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HEPATITIS HA: Infectious hepatitis, Catarrhal- HB: Serum Hepatitis HC: Post-transfusion hepatitis
jaundice hepatitis
MOT: percutaneous, sexual, MOT: percutaneous, sexual
MOT: fecal-oral, oral-anal sex mother- child. intercourse
Clinical Manifestations
Preicteric phase Icteric “Yellowish” phase Post icteric phase
- anorexia - dark urine (increase bilirubin) - malaise
- nausea - pruritus - fatigue
- RUQ pain - clay-colored stools: due to - hepatomegaly (several weeks)
- malaise decrease excretion of conjugated
- headache bilirubin in intestine
- low grade fever - enteric jaundice (scleral
jaundice)
CLASSIFICATION OF SEVERITY
I: MILD Mild Trismus, General Spasticity; NO RESPI EMBARRASMENT, SPASMS & DYSPHAGIA
II: MOD Moderate Trismus, Rigidity, short Spasms, Mild dysphagia, No respi involvement,
RR > 30
III: SEVERE Severe Trismus, Generalized Spasticity, prolonged spasms, RR > 40, Apnoiec Spells, PR
> 120
IV: V. SEVERE Grade 3 Plus severe autonomic disturbances involving Cardio sys
*DECORTICATE: flexion
*DECEREBRATE: extension
DIAGNOSTIC EXAM MANAGEMENT
- Clinical manifestations Equine tetanus antitoxin
- History of wound ➢ should no longer be used, as there is
MED MANAGEMENT a risk of hypersensitivity and serum
- ATS (ANTI T. SERUM): both preventing and curing Tetanus sickness.
- TAT (T ANTITOXIN) ➢ It should be replaced by human
- TIG (T. IMMUNOGLOBULIN) tetanus immunoglobulin
- Pen G, Metronidazole
- Diazepam (cover from sunlight) ATS
- Muscle relaxant ➢ purified antibodies prepared from
Equine Blood (Horse)
NX MANAGEMENT ➢ Skin test is needed
➢ Keep the room dim and quiet. ➢ temporary passive immunity against
➢ Avoid stimuli of spasm tetanus for 2 weeks
➢ Avoid unnecessary handling ➢ 1500 IU: single dose
➢ Close monitoring of v/s & muscle tone ➢ 3000 IU: if > 24 hours has elapsed.
➢ Provide adequate airway ➢ admin as soon as possible after
injury, along with tetanus vaccine, in
PREVENTION a separate syringe and injection site.
➢ Immunization with tetanus toxoid for adults
➢ DPT for babies and children
POLIOMYELITIS Causative Agent MOT
LEGIO DEBILITANS - fecal-oral: through saliva, vomitus and feces
- TYPE 1 BRUNHILDE: permanent immunity; most - Direct contact from one person to another
paralytogenic - Ingestion through of contaminated food (fecal-oral
- TYPE 2 LANSING: Tempo immunity route)
- TYPE 3 LEON: Tempo immunity INCUBATION PERIOD
PREDISPOSING FACTORS 7 – 14 days
➢ Age: 60% of patient 10 yo PERIOD OF COMMUNICABILITY
➢ Sex. Males more prone than females. Death rate - Not accurately known
is proportionately higher in males. - Polio virus can be found in throat secretions as
➢ Heredity. Not heredity early as 36 hours and in the feces 72 hours after
➢ Environment and hygienic condition: rich are exposure to infection.
more often - Risk of spreading the microorganism is highest
➢ Excessive work, strain & marked overexertion during the prodromal period
are also factors causing the disease
SIGNS AND SYMPTOMS
Inapparent/ Abortive (Minor Major Illness Stage
Subclinical Stage Illness Stage) A. NON-PARALYTIC/ PREPARALYTIC or MENINGITIC TYPE
asymptomatic - Fever Tightness and spasm of hamstring: Pathognomonic
stage (90-95%) - Sore throat - Recurrence of fever
- GI symptoms - Poker spine (stiffness of the back)
- Low lumbar - Hypersensitiveness of the skin
backache/ cervical - Deep reflexes are exaggerated
stiffness on ante- - Paresis
flexion of spine B. PARALYTIC
- With paralysis depending on the part affected
- Positive hoyne’s sign: head drop
- (+) kernig’s and brudzinki signs:
➔ Kernig: Raise (K)nee → Head will also raise
➔ Brudzinki: Head towards chest (B)aba → leg will
also raise
TYPES OF PARALYSIS
BULBAR SPINAL BULBOSPINAL
Respiratory paralysis Paralysis of the upper and lower Involvement of neurons both in
extremities and intercostal brainstem and the spinal cord
muscles
MED TREATMENT
➢ Antibiotic
▪ Penicillin G- DOC
▪ Chloramphenicol: Alternative
➢ Osmotic Diuretic
▪ Mannitol: Decrease Cerebral Edema
NURSING MANAGEMENT ➢ CNS stimulant
➢ Respiratory Isolation: 24 hours after onset of ▪ Pyrentinol/Encephabol
antibiotic therapy
➢ Provide non-stimulating environment ➢ Anticonvulsant
➢ Initiate seizure precaution ▪ Diazepam.
➢ Avoid factors that increase ICP ▪ Phenytoin (Dilantin): SE Gingival
Hyperplasia
PREVENTIVE
➢ Vaccination: Hib- for children ➢ Corticosteroid
➢ Avoid MOT ▪ Prednisone
➢ Rifampicin: prophylactic treatment ▪ Dexamethasone
➢ Ciprofloxacin: Alternative