Cau52: K/nag gay benh cua fe cau.

a/ K/nag gay benh:

-Doi tuong cam nhiem :Ng

-Dg lay: Ho hap

- Thuong gap fe cau o nhung vung ty hau cua ng lanh voi ti le cao.

- Gay benh dg ho hap, dien hinh la viem foi, fe quan-foi, ap' xe foi, viem mang foi...viem foi thuong xay ra sau khi dg ho hap bi ton thuong do nhiem VK or do hoa chat. Cac typ thuong gay benh la 1,2,3 ( o ng lon) va 1,4,14 o tre em.

- Ngoai ra con gay viem tai, viem xoang, viem hong, viem mang nao ( thuong o tre em) : Viem mang bung, mang tim, viem than, viem tinh hoan, nhiem khuan huyet.

- O noi ton thuong fe cau hinh thanh 1 lop vo day ngan can hien tuong thuc bao, co nhieu fibrin quanh cho ton thuong tao nen vung cach biet lam cho thuoc KS kho tac dug du VK con nhay cam voi nhieu KS, do do chua = KS fai som va triet de.

b/ Phong:

- ko dac hieu: Thuong lay theo dg ho hap =>Viec fong benh ko dac hieu rat kho khan.

- Dac hieu : Vaccin poly saccharid cua vo fe cau thuong su dug vo cua 1 so rerotyp thuong gay benh. Vaccin co tac dug bao ve ko hoan toan nhung co tac dug ngan can nhung nhiem fe cau nang ( Viem mang nao, nhiem khuan huyet)

c/ Dieu tri.

- Fe cau con nhay cam voi KS =>thuong dug penicillin or ket hop penicillin voi gentamycin, co the dug cephalosporin.

- Su khang KS cua fe cau ngay cang tang. Fe cau khang KS = cach thay doi 1 trong 6 protein gan penicillin( PBP) =>giam ai luc gan PBP voi thuoc. Su de khang nay thuong do bien co di truyen.

Cau 53:Nao mo cau:

a/ K/nag gay benh:

- Ng la doi tuong cam nhiem duy nhat cua nao mo cau

- NMC thuong ki sinh o hong mui, o trang thai ko gtay benh.

- Khi dieu kien thuan loi, NMC gay viem hong mui( thuong la nhe, ko co trieu chung), 1 ti le nho tu hong mui xam nhap vao mau, thuong la qua dg bach huyet => gay nhiem khuan huyet. Tu mau, NMC co the den mang nao gay viem mang nao, den da gay nen cac cham or ban xuat huyet; co the gap cac ton thuong o khop, foi. Ton thuong xuat huyet co the gap o da va cac co quan noi tang, dac biet la than do giai phong cac buou noi doc to tren vach TB VK

-nao mo cau con co the gay dong mau noi mach rai rac do 1 luong lon noi doc to dc giai phong va kich thik co the tong hop yeu to hoai tu U loai ((TNF-() va hoat hoa yeu to dong mau 12.

-bien chung nguy hiem nhat cua nhiem khuan huyet do nao mo cau la viem mang nao voi cac trieu trung xuat hien dot ngot:nhuc dau du doi, non mua,co cung, hon me trong vai gio

-roi loan do nhiem nao mo cau la do cac Cytokin, dac biet la TNF-(.

-Yeu to doc luc cua NMC la k/nag khang thuc bao cua vo Poly saccharid va k/nag giai phong 1 luong lon Noi doc to.

b/ Phong:

-Ko dac hieu: phai fat hien som benh va cach li. Tap the nao co ng bi benh or tiep xuc voi ng bi benh fai uong KS fong( nhu Rifampicin or Mynocyclin) vi viem mang nao do NMC lay qua dg ho hap.

-Dac hieu: Vaccin tinh che tu vo polysaccharid cua NMC

c/ Dieu tri:Cang som cang tot.

- KS chon: Penicillin. Neu di ung thi dug Erythromycin or chloramphenicol.

- Dug KS co hieu qua tich cuc fong va dieu tri cac roi loan khac.