Cau 78: khnag gay benh cua vk H.influenzae.

(vr cum gay ra benh cum con H.influenzae la vk an theo sau khi cac tbao niem mac dg ho hap da bi ton thg nag ne boi vr cum)

1/ khnag gay benh:

- H. influenzae ki sinh bat buoc tren niem mac dg ho hap cua ng. H" 75% tre lanh co mang H. influenzae o hong muinhu 1 thanh vien cua vk chi bthuog. o ng lon, ti le nay thap hon.

- benh do H. influenzae thg la thu phat (sau soi, cum), gom: viem mang nao, viem dg ho hap tren (thanh quan, tai giua, xoang), viem dg ho hap duoi (viem phe quan cap va man tinh, viem phoi), nhiem khuan dg huyet, viem noi tam mac (hiem), viem nieu dao va cac nh.trung sinh duc (am dao, co tu cung, tuyen Bartholin, voi tu cung).

- viem mang nao do H. inluenzae la 1 benh nag va cap tinh, can dc chan doan va dtri tu som. o tre em ma khnag de khag giam (suy dinh duog, suy giam mien dich, dag mac cac benh nag khac) vk tu hog mui xam nhap vao mau, roi theo dg mau den mag nao or co the vk den mag nao = cach chui qua xoang sang.

*/p.benh

-vmn do h. inluenzae tyb b lay theo dg ho hap(benh nhan phai duoc cach ly+nguoi lanh tiep xuc voi bnhan phai uong KS du phong

-dac hieu:

+/vain the he I:tinh che tu vo polyacchrid cua h. inlenzae tyb(dap ung mdich tot doi voi tre em>2 tuoi va rat kem o tre nho duoi 2 tuoi. nhuoc diem:tinh sinh mdich kem

+/vacin the he II:gan Kn cua vk vao 1 prtein mang hoat dong nhu 1 ta chat(tinh sinh mdich duoc tang cuong va gay dap ung mdich tot hon the he I o tre nho

*/dieu tri

-khang ampicillin do vk sinh ra men beta-lactamase

-khang chloramphenicol nho men chlororamphenicol acetyl transferase(CAT)( xuc tac qtrinh chuyen hoa 2 nhom acetyl tu CoA( den nhung vi tri hoat dong cua chloramphenicol( tinh uc che tong hop Pr cua chloramphenicol bi mat di

=>dtri cac benh nh.trung do H. inluenzae phai dua vao KSD khi chua co ket qua KSD hoac chua phan lap duoc vk

(hien nay, uu tien chon ampicillin va chloramphenicol hay cephalosporin the he 3

Cau 79:VK bruccella

*/knang gay benh

-gay benh cho DV. Bruccella thuc chat la vk ki sinh o DV.trong dkien thuan loi(gay benh cho vat chu.gay benh cho nhieu loai DV:bo,lon,cho...

+bieu hien:rat thay doi,thuong la xay thai, co khi vk xam nhap vao dg sinh duc cua con duc,gay nen benh o the an

-gay benh cho nguoi:

+/thoi gian u benh 2-4 tuan le, tuong ung voi tki nhiem khuan tai cho.tiep den benh nhan sot,met moi va dau vung co ton thuong.vk vao he thong bach huyet(o nhiem khuan nguyen phat thuong la o hach. benh co the tien trien thanh vrucella cap tinh voi nhiem khuan huyet.neu dieu tri ko tot,sot co the keo dai 2-4 thang

+/tiep theo gd nhiem khuan huyet co the hinh thanh nhung o nhiem khuan thu phat. Do la brucella ban cap khu tru.cac o nhiem khuan chu yeu thuong gap o khop,cac phu tang,bo phan sinh duc hay o mang nao.benh brucella co the x/h som hay muon sau gd cap tinh.thuong thi benh nhan mac benh brucella man tinh,trieu chung ko dien hinh,chu yeu la sot nhe,keo dai,met moi, dau o vung ton thuong, dac biet co cac dau hieu ve tkinh

-duong xam nhap:vk brucella xam nhap vao co the theo:

+/dg tieu hoa: an phai thuc an bi nhiem khuan

+/dg ho hap:hit phai bui co mang vk

+/qua da:do tiep xuc truc tiep voi mam benh. (he thong bach huyet(mau( vao cac co quan(gan lach..)

Trong co the brucella ki sinh noi bao(tinh trang benh man tinh

*/phong

-ko dac hieu: cach ly hay giet cac dong vat bi nhiem benh;khu khuan sua va cac san pham cua sua= p.p Pasteur;tranh tiep xuc voi gia suc de non.xu ly chat thai hay phu tang cua suc vat bi om 1 cach than trong

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*/dieu tri

-brucella cap va ban cap(thuong dung khang sinh phoi hop:tetracycline va streptomycin

-doi voi the man tinh,Ks hau nhu ko co tac dung.chu yeu la giai man cam cho benh nhan= kha nang lieu phap(tiem vacxin vao duoi da benh nhan voi lieu thap)