Healthcare Quiz: Immune System & Infections

Vital Signs

• Normal Values:

  • Blood Pressure (BP): 100-120/60-80 mmHg (standing)
  • Heart Rate (HR): 60-100 beats per minute (BPM)
  • Respiration Rate (RR): 12-22 breaths per minute
  • Temperature: 97°F/36.1°C - 99°F/37.2°C
  • Blood Oxygen Saturation: 95-100%

• Factors Affecting Values:

  • Diet
  • Age
  • Lifestyle (exercise, smoking, drug use)
  • Weight
  • Physical trauma
  • Illness
  • Stress/mental health
  • Past medical history

• Abnormal Values Terminology:

  • Hypertension: High blood pressure
  • Hypotension: Low blood pressure
  • Tachycardia: Fast heart rate (over 100 BPM)
  • Bradycardia: Slow heart rate (under 60 BPM)
  • Tachypnea: Fast breathing rate (over 22 breaths/minute)
  • Bradypnea: Slow breathing rate (under 12 breaths/minute)
  • Fever: Temperature over 100.4°F/38°C (often due to infection/illness)
  • Hyperthermia: Temperature exceeding 99°F/37.2°C
  • Hypothermia: Temperature below 97°F/36.1°C
  • Hypoxemia: Blood oxygen saturation below 95%

Microorganisms

• Protozoa (Protists):

  • Single-celled, heterotrophic (consume organic material).
  • Live in moist environments.
  • Reproduce asexually (binary fission).
  • Can be pathogenic (causing disease) or non-pathogenic.
  • May be found in decayed materials, contaminated water.
  • Move using flagella, cilia, or amoeboid motion.

• Helminths:

  • Multicellular, heterotrophic invertebrates.
  • Develop through egg and larval stages.
  • Can be parasitic or non-parasitic.
  • Infections might be asymptomatic or persist for years.
  • Reproduce sexually.

• Fungi:

  • Heterotrophic (feed on dead organic matter).
  • Reproduce asexually (spores) and/or sexually.
  • Can be unicellular or multicellular.
  • Found in environments like air, soil, water, plants, and the human body.
  • Some are helpful (e.g., in food production), others harmful (especially for those with weakened immune systems).

• Prions:

  • Not living; misfolded proteins.
  • Extremely rare, fatal neurological diseases.
  • Do not reproduce (no replication).

• Viruses:

  • Non-living; rely on hosts for replication.
  • Contain genetic material (DNA or RNA).
  • Require host cells to reproduce.

• Treatment (General):

  • Protozoa: Antiparasitic medications.
  • Helminths: Antiparasitic/antifungal/antibiotic medications.
  • Fungi: Antifungal medications (spray, creams, oral).
  • Prions: Symptom management (e.g., antidepressants, pain relievers); palliative care.
  • Viruses: Optimizing the immune system (hydration, rest, pain relievers).
  • Bacteria: Antibiotics, rest, fluids, pain/fever management, good nutrition.

Antibiotic Resistance and MROs

• Antibiotic resistance occurs due to bacterial DNA mutations (leading to changes in proteins that deactivate antibiotics), or conjugation (sharing resistance genes between species).
• MROs (Multi-drug-resistant organisms) are bacteria resistant to multiple antibiotics. They are difficult to treat and pose significant health threats.
• Causes of resistance:
  • Overuse of antibiotics in humans (over-prescription, incorrect use, pressure from patients).
  • Overuse in livestock and fisheries.
  • Patients not completing antibiotic courses.
  • Improper disposal of unused antibiotics.
  • Poor infection control standards.
  • Lack of new antibiotic development.
• Prevention strategies:
  • Reduce unnecessary antibiotic use.
  • Proper hand hygiene.
  • Preventing misuse in livestock management.
  • Ensure complete antibiotic courses are taken.
  • Correct disposal of unused antibiotics.
  • Improve infection control in healthcare settings.
  • Funding research for new antibiotics.

Chain of Infection

• Chain of Infection Links:
  • Pathogen: Disease-causing microorganisms (bacteria, viruses, parasites, fungi, prions).
  • Reservoir: A host where the pathogen lives (human, animal, soil, water, surfaces).
  • Portal of Exit: How the pathogen leaves the reservoir (body openings, breaks in skin/mucous membranes).
  • Mode of Transmission: How the pathogen moves from exit to new host (contact, droplet, airborne, fomite, vector-borne).
  • Portal of Entry: How the pathogen enters a new host (body openings, breaks).
  • Susceptible Host: A host vulnerable to the pathogen (due to age, health status, medical devices).
• Breaking the Chain: Interrupt any link in the chain to prevent infection.
• Key Prevention: Hand hygiene, sterilization, appropriate PPE.

Standard Precautions

• Types of isolation:

  • Contact: Infections spread through physical contact. Often requires private rooms (or 6ft separation).
  • Droplet: Diseases spread via droplets (travel up to 6 feet). Usually includes a mask and gown.
  • Airborne: Airborne pathogens (travel farther). Requires private rooms, N95 masks, and negative air pressure.

• Infection Classifications:

  • Local: Infection confined to a specific area.
  • Systemic: Infection spreads throughout the body.
  • Healthcare-associated: Acquired in a healthcare setting.
  • Opportunistic: Infection occurs when the immune system is compromised.

Medical and Surgical Asepsis

• Medical Asepsis: "Clean technique." Practices that reduce the number of pathogens to prevent spread. Hand hygiene, PPE (gloves, gowns, masks), and decontamination of equipment.

• Decontamination Levels:

  • Cleaning/Sanitization: Reduces microbes (dirt, secretions). Frequent cleaning for reusable equipment.
  • Disinfection: Destroys most pathogens (not endospores). Chemicals used on reusable items.
  • Sterilization: Destroys all microorganisms (even endospores). High temperatures, chemicals, or steam used for items that enter the body.

• Surgical Asepsis: "Sterile technique." Free of all microbes, required for procedures involving skin or sterile tissues. Only sterile items touch sterile items; treat everything that might be contaminated as contaminated.

PPE for Transmission-Based Precautions

• Contact: Gown, Gloves
• Droplet: Mask, Gown, Gloves
• Airborne: N95 respirator, Gown, Gloves, Eye protection

Outbreak vs. Epidemic vs. Pandemic

• Outbreak: Sudden increase in cases in a small area.
• Epidemic: Rapid spread of disease within a city or region.
• Pandemic: Widespread spread across countries.

Outbreak Management

• General Public: Infection control, education, communication, vaccinations.
• Healthcare Facilities: Cleaning/decontamination, isolating patients, limiting movement.

Lymphatic and Immune Systems

• Lymphatic System: Vessels, lymph fluid, lymph nodes, spleen, thymus, tonsils.

• Immune System: Bone marrow, antibodies, skin. (Shared with lymphatic system: Thymus, spleen.)

• Lymph Function: Drains excess fluid, filters out pathogens, activates immune system.

• Immune Defense Lines:

  • First Line: Physical/chemical barriers (skin, mucus, stomach acid) and resident microorganisms.
  • Second Line: Non-specific defenses (inflammation, phagocytes, fever, interferons, complement system).
  • Third Line: Specific defenses (T cells, B cells, antibodies, immunological memory).
  • Shared components: macrophages are active in both second and third line.

• Immune Types:

  • Specific vs. Non-Specific: Specific immunity targets particular pathogens; non-specific mechanisms provide general protection.
  • Types of Adaptive Immunity: Natural (exposure to the pathogen) and artificial (vaccination) adaptive immunity; cytotoxic T cells are part of cell-mediated immunity.

• Inflammation: General signs and symptoms (redness, swelling, heat, pain), triggered to isolate or destroy injuries or pathogens.

• Autoimmune Disorder: Misdirected immune response where the body attacks own cells.

• Antigen vs Antibody: Antigenic is foreign molecule that triggers an immune response; antibody is an immune protein that targets specific antigens.

• Adaptive Immunity Types: Natural (exposure to pathogen) and artificially created (vaccination).

Diagnostic and Preventative Medicine

• Screening Tests:

  • Annual physical exam, colorectal cancer screening, mammograms, self-breast exams, pap tests, prostate cancer screening, testicular self-exams, osteoporosis screening, vision exams, dental hygiene, skin cancer screenings, TB screening, cognitive impairment.

• Importance of Screening: Early detection of diseases to improve treatment options and outcomes.

• Diagnostic Methods:

  • Blood tests (CBC, urinalysis), X-rays, fluoroscopy, CT scans, MRI, PET scans, ultrasound, ECG, spirometry.

Regulation of Healthcare

• Regulatory Colleges: Government-regulated groups that oversee licensing, ethical conduct, and standards of practice.
• Professional Associations: Organizations that provide continuing education, professional development, insurance, and advocacy.

SOAP Notes

• SOAP format:
  • Subjective: Patient's reported symptoms, history.
  • Objective: Measurable, observable data (vital signs, lab results).
  • Assessment: Diagnosis, clinical impression.
  • Plan: Proposed treatment, next steps.

Blood Typing

• Blood Types (with Rh):

  • A+ : A antigens, B antibodies, Rh antigen
  • A- : A antigens, B antibodies, Rh antibodies
  • B+ : B antigens, A antibodies, Rh antigen
  • B- : B antigens, A antibodies, Rh antibodies
  • AB+ : A & B antigens, no antibodies, Rh antigen
  • AB- : A & B antigens, no antibodies, Rh antibodies
  • O+ : No A or B antigens, A & B antibodies, Rh antigen
  • O- : No A or B antigens, A & B antibodies, Rh antibodies

• Blood Donation Compatibility:

  • Recipient blood type dictates who can donate.
  • Important rule in blood transfusions: Recipients can only receive blood with matching antigens; receiving incompatible blood can be fatal. Rh-negative individuals can receive only Rh-negative blood (except in life-threatening situations, where + blood is accepted ONLY ONCE).

Organ Donation

• Donatable Tissues/Organs: Cornea, skin, islet cells of pancreas, cardiovascular tissue, connective tissue; lungs, kidneys, liver, heart, pancreas, and small intestine.

Medical Ethics

• Malpractice: Negligence that results in harm.
• Informed Consent: The patient's voluntary agreement to undergo a procedure after receiving adequate information about risks, benefits, and alternatives. (This includes minors requiring a legal guardian's signature).