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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?
What is a common clinical manifestation associated with diphtheria?
What is the incubation period for diphtheria?
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What method is commonly used in diagnosing diphtheria?
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Which method is part of the prevention and control measures for diphtheria?
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What is the period of communicability for diphtheria?
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The Schick Test is utilized to determine what concerning diphtheria?
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What is the main mode of transmission for dengue fever?
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Which clinical manifestation is pathognomonic for dengue fever?
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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?
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Which diagnostic test is specific for confirming dengue infection?
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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?
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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?
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What are the effects of congenital varicella?
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When should Varicella – zoster Immune Globulin (VZIG) be administered?
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What is the primary mode of transmission of measles?
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What is the period of communicability for measles?
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What is a pathognomonic sign of measles?
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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?
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What is the primary etiologic agent of amoebiasis?
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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?
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What is the drug of choice for treating schistosomiasis?
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How long is the typical incubation period for amoebiasis?
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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?
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What is a common source of infection for amoebiasis?
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Which symptom is associated with the chronic stage of schistosomiasis?
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What type of diagnostic test is confirmatory for schistosomiasis?
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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?
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Which factor is essential in preventing schistosomiasis?
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What is the characteristic symptom of secondary syphilis?
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What is the primary etiologic agent of gonorrhea?
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Which symptom is commonly associated with candidiasis in the oropharyngeal region?
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What is a common complication of untreated gonorrhea?
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What is typically the first line treatment for gonorrhea?
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Which of the following best describes the incubation period for gonorrhea?
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What type of organism is Candida albicans?
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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?
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Which diagnostic test is not commonly used for confirming candidiasis?
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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?
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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?
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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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