Cau 83:truc khuan mu xanh

*knang gay benh:TKMX la vk gay benh co hoi o nguoi TKMX chi co knang gay benh khi hang rao bve co the bi ton thg

+/da,niem mac(b.nhan dug thuoc dg tieu hoa, dug cac dug cu can thiep nhu o g noi khi quan, catheter dg tinh mach,sonde dg tiet nieu, bong, chan thuong...)

+benh nhan bi suy giam mien dich khi dung thuoc

Vd:dtri ung thu, dung corticoid keo dai

( nhung yeu to nay tao dkien cho vk xam nhap vao da,n.mac gay nh.trung tai cho va nh.trug toan than

-cac nh.trung do TKMX gay nen gom:

1/viem phoi:b.nhan suy jam mdich, Bn ug thu, dang dtri tai khoa hoi suc cap cuu

2/viem xuong tuy:bn dai thao dg de bi loet chi do TkMX.tre em co the bi viem tuy xuong thu phat sau cac nh.trung vet thuong o chan:rach da do gai, dinh

3/nh.trung viet bong: thuong gap, lien quan den nh.trung benh vien. TK MX thuong phat trien tai cac vet bong(tao mu cac vet thuong mau xanh.1so t.hop nh.trung mau

4/nh.trung mau

5/nhiem khuan tiet nieu: hay gap o BN sau cac phau thuat he thong tiet nieu phai dat sonde, Bn di chung tk, Bn tan tat

6/viem noi tam mac:tu cau vang va TKMX la 2 nguyen nhan thuong gap gay viem noi tam mac o b.nhan thuog dung thuoc dg tinh mach

7/viem og tai ngoai:hay gap o ng cao tuoi bi dai thao dg.

8/viem ket mac, giac mac: o doi tuog dug kinh ap trong.

9/viem da,viem mo,to chuc, viem da day,ruot

-ng.nhan lam tag knang gay benh TKMX o mtruong benh vien

+/su dug thuoc kh.sinh bua bai trong dtri => chon loc ra cac chung vk khag da KS

+/su dung rong rai cac thuoc chong viem, uc che mien dich. Vd:coticoid

+/su dung da dang cac dung cu tham do: ong sonde, ong noi khi quan,cartherter TM, may tho,loc mau than( cac dang kho khu khuan)

+/lay lan cheo nguon vk (.) bnhan. BN-BN, BN-BS

*/phong: -ko dac hieu la chinh: mdich ngan chan cac nguy co lam TKMX thanh vkhuan gay benh

+/tang cuong b.phap vo trung vet thuong,vet bong

+/vo khuan dung cu: sonde..

+/ve sinh mtruong bvien

+/dtri theo khuyen cao cua khang sinh do

*/dieu tri: -dung cac KS thuoc phan nhom pseudo, penicillin. Vd:peperacillin,

Cau 84: dd nhom myxovr

*/dac diem chung:

-la nhung vk co knang xam nhap va gay benh o niem mac dg ho hap

-dac diem cau tao

+acid nhan mangARN(1soi

+vo capid co doi xung xoan

+co vo bao ngoai. Tren be mat vo bao mang KN gay ngung ket hong cau

-ban chat Kn: cau tao boi 2 tp:+hemagglutinin (H)

+Neuraminidase (N)

(yeu to H va N rat hay thay doi tao thanh chung vr moi

-dua vao dac diem cau truc va knang gay benh chia lam 2 nhom chinh

+ orthomyxovr: gay cum A,B,C

+paramyxovr:quai bi, soi, RSV, a cum, 1 so benh tren dong vat

-qua trinh giai phong vr: theo hinh thuc nay choi

-doi tuong cam nhiem: nguoi va dv

*/cac vr gay benh chinh: vr cum(influenza vr)

Vr soi(measles vr hoac rubeola vr)

Vr quai bi(mump vr)