STUDY QUESTIONS - NURS 3110 - EXAM 2

1. Where do most organisms that cause UTIs come from? Which organism is the
most common cause? What other organisms cause UTIs?
2. Compare and contrast the clinical presentation (symptoms) of each of the
following in a young child Corynebacterium diptheriae! Haemophilus
infuenzae! Bordetella pertussis.
Coryne Bacteri!
"irregular! non spore forming rods
To"in
-arrests proteins synthesis
-necroti#ing and neuroto$in (only defense is antito$in)
"antito$in %loc&s to$in produced %y organism to lower I'CI()'C)
and
*+,T-.IT/
C#inica# $i%ea%e
-spread %y respiratory droplets (healthy carriers always present)
-to$ins causes destruction of epithelium mi$ed w. 0%rin
-,1C and W1C are pseudomem%ranes that co2er the pharyn$
can cause asphy$iation and su3ocate a young child
"enlarged lymph nodes (often green)
"to$in can damage heart and 2al2es
Dia&no%tic 'a( Te%t%
-specimens swa% nose and throat
-culture need 45)CI-. media! su%mit isolate for to$igenicity testing
Treat!ent
"gi2e diphtheria antito$in immediately
"5enicilin arrests to$in production
)re*ention
"isolation of patients
"2accination (Ta5 or Td 6 2acinnations for appropriate co2erage
+ae!o,-i#% in.en/a
Bor$ete##a ,ert%%i%
7. 8ow do the symptoms of 1ordetalla pertussis di3er in an infant or young child
compared to an adult?
9. 'ame two immuni#ations that ha2e waned in most adults? (8ow often should
adults get each of these immuni#ations?)
6. .ist 7 gram negati2e organisms that can cause nosocomial infections. What is
the mode of transmission of each?
:. Which is the most common %acterial opportunistic infection and 7
rd
most
common cause of death in people with 8I;<=-I(4? (-lso! when a person who
is 8I;< contracts this infection! the person is said to ha2e >-I(4.? In other
words! this infection is one of se2eral >-I(4 de0ning characteristics.?
@. What organism causes most cases of tra2elerAs diarrhea?
B. What are the food sources for Listeria monocytogenes? What are results of
infections of .isteria monocytogenes in neonatal infants compared to adults?
T-e or&ani%!0
"2aria%le morphologyC cocco%acilli to long 0laments! Dagella! no
capsules or spores
"resistant to cold! heat! salt! p8 e$tremes (ca%age! deli)
"rapid test in food industry for cold cuts etc.
"a2oid if pregnant! need to coo& %ologna %y %oil
"listeria I'(UC)( phagocytosis
"o%logate intracellular parasite
S,eci!en%0 %lood! C4E! placenta! amniotic Duid
1oo$ %orce%0 c#inica# $i%ea%e 2 e,i$e!ic #i%tero%i%
-me$ican cheesecream cheese not pasteuri#ed
-coleslaw
-mil&
-ice cream Fgrows in cold F
-hummus
-cold cuts
Se3e#ae o4 in4ection% in neonata#0
-early onset intrauterine
-sepsis
-still%irth or shortly after
"late onset
"meningits (if infant sur2i2es)
"%etween %irth and 7 wee&s
Se3e#ae o4 in4ection% in a$#t%0
-meningitis or sepsis in immunocompromised patients
Treat!ent5,re*ention
-ampicillin(%actericidal) or erythromycin (%acteriostatic)
-suscepti%le indi2iduals should a2oid products made from raw mil&!
pac&aged shredded ca%%age! cold cuts and salads
-pasteuri#ation! coo&ing of food
G. What patient characteristics place them at ris& for infections from Listeria
monocytogenes? Pseudomonas aeruginosa? Tu%erculosis? *-C? 8ow is each
acHuired? What are the 2irulence factors of each?
1I. Which organism causes each of the following .egionnairesAs (isease!
whooping cough! typhoid fe2er?
11. What is meant %y the >%ooster reaction? to the 55( screening test?
12. 8ow is active T1 con0rmed?
17. What are the symptoms of T1?
19. Why do immigrants from the UJ and )urope usually ha2e positi2e 55( tests
and a negati2e chest K"ray and sputum culture for T1?
16. Why are hopes high for the new T1"L+.( screening test?
1:. Why are gram negati2e cells more diMcult to &ill with anti%iotics and
disinfectants?
1@. 8ow long is a person with tu%erculosis contagious?
1B. Why is the incidence of T1 rising in patients in long"term care facilities?
1G. Which indi2iduals with con0rmed T1 are most at ris& for multiple drug
resistance and should %e started on a multi"drug regimen?
2I. What is the most common cause of multiple drug"resistant T1 (*(,T1)
infection?
21. Why were there no deaths among .egionnaires stric&en with pneumonia and
allergic to penicillin at a con2ention in 5hiladelphia in 1G@:? (8int Where does
the organism grow?)
22. 8ow is .egionnairesA disease transmitted? What are the common reser2oirs of
the organism?
27. Compare and contrast the onset and symptoms of food poisoning=food
infection caused %y 4almonellosis! 4higella! Campylo%acter. What foods are
associated with each?
29. What cur2ed gram"negati2e rod is a common cause of diarrhea and is
associated with undercoo&ed chic&en?
26. What is the most important treatment for patients with dysentery?
2:. What organism causes gastric and duodenal ulcers?
2@. Indi2iduals with gonorrhea are often co"infected with chlamydia. What
symptoms of these infections would %ring a male to a campus clinic?
2B. What organism can immunosuppressed indi2iduals contract from %reathing air
near a construction site?
2G. What are the symptoms of ,oc&y *ountain 4potted Ee2er 2ersus .yme
(isease?
7I. 'ame one factor a%out ,ic&ettsia and .egionella that ma&es them fairly uniHue
among %acteria.
71. What is the most pre2alent se$ually transmitted non2iral disease?
72. What organ(s) are attac&ed %y Chlamydia trachomatis?
77. What organisms cause each of the following granuloma! gumma! ghon
comple$! chancre.
79. What organism can %e contracted from %at droppings?
76. 5ro%ioni%acterium acnes causes acne 2ulgaris and also what other infections?
)ro(ioni(acteri!- irregular! non spore forming rods
T-e or&ani%!0
"common resident of pilose%aceous glands! U,T
"thri2es on se%us
"if on s&in! donAt get yeast infection on s&in
"cause %io0lm that are chronic
C#inica# $i%ea%e
-acne 2ulgaris
"infects eyes! arti0cial Noints
"can cause upper respiratory infections
Treat!ent
-(en/oy# ,ero"i$e releases +2 which suppresses growth
"%ecoming resistant to tetracyc#ine an$ eryt-o!yocine
-c#in$a!ycin 6topicalC 2ery e3ecti2e) cam cause c.diMcile O is '+T
a%sor%ed through s&in
"interrupts 1C
-tretinoin 6retin-A7 topical agent that increases turno2er and reduces
cohesi2eness of
epithelial cells in hair follicles
"i%otretinoin 6actane7 5+ agent that decreases se%um glands (5L K)
7:. /our %urn patient has %lue"green pus on one of his wounds and the room is
0lled with the odor of PPPPP? What organism is he li&ely infected with?
7@. ,ecurrent infections in a neonatal ICU were attri%uted to what organism that is
har%ored under long=arti0cial 0ngernails?
7B. What is >herd protection?? 'ame two diseases where herd protection is
important.
7G. 8ow do Eoley indwelling catheters (which are related to BIQ of nosocomial
UTIs) increase the ris& of nosocomial UTI?
9I. Compare and contrast enteropathogenic ). Coli! enteroto$igenic ). Coli and
enterohemorrhagic ). Coli I16@8@ with respect to symptoms and pre2ention
of disease.
91. What is the signi0cance of the coliform count in water samples?
92. Klebsiella pneumoniae causes pneumonia! UTIs! %acteremia! and wound
infections. Where does it inha%it? 8ow is infection acHuired?
97. Where do carriers of salmonella infections har%or the organism?
99. Why has childhood epiglottitis all %ut disappeared o2er the last 26 years?
96. What is the most common cause of conNuncti2itis (pin&eye)?
9:. (escri%e the updated .yme disease guide from the Infectious (iseases 4ociety
of -merica (I(4-).
9@. (escri%e the symptoms of these other tic& %orne diseases 1a%esiosis!
)rlichiosis.
9B. Why is infection from *ycoplasma peumoniae called >atypical pneumonia??
8ow is it diagnosed?
9G. Compare and contrast infections from Chlamydia trachomatis with Chlamydia
pneumoniae.
6I. Eingers! fomites! Dies in a hot dry climate can increase ris& of infection from
what organism &now to cause %lindness?
51. What is a dimorphic fungus?
52. What is a troph?
53. List as many obligate intracellular organisms as you can (including bacteria.
5!. What organism causes a red" #eepy rash #ith $esicles in the intertriginous folds of s%in
55. and is often nosocomial in obese patients?
5&. What is the most important treatment for patients #ith dysentery?
5'. What organism can immunosuppressed indi$iduals contract from breathing air near a construction site?
5(. What organism can be contracted from bat droppings? )o# else can it be contracted?
5*. Why is the +,-s community encouraged by the return of .erigrine falcons to urban areas?
&/. + patient diagnosed #ith 0richomonas should also be tested for #hat other infections?
&1. -escribe ho# 0richomonas may be identified in the #omen1s health clinic setting.
&2. What organism causes fungus flu?
&3. What precautions should people ta%e to a$oid contracting Tinea species?
&!. -iscuss the $arious #ays one can de$elop to2oplasmosis.
&5. What are the symptoms of 0o2oplasma gondii in a neonate? +dult #ith +,-s?
&&. )o# do hormonal influences alter $aginal flora?
&'. .ublic #ater supplies are chlorinated. What organisms are %illed in this process? What organisms are not
%illed by chlorine (i.e. bleach?
&(. Where does Candida albicans typically reside in the human host? What situations can cause the
organism produce a superinfection?
&*. What are the symptoms of 3ryptococcus neoformans infection in an ),4 positi$e indi$idual?
'/. What symptoms are seen in patients infected #ith Pneumocystis carinii (jirovici)?
'1. )o# is Giardia lamblia contracted? What are the symptoms of infection? What foods should patients
a$oid during and for about !5& #ee%s follo#ing infection?
Read:
Neafsey, P.J. (2009). Case Mysteries in Pathophysiology. Engleood, Co: Morton P!". Co.
Case #$ (%rand&a's %ot a (rand Ne (ag)
Case 22 (Ne)er *oo +ld to ,earn a (ad -a"it)