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Questions and Answers
What is the primary causative agent of leptospirosis?
What condition can cause jaundice during the second phase of severe leptospirosis?
Which of the following is NOT a known mode of transmission for leptospirosis?
During which phase do symptoms such as fever, headache, and muscle aches first appear in leptospirosis?
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What characteristic symptom is associated with leptospirosis that affects the eyes?
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What is the drug of choice for treating leptospirosis?
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Which diagnostic test is specifically recommended for identifying the presence of Leptospira bacteria?
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Which animal is commonly associated with the transmission of Weil's disease?
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Which complication is NOT associated with severe leptospirosis?
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What is one of the recommended treatments for adults with amoebic dysentery?
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What preventive measure should individuals take to avoid leptospirosis exposure?
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What is a common symptom that can recur during the second immune phase of leptospirosis?
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Which method is a less common route for the bacteria Leptospira to enter the human body?
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Which treatment is NOT typically included in the management of leptospirosis?
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How long can Leptospira be found in the urine of an infected individual after disease onset?
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Which of these symptoms indicates a serious complication of severe leptospirosis?
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Which group is at a higher risk for contracting leptospirosis due to their occupation?
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What is a crucial aspect of nursing management in treating patients with amoebic dysentery?
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What is indicated for the prevention and control of amoebic dysentery?
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What characteristic of the cyst of Entamoeba histolytica is significant for its transmission?
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What is one risk factor for amoebiasis?
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What must be done with human waste as part of the prevention strategies?
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What stage of fluid management is important when treating a patient with amoebic dysentery?
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Which of the following is a correct statement about the incubation period for severe amoebic dysentery?
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What is the typical duration of the incubation period for the disease mentioned?
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Which of the following is NOT a mode of transmission for the disease?
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What symptom is associated with acute amoebic dysentery?
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Which clinical feature is associated with chronic amoebic dysentery?
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What condition may develop from extra-intestinal forms of amoebiasis?
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Which sign indicates a more severe form of amoebiasis?
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During which examination might you see scattered ulceration with yellowish and erythematous borders?
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Which of the following symptoms is common during the onset of amoebiasis?
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How soon should hepatitis immune globulin be administered after exposure to hepatitis B virus?
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What is the primary cause of hepatitis C infection?
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Which of the following is NOT a symptom of hepatitis C?
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What diagnostic test is commonly used to detect the extent of liver damage caused by hepatitis C?
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What is a primary method for preventing hepatitis C infection?
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Which treatment is known to amp up the immune system in the management of hepatitis C?
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Which of the following is a characteristic of hepatitis D?
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What is a common incubation period for hepatitis D?
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Study Notes
Leptospirosis
- Leptospirosis is caused by the bacteria Leptospira interrogans
- The incubation period is 6 to 15 days although it can take up to 7-10 days
- The bacteria can be found in urine 10 to 20 days after disease onset and may be excreted for several months
- Leptopsirosis is transmitted through the ingestion or contact with the skin of infected urine or corpses of wild or domestic animals
- Leptospirosis can be transmitted through the mucous membranes of the eyes, nose, and mouth, and through breaks in the skin
- Leptospira enters the blood causing damage to the kidneys, liver, meninges, and conjunctiva
- Leptospirosis can also be transmitted through semen of infected animals
- Water sport enthusiasts can be at risk due to prolonged immersion in water that promotes bacterial entry
- Occupations at risk include veterinarians, slaughterhouse workers, farmers, and sewer workers
- Human-to-human transmission is rare
- Leptospirosis usually occurs in two phases:
- First phase: Fever, headache, sore throat, severe muscle aches in the calves and back, and chills occur suddenly, typically 2 to 20 days after infection. The eyes become red (orange eyes, pathognomonic sign of Leptospirosis)
- Second (immune) phase: Symptoms recur a few days later due to inflammation caused by the immune system eliminating the bacteria from the body. The fever returns, and the tissues covering the brain and spinal cord become inflamed (meningitis).
- Weil syndrome or severe Leptospirosis occurs in the second phase and causes jaundice, kidney failure, and a tendency to bleed
- Weil syndrome can also cause anemia and organ failure
- Complications of Leptospirosis include:
- Meningitis
- Respiratory distress
- Renal intestinal tubular necrosis that results in kidney failure (Weil’s disease)
- Cardiovascular problems.
- Diagnostic tests include:
- Blood culture
- Leptospira Agglutination test
- Leptospira Antigen-Antibody Test
- BUN and Creatinine
- Complete blood count (CBC)
- Creatine kinase
- Liver enzymes
- Liver function tests
- Treatment is aimed at suppressing the causative agent and fighting possible complications
- Leptospirosis treatment includes:
- A 5-7 day course of antibiotics such as Ampicillin, Azithromycin, Ceftriaxone, Doxycycline, and Penicillin
- IV fluid for hydration, administration of electrolytes, and possible blood transfusions
- Peritoneal Dialysis
- Nursing management can be divided into Health teaching and Management
- Health teaching includes:
- Avoiding swimming or wading in potentially contaminated water or flood water.
- Wearing proper protection such as boots and gloves when work requires exposure to contaminated water.
- Draining potentially contaminated water when possible.
- Controlling rats in the household by using rat traps or rat poison, and maintaining cleanliness in the house.
- Management of Leptospirosis involves:
- Isolate the patient and disinfect soiled articles.
- Provide oral therapy rehydration, unless contraindicated or if the patient is vomiting.
- Administer antibiotics such as:
- Tetracycline 500 mg every 6 hours to adults or 125 mg/kg body weight every 6 hours to children for 72 hours.
- Furazolidone 100 mg for adults or 125 mg/kg for children every 6 hours for 72 hours.
- Chloramphenicol 500 mg every 6 hours for adults or 18mg/kg for children every 6 hours for 72 hours.
- Cotrimoxazole 8mg/kg for 72 hours.
- Continued nursing management involves:
- Medical aseptic protective care; handwashing before handling food is imperative.
- Enteric isolation must be observed.
- Vital signs must be recorded accurately.
- Intake and output must be accurately measured.
- Provide through and careful personal hygiene.
- Excreta must be properly disposed of.
- Concurrent disinfection must be applied.
- Food must be properly prepared.
- Environmental sanitation must be observed.
- Weighing the patient provides additional data for fluid intake levels.
- Provide appropriate diet for the stage of recovery.
- Prevention and control measures include:
- Drinking only safe and clean water; boil drinking water for two or more minutes or use water chlorination.
- Keeping food away from insects and rats.
- Washing and cooking food properly.
- Sanitary disposal of human waste.
- Using toilet properly and cleaning it daily.
- Wash hands with soap after using the toilet and before eating.
- Keep surroundings clean to prevent flies and other insects and rodents from breeding.
Amoebic Dysentery
- Amoebic dysentery, also known as amoebiasis, is a protozoal infection caused by Entamoeba histolytica
- The infection is prevalent in unsanitary areas.
- The infection is common in warm climates.
- The infection is acquired by swallowing cysts from contaminated water or food
- Cysts can survive for a few days outside of the body
- Cysts enter the large intestine and hatch into amoeba, which can pass into the liver and cause amoebic liver abscess
- The source of infection is human excreta.
- The incubation period in severe infections is three days. In sub-acute and chronic infections, it can last for several months. The average incubation period varies from three to four weeks.
- The period of communicability is the entire duration of illness.
- Amoebic dysentery is transmitted through:
- Fecal-oral transmission.
- Direct contact, including sexual contact (orogenital, oroanal, and proctogenital sexual activity).
- Indirect contact; ingestion of food, especially uncooked leafy vegetables or food contaminated with fecal material containing E.histolytica cysts.
- Food or drinks contaminated by cysts through pollution of water supply, exposure to flies, use of night soil for fertilizing vegetables, and through unhygienic practices of food handlers.
- Clinical manifestations include:
-
Acute amoebic dysentery:
- Slight attack of diarrhea with periods of constipation and tenesmus (the urge to defecate).
- Watery, foul-smelling stools often containing blood and mucus.
- Colic and gaseous distension of the lower abdomen.
- Nausea, flatulence, abdominal distension, and tenderness in the right iliac regions over the colon.
-
Chronic amoebic dysentery:
- Attacks of dysentery that last for several days, usually succeeded by constipation.
- Tenesmus
- Anorexia, weight loss, and weakness
- The liver may be enlarged.
- Stools become watery, bloody, and mucoid.
- Vague abdominal distress, flatulence, constipation or irregularity of bowel movement.
- Mild toxemia, constant fatigue, and lassitude
- The abdomen loses its elasticity when picked up between the fingers.
- On sigmoidoscopy, scattered ulceration, with yellowish and erythematous border is often noted.
- Gangrenous type is characterized by the appearance of large sloughs of intestinal tissues in the stools, accompanied by hemorrhage.
-
Extra-intestinal forms
- Hepatic (liver-related)
- Pain in the upper right quadrant of the abdomen, with tenderness of the liver
- Jaundice
- Intermittent fever
- Loss of weight or anorexia
- Abscess may break through the lungs and the patient may cough "anchovy-sauce" sputum.
-
Acute amoebic dysentery:
- Clinical features of amoebiasis:
- Gradual onset
- Diarrhea increases and stools become bloody and mucoid.
Hepatitis B
- Hepatitis B is bloodborne and caused by the hepatitis B virus
- Hepatitis B can be asymptomatic but can cause scarring of the liver (fibrosis) and eventually cirrhosis
- Hepatitis B is associated with a high rate of chronic liver diseases
- Clients with chronic hepatitis B are considered infectious
- There is a vaccine available for hepatitis B
- The incubation period is 2 weeks to 6 months
- The period of communicability is from one or more weeks before the onset of symptoms
- Most people are probably infectious indefinitely.
- Hepatitis B is transmitted through:
- Unsafe injection practices
- Inadequate sterilization of medical equipment in health-care settings
- Unscreened blood and blood products
- Signs and symptoms include:
- Belly pain
- Clay-colored poop
- Dark urine
- Fatigue
- Fever
- Jaundice
- Joint pain
- Poor appetite
- Nausea
- Vomiting
- Diagnostic tests include:
- Anti-Hepatitis B surface antigen (HBsAg)
- Hepatitis B surface antibody (anti-HBs)
- Hepatitis B core antibody (anti-HBc)
- Liver function tests
- Treatment and management includes:
- Interferon – amped the immune system
- Ribavirin- anti-viral drug
- Prevention includes:
- Never sharing needles
- Avoid direct exposure to blood and blood products
- Avoid sharing personal care items
- Practice safe sex
- Choose tattoo and piercing parlors carefully
Hepatitis C
- Hepatitis C is a bloodborne infectious disease caused by the hepatitis C virus
- The infection is often asymptomatic, but once established can cause scarring of the liver (fibrosis) and eventually, cirrhosis (advance scarring)
- The Hepatitis C virus is associated with a high rate of chronic liver diseases
- Clients with chronic hepatitis C are considered infectious
- No vaccine is available for hepatitis C
- The incubation period is 2 weeks to 6 months
- The period of communicability is from one or more weeks before the onset of symptoms
- Most people are probably infectious indefinitely.
- Hepatitis C is transmitted through:
- Unsafe injection practices
- Inadequate sterilization of medical equipment in some health-care settings, and
- Unscreened blood and blood products
- Signs/Symptoms include:
- Belly pain
- Clay-colored poop
- Dark urine
- Fatigue
- Fever
- Jaundice
- Joint pain
- Poor appetite
- Nausea
- Vomiting
- Diagnostic tests include:
- Anti-Hepatitis C antibodies
- PCR (Polymerase Chain Reaction)
- Liver function tests
- Treatment and management includes:
- Interferon – amped the immune system
- Ribavirin- anti-viral drug
- Prevention includes:
- Never sharing needles
- Avoid direct exposure to blood and blood products
- Avoid sharing personal care items
- Practice safe sex
- Choose tattoo and piercing parlors carefully
Hepatitis D
- Hepatitis D, also known as delta virus, is a small circular RNA virus
- The incubation period is 2 - 8 weeks
- The period of communicability is thought to be most infectious before the onset of acute illness
- Hepatitis D is transmitted through:
- Exposure to infected blood and serous body fluids; and contaminated needles, syringes, blood and plasma product transfusions.
- Sexual transmission, although less common than with HBV.
- A patient can have both hepatitis D infection and hepatitis B virus which is called co-infection
- Symptoms of Hepatitis D often include:
- Yellowing of the skin and eyes (jaundice)
- Joint pain
- Abdominal pain
- Vomiting
- Loss of appetite
- Dark urine
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Description
This quiz covers the essential aspects of Leptospirosis, focusing on its causative agent, transmission methods, and at-risk populations. Learn about the incubation period, symptoms, and potential complications associated with this infectious disease caused by Leptospira interrogans.
