Lecture Day 5

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Lecture Day 5

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

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