Communicable Disease

COMMUNICABLE DISEASE: NERVOUS SYSTEM Disease Tetanus Causative Agent Clostridium tetani Mode of Transmission *punctured wound *unsterile cutting of e cord *dental extraction FIND IN: manure,pasture areas; rusty materials; plaster of Paris *bite of an infected animals (dogs, cats, rats) Incubation Period 3-21 days Pathogmnemonic Sign *Trismus (lock jaw) *opisthotomus(overarching of e back due to stiffness) *seizure Diagnostic Test *culture test of bacteria *CSF culture through lumbar tap Treatment DOC: *pen-G *Erythromycin *Diazepam *Mannitol *Phenobarbital for active seizure

Rabies

Rhabdovirus

10-14 days (rarely 15 yrs)

*for humans: -prodromal/invasive phase: excessive salivation, hyperexcitable due to ANS activation -excitement/neurologic phase: hydrophobia, aerophobia -terminal/paralytic phase: virus reached medulla; respiratory arrest; terminal fever

*presence of Negri bodies in brainf of dogs *Diffuse Fluorescent Antibody Test(DFA)/ Fluorescent Rabies Antibdoy Test (FRA)

Passive immunity: Rabies Ig Active immunity: Rabies Vaccine (Rabivar, Rabipur) Guidelines for Immunization Rabies Ig: *look for site of bite *wash c soap and running water *check for open wound -on the wound if open -if unopen: --above torso: on the wound --below torso; IM deltoid Rabies Vaccine: 5 doses *day 0, 3, 7, 14, 21 DOC: *pen-G *Rifampicin (prophylactic treatment)

Meningitis / cerebrospinal fever

Neisseriae meningitides

RESPI SECRETION

*Spiking fever 40 C *nuchal rigidity *meningeal reflexes *change in LOC (slow) *anterior horn (spinal cord) *asymmetric/unilateral permanent paralysis

*lumbar tap

Poliomyelitis/ infantile paralysis

Legio debilitans 1. Brunhildeparalytic polio; Hoyne’s sx (tripod positioning) 2. Lansing 3. Leon

Oral-fecal

*pandy’s test *throat swab

Vaccine: OPV Mgt: Foot board Fluid Apply warm packs on weakened mm Morphine (do not give) Enteric precaution Support

Compiled by: Zyrine Jhen A. Cortes BSN-IV Lectured by: Diane Celeste B. Mananquil, RN

COMMUNICABLE DISEASE: RESPIRATORY SYSTEM Disease Diphtheria Causative Agent Corynebacterium diphtheria Klebs-loeffler bacillus Mode of Transmission Respi secretion Incubation Period Pathogmnemonic Sign *grayish nodular growth: palatine area = pseudomembrane Subtypes: -cutaneous: PM+impetigo -pharyngeal: PM+ pharyngeal inflammation Bull’s neck appearance -nasolaryngeal: PM+excoriation of e upper lip & nares +serosannguinous exudates *paroxysmal cough *fainting spells 7-10 days *arthralgia/myalgia *malaise *catrrhal stage *low grade fever 3C- cough, cold, conjunctivitis *parotid gland swelling *ear pain *dysphagia *neck pain *spiking fever *prostration 5 Pillars of TB: -wt. Loss -anorexia -night sweats -low grade afternoon fever -hemoptysis Screening: exposure to TB *Purified Protein Derivative/ Mantoux Test -ID 48-72 hrs -check for presence of induration: 0-5mm = nega 5-6mm= doubtful 6-10mm= positive *steemedle test: -6 ID ; 4 out of 6 (+) Confirmatory: *Sputum analysis/ Acid Fast Bacilli staining *Chest X-ray =TB= Diagnostic Test *Schick’s test: susceptibility *throat culture Treatment DOC: erythromycinototoxic drug (damage of CN 8)

Pertussis/ Wooping Cough Influenza A Influenza B (seasonal flu) Mumps/ Epidemic parotitis

Pertussis bacilli: -Bordatella pertussis -Haemophilus pertussis H5N1 (avian flu) H1N1 (swine flu)

Respi secretion

*Throat culture

DOC: erythromycin

Respi secretion Avian: poultry, eggs Swine; human to human Respi secretion

*throat culture

DOC: osellamivir & zanamivir

Paramyxovirus

CP: 48 hrs after onset 4 days after check for ORCHITIS (swelling of testes)

Vaccine: MMR Immunosin (booster)

Tuberculosis

Mycobacterium tuberculosis

Respi secretion

RA 1135- TB pt. Should not be institutionalized (DOTS) Rifampicin: red orange urine Isoniazid: neuritis; do not take pills Pyrazinamide: hyperuricemia Ethambutol: eye problem Streptomycin; damge to CN 8 Category I extrapulmonary II noncompliance III newly dx mild TB 1-2 mos RIPE RIPES RIP 3mos RIPE 3-6 m0s RI RIE RI

*for 2 wks continuous tx, pt is not contagious.

Compiled by: Zyrine Jhen A. Cortes BSN-IV Lectured by: Diane Celeste B. Mananquil, RN

-presence of bacteria in UPPER lobe (cessation/nodules) -blood tinge sputum =Pneumonia= -LOWER lobe @ parenchyma -rusty color COMMUNICABLE DISEASE: INTEGUMENTARY SYSTEM Disease Leprosy/ Hansen’s disease Causative Agent Mycobacterium leprae (Hansen’s bacillus) Mode of Transmission No known but hypothesize -respiratory secretion -prolonged intimate skin to skin contact Incubation Period 1-5 yrs Pathogmnemonic Sign Cardinal signs: Peripheral nerve enlargement Postive SLIT SKIN SMEAR test Loss of sensation Early Signs Change in skin color Hypoaesthesia( dec. Sensation) Anhydrosis Muscle Weakness Painful nerves Late Signs Gynecomastia Madarosis (loss of eyebrows) Lagopthalmus (inability to close eyes) Autoamputation Contractures Leonine face *vesiculopapularr lesions *progresses in PROXIMODISTAL Stages: -macule -papular -vesicular: c serious fluid Problem: systemic itchiness (treat c Calamine lotion, Colloidal bath, Zinc Oxide) *vesiculopapular rash ff. A LINEAR NERVE PATHWAY (localized) Problem: pain 2 warning sx: Parethesia Pruritus *strawberry tongue *circumpolar pallor * pastai;s sign: antecubital *rash (CEPHALOCAUDAL) Diagnostic Test SLIT SKIN SMEAR TEST Biopsy if there’s lesion Treatment RA 4073: Liberalization of Leprosy treatment DOC: Monotherapy: Dapsone MDT/ Multi Drug Therapy (2 categories) -Paucibacillary; inc. Infective dose *6-12 mos *Dapsone+Rifampicin 1st day: supervised 2nd -30th day: dapsone only -Multibacillary; dec. Infective dose *Dapsone+Rifampicin+Clofazimin 1st day: all 3 drugs 2nd-30th day: Dapsone+Clofazimin Dapsone: Dermatitis Clofazimin; further skin discoloration *complement fixation *hetrophil Agglutination test *viral isolation Acetaminophen/ Paracetamol for fever *do not give ASA (aspirin) to all viral diseases which can lead to fatty disposition to the liver or REYE’S SYNDROME. DOC: Acyclovir (Zovirax) hazen the healing time

Chicken Pox

Varicella Zoster (virus)

Respiratory and direct contact

CP: 1-2 days

Herpes Zoster (shingles)

Varicella Zoster reactivated through: -inc. 60 y.o. -steroid therapy -immunosuppress

Respiratory and direct contact

CP: 2wks from onset of dse

*complement fixation *hetrophil Agglutination test *viral isolation

DOC: acyclovir (Zovirax)

Scarlet Fever/ Scarlatina

GABHS Group A beta Hemolytic Streptococcus

Respi

*culture test: confirmation *Dick’s test: immunity *Schultz-charlton test: sensitivity

DOC: erythromycin

Compiled by: Zyrine Jhen A. Cortes BSN-IV Lectured by: Diane Celeste B. Mananquil, RN

*desquamation(convalescence stage) Rubeola/ measles Morbilli paramyxoviridae Respi 7 day CP: 4 day rule after onset Respi 3 day CP: 4 day rule after onset SORETHROAT WITH A RASH!!! *maculopapular rash c desquamation *enanthema: rupture inside KOPLIK’S *bluish gray lesions c ared base buccal mucosa *Polymorphous rah *enanthema: FORSCHEIMER’S SPOTS *red spots in soft palate *complement fixation *hetrophil Agglutination test *viral isolation No drugs Vaccine: MMR

Rubella/ German Measles

Togaviridae

*complement fixation *hetrophil Agglutination test *viral isolation

No drugs Vaccine: MMR German measles virus can cross to the placenta can lead to Congenital Rubella Syndrome (1st tri) -microcephaly, MR, CHD, glaucoma Cycle: 1st: catarrhal 2nd: fever 3rd: Psx 4th: rash No drugs Vaccine: MMR Scabicide: *kwell/lindane CI: lactating mothers, pregnant *eurax/crotamiton *permethrine (overnight for 5 consecutive nights) DOC: kwell shampoo -regular shapoo then kwell Home remedies; vinegar sol’n 1:2 Antifungal: Topical- ketoconazole, miconazole, cotrinazole, giriseofulvin Parenteral: amphotericin DOC: ertythromycin, penicillin

Roseola/baby measles Scabies

HHSV type 6

Respi

Mild preliminary CP: 4 day rule after onset

*maculopapular rash s desquamation *rash *multiple, wavy, linear, threadlike lesions *weeping itch

*complement fixation *hetrophil Agglutination test *viral isolation Mineral oil test

Sarcoptes scabiei: parasite

Pediculosis

Tinea/ Ring worm

Pediculosis humanis (human mite) -capitis -corporis -pubis Dermatophyte: fungi

Close contact Personal article

*itchiness

Mits in the follicle

*circumscribed/circular lesion c scaling & crusting patchy hairless

*culture *clinical picture

Impetigo

GABHS, staphylococcus

*vesiculopapular lesion *thick, honey-comb crust

Culture test

Compiled by: Zyrine Jhen A. Cortes BSN-IV Lectured by: Diane Celeste B. Mananquil, RN

COMMUNICABLE DISEASE: CIRCULATORY DISEASE Disease Malaria Causative agent Plasmodium: protozoan -falciparum: worst -malariae -vivax -ovale Incubation Period 12-30 days 3 stage Cold: chills Warm: violent fever Wet: diaphoretic Vector Anopheles malariae *night biting 9pm-12mn *high flying *clear, flowing water *strip dotted Pathogmnemonic sign FEVER: 6-8hrs every 2-3 days Types: *tertian: 1 day free of fever between paroxysms *quartan: 2 day free of fever between paroxysms Complications: *coagulation defect *liver & renal failure *anemia *shock Classic dengue -arthralgia/myalgia -biphasic -intermittent (3-7days) -+ tourniquet test - Herman’s Rash c generalized erythema; upper extremities Diagnostic test Malarial Blood Smear Test in Warm Stage Treatment DOH PROGRAM: on stream seeding/fishing *chloroquine: 2wks before going to a endemic area If pregnant and living in the malarial area, take chloroquine always. *quinine: “cinchonism” neurologic toxicity *primaquine, sulfadoxine, pyrimethamine (2hrs before taking quinine)

Dengue Fever

Arbovirus/flavivirus Chikunguya/onyon g-onyong virus DV types 1-4

Aedes aegypti: breed inside house Aedes albopictus: breed outside *day biting 8am-12nn 3pm-5pm *low flying *clear, stagnant water *stripped black

Screening: *Rumpel leads (tourniquet test) Petechiae: >15-20 (+) DF (-)DHF *platelet ct: <150,000 >100,000 =Classic <150,000 <100,000= DHF *hct: increase *viral isolation

Medical: *fresh whole blood transfusion *platelet transfusion NSG.: *observe and Hydrate 1:8:1 oresol (1L+8tsps sugar+1tsps salt) Pedia: 75ml/kg Adult: 2-3L DOH: CLEAN Chemically treated mosquito nets Larvae eating fish Env’t sanitation Anti mosquito repellant Natural mosquito repellent Palliative: *lymphanastosmosis *inversion of tunica vaginasis DOC: diethylcarbamazepine citrate (DEC)Hetrazan, Beltrazan Penicillin Doxycycline

Filariasis

Blood helminths: -Wuchereria bancrofti -Brugia malayi -Brugia timori Leptospira interrogans (bacteria) 2-3 days 9 -16 day: crucial period
th th

Aedes poecillus

Lymphangitis: swelling of lymphatic capillaries Lymphadenitis: lymph nodes

*Nocturia blood smear 8pm above *dip stick/ immunochromatographic test Culture (urine, CSF)

Leptospirosis/ Mud Fever

Rodents MOT: eating foods in contact with feces or urine Deer ticks

Complication: scrotal hydrocele Orange eyes Wt. Loss Jaundice Anorexia Acholic stool RUQ pain Bile colored urine Malaise Bull’s eyes rash

Lyme’s Disease

Borrelia burgdorferi

Culture

any form of broad spectrum antibiotic

Compiled by: Zyrine Jhen A. Cortes BSN-IV Lectured by: Diane Celeste B. Mananquil, RN

COMMUNICABLE DISEASE; GASTROINTESTINAL Scientific Name Roundworm Pinworm Tapeworm Whipworm Hookworm Disease Food Posioning Ascaris lumbricoides Enterobius vermicularis Taenia solium (pork)/ saginata (beef) Trichoris trichiora Ancylostoma duodenale CA Staphylococcal: CHO rich Salmonella: CHON rich Botulism: damange Canned goods Psx Passing out of worm; protuberant abdomen; colicky, abd’ pain Nocturnalitchiness; constant picking of e anus Passing out of a segment of the worm Rectal prolapsed IDA, long standing bleeding; paleness Psx n/v; diarrhea Greenish, foul smeeling stool Nero signs: headaches, visual disturbances, projectile vomiting Rose red spots in trunk of the patient Ladder like fever (peaks in the afternoon) N/V, diarrhea Splenomegaly Itchy red pustule/ “swimmer’s itch” Typhidot: antibody formed Widal’s test Fecal exam COPT (Cerco-Ova Precipitin Test) Fluid Replacemnt DOC: Chlormphenicol DOC: Praziquantel (biltricide, Fuadin) S. Japonicum: Praziquantel S. mansoni: Oxamniquine S. haematobium: Metrifonate Disease Cholera/ El tor Dse Amoebia sis CA Bacteria: Vibrio comma, chlorae, El tor Protozoan: Entamoeba histolytica Px Rice watery/ washerwoman’s stool; massive diarrhea Dx 3+ stool exam Tx Boil h2o for 20mins Antibiotic: tertracycline Boil h20 for 20 mins Metronidazole MOT 5fs Auto infxn Improper cooked foord 5fs Barefoot/ 5fs Dx Culture of vomitus dx Stool exam Graham’s Test/ Scotch tape Method Stool exam Stool exam Stool exam Tx Give antitoxin: Trivalen Gastric Lavage Rehydrate patient Tx (anti helminthics) Mebendazole Albendazole Piperazine Pyrantel

Typhoid Fever

Salmonella typhi

Schistosomiasis/snail fever/ Katayama’s Dse

Blood Flukes: Schistosoma japonicum S. mansoni S. haematobium Vector: Snail ( Oncomelania quadrasi)

Tenesmos, mucoid diarrhea Amoebic dysentery: blood in stool

3+ stool exam

Compiled by: Zyrine Jhen A. Cortes BSN-IV Lectured by: Diane Celeste B. Mananquil, RN

Hepatiti s A B C D E

Dx Food and h20 Blood borne/body fluid/STD Post transfusion Fulminant/ chronic Food and h20 Antigen-antibody screening

TX Interferon-alpha 2b

STD AIDS (acquired Immune Deficiency Syndrome)

HbSAg if reactive + Anti IgM HbC if reactive immune CA PsX HIV/ retrovirus, Major: fever, Wt. Loss, diarrhea lentivirus Minor: 3 ways: Pruritic dermatitis Placental. Parenteral. Progressive dissmeninated herpes simplex Person to person Oral thrush Recurrent herpes zoster Night sweats Lymph adenopathy Chronic dry cough

COMMUNICABLE DISEASE: SEXUALLY TRANSMITTED DISEASE DX Probable: CD4 Ct. Screening test: ELISA (Enzyme Link Immunosorbent Assay) Confirmatory: Western-blot test Adult: #1 PCP (Pneumocystis carnii Pneumonia Child: #1 Cryptococcus neoformans meningitis Culture TX DOC: Reverse transcriptase inhibitors -Zidovudine (ZDV) -Azidothymidine (AZT) *develop resistance in 6 mos *give in full stomach *CBC: leukopenia

Candidiasis

Candida albicans

Chancroid Syphilis

Haemophilus ducreyi Treponema pallidum

Cheese like vaginal d/c Mouth: thrush Vulva: moniliasis Skin: onychomycosis BUBO: start as inguinal ademitis, painful, draining ChANCRE: painless, moist, non draining Stage: Primary-infectious; curable (Chancre) Secondary –infectious; curable Psx: qlopecia areata & condylomata lata Latency- non infectious; terminal asymptomatic Tertiary- no infectious; terminal; GUMMA, necrotic lesion Condylomata acuminate (fibrious tissue overgrowth) Male: dysuria, greenish, mucopurelent d/s Female: 80% aymptomatic Serosanguinous d/c

Antifungal: Nystatin Amphotericene IV DOC: azithromycin DOC: Benzathine Pen G

Culture biopsy Venereal dse research Lab Slide test (VDRL)

Genital Warts Gonorrhea/ Great Scar Former Chlamydia

HPV Neisseria gonorrhoea Chlamydia trachomatis

Biopsy; pap smear

Crocautery- 7 days Topical: podophyelum; Podofilux; imiquimod DOC: Ceftriaxone + Doxycyccline

ELISA, culture

Doxycycline

Compiled by: Zyrine Jhen A. Cortes BSN-IV Lectured by: Diane Celeste B. Mananquil, RN

Herpes Simplex Type I

Fever blister Vesiculopapular lesion Localized in oral mucosa or nares Genital herpes

Clinical picture Viral isolation

Acyclovir *educate: limit emotional stress

Type II

Same

Same

Infectious Mononucleosis/ Kissing’s Dse HEMATOLOGY: Normal Value Female: 12-16 mg/dl Male: 13-18 mg/dl 4.5-6.2/ cu mm < 200ng/dl <130 ng/dl >35 ng/dl 70-110 mg/dl 5-20 mg/dl 0.5-1.5 mg/dl

Epstein-Barr virus

Heterophil agglutination Test

No drug

Hgb RBC Cholesterol LDL HDL Glucose BUN Creatinine

Anemia Iodine Deficiency Anemia Pernicious Anemia

Definition Dec. Fe common in pregnancy, infant, adolescent Dec. Absorbtion of Vit. B12 (cyanocobalamia) Bone marrow depression < 4ng/mL Crisis: vaso occulisve crisis

Psx Pale; dec. Appetite, palpitation, easily fatigue Glossitis

Mgt Fe for 6mos. Check to Schilling’s Test; absorption rate of Vit. B12 monthly; Vit b12 injection Reverse isolation, check CBC Give corticosteroids

Aplastic Anemia Folic Acid Anemia Sickle Cell Anemia

Inc. Risk for infxn Give folic acid for 6 mos Leafy green & organ meat Autosomal recessive d/o

Compiled by: Zyrine Jhen A. Cortes BSN-IV Lectured by: Diane Celeste B. Mananquil, RN