat Strep
- Penicillin, if allergic then erythromycin
- What is a macule?
- a flat rash
- What are Koplik's spots?
- Small, irregular red spots with a small bluish-white center first seen on the buccal mucosa opposite the molars two days before the rash appears.
- What is the most debilitating aspect of Mono?
- fatigue
- What is the most common symptom of a strep infection?
- sore throat
- What is the complication to strep throat (acute pharyngitis)?
- glomerulonephritis
- You should have tracheostomy equip at the bedside for a patient with
- epiglottis
- The symptoms of meningitis are
- headache, nuchal rigidity, and Kernig’s sign (symptom of meningitis; patient cannot extend the leg at the knee when the thigh is flexed because of stiffness in the hamstrings)
- Dilantin causes
- Hyperplasia of gingiva
- Zoster vaccine is for
- varicella
- Mumps is caused from
- A viral infection that causes the salivary glands, especially the parotid gland, to swell.
- ESR will be elevated in inflammatory diseases such as
- Rheumatoid arthritis or lupus
- Give the primary symptom of Lupus
- butterfly rash
- Define Lupus
- A systemic disease that results from an autoimmune mechanism. Individuals with lupus will produce antibodies to their own body tissues. The resultant inflammation can cause kidney damage, arthritis, pericarditis and vasculitis.
- What position should the patient be in when having a seizure?
- Lateral (side-lying)
- Myasthenia Gravis is caused from a deficiency of
- acetylcholine
- Define Legg-Calve-Perthes Disease
- A temporary condition in children in which the head, or "ball," of the thigh bone, referred to as the femoral head, loses its blood supply. As a result, the "ball" of the thigh bone collapses. The body will absorb the dead tissue and replace the dead bone cells with new bone cells. The new bone cells will eventually reshape the "ball" of the thigh bone. This condition causes the hip joint to become painful and stiff for a period of time.
- The most important way to prevent seizures is
- medication compliance
- Extrapyramidal effect is caused by
- degeneration of the parts of basal ganglia
- What are the s/sx of Dumping Syndrome?
- sense of fullness, weakness, faitness, cramping, diarrhea
- What is the nursing intervention for dumping syndrome?
- following the meal, lie down for 20-30 minutes, avoid fluids except during meals
- Why is traction used preop for a total hip replacement?
- to prevent dislocation. use abduction pillow
- What would make a lupus patient feel better about themselves?
- Have a cosmetologist cover their face rash. A patient with lupus has a defiency in acetycholine and also should get plenty of rest. Butterfly rash. Nursing Diagnosis-self care deficit. Pt sholud be told to restriict exposure to sunlight to prevent an acute onset of symptoms
- What vitals indicate increased Intracranial Pressure (ICP)?
- Rising systolic B/P & slowing of pulse rate. You can tell that an infant has ICP by bulging fontanels
- Fat embolis s/sx
- sudden respiratory distress and restlessness. Common in femur fractures
- LYME DISEASE
- looks like a rash, carried by tick S/sx include “bulls eye†rash. ESR increased in early disease. Tetracycline is treatment of choice. Pt’s should be taught to never take the medication with milk or dairy products or vitamins with iron.
- What causes jaundice in hep A?
- bile salts deposited on skin.
- Define agglutination
- A type of antigen-antibody reaction in which a solid antigen clumps together with a soluble antibody
- Define cytokines
- Nonantibody proteins that act as intercellular mediators in the generation of the immune response.
- Define Cytotoxic T cells
- Leukocytes that lyse cells infected with a virus and also play a role in graft rejection.
- Define helper T cells
- Lymphocytes that can directly attack foreign invaders (antigens)
- Define humoral immune response
- The immune system's second line of defense, or the antibody response.
- Define null lymphocytes
- A specific type of lymphocyte that destroys antigens already coated with an antibody.
- Define opsonization
- The process of coating an antigen with a thick substance to aid in phagocytosis.
- Define helminthes
- worms
- What kind of immunity are B cells responsible for?
- Humoral immunity (B cells mature in the bone marrow and become memory cells or plasma cells that lead to antibodies)
- What kind of immunity are T cells responsible for?
- cellular or cell-mediated immunity (Tcells directly attack foreign invaders)
- Where do T cells reside?
- In the lymphoid tissue and then my grade to the thymus gland (T stands for thymus)
- What organs compose the lymphoid tissues?
- thymus gland, spleen, lymph nodes, tonsils, adenoids
- What does the spleen do?
- Filters and concentrates white blood cells
- What do lymph nodes and vessles do?
- Filter and remove foreign material before entry into the bloodstream.
- What are the three means by which the body defends itself against microorganisms?
-
Phagocytic immune response,
Humoral or antibody immune response and
Cellular immune response - The phagocytic immune response occurs when
- WBCs move to the site of invasion and engulf and thereby destroy the foreign invaders.
- What are the two types of white blood cells (WBCs)?
- Granulocytes and macrophages
- The humoral or antibody immune response occurs when
- B lymphocytes transform themselves into plasma cells and manufacture antibodies.
- The cellular immune response occurs when
- T lymphocytes turn into special cytotoxic killer T cells and attack pathogens.
- Recognition of foreign invaders is believed to be initiated by
- circulating lymphocytes discharged from lymph nodes
- What is the first stage of the immune response?
- Recognition of foreign invader's antigens by circulating lymphocytes and macrophages
- What is the second stage of the immune response?
- Proliferation, where dormant lymphocytes proliferate adn differentiate into cytotoxic (killer) T cells or B cells which form and release antibodies.
- What two cells proliferate in the second stage?
- T and B lymphocytes, Ts become cytotixic or killer T cells while Bs produce antibodies
- What is the third stage of immune response?
- Response, where antibodies and lymphocytes are released into the bloodstream.
- What happens with B cells during the response stage?
- Antibody production by B cells begins the humoral responses, or the release of antibodies into the bloodstream
- When is cellular response initiated?
- when the sensitized lymphocytes migrate to areas of the lymph nodes and stimulate residing lymphocytes to directly attack microbes.
- What is the fourth stage of immune response?
- Effector stage, where antigens are destroyed or neutralized through the action of antibodies, complement, macrophages and cytotoxic T cells.
- What are the three ways in which antibodies defend the body?
-
Agglutination and opsonization,
Release of vasoactive substances (histamine) from the cells and a
Activation of the complement system. - What is the complement system composed of?
- circulating plasma proteins produced in the liver and activated when an antibody couples with an antigen or when bacterial products (endotoxins) are released.
- What are the two strains of food-borne hepatitis?
- A and E
- What are the strains of blood-borne hepatitis?
- Hep B, C, D and G
- Define percutaneous
- Denoting the passage of substances through unbroken skin, for example, by needle puncture, including introduction of wires and catheters.
- What strain of Hepatitis is transmitted usually percutaneously?
- Hep G
- Define impetigo
- A bacterial skin infection characterized by microscopic, pus-filled blisters.
- What is the name of the virus that transmits mononucleosis?
- Epstein-Barr virus
- What kind of virus is HIV?
- A retrovirus (carries its genetic material in RNA instead of DNA)
- What is HIV coated with?
- Glycoprotein envelope
- What kind of cells does HIV bind onto?
- CD4 on T lymphocytes
- What cells have the CD4?
- Monocytes, macrophages and helper (t4) lymphocytes.
- Once the DNA is incorporated into the T4 cell nucleus, it is known as a
- Provirus, permanent infection is established
- The replication of HIV occurs primarily in what tissue?
- Lymphoid
- How is Hep B trasmitted?
- blood or mucous membranes
- Where does Hepatitis B (HBV) replicate?
- the liver
- How long does it take for a patient with an HBV infection to recover?
- 6 months
- What is the HBV core antigen?
- HBcAg
- What is the HBV surface antigen?
- HBsAg (means the antigenic material is on the surface of the virus)
- Patients who exhibit HBsAg for 6 months after acute infection are called
- HBsAg carriers
- What is the HBV independent protein circulating in the blood?
- HBeAg
- What is the gene product of X gene or HBV DNA?
- HBxAg
- For those who are exposed to HBV adn who do not have immunity, what provides passive immunity?
- Hepatitis B immunoglobulin
- What is the most effective treatment for HBV patients?
- Alpha interferon
- How is tuberculosis (TB) trasmitted?
- Droplet, airborne trasmission
- What is a granuloma?
- A tissue mass composed of live and dead TB bacilli
- What is the center of a granuloma mass called?
- Ghon's tubercle
- Define Legionnaire's disease
- A multisystem illness cause by a gram-negative bacteria transmitted to the respiratory tract by environmental aerosols. This affects the lungs.
- How long is the incubation period for Legionnaire's disease?
- 2-10 days
- What is the incubation period for Mononucleosis?
- four-six weeks
- What is the condition caused by acute pharangitis?
- strep throat
- What virus causes chicken pox?
- Varicella zoster
- How is the distribution of the chicken pox rash?
- Centripetal, meaning spreads from the trunk to the face and proximal extremeties.
- When the chicken pox leisions crust, the disease is
- no longer communicable
- How long is the chicken pox incubation period?
- two weeks (10-21 days)
- How long is the incubation period for Diptheria?
- 2-3 weeks
- What are the three areas affected by Diptheria?
- Nasal, tonsillar/pharyngeal and Laryngeal
- How long is the incubation period for Measles?
- 10-20 days
- When can Measles be communicated?
- Four days before the rash appears and five days after the rash has appeared.
- How is mumps transmitted?
- By direct contact with the saliva of an infected person.
- What is the major sign of mumps?
- Parotitis
- Define parotitis
- infection of the parotid glands, either unilateral or bilateral
- How is pertussis transmitted?
- Direct contact with or droplet spread from the respiratory tract of an infected person.
- What is the common term for pertussis?
- Whooping cough
- What is the incubation period for pertussis?
- 5-21 days
- When is the greatest communicability for pertussis?
- During the catarrhal stage before the onset of paroxysms.
- Define paroxysms
- Rapid coughs followed by sudden inspiration.
- What causes poliomyelitis?
- Enteroviruses (type 1, 2 or 3)
- How is poliomyelitis transmitted?
- Direct contact through fecal-oral and pharyngeal-oropharyngeal routes.
- How long is the incubation period for poliomyelitis?
- 7-14 days
- What are the three types of polio?
- Abortive or unapparent, nonparalytic and paralytic
- Define the abortive or unapparent form of poliomyelitis
- Symptoms include fever, uneasiness, sore throat, headach, anorexia, vomiting and abdominal pain.
- Define the nonparalytic form of poliomyelitis
- Same as abortive type but more severe, with pain and stiffness in the neck, back and legs.
- Define the paralytic form of poliomyelitis
- Inital course is similar to nonparalytic poli, followed by recovery adn then signs of central nervous system paralysis.
- What are four complications of paralytic poliomyelitis?
- Permanent paralysis, respiratory arrest, hypertension and kidney stones.
- How is rubella transmitted?
- nasopharyngeal secretions
- How long is the incubation period for rubella?
- 14-21 days
- What is the defining characteristic of rubella?
- A rash which appears on the face and rapidly spreads down to the neck, arms, trunk and legs. It has a pinnkish-red maculopapular exanthema
- What is the precaution of pregnant women with rubella?
- Possible teratogenic effects.
- How is the flu transmitted?
- Airborne droplets
- What drug should not be given to flu patients? Why?
- Aspirin, as Reye's syndrome has been associated with it.
- What are elderly patients susceptible to with the flu?
- Guillain-Barre syndrome and temporal arteritis.
- Define nosocomial infection
- Infection that occurs while the patient is in the hospital
- Why is clostridium difficle often a nosocomial infectious agent?
- It is resistant to handwashing and cleaning.
- Define sepsis
- This is a generalized infection of the bloodstream.
- What is primary sepsis?
- The host has no preexisting infection and becomes contaminated.
- What is secondary sepsis?
- When the patient has an infection and this serves as the source of contamination.
- Define MRSA
- Methicillin-resistant staphylococcus aureus
- What two drugs has MRSA become resistant to?
- Penicillin and methicillin
- What is used to prevent cross-contamination to other patients with a MRSA patient?
- Contact isolation
- Define VRE
- Vancomycin-resistant enterococcus
- What organism causes syphilis?
- Treponema pallidum
- What is the first stage of syphilis?
- Appearance of a chancre, or a painless leision at the site of infection.
- How long does the primary stage occur after an inital inoculation with syphilis?
- 2-3 weeks
- What is the second stage of syphilis?
- A hematogenous spread of organisms from original lesions to a generalized infection.
- How long after syphilis infection does a rash occur after the chancre?
- 2-8 weeks
- Where does the 2nd stage rash of syphilis develop?
- On the trunk and the extremeties, including the palms of the hand and soles of the feet.
- What is the third stage of syphilis?
- A slowly progressive inflammatory disease and occurs years to decades after the initial infection.
- What are the most common manifestations of 3rd stage syphillis?
- Aortitis and neurosyphilis (dementia, psychosis, paresis, stroke, tabes dorsalis (syphilitic disorder that involves wasting, pain, lack of coordination, and sensory disorders) or meningitis.
- What does the Treponemal test measure?
- The presence of antibodies to the organism.
- What bacteria causes gonorrhea?
- Neisseria gonorrhea
- Gonorrhea may be _______ in women.
- asymptomatic
- What is a serious complication in women with gonorrhea?
- Pelvic inflammatory disease (PID)
- Describe PID
- Pelvic inflammatory disease occursh when the infection spreads to the reproductive organs and peritoneal fluid.
- What are complications associated with PID
- ectopic pregnancy and bilaterial tubal occulusion that causes infertility.
- How is gonorrhea diagnosed?
- Clinical signs and culture and sensitivity tests.
- What kind of laboratory test can be taken in order to identify the causitive organsims at the time?
- Wet mount laboratory test
- What microorganism causes chlamydia?
- Chlamidia trachomatis (bacterium requires intracellular growth, like a virus)
- What do women with chlamydia present with?
- PID or subtle or undetectable symptoms.
- Define cytomegalivirus (CMV)
- Virus of the herpes family with many strains, the leading cause of congenital viral infections in North America. No immunity exists.
- What are the three types of CMV infection?
- Congential, acute-acquired and generalized-systemic disease.
- Define congential infection of CMV.
- This involves infected women who transmit the virus to their babies during birth.
- What is the most severe form of congential CMV?
- The most severe form is cytomegalic inclusion disease.
- Describe Acute-acquired CMV.
- This involves acquiring the virus anytime in adulthood and resembles the symptoms of mononucleosis.
- Describe generalized-systemic disease CMV.
- This infection involves individuals who are immunosuppressed, especially those who have had a transplant. Symptoms include pneumonitis, hepatitis and leukopenia.
- What are some complications of generalized-systemic disease CMV?
- Variable hearing loss and congenital defects of the newborn.
- How is HPV transmitted?
- sexually
- What strains of HPV cause genital warts?
- Strains 6 and 11.
- What is the term for warts occurring on the genitalia and perianal area?
- condylomata acuminata
- What is the name of the warts on the genitalia and perianal area?
- condylomata acuminata
- What are four methods used to treat genital warts?
- trichloroacetic acid, podophyllin, electrocautery and laser therapy
- By what route is shigella contracted?
- oral-fecal route
- What kind of organism is Giardia?
- giardia lamblia is a protozoan
- By what route is Hepatitis A spread?
- oral-fecal route
- What spirochete causes Lyme disease?
- Borrelia burgdorferi
- What are some serious neurological conditions caused by Lyme disease?
- Bell's palsy and Guillain Barre-like syndrome. Also the skin, joints, heart and eyes can become affected.
- What microorganism causes Hantavirus pulmonary syndrome (HPS)?
- Sin nombre
- How is Hantavirus contracted?
- Rodents
- What treatment is given for patients with Hantavirus?
- Ribavirin
- Define dyspnea
- Labored breathing from decreased lung compliance or increased airway resistance
- What cough causes a high pitched sound?
- obstruction
- What kind of cough do patients with tracheal infections have?
- Brassy cough
- What would a productive cough in the morning indicate?
- bronchitis
- What is characterized by a cough in the supine position?
- Sinusitis
- What kind of pain is caused by pleurisy?
- Sharp and stabbing
- What is an indication of long-standing respiratory dysfunction?
- Clubbing of the fingers
- What three ways can bacteria enter the genitourniary tract?
- Through the urethra, through the bloodstream or directly from the intestine (fistula)
- What risks do indwelling catheters pose?
- Gram-negative sepsis
- What are three signs of upper urniary tract infection (UTI)?
- flank and lower back pain, painful urination and costovertebral tenderness on palpitation.
- Define colony counts
- The number of bacteria found in the urine
- What is a criteria for UTI?
- A colony count of at least 10 to the fifth on a clear-catch midstream sample.
- How many red or white blood cells in a high powered field indicate UTI?
- Four
- When does dermatosis occur?
- When there is a break in the skin's barrier allowing microorganisms to enter.
- Define macule
- Less than 1 cm in diameter, flat, nonpalpable and either red, purple, brown, white or tan in color.
- What size are papules?
- Less than 0.5 cm in width.
- Describe vesicles
- Less than 0.5 cm in width, and circumscribed with an elevated palpable mass containing serous fluid (e.g. chicken pox, herpes).
- What temperature fever causes convulsions?
- 106*F
- What temperature fever causes irreversible brain damage?
- 108*F
- Define remittent fever
- Fluctuates but does not return to normal
- Define Fever of unknown origin
- Greater than 103*F daily for more than two weeks with no readily detectable source. Associated with infection, neoplasm (tumor) or connective tissue disease.
- What are three indications of bacterial meningitis?
- Nuchal rigidity (stiff neck), Positive Kernig's sign (leg cannot be completely extended when thigh is flexed) and Positive Brudzinski sign (passive flexion of a lower extremity produces similar action on opposite extremity)
- Define natural immunity
- This immunity is present from birth, is a nonspecific response to any kind of invader that distinguishes if the invader is harmful or harmless.
- Name three natural barriers that prevent pathogens from gaining access to the body.
- Physical barriers, cilia of the respiratory tract and natural responses (sneezing and coughing)
- Name three chemical barriers that prevent pathogens from gaining access to the body.
- Acidic gastric juices, enzymes in tears and saliva and substances in sebaceous and sweat secretions.
- What is an interferon?
- A virucidal protein.
- What are the three types of granular leukocytes?
- neutrophils, eosinophils and basophils
- What is a cell mediator?
- Substances that engulf the foreign or toxic substances.
- What are the three types of cell mediators?
- Histamine, bradykinin and prostoglandins
- Which two granular leukocytes increase in number during allergic or stress periods?
- Eosinophils and basophils
- What are the two nongranular leukocytes?
- monocytes and macrophages
- What kind of cells are monocytes and macrophages?
- Phagocytic cells
- Define acquired immunity
- This immunity is an immunological response from vaccination or by contracting a disease.
- What type of immunity is developed by a person's own immune system?
- Active acquired immunity
- How long does active acquired immunity last?
- Many years to a lifetime
- What is passive acquired immunity?
- Temporary immunity transmitted from another source that had developed immunity through previous disease or immunizations.
- Define stress
- A state characterized by an increase of neuroendocrine influences which can impact the immunie system.
- What five antimicrobial agents inhibit cell wall synthesis?
- Penicillins, Cephalosporins, Vancomycin, Bacitracin and Cycloserine.
- What four antimicrobial agents alter membrane permeability?
- Amphotericin B, Nystatin, Polymysix and Colistin
- What five antimicrobial agents inhibit protein synthesis by impeding replication of genetic information?
- Nalidixic acid, Griseofulvin, Novobiocin, Rifampin and Pyrimethamine
- What five antimicrobial agents inhibit protein synthesis by impairing translation of genetic information?
- Chloramphenicol, Tetracycline, Erythromycin, Aminoglycosides and Lincomycin
- What four antimicrobial agents are antimetabolites?
- Sulfonamides, Paraaminosalicyclic acid (PAS), Isoniazid (INH) and Ethambutol
- What are two important side effects of antimicrobials?
- allergic reaction and superinfection
- What is Stevens-Johnson syndrome?
- Toxic epidermal necrolysis, in which the epidermis separates from the dermis
- What is a superinfection?
- An infection that occurs as a result of antimicrobial therapy where normal flora is destroyed resulting in an overgrowth of resistant exogenous or endogenous bacteria.
- How often is the Diptheria-tetanus-pertussis immunization given?
- Four times
- In what two forms is the polio vaccine given?
- Inactivated polio virus (IPV) and oral polio virus (OPV)
- How often is the MMR vaccine given?
- Twice
- How often is the Haemophilus influenzae type B (HIB)
- Twice
- How often is the Hepatitis B vaccine given?
- Three times
- How often is the varicella vaccine given?
- Once
- What three individuals would be excluded from further doses of vaccine?
- Those who have developed an encephalopathy within 7 days of DPT, Children who develop a fever of greater than 104*F within 48 hours of immunization and those who develop seizure following immunization.
- What are preventive measures?
- Behaviors and responsibilities for reduction of risk exposure.
- What are standard precautions?
- A set of protective behaviors that replace the universal precautions
- What are transmission-based precautions?
- A set of behaviors to reduce the spread of specific microorganisms.
- How many seconds for handwashing?
- At least ten
- What diseases require airborne precautions?
- probable or proven pulmonary TB, chicken pox or measles.
- What are two microorganisms transmitted by droplet which need droplet precautions?
- Influenza and meningococcal meningitis.
- What is an example of an organism transmitted by skin-to-skin contact?
- C. difficle
- How many diseases are considered notifiable infectious diseases?
- 52, such as AIDS, TB and STDs
- What is the primary source of confirmation for most bacterial infections?
- Microbiological culture
- What three sets of information are contained in the microbiological culture?
- Smear and stain, culture and identification of the organism and antimicrobial susceptibility or sensitivities.
- What kind of stain does TB require?
- acid-fast stain
- What is the normal white blood cell count for an infant?
- 6,000-17,500 (cells/microliter)