Контрольная работа по "Иностранному языку"

1. A full-term, healthy male neonate was delivered by caesarian section to a 26-year-old primigravida woman who had a history of fever and upper respiratory tract infection. On the fourth day of life, the neonate developed a sepsis-like syndrome, acute respiratory and renal failure, and disseminated intravascular coagulopathy. He died 13 days after birth. Postmortem examination revealed jaundice, anasarca, massive hepatic necrosis, adrenal hemorrhagic necrosis, renal medullary hemorrhage, hemorrhagic noninflammatory pneumonia, and severe encephalomalacia. 1. Describe the properties and transmission of ECHO type 6.

2. Suggest prevention measures and prophylaxis.

Echovirus type 6 was isolated from blood, liver, and lungs. Although uncommon, echovirus type 6 infection may produce a spectrum of pathologic findings similar to those seen with the more comm virulent echovirus type 11.

Echovirus type 6 (ECHO-6) is a single-stranded RNA virus belonging to the Enterovirus genus of the Picornaviridae family. Here are some key properties and transmission characteristics of ECHO-6:

Virulence: ECHO-6 is considered less virulent compared to some other enteroviruses like ECHO-11. However, in rare cases, it can cause severe illness, particularly in neonates and individuals with compromised immune systems.

Clinical manifestations: ECHO-6 infection can present with a wide range of symptoms, ranging from mild febrile illnesses to more severe manifestations such as respiratory distress, sepsis-like syndrome, hepatic necrosis, and renal failure, as observed in the described case. Jaundice, anasarca (generalized edema), and hemorrhagic complications can also occur.

Transmission: ECHO-6 is primarily transmitted through the fecal-oral route. It can be acquired by ingesting contaminated food or water, or by direct contact with infected individuals or their secretions (e.g., respiratory droplets, feces). The virus can survive for extended periods in the environment, contributing to its transmission.

2, Prevention measures and prophylaxis for ECHO-6 infection involve general strategies for reducing the risk of enterovirus infections:

Hand hygiene: Frequent and thorough handwashing with soap and water, especially after using the toilet, changing diapers, or handling potentially contaminated objects, is crucial to minimize the spread of enteroviruses.

Sanitation: Ensuring clean and hygienic environments, particularly in areas with high population density, can help prevent the contamination of food, water, and surfaces with the virus.

Vaccination: Unfortunately, there is currently no specific vaccine available for ECHO-6. However, maintaining routine immunization schedules, including vaccines against other enteroviruses (such as poliovirus), can indirectly contribute to overall enterovirus infection prevention.

Avoiding close contact with infected individuals: Limiting contact with individuals displaying symptoms of respiratory or gastrointestinal infections, as well as practicing respiratory etiquette (e.g., covering the mouth and nose when coughing or sneezing), can reduce the risk of transmission.

Infection control in healthcare settings: Adhering to proper infection control practices, such as hand hygiene, disinfection of surfaces, and appropriate use of personal protective equipment, is essential in healthcare settings to prevent the spread of ECHO-6 and other infections.

It's important to note that the specific prevention measures and prophylaxis recommendations may vary based on the local guidelines and recommendations provided by public health authorities. It's advisable to consult with healthcare professionals and follow their guidance for the most up-to-date information on prevention and control measures for ECHO-6 and other enterovirus infections.

2. A 55-year-old man is admitted to hospital with headache and confusion. He has a cough and a temperature of 38.2°C. He does not complain of any other symptoms. Two months earlier be had been admitted with a productive cough and acid-fast hacilli had been found in the sputum on direct smear. He had lost weight and complained of occasional night sweats. He had a history of a head injury 10 years previously. He smoked 15 cigarettes a day and drank 40-60 units of alcohol each week. His chest X-ray at the time was reported as showing probable infiltration in the right upper lobe. He looked thin and unwell and he was slightly drowsy. His mini mental test score was 8/10. There were some crackles in the upper zones of the chest posteriorly. His respiratory rate was 22/min. There were no neurological signs.

1. Name the possible pathogen and explain your answer.

2. Describe treatment and prevention.

The possible pathogen in this case is Mycobacterium tuberculosis, the causative agent of tuberculosis (TB). The presence of acid-fast bacilli in the sputum, the history of a productive cough, weight loss, night sweats, and the chest X-ray showing probable infiltration in the right upper lobe are indicative of pulmonary tuberculosis. The patient's symptoms of headache, confusion, and slightly drowsy state may suggest the involvement of the central nervous system, indicating possible tuberculosis meningitis.

2, Treatment and prevention of tuberculosis involve the following approaches:

Treatment: The patient requires immediate initiation of anti-tuberculosis therapy. The standard treatment regimen for tuberculosis typically consists of a combination of multiple antibiotics to prevent the development of drug resistance. This usually includes isoniazid, rifampin, pyrazinamide, and ethambutol. The duration of treatment is typically prolonged (often 6 to 9 months or longer), and the exact regimen and duration may vary based on factors such as the site and severity of the infection, drug susceptibility, and the patient's overall health condition.

Supportive care: In cases of tuberculosis meningitis, supportive care is crucial to manage the patient's symptoms and prevent complications. This may involve measures such as maintaining hydration, managing pain, controlling fever, and addressing any neurological sequelae.

Contact tracing and screening: It is important to identify and screen individuals who have come into close contact with the patient to detect any latent or active tuberculosis infection. This allows for early diagnosis and treatment to prevent further transmission.