Tetanus AKA AKA : “lockj ockja aw” C.A. C.A. : clostr clostridi idium um tetani tetani M.O.T. :open wounds I.P. :7-14 days S/S: Six P’s - pain at the site - painful swallowing - perspiration - position alteration - “plastic” smile - painful movt. of the jaw and neck Diagnostic exam: 1. Clinical observation 2. History of wound Management: Tetanus immune globulin antibody antibiotic Nursing responsibility: Safety and prevent injury Provide adequate nutrition Prevent spasm as much as possible Prevention: Immunization Wound care -
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Meningitis - Infection/inflammation of the covering of the brain and spinal cord C.A. C.A. : H. infl influe uenz nza a baci bacill llii CMV (if with AIDS) cryptococcus (with AIDS)
Corticosteroid Anticonvulsant Osmotic diuretic Nursing responsibility: • Assess neurologic function Maintain fluid balance • Adequate nutrition • Provision Provision of comfort • Prevention: Immunization • Covering of mouth and nose • Proper disposal of secretion • -
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VIRAL Poliomyelitis • AKA infantile paralysis/heinemedin disease/acute flaccid paralysis • C.A. C.A. : poliov polioviru irus s (ent (enter ero o virus virus)) M.O.T. : direct contact • Types: Unapparent/sub clinical • • Abortive Major • a. non- paralytic b. paralytic Non paralytic Painful head • Irritability • Lethargy • • Arm, neck and leg pain Yielding muscle spasm • Paralytic affectation of the medulla Diagnostic procedure: Throat culture Stool exam Convalescent Convalescent serum antibody titer Nursing responsibility: assess for the exacerbation of paralysis Assess for neurologic damage VS Nutrition Emotional support Prevention: immunization -
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MENINGOCOCCEMIA/MENINGOCOC CAL INFECTION/SPOTTED FEVER - most fatal, involves the vascular system C.A. C.A. : neisseri neisseria a meningiti meningitis s M.O.T. :direct contact/droplet I.P. : 2- 10 days
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Signs and symptoms: flu-like flu-like symptoms (SIC) Severe HA/Joint Pain Increased temp. Chills -
Signs and symptoms: Photophobia Restlessness Increased ICP Nausea and vomiting Seizure Increased ICP Photophobia,diplopia Ecchymosis -
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Rabies AKA : hydrophobia, hydrophob ia, lyssa, La Rage C.A C.A. : rhab rhabdo do viru virus s M.O.T. : contact with saliva of a rabid animal/ droplet I.P. I.P. : 10 days to years
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Diagnostic procedure: Lumbar puncture C & S of CSF Counter immuno electrophoresis Culture of blood, urine, throat Management: Antibiotic (ampicillin) (ampicillin) •
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Signs and symptoms: Prodromal stage -local pain and burning sensation, pruritus at the bite site - flu-like symptom (SIC) - nervousness - photophobia - sensitivity to noise - pupillary dilatation and altered LOC Excitement stage - intermittent hyperactivity
- aerophobia - hydrophobia - CNS dysfunction Paralytic stage - rapid and progressive deterioration - coma - death Diagnostic procedure: • Rapid fluorescent focus inhibitor test Brain biopsy • Management: Post exposure prophylaxis • vaccination • Creutzfeldt-jacob disease Slow progressive disease • commonly affecting 40 years old and above C.A. C.A. : infe infect ctiv ive e pro prote tein in • pathogen M.O.T. :corneal transplant, • human growth hormone, beef with mud cow dse. Signs and symptoms: Memory changes • Nervousness • Startle reflex • Sleep disturbance • • Rapid deterioration Confusion • Dementia • (+) babinski reflex • Diagnostic Procedure: Neurologic exam • CT scan • Management: • NO SPECIFIC TREATMENT Comfort measure • Prevention: Avoid mode of transmission • Circulatory System Lyme’s disease C.A. :borrelia burgdoferi (spirochete) M.O.T. : bite of tick or feces of tick I.P. : 3-32 days Signs and Symptoms: First stage - flu like symptoms with regional lymphadenopathy - bull’s eye rash – classic skin lesion - erythema chromicum migrans (ECM) Second stage Neurologic affectation - HA - stiff neck - memory loss Cardiovascular Cardiovascular affectation - heart block - palpitation Third stage musculoskeletal affectation - bone pains - cartilage affectation - arthritis - joint swelling and pain - limited movement Diagnostic Procedure:
Observation • ELISA Blood tests • Management: Antibiotic Nursing Responsibility: Rest • Passive exercise • Strengthening exercise • Prevention: Avoid tick infested places • Use of protective clothing • •
Colorado tick fever C.A. .A. : arbo rbo vi virus M.O.T. M.O.T. :wood tick I.P. : 3-6 days Signs and Symptoms: Abrupt onset of fever and chills Arching of the back Photophobia HA with eye movement N&V Conjunctival infection Alt.LOC Maculo papular petechial rashes Diagnostic Procedure: Blood tests • Smear stain • Management: Removal of tick’s head • Nursing Responsibility: Bleeding precaution • • Comfort measures measures •
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Rocky Mountain spotted fever C.A. C.A. : ricke ricketsi tsia a rick rickets etsii ii M.O.T.:wood/dog tick I.P. : 2-12 days S/S: Flu-like symptom Excruciating pain Anorexia Rashes Petechiae Erythomatous macule Bronchial cough Rapid RR thrombocytopenia Diagnostic Procedure: Immunofluorescent Immunofluorescent assay • Cutaneous biopsy of rash • Blood test • Management: careful removal of tick’s head Antibiotic treatment Provision Provision of comfort •
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Integumentary system Viral 1. Measles AKA AKA : rubeol rubeola a morbil morbilli, li, har hard d measle measles, s, little red disease C.A. : rubeola virus (paramyxovirus) (paramyxovirus ) M.O.T. M.O.T. :airborne : airborne I.P. : 8-14 days
S/S: Prodromal stage - high grade fever (3-4days) - anorexia - voice hoarseness - 3 C’s (coryza, conjunctivitis, cough) - white spot in buccal mucosa - Koplik spots Eruptive stage - fever peaks - rash appears Post eruptive stage fine desquamation Dx: Clinical observation • • Blood tests Management: Symptomatic treatment • Antibiotic • Keep warm and dry • • Hygienic measure Prevention: • immunization 2. Germ German an Mea Measl sles es AKA AKA : third third disea disease, se, Rote Roteln, ln, Rube Rubell lla a C.A. toga viridae (psedoparamyxovirus) M.O.T. M.O.T. :droplet I.P I.P. : 14--21 days 14 days (18 day days) S/S: Pre eruptive - low grade fever - HA - malaise - sore throat - coryza - colds - fine red, petechial spots on soft palate Eruptive - maculo-papular pinkish rash, - enlargement of lymphnodes DX : clini linica call obs obse ervati vation on MNGT :symptomatic 3. Eryth Erythem ema a infect infectio iosu sum m AKA AKA : 5th dis diseas ease, e, slappe slapped d chee cheek k disease C.A. C.A. : huma human n paro parovi viru rus s M.O.T. M.O.T. :direct, droplet I.P. : 4-10 days S/S: -
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Low grade fever Mild colds Intensify red rash Body malaise Pale ring around the mouth
Dx: -
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Clinical exam Light and electron microscopy
4. Roseola infantum AKA : 6th disease, exanthum subitum C.A. C.A. : human human herp herpes es viru virus s strai strain nB I.P. : 10-15 days S/S: •
High grade fever
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Anorexia Irritability Listlessness Maculopapular rash on trunks, arms, neck Nagayama spot
Dx: -
Clinical observation
5. Chicken pox AKA : var varice icella lla C.A. C.A. : vari varice cell lla a vir virus us M.O.T. :airborne, direct or indirect I.P. : 13-17 days S/S: Slight fever Malaise • Anorexia • • Vesico-pustular rash pruritus • Management: Comfort measure • Administration Administration of zovirax • •
6. Herpes zoster AKA AKA : shin shingl gles es,, Z Zon ona a C.A. C.A. : varice varicella lla zoster zoster virus virus M.O.T. : S/S: Fever Malaise Musculoskeletal pain Pleurisy Painful vesico papular rash Dx Procedure: - Clinical observation - Tzanck smear -
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Bacterial 1. Scar Scarle lett Fev Fever er AKA AKA : scarla scarlatin tina, a, 2nd dis diseas ease e C.A. C.A. : group group A bet beta a hemo hemoly lyti tic c streptococci M.O.T. M.O.T. :direct/ indirect I.P. : 2-4 days S/S: Prodromal stage - abrupt high fever - Nausea &Vomiting - Head Ache - abdominal pain - sore throat - circum oral pallor - exanthum Eruptive stage - edematous and beefy red pharynx and swollen uvula - strawberry tongue - tiny subcutaneous vesicles around the cuticles of the nails - erythema group together at the skin folds Diagnostic Procedure: • Pharyngeal culture
Throat culture • Rapid antigen test CBC • Dick’s test • Schult’z charlton test • Management: Antibiotic • Proper nutrition • •
2. Erys Erysiipela pelas s C. A. A. : Group A betahemolytic betahemolyt ic streptococci M.O.T. :direct contact S/S: flu like symptoms Bright red, large raised spots Painful, itchy lesions Dx. Procedure: C&S of secretions • CBC • Management: antibiotic -
3. Impetigo AKA : “mamaso” C.A. : staphylococcus aureus Group A beta hemolytic streptococci M.O.T. M.O.T. : direct or indirect I.P. I.P. : 4-10 days S/S: Non bullous - pustular honey colored crust - pruritus - burning sensation - regional lymphadenopathy Bullous - thin vesicle - clear crust - painless Dx. Procedure: • Gram stain of vesicle Culture and sensitivity • Management: Antibiotic treatment • Comfort measures measures • 5. Leprosy Affectation Affectation of the skin and peripheral nerves C.A. : mycobacterium leprae/ hansen’s bacillus M.O.T. :prolonged skin contact, droplet infection S/S: Early - change in skin color (reddish / whitish) - loss of sensation on skin lesion - Decrease /loss sweating & hair growth over lesion - thickened or painful nerves - muscle weakness/paralysis weakness/par alysis pain -redness of the eyes nasal obstruction or bleeding - ulcer that does not heal Late sign - loss of eyebrow (madarosis - inability to close eyelids (lagopthalmos - clawing of fingers and toes - contractures contractures
- sinking of nose bridge - enlargement of male’s breast (gyne) - chronic ulcer Types 1. Paucibacillary (tuberculoid/indeterminate) -non infectious type 6-9 mos. Of treatment 2. Multibacillary Multibacillary (lepromatous/ (lepromatous/ borderline) - infectious type 24-30 mos treatment Management: Multi drug therapy (use of two or more drugs, 1 week no longer communicable) Treatment Paucibacillary Multibacillary days 9 mos 18 mos Day 1 and Rifampicin6,4 Rifampicin6,45 monthly 5 Clofazimine 3 TX Dapsone 1 Dapsone 1
Daily Dapsone 1 treatment
Clofazimine50/ Dapsone 1 50
Prevention: • Avoidance of prolonged skin contact BCG • • Hygiene NTN • Education • Support • Fungal 1. Ringworm AKA : tinea C.A. : dermatophytes dermatophy tes M.O.T. :direct Types Tinea capitis • Tinea corporis Tinea ungium • Tinea barbae • Tinea pedis • Tinea cruris • Dx. Procedure: C&S • Wood light exam • Management: Antifungal • Comfort measures measures • •
2. Pedi Pedicu culo losi sis s AKA : lice M.O.T. : direct contact
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Types Corpora's Capitis Pubis
3. Scabies C.A. C.A. : sar sarcopt coptes es scab scabie ie M.O.T. : direct contact S&SX : itchiness, threadlike lesion DX : visual exam of burrow
MNGT :
antifungal Respiratory System
1.
Pneumonia - Inflammation of the lung parenchyma parenchyma C.A. : bacteria, virus, protozoa M.O.T. : direct or indirect I.P. : 24-72 hours Classification i. Primary ii. Secondary S/S: Chills High grade fever Productive Productive cough • Purulent sputum • • Pleuritic chest pain HA • Myalgia • Crackles • • Dyspnea Dx. Procedure: general assessment X-ray Blood culture CBC bronchoscopy Types a. Very severe disease - Stridor Stridor - Convulsion Convulsion - Abnormally Abnormally sleepy - Not Not able to drink and eat b. Severe pneumonia - Chest indrawing - Fast breathing Pneumonia c. - No chest indrawing - Fast breathing d. No pneumonia - Cough and colds - No chest indrawing - No fast breathing Management: • Antibiotic Bronchodilator • Mucolytic • Inhalation therapy • Nursing Responsibility: Positioning • Increased Oral Fluid Intake • CPT • EDBE • • Suctioning Postural drainage • Inhalation TX •
ESR • Liver enzymes Management: Antibiotic • • Antipyretic Apply chest binder • oxygen PRN • •
3. Epiglotitis AKA : syngl ynglot otit itis is C.A. C.A. : Haemop Haemophil hilus us influe influenza nza B pneumococci GAB streptococci streptococci M.O.T.: direct/indirect
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2. Legionaire’s disease AKA AKA : lego legone nell llos osis is C.A C.A. : legon egone ella lla M.O.T. : airborne I.P. : 12-20 days S/S: Flu-like symptoms General malaise • Grayish non purulent sputum Chestpain on coughing • Dx. Procedure: • CXR CBC • • •
S/S: High fever Sore throat • • Dysphagia Inspiratory retraction retraction • Nasal flaring • Stridor • • Tripod position Dx. Procedure: Throat culture • Management: antibiotic •
4. Diptheria C.A. C.A. : coryne corynebac bacter terium ium dipthe diptheria ria M.O.T. : direct/indirect I.P. : 2-5 days
S/S: Low grade fever Foul smelling mucopurulent • nasal discharge • Sore throat Inflammation of cervical • lymphnodes • Grayish white membrane on soft palate Dx. Procedure: Nose culture • Throat culture • Schick test • Molony test • Management: • Diptheria antitoxin Airborne precaution • •
4. Pertu rtusis AKA AKA : whoo whoopi ping ng coug cough h C.A. C.A. : bord bordet etel ella la per pertu tusi sis s M.O.T. M.O.T. : direct/indirect d irect/indirect I.P. : 5-21 days S/S: Catarrhal stage - highly contagious - low grade cough - colds, sneezing, lacrimation - listlessness - night cough Paroxysmal stage - spasmodic cough - 5-10 forceful cough and ends with a whoop - expels mucous Convalescent stage - symptoms subsides - no longer communicable Dx. Procedure:
nasopharyngeal swab Sputum C & S Management: Antibiotic • • Pertusis immune globulin Oxygen therapy • Antitussive • Codeine • Rest • • Aspiration prec! Application of abdominal hernia • -
5. Tuberculosis AKA AKA : gallop galloping ing cons consump umptio tion, n, phiti phitisis sis C.A. C.A. : tube tuberc rcle le baci bacill llii M.O.T.: M.O.T.: airborne ingestion of contaminated milk I.P. : 4-8 weeks
S/S: fatigue/weakness Low grade fever Chest pain/back pain Productive Productive cough Mucopurulent sputum Occasional Occasional hemoptysis Dx. Procedure: Tuberculin syringe test • Sputum exam • CXR • Management: Rifampicin 450 mg • Isoniazid 300 mg • Pyrazinamide Pyrazinamide 500 mg (2 tabs) • • Ethambutol 400 mg (2 tabs) Streptomycin 1 gm • -
Viral 1. Colds AKA AKA : cory coryza za,, rhi rhini niti tis s C.A. C.A. : subgr subgroup oup of myxovi myxovirus rus M.O.T. M.O.T. :direct/indirect :di rect/indirect I.P. : 1-4 days
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coughing, wheezing, malaise, dyspnea
DX : C&S of secretion, serum antibody titer, ELISA
4. Hantavirus pulmonary syndrome C. A. A. : hant hantav avir irus us M.O.T. :inhalation, ingestion and contact with infected rodents S/S: fever myalgia HA, N&V cough, Hypoxia dec. BP, inc. RR & CR DX : CXR, blood exam MNGT : ribavirin Fungal 1. Coccidioiodomycosis AKA AKA : San Joaqui Joaquin n Val Valley ley fever fever C.A C.A. : cocc coccid idio iode des s M.O.T. : inhalation of spore in soil I.P. : 1-4 weeks S/S: Flu like symptoms Sore throat • Malaise • Itchy macular rash • Dry cough • Chest pain • Dx. Procedure: • Coccidiodine skin test CBC • ESR • CSF analysis • Management: Antifungal •
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2. AKA : C.A. C.A. : M.O.T. I.P. :
pharyngitis chills HA watery eyes Infl Influ uenza enza flu, la grippe myxo myxovi viru rus s in infl flue uenz nza a : direct/ indirect 24-72 hours
S/S: -body malaise - HA - chills - myalgia - conjuctivitis MNGT :amantadine 3. Respiratory syncitial virus C.A. C.A. : subgr subgroup oup of myxo myxo viru virus s M.O.T. : direct/indirect I.P. : 4-5 days S/S: nflamed mucous membrane
2. Blastomycosis AKA AKA : Gilc Gilchr hris ist’ t’s s di dise seas ase e C.A. C.A. : blasto blastomyc myces es dermat dermatiti itidis dis M.O.T. M.O.T. : inhalation inhalatio n I.P. I.P. : weeks- months S/S: mimics URTI, night sweats, chest pain DX : C&S MNGT :antifungal 3. Histoplasmosis AKA AKA : Ohio Ohio Vall Valley ey Diseas Disease/c e/cult ultura urall Mississippi disease/amphotericin disease/amphotericin mountain disease/Darling’s disease/Darling’s disease C.A C.A. : H. cap capsu sula latu tum m H. Duboisi M.O.T. : inhalation of spores from infected source I.P. : 5-18 days S/S: • •
Flu like symptoms TB like symptoms if chronic
Dx. Procedure:
Tissue biopsy • Sputum culture Management: Antifungal • • glucocorticoids •
Gastrointestinal System Bacterial 1. Gast Gastro roen ente teri ritis tis C. A. A. : bacteria bacteriall- salmon salmonella ella virus- norvale virus protozoa – amoeba helminths – enterobius toxin – plants, toad stool drug RX – antibiotic M.O.T. :fecal-oral 5 F’s - feces - food - fomites - flies - fingers S/S: Anorexia • N&V • • Abdominal pain and cramping Borborygmi • Diarrhea • Dx. Procedure: Stool exam • • GM stain Blood culture • Management: • Antibiotic Oral rehydration • IVF replacement • F & E balance • Nutrition • 2. Salmonellosis AKA AKA : salmo salmonel nella la food food pois poisoni oning ng C.A. C.A. : salm salmon onel ella la spec specie ie M.O.T. : ingestion of protein rich infected foods I.P. : 6-8 hours 3. Staphylococcal food poisoning C.A. C.A. : stap staphy hylo loco cocc ccus us M.O.T. :CHON & CHO rich infected foods I.P. : 2- 6 hours 2. Botulism C.A C.A : clos clostr trid idiu ium m botu botuli linu num m M.O.T. :ingestion of improperly preserved preserved food, contaminated honey, wound infection I.P. : 12-36 hours
S/S: Vertigo dry mouth sore throat weakness, constipation CNS affectation Dx. Procedure: Lab analysis Management: Botulism antitoxin • NGT gastric lavage • -
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4. Shigellosis AKA AKA : dysent dysentery ery baci bacilla llary, ry, bloo bloody dy flux flux C. A. : shigella shigella dysenter dysenteriae iae M.O.T. M.O.T. :fecal oral I.P. : 1-4 days S/S: - abrupt diarrhea - abdominal cramping, - painful straining - mucoid stool with blood 5. Cholera AKA AKA : Viole Violent nt dysen dysenter tery, y, El Tor C.A. C.A. : Vibri Vibrio o chole cholera/ ra/Com Comma ma M.O.T. M.O.T. :ingestion :ing estion I.P I.P. : few few hou hours rs-- 5 day days s usu usual ally ly 3 days S/S: - vomiting - abdominal cramping - severely frequent defecation 6. Traveller’s diarrhea C. A. A. : E. coli coli M.O.T. : ingestion I.P. : 24-72 hours S/S: abrupt diarrhea abdominal cramping, N&V 7. Hepatitis Hepatitis C.A.
M.O.T.
A Hepa A Fecal-or -oral (infectious RNA hepa/catar containing rhal virus jaundice)
B (serum HBV DNA Sexual / hepa/viral) containing parenteral
C (post HCV tranfusion)
I.P. 2-6 wee weeks
8-24 weeks
Sexual / 5-12 weeks parenteral
D HDV delta Sexual / 3-13 weeks (dormant virus parenteral type of hepa B
E (enteric HEV virus)
Fecal oral
G
Sexual / unknown parenteral
HGV
3-6 weeks
S/S: Pre icteric stage - malaise, fatigue, fever, HA, N & V - anorexia - RUQ pain
- diarrhea - anemia Icteric stage - jaundice - pruritus - tea colored urine - light colored stool Post icteric/ convalescent stage - increase energy - GI symptoms subsides Dx. Procedure: Serum antigen antibody HBSag HBEag anti HBS Liver enzyme tests Bilirubin test Prothrombin test Management: Symptomatic treatment Diet Rest medicate Prevention: Immunization Proper handwashing Proper food handling Protozoan 1. Giard iardia ias sis AKA AKA : lambli mblia asis sis C.A. C.A. : giar giardi dia a lam lambl blia ia M.O.T. M.O.T. :fecal oral I.P. : 1-3 weeks S/S: Abdominal cramps Nausea Anorexia • Diarrhea • Stool changes • • Vomiting Weight loss • Distention/flatulence Distention/flatulence / belching • Dx. Procedure: Stool exam • Duodenal aspiration biopsy • Management: Increase OFI • • F & E balance Nutrition • Medicate • • •
2. Amoe Amoebi bias asis is AKA : amoebic dysentery C.A. C.A. : ento entomo moeb eba a hysto hystoli liti tica ca M.O.T. : fecal –oral I.P. : 2-4 weeks S/S: Stool changes Diarrhea • • Foul smelling stool Dx. Procedure: Stool exam • Indirect hemo agglutination test • Management: Increased OFI • Nutrition • Rest • • Medicate •
3. Cryptosporidiosis C. A. A. : crypto cryptospo spori ridiu dium m
M.O.T. : fecal –oral I.P. : 2-10 days S & SX : sudden watery stool DX : specific stool exam, small bowel biopsy MNGT : medicate 4. Schistosomiasis AKA : bilhariasis or snail fever C.A. C.A. : Schis Schistos tosoma oma japoni japonicum cum (bld (bld fluke) S. Mansoni S. haematobium S/S: Diarrhea • • bloody stool Enlargement Enlargement of abdomen • Spleenomegaly • Weakness • Anemia • • Inflamed liver p222 • Management: • Praziquantel (biltricide) Oxamniquine (S.mansoni) • Metrifonate (S. haematobium) •
Genito-urinary system Bacterial 1. Chla Chlam mydia ydia C.A. C.A. : chlamy chlamydia dia tracho trachomat mates es M.O.T. :sexual contact, delivery I.P. : 7- 14 days S & SX :women - clear vaginal discharge, burning sensation, itchiness, PID men – clear penile discharge, dysuria, epididymitis DX : vaginal culture, Gram stain,ELISA MNGT :medicate (doxycycline, azithromycin, erythromcin) education behavior modification 2. Gonor onorrh rhea ea AKA AKA : clap, clap, stra strain, in, jack jack,, mornin morning g drop drop C.A. C.A. : neis neisse seri ria a gonor gonorrh rhea ea M.O.T. :sexual contact, delivery I.P. : 2-10 days S/S: Women -low abdominal pain, dysuria, urinary frequency,itchy, red edematous meatus, purulent discharge Men - Sx of urethritis, dysuria, purulent discharge •
Complication: Sterility • • Gonococcal septicemia Dx. Procedure: Vaginal/penile culture • Cervical exam • Pap smear • Management: Medicate • oral - cephalosporin, ciprofloxacin, ciprofloxacin, ofloxacin
IV/IM – ceftriaxone (rocephin) 3. Syphilis AKA AKA : Rox, ox, Lues, Lues, Bad blood blood disea disease se C.A. C.A. : Trepon reponema ema palli pallidum dum M.O.T.: sexual/blood transfusion/vertical transfusion/vertical transmission I.P I.P. : 10-9 10-90 0 day days s ave avera rage gely ly 21 days days
Protozoan 1. Tricho richomo moni nias asis is C.A. C.A. : tricho trichomon monas as vagin vaginal alis is M.O.T. : sexual contact, contaminated douche, delivery I.P. : 4-20 days S/S: itching, itching, dyspare dyspareunia, unia, dysuria, dysuria, urinary frequency Post coital spotting, menorrhagia, dysmenorrhea Gree Greeni nish sh yell yellow ow disc discha harrge, ge, malodorous frothy Dx. Procedure: Direct microscopic exam • Urine culture • Cervical exam • Management: Metronidazole • Sitz bath to relive symptoms • -
S/S: Primary stage - chancre - regional lymphadenopathy Second stage - infectious, skin rashes, flu like symptoms - condylomata lata/condylomata Third stage/ late stage - assymptomatic - not communicable - CV changes - CNS changes - gummatous lesion - generalized lymphdenopathy Dx. Procedure: • History taking VDRL • FTA ABC • Rapid plasma reagent • Management: Antibiotic (peniccilin G • benzathine, doxycycline, doxycycline, tetracycline) Complication: Effects on pregnancy saw like teeth anterior bowing of tibia inflammation of fingers 4. Chancroid C.A. C.A. : Haem Haemoph ophil ilis is Duc Ducru ruyi yi M.O.T. :sexual contact I.P. : 3-7 days S & SX :irregular painful papule inguinal tenderness dysuria DX : Gm stai stain, n, bloo blood d cul cultu ture re,, les lesio ion n biopsy MNGT :azithromycin, erythromycin,IM ceftriazone 4. Bact Bacter eria iall Vagi Vagini niti tis s C.A. C.A. : Gard Gardne nell lla a vagi vagina nali lis s M.O.T. : sexual contact I.P. : 5-7 days S & SX : itchiness, thin white discharge, discharge, gas bubbles, fishlike odor DX : culture MNGT : metronidazole Fungal 1. Cand Candid idia iasi sis s AKA AKA : candi candidos dosis is// monili moniliasi asis s C.A. C.A. : cand candid ida a alb albic ican ans s M.O.T. : sexual contact, delivery I.P. : 2-5 days S & Sx : pruritus, dyspareunia, white gray raised patches,cottage cheese yellow odorless, contain curds DX : culture, GM MNGT :ketoconazole, fluoconazole
Viral 1. Geni Genita tall War Warts ts AKA AKA : codylo codylomat mata a accumi accumina nata, ta, venereal warts C.A. C.A. : huma human n papi papill lloma oma vir virus us M.O.T M.O.T.: sexual contact I.P.: I.P.: 4 wks-9 mos. S & Sx : painless warts DX : dark filled microscopy MNGT : podofilox podofi lox 0.5%, cryosurgery, electo cautery, laser 2. Geni Genita tall Herp Herpes es C.A. C.A. : genita genitall herpe herpes s simpl simplex ex type type 2 M.O.T. :sexual contact, delivery I.P. : 3-7 days S & SX :fluid filled, painless, painless, inguinal lymph node, fever, body malaise, dysuria DX : phys physic ical al exam, xam, TZAN TZANCK CK TEST TEST MNGT :acyclovir 3. HIV/AIDS C.A. : human immuno virus/ retrovirus M.O.T. :sexual contact, blood transfusion, exposure exposure to infected blood, pregnancy, sharing of infected needles S/S: Major - fever - chronic diarrhea 10% weight loss Minor - persistent cough -generalized -generalized lymphadenopathy - pruritus - oral pharyngeal candidiasis - recurrent herpes zoster - progressive disseminated herpes simplex Dx. Procedure: ELISA • Western blot • CD4 cell count • Management: 4 cocktail drug (21 tabs a day) • 1. AZT – termin terminate ate vira virall replic replicati ation on
2. Viram Viramune une – block blocks s DNA DNA activ activity ity of virus 3. Prote Protease ase inhibi inhibitor tor – inhi inhibit bits s maturation of virus 4. Fusi usion on inhi inhibit bitor or –n –n does does not not allow fusion of virus to human cell Other Communicable Dse. 1. Fila Filari rias asis is C. A. A. : wuchere wuchereria ria bancrof bancrofti ti brugia malayi brugia timori M.O.T. :insect bites (aedes poecillus I.P. : 8-16 mos. S/S: Assymptomatic at first Inflammation of lymph nodes Inflammation of blood vessel • Swelling of scrotum • Swelling of upper and lower • extremities Enlargement and thickening of • the skin Dx. Procedure: History taking • Observation • Nocturnal blood exam • Immunochromatographic Immunochromatogr aphic test • Management: Diethylcarbamazine Diethylcarbamazine or hetrazan • surgery • • •
2. Malaria C.A. C.A. : genu genus s plas plasmo modi dium um types : Plasmodium falciparum P. vivax P. ovale P. malariae M.O.T. :insect bite S/S: Recurrent chills • Fever Profuse sweating • Anemia • Malaise • Hepatomegaly • • spleenomegaly Management: Medicate (blood schizonticides) schizonticides) • •
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Deng Dengue ue Hemo Hemorr rrha hag gic Fever AKA : H fever C.A. C.A. : dengue dengue virus virus types types 1,2,3, 1,2,3,4 4 and and chikungunya virus (aedes aegypti) M.O.T. : mosquito bite I.P I.P. : unce uncert rtai ain n (6da (6days ys-1 -1we week ek)) Stages First 4 days / invasive stage high fever abdominal pain HA hot flushes vomiting conjunctival infection epistaxis 4th-7th days/ toxic or hemorrhagic stage lowering of temperature temperature
abdominal pain bleeding unstable bp tourniquet test no longer reliable death may occur 7th-10th days/ convalescent or recovery stage - generalized flushing - regained appetite - stable BP Classification Severe, frank type - flushing, sudden high fever, severe hemorrhage followed by sudden drop of temp.,shock Moderate - with high fever but less hemorrhage mild - slight fever with or without petechial hemorrhage
Dx. Procedure: • Tourniquet Tourniquet test Supportive • Symptomatic • Rapid replacement of body • fluids 4.
Mumps - Swelling of one or both parotid glands C. A. A. : filter filterabl able e virus virus M.O.T. : contact with infected secretion secretion of the mouth and nose I.P. : 12-26 days S/S: Painful swelling in front of ear jaws and neck Fever • Malaise • Anorexia • • Swollen testicle Management: Prophylaxis • Active treatment • • Soft or clear liquids Nasal and oral care • •
5. Para Parago goni nimi mias asis is C.A. C.A. : parago paragonim nimus us weste westerm rmani ani,, P. P. siamenses M.O.T. : ingestion of improperly handled food S & SX : chronic cough, blood streaked streaked sputum, chest or back pain, PTB like symptoms DX : sputum exam, immunology, cerebral paragonimiasis paragonimiasis MNGT : praziquantel, bithionol, 6. Paraly Paralytic tic Shell Shellfis fish h Poisoni Poisoning ng AKA AKA : PSP / red red tide tide pois poisoni oning ng C. A. A. : dinofl dinoflage agella llates tes M.O.T. : ingestion of raw or mishandled shellfish I.P I.P. : 30 mins mins-s -sev ever eral al hour hours s S & SX : numbness, vomiting, dizziness, HA, tingling sensation, rapid,
difficulty in speaking and swallowing, respiratory arrest Management: • No specific treatment Induced vomiting • Coconut milk in the early stage • 7. Lept Leptos ospi piro rosi sis s AKA AKA : weil’ weil’s s disea disease, se, mud fever fever,, tench tench fever, flood fever, japanese seven days fever, spiroketal jaundice C.A C.A. : lept leptos ospi pirres (leptospirainterrogans) M.O.T. : skin contact esp. open wound I.P. : 7-19 days S/S: Leptospiremic phase - fever - HA - myalgia -N&V - vomiting - cough - chest pain Immune phase with circulating IgM Dx. Procedure: Culture • Blood test • • CSF test Urine testing • Management: Antibiotic • - penicillin - tetracycline tetracycline - ertyhtromycin ertyhtromycin 8. Anthrax AKA: AKA: mali malign gnan antt pustu pustule le,, mali malign gnan antt edema, woolsorter disease, ragpicker disease) C.A. C.A. : baci bacill llus us ant anthr hrac acis is M.O.T. : contact with infected animals, flies bites that fed on infected animals I.P I.P. : few few hou hours – 7 da days •
S/S: Cutaneous form -itchiness, papule becomes vesicle then black eschar, painless lesion if left untreated can lead to death pulmonary form - urti like symptoms, after 3-5 days can become acute can cause death gastrointestinal form - violent gastroenteritis, gastroenteritis, vomiting, bloody stools Management: Education • • Immunize high risk person Control dust • Handwashing •
SEY (-.-)
