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Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
Lecture Day 3 And 4
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Lecture Day 3 And 4

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laecture day 3 and 4

laecture day 3 and 4

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  • 1. Lecture day 3 and 4
  • 2. Objectives
    To have a group presentation regarding the promotion of AIDS awareness
    To discuss the different types of autoimmune deficiencies
  • 3. AUTOIMMUNE DEFICIENCIES
    Are conditions wherein antibodies are formed against endogenous antigens that result in tissue injury
  • 4. RHEUMATOID ARTHRITIS
    Its autoimmune reaction occurs in the synovial joint.
    Greater incidence in women
    Phagocytosis produces enzymes that break down collagen causing edema, proliferation of the synovial membrane and pannus formation which destroys cartilage and degrades the bone.
    Sx: joint pain, swelling, warmth, erythema, lack of function, deformities
    Classic sign: joint stiffness in the morning
  • 5. Diagnosis: positive rheumatoid factor, elevated ESR, he rate at which red blood cells precipitate in a period of 1 hour, a non-specific measure of inflammation
    Mgt:
    Early stage: rest and exercise, analgesics
    Moderate/erosive: physical therapy,cyclosporine
    Persistent: surgery, corticosteroids
    Surgery includes:
    Synovectomy
    Tenorrhaphy
    Arthrodesis
    Arthroplasty
    Advanced/unremitting: immunosuppressive agents
  • 6. Systemic Lupus Erythematosus
    10 times more frequent in women, 3 times more frequent in African-americans
    It is a result of disturbed immune regulation that causes an exaggerated production of autoantibodies which is brought about by a combination of genetic, hormonal, environmental and drug-related causes.
    Sx: Affetcts different body systems
    MS: arthralgia and arthritis, joint swelling
    Skin: discoid SLE-erythematous papules and scaling, butterfly rash in scalp,face and neck
    Lesions worsen (excacerbate) upon exposure to sunlight/UV light
  • 7. Diagnosis: complete history, PE, and blood tests
    Mgt: Pharmacologic therapy: corticosteroids, immunosuppressive agents
  • 8.
  • 9. Hashimoto’s thyroiditis
    Or chronic thyroiditis, occurs in women more frequently and in between 30-5- years of age
    an autoimmune disease in which the thyroid gland is gradually destroyed by a variety of cell and antibody mediated immune processes, was first described by Dr. Hakaru Hashimoto, in 1912.
    Blood drawn from patients with Hashimoto's throiditis reveals an increased number of antibodies to the enzyme, thyroid peroxidase an enzyme found within the thyroid gland. As result of the antibodies' interaction with the enzyme, inflammation develops in the thyroid gland, the thyroid gland is destroyed, and the patient ultimately is rendered hypothyroid
  • 10.
  • 11. Sx: weight gain, depression, mania, sensitivity to cold, fatigue, panic attacks, bradycardia, tachycardia, high cholesterol, reactive hypoglycemia, constipation, migraines, muscle weakness, cramps, memory loss, infertility and hair loss.
    Dx: T3 and T4, anti-thyroid peroxidase antibodies to aid in the diagnosis.
    Mgt: thyroid hormone therapy, surgery
  • 12. MULTIPLE MYELOMA
    A malignancy involving plasma cells in bone marrow.
    Exact etiology is unknown .Abnormal plasma cells proliferate in the bone marrow where they release osteoclast activating factor causing a breakdown of bone cells and increasing blood calcium levels and risk for pathologic fractures.
    The cells release two types of proteins, one of them, the Bence-jones proteins impair renal tubules and result to renal failure.The other, M-type protein compromises the production of immunoglobulins .
  • 13. Sx: bone pain, relieved by rest, pathologic fractures, fatigue, weakness, renal calculi
    Diagnosis:X-ray, high calcium levels, low blood cell counts, positive bence-jones protein in the urine
    Mgt: Steroids and anti-cancer drugs, radiation, analgesics, bone marrow transplants
  • 14. IMMUNIZING AGENTS
    Vaccine- suspension of live or dead organism
    Toxoid-bacterial toxin that has been rendered non toxic
    Immune globulin-sterile solution containing antibodies from human blood
    Antitoxin- solution of antibodies derived from serum of animals immunized from specific antigens
  • 15. In live attenuated vaccines, the organism in the vaccine is alive but unable to infect a person with a normal immune system.
    Patients with impaired immunity-such as those with immune deficiencies, on chemotherapy for cancer, or with AIDS-and pregnant women must not be given live vaccines.
    Examples of live attenuated vaccines are measles, mumps, rubella, and oral polio.
  • 16. Inactivated or killed vaccines contain dead, but intact, organisms, so the immune system can still recognize them. Most vaccines are inactivated.
  • 17. COMMUNICABLE DISEASES
  • 18. CHAIN OF INFECTION
  • 19. DISORDERS AFFECTING THE RESPIRATORY SYSTEM 
  • 20. Pneumonia
    Is an inflammatory process of lung parenchyma with many causes including aspiration of food and fluid, inhalation of toxic chemicals and gases
    S.pneumonia,S. aureus, H. influenza, P. aeruginosa are some of the common pathogens pathogens
    Risk factors: smoking, air pollution, URTI, prolonged immobility, immunocompromised, aspiration, chronic disease
  • 21. Sx: adventitious breath sounds, crackling
    Dull sound over affected are upon percussion
    Unequal chest wall expansion
    Fever, chills, sweating
    Cough, sputum production, hemoptysis
    Diagnosis:
    Skin tests
    Chest x-ray
    Sputum exam/culture
  • 22. Pneumonia according to location:
    Bronchopneumonia- involves terminal bronchioles and alveoli
    Segmental-one or more segents of a lobe
    Lobar- one or more lobes of lung
    Bilateral- lobes or segments of both lungs
    Mgt:
    Promote airway patency, breathing exercises
    Increase fluid intake
    antibiotics
  • 23. DIPHTHERIA
    Is severe localized throat infection caused by corynebacterium diphtheria or the Klebs-Loeffler bacillus
    It is common in temperate climates, and in overcrowded populations
    Mode of transmission: droplet infection
    Sx:
    Classic sign: psudomembrane covering the posterior pharynx
    Others: headache, sore throat, fever
  • 24.
  • 25. Diagnosis: swabbing and culture
    Mgt:
    Antibiotics and antitoxin
    Maintain patent airway
    Analgesics and antipyretics
    Keep emergency tracheostomy set available at bedside
  • 26. TUBERCULOSIS
    One of the leading causes of death worldwide
    According to the World Health Organization, the Philippines ranks fourth in the world for the number of cases of tuberculosis and has the highest number of cases per head in Southeast Asia. Almost two thirds of Filipinos have tuberculosis, and up to five million people are infected yearly in our country. (DOH, NTP)
  • 27. Pulmonary TB is suspected if a person has symptoms of cough for more than 2 weeks, fever, chest and back pains, poor appetite, loss of weight and hemoptysis. He should seek medical consultation and his sputum should be examined to detect the presence of Mycobacterium tuberculosis.
    Mode of transmission: droplet infection
    Diagnosis: mantoux test, sputum exam, chest x-ray
  • 28.
  • 29. Mantoux Test:
    Or tuberculin test, or purified protein derivative
    Given intradermally, when the skin reacts to it, it means that the person has been infected with tuberculosis
    Prevention:
    Cover nose and mouth when coughing, sneezing or laughing
    BCG, bacillus calmette-guerin
  • 30. Extrapulmonary TB also exists.
    Infections are characterized by the formation of gray, translucent tubercles / granulomas which gradually become necrotic, liquefies and coughed out as sputum and the nodule becomes an air filled cavity.
    Primary infection
    First the person gets infected
    Gohn tubercle/Gohn complex may be formed
    Secondary/Reinfection
  • 31. Sx:
    Fatigue, anorexia, weight loss, low grade fever, chills and night sweats, dyspnea, hemoptysis, chest pain
     
    Tuberculosis is a curable disease. Patients are prescribed with appropriate regimen to render them non-infectious and cured, as early as possible. The treatment for TB is a combination of 3-4 anti-TB drugs.
    NEVER should we prescribe a SINGLE DRUG for TB treatment! This will worsen the patient’s condition.
  • 32. DISORDERS AFFECTING THE GASTROINTESTINAL SYSTEM
  • 33. CHOLERA
    Caused by organism Vibrio cholera
    Transmitted by contaminated food and water
    It is characterized by copious diarrhea, ”rice watery stool” up to 1 liter per hour which may result to dehydration and cardiopulmonary collapse.
    Prevention:
    Drink only safe and clean water. If unsure, boil drinking water (Upon reaching boiling point, extend boiling for two or more minutes), or
    Do water chlorination.
  • 34. Keep food away from insects and rats by covering it.
    Wash and cook food properly.
    Sanitary disposal of human waste.
    Use toilet properly and clean toilet everyday.
    Management:
    Replace lost body fluid by giving Oral Rehydration Solution (ORESOL) or a homemade solution composed of 1 teaspoon of salt, 4 teaspoons of sugar mix to 1liter of water.
  • 35. TYPHOID FEVER
    Caused by organism Salmonella typhi
    Mode of transmission: ingestion of contaminated food
    Sustained high fever
    headache
    malaise (weakness)
    anorexia (loss of appetite)
    diarrhea or constipation and abdominal discomfort
  • 36. Diagnosis is made by any blood, bone marrow or stool cultures and with the Widal test, demonstration of salmonella antibodies against antigens O-somatic and H-flagellar
    Where resistance is uncommon, the treatment of choice is a fluoroquinolone such as ciprofloxacin

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