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1、-Frequently asked question (in English)Part Noun e*planation 1. convert infection/subclinical infection(隐性感染/亚临床感染)：it means only a special immune response without or with very mild damage to the host after the agent entered which can be diagnosed by serologic means with demonstration of either a si
2、ngle high titer or a fourfold rise in titer to the infection. It is the most mon model.2. 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
3、organisms can be disseminated from him.3. 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.4. invasiveness(侵袭力)：the ability of the agent to enter and to move through ti
4、ssue.5. 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 .6. route of transmission(传播途径): the route the pathogen entered another susceptible after been disseminated from the source of infection.7. susceptible(易感者): it is r
5、eferred to a person who lacks immunity to a specific infectious disease.8. 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.9. recrud
6、escence(再燃): it means the reappearance of symptoms after temporary cessation.10. 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 deferva
7、scence of typhoid fever or EHF.12. 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.13. Intermittent fever间歇热: temperature fluctuates between the high fever and the degree below the normality. Usually s
8、een in septicemia and malaria. 14. Irregular fever不规则热:the fever curve is irregular. Seen in influenza or septicemia.15. palmer erythema/liver palm(肝掌): This is intense reddening, mottled in nature, of the palmer aspects due to vasodilation. Seen mainly over the thenarand hypothenar大、小鱼际 eminences.1
9、6. spider angiomata(蜘蛛痣)：Spider angiomata are small red macules with fine red lines radiating from it like spider legs. They blanch when pressed(压之褪色). They represent tiny dilated collateral blood vessels and are seen in patients with chronic hepatitis or cirrhosis.17. window phase窗口期：The window pha
10、se is the time from e*posure 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.18. street strain(野毒株/街毒株): it is referred to rabies virusisolated from the naturallyinfected animals or
11、 human with strong pathogenecity and long incubation period.19. fi*ed 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 fi*ed strain and often used for vaccine
12、production.20. Negri body根本氏小体: 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.21. septicemia(败血症
13、)：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 to*ins or metabolites which elicit general to*ic symptoms and tis
14、sue damage of various organs.22. bacteriemia菌血症：The bacteria enter the blood and multiply in it, but stay only a short time and dont liberate to*ins or metabolites which elicit general to*ic symptoms and tissue damage of various organs.23. pyemia脓毒血症: The multiplying site of bacteria is also in the
15、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.24. to*emia毒血症: The bacteria only live and multiply in the local parts of the body, they dont enter the blood stream,but the to*ins and metabolites liberated by th
16、em do.The symptoms are similar to septicemia.25. 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 monly on the thora* and abdomen, rarely on back and the e*tremities. 26. relative bradycardia(相对缓脉)：it means pulse-temperature d
17、issociation. 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.27. her*heimer reaction(赫氏反响):It is caused as a direct result of using spirocheticidal drugs (mainly
18、antibiotics) to treat individuals with a spirochetaldisease which results in an increase in the symptoms of the treated condition.28. hemolytic urinemic syndrome /black urine fever: A serious, often fatal plication of malaria, characterized by an acute intravascular hemolysis, hemoglobinuria and hem
19、olytic jaundice. It is often provoked by antimalarial drugs.29. 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.30. Hepatorenal syndrome: Acute renal failure occ
20、urring without other cause in a person with severe liver disease. The e*act 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.31. Widals test: A test involving agglutination o
21、f typhoid bacilli when they are mi*ed 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 infecti
22、on or subclinical infection, it is usually the most mon;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 infec
23、tion: 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 to*ins and other virulen
24、t 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 municable disease(传染病流行的必要条件)Three prerequisite are required for a municable disease to spre
25、ad. 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 municable disease
26、传染病的根本特征The main difference between municable disease and other disease is that the former has four basic characteristics. All municable diseases are infectious diseases and both are caused by a pathogen. But the former have infectivity/ municability, it is the main difference between them. And muni
27、cable 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 w
28、ith 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 live
29、r;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, bac
30、k, and wrists. Stool color bees lighter and urine color bees darker. Although there can be many symptoms, the patient usually will not feel e*tremely ill. l Laboratory tests: Direct bilirubin in the serum elevated and its proportion is more than 60% of the total bilirubin. Serum bined bile acid elev
31、ated 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 e*tra liver obstruction. 7.mon / main manifestation of acute viral hepatitis.l Malaise, anore*ia, fev
32、er, 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.th
33、e 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 mi*ed together); then rinse with 70% ethanol or iodine; damaged tissues should be e*ci
34、sed and the wound left unsatured. Rabies can usually be prevented if treatment is started within a day or two of biting. For ma*imum protection hyperimmune serum and vaccine are required. One should pay attention to tetanus and infection of other bacteria.9.the key points of blood culture1before adm
35、inistration of antibiotics and during chills or high fever；2repeat more than 3 times；3the amount of the blood sample should be10ml in adults or older children, 5ml in infants；4blood samples should be treated with chemicals if antibiotics was used before or use blood clot for culture. bone marrow cul
36、ture is remended; drug sensitivity test is very necessary.10.therapeutic principals of fulminant meningococcal meningitisspecific 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 D*M;
37、 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. 11. main manifestation of cholera霍乱.Cholera is an acute, sometimes fulmin
38、ant watery diarrheal disease resulting from an enteroto*in elaborated by Vibiro. Cholerae in the small intestine. It generally occurs in epidemics and may cause a rapid massive gastrointestinal fluid loss with e*treme saline depletion, acidosis, and shock.12 main manifestation of malaria(疟疾)The firs
39、t symptoms of malaria are nonspecific, including the lack of a sense of well-being, fever, headache, fatigue, and abdominal disfort. The classic“trilogy of malarial paro*ysm(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 48
40、h in P. viva*间日疟,and 72h in P. malariae三日疟, respectively. Splenic enlargement is very mon.The diagnosis of malaria rests on the demonstration of the parasite in peripheral blood smears. Both thin and thick blood smears should be e*amined.13. theprerequisite for the transmission of schistosomiasis(血吸
41、虫病) . the unsanitary disposal of faeces, the presence of suitable snail hosts, a human e*posure to cercaria-infected (尾蚴) water bodies.14. main manifestations of acute schistosomiasisThe majority of infected person are asymptomatic or have mild, nonspecific symptoms. Only 5 to 10 percent of infected
42、 populations have severe clinical symptoms. They include chills, spiking fever, generalized weakness, myalgia, headache, anore*ia, profuse diarrhea, and weight loss. E*tensive urticaria may occur in large patches on various parts of the body. Nausea and vomiting are mon and cough may be prominent. T
43、he 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 mon.15Hemodialysis i
44、ndication :Oliguric lasts4d，or anuria 24hConcentration of blood urea nitrogen and creatinine increased:BuN28.56mmol/lHigh catabolism Hyperkalemia, 6mmol/lPulmonary edema or hypervolemic state15. Differential Diagnnosis ofcentral nervous systeminfectionsMeningococcal PurulentTuberulous Epidemic To*ic
45、 meningitis cerobrosoinalmeningitismenigitisencephalitis Shigellosis Etiology Meningococcus Other bacterial T.B Encephalitis B virus Shigelle Onset abrupt slow slow abrupt abruptAge 10year any age any age 1.0 1.0 0.050.3 0.050.5 normalGlucose normal normalChloride normal normalStoolroutine normal normal normal normal +16.The main Difference Between G- Septicemia and Typhoid FeverG -Septiemia Typhoid FeverOnset abruptly insidiously or slowlyTo*ic Symptoms severe slightGastrointestinal Symptoms seldom
