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Questions and Answers
What is the primary reservoir for the bacterium causing diphtheria?
What is the primary reservoir for the bacterium causing diphtheria?
Which type of diphtheria is most commonly found in children ages 2 to 5 years old?
Which type of diphtheria is most commonly found in children ages 2 to 5 years old?
What is a common clinical manifestation associated with diphtheria?
What is a common clinical manifestation associated with diphtheria?
What is the incubation period for diphtheria?
What is the incubation period for diphtheria?
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What method is commonly used in diagnosing diphtheria?
What method is commonly used in diagnosing diphtheria?
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Which method is part of the prevention and control measures for diphtheria?
Which method is part of the prevention and control measures for diphtheria?
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What is the period of communicability for diphtheria?
What is the period of communicability for diphtheria?
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The Schick Test is utilized to determine what concerning diphtheria?
The Schick Test is utilized to determine what concerning diphtheria?
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What is the main mode of transmission for dengue fever?
What is the main mode of transmission for dengue fever?
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Which clinical manifestation is pathognomonic for dengue fever?
Which clinical manifestation is pathognomonic for dengue fever?
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What should be avoided in the treatment of dengue fever?
What should be avoided in the treatment of dengue fever?
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During which stage of dengue fever is high fever typically observed?
During which stage of dengue fever is high fever typically observed?
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Which diagnostic test is specific for confirming dengue infection?
Which diagnostic test is specific for confirming dengue infection?
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What is a key nursing management practice for dengue patients?
What is a key nursing management practice for dengue patients?
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What factor is important in the prevention and control of dengue fever?
What factor is important in the prevention and control of dengue fever?
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What kind of diet is recommended during the convalescent stage of dengue fever?
What kind of diet is recommended during the convalescent stage of dengue fever?
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What is the recommended nursing consideration for a patient with varicella?
What is the recommended nursing consideration for a patient with varicella?
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What are the effects of congenital varicella?
What are the effects of congenital varicella?
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When should Varicella – zoster Immune Globulin (VZIG) be administered?
When should Varicella – zoster Immune Globulin (VZIG) be administered?
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What is the primary mode of transmission of measles?
What is the primary mode of transmission of measles?
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What is the period of communicability for measles?
What is the period of communicability for measles?
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What is a pathognomonic sign of measles?
What is a pathognomonic sign of measles?
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What are common clinical manifestations during the pre-eruptive stage of measles?
What are common clinical manifestations during the pre-eruptive stage of measles?
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How long after the onset of a rash can serum antibodies be detected?
How long after the onset of a rash can serum antibodies be detected?
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What is the primary etiologic agent of amoebiasis?
What is the primary etiologic agent of amoebiasis?
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Which of the following is NOT a mode of transmission of schistosomiasis?
Which of the following is NOT a mode of transmission of schistosomiasis?
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What is the primary clinical manifestation of acute amoebic dysentery?
What is the primary clinical manifestation of acute amoebic dysentery?
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What is the drug of choice for treating schistosomiasis?
What is the drug of choice for treating schistosomiasis?
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How long is the typical incubation period for amoebiasis?
How long is the typical incubation period for amoebiasis?
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What clinical manifestation may occur during the second stage of schistosomiasis?
What clinical manifestation may occur during the second stage of schistosomiasis?
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What nursing intervention is essential for a patient with amoebiasis?
What nursing intervention is essential for a patient with amoebiasis?
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What is a common source of infection for amoebiasis?
What is a common source of infection for amoebiasis?
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Which symptom is associated with the chronic stage of schistosomiasis?
Which symptom is associated with the chronic stage of schistosomiasis?
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What type of diagnostic test is confirmatory for schistosomiasis?
What type of diagnostic test is confirmatory for schistosomiasis?
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What is a potential complication of untreated schistosomiasis?
What is a potential complication of untreated schistosomiasis?
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In which case would you find a painless chancre as a clinical manifestation?
In which case would you find a painless chancre as a clinical manifestation?
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Which factor is essential in preventing schistosomiasis?
Which factor is essential in preventing schistosomiasis?
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What is the characteristic symptom of secondary syphilis?
What is the characteristic symptom of secondary syphilis?
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What is the primary etiologic agent of gonorrhea?
What is the primary etiologic agent of gonorrhea?
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Which symptom is commonly associated with candidiasis in the oropharyngeal region?
Which symptom is commonly associated with candidiasis in the oropharyngeal region?
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What is a common complication of untreated gonorrhea?
What is a common complication of untreated gonorrhea?
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What is typically the first line treatment for gonorrhea?
What is typically the first line treatment for gonorrhea?
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Which of the following best describes the incubation period for gonorrhea?
Which of the following best describes the incubation period for gonorrhea?
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What type of organism is Candida albicans?
What type of organism is Candida albicans?
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Which symptom is least likely to be associated with male gonorrhea infections?
Which symptom is least likely to be associated with male gonorrhea infections?
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What is one of the nursing considerations for a patient with gonorrhea?
What is one of the nursing considerations for a patient with gonorrhea?
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Which diagnostic test is not commonly used for confirming candidiasis?
Which diagnostic test is not commonly used for confirming candidiasis?
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What is a common source of infection for Candida albicans?
What is a common source of infection for Candida albicans?
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Which of the following patients is likely at higher risk of candidiasis?
Which of the following patients is likely at higher risk of candidiasis?
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What precaution should be taken when handling specimens from patients with HIV?
What precaution should be taken when handling specimens from patients with HIV?
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Which of the following is a classic symptom of esophageal candidiasis?
Which of the following is a classic symptom of esophageal candidiasis?
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What is the purpose of treatment with antifungal medications in cases of candidiasis?
What is the purpose of treatment with antifungal medications in cases of candidiasis?
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Study Notes
Varicella Zoster Virus (VZV)
- VZV is the cause of chickenpox and shingles
- VZV can be isolated from vesicular fluid within 3-4 days of rash appearance
- Serum antibodies appear 7 days after disease onset
- Congenital varicella can lead to limb deformities, retarded growth, and CNS/ophthalmic problems
- Nursing considerations include strict isolation, exclusion from school for 1 week after rash appears, avoiding contact with susceptible individuals, concurrent disinfection of throat/nose secretions, teaching proper use of topical antipruritic medication, and advising patients not to scratch lesions
Measles
- Also known as Rubeola or Morbilli
- Highly contagious viral disease
- Primarily affects susceptible children
- Etiologic agent: Measles virus (Paramyxoviridae)
- Source of infection: Secretions from nose and throat of infected individuals
- Mode of transmission: Droplet spread, direct contact with infected person, or indirect contact with contaminated articles
- Incubation period: 1-2 weeks
- Period of communicability: Starts just before prodrome and lasts until 4 days after rash appears
-
Key Clinical Manifestations:
- Koplik spots (pathognomonic sign)
- Pre-eruptive Stage: Fever, catarrhal symptoms (cough, conjunctivitis, coryza), photophobia, Stimson’s line (red line on the lower conjunctiva)
- Eruptive Stage: Maculo-papular rash, high-grade fever, anorexia, irritability, sore throat
Diphtheria
- Etiologic agent: Corynebacterium diphtheria (Klebs-Loeffler bacillus)
- Source of infection: Discharges and secretions from mucous surfaces of nose and nasopharynx, skin lesions
- Mode of transmission: Direct contact with patient or carrier, contact with contaminated articles, milk (vehicle)
- Incubation period: 2-5 days
- Period of communicability: 2 weeks to over 4 weeks, variable until virulent bacilli disappears from secretions and lesions
- Types: Nasal (serosanguinous secretions), Tonsillar (confined to tonsils), Nasopharyngeal (swollen cervical lymph nodes, edematous neck tissue), Laryngeal (most common in children 2-5 years old, most severe/fatal, hoarseness, vocal loss), Wound/Cutaneous (affects mucous membranes and breaks in skin)
- Key Clinical Manifestations: Bull neck formation (neck swelling), grayish exudates forming a pseudomembrane, fatigue/malaise, sore throat, dyspnea, husky voice, palate swelling, low-grade fever
Gonorrhea
- Sexually transmitted bacterial disease
- Affects mucosal lining of genitor-urinary tract, rectum, pharynx
- Etiologic agent: Neisseria gonorrhoeae
- Incubation period: 2-5 days
- Mode of transmission: Direct sexual contact, contaminated secretions during vaginal delivery, indirect contact with fomites
-
Clinical Manifestations:
- Females: 80% asymptomatic, burning sensation/frequent urination, yellowish purulent vaginal discharge, genital redness/swelling
- Males: Dysuria with purulent discharge, rectal infection, urethritis, prostatitis, pelvic pain
- Complications: Sterility, pelvic infection, epididymitis, arthritis, endocarditis, conjunctivitis, meningitis
Candidiasis
- Also known as Candidosis or Moniliasis
- Superficial fungal infection affecting skin, nails, mucous membranes, vagina, esophagus, GI tract
- Etiologic agent: Candida albicans
- Source of infection: Candida is part of normal flora, infection occurs due to changes in the body (e.g., increased blood glucose, immunocompromised)
-
Key Clinical Manifestations:
- Skin: Scaly, erythematous, papular rash, exudates, often under breasts, between fingers, axillae, groin, umbilicus
- Nails: Red, swollen, darkened nail bed, purulent discharge, nail separation
- Oropharyngeal mucosa (thrush): Cream-colored or bluish white curd-like patches on tongue, mouth, or pharynx, reveal bloody engorgement when scraped
- Esophageal mucosa: Dysphagia, retrosternal pain, regurgitation, scales in mouth/throat
- Vaginal mucosa: White or yellow discharge with pruritus and excoriation, white or gray raised patches on vaginal walls, dyspareunia
- Lungs: Hemoptysis, cough, fever
- Kidneys: Fever, flank pain, dysuria, hematuria, pyuria, cloudy urine
- Brain: Headache, nuchal rigidity, seizures, focal neurologic deficits
- Endocardium: Systolic or diastolic murmur, fever, chest pain, embolic phenomena
- Eye: Endophthalmitis, blurred vision, orbital or periorbital pain, scotoma, exudates
Human Immunodeficiency Virus (HIV)
- Transmission through bodily fluids (blood, semen, vaginal secretions, breast milk)
- Causes Acquired Immunodeficiency Syndrome (AIDS)
- HIV weakens the immune system, making infected individuals more susceptible to infections
-
Key Clinical Manifestations:
- Flu-like symptoms (fever, fatigue, muscle aches, headache)
- Swollen lymph nodes
- Rash
- Night sweats
- Weight loss
- Opportunistic infections (pneumonia, tuberculosis, candidiasis, etc.)
Dengue Fever
- Also known as Breakbone Fever, Hemorrhagic Fever, Dandy Fever, Infectious Thrombocytopenic Purpura
- Acute febrile disease caused by dengue virus serotypes
- Etiologic agents: Dengue virus types 1, 2, 3, and 4. Chikungunya virus can also cause similar symptoms
- Mode of transmission: Bite of infected Aedes aegypti mosquito
- Incubation period: 3-15 days
- Period of communicability: Unknown, presumed to be within first week of illness, human-to-human spread not recorded, but infected people are infectious to mosquitoes during the febrile period
-
Key Clinical Manifestations:
- Herman’s Sign (maculopapular rash with patches of normal skin)
- Febrile/Invasive Stage (First 4 days): High fever (39-40°C), abnormal pain, headache, flushing
- Toxic/Hemorrhagic Stage: Lowering of temperature, severe abdominal pain, vomiting, melena, hematemesis
- Convalescent/Recovery Stage: Generalized flushing with areas of blanching, appetite, stable BP
Malaria
- Acute and chronic parasitic disease
- Transmitted by bite of infected mosquitoes
- Primarily found in tropical and subtropical areas
- Etiologic agents: Plasmodium species (Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae)
- Mode of transmission: Bite of infected female Anopheles mosquito
- Incubation period: 8-40 days (depending on species)
- Period of communicability: While parasites are present in the blood
-
Key Clinical Manifestations:
- Fever, chills, sweating, headache, muscle aches, fatigue
- Nausea, vomiting, diarrhea
- Anemia
- Enlarged spleen and liver
- In severe cases, cerebral malaria, respiratory distress, organ failure.
Amoebiasis
- A protozoal infection that primarily affects the colon, but can spread to the liver and lungs.
- Caused by Entamoeba histolytica, which exists in two stages:
- Cyst: The infective stage, resistant to environmental conditions and can survive outside the body for days.
- Trophozoites (vegetative form): Facultative parasites that invade tissues.
- Transmitted through contaminated food and water and flies.
- Primarily transmitted via fecal-oral and oral-anal routes.
- Incubation period ranges from 3 days for severe infections to 2-4 weeks on average.
- Communicable throughout the illness or until cysts are present in stool.
- Symptoms vary depending on severity and stage:
-
Acute Amoebic Dysentery:
- Intermittent diarrhea and constipation.
- Watery, foul-smelling stools containing blood and mucus.
- Abdominal distention, nausea, flatulence.
- Tenderness in the right iliac region.
-
Chronic Amoebic Dysentery:
- Prolonged diarrhea followed by constipation.
- Anorexia, weight loss, fatigue.
- Watery, bloody, mucoid stools.
- Flatulence, irregular bowel movements.
- Decreased abdominal elasticity.
- Severe cases may show scattered ulcers during sigmoidoscopy.
-
Acute Amoebic Dysentery:
- Diagnosis involves:
- Stool exams: Identifying cysts (abundant amoeba in the stool).
- Blood exams: Detecting leukocytosis.
- Sigmoidoscopy.
- Treatment involves:
- Metronidazole (Flagyl): 800mg TID for 5 days.
- Other antibiotics: Tetracycline, Ampicillin, Streptomycin, Chloramphenicol.
- Nursing interventions:
- Observe isolation and enteric precautions.
- Proper stool specimen collection:
- No oil prep for 48 hours prior.
- Collect large portion of stools containing blood and mucus.
- Label specimen accurately.
- Deliver specimen to the lab immediately.
- Provide skin care and hygiene.
- Ensure patient comfort, especially preventing chills.
- Force fluids and provide a bland diet:
- Cereals, strained meat broths (without fats).
- Bland diet without cellulose or bulk-producing foods.
- Gradually add chicken and fish during convalescence.
- Prevention strategies:
- Health education and fly control.
- Sanitary disposal of feces.
- Safe drinking water.
- Proper food preparation and handling.
- Detection and treatment of carriers.
Schistosomiasis (Bilharziasis/Snail Fever)
- A slowly progressive disease caused by blood flukes.
- Causative agents:
- Schistosoma japonicum: Endemic in the Philippines and China.
- Schistosoma mansoni: Found in South America, the Caribbean, Africa, and Middle East.
- Schistosoma haematobium: Prevalent in Africa and the Middle East.
- Source of infection: Stool and urine of infected humans or animals.
- Transmission:
- Ingestion of contaminated water.
- Penetration through skin pores.
- Intermediary host: Oncomelania hupensis quadrasi.
- Incubation period: At least 2 months.
- Clinical manifestations progress in stages:
-
Stage 1:
- Pruritic rash known as "swimmer's itch" develops 24 hours after cercariae skin penetration.
-
Stage 2:
- Intermittent bloody, mucoid stools.
- Katayama Fever:
- Fever, headache, cough, chills, sweating.
- Lymphadenopathy and hepatosplenomegaly.
-
Stage 3 (Chronic):
- Granulomatous reactions due to egg deposition in the intestines, liver, and bladder.
- Liver inflammation, jaundice, abdominal distention, splenomegaly.
- Possible brain involvement leading to epilepsy.
- Egg deposition in the bladder wall causes hematuria, obstruction, hydronephrosis, and recurrent urinary tract infections.
- Paleness and muscle wasting.
-
Stage 1:
- Complications:
- Liver cirrhosis and portal hypertension.
- Bleeding esophageal varices.
- Bladder cancer.
- Pulmonary hypertension.
- Heart failure.
- Ascites.
- Renal failure.
- Cerebral schistosomiasis.
- Diagnosis involves:
- Fecalysis.
- Liver and rectal biopsy.
- ELISA.
- Circumoval precipitation test (COPT): Confirmatory test.
- Management:
- Drug of choice: Praziquantel for 6 months.
- 1 tablet 2x daily for the first 3 months.
- 1 tablet daily for the next 3 months.
- Alternative: Ovamniquine.
- Drug of choice: Praziquantel for 6 months.
- Nursing interventions:
- Total bed rest (TSB).
- Skin care.
- Provide comfort.
- Ensure proper nutrition.
- Prevention and control:
- Reduce snail density:
- Molluscicides.
- Stream cleaning and vegetation removal (exposing snails to sunlight).
- Proper waste disposal.
- Control of stray animals.
- Safe and adequate water supply for bathing, laundry, and drinking.
- Foot bridges over snail-infested streams.
- Health education regarding transmission and prevention.
- Reduce snail density:
Syphilis (Sy, Bad Blood, The Pox, Lues Venereal, Morbus Gallicus)
- An acute, chronic infectious disease caused by the spirochete Treponema pallidum, acquired through sexual contact.
- Source of infection:
- Discharges from visible or concealed skin or mucous membrane lesions.
- Semen, blood, tears, urine, mucous discharge from the nose, eyes, or genital tract.
- Surface lesions.
- Incubation period: Varies but typically lasts 3 weeks.
- Communicable for a variable and indefinite duration.
- Transmission occurs through:
- Sexual contact.
- Indirect contact with articles freshly soiled with discharges or blood.
- Placental transmission.
- Clinical manifestations progress through stages:
-
Primary:
- Painless chancre (sore) at the site of the infection, swollen lymph nodes.
- Chancre disappears after 3-6 weeks, even without treatment.
-
Secondary:
- Rash can be macular, papular, pustular, or nodular.
- Macules often erupt between skin folds, on the trunk, arms, palms, soles, face, and scalp.
- Temporary hair loss (alopecia).
- Brittle and pitted nails.
-
Latent:
- Asymptomatic for several months.
- Bacteria enter a dormant stage.
-
Late:
- Ranging from no symptoms to damage in body organs like the brain, heart, and liver.
-
Primary:
- Diagnosis:
- Dark Field Illumination Test: Identifies Treponema pallidum.
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