NCM 112 Medsurg (Finals) PDF

NCM 112 - MEDSURG LECTURE | Finals Saprophyticus, Staphylococcus GENITOURINARY (GU) SYSTEM epidermidis and Candida albicans URINARY TRACT INFECTION...

NCM 112 - MEDSURG LECTURE | Finals Saprophyticus, Staphylococcus GENITOURINARY (GU) SYSTEM epidermidis and Candida albicans URINARY TRACT INFECTION NEPHRITIS Upper Urinary Tract Infections General term is referring to inflammation of the kidney (nephritis and pionephritis) Kidneys. Pyelonephritis is inflammation of the Lower Urinary Tract Infections renal parenchyma Infection of the urinary bladder (Cystitis) E coli is the most common cause of Urethra (Urethritis) nephritis and pyelonephritis Prostate (Prostatitis) in male Most often, it is perceded by cyctitis; the bacteria migrate up the ureters, from the A WET BED urinary bladder to the kidneys. Bacteria ❖ Acid base balance may also gain access to the kidney via the bloodstream. ❖ Water removal ❖ Erythropoiesis URETERITIS ❖ Toxin Removal ❖ Blood Pressure Control Inflammation of one or both ureters. ❖ Electrolyte Imbalance Usually due to the spreading of infection ❖ Vitamin D Activations upward from the urinary bladder or downward from the kidneys. PYELONEPHRITIS URETHRITIS Pyelonephritis - kapag sobrang taas na, colonized with bacteria na. Inflammation of the urethra. Pathogens are usually transmitted sexually. The URINARY TRACT INFECTION (UTI) most common causes of urethritis are Chlamydia trachomatis, Neisseria ❖ UTI may be caused by any of the variety of gonorrhoeae, ureaplasmas, and microorganisms introduced by: mycoplasmas. Poor personal hygiene Urethritis that is not caused by N. Sexual intercourse gonorhea is often referred to as Insertion of catheters (3-4 days) and nonspecific urethritis (NSU) or other means (urinal catheter, the urine nongonococcal urethritis (NGU) bag should be hanged and not placed on Greenish discharge – Tulo sa mga inheat the floor) palagi! ❖ The urinary tract is usually protected PROSTATITIS from pathogens by the frequent flushing action of the urination. Inflammation of the prostate gland. ❖ The acidity of normal urine also discourages Most often, prostatitis is not an growth of many microorganisms. infectious disease. If it is caused by pathogen may be a bacterium, a virus, a ❖ Indigenous microflora are found at and near fungus, or a protozoan the outer opening (meatus) of the urethra of both males and females Patak-patak na pagihi. Rectal examination – ipapasok ang CYTITIS isang daliri sa pwet ng pasyente at Inflammation of the urinary bladder and kakapain ang taas. Kapag may nakapa the most common type of UTI. na malaki, positive. (Side lying with The most common cause is E. coli knee flexed) (Escherichia) Other common causes are species of Klebsiella, Proteus, Enretobacter Cannot send signal because of spinal injury Pseudomonas and Enterococcus as well as Staphylococcus Type your initials here | 1 NCM 112 - MEDSURG LECTURE | Finals CERVICITIS Inflammation of the cervix (that part of the uterus that opens into the vagina) I NFECTIONS OF THE GENITAL TRACT The female genital region supports the growth of many other microorganisms ENDOMETRITIS In the adult vaginal microflora, Inflammation of the endometrium (the there are many species of Lactobacillus, inner wall of the uterine wall) Staphylococcus, Streptococcus, Enterococcus, Neisseria, Clostridium, Actinomyces, Prevotella, diphteroids, enteric bacilli and Canfifa. The balance among these microbes depends on the estrogen levels and pH of the site. BARTHOLINITIS Inflammation of the Bartholin’s ducts in females. (Gilid ng kiffy) EPIDIDYMITIS Inflammation of the epididymis (an elongated structure connected to the testis) 2 NCM 112 - MEDSURG LECTURE | Finals Sexually Transmitted Disease of the Genital Tract The term STD, formerly called Venereal Disease (VD), includes any PELVIC INFLAMMATORY DISEASE (PID) of the infections transmitted by sexual Inflammation of the fallopian tubes; also activities. They are diseases not only the known as Salpingitis. genital and urinary tracts, but also by the skin, mucous membranes, blood, lymphatic and digestive systems, and many other body areas. Epidemic STDs include acquired immunodeficiency syndrome (AIDS), chlamydial and herpes infections, gonorrhea and syphilis. The AIDS VIRUS (HIV) primarily causes damage to helper T cells and thus inhibits antibody production. VIRAL STD ANOGENITAL HERPES VIRAL INFECTIONS, Liver – Fitz Hugh Curtis Syndrome GENITAL HERPES Once it reaches the liver – Violin String Adhesion Herpes Simplex Infections are (Dikit-dikit na string) – Pain in the right characterized by a localized primary upperquadrant lesion, latency and a tendency to localized recurrence. VAGINITIS In women, the primary sites are the Inflammation of the vagina. Can be cervix and the vulva and wih recurrnt caused by Candida Albicans (a yeast), diseases affecting the vulva, perineal Trichomonas vaginalis (protozoan) and skin, legs and buttocks. a mixture of bacteria in the genera In men, lesions appear on the penis, and Mobiluncus and Gardnerella which is in the anus and rectum of persons referred to as Bacterial Vaginosis engaging in anal sex. (BV) Vaginismus – nagla-lock INITIAL SYMPTOMS are usually itching, Pap Smear tingling and soreness, followed by a small patch of Metronidazole and Clyndamycin redness and then a group of small, painful blisters. Strong fish-like odor The blisters break and fuse to form painful, circular sores, which become Buring sensation while urination crusted after a few days. The sores heal VULVOVAGINITIS in about 10 days but may leave scars. The initial outbreak is more painful, Inflammation of the vulva (external genitalia of females in the vagina) prolonged, and widespread than subsequent outbreaks and may be associated with fever. Gonorrhea – Ceftriaxole GENITAL WARTS, GENITAL PAPILLOMATOSIS, CANDYLOMA ACUMINATUM Genital warts start as tiny, soft, moist, pink or red swellings, which grow rapidly and may develop stalks. Their rough surfaces give them the appearance of small cauliflowers. MULTIPLE WARTS often grow in the same area, most often on the penis in males, and in the vulva, vaginal wall, 3 NCM 112 - MEDSURG LECTURE | Finals cervix, and skin surrounding the vaginal sexual abuse); and mother-to-neonate area in women. Genital warts also during birth. develop around the anus and in the rectum in males and females who SYPHILIS engage in anal sex. A treponemal disease that occurs in Pathogen: Genital warts are caused by three stages: primary siphilis – a HPVs of the Papovaviridae family DNA painless lesion known as a chancre viruses (human wart viruses). HPV Secondary syphilis – a skin rash (palms genotypes 16 and 18 have been and soles) about 4-6 weeks later, with associated with cervical cancer. fever and mucous membrane lesions, Reservoirs and Made of Transmission: and a long latent period (as long as 5-20 Infected humans serve as reservoirs. years) Transmission occurs via direct contact, Tertiary syphilis – with damage to the usually sexual; through breaks in skin or CNS, cardiovascular system, visceral mucous membranes; or from mother to organs, bones, sense organs and other neonate during birth sites. Laboratory Diagnosis: Usually Caused by T. pallidum and transmitted diagnosed clinically, Molecular via direct contact with lesions, body diagnostic procedures are available. secretions, mucous membranes, blood, semen, saliva and vaginal discharge of infected people, usually during sexual BACTERIAL STDs contact; blood transfusions; or Genital Chlamydial Infections, Genital transplacentally from mother to fetus. Chlamydiasis Diagnosed by DARK FIELD MICROSCOPY of material scraped from Caused by certain serotypes of C. the margin of chanres. trachomatis; tiny, obligate intracellular, Gram-negative bacteria. PROTOZOAL INFECTIONS OF THE Chlamydia Trachomaits is GENIQUIRINARY SYSTEM considered to be the most common sexually transmitted pathogen. TRICHOMONIASIS The most frequent cause of Sexually transmitted protozoal disease nongonococcal urethritis (NGU), affecting both men and women. The causing mucopurulent urethral disease is usually symptomatic in discharge, urethral itching and women, causing vaginitis with a profuse, burning on urination??? thin, foamy, malodorous, greenish- yellowish discharge. GONORRHEA Gonococcal infections of the GU tract INFECTION DISEASE OF THE CIRCULATORY include urethritis and epididymitis in SYSTEM (hindi gumagaling) males and cervicitis, Bartholinitis, pelvic inflammatory disease (PID), Endocarditis salphingitis, endometritis and vulvovaginitis in females. Myocarditis Urethral discharge and painful urination Bacteremia – presence of bacteria in the are common in infected males, usually bloodstream, which can be, but is not starting 2-7 days after infection always a sign of disease. Infected women may be asymptomatic Transient Bacteremia (temporary for weks or months during which time presence of bacteria in the blood) – often severe damage to reptoductive system results from dental extractions, wounds, may occur. bites, and damage to the intestinals, Caused by Neisseria Gonorrhoeae respiratory, or reproductive tract mucosa. (gonococcus or GC) Even aggressive toothbrushing, which causes bleeding of the gums, can lead to Transmission occurs via direct, usually transient bacteremia. contact; adult-to-child (may indicate 4 NCM 112 - MEDSURG LECTURE | Finals Septicemia – is a disease in which the o Orchitis (inflammation of the patient experiences chills, fever and testes) prostration (extreme exhaustion) and o Oophoritis (inflammation of the has bacteria and/or toxins in their ovaries) bloodstream. o Meningitis Viremia – viruses in the bloodstream o Encephalitis Viral load – number of viruses in the o Deafness bloodstream, which may be described as o Pancrealitis being heavy or light. o arthritis o Mastitis TESTS THAT ARE ROUTINELY PERFORMED ON o Nephritis DONOR OF BLOOD (US) o Thyroidilis Treponema pallidum antigen (T. o Pericarditis pallidum cause of syphilis) o Caused by mumps virus. HIV – 1 antibody o Transmitted via droplet spread and HIV – 2 antibody direct contact with the saliva of an HIV p24 antigen infected person. HTVL – 1 antibody (human T-cell o Causative Agent: Myxovirus lymphotropic virus type 1) Parotidis Hepatitis B surface antigen VIRAL HEMORRHAGIC DISEASES Hepatitis B core antibody o Exteremely serious, acute viral illnesses Hepatitis C antibody o Initial symptoms include sudden onset INFECTIOUS MUNONUCLEOSIS of fever, malaise (a feeling of general discomfort, feeling “out of sorts”) myalgia and headache, followed by Also called as "mono" or the "kissing pharyngitis, vomiting, diarrhea, rash disease" is an acute viral disease that and internal hemorrhaging. may be asymptomatic or may be o Can be caused by many different viruses, characterized by fever, sore throat, including dengue virus, yellow fever lymphadenopathy (posterior cervical virus, Crimean-Congo hemorrhagic lymph nodes), splenomegaly (enlarged fever virus, Lassa virus, Ebola virus and spleen), and fatigue. Marburg virus Usually a sell-limited disease of 1 to several o Can be transmitted via person-to-person weeks' duration. It is rarely fatal. direct contact with infected blood, Etiologic agent is Epstein-Barr Virus secretions, internal organs or semen, or (EBV), which is also known as Human by needlestick. The risk is highest when the patient is vomiting, having diarrhea, Herpesvirus 4. or haemorrhaging. EBV is known to be oncogenic (cancer o Crimean-Congo hemorrhagic fever is a causing). tickborne disease Transmission occurs from person to person o Dengue fever and yellow fever are by direct contact with saliva. mosquito-borne diseases, transmitted Kissing facilitates spread among primarily by mosquitoes in the genus adolescents. EBV can be transmitted via Aedes. blood transfusion o Tachycardiac VIRAL INFECTIONS OF THE CIRCULATORY SYSTEM MUMPS (INFECTIOUS PAROTITIS) o Is an acute viral infection characterized by fever and swelling and tenderness of the salivary glands. BACTERIAL INFECTIONS OF THE o Complications can include CIRCULATORY SYSTEM (RICKETTSIAL EHRLICHIAL INFECTIONS OF THE CV SYSTEM 5 NCM 112 - MEDSURG LECTURE | Finals o Reservoirs are unknown, transmission ROCKY MOUNTAIN SPOTTED FEVER (TICKBORNE occurs via tick bite TYPHUS FEVER) o Characterized by sudden onset of LYME DISEASE moderate-to-high-fever, extereme Also known as Lyme Borreliosis, it is a exhaustion (prostration), muscle pain, tickborne disease characterized by three severe headache, chills, conjunctival stages: infection, and mucolopapular rash on o An early distinctive targetlike, red skin, extremities on about the third day, lesions usually at the site of the tick bite, which spreads to the palms, soles and expanding to a diameter of 15 cm, often much of the body with a central clearing. o Resevoirs include infected ticks on dogs, o Early systemic manifestations that may rodents, and other animals. include fatigue, chills, fever, headache, Transmission occurs via the bite of an stiff neck, muscle pain, join achess, with infected tick. Person to person or without lymphadenopathy. transmission rarely occurs-through o Neurologic abornmalities (aseptic blood transfusion meningitis, facial paralysis, myelitis and ENDEMIC TYPHUS FEVER encephalitis) and cardiac abnormalities (arrythmias, pericarditis) several weeks o Also known as Murine Typhus Fever and or months after the initial symtoms Fleaborne Typhus, is an acute febrile appear. disease that is similar to, but milder than epidemic typhus. Sysmptoms o Reservoirs include ticks, rodents include shaking chills, headaches, fever (especially deer mice) and mammals and a faint, pink rash (especially deer). Transmission occurs via tick bite, person-to-person o Reservoirs include rats, mice, possibly transmission does not occur. other mammals annd infected rat fleas. Transmission occurs from rat to flea to YERSINIA PESTIS human. Person-to-person transmission does not occur lives in fleas and some 200 rodent speicies it usually inters humans though bites. EPIDEMIC TYPHUS FEVER o Also known as, Louseborne typhus is an PLAGUE acute rickelssial disease, often with o Is an acute, often severe zoonosis. Initial sudden onset of headache, chills, signs and symptoms may include everm prostralion, fever, and general pains. A chills, malaise, myalgia, nausea, rash appears on the filth or sidh day, prostation, sore throat, and headache. initially on the upper trunk, followed by spread to the entire body, but usually BUBONIC PLAGUE not on the face, palms or soles. o Is named for the swollen, inflamed and o May be fatal if untreated. It occurs in tender lypmh nodes (buboes) that cold climates in areas where people live develop under unhygienic conditions and are louse infested. PNEUMONIC PLAGUE o Reservoirs include infected humans and Which is highly communicable, involves the body lice. Transmission occurs from lungs. It can result in localized outbreaks or human to louse in human. devastating epidemics. EHRLICHIOSIS SEPTICEMIA PLAGUE o Is an acute, febrile illness ranging from May lead to septic shock, meningitis and asymptomatic to mild to severe and life death threatening. Patients usually present with acute influenza-like illness with fever, headache and generalize malaise. TULAREMIA o Ehrlichiosis is reminiscent of RMSF, without the rash. Also known as Rabbit fever, is an acute zoonosis with a variety of clinical 6 NCM 112 - MEDSURG LECTURE | Finals manifestations depending on the portal of becomes infected when it takes entry of the pathogen into the body. blood meal from an infected animal. Most often presents as a skin ulcer and o Causative agent: TRYPANOSOMA regional lymphadenitis. CRUZI Ingestion of pathogen results in pharyngitis, BABESIOSIS abdominal pain, diarrhea and vomiting. o Is a sporozoan disease that may Inhalation of pathogen results in include fever, chills, myalgia, fatigue, pneumonia and septicaemia, with a 30% - jaundice, and anemia 60% fatality rate. o Transmission occurs by tick bite and Reservoirs include wild animals (especially rarely by blood transfusion rabbits, muskrals and beavers) some o Causative agent: Babesia Microtic domestic animals and hard ticks. Tronaminated me or drinking water, shom MALARIA of organisms into a wound while skinning o Is a systeric sporozoan infection with infected animals, inhalation of dust or malaise, fever, chills, sweating. animal bites. Person to person transmission headache and nausea. The frequency does not occur. with which the cycle of chills, fever, sweating is repeated is referred to as periodicity, which depends on the PROTOZOAL INFECTIONS OF THE parlicular species of malarial parasile CIRCULATORY SYSTEM that is causing the infection. o The intermittent bouts of chills and AFRICAN TRYPANOSOMIAS (AFRICAN SLEEPING lever are sometimes referred as SICKNESS) paroxysms. o Is a systemic disease caused by o Falciparum malaria may be flagellated prolozoa in the accompanied by cough, diarrhea, bloodstream known OS respiratory distress, shock, renal and hemollagellates. Early slages liver failure, pulmonary and include a painful chancre al the site cerebraledema, coma and death. of a isetse fly bite, lever, intense o Il is a major health problem in many headache. insomnia, lymphadenitis, tropical and subiropical countries. anemia, local edema and rash. Later o Infected humans and infected stages of the disease include body mosquitoes serve as reservoirs. Most wasting. falling asleep, coma, and human infections occur as a result of death if untreated. injection of sporozoites into the bloodstream by an infected female AMERICAN TRYPANOSOMIASIS (CHANGAS’ Anopheles mosquito while taking a DISEASE) blood meal. o In the acute stage of the disease. Causative Agent of MALARIA patients may present with an o Plasmodium ovale inflammatory response ot the site of the reduvid bug bite, lever, malaise. o Falciparum lymphadenopathy, hepatomegaly o Vivax (enlarged liver) and splenomegaly o Malariae (enlarged spleen). although it may Signs and Symptoms be asymptomatic Chronic ineversible o Dark colored urine complications include heart damage, Diagnostic arrythmias, enlarged esophagus o Malarias Smear (megaesophagus) and enlarged o Quantitative Buffy Coat colon (megacolon). Life threatening meningoencephalitis may occur. Treatment o Reservoirs include infected humans o Chloroquine and more than 150 species of HELMINTHS domestic and wild animals, including dogs. cots. rodents, carnivores and primates. A bug Parasitic worm 7 NCM 112 - MEDSURG LECTURE | Finals Divided into roundworms (nematodes) and flatworms Flatworms are divided into tapeworms (cestodes) and flukes (trematodes) NIYUG-NIYUGAN - Quisqualis indica 8