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NURS 216A
September 26
| Question | Answer |
|---|---|
| What are neutrophils? | - A type of immune cell (granulocyte) that makes up 65% of WBC - It is first to the site of tissue damage - Have a lifespan of up to one week in tissue and blood - Immature cells are called band cells |
| What are lymphocytes? | - A type of immune cell that make up innate and memory - 3 types: B cells, T cells, and NK cells - B and T cells become specific with pathogens |
| What are monocytes? | - Immune cells in the blood that differentiate into macrophages and dendritic cells - Mature into macrophages |
| What are eospinophils? | - Allergy response immune cells - Release enzymes and are chemical mediators - Destroy allergens and parasites |
| What are basophils? | - Allergy response immune cells - Pro inflammatory and anti-coagulating factors |
| What are five causes of decreased WBC count? | 1. Autoimmune diseases 2. Chronic infections 3. Cancer 4. Immunodeficiencies 5. Drug therapy |
| What happens with autoimmune diseases? | - Lupus - Systemic inflammation decreases synthesis and proliferation - Depletion due to chronic requirements |
| What happens with chronic infections? | - Mononucleosis, HIV - Depletion due to chronic requirements |
| What happens with cancer? | - Lymphoma, leukemia - Destruction of production organs - Interference with maturation of normal WBCs |
| What happens with immunodeficiencies? | - Inborn errors (DiGeorge syndrome - malformed thymus) - Thymus produces T cells in children |
| What happens with drug therapy? | - Glucocorticoids - Cytotoxic agents (chemotherapy drugs, immunosuppressants) |
| What are the four body defenses? | 1. Physical barriers 2. Immune system 3. Pro inflammatory chemical mediators 4. Fever |
| How do physical barriers work? | - Skin (4-5 keratinized layers) - Mucous membranes (nose, GI tract, can have specific cells in them for protection) |
| How does the immune system work? | - Phagocytosis - Specific responses - Interferons - Immunoglobulins |
| What is the function of pro-inflammatory chemical mediators? | - Initiate and sustain inflammation |
| What is the function of fever? | - Pyrogen activated increase in body temperature |
| Which cells are phagocytosis cells? | - Neutrophils - Monocytes and macrophages - NK cells - Eosinophils - Cytotoxic T cells |
| Which cells produce specific immune response? | - B and T memory cells - B cell secreted antibodies |
| What are the function of interferons? | - Immunogenic proteins secreted by lymphocytes and macrophages that stimulate immune responses |
| What are immunoglobulins? | - Circulating antibodies - Known as Ig |
| What is pathogenicity? | An organisms ability to evade or overcome body defenses - Bacteria, virus, fungus, parasite |
| What are two mechanisms of pathogenicity of a bacteria or virus? | 1. Strength in numbers 2. Toxin production |
| What is a common bacteria found in hospital and how to prevent the spread of it? | - Streptococcus septicemia - Hand washing (80% of infections spread this way) |
| What are the three steps to treating an illness? | 1. Where is the illness? 2. Identify the cause of the illness 3. Treatment |
| How do we identify where an illness is? | Based on health history and focused health assessment findings |
| What are common viruses, their prevention, and symptom management? | 1. Covid-19, influenza, common cold, laryngitis (enter the host cell and multiply, making target hard to reach) 2. Immunization 3. Antivirals, supportive therapy |
| What are common bacteria, pathogens and their treatment? | 1. Strep throat and pneumonia (less contagious) 2. TB, E-coli, Enterococci, Staph. aureus, acinetobacter 3. Antibiotics, focused treatment (worry about resistance) |
| Which preservatives have changed how Botulism has traveled? | Sodium = potassium nitrate salt Nitrates/nitrites |
| What type of gram is Botulism, and how does it infect the body? | - Gram positive, anaerobic, neurotoxin (ach block) Ach block = CNS problems (paralytic, patient can't breathe) |
| Where does a culture sample have to be taken from? | Directly from the source (ie. throat, open wound) |
| What are some examples of gram negative bacteria, and what is their gram stain colour? | Gram stain: RED - E-coli - Klebsiella - Pseudomonas - Salmonella - Hib - Cholera - Syphillis - Gonorrhea - Nesseria M |
| What are some examples of gram positive bacteria, and what is their gram stain colour? | Gram stain: PURPLE - Staphylococci - Streptococci (Pneumococci) - Enterococci - Listeria - C dif |
| What is antibiotic emperic treatment? | - Based on suspected bacteria: evidence decision, broad spectrum may be used if many regions affected or more than one pathogen is suspected - Started ASAP |
| What is antibiotic focal treatment? | - Culture and sensitivity results = focus treatment - Treatment initiated ONCE results are known - Empirical tx may be switched to focal tx - Narrow spectrum antibiotics (better choice for that pathogen) |
| What is an example of Streptococcus pyogenes, its incubation period, and its symptoms? | - Pharyngitis - 2-4 days incubation, highly infectious - Fever, sore throat, headache, malaise - Post strep: glomerulonephritis, endocarditis |
| What other infections can stem from Streptococcus pyogenes? | - Meningitis - Pneumonia - Cellulitis, fasciitis - Septic arthritis - Bacteremia - Sepsis |
| What are the two steps of treatment? | 1. Treat according to clinical presentation and patient medical history: empiric therapy 2. Confirm with C&S: focal therapy |
| What are four classes of antimicrobial mechanisms of action, and examples of each? | 1. Cell wall synthesis (penicillins, cephalosporins, bacitracin, vancomycin) 2. Protein synthesis inhibitors (Chloramphenicol, erythromycin, tetracyclines, streptomycin) 3. Nucleic acid inhibitors (DNA, RNA, quinolones, rifampin) 4. Antimetabolites |
| What are three examples of beta-lactam antibodies? | - Beta lactam ring: bacteriocidal action 1. Penicillins 2. Cephalosporins 3. Carbapenams |
| What is the suffix and efficacy for penicillins? | - "illin" - Gram negative and positive bacteria - Allergy: rash, prutitis, bronchoconstriction, and swelling around the mouth, nose, and eyes) |
| What are two treatment examples for penicillin? | 1. Pharyngitis - Streptococcus pyogenes (Gram +) - 1st choice: Penicillin V, PO 2. Otitis media - S. pneumoniae, Hib, Moraxella - 1st choice: Amoxicillin, PO |
| What are three combined clavulanic acid and tazobactam? | 1. Amoxicillin (co-amoxiclav [Augmentin]) 2. Ticarcillin (co-ticarclav [Timentin]) 3. Pip-taz (Pipercillin/Tazobactam, Tazosin, Zosyn) |
| What is the prefix, the first choice for skin infections, and information about the 3-5th generations of cephalosporins? | - "Cef" - Cefazolin (Ancef, IV), Cephalexin (Keflex, PO), Cefuroxime - 3rd-5th generations cross the BBB (Cefraixone, cefazidime, cefraoline) and efficacy for bacterial meningititis |
| What is the suffix, medications, and efficacy for carbapenems? | - "penem" - Imipene, Metropenem - Potent, IV, not first line therapy, broad spectrum, used for meningitis and aspiration pneumonia |
| What is the medication, efficacy, and treatment for bacitracin? | - Polysporin - Efficacy: gram +, broad spectrum, topical, opthalamic, ear - Treatment: conjunctivitis, skin and soft tissue topical infections, prophylactic |
| What is the first and second choice for the glycopeptide antibiotic vancomycin? | - 1st choice: MRSA (Staph. Aureus) - 2nd choice: C. difficile bacterium |
| What is the gram stain, S&S, and treatment for C. Difficile infection? | - Clostridium difficile gram + - Severe diarrhea (long antibiotic tx), blood or pus in stool, fever, abdominal pain - Tx: antibiotics (1st: Flagyl PO, 2nd: Vancomycin PO) |
| What is the pharmacotherapy of penicillin? | - Penicillin weakens the cell wall and allows water to enter, thus killing the organism. Human cells do not have a cell wall - Many bacterial cell walls contain a substance called penicillin binding protein that serves as a receptor to penicillin |
| What is the beta-lactam ring? | - The portion of the chemical structure of penicillin that is responsible for its antibacterial activity - Some bacteria secrete the enzyme beta lactamase (penicillinase) that splits the beta lactam ring, which causes the bacteria to become resistant |
| What are the ADME's of penicillin? | A: active against gram + bacteria D: most have narrow spectrum of antimicrobial activity M: short half lives. Majority is excreted by kidneys E: urine |
| What is the pharmacotherapy of cephalosporins? | - Are bactericidal and act by attaching to penicillin-brining protein to inhibit cell wall synthesis - Like penicillins, the primary mechanism of resistance is the secretion of beta lactamase enzymes - Cephalosporins contain a beta-lactam ring |
| What is the pharmacotherapy of carbapenams? | - Broad-spectrum antibiotics with similar properties to other beta-lactams - Resistant to beta-lactamase and are broad-spectrum alternatives to penicillin. -Provide better activity against serious Gram - and multidrug-resistant infections |
| What is the pharmacotherapy of tetracyclines? | - Exert a bacteriostatic effect by selectively inhibiting bacterial protein synthesis - Bind to the 30S bacterial ribosome, thereby preventing the addition of amino acids to their growing polypeptide chain |
| How does a resistance to tetracyclines develop? | - When bacteria prevent tetracyclines from concentrating inside their cells - When their ribosome shape is altered so that the antibiotics can no longer bind |
| What is the pharmacotherapy of macrolides? | - Inhibit bacterial protein synthesis and may be bactericidal or bacteriostatic depending on the dose and target organism - Inhibit bacterial protein synthesis by binding to the 50S subunit, preventing movement of the ribosome along the mRNA |
| What is the pharmacotherapy of aminoglycosides? | - Bactericidal and act by inhibiting bacterial protein synthesis and by causing the synthesis of abnormal proteins - Normally reserved for aerobic gram - infections |
| What is the pharmacotherapy of fluroquinolones? | - Bactericidal and affect DNA synthesis by inhibiting two bacterial enzymes: DNA gyrase and topoisomerase IV |
| What is the pharmacotherapy of sulfonamides? | - Suppress bacterial growth by inhibiting the essential compound (folic acid) which is responsible for cellular biosynthesis |
| Which drug families target bacterial cell walls? | 1. Penicillins: -cillin 2. Cephalosporins: cef-, ceph- 3. Carbapenams: -penem 4. VancomycinL it does inhibit bacterial cell wall, known under miscellaneous antibacterial |
| What antibiotics inhibit bacterial protein synthesis? | 1. Tetracyclines: -cyclines 2. Macrolides: -thromycin 3. Aminoglycosides: -mycin, -micin |
| What is the MOA of antibiotics that inhibit bacterial protein synthesis? | - Disrupt translation at the subunit and tRNA/mRNA level - Translation carried out in the ribosomes, composed of 30S and 50S subunits and requires tRNA and mRNA to connect |
Created by:
aschelle
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