Communicable Disease Lecture Notes PDF

lOMoARcPSD|47894294 Communicable Disease - This is a resource unit from our lecture Microbiology (Far Eastern University) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university...

lOMoARcPSD|47894294 Communicable Disease - This is a resource unit from our lecture Microbiology (Far Eastern University) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university Downloaded by Dash Vie ([email protected])  lOMoARcPSD|47894294 TOP RANK REVIEW (WEEKEND CLASS) FAR EASTERN UNIVERSITY - DR. NICANOR REYES MEDICAL FOUNDATION School of Nursing COMMUNICABLE DISEASE Incubation Period (1st Stage) It is the time from the entry of Lecturer: Jessie Daclis, RN microorganism until the first signs and symptoms appear Communicable Disease ○ Eg. Covid-19 (Incubation period: 2-14 days) It is a disease that can be transmitted The patient is asymptomatic from one person to another. Incubation period ends when first A disease that has causative agent signs and symptoms appear ○ Eg. Covid-19 (Causative Agent: Beta Corona Virus) Prodromal Period (2nd Stage) ○ Dengue (Causative Agent: This is the time in which the patient Flavivirus or Dengue Virus) has already signs and symptoms ○ Tetanus (Causative Agent: The symptoms here are non-specific Clostridium Tetani) Most common prodromal symptoms Take note: Any diseases that have no ○ Flu-like signs and symptoms causative agent agent are called non- Fever communicable diseases Cough ○ Eg. Hypertension, Diabetes Sore throat Headaches Infection Fatigue Runny nose Presence of pathogenic Body aches microorganism in the body ○ These are the general signs and The disease causing microorganism is symptoms inside the body ○ Rashes are also example of Pathogenic means disease causing prodromal symptoms organism Take note: Vomiting and diarrhea are Stages of Infection (I.P.A.C.R) flu signs and symptoms among children Acute Period (3rd Stage) The symptoms here are specific In this period, the patient would have pathognomonic sign (characteristic of a particular disease) ○ Eg. Rabies Specific signs and symptoms: Hydrophobia ○ Dengue LJ. RM. YT. CT. Downloaded by Dash Vie ([email protected])  lOMoARcPSD|47894294 Specific signs and ○ The answer is IgM symptoms: Petechial as it usually Herman’s sign (redness increases during on the skin as a result of the acute disease histamine release) ○ 2nd: IgG (increases ○ Leprosy during the Specific signs and convalescent symptoms: Leonine period) Appearance Take note: Antibodies Convalescence Period (4th Stage) are more abundant in Signs and Symptoms start to the body if an individual disappear is immune Resolution Period (Final Stage) Types of Immunity The patient becomes healthy again Natural ○ Immunity that is inherent in the Immunity body ○ Species-specific (Certain species Refers to the body’s ability to prevent don’t affect an individual’s the invasion of pathogens. immunity) Immune: Resistant (↑↑ Antibodies) ○ Eg. Parvovirus Two terms need to remember: ○ Antigen Acquired These are called foreign ○ Immunity that is achieved when bodies exposed to the environment These are bacteria, ○ Question: How many percent of viruses, parasites, microorganism cause disease protozoa, and toxins that ➔ Less than 1 percent produce infection make an individual sick. These are “enemy” The majority are helpful microorganisms in the body such as ○ Antibodies normal flora and These are proteins that lactobacillus. destroy familiar antigen ○ Question: What vitamin is These are also called injected once right after birth? Immunoglobulins ➔ Vitamin K is given after ○ IgG birth because newborns ○ IgA have minimal vitamin K ○ IgM stored in their bodies as ○ IgE only small amounts pass ○ IgD to them through the Question: If infection placenta from their occurs, what antibodies mothers. It is only given go first to the injury site? once because the LJ. RM. YT. CT. Downloaded by Dash Vie ([email protected])  lOMoARcPSD|47894294 newborn’s intestines are sed and pregnant still sterile. individuals Eg. BCG and MMR Types of Acquired Immunity vaccines Inactivated Active Killed ○ Antibodies are produced by an microorganisms individual (self). Question: Can this ○ The protection is long-term type of vaccine be since the body itself produces given to a child the antibodies. with aids or ○ Results when exposure to a leukemia? disease organism triggers the ○ Yes immune system to produce antibodies to that disease. Eg. Inactivated Polio Vaccine Toxoid Passive Eg. Tetanus Toxoid ○ Antibodies are given to the Modified toxins individual ○ The protection is short-term since the antibodies are just given (i.e IV Injection) ○ Provided when a person is given Types of Passive Acquired Immunity antibodies to a disease rather than producing them through Natural Passive his or her immune system. ○ Transplacental Acquires passive immunity from the Types of Active Acquired Immunity mother through the Natural Active placenta. ○ This will be achieved once Starting at the end of the recover from the disease 2nd trimester and Artificial Active throughout the 3rd ○ Acquired through the trimester introduction of a killed or IgG - the antibodies weakened form of the disease passed from mother to organism through vaccination. fetus ○ Types of Vaccines: ○ Breastfeeding Live Attenuated Colostrum - the first flow Attenuated means of milk weakened IgA - the antibodies microorganism passed when Can’t be given for breastfeeding immunocompromi ○ Mother to fetus LJ. RM. YT. CT. Downloaded by Dash Vie ([email protected])  lOMoARcPSD|47894294 Artificial Passive ○ Antibodies are being injected particularly in the form of Gamma Globulin These antibodies are injected after exposure to certain antigens (post- exposure) Ie. Given to those patients who have been bitten by a rabid animal or punctured on a Infectious Agent rusty nail These antibodies are Take Note: given within 72 hours Mode of Transmission (MOT) is considered as the easiest link to break Aseptic Technique 2 Types: 4 Types (CAVeVe) 1. Medical Asepsis (Clean Technique) 1. Contact Transmission Absence of pathogenic a. Direct Contact microorganisms physical contact Eg. Done before doing eye care, b. Indirect Contact contaminated object enema administration, oral suctioning, NGT feeding or vaginal (fomites) douching c. Droplet Contact 2. Surgical Asepsis (Sterile Technique) 2. Airborne Transmission Absence of all microorganisms 3. Vehicle Transmission Always done or practiced before non-living invasive procedures (Operating room) 4. Vector Transmission Take note: Nasopharyngeal, tracheal, living E.T. tube suctioning requires sterile technique Rabies (Lyssa) Chain of Infection Causative Agent: Rhabdovirus LJ. RM. YT. CT. Downloaded by Dash Vie ([email protected])  lOMoARcPSD|47894294 - Bullet-shape Virus Rabies Brain Antibody (+) s/sx Test (+) contagious (+) death You won’t get a rabies if the rat bit you because they are dry biter Body (-) s/sx Management: (-) contagious If the virus is still in the body the goal is to (-) death prevent virus from reaching the brain 1. First Aid: Wash wound with soap and Mode of Transmission: water Animal Bite (common) (+) Betadine Scratch (rare) 2. Tetanus Prophylaxis Tissue Transplant (rare) 3. Rabies Immunization RA7170: Organ Donation Act Active (All of the people who died from infection Verorab/Imurab can't donate organ or tissue) (stimulate Antibody protein) Airborne - Droplet (rare) 5 doses -> IM -> ID (evidence-based) Signs and Symptoms o cost-effective 1. Invasive Stage Day 0, 3, 7, 14, 28 o Prodromal Signs and Symptoms non-specific Passive - fever Rabies Immunoglobulin (Rabuman) - headache - based on body weight - photophobia - half wound site and half IM - numbness 2. Excitement Stage If the virus is in the brain it is dangerous o Acute Stage (HAM) (Palliative) Hydrophobia (laryngospasm) Aerophobia 1. Strict Isolation Maniacal behavior - All PPE 3. Paralytic Stage 2. Non Stimulating environment (quiet) Generalized Paralysis -> whole body paralysis 3. Restraint -> main problem is Respiratory Paralysis 4. Avoid any sense of fluid stimulation 5. COVER IVF Diagnostics: 1. Observe for 10-14 days Prevention: Responsible Pet Ownership 2. Brain Biopsy Dog Immunization: 3 months (dark inclusion bodies called negri bodies) Booster: yearly - It does not confirm bodies 3. FRAT (confirmatory) Fluorescent Dengue (H-Fever/ Breakbone Fever) LJ. RM. YT. CT. Downloaded by Dash Vie ([email protected])  lOMoARcPSD|47894294 Tachycardia Tachypnea Pulse Pressure: Narrow Widened Pulse Pressure is in Increased ICP Causative Agent: Dengue Virus 1,2,3,4 , Grade 4: profound Shock Onyong-yong Virus, Chikungunya Virus - undetectable BP/pulse DSS: Dengue Shock Syndrome Mode of Transmission: Aedes Aegypti Grade 1 (Mild Dengue) - Can be cured at home o Fever (High) -> 2-4 days -> Biphasic / Saddleback (remain elevated 2-4 days and it will go down on the 4th day and elevated on the 2nd day/ 2 times the fever goes up) Decreased fever (most dangerous) -> decreased platelet -> bleeding Diagnostics: 1. Tourniquet Test/Rumpel Lead Test -> Chemicals released by the body: vascular resistance Bradykinin o done on older than 6 months Prostaglandin o Screening Test Histamine o not advisable if the person has dehydration and bleeding because it is not accurate Symptoms associated is pain, headache, a.) Check BP muscle, bone pain, and joint pain b.) Solve Mid systolic, Diastolic Pressure S+D /2 - e.g. 120+180/2 = 100 -increased histamine -> herman’s sign c.) Inflate BP cuff mid systolic diastolic (flushing of skin) pressure at least 5 minutes - petechial d.) Petechiae - 1 inch or 2.5cm: (+) 20 or more o Positive result indicates weak vein Grade 2: Symptoms of Grade 1 + Spontaneous People who have dengue has weak Bleeding (decreased platelet below 50,000) vein o Epistaxis 2. CBC: o Hematemesis (vomiting of blood) Platelet decrease o Melena (black tarry stool) Hematocrit: increase because of concentrated blood Grade 3: Bleeding + Shock 3. Serological Test - Plasma Leakage (+) Antibody Symptoms of Hypovolemic Shock EIA (Enzyme Immunosorbent assay) Hypotension Acute: (+) Ab LJ. RM. YT. CT. Downloaded by Dash Vie ([email protected])  lOMoARcPSD|47894294 Convalescent: 4 times increase in Merozoites (mature) -> go out in the liver -> antibodies (confirmatory) bloodstream -> eat the Red blood cells -> 4. Dengue Duo Anemia: (decreased RBCs) - Rapid test Severe anemia: Malarial Cachexia (+) NS1 Antigen (viral particle) - IgM, IgG First day of dengue it can be seen Signs and Symptoms: already 1. Cold Stage: 10-15 minutes Management: - Chills Palliative - Clatter teeth Paracetamol 2. Hot Stage: 4-6 hours Aspirin can’t be given (Platelet - high fever, headache, body malaise Inhibitor) The best time to collect the blood 3. Diaphoretic / Wet Stage Nursing management 1. Rest Diagnostic: 2. Fluid Replacement 1. Blood Smear -> “Peak” the parasite can ORS be seen IVF -> Isotonic (Lactated Ringers and NSS) 3. Ice Pack Management 4. Diet: No colored food/fluids 1. Artemether Lumefantrine (first line) Chloroquine is not used anymore because it is resistant -> prophylactic Malaria (Marsh Fever) drug -> effective in plasmodium vivax 2. Quinine - IM/IV Best position is Supine -> causes dizziness Supine position for 1 hour Causative Agent: Protozoal Parasite Filariasis (Elephantiasis) Plasmodium Vivax - most common Plasmodium Ovale Plasmodium Malariae Plasmodium Falciparum - fatal and common in Philippines Causative Agent: Wuchereria Bancrofti, Brugia Malayi, Brugia Timori Mode of Transmission: Anopheles Mode of Transmission: Aedes Poecillus Transmitted via Blood transfusion and contaminated needles and syringe 100 or more mosquitos bit you to have this SM Signs and Symptoms: Sporozoites (immature) -> liver 1. Asymptomatic Stage (8-16 months) 2. Acute Stage (-itis) LJ. RM. YT. CT. Downloaded by Dash Vie ([email protected])  lOMoARcPSD|47894294 Lymphadenitis (enlargement of lymph Afternoon - low grade fever nodes) Blood in sputum (Hemoptysis) Lymphangitis (inflammation of lymph nodes) Cough (more than 2 weeks) Funiculitis (inflammation of spermatic cord) Decrease in weight Orchitis - inflammation of testes Evening sweat (night sweats) Epididymitis - inflammation of epididymis 3. Chronic Stage (10-15 years) 3. Extrapulmonary TB (outside the lungs) Hydrocele Elephantiasis Lymphedema Lymphedema first before Elephantiasis Diagnostic: 1. NBE (Nocturnal Blood Exam) - After 8 pm 2. ICT: Immuno Chromatobraphic Test Diagnostic - daytime 1. PPD (Purified Protein Derivative) - Mantoux Test Management: - exposure to TB DEC (Hetrazan) - inner forearm Diethyl carbamazepine - inject 5 tuberculin units of PPD - tuberculin syringe Prevention: Dengue, Malaria, Filariasis (+): >10mm Induration 4S: Immunocompromised (+): >5 mm Induration o Search and Destroy o Self-protection 2. Sputum Microscopy (DSSM) - Direct o Say “no” to indiscriminate fogging Sputum Smear Microscopy o Seek Early Consultation - Primary Diagnostic Tool o 2 sputum specimen o Early AM Tuberculosis o 10 year older 3. Xray: Lesions Causative Agent: Mycobacterium tubercle 4. Sputum Culture (confirmatory) Result: wait 1-2 weeks Mode of Transmission: Airborne Droplet Management: Signs and Symptoms: DOTS: Direct Observed Treatment Short Latent Stage Course Chemotherapy -> dormant o ensure compliance Active Infection RIPES LJ. RM. YT. CT. Downloaded by Dash Vie ([email protected])  lOMoARcPSD|47894294 oRifampicin Side effect: Red-orange BODY fluids Early: Adverse effect: hepatotoxicity Loss of skin (anesthetic) Extremities paralysis o INH (Isoniazid) Painful thick nerves Inadequate Vitamin B6 (Pyrazinamide) -> Redness Eyes Peripheral neuritis Obstruction of nose No to Tyramine Foods -> Hypertensive crisis Skin color changes - reddish/white Hepatotoxic Your ulcer do not heal RI (Rifampicin and Isoniazid) - Most powerful LATE TB drug Large breast in Male (Gynecomastia) A chronic ulcer o Pyrazinamide (PAIN) contracture A Toes and fingers clawing I - inhibit excretion of uric acid -> increase Eyebrows loss (Maarosis fluid intake, NSAIDs, allopurinol yelids can’t close completely N (lagophthalmos) Sinking Nose Bridge (Saddle Nose) o Ethambutol (EYES) Y E -> Optic Neuritis -> CN8 Blindness Gonorrhea (Gonorrhea Chlamydia) S Causative Agent: Neisseria Gonorrhea Not given to 6 years old and below Morning Drop/Drip o Streptomycin (Aminoglycoside) Nephrotoxicity Mode of Transmission: Ototoxicity - Sexual contact - oral, vaginal, anal - Vaginal delivery The fluid can cause ophthalmia Leprosy (Hansen’s Disease) neonatorum to newborn leading to Causative Agent: Mycobacterium leprae blindness Mode of Transmission: Signs and Symptoms: - prolonged skin-skin contact Male - Droplet - Dysuria - Burning sensation upon urination Main Tissues affected: - Pus Discharge Skin Mucous membrane Female Peripheral nerve - 80% Asymptomatic Testes Diagnostic: EARLY VS. LATE -Pap Smear LJ. RM. YT. CT. Downloaded by Dash Vie ([email protected])  lOMoARcPSD|47894294 -Urethral Smear 2. Primary HIV infection (2 weeks - 3 months) Management: o nonspecific Penicillin (IM) + Doxycycline (Oral) - taken for o flu-like sign and symptoms 7 days 3. AIDS: Acquired Immune Deficiency Syndrome Azithromycin (3 days, 1 dose) Ceftriaxone (IM) T-cell: Normal value : 600-1200 AIDS: