Lecture Day 5
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Lecture Day 5

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5th day

5th day

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Lecture Day 5 Presentation Transcript

  • 1. Lecture day 5
  • 2. Diagnosis:
    identification of eggs in the stool
    Tape test
    Treatment:mebendazole, pyrantelpamoate
  • 3.
  • 4.
  • 5. HEPATITIS
    Inflammation of the liver characterized by diffuse patchy necrosis
    Causes: virus,bacteria,toxins,alcohol, drugs, or may be autoimmune,parasites
    Hepatitis A, is endemic mostly in the world due to poor sanitation.
    Mode of transmission: ingestion of contaminated food/fecal-oral route
    Hepatitis B, has a longer incubation period
    Mode of transmission: Blood and body fluids
  • 6. Hepatitis a
    Also known as infectious hepatitis, common among children and adults, most common cause of acute viral hepatitis
    Transmitted through oral-fecal route
    Diagnosis:HAV-specific IgM antibodies in the blood
    Prevention:can be prevented by vaccination, good hygiene and sanitation
    Mgt:rest, avoid fatty foods and alcohol ,eat a well-balanced diet, and stay hydrated
  • 7. HEPATITIS B
    Also called serum hepatitis, 2nd common cause of acute viral hepatitis
    hepatitis B virus primarily interferes with the functions of the liver by replicating in liver cells
    Transmitted through blood and blood products, sharing of needles, body fluids, sexual contact
    Diagnosis: screening of HbsAg
    Treatment: antivirals
  • 8. Hepatitis c
    spread by blood-to-blood contact.
    estimated 270-300 million people worldwide are infected with hepatitis C
    decreased appetite, fatigue, abdominal pain, jaundice, itching, and flu-like symptoms
  • 9. Hepatitis d
    A defective RNA virus that can replicate only with the presence of HBV
    Not very common
  • 10. Sx:
    Jaundice, lethargy
    Nausea vomiting
    Pruritus/itching
    Jaundice
    Abdominal pain, diarrhea, constipation
    Dark urine, clay colored stool
    Diagnosis:
    marked elevation in AST and ALT
    urinary bilirubin, hyperbilirubinemia,
    serology
    Complications: Hepatic encephalopathy
  • 11. serology
  • 12.
  • 13.
  • 14. Phases of hepatitis infection
    Incubation- may range from 15-180 days
    Prodromal/pre-icteric-non-specific symptoms
    Icteric-jaundice, organ enlargment
    Recovery
  • 15.
  • 16. Treatment and prevention
    Handwashing and hygiene
    Vaccination
    Screening of blood
    HBIG
    antivirals
  • 17. AST – aspartateaminotraspeptidase also called SGOT or serum glutamicoxaloacetictransaminase
    ALT- alanineaminotransferase or SGPT, serum glutamicpyruvictransaminase
    Both are found in the liver
    Increase in amount indicates possible liver damage
  • 18. Leprosy
    a granulomatous disease of the peripheral nerves and mucosa of the upper respiratory tract; skin lesions are the primary external sign
    Mycobacterium leprae or leprosy bacilli, acid fast
    Mode of Transmission: Airborne, inhalation of droplet/spray from coughing and sneezing of untreated leprosy patient
  • 19.
  • 20. Sx:
    long standing skin lesions that do not disappear with ordinary treatment
    loss of feeling/numbness on the skin
    loss of sweating and hair growth over the skin lesions
    thickened and/or painful nerves in the neck, forearm, near elbow joint and the back of knees
    RASH is NON-PRURITIC
  • 21. Types
    Tuberculoid –paucacillary or hansen’s disease is the mildest form, limited to skin patches, macules with sharp raised borders, or individual nerves
    Lepromatous- or multibacillary, is widespread and systemic infection if skin, nerves, and organs, skin macules, papules and plaques occur so does, ynecomasti, peripheral neuropathy, loss of eyelashes and eyebrows
  • 22. Complications: peripheral neuritis, distal hypoesthesia, plantar ulcers, lagopthalmus
    Diagnosis: biopsy, clinical picture of skin lesions and peripheral neuropathy
  • 23. Multidrug therapy (MDT) is the cornerstone of the leprosy elimination strategy as it cures patients, reduces the reservoir of infection and thereby interrupts its transmission. MDT also prevents disabilities through early cure.
    For purposes of treatment, leprosy is divided into two types :
    a) Pauci-bacillary(PB) leprosy : 1-5 skin lesions – Regimen of two drugs – Rifampicin and Dapsone for 6 months;
    b) Multi-bacillary(MB) leprosy : >5 skin lesions – Regimen of three drugs – Rifampicin, Clofazimine and Dapsone for 12 months;
  • 24. SCABIES
    The infection of the skin caused by SarcoptesScabiei, causes intensely pruritic lesions with erythematous papules
    May be found in people with substandrard hygienic living conditions.
    Mode of Transmission: Contact
    The adult mite burrows itself in the skin, lays eggs
    Sx:
    Severe itching most specially at night
    Lesions, papules, excoriations
    Mgt: advise pt. to take shower and apply scabicide in the area.
    Lindane, crotamiton, permethrin
  • 25.
  • 26. PSORIASIS
    A chronic inflammatory disease of the skin wherein epidermal cells are produced at a rate six to nine times faster than normal
    Sx: red, raised patches or lesions appear covered with silvery scale
    Usual sites are the scalp, elbows and knees and genitalia
    Mgt: removal of scales through baths, oils, coal and tar preparations
  • 27.
  • 28. MENINGITIS
    Inflammation of the meninges, may be acute bacterial, aseptic or menigococcal
    common causes are group B streptococciEscherichia coli,ListeriamonocytogenesNeisseriameningitidis (meningococcus), Streptococcus pneumoniaeHaemophilusinfluenzae type B N. meningitidis and S. pneumoniae
  • 29. Sx:
    Nuchal rigidity, Kernig’s and brudzinki’s sign
    High fever, headache
    Phonophobia and photobia
    Neisseriameningitidis: a rapidly spreading petechial rash which consist of numerous small, irregular purple or red spots on the trunk, lower extremities, mucous membranes, conjuctiva, and the palms of the hands or soles of the feet.
  • 30.
  • 31.
  • 32. Diagnosis: lumbar puncture and gram staining
    done by positioning the patient, usually lying on the side, applying local anesthetic, and inserting a needle into the dural sac to collect CSF
    Treatment:
    Antibiotics
    steroids
  • 33. MENINGOCOCCEMIA
    an acute and potentially life-threatening infection of the bloodstream that commonly leads to inflammation of the blood vessels caused by Neisseriameningitidis ,surrounded by an outer coat that contains disease-causing endotoxin. With levels 100 to 1,000 times greater, multiply and move through the bloodstream, it sheds concentrated amounts of toxin affecting the heart, reducing its ability to circulate blood, and also causes pressure on blood vessels throughout the body. As some blood vessels start to hemorrhage, major organs like the lungs and kidneys are damaged.
    MOT: droplet infection
    Incubation period lasts for 2-10 days with an average of 3-4 days. 
  • 34. Anxiety Fever Irritability
    Spotty red or purple rash
  • 35. Complications:
    septicemia, profound shock
    Multiple organ failure
    DIC
  • 36. Diagnosis: blood culture, lumbar puncture
    Treatment and prevention
    Vaccination
    Aqueous Penicillin G may be given to both children and adults. Chloramphenicol may be given in cases of Penicillin allergy.
    Prophylaxis is reserved for those who have intimate contact with the patient; household members, boyfriend/girlfriend, sexual partners, hospital personnel who did suctioning of secretions and/or mouth resuscitation. Rifampicin is the drug of choice and may be given to both children and adults.
  • 37. Encephalitis
    Inflammation of brain tissue
    It my be a primary manifestation or a secondary complication
    Viral encephalitis can be due either to the direct effects of an acute infection, or as one of the sequelae of a latent infection.
    can be caused by a bacterial infection such as bacterial meningitis spreading directly to the brain (primary encephalitis), or may be a complication of a current infectious disease syphilis
  • 38. Sx:
    fever, headache and photophobia with weakness and seizures
    Diagnosis: lumbar puncture, MRI
  • 39. TETANUS
    characterized by a prolonged contraction of skeletal muscle fibers caused by a neurotoxin clostridium tetani, a gram-positive, obligate anaerobic bacterium
    MOT: wound contamination and often involves a cut or deep puncture wound. As the infection progresses, muscle spasms develop in the jaw and elsewhere in the body
    Tetanus begins when spores enter damaged tissue,transform into rod-shaped bacteria and produce the neurotoxin tetanospasmin
  • 40. Sx: Incubation may range from 2 to 50 days
    trismus, or lockjaw,
    facial spasms called risussardonicus,
    stiffness of the neck,
    difficulty in swallowing
    and rigidity of pectoral and calf muscles
    Opisthotonos
    Neonatal tetanus is also possible
  • 41.
  • 42.
  • 43. Diagnosis:
    spatula test-a clinical test for tetanus that involves touching the posterior pharyngeal wall with a sterile, soft-tipped instrument, and observing the effect.
    positive test result is the involuntary contraction of the jaw
    negative test result would normally be a gag reflex attempting to expel the foreign object.
    Treatment:
    Metronidazole, passive immunization, diazepam, debridement, antibiotics
    Keep patient in a dim, quiet room