Ch.13 Infection and Disease

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1. Infection occurs when:
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A) contaminants are present on the skin B) a person swallows microbes in/on food C) a person inhales microbes in the air D) pathogens enter and multiply in body tissues* E) all of the choices are correct
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2. All infectious diseases:
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A) are contagious B) only occur in humans C) are caused by microorganisms or their products* D) are caused by vectors E) involve viruses as the pathogen
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3. Which is not terminology used for resident flora:
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A) pathogenic flora* B) normal flora C) indigenous flora D) normal microflora E) all of the choices are correct
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4. Endogenous infectious agents arise from microbes that are:
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A) in food B) the patient’s own normal flora* C) on fomites D) in the air E) transmitted form one person to another
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5. The human body typically begins to be colonized by its normal flora:
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A) before birth, in utero B) during, and immediately after birth* C) when a child first goes to school D) when an infant gets its first infectious disease E) during puberty
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6. Resident flora are found in/on the:
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A) skin B) mouth C) nasal passages D) large intestine E) all of the choices are correct*
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7. All of the following genera are considered resident flora of skin sites except:
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A) Escherichia* B) Staphylococcus C) Corynebacterium D) Micrococcus E) Mycobacterium
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8. Resident flora of the intestines include the following:
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A) Streptococcus B) Bacteroides C) Staphylococcus D) Haemophilus E) all of the choices are correct*
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9. Which genus is resident flora of the mouth, large intestine, and, from puberty to menopause, the vagina?
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A) Lactobacillus* B) Streptococcus C) Haemophilus D) Escherichia E) Mycobacterium
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10. Which genus is the most common resident flora of mouth surfaces?
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A) Lactobacillus B) Streptococcus* C) Haemophilus D) Escherichia E) Mycobacterium
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11. The body site with resident flora that produces beneficial body products, including vitamin K and several other vitamins is the:
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A) skin B) mouth C) large intestine* D) vagina E) nasal passages
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12. Virulence factors include all the following except:
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A) capsules B) ribosomes* C) exoenzymes D) endotoxin E) exotoxin
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13. STORCH is an acronym that represents the most common:
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A) genera of resident flora B) sexually transmitted diseases C) portals of entry D) vectors E) infections of the fetus and neonate*
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14. Microbial hyaluronidase, coagulase, and streptokinase are examples of:
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A) adhesive factors B) exotoxins C) hemolysins D) antiphagocytic factors E) exoenzymes*
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15. Exotoxins are:
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A) proteins* B) only released after a cell is damaged or lysed C) antiphagocytic factors D) secretions that always target nervous tissue E) lipopolysaccharides
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16. Enterotoxins are:
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A) virulence factors B) toxins that target the intestines* C) proteins D) exotoxins E) all of the choices are correct
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17. Which is mismatched?
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A) fimbriae – adherence to substrate B) capsules – antiphagocytic factor C) coagulase – dissolve fibrin clots* D) leukocidins – damage white blood cells E) hemolysins – damage red blood cells
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18. The stage of an infectious disease when specific signs and symptoms are seen and the pathogen is at peak activity is:
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A) prodromal stage B) convalescent stage C) incubation period D) period of invasion* E) all of the choices are correct
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19. The time from when pathogen first enters the body and begins to multiply, until symptoms first appear is the:
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A) prodromal stage B) convalescent stage C) incubation period* D) period of invasion E) all of the choices are correct
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20. The initial, brief period of early, general symptoms such as fatigue and muscle aches, is the:
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A) prodromal stage* B) convalescent stage C) incubation period D) period of invasion E) all of the choices are correct
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21. Which is mismatched:
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A) secondary infection – infection spreads to several tissue sites* B) mixed infection – several agents established at infection site C) acute infection – rapid onset of severe, short-lived symptoms D) local infection – pathogen remains at or near entry site E) toxemia – pathogen’s toxins carried by the blood to target tissues
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22. The subjective evidence of disease sensed by the patient is termed:
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A) syndrome B) symptom* C) sign D) pathology E) inflammation
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23. The objective, measurable evidence of disease evaluated by an observer is termed:
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A) syndrome B) symptom C) sign* D) pathology E) inflammation
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24. Local edema, swollen lymph nodes, fever, soreness, and abscesses are indications of:
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A) toxemia B) inflammation* C) sequelae D) a syndrome E) latency
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25. The study of the frequency and distribution of a disease in a defined population is:
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A) pathology B) clinical microbiology C) medicine D) immunology E) epidemiology*
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26. The principal government agency responsible for tracking infectious diseases in the United States is:
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A) Centers for Disease Control and Prevention* B) World Health Organization C) National Institutes of Health D) United States Department of Agriculture E) Infection Control Committee
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27. The number of new cases of a disease in a population over a specific period of time compared with the healthy population is the:
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A) mortality rate B) morbidity rate C) incidence rate* D) prevalence rate E) epidemic rate
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28. A disease that has a steady frequency over time in a population is:
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A) epidemic B) endemic* C) pandemic D) sporadic E) chronic
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29. The primary, natural habitat of a pathogen where it continues to exist is called the:
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A) fomite B) carrier C) vector D) reservoir* E) source
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30. Someone who inconspicuously harbors a pathogen and spreads it to others is a:
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A) fomite B) carrier* C) vector D) reservoir E) source
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31. An animal, such as an arthropod, that transmits a pathogen from one host to another is a:
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A) fomite B) carrier C) vector* D) reservoir E) source
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32. An inanimate object that harbors and transmits a pathogen is a:
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A) fomite B) carrier C) vector D) reservoir E) source
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33. The intermediary object or individual from which the infectious agent is actually acquired is termed the:
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A) fomite B) carrier C) vector D) reservoir E) source*
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34. Reservoirs include:
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A) humans B) animals C) soil D) water E) all of the choices are correct*
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35. A laboratory technologist splashed a blood specimen onto his face, eyes, nose, and mouth. This specimen was from an HIV positive patient. If this blood exposure leads to HIV infection in the technologist, the transmission route is:
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A) direct B) fomite C) vehicle+ D) droplet nuclei E) aerosols
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36. The dried residues of fine droplets from mucus or saliva that harbor and transmit pathogen are:
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A) fomites B) aerosols C) mechanical vectors D) droplet nuclei* E) biological vectors
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37. Animals that participate in the life cycles of pathogens and transmit pathogens from host to host are:
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A) fomites B) aerosols C) mechanical vectors D) droplet nuclei E) biological vectors*
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38. Nosocomial infections involve all the following except:
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A) are only transmitted by medical personnel B) often involve the patient’s urinary tract and surgical incisions C) the patient’s resident flora can be the infectious agent D) Escherichia coli and staphylococci are common infectious agents E) medical and surgical asepsis help lower their occurrence*
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39. When would Koch’s Postulates be utilized:
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A) determination of the cause of a patient’s illness in a hospital microbiology lab B) development of a new antibiotic in a pharmaceutical lab C) determination of the cause of a new disease in a microbiology research lab* D) formulation of a vaccine against a new pathogen in a genetic engineering lab E) whenever the scientific method is used to investigate a microbiological problem
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40. Most of the skin’s resident flora are found in the uppermost, superficial layers of the epidermis.
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A) True
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41. Under certain circumstances, a person’s resident flora can be opportunistic pathogens.
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A) True
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42. The virulence factors of a pathogen are established by how strong or weak a patient’s body defenses are at the time of infection.
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A) True
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43. The Centers for Disease Control and Prevention assigns the most virulent microbes known to cause human disease to biosafety level 4.
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A) True
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44. A fetus can get an infection when a pathogen in the mother’s blood is capable of crossing the placenta to the fetal circulation and tissues.
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A) True
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45. When an infected person is in the incubation period, that person cannot transmit the pathogen to others.
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B) False
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46. Septicemia means that a pathogen is present and multiplying in the blood.
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A) True
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47. Sentinel animals are monitored for specific diseases in order to determine the potential for human exposure to a disease.
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A) True B) False
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48. Fomites, food, and air serve as indirect transmission routes of pathogens.
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A) True
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49. Leukopenia is the _____ in the level of white blood cells in a patient.
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Decrease
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50. A _____ is an infection indigenous to animals that can, on occasion, be transmitted to humans.
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Vector
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51. _____ carriers are shedding and transmitting pathogen while they are recovering from an infectious disease.
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Convalescent
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52. A _____ is the presence of small numbers of bacteria in the blood.
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Bacteremia or Viremia
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53. _____ are toxins that are the lipopolysaccharide of the outer membrane of gram negative cell walls.
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Endotoxin
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54. _____ are various bacterial enzymes that dissolve fibrin clots.
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Bacterial kinases (Ex.Streptokinase, Staphylokinase)
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55. The total number of deaths in a population due to a disease is the _____ rate.
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Mortality
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56. _____ are a set of criteria used to identify and link a specific microorganism as the etiologic agent of a new infectious disease.
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Koch P.
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What is an Infection?
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a condition in which pathogenic microbes penetrate host defenses, enter tissues & multiply
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What is a Disease?
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any deviation from health, disruption of a tissue or organ caused by microbes or their products
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What is Resident Flora?
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*includes bacteria, fungi, protozoans, viruses and arthropods (see word document) *most areas of the body in contact with the outside environment harbor resident microbes; large intestine has the highest numbers of bacteria *internal organs, tissues & fluids are microbe-free *bacterial flora benefit host by preventing overgrowth of harmful microbes
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What is True pathogens
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-capable of causing disease in healthy persons with normal immune defenses -Influenza – virus, plague – bacillus, malarial – protozoan
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What is an Opportunistic pathogens
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-cause disease when the host’s defenses are compromised or when they grow in part of the body that is not natural to them -Pseudomonas sp & Candida albicans
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List all Portal of Entries
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– skin – gastrointestinal tract – respiratory tract – urogenital tract
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what is Infectious dose (ID)
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-minimum number of microbes required for infection to proceed -microbes with small Infectious Dose have greater virulence -1 rickettsial cell in Q fever -10 bacteria in TB, giardiasis -109 bacteria in cholera (1,000,000,000) -Lack of ID will not result in infection
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List Mechanisms of adhesion
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fimbrae flagella adhesive slimes or capsules cilia suckers hooks barbs
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Virulence factors – what is exoenzymes
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-digest epithelial tissues & permit invasion of pathogens -Mucinase (amoebic dysentery), keratinase (ringworm), Collagenase (gangrene), hyaluronidase (staph, strepto)
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Virulence factors – Toxigenicity
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-capacity to produce toxins at the site of multiplication
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Virulence factors – exotoxins
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– secreted by gram-positive and gram-negative bacteria, the cell wall stays intact (does not have to be lysed
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Virulence factors – endotoxins
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-secreted by gram-negative bacteria during lysis of the cell wall
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Virulence factors -antiphagocytic factors
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help them to kill or avoid phagocytes, include leukocidins and capsules
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Patterns of infection – localized infection
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microbes enters the body & remains confined to a specific tissue
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Patterns of infection – focal infection
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when the infectious agent breaks loose from a local infection and is carried to other tissues
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Patterns of infection – systemic infection
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infection spreads to several sites and tissue fluids (usually in the bloodstream)
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Patterns of infection – Primary infection
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initial infection, first microbe
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Patterns of infection – Secondary infection
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another infection at another site by a different microbe
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Patterns of infection – Mixed infection
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several microbes grow simultaneously at the same infectious site
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Patterns of infection – Focal infection
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– is an infection at 2 different sites by one organism.
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Bacteremia
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is the presence of bacteria in the blood. The blood is normally a sterile environment, so the detection of bacteria in the blood is considered abnormal
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Septicemia
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is a related medical term referring to the presence of pathogenic organisms in the bloodstream, leading to sepsis, infection in a system or two.
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Sepsis
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is a potentially serious medical condition that is characterized by a whole-body inflammatory state and the presence of a known or suspected infection. The body may develop this inflammatory response by the immune system to microbes in the blood, urine, lungs, skin, or other tissues. Severe sepsis is the systemic inflammatory response, plus infection, plus the presence of organ dysfunction.
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Symptom
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subjective evidence of disease as sensed by the patient ex. vomiting
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Sign
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objective evidence of disease as noted by an observer, factual, should be recorded ex. White blood cell count, temperature
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True pathogens
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capable of causing disease in healthy persons with normal immune defenses Influenza – virus, plague – bacillus, malarial – protozoan
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Opportunistic pathogens
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cause disease when the host’s defenses are compromised or when they grow in part of the body that is not natural to them Pseudomonas sp & Candida albicans
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List the Portals of exit
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Respiratory, saliva Skin scales Fecal exit Urogenital tract Removal of blood
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Sequelae
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long-term or permanent damage to tissues or organs, a pathological condition resulting from a disease, injury, or other trauma, a secondary consequence or result Latin sequēla – something that follows; a continuation Examples. Streptococcus pyogenes, Strep throat, can lead to rheumatic fever, and kidney damage or Chronic kidney disease, for example, is sometimes a sequela of diabetes
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Epidemiology
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The study of the frequency and distribution of disease & health-related factors in human populations, how often a disease presents itself and where it occurs
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Etiology
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is the study of causation, or origin. The word is derived from the Greek αἰτιολογία, aitiologia, “giving a reason for”, it can be the genetic reason for the disease
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Surveillance
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– collecting, analyzing, & reporting data on rates of occurrence, mortality, morbidity, and transmission of infections
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Prevalence
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total number of existing cases with respect to the entire population usually represented by a percentage of the population USA – 861,533 with diabetes 293,655,405 total population = 2.9% Canada – 95,372 with diabetes , 32,507,874 total population = .29%
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Incidence
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measures the number of new cases over a certain time period, as compared with the general healthy population Down’s Syndrome – 340,000 per year, 28,333 per month, 6,538 per week, 931 per day, 38 per hour, 0 per minute, 0 per second
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Mortality rate
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the total number of deaths in a population due to a certain disease
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Morbidity rate
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number of people afflicted with a certain disease per 1000, an inexact term that can mean either the incidence rate or the prevalence rate.
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Sporadic
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when occasional cases are reported at irregular intervals
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Endemic
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disease that exhibits a relatively steady frequency over a long period of time in a particular geographic locale
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Epidemic
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when prevalence of a disease is increasing beyond what is expected
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Pandemic
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(from Greek παν pan all + δήμος demos people) epidemic across continents
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Describe a Pandemic
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A pandemic is a global disease outbreak. A flu pandemic occurs when a new influenza virus emerges for which people have little or no immunity, and for which there is no vaccine. The disease spreads easily person-to person, causes serious illness, and can sweep across the country and around the world in very short time.
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Antonine Plague
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165-180 BC. Possibly smallpox brought back from the Near East; killed a quarter of those infected and up to five million in all. 5,000 people a day were said to be dying in Rome
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Peloponnesian War
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430 BC, Typhoid fever killed a quarter of the Athenian troops and a quarter of the population over four years.
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The Black Death
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the bubonic plague returned to Europe, Starting in Asia, the disease reached the Mediterranean and western Europe in 1348 (possibly from Italian merchants fleeing fighting in the Crimea) killed twenty million Europeans in six years, a quarter of the total population and up to a half in the worst-affected urban areas
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Influenza
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the “first” pandemic of 1510 traveled from Africa and spread across Europe, it is estimated that it killed about ten people in a thousand per day, or about 1%
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Cholera
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the first pandemic 1816-1826, previously restricted to the Indian subcontinent, the pandemic began in Bengal, then spread across India by 1820. It extended as far as China and the Caspian Sea before receding. The third pandemic (1852-1860) mainly affected Russia over a million deaths
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The “Spanish flu” – 1918-1919
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In six months, 25 million were dead; some estimates put the total of those killed worldwide at over twice that number, An estimated 17 million died in India, 500,000 in the United States and 200,000 in the UK.
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The Asian Flu
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caused about 70,000 deaths in the United States
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The “Hong Kong Flu
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caused about 34,000 deaths in the United States
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Reservoirs of infection
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Any person, animal, plant, soil or substance in which an infectious agent normally lives and multiplies. The reservoir typically harbors the infectious agent without injury to itself and serves as a source from which other individuals can be infected. The infectious agent primarily depends on the reservoir for its survival. It is from the reservoir that the infectious substance is transmitted to a human or another susceptible host.
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Living reservoirs may or may not have symptoms
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Asymptomatic carriers – gonorrhea, genital warts Passive carriers – health care professionals Vectors – live animals that transmits infectious disease, ticks, fleas, mosquitoes, flies, cockroaches, birds, rats
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Nonliving reservoirs
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soil, water, air bacteria, fungi, helminths, protozoa (in all forms – spores, cysts, larvae)
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Patterns of transmission – Direct contact
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-contact between mucous membranes &/or skin, portal of exit meets a portal of entry -Kissing, nursing, animal bites
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Patterns of transmission -Indirect contact –
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-contact achieved through some intervening medium implicated in the spread of infection -Vehicle – fomites (inanimate material), food, water, biological products Airborne -droplet nuclei – the dried residue formed by evaporation of droplets coughed or sneezed into the air -Aerosols – is a suspension of airborne particles that contain living organisms or were released from living organisms
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Nosocomial infections
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Diseases that are acquired during a hospital stay

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