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精选优质文档-倾情为你奉上Frequently asked question (in English)Part Noun explanation 1. convert infection/subclinical infection：it means only a special immune response without or with very mild damage to the host after the pathogens entered which can be diagnosed by serologic means with demonstration of either a single high titer or a fourfold rise in titer to the infection.The patients havent any symptoms and signs clinically,no changes of biochemical aspects are present in laboratory findings. It is also called subclinical infection.2. black-water fever: A complication of MALARIA,FALCIPARUM characterized by an acute intravascular hemolysis, hemoglobinuria and hemolytic jaundice when the red blood cells are destroyed and lytic in the blood vessel，severe patients can result in acute renal failure. Most commomly in those who have taken antimalarial treatment irregularly or are deficient in G-6-PD.May be provoked by administering primaquine or chlorquine, or by fatigue. It is also called hemolytic urinemic syndrome3. carrier state(病原携带状态)：it is a person who is colonized with an organism but shows no evidence of disease, although disease may have been present earlier. A carrier is a very important source of infection as the organisms can be disseminated from him.4. latent infection(潜伏性感染)：it means an organism enters a host and lies dormant( 静止的) for a period of time, possibly for years, before producing disease as the hosts immunity decreased.5. invasiveness(侵袭力)：the ability of the agent to enter and to move through tissue.6. source of infection(传染源)： it is referred to a person or animal in which the pathogen stay and multiply and can be disseminated .7. route of transmission(传播途径): the route the pathogen entered another susceptible after been disseminated from the source of infection.8. susceptible(易感者): it is referred to a person who lacks immunity to a specific infectious disease.9. relapse(复发)：it means the return of symptoms after they have apparently ceased during convalescence which is caused by the multiplication of the pathogen in the host. It is often seen in typhoid fever, malaria, et al.10. recrudescence(再燃): it means the reappearance of symptoms after temporary cessation.11. sustained fever (稽留热）: high fever, lasting and little change in 24 hours, usually 1 degree in 24 hours, but the lowest point of the fever is still above the upper limit of the normal temperature. Often seen in the defervascence of typhoid fever or EHF.13. relapsing fever回归热）: several days of high fever with interruption of a few days normality. typical fever pattern in brucellosis and relapsing fever.14. Intermittent fever（间歇热）: temperature fluctuates between the high fever and the degree below the normality. Usually seen in septicemia and malaria. 15. Irregular fever（不规则热）:the fever curve is irregular. Seen in influenza or septicemia.16. palmer erythema/liver palm(肝掌): This is intense reddening, mottled in nature, of the palmer aspects due to vasodilation. Seen mainly over the thenar and hypothenar（大、小鱼际） eminences.17. spider angiomata(蜘蛛痣)：Spider angiomata are small red macules with fine red lines radiating from it like spider legs. They blanch when compressed(压之褪色). They represent tiny dilated collateral blood vessels and are seen in patients with chronic hepatitis or cirrhosis.18. window phase（窗口期）：The window phase is the time from exposure to the organism until one is tested positive for the infection. Someone in the window phase may test negative but actually be positive and able to spread the organism.19. street strain(野毒株/街毒株): it is referred to rabies virus isolated from the naturally infected animals or human with strong pathogenecity and long incubation period.20. fixed strain(固定毒株): After being subcultured in rabbit brain for many times (at least 50 times), the virulence of the street strain decreased greatly, but its immunogenicity remained. It is called fixed strain and often used for vaccine production.21. Negri body（内基本氏小体）: Negri body is pathognomonic for rabies virus infection. It is oval eosinophilic neuronal cytoplasmic inclusion measuring 3-10 micron in diameter. They are most consistenetly seen in the pyramidal cells of hippocampus and Purkinje cells of cerebellum.22. septicemia(败血症)：Septicemia is an acute generalized infection caused by the invasion into the blood stream of a pathogenic or an opportunistic organism. While staying persistently and multiplying rapidly in the blood stream, these organisms liberate toxins or metabolites which elicit general toxic symptoms and tissue damage of various organs.23. bacteriemia（菌血症）：The bacteria enter the blood and multiply in it, but stay only a short time and dont liberate toxins or metabolites which elicit general toxic symptoms and tissue damage of various organs. 24. pyemia（脓毒血症）: The multiplying site of bacteria is also in the blood, but it is caused by pyogenic（化脓性的）gram-positive cocci, metastatic lesions are always present, the symptoms are the same as septicemia.25. toxemia（毒血症）: The bacteria only live and multiply in the local parts of the body, they dont enter the blood stream, but the toxins and metabolites liberated by them do. The symptoms are similar to septicemia.26. rose spots(玫瑰疹)：They are blanking pink macular spots 2-4 mm in diameter at day 713 of typhoid fever. The rash is seen most commonly on the thorax and abdomen, rarely on back and the extremities. 27. relative bradycardia(相对缓脉)：it means pulse-temperature dissociation. It is usually defined as increase in heart rate 10 beats/minutes/1C increase in temperature in adults. It is usually seen in typhoid fever, acute schistosomiasis, severe jaundice, et al.28. herxheimer reaction(赫氏反应): It is caused as a direct result of using spirocheticidal drugs (mainly antibiotics) to treat individuals with a disease which results in an increase in the symptoms of the treated condition.29. hemolytic urinemic syndrome /black urine fever: A serious, often fatal complication of malaria, characterized by an acute intravascular hemolysis, hemoglobinuria and hemolytic jaundice. It is often provoked by antimalarial drugs.30. ectopic lesion(异位损害): the schistosome eggs and/or adult worm migrate and parasitize the organs outside the portal venous system and cause damages. It is relatively high in lung and brain.31. Hepatorenal syndrome: Acute renal failure occurring without other cause in a person with severe liver disease. The exact cause of hepatorenal syndrome is unknown. The kidney structure remains essentially normal and the kidneys often will instantly function well if the liver disease is corrected.32. Widals test: A test involving agglutination of typhoid bacilli when they are mixed with serum containing typhoid antibodies from an individual having typhoid fever; used to detect the presence of Salmonella typhi and S. paratyphi.Part : Qustion.1. the five manifestation of infection(感染过程的五种表现)l Pathogen is killed or eliminated;l Covert infection or subclinical infection, it is usually the most common;l Overt infection or clinical infection: the pathogen enter the host and caused damages as well as immunological response. It is usually easy to be recognized in clinics.l Carrier state: It is a very important source of infection;l Latent infection: it is usually seen in herpesviridae, tuberculosis, malaria, et al.2. Please describe briefly the factors involved in the pathogenecity of a pathogen(致病能力包括哪几个方面)?l Invasiveness: the ability of the agent to enter and to move through tissues;l Virulence: it is consists of toxins and other virulent factors;l Quantity: bigger quantity, stronger pathogenecity in the same disease;l Variability: The pathogen may mutate under the pressure of the environment or host. 3. the prerequisite of an epidemic of a communicable disease?(传染病流行的必要条件)Three prerequisite are required for a communicable disease to spread. First, there must be a source of infection which disseminate pathogen continuously. Second, there must some persons who lack special immunity to the disease, ie, susceptible. Last, the pathogen must reach the susceptible, the route of transmission.4. the basic characteristic of communicable disease（传染病的基本特征）?The main difference between communicable disease and other disease is that the former has four basic characteristics. All communicable diseases are infectious diseases and both are caused by a pathogen. But the former have infectivity/ communicability, it is the main difference between them. And communicable diseases have some epidemiological feature. In addition, there is post-infection immunity no matter covert infection or overt infection.5.clinical characteristics / diagnostic criteria of fulminant hepatitis/hepatitis gravis(重型肝炎的诊断标准)?Fulminant hepatitis is a rare syndrome usually associated with hepatitis B. It is characterized by rapid clinical deterioration. Its diagnostic criteria in our country is:l Severe digestive disorder: poor feeding, nausea and frequent vomiting, fatigue; l Progressively deepened jaundice;l Hepatoencephalopathy;l Hepatorenal syndrome;l Decreased volume of liver;l Bleeding pronenss;l Rapidly increased ascites6.clinical characteristics / diagnostic criteria of cholestatic hepatitis？l Clinical symptoms: Jaundice is the main manifestation and it lasts longer than three weeks. Skin itch is usually more severe at night. Rashes can occur on the neck, chest, back, and wrists. Stool color becomes lighter and urine color becomes darker. Although there can be many symptoms, the patient usually will not feel extremely ill. l Laboratory tests: Direct bilirubin in the serum elevated and its proportion is more than 60% of the total bilirubin. Serum combined bile acid elevated to 10 to 20 times higher than the normal range. AKP, GGT, cholesterol, and 5- nucleotidase are obviously elevated, and the ALT elevation is moderate. l B-Ultrasound: It can distinguish intra or extra liver obstruction. 7.common / main manifestation of acute viral hepatitis？l Malaise, anorexia, fever, dark urine, pale stools, jaundice, right upper quadrant pain and tender hepatomegaly;l Increased liver enzymes (ALT, AST), bilirubin, prothrombin time and globulin;l Serum positive for hepatic virus;l May have history of recent ingestion of undercooked shellfish or sewage-contaminated water.8.main manifestation of epidemic encephalitis B?The disease is mainly manifested by high fever, impairment of consciousness, convulsion, respiratory failure. Signs of meningeal irritation, increased intracranial pressure and other neurological signs. The typical profile in cases of epidemic encephalitis B is lymphocytic pleocytosis, normal or slightly elevated protein level, normal glucose level, and elevated CSF pressure. The specific IgM antibody detection is most useful for the diagnosis of this disease.9.the principal of wound treatment after bitten by a rabid dog(被狂犬咬伤后伤口处理)?The wound should be thoroughly cleansed for half an hour, preferably with a quaternary ammonium detergent(季胺类消毒液) or 20% soap (which can not be mixed together); then rinse with 70% ethanol or iodine; damaged tissues should be excised and the wound left unsatured. Rabies can usually be prevented if treatment is started within a day or two of biting. For maximum protection hyperimmune serum and vaccine are required. One should pay attention to tetanus and infection of other bacteria.10. main manifestation of rabies/ hydrophobia?The disease begins as a nonspecific illness marked by fever, headache, malaise, nausea, and vomiting. Abnormal sensations at or around the site of viral inoculation occur frequently and probably reflect local nerve involvement. After the prodromal period of 24 days, the characteristic fear of water, responsible for the alternative name of hydrophobia, and fear of wind, becomes evident in many cases. Delusions and hallucinations may develop accompanied by spitting, biting and, and maniacal behavior, with lucid intervals in which the patient is acutely anxious. Cranial nerve lesions develop and terminal hyperpyrexia is common. Death ensues, usually within a week from the onset of symptoms.11.describe briefly the five phase of hemorrhagic fever with renal syndrome.Typical cases of HFRS evolve in 5 stages: the febrile stage with myalgia, lasting 3 to 4 days; the hypotensive stage, often associated with shock and lasting from a few hours to 48h; the oliguric phase usually lasts from 3 to 7 days. The rising concentration of blood urea and creatinine is accompanied by persistent oliguria. the diuretic stage with diuresis and hyposthenuria; and the convalescent stage, getting full recovery within 1 to 6 months.12.main manifestation of sepeticemiaThe main clinical manifestations of septicemia are chills, high fever, severe toxemic symptoms(such as headache, dysphoria), petechia（瘀点）,arthralgia（关节痛）, hepatosplenomegaly（肝脾肿大）, some patients may have metastatic（迁徙性） lesions;in severe patients, septic shock, toxic cerebrosis（脑病）, toxic pneumonia, toxic myocarditis（心肌炎）,toxic hepatitis and toxic enteritis（肠炎） may be present13.the key points of blood culture（1）before administration of antibiotics and during chills or high fever；（2）repeat more than 3 times；（3）the amount of the blood sample should be10ml in adults or older children, 5ml in infants；（4）blood samples should be treated with chemicals if antibiotics was used before or use blood clot for culture. bone marrow culture is recommended; drug sensitivity test is very necessary.14.main manifestation of epidemic cerebrospinal meningitisEpidemic encephalitis B is an encephalitis caused by flavovirus, which belongs to the family of Togaviruse. The infection is transmitted by mosquito.The disease is mainly manifested by high fever, impairment of consciousness, convulsion, respiratory failure. Signs of meningeal irritation, increased intracranial pressure and other neurological signs. The typical profile in cases of epidemic encephalitis B is lymphocytic pleocytosis, normal or slightly elevated protein level, normal glucose level, and elevated CSF pressure. The specific IgM antibody detection is most useful for the diagnosis of this disease.15.therapeutic principals of fulminant meningococcal meningitis?specific antibiotics should be given intravenously promptly. The preferred drug is penicillin; anti-shock therapy; use of glucocorticoids(糖皮质激素) such as methylprednisolone or DXM; if clinical signs suggest cerebral edema or the cerebrospinal fluid pressure is very high, measures to reduce brain swelling are indicated; anticoagulant therapy if DIC is present; supportive therapy to maintain vital organs. 16.main characteristic of typhoid feverTyphoid fever, also called enteric fever, is characterized by sustained fever, gastrointestinal symptoms, rose spots, relative bradycardia, hepatoslenomegaly, neuropsychiatric features and leukopenia. The clinical course of the disease can be divided into 4 stages:（1）prodromal stage, （2）stage of prominent manifestation,（3）remission stage, and（4）convalescent stage. The two major complications are intestinal hemorrhage and perforation, both can be life-threatening.17. main characteristic of bacillary dysentery/shigellosisshigellosis is an acute bacterial infection caused by the genus Shigella resulting in colitis affecting predominantly the rectosigmoid colon. It is characterized by fever, diarrhea, abdominal pain, and tenesmus. It is usually limited to a few days. Early treatment with antimicrobial drugs results in more rapid recovery.18. main manifestation of cholera（霍乱）.Cholera is an acute, sometimes fulminant watery diarrheal disease resulting from an enterotoxin elaborated by Vibiro. Cholerae in the small intestine. It generally occurs in epidemics and may cause a rapid massive gastrointestinal fluid loss with extreme saline depletion, acidosis, and shock.19.main manifestation of leptospirosis（钩体病）Leptospirosis is a zoonotic (动物源的) disease of worldwidedistribution caused by spirochetes (螺旋体) of the genus (种) Leptospira. It is divided into three phases according to its clinical manifestation: the initial phase: leptospira bacteremia (钩体菌血症); the second phase: organic injury and dysfunction; the third phase: immune response. The initial clinical symptoms are fever, headache, myalgia (肌痛), conjunctival injection (眼结膜充血) and swelling of lymph nodes (淋巴结肿大), in some cases followed by a more severe illness that may include jaundice (黄疸) and renal failure, meningitis (脑膜炎) or hemorrhagic pneumonitis (出血性肺炎). Intravenous penicillin has demonstrated good clinical efficacy for leptospirosis. 20.amebic colitis/ intestinal amebiasis (肠阿米巴病) .Amebiasis is defined as infection with the protozoan parasite Entamoeba histolytica. The manifestation of amebic colitis may be subtle or severe and range from mild watery diarrhea to explosive, bloody dysentery with a fulminant couse. Amebic colitis mainly presents with lower abdominal pain, mild diarrhea, malaise, and weight loss. The stools contain little fecal material and consist chiefly of blood and mucus.21.main manifestation of hepatic amebiasis/ amebic liver abscess(肝阿米巴病/阿米巴肝脓肿).Amebic liver abscess is the most common extraintestinal manifestation of amebiasis. Patients may note right-upper-quadrant pain that is either dull or pleuritic in nature. Often pain is referred to the right upper shoulder. Less than 50% of patients have an enlarged liver. Patients typically manifest long-term fever and weight loss. Diarrhea is found in less than one-third of patients with Amebic liver abscess. Exam may reveal abdominal tenderness, tender hepatomegaly, and crackles at right lung base. Jaundice is uncommon.22. main manifestation of malaria(疟疾)The first symptoms of malaria are nonspecific, including the lack of a sense of well-being, fever, headache, fatigue, and abdominal discomfort. The classic“trilogy” of malarial paroxysm(发作) includes chills, rigors, spike fever（体温骤升骤降）, and heavy sweating. The intervals are irregular in P. falciparum（恶性疟）, within 48h in P. vivax（间日疟）, and 72h in P. malariae（三日疟）, respectively. Splenic enlargement is very common.The diagnosis of malaria rests on the demonstration of the parasite in peripheral blood smears. Both thin and thick blood smears should be examined.23. the prerequisite for the epidemic of schistosomiasis(血吸虫病) .the epidemic of schistosomiasis in any specific area is dependent upon the unsanitary disposal of faeces, the presence of suitable snail hosts, and human exposure to cercaria-infected (尾蚴) water bodies.24. main manifestations of acute schistosomiasis?The majority of infected person are asymptomatic or have mild, nonspecific symptoms. Only 5 to 10 percent of infected populations have severe clinical symptoms. They include chills, spiking fever, generalized weakness, myalgia, headache, anorexia, profuse diarrhea, and weight loss. Extensive urticaria may occur in large patches on various parts of the body. Nausea and vomiting are common and cough may be prominent. The fever usually lyses spontaneously 2 to10 weeks after onset.Physical findings are usually minimal but many include urticaria, patches of moist rales over both lung fields, generalized lymphadenopathy, and hepatosplenomegaly. Marked elevation of peripheral blood eosinophilia is common.25.Hemodialysis indication :Oliguric lasts4d，or anuria 24hConcentration of blood urea nitrogen and creatinine increased:BuN28.56mmol/lHigh catabolism state Hyperkalemia, Pulmonary edema or hypervolemic syntromeCc15. Differential Diagnnosis of Epidemic encephalitis Meningoc
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