Infection

Infection Dr.
Abo El -Asrar
infection
Infection
Infection slide
Infection Infection
scheme
scheme causative organism source of infection route of infection Infection incubation period Incubation period Incubation
Infectivity period
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Infection Dr. Abo El -Asrar
Infectious clinical pictures complications differential diagnosis Investigations treatment prevention and active treatment
skeleton source of infection
Source of infection
source of infection carrier case human sources case or carrier animal source route of infection
animal source
Route of infection
feco oral
droplet infection parentral infection sex
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feco oral droplet parentral .. Incubation period
Incubation period
Incubation period Incubation period
Curriculum
incubation period incubation period
scarlet fever diphtheria Incubation period 6 2 scarlet fever measles T.B.
Incubation period scarlet fever diphtheria polio measles T.B. Prevention Infection
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golden rules Prevention
avoidance of exposure to sources of infection
droplet infection Avoidance of exposure to sources of infection
Immunization Immunization passive active passive immunization
sepsis
viral infection Immunoglobulin bacterial infection
chemo prophylaxis
bacterial infection meningitis chemo prophylaxis rifampcin anti toxins
anti toxins infection Infection neutralizing anti toxins vaccine Anti toxins passive immuno globulin chemo prophylaxis anti toxins
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vaccine
active immunization vaccine
attenuated
vaccines vaccination organism Live attenuated vaccine killed toxid genetic engineering genetic vaccines killed live attenuated
genetic engineering
toxoid
vaccine vaccination Immunization
active treatment
Active treatment
non infectious
spread of infection non infectious Specific treatment causative organism specific treatment Organism symptomatic treatment anti pyretic anti histaminic symptoms
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Infection Dr. Abo El -Asrar complications complications active treatment causative organism specific treatment symptomatic treatment under lying complications
Infection differential diagnosis of skin rash
Differential diagnosis of skin rash

skin rash Infection skin rash 2/3
Just discoloration of the skin surface of the skin discolored macule
discoloration raised above the surface of the skin papule papule degeneration Vesicle vesicle secondary bacterial infection
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Infection Dr. Abo El -Asrar Pus Pustule Pustule vesicle crust
fever systemic
skin rash Fever and rash
fever and maculo papular rash maculo papular rash erythema rosella infantum scarlet fever rubella measles infectiosum sweat rash drug eruption
fever
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fever rash patho gnomonic signs Patho gnomonic sign sign differential diagnosis patho gnomonic signs rash fever
measles
Measles
measles fever
fever measles high grade fever high grade fever 38.5

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febrile convulsion Even acute onset of fever
viral infection
rhinitis High grade fever
rhinitis bronchitis
conjunctivitis
40 anti pyretic Measles
patho gnomonic sign
rash rash 40 38.5 high grade fever Low grade fever
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Infection Dr. Abo El -Asrar rash 38.5 38 rash gradually gradually suddenly rash
low grade
gradually rash maculo papular rash hair line
neck nipple line
hair line nipple line 24 fever 38.5
extended trunk mid thigh rash mid thigh 38

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rash
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Infection Dr. Abo El -Asrar Maculo papular rash
rash
sole sole sole palm sole
palm
palm rash
palm
rash rash sequence Hair line neck rash maximum rash
rash rash rash
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Infection Dr. Abo El -Asrar branny desquamation rash
branny desquamation
branny
branny desquamation dorsum of the hand dorsum of the foot
branny desquamation Palm branny desquamation dorsum surface palmer surface
rash measles patho gnomonic sign measles
measles
patho gnomonic sign Kopliks spots kopliks spots Pro dromal stage High grade fever
Koplik's spots rash
rash
prodroma rash
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Kopliks spots eruptic stage
12
rash Koplik's spots
rash
Maculo papular rash rubella
Rubella
Low grade fever fever fever low grade fever Onset rubella
offset
History rash macul papular rash hair line
maculo papular rash hair line
extending
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Infection Dr. Abo El -Asrar measles
hair line
sole
palm rash
measles
branny desquamation
Patho gnomonic sign Patho gnomonic sign occipital post auricular Lymph nodes post auricular and occipital lymph node Are enlarged and tender
rubella mother
Occipital
post auricular Lymph nodes
congenital rubella syndrome scarlet fever
Scarlet fever
pattern of fever
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scarlet fever
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Infection Dr. Abo El -Asrar scarlet fever pattern High grade fever measles differential diagnosis of rash
scarlet fever High grade fever sore throat sore throat
shivering
even
fever
streptococci antibiotic streptococci toxins feverish still
tonsillitis follicular tonsillitis antibiotic
48 onset of therapy
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Infection Dr. Abo El -Asrar streptococcal infection antibiotic therapy
rash rash erythematous rash erythogenic toxins vasodilatation of all vessels rash
erythrogenic toxins
flushing
circum oral pallor circum oral pallor lips Lips circum oral pallor lips skin orbicularis oris muscle subcutaneous vessels dilated vessels flushing flushing circum oral pallor
circum oral pallor
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erythematous
vaso dilated capillaries Pressure
blanching
vaso dilated capillaries
sole
Palm
palm and sole
sole
Palm sole palm measles sole palm
rash branny desquamation palmer surface dorsum
rash
branny desquamation
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Infection Dr. Abo El -Asrar History of high grade fever maculo papular rash rash branny desquamation
fever
measles scarlet fever
scarlet fever measles history history
measles
scarlet fever Sole palm desquamation scarlet fever desquamation measles
Patho gnomonic sign scarlet fever patho gnomonic sign pathognomonic sign Strawberry tongue Sign red strawberry tongue white strawberry tongue red strawberry tongue white scarlet fever pathognomonic sign
roseola infantum
Roseola infantum
roseola infantum fever fever
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Infection Dr. Abo El -Asrar roseola infantum High grade fever acute fever
Onset
acute fever acute fever High grade fever
high grade fever
trunk maculopapular rash afebrile rash maculopapular rash
afebrile
high grade fever Measles rash rash sudden drop of temperature drop abruptly temperature
rash
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Infection Dr. Abo El -Asrar Maculopapular rash trunk extending to the extremities hair line Measles
high grade fever rash
High grade fever rash
Measles roseola infantum
measles Roseola infantum
fever gradual drop sudden drop rash
measles Roseola infantum extending
Hair line trunk
rash Roseola infantum branny desquamation
pathognomonic sign pathognomonic sign

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Erythema Infectiosum
fever Low grade fever High grade fever afebrile variable fever fever high grade Low grade fever
rash slapping cheeks rash
slapping cheeks abuse
trunk slapping cheeks trunk rash erythema infectiousum pathognomonic sign

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Infection Dr. Abo El -Asrar rash fever vesicular rash vesicle pustule Macule, papule crust
chicken pox herpes simplex Herpes zoster chicken pox
Chicken pox
fever chicken pox chicken pox
chicken pox fever Low grade fever low grade fever fever Low grade fever
rash rash spread rash Macule papule

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Infection Dr. Abo El -Asrar vesicle pustule pustule vesicle Papule pus
macule rash paleomorphic rash rash paleomorphic rash paleomorhphic rash
trunk
centripetal
rash
septic papular urticaria
exposed extremities
rash chicken pox
rash
trunk chicken pox
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Infection Dr. Abo El -Asrar paleomorphic paleomorphic centripetal trunk extremities
rash secondary bacterial infection
scars
Guillain Barre syndrome secondary bacterial infection scars Guillain Barre syndrome encephalitis
chicken pox
pathognomoncic sign pathognomonic sign vesicular rash
Herpes Simplex
High grade fever
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source of infection
tonsilitis otitis media Pyelonephritis
focus of infection
I dont know
viruses frankly bacterial infection random antibiotic give
even rash
Ulcers Ulcers Mucocutaneous junction mouth
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Herpes antibiotics antibiotics bacterial flora flaring up virus antibiotics specific treatment
herpes simplex
Herpes Zoster
Herpes Zoster
Varicella chicken pox virus posterior root ganglion Extend

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Infection Dr. Abo El -Asrar reactivation fever
root Radicular pain distribution of the nerve mandibular division trigeminal C2 sparing Mandibular division rash
Ophthalmic division Herpetic ulcer Cornea Keratitis corneal ulcers corneal opacity blindness
measles
Measles
Causative organism
causative organism measles virus virus
Source of infection
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Infection Dr. Abo El -Asrar Only Measles carrier measles cases
human animals
cases only
Route of infection
Infection Droplet infection virus Nasal mucosa
nasopharynx
Nose throat throat nasopharynx Infection
virus throat Mucosa Implanted nasopharynx
incubation period
Incubation period
Prodromal stage clinical pictures rash

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Infectious
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Infection Dr. Abo El -Asrar Measles onset of rash rash Infectious
Infectively period
rash rash 12 infectious rash infectively period rash
rash rash rash rash after disappearance of the rash rash rash rash
Clinically
prodromal stage rash

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erupted stage
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Infection Dr. Abo El -Asrar recovery stage convalescence stage
prodromal stage prodromal stage high grade fever conjunctivitis rhinitis rhinitis
Coryza
common cold high grade fever Conjunctivitis Rhinitis bronchitis
fever and bronchitis cough Measles conjunctivitis
throat cough reflex
virus throat
High grade fever bronchitis rhinitis conjunctivitis prodromal stage
rhinitis
prodromal stage
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Koplik's spots Koplik's spots
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Infection Dr. Abo El -Asrar pathognomonic sign Measles generalized lymph adenopathy
Lymph adenopathy
lymph adenopathy High grade fever bronchitis conjunctivitis rhinitis Koplik's spots
erupted stage erupted stage Hair line maculopapular rash
nipple line
trunk
Koplik's spots Koplik's spots rash
Mid thigh
trunk
rash palm and sole

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3 convalescence stage regression Hair line face Nipple line trunk mid thigh rash rash
branny branny desquamation dorsum surface
dark skin
branny desquamation palm and sole
Investigations scheme causative organism source of infection route of infection incubation period Infectively period clinical pictures investigations
Investigations
It is not necessary to do investigations for measles clinically
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measles Ig M anti measles antibody titer Urine blood
Complications
complications measles
viral infection
complications vrial infection complications complications viruses naso pharynx oro pharynx complications GIT respiratory CNS
GIT
respiratory
CNS
respiratory system respiratory system
hyperemic
drum erythematous
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otitis media Otitis media
Naso pharynx sinusitis sinuses otitis media sinusitis pharyngitis
hoarseness of voice cropy cough stridor laryngitis bronchitis
alveoli pneumonia pneumonia viral pneumonia viral pneumonia secondary bacterial infection bacterial pneumonia
Measles
Measles pneumonia
pneumonia
Measles pneumonia
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Infection Dr. Abo El -Asrar Clinically Interstitium Pneumonic wheeze viral pneumonia viral pneumonia wheeze wheeze Pneumonia pneumonia
Measles
Pneumonia
measles secondary bacterial infection
measles
Pneumonia
clinically
wheeze and siblent rhonchi
wheeze siblent rhonchi Manifestation of pneumonia measles virus wheeze measles T.B. infection bacteria specific activation virus measles Measles
dormenant T.B. infection
activation
Measles suppression cell mediated immunity cell mediated immunity supperssion T.B. activation Minimal change glomerulo nephritis
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Infection Dr. Abo El -Asrar Immuno supperssion cell mediated immunity suppression T.B. activation T.B. GIT Oral moniliasis suppression of cell mediated immunity even oral ulcers watery diarrhea viral diarrhea Gastroenteritis
GIT
acute appendicitis even mesentric lymph adentitis
Mesentric lymph nodes
GIT oral moiliasis Oral ulcers viral gastro enteritis appendicitis lymph adentitis
CNS encephalitis encephalitis virus viral encephalitis
auto immune encephalitis viral infection auto immune disorders

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Infection Dr. Abo El -Asrar auto immune encephalitis allergic encephalitis auto immune encephalitis encephalitis measles viruses brain brain Cell acute encephalitis 30 sub acute sclerosis pan encephalitis slow virus infection of CNS virus measles encephalitis acute encephalitis slow viral infection of the CNS allergic encephalitis auto immune CNS Post viral infection demylination antibody sheath Guillain Barre syndrome Optic neurtitis auto immune ( allergic encephalitis) DIC post
DIC
measles Measles virus rash bleeding black measles rash hemorrhage
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Infection Dr. Abo El -Asrar keratitis keratitis Measles keratitis vascularization photo phobia corneal ulceration septic corneal ulcer corneal opacity viral myocarditis congestive heart failure
Differential diagnosis
common cold
prodromal stage whooping cough
eruptic stage differential diagnosis
Treatment
prevention Measles Immunization Passive active immunization
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67 measles treatment treatment prevention active treatment prevention of the disease Infection avoidance of exposure to infection immunization passive Immunization active immunization passive immunization contact contact Immunoglobulin immunoglobulins
zero prevention attack abortion contacts catch up of infection Manifestation mild manifestations Manifestations complications zero attenuation
Measles measles
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Infection Dr. Abo El -Asrar contact rash Measles rash
contact
contact contact contact you can catch up the virus
Sero prevention virus replication
exposure 0.25 Immunoglobulin viremia attack attack of measles Zero prevention zero prevention to infection
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within five days of exposure to
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attack immunoglobulin immunoglobulin viremia blood
attack Out of control
to abort
immunoglobulin intra muscular blood 0.5
blood attack mild manifestations complications
zero attenuation Passive immunization attack abortion zero prevention infection
infection You can not abort the attack manifestations attenuation Low dose immunoglobulin
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active immunization measles vaccine vaccine measles live attenuated vaccine dose vaccination
points
rash rash Onset of rash rash Infectious
rash
rash
measles virus
specific treatment
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Infection Dr. Abo El -Asrar bypass specific drug therapy measles virus
symptomatic treatment viral infection feverish Paracetamol non steroidal
Rey syndrome
varicella
chicken pox
Measles keratitis
Keratitis corneal ulcer corneal ulcer corneal opacity and blindness you must care of the eye Prodromal stage conjunctivitis
conjunctivitis excreta cornea implanted Keratitis
You must care of the eye de congestant

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Infection Dr. Abo El -Asrar Local antiseptic
keratitis complications I will manage according complications
rubella
Rubella
rubella Infection
Causative organism
causative organism of rubella rubella virus Measles
Source of infection
rubella Cases only rubella carrier
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Route of infection
rubella virus Naso pharynx nose Implantation excreta route of infection droplet infection
Incubation period
rubella general roles incubation period
Infectivity period
Measles Infectious rash
Infectious Onset of rash Infectivity period
rash
12 before the onset of rash after the onset of rash Infectious
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Infection Dr. Abo El -Asrar congenital rubella syndrome congenital rubella syndrome Infectious congenital rubella syndrome Infectious rubella Infectious
Onset of rash
rubella contact onset of rash
rubella
Clinically
Prodromal stage Prodromal stage measles High grade fever
Prodromal stage
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Infection Dr. Abo El -Asrar Mild fever just low grade fever
Low grade fever contacts
rash
rash tender postro auricular occipital lymph nodes tender enlarged rash erupted stage even erupted stage maculopapular rash hair line Palm and sole rash
branny desquamation
Investigations
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Infection Dr. Abo El -Asrar Investigations rubella rubella Ig M anti bodies detection of rubella Ig M Not Ig G vaccine rubella Ig G Ig M recent infection of rubella
Complications
complications viral infection stress encephalitis CNS Guillain Barre syndrome encephalitis Measles viral encephalitis auto immune encephalitis allergic encephalitis rubella slow virus of the CNS
auto immune demylination of the central nervous system and peripheral nervous system Guillain Barre syndrome
arthritis auto immune disorder

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Infection Dr. Abo El -Asrar Immune thrombocytopenic purpura auto immune hemolytic anemia viral infection Post viral post viral
auto immune auto immune disorder
complications congenital rubella syndrome rubella Infection rubella
Differential diagnosis of rubella

differential diagnosis Prodromal stage Prodromal stage erupted stage erupted stage maculopapular rash and fever
Treatment
prevention Prevention avoidance of exposure to infection
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Infection Dr. Abo El -Asrar Pregnant female pregnant rubella rubella related
rubella party rubella party
rubella party natural infection natural infection Solid immunity
rubella virus viruses natural infection
vaccine
rubella party
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rubella rubella vaccine
Immunization passive and active Immunization Passive immunization passive immunization infection Immunoglobulins immunoglobulins
expsure to infection Infection Incubation period
exposure viremia virus Measles
Can abort the attack of rubella Immunoglobulins
pregnant female rubella congenital syndrome rubella
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active immunization live attenuated vaccine MMR vaccine an obligatory vaccine measles MMR rubella Mumps Measles Live attenuated organisms
active immunization obligatory vaccine
Active treatment active treatment isolation Of rash Onset of
rubella virus
specific anti viral therapy specific treatment symptomatic treatment
tender
Lymph nodes analgesics
Any complications you must manage according to complications

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Infection Dr. Abo El -Asrar schemes
Pregnant rubella rubella virus Placental barrier feteus
How to diagnose sub acute sclerosing pan encephalitis sub acute sclerosing pan encephalitis neuro degenrative disease
degenerative disease acutally viral infection
Pregnant rubella virus
rubella Intra uterine Intra uterine
Pregnant female Pregnant female
marked viremia virus multiple congenital anomalies abortion
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Infection Dr. Abo El -Asrar still birth immediately after delivery
manifestations congenital rubella syndrome
Most common
congenital rubella syndrome STORCH infection SRORCH infection
rubella virus
placenta
Organism infected baby rate of growth
pre term Intra uterine growth retardation intra uterine growth retardation full term Neonatology Intra uterine growth retardation
STORCH
golden roles
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Infection Dr. Abo El -Asrar Organism virus Placenta intera uterine Intra uterine brain brain encephalitis Intra uterine period brain cell Micro cephaly micro cephaly mental retardation Mental 27 : 18
Micro cepahly and mental retardation
brain brain
brain STORCH infection
Optic nerve blind
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Infection Dr. Abo El -Asrar development Micro ophthalemia
ano ophthalemia
6:03
virus heart STORCH heart heart congenital heart disease rubella congenital heart disease patent ductus arterious cardiology virus Intra uterine replication endothelial cells ductus proliferation endothelial cells
ductus arterious prostaglndins
Prostaglandins closure of the ductus arterious delayed closure persistent ductus arterious
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Liver hepatitis neonatal hepatitis
neonatal hepatitis Lemon jaundice enlarged tender liver colored urine colored stool
organism Hemolysis of the RBCs Indirect bilirubin neonatal jaundice
neonatal hepatitis jaundice Neonatal hepatitis jaundice hemolysis
spleen Liver lymph nodes reticuloendothelial system hyper plasia
STORCH infection bone marrow bone marrow Pan cytopenia anemia purpuric eruption brain
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Infection Dr. Abo El -Asrar 8th cranial nerve 8th cranial nerve sensory neural defness
infant clinical manifestations congenital rubella intra uterine growth retardation small for date micro cephaly Mental retardation micro ophathalmia glucoma cataract sensory neural defness congenital heart disease patent ductus arterious neonatal jaundice hepatitis hemolysis hepatosplenomegaly Lymph adenopathy Megaly endothelial system hyperplasia neonatal thrombocytopenia And pallor After bone marrow depression
triad congenital cataract mental retardation hydrocephaly

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Infection Dr. Abo El -Asrar patent ductus arterious
even blindness
Cataract
ano ophthalmia
cataract
sensory neural defness 8th cranial nerve damage nerve defness rash rubella purpuric eruption jaundice jaundice Hemolysis hepatitis purpura bone marrow depression infiltration of the bone marrow
congenital rubella investigations detection of rubella Ig M

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Infection Dr. Abo El -Asrar Ig M Ig G screening positive Positive solid immunity Measles rubella Ig G
rubella Ig G
rubella rubella Ig M Positive
treatment congenital rubella syndrome No specific treatment Only supportive treatment congential heart thrombocytopenia management neonatal jaundice
Just supportive treatment
Infectious excreta virus
will die within two years
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congenital rubella syndrome
pregnant woman Pregnant
rubella
wart
rubella antibody
Infection rubella congenital rubella

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infection
non immune
immune antibody antibody Positive Immune
immune
negative antibodies antibodies
susceptible
abortion infected abortion mother about the consent of abortion is accepted or not termination of pregnancy antibodies infection susceptible
infection
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Infection
Infection abortion abortion
abortion is not accepted
is not accepted at all
abortion
passive immunization human serum immunoglobulins 20 - 30 intra muscular intra muscular Immunoglobulins viremia you can save the mother mother
human serum immunoglobulins
termination of the pregnancy
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abortion Abortion we will wait Incubation period manifestations re assessment
antibodies
negative
antibody titer
positive antibody titer Infection Infection abortion therapeutic abortion therapeutic abortion Legal
anomalies you can terminate the pregnancy malformation baby malformation anomalies
trimester
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congenital rubella
Infection
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Infection Dr. Abo El -Asrar 1st trimester 1st trimester
positive
antibody Immune
still negative antibody titer
antibody rising
Infection chicken pox
Chicken pox
chicken pox chicken pox
Causative organism
chicken pox causative organism Varicella zoster virus causative organism
Source of infection
cases only carrier
Varicella Varicella
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Route of infection
droplet infection throat virus
skin rash skin rash infectious Infectious macule Infectious papule infectious vesicle infectious pustule crust rash infectious crust direct contact with the vesicle crust is not infectious
small pox
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infectious
small pox crust
Incubation period
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Infection Dr. Abo El -Asrar Incubation period
Infectively period
Infectious infectively period rash rash complete crustation of the rash crust rash chicken pox rash rash
completely crusted completely crusted crust clinically
rash rash
48: 12
Clinically
Clinically prodromal stage So mild Low grade fever
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erupted stage
vesicle crust
vesicle
rash paleomorphic
rash trunk trunk
trunk
extremities
itchy
rash
sever itching sensation rash
chicken pox
vesicle
varicella zoster focus throat

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very painful throat
rash rash secondary infection scar scar
Investigations
actually varicella zoster chicken pox
Investigations varicella screen
Clinically
Complications
3 mainly Neonatology, infection and infant feeding
infection
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Incubation period Infectively period
complications
most common complication complications chicken pox The most common complication of chicken pox is the secondary bacterial infection
The most common complication of chicken pox is the secondary bacterial infection MCQ most common complication of chicken pox complications secondary bacterial infection Pustule secondary bacterial infection Pustule chest infection Respiratory system
stridor laryngitis bronchitis bronchopneumonia
chicken pox
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pneumonia
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Infection Dr. Abo El -Asrar chicken pox respiratory distress grunting
Bornchial breathing
complicated Pneumonia
Pneumonia
virus secondary bacterial infection
chicken pox
Pneumonia
Clinically
wheezy chest Pneumonia siblent rhonchi palpaption palpable wheeze audiable sound Noisy respiration wheeze varicella virus
broncho pneumonia CNS viral infection

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encephalitis
brain
chicken pox encephalitis chicken pox encephalitis chicken pox brain cerebellum
cerebellar ataxia
Guillain Barre syndrome brain cerebellum ataxia
Guillain Barre syndrome
keratitis corneal ulcers
Other complications carditis Hepatitis pregnant chicken pox
congenital varicella
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Infection Dr. Abo El -Asrar STORCH infection micro cephaly Varicella mental retardation extensive skin rash thrombocytopenia
bleeding
STORCH
differential diagnosis erupted stage erupted stage herpes Simplex
herpes Zoster impetigo papulo vesicular rash mucocutaneous junction
Scabies
Scabies perineum
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Infection Dr. Abo El -Asrar abdomen
Scabies
Treatment
treatment prevention avoidance of exposure to infection immunization passive and active
zoster immunoglobulin
passive immunization passive immunization zoster immunoglobulins exposure exposure 72
infection chicken pox 72 zoster immune globulin
immune comperomised say Leukemia chemotherapy herpes Zoster complications immunoglobulins steroid therapy
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Immune deficiency Zoster immuneglobulins Zoster immuneglobulins Immune compromised
Infection
steroid chemotherapy Immune deficiency Immune globulins exposure chicken pox
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active immunization active immunization live attenuated vaccines obligatory vaccine Live attenuated vaccines Immune compromised Immune compromised Varicella vaccine
Leukemia corticosteriods Immune deficiency
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Infection Dr. Abo El -Asrar manifestations chicken pox
Immune compromised
egypt Now it is present inf Egypt Immune deficient varicella vaccine
basics Indications
Indications
Varicella vaccine
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Rota vaccine
chicken pox
vaccine
solid immunity
rota virus infection
Indicated
active treatment active treatment Isolation
complete crustation of the rash crusted rash
Varicella
Specific treatment specific treatment Acyclovir Acyclovir 500 15 dose
specific treatment
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Infection Dr. Abo El -Asrar Acyclovir
chicken pox antihistaminic Symptomatic treatment
paracatemol Rye's snydrome
antibiotics pustule antibiotics
Secondary bacterial infection
viral infection Varicella auto immune disorder Guillian Barre syndrome transverse myelitis allergic encephalitis
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you must interfer so early
specific therapy
Immune system
complications viral infection
Acyclovir chicken pox Acyclovir Acyclovir So mild viral infection
Acyclovir symptomatic treatment anti histaminic local lotions
complications treatment
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Mumps
Causative organism
causative organism of mumps causative organism of mumps Mumps virus Mumps virs
Source of infection
cases Mumps Mumps carrier cases
Route of infection
droplet infection vomites direct contact droplet infection
Incubation period
Infectively period
Infectious Infectious
swelling
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Infection Dr. Abo El -Asrar swelling salivery gland
swelling
Infectious Just before apperance of the swelling one day Infectious swelling
later
Clinically
prodroma non specific
Non specific
salivery gland parotid gland salivery gland parotid swelling parotid swelling unilateral Raising the lobule of the ear swelling
Bilateral
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bilateral Unilateral
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Stensen's duct
opening Opposite the second molar opening of the hyperemia Stensen's duct
mumps
differential diagnosis
bed side test Mumps
tonuge Oral mucosa
swelling
sensation So painful sensation
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sensation
Is the sensation numbness
oral mucosa alkaline PH alkaline Saliva acidic salivary glands to reset the PH of the oral mucosa Hyper activity PH saliva oral mucosa Inflammation congested reactivation more congested More congested More painful sever pain Mucosa of the mouth
Mouth
Pain PH acidic alkaline normal PH salivary gland saliva alkaline PH neutralization
Hyperemic of Stensen's duct

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Infection Dr. Abo El -Asrar swelling
submandibular
sublingual
Parotid salivary glands
parotid gland swelling
Investigations
Mumps Investigations
hyperemic Stensen's duct Mumps clinically Investigations complications of mumps
Complications
complications of mumps meningeo encephalitis orchitis adolescent orchitis One testis severe pain bilateral unilateral testis tender examiner orchitis
edematous
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Infection Dr. Abo El -Asrar orchitis testis thick tunica albuginia tunica albuginia sheath testis
tunica
testis stretch
Inflammation edema gonads gondal atrophy fertility Infertility female ooveritis ooveritis
Male
thick tunica
Ovary Inflammation edematous
fertility Orchitis Ooveritis orchitis
acute panceritis Inflammation
Acute pancreatitis
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acute pancreatitis
severe pain epigastrium
pancreas
viscera severe pain prone Prayer position
edematous pancreas viscera Pain serum amylase
islets cells
thyroiditis thyrotoxic hyper activity

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thyroiditis hypo thyroid thyroid
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Infection Dr. Abo El -Asrar thyrotoxic manifestations of hypo thyroid function
8 th cranial nerve sensory neural deefness adolescent female acute mastitis hyperemia breast congestion breast severe tenderness Viral mastitis complications viral infection carditis , hepatitis myositis complications
differential diagnosis of mumps parotid swelling acute supprative parotitis parotid
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38
Parotid
Mumps high grade fever toxemia unilateral swelling Severely painful
Pus acute suppurative parotitis unilateral bilateral

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Infection Dr. Abo El -Asrar mumps unilateral bilateral
acute calcular obstructive parotitis parotid duct parotid duct
Unilateral parotid swelling
Raising the lobule of the ear generally
mumps
swelling
swelling unilateral mumps
calcular obstructive parotitis parotid duct

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unilateral parotid swelling raising the lobule of the ear
mumps
history of repeated attacks
repeated attack
mumps mumps
mumps History of repeated attacks attacks calcular obstructive parotitis
endemic parotitis endemic parotitis Any parastic infection
esinophilia esinophils parotid infiltration bilateral parotid swelling of long time
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Infection Dr. Abo El -Asrar mumps
parastic infection esinophils infiltration it is not painful bilateral long duration parotid tumor huge parotid tumor parotid tumor tumors parotid tumors
cervical lymphadenitis Jugulo digastric lymph nodes tonsilitis Jugulo digastric lymph nodes parotid gland angle of the jaw Lymph nodes Mumps
Treatment
Avoidance of exposure to infection

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90
Infection Dr. Abo El -Asrar Immunization active passive passive immunization Immunoglobulins immunoglobulins immunoglobulins exposure immune compromised mumps solid immunity for life 72
Immune compromised active Mumps MMR vaccine Obligatory vaccine active treatment
3 swelling infectively period
symptomatic treatment
sense
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91
parotid
orchitis complications complications complete rest in bed orchitis congestion congestion gonads compression Infertility
complete bed rest local testicular support
testis testis congestion
anaglesics so painful steroid non steroidal anti inflammatory drugs
steroid tissue edema gonads compression steroid

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92
viral infection
steroid
steroid steroid infection fertile
Polio
Causative organism
causative organism polio virus polio polio virus strains type one type two type three
type one , type two and type three Most common in Egypt Type two
Type one type Epidemics virus epidemics Most common in Egypt Type two Type three
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93
cross related immunity cross related immunity solid immunity
solid immunity
polio
polio vaccine
polio polio
vaccine vaccine attack of polio
attack
polio type
vaccine attack
cross related immunity Polio myelitis virus
Source of infection
carrier
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case
94
Infection Dr. Abo El -Asrar Carrier polio carrier Immune immune polio virus carrier Immune compromised cases or carrier
Route of infection
oro and nasopharynx
replication
virus virus
oro and nasopharynx upper respiratory tract Manifestations droplet infection droplet infection throat intestine intestine replication stool stool stool contamination contamination
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95
Infection Dr. Abo El -Asrar feco oral route route
feco oral route polio virus
stool
Incubation period
Infectively peroid
Infectious polio virus stool
naso pharynx
Completely radicated
polio Stool isolation throat Isolation virus naso pharyngeal secretion stool virus stool
virus
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96
Clinically
clinical pictures polio virus infection polio virus infection viral infection catch up droplet feco oral surface Nose mucosa naso pharynx naso pharynx Nose mucosa
Mucosa immune globulins A
virus
surface mucosa immune globulins A attack virus Mucosa surface virus immune system virus surface of the mucosa virus Say antibodies virus
Immune system
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97
Immune system organism
antigen processing cells Markers immune system Immune system organism criteria specific memory cells specific memory cells
specific memory cells antibody solid immunity rubella measles
catch up infection organism raising antibody memory cells strain for life protection
clinical pictures Polio silent infection

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98
Infection Dr. Abo El -Asrar silent infection attack infection Immune system antibody
95
90
egyptian personnel
95
90
virus mucosa immune globulins A to attack virus replication of the virus naso pharynx replication
hoarsness of voice laryngitis small intestine virus small intestine Mucosa replication watery diarrhea Viral diarrhea
watery diarrhea
virus Local manifestations
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99
Infection Dr. Abo El -Asrar Lymphatic system payer's patches Mesentric lymph nodes blood viremia
Immune system viremia immune system antibody antibody attack
virus
immune system specific antibody complete eradication of the virus Immune globulins Mucosa surface virus surface mucosa rhinitis watery diarrhea
Abortive polio polio infection manifestations Upper respiratory tract catarrhal watery diarrhea attack Aborted CNS
viremia CNS manifestations

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100
Infection Dr. Abo El -Asrar abortive polio
paralytic polio aboritve intra muscular injection paralytic
muscle hematoma Muscle muscle capillaries Leakage of blood Muscle Muscle virus muscle virus CNS paralytic polio
Nerve supply
vagus
tonsillectomy elevation tonsillar bed vagus fibers naso pharyngeal viruses elevation of the vagus CNS paralytic polio
corticosteroids Immune system CNS virus paralytic polio paralytic risk factor intra muscular injection tonsillectomy steroid
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101
Infection Dr. Abo El -Asrar severe muscular exertion polio abortive polio risk factors paralytic polio
clinical manifestations polio myelitis virus oro pharynx naso pharynx immune globulins A surface of the mucosa Immune globulins A virus antigen processing cells antigenic pattern virus immune system antigenic pattern immune system for life memory cells Polio virus strain Immune globulins Permanent immunity strian
Infection
catch up
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102
Infection Dr. Abo El -Asrar Infection solid immunity polio infection 95 silent polio
polio virus surface of mucosa naso pharynx gut immune globulins A eradication virus replications surface of the mucosa local manifestations Low grade fever rhinitis hoarsness of voice cough laryngeal affection
common cold gut viral diarrhea watery diarrhea virus mucosa replication
lymph node drains throat Jugulo digastric mesentric lymph nodes blood viremia
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103
Infection Dr. Abo El -Asrar gut Once
Immune system virus blood stream virus blood stream antigenic pattern memory cells specific immune globulins blood virus eradications surface of the mucosa watery diarrhea
virus CNS abortive polio abortive polio risk factors Predisposing factors corticosteroid tonsillectomy polio Immunity CNS Intramuscular injection sever muscular exertion
CNS
virus abortive polio paralytic polio
virus surface mucosa GIT naso pharynx

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104
immune globulins immune globulins Local manifestations viremia eradication CNS blood immune system virus CNS meninges viral meningitis viral
Immune system antibody blood eradication naso pharynx mucosal membrane meninges GIT virus CNS Immune system motor neurons Main target polio Non paralytic polio
silent polio non paralytic Paralysis
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105
Infection Dr. Abo El -Asrar abortive polio non paralytic paralysis
non paralytic CNS paralysis virus
silent polio Mucosa abortive polio blood viremia CNS CNS viral meningitis motor neurons
Non paralytic
non paralytic polio Clinically abortive manifestations
Hoarsness of voice watery diarrhea
meningeal irritation viral meningitis

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signs of
106
Infection Dr. Abo El -Asrar signs of meningeal irritations neck regidity spasm of the back muscles neck regidity spasm of the back muscles sign spelling Tripod sign back muscle spasm tripod sign tripod sign back muscles severe pain spasm back muscle back
spasm
relaxation of the back muscle
flexion knee flexion meninges traction back meninges stretch pain tripod
hip
gluteal region
tripod sign gluteal region
spasm
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107
Infection Dr. Abo El -Asrar back muscles spasm
signs of meningeal irritation Brudzinski sign Brudziniski sign supine supine supine supine
Chin
supine meningitis meningeal irritation back muscles severe spasm meningeal irritation
knee
flexion hip neck flexion Hip knee Brudizinski sign
flexion
flexion
meningeal irritation supine

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Kernig's sign sign
108
knee flexed
hip flexed knee Hip flexed flexed Knee Hip
extension of the knee hip flexed
knee
Extension Hip flexed
back
pain
Knee
hip
flexion One limb
extension of the knee Hip flexed
kernig's sign
meninges
virus Neurons paralytic polio paralytic polio virus
neurons
anterior horn cells spinal polio

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109
Infection Dr. Abo El -Asrar cranial nerve nuclei vaso motor centre respiratory centre bulbar polio
Bulbo spinal paralytic polio viral encephalitis encephalitic polio paralytic polio Spinal Bulbar Bulbu spinal Encephalitic criteria of paralytic polio virus virus In arndom pattern
common cold
randomized target target random pattern virus

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110
Infection Dr. Abo El -Asrar Neurons neurons random pattern
triceps adductors
main target motor neurons acute stage virus neurons Say neurons biceps quadriceps What ever Pathology Bilateral or unilateral bilateral asymmetrical in distribution
Motor neurons sensory motor intact sensation anterior horn cells cranial nerve upper motor lower lower motor neuron lesion Lower motor neuron lesion neuro criteria of lower motor neuron lesion muscle weakness or paralysis hypotonia hyporeflexia muscle wasting neurons say acute stage edema suppression edema
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111
Infection Dr. Abo El -Asrar neurons acute stage manifestations
neurons
edema
Neurons acute stage 30 neurons edema
Say 3
20 neurons recovery edema suppressed
3 20 neurons recovery
course Neurons progressive course course 10 30 regressive in course criteria of paralytic polio
regressive
criteria of paralytic polio myelitis acute onset of paralysis
acute onset of paralysis
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112
Of lower motor neuron lesion Muscle weakness or paralysis Hypotonia hypo reflexia muscle wasting sensory loss main target motor neurons sensory neurons
Asymmetrical in distribution bilateral
right biceps triceps quadriceps adductors Polio infection asymmetrical virus criteria target In a random pattern
Massive from the start neurons edema Neurons
edema regressive in course
course
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113
head drop posterior drop head drop neck support Head dropped
Anterior drop Neck support
viral viral
Polio
limb
bulbar polio bulbar polio brain stem bulbar polio brain stem cranial nerve neucli cranial nerve neculi nasal tone of voice Nasal regurgitation of food
hoarsness of voice 19:55 bulbar affection facial nerve paralysis facial nerve paralysis
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114
Infection Dr. Abo El -Asrar Motor cranial nerve bulbar cranial nerves nasal regurgitation nasal tone palatal paralysis Pharyngeal paralysis
Pharyngeal paralysis Hoarsness of voice Even stridor
brain stem vital centers vital centers respiratory cneter slow irrgular respiration apnea so early vaso motor center
tachycardia bradycardia hypertension Hypotension
encphalitic polio encephalitis disturbed level of consciousness Signs of meningeal irritation convuslions
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115
Investigations
Investigations polio polio
flaccid paralysis
polio
to isolate the virus virus virus virus stool stool virus sure
nasopharyngeal secretion nasopharyngeal swab Naso pharynx
virus isolation
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116
Infection Dr. Abo El -Asrar blood sample blood sample specific antibodies onset pharyngeal secretion pharyngeal secretion stool
antibody titer
meningitis encephalitis CSF examination CSF examination criteria viral infection bacterial tuberculosis Meningitis in general
Motling of the skin Motling of the skin cardiovascular in stability pallor Hyperemia Motling of the skin cardio vascular system instable
Complications
complications of polio
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117
Infection Dr. Abo El -Asrar respiratory complications the main cause of death in acute polio respiratory complications acute stage respiratory complications
bulbar affection respiratory centre
Central
Apnea cranial nerve bulbar affection repeated chocking chest infection aspiration
spinal spinal phernic nerve neucli diaphragmatic paralysis paradoxical respiration respiratory distress Inter costal muscle paralysis Intercostal Mild distress diaphragmatic paralysis GIT Polio virus virus infection gut virus mucosa replication gastritis gastric erosion melena hematemeis
stomach
gastritis
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118
Infection Dr. Abo El -Asrar viral infection urinary tract Urinary tract acute urinary retention acute urinary retention acute retention of urine polio acute retention of urine
defecation
Urination
viscous Local reflex contraction of the wall relaxation of the sphincter evacuation of the bladder evacuation of the rectum
tracheostomy retention of urine and stool tracheostomy evacuation of the bladder and rectum Intra abdominal pressure Intra abdominal pressure rectum bladder complete evacuation cardiology defecation Hyper inflation of the lung diaphragm diaphragm push vertical diameter of the abdomen anterior abdominal wall contraction anterior abdominal wall contraction antero posterior diameter
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119
vertical diameter contraction of the abdominal muscles antero posterior diameter Intra abdominal pressure viscous evacuation of the viscous bladder rectum
abdominal muscle paralysis diaphragmatic paralysis
complete evacuation bladder 400 cc
diaphragmatic paralysis anterior abdominal wall paralysis retention of urine
urinary tract infection
acute polio acute polio stage urinary tract infection

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120
Infection Dr. Abo El -Asrar retention of urine liable to renal stones renal stones retention retained urine Liable for infection renal stones renal stones urinary tract infection Hyepr calcemia hypercalcemia Paralysed paralysed
bone
Ca apatite crystals
osteoblast Osteobalst bone bone osteomalacia
Ca poly serum Ca renal threshold kidney Ca oxalate
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121
Infection Dr. Abo El -Asrar Ca phosphate stones hyper calcemia immobility of the child retained urine Infection retained urine Stone immobility
urinary tract complications cardiovascular variable blood pressure and heart rate vaso motor center vaso motor center
inhibitory
stimulatory
musuclo skeletal musculo skeletal polio paralysed Muscle physiotherapy ankle deformity
flextion deformity knee
muscle contraction fibrosis big joints fibrosis

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122
Infection Dr. Abo El -Asrar flextion knee permanent flextion extension of the knee
contracture deformity
Left
More paralysed one limb Linear growth Limb
Left
right lower limb growth
shortening
limbing limbing
Treatment
Prevention differential diagnosis Inability to walk Prevention prevention of polio prevention avoidance of exposure to infection
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123
active
immunization passive Immunization passive immunization polio immune globulins contacts
infection Immune globulins
catch up attack to abort 0.2 give Intra muscular
paralytic polio
Intra muscular injection One of the risk factors abortive
polio stage Intra muscular Immune globulins
Muscle
Hematoma
contacts
virus Immune globulins CNS Immune globulins IM stage of viremia
active immunization vaccination two vaccines

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124
Infection Dr. Abo El -Asrar Live attenuated vaccine Oral
sabine vaccine
killed vaccine Salk vaccine intra muscular
active treatment complete disapperance of the virus from the stool feco oral route route of infection stool virus stool
abortive polio abortive abortive polio watery diarrhea
watery diarrhea abortive polio abortive polio abortive polio suspecting epidemics of polio polio myelitis watery diarrhea abortive polio
epidemics History of exposure to a case of poliomyelitis abotive polio

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suspected
125
Infection Dr. Abo El -Asrar isolation virus stool complete rest in bed Immunity severe muscular exertion Paralytic polio Precipitating factors intra muscular injection tonsillectomy cortisone anti pyretics analgesics symtomatic treatment Non paralytic polio signs of meningeal irritation abortive polio
muscle spasm
Muscle relaxant
paralytic polio acute stage historical nowadays
polio myelitis
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126
polio myelitis
tripod position ankle semi-flexion two lower limbs adduction
prone leg position
Muscle stretched acute stage 30 neurons

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127
Infection Dr. Abo El -Asrar acute stage recovery 20 Muscle wasting Muscle
prostigmine bladder retention evacuation of the bladder prostgmine
muscle spasm Muscle Muscle vascularity
analgesic and anti pyretics source of pain
Intra muscular injection
Intra muscular injection CNS all viruses more paralysis Old polio Old polio
Physiotherapy
sugery
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128
Infection Dr. Abo El -Asrar muscle
anterior horn cells
fasiculations May be
diaphragmatic paralysis paralysis diaphragm diaphragm
Infectious Mononucleosis
Causative organism
causative organism Infectious mononucleosis Epstein-Barr virus
Source of infection
cases sub clinical or clinical carrier clinically sub clinical cases
Route of infection
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129
Infection Dr. Abo El -Asrar Infectious mononucleosis blood transfusion legal blood transfusion Infectious mononucleosis Legal pattern Legal pattern infectious mononucleosis Naso pharynx virus oropharynx droplet infection droplet infection through mixing of saliva through deep kissign deep kissing
spinal and respiratory polio differential diagnosis
polio historical disease disease small pox
polio
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130
Incubation period
Incubation period
Infectivity peroid
through illegal pathway Infectivity period unknown
there is no prevention prevention to prevention
Infectivity period is unknwon
Clinically
Infectious mononucleosis
fever infectious mononucleosis Low grade fever high grade fever Immunity fever
Immunity Immunity
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131
Infection Dr. Abo El -Asrar fever
spinal
respiratory spinal respiratory
infectious mononucleosis fever exudative pharyngitis throat Membrane toxins exudative pharyngitis pus
Splenomegaly and lymphadenopathy infectious mononucleosis fever tonsilitis Lymph nodes spleen
Epstein- Barr virus acute hepatitis Hepatomegaly acute hepatitis Liver enzyems
bed side test

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132
Infection Dr. Abo El -Asrar Infectious mononucleosis maculo papular rash Maculo papular rash ampicillin ampicillin
Investigations
Investigations Infectious mononucleosis Infectious mononucleosis CBC CBC total leucocytic count
Marked leucocytosis total leucocytic count WBCs count leukemia
blood film atypical lymphocytes
atypical lymphocytes Immature lymphocytes malignant cells blood cells
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133
Infection Dr. Abo El -Asrar acute lymphoblastic leukemia
malignant cells
WBCs atypical cells
bone marrow leukemia exclusion
mono spot test Paul funnel positive test Mono spot
suggestive not conclusive conclusive Epstein Barr virus neuclear antigen more specific serological tests immunoflorecsent antigens M Ig M acute stage G Ig G
modern
sepcific antibody
serology
Complications
Immediately within one week spleen spleen
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134
Infection Dr. Abo El -Asrar Minor truama abdominal examination
trumatic rupture spleen trumatic rupture spleen Internal hemorrhage Internal hemorrhage
CNS viral auto immune meningtitis aseptic meningitis encephalitis Guillian Barre syndorome Transverse myelitis auto immune cardio vascular viral pneumonia viral myocarditis hematology immune thrombocytopenic purpura Immune hemolytic anemia bone marrow aplastic anemia
Burkit lymphoma One of the risk factor nasopharyngeal carcinoma One of the risk factors Epstien Barr virus
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135
Infection Dr. Abo El -Asrar carcinogenic factors nasopharyngeal carcinoma Burkit lymphoma
Treatment
treatment prevention active treatment
virus Just support treatment and treatment of complications
severe bone aches viral infection antipyretics analgesic
traumatic rupture spleen fresh blood transfusion consultant splenoectomy hemorrhagic shock auto immune disorder immune suppressant therapy steroid idiopathic thrombocytopenic purpura ITP , Guillain Barre syndrome , transverse myelitis auto immune What ever no treatment No prevention treatment
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136
viral infection bacterial infection
Bacterial infection
Scarlet fever
Causative organism
Beta hemolytic strepto cocci strain toxins strain erythrogenic toxins erythrogenic toxins
Source of infection
cases or carrier carriere carrier scarlet fever infection sore throat manifestations rash
neutralizing antibody erythrogenic toxins toxins erythrogenic toxins
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137
Route of infection
droplet infection throat
Incubation peroid
Infectiviy period
bacteria bacteria bacterial infection Infectivity period 3 negative cultures 3 negative cultures
throat
thorat 3 negative cultures typhoid stool What ever
3 negative cultures
Clinically
scarlet fever differential diagnosis of maculo papular rash prodromal stage acute onset of high grade fever
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138
sore thorat headache toxins acute follicular tonsillitis
eruptic stage
vaso dilated capillaries blanching
Circum oral pallor
subcutaneous vessels lips palm and sole rash Once rash desquamation desquamation dorsum and palmer surface of hand and foot fading
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139
Infection Dr. Abo El -Asrar measles
pathognomonic sign
strawberry tongue red strawberry tongue white strawberry tongue
Investigations
Investigations scarlet fever CBC Neutrophilia bacterial infection throat swab group A beta hemolytic streptococci
Detection of streptococcal antibodies anti streptolysin O titer Anti hyalourindase
contacts scarlet fever
test
scarlet fever scarlet fever Immune
susceptible
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140
Infection Dr. Abo El -Asrar neutralizing toxins Intra dermal 0.1 contacts 24 erythema Immune non immune erythema toxins non immune susceptible
toxins
Neutralizing antibody Immune non immune immuen
strepto coccal infection local otitis media Sinusitis Mastoiditis Interopharyngeal
parapharyngeal
bronchitis bronchpneumonia respiratory systemic dissementation meningitis Osteomyelitis streptococcal infection tonsillitis
complications
rheumatic fever glomerulonephritis Post streptococcal glomerulonephritis

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141
Infection Dr. Abo El -Asrar rheumatic fever Post streptococcal auto immune disease
Treatment
avoidance of exposure to infection
Specific treatment International unit 100 50
amoxacillin
erythromycin 50 erythromycin severe gastritis
symptomatic treatment antipyretic bacterial infection complications Must be treated
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142
Whooping cough
contacts neutralizing anti toxins neutralizing anti toxins rash scarlet fever
contacts neutralizing toxins
neutralizing toxins reaction immune + TB
toxins
antibody
immune toxins reaction TB
whooping cough
Causative organism
Bordetella pertussius para pertussius
Source of infection
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143
Infection Dr. Abo El -Asrar cases or carrier
Route of infection
droplet infection
Incubation period
Infectivity peroid
bacteria Infectivity peroid 3 negative cultures
Clinically
whooping cough cattarhal stage Bordetella mucosa bacterial penetration of the mucosa penetration of the mucosa bacteriemia Bordetella Bacteremia
Bordetella protein Is very irritative
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144
surface of the mucosa
very irritative irritation Irritant
whooping cough bacteria is an irritant bacteria is very irritant catarrhal stage
rhinitis low grade fever fever
rhinitis nasal discharge sneezing cough Measles whooping cough

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145
bacteria secretion
secretion Nose salivary secretion
spreading of infection
paroxysmal stage of whooping cough paroxysmal stage of whooping cough
characteristic whoop whoop whoop
expiration
expiration
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146
Infection Dr. Abo El -Asrar whooping cough 6 5
single expiration
expiration
whooping characteristic whoop
Paroxysmal attack of cough single expiration Followed by characterisitic whoop
whooping cough
: Repetitive contraction of the diaphragm stomach Irritation
vagus irritation
vomiting You must exclude whooping cough You must exclude whooping cough
vomiting common association

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147
Gastro esophageal reflux gastro esophageal reflux
aspiration congenital hypertrophy of aortic stenosis aspiration
vomiting
whoopign cough vomiting
whooping cough
vomiting vomiting aspiration vomiting cough convalscent stage paroxysmal stage
complication
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148
Infection Dr. Abo El -Asrar convalscent stage
Investigations
Investigations
CBC CBC Lymphocytosis
bacterial infection Lymphocytosis neutrophilia Neutrophilia
Lymphocytosis
bacteria Bordetella TB
throat swab specific media organism
bacteria
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colonies
149
cough plate technique
chest X-ray chest X-ray Pneumonia broncholitis asthma chest trobules exclusion Hyper inflated chest What ever
emphysema
Complications
complications of whooping cough
Epstien Barr virus Infectious mononucleosis Mixing of saliva
child abuse
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150
18 adolescent adult adolescent adult growing adolescent
infectious mononucleosis
complications complications whooping cough whooping cough complications
Prolonged expiration Prolonged expiration

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151
Infection Dr. Abo El -Asrar emphysema in lung Hyper inflated chest diaphragm ribbon shaped heart heart lung ribbon Lung emphysematous changes
heart
compression
broncho pnuemonia bronchopneumonia Bordetella pertussius
secondary bacterial infection tension pneumothorax emphysematous changes pleura Pleura pleura tension diaphragm Lung compression collapse trachea to the opposite side tension pneumo thorax pneumothorax
endotracheal pressure bronchetic changes bronchiectasis
suppression cell mediated immunity TB infection activation infection

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152
Infection Dr. Abo El -Asrar TB activation measles whooping cough
CNS head and neck drainage Intra cranial hemorrhage
brain edema defect in drainage of head and neck chronic severe cough brain edema
carpo pedal spasm alkalosis alkalosis single expiration carbon dioxide wash Carbon dioxide wash alkalosis alkalosis tetany
Lower central incisor
very sharp
teeth
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153
frenulum of the tongue frenulum of the tongue Ulcers
dehydration whooping cough dehydration persistent vomiting Intake
Intake
evaporation of the lung secretion evaporation water in expired air dehydration
water evaporation
vomiting expired air
abdominal muscles Contraction inguinal hernia umblical hernia Hernia Inguinal hernia umblical hernia
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154
Infection Dr. Abo El -Asrar incisional hernia
Relaxed relaxed
attack rectal prolapse prolapse of the rectum
Welcome rectal prolapse rectum prolapse
Subconjunctival hemorrhage subconjunctival hemorrhage mechanical complications rupture of the diaphragm very rare complication rupture of the diaphragm diaphragmatic hernia
Treatment
treatment Prevention whooping cough prevention of whooping cough
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155
Infection Dr. Abo El -Asrar avoidance of exposure to infection
Immunization active or passive Passive immunization whooping cough contacts 1.5 immune globulins contact erythromycin 50 erythromycin contacts bacteria Mucosa contacts carrier carrier state eradication contacts erythromycin carrier
active immunization DPT vaccine
treatment
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156
Infection Dr. Abo El -Asrar ampicillin erythromycin dose Immune globulins
symptomatic treatment
Mucolytic expectorant cough sedative dry cough complications treatment
cough Dryness of the airway
Typhoid fever
Causative organism
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157
causative organism Salmonella Salmonella typhi Salmonella para typhi Salmonella organism flagellae flagellated organism
Source of infection
source of infection feaces Mainly excreted in bile Organism stool contamination stool contact infection
carrier
organism
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158
Infection Dr. Abo El -Asrar Salmonella
Salmonella Salmonella
Salmonella
Salmonella
animals
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159
Route of infection
feco oral route
Incubation peroid
Infectivity peroid
bacteria 3 negative cultures
Clinically
typhoid prodromal stage fever pattern of fever typhoid fever
38.5 38 39 39.5 40
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160
Infection Dr. Abo El -Asrar In a ladder step manner base line base line High grade fever in a ladder step manner
pulse brady cardia brady cardia Inspite of fever bradycardia inspite of fever typhoid toxins S.A.Node suppression S.A.Node suppression beat per minute pulse toxins
relative bradycardia
heart rate typhoid relative brady cardia
heart rate beats per minutes typhoid fever heart rate 5 relative bradycardia bradycardia
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161
Charcot's fever
viral infection typhoid fever S.A.Node
typhoid fever toxins Inhibition
Upper abdomen
lower chest
Lower chest Upper abdomen constitutional manifestations severe headache malaise generalized bone ache toxiemia anorexia
GIT manifestations GIT manifestations
white coated tongue white coated tongue typhoid toxins severe liquefaction superficial mucosa of the tongue Necrosis white coated white coated tongue
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162
Infection Dr. Abo El -Asrar milk
monillia
scarlet fever white strawberry tongue
GIT manifestations abdominal colic abdominal colic pathology small intestine typhoid small intestine Salmonella small intestines Ulcers compression Ulcers
abdominal distention toxins abdominal distention toxins Organism constipation diarrhea
diarrhea
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163
spleen splenomegaly
Investigations
Investigations CBC typhoid toxins suppression of the bone marrow suppression of the bone marrow normocytic normo chromic anemia total count Lymphocytes lymphopenia blood culture positive bacteremia blood culture
widal test blood culture MCQ blood culture widal test widal test negative typhoid
widal
widal anti O titre
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164
Infection Dr. Abo El -Asrar anti H anti O vaccine Anti H anti H antibody positive
Complications
complications GIT hemorrhage Intestinal hemorrhage Ulcers wall of the small intestine
perforation of the viscous wall of the intestine Ulcers compression acute abdomen chronic cholycystitis chronic cholycystitis gall stones toxic complications Toxic myocarditis Toxic encephalopathy Bone marrow depression
surgical complications typhoid typhoid Intestinal perofration paralytic ileus
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165
Infection Dr. Abo El -Asrar surgical emergency acute cholecystitis chronic cholecystitis osteomyelitis
Orchitis
Treatment
typhoid treatment typhoid
prevention good hygiene feco oral good hygienic control of water typhoid stool typhoid contamination Contamination contamination
disposale
typhoid
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166
Infection Dr. Abo El -Asrar typhoid good hygienic control of food and water
obligatory vaccine
vaccination vaccination
killed type live attenuated type Killed type subcutaneous
subcutaneous
Live attenuated Oral
booster dose valid active treatment 3 negative cultures
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167
Infection Dr. Abo El -Asrar bacteria chloramphenicol nowadays
specific drug
bone marrow depression amoxicillin ampicillin
3rd generation cephalosporin symptomatic treatment anti pyretic
infection typhoid fever
Non typhoidal Salmonella infection

Gatroenteritis gastroentritis Bacterial gastroenteritis
organism Immune compromised Neoborn Infant

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168
Infection Dr. Abo El -Asrar early infancy bacteremia bacteremia extra intestinal manifestationa of Salmonella bone osteomyelitis joints arthitis brain Meningitis testis orchitis
septic focus Just enumeration chronic carrier chronic cholecystitis Salmonella pass salmonella stool
spreading of the salmonella infection
STORCH infection
STORCH infection
STORCH syphilis S toxoplasma T
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169
Infection Dr. Abo El -Asrar others HIV hepatitis rubella cytomegalo virus herpes Epstein Barr virus E O H R C H
consequence of STORCH infection STORCH Infection extra uterine Intra uterine Placenta Infection So early sever anomaly anomaly Intra uterine fetal death abortion
Premature delivery
still birth manifestations of infection
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170
syphilis syphilis
congenital toxoplasmosis
congenital toxoplasmosis so common in our community
obligatory
Parasitology
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171
Pregnant contact contamination
contamination toxoplasma gondai causative organism toxoplasma Pregnant toxoplasma toxoplasma
toxoplasma
Clinically
Clinically toxoplasma
Intra uterine growth retardation
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172
Microcephaly hydrocephaly STORCH infection hydrocephalus STORCH infection STORCH Microcephaly
microcephaly microcephaly
toxoplasma hydrocephalus STORCH
toxoplasma brain Local inflammation brain Local inflammation glioma Local inflammation glioma glioma pathway CSF hydrocephalic manifestations local infection local infection gliosis glioma gliosis glioma CSF pathway Obstruction hydrocephalus SRORCH pan encephalitis intra uterine
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Pan encephalitis STORCH
173
Infection Dr. Abo El -Asrar encephalitis marked brain atrophy microcephaly Pan encephalitis STORCH toxoplasma
toxoplasma local inflammation brain brain local inflammation gliosis glioma CSF pathway hydrocephalic changes Gliosis brain fibrosis fibrous tissue gliosis
tissues
micro ophthalmia micro ophthalmia
micro ophthalmia cataract optic atrophy Intra uterine infection trans placental infection rubella Organism bone marrow
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174
Infection Dr. Abo El -Asrar bone marrow pan cytopenia pancytopenia petichae ecchymosis Purpura bleeding under the skin thrombocytopenia bone marrow depression
depression bone marrow depression pallor
organism anemia anemia
hemolysis of the RBCs organism hemolysis of the RBCs Neonatal jaundice anemia depression bone marrow RBCs hemolysis organism Jaundice hemolysis
hepatitis Organism neonatal hepatitis STORCH infection neonatal hepatitis Jaundice jaundice STORCH hemolysis of the RBCs neonatal hepatitis
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175
Infection Dr. Abo El -Asrar STORCH pallor
bone marrow depression Hemolysis of the RBCs STORCH infection skin rash skin rash maculopapular vesicular criteria
Investigations
Investigations toxoplasmosis Skull X-ray skull X-ray micro cephaly Hydrocephaly
Intra cranial calcification
Intra cranial calcification toxoplasmosis
Cytomegalo virus dots intra cranial calcificatiton

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176
Infection Dr. Abo El -Asrar dots toxoplasma
X-ray OSCE Intra cranial calcification dots toxoplasma
Intra cranial calcification for differential diagnosis dystrophic metastatic STORCH infection dystrophic toxoplasma
X-ray toxoplasma fundus examination fundus examination chorio retinitis toxoplsama STORCH infection chorio retinitis
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177
toxoplasma
toxoplasma antibody titer raising titer active infection raising antibody titer toxoplasma active infection
Treatment
toxoplasma
toxoplasma Infected
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178
Infection Dr. Abo El -Asrar clinical manifestations
treatment manifestations
raising antibody titer toxoplasma
G6PD
toxoplasma free oxygen radicals
toxoplasma G6PD treatment severe hemolysis G6PD deficiency
multi centers study toxoplasma infection G6PD association 1
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179
therapy STORCH
Congenital Cytomegalo virus infection

Causative organism
cytomegalo virus
Clinically
Intra uterine growth retardation microcephaly even an encephaly
brain stem
severe infection brain stem Hemorrhage
micro ophthalmia STORCH pallor Purpura jaundice

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180
Infection Dr. Abo El -Asrar toxoplasma
CMV 8th cranial nerve rubella sensory neural deafness hepato splenomegaly reticulo endothelial system hyperplasia
CMV
skull X-ray Intra cranial calcification intra cranial calcification toxoplasma calcification periventricular Periventricular calcification MRI CT MRI CT lateral ventricle Lateral ventricle
lumen
brain
lateral ventricle wall calcification
wall of lateral ventricle periventricular calcification X-ray patch
ventricle
calcification periventricular periventricular
ventricle
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181
Infection Dr. Abo El -Asrar brain X-ray skull
CT
periventricular
congenital toxoplasmosis active infection
toxoplasma congenital toxoplasmosis
congenital toxoplasma congenital toxoplasma infection catch up
toxoplasma repeated abortion Intra uterine fetal death
abortion
Infection
catch up
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182
source of infection
fundus examination chorio retinitis
antibody titer raising antibody titer
Treatment
under trial nowadays Very acurrate drug
very effective drug
Congenital syphilis
nowadys congenital syphilis
Causative organism
trepnema pallidum
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183
culture
Clinically
congenital syphilis
intra uterine growth retardation STORCH
rash
Purpura
Jaundice
STORCH edema edema Hepatosplenomegaly
Liver
congenital syphilis
edema syphilis myocarditis intrauterine heart failure edema
heart heart edema
Infancy period
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184
Mucocutaneous lesions Mucocutaneous lesions Nose fungating mass Ulcer mucocutaneous junction
anus
anus valva
maculopapular rash maculopapular rash
Nose Multiple nasal polyp Mucosa
severe reaction
childhood gumma stage destructive pathology destructive pathology Nasal septum depressed nasal bridge saddle nose nose Saddle shaped nose teeth teeth tooth
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185
edge
edge
teeth Interstitial keratitis corneal opacity tibia tibia tibia
deformity
Palate Perforated palate lips Lips nose Hear gamma
heart block
Investigation
syphilis syphilis serology serum antibody specific fungating mass Mucocutaneous lesions surface dark field examination
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186
Infection Dr. Abo El -Asrar specific stain
immuneflorcent
Treatment
CNS affection crystaline pencillin CNS CNS CNS dose 50
International unit
30
STORCH
Congenital herpes
congenital herpes infection Varicella Zoster virus
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187
vagina
infection catch up infection birth canal Acquired type 2 herpes herpetic eruption cervix even birth canal
infection
catch up
herpetic type 2 herpes vagina cervix painless
type two herpes cesarean vaginal delivery vaginally Infection catch up birth canal
blister skin vesicles
herpes
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188
Infection Dr. Abo El -Asrar bone marrow bone marrow severe thrombocytopenia severe thrombocytopenia bleeding tendency purpura petichae ecchymosis
CNS
Varicella herpes encephalitis encephalitis herpes temporal lobe
temporal lobe Varicella zoster cerebellum herpes temporal lobe hepatosplenomegaly Infection through the placenta STORCH Micro ophthalmia cataract Intra uterine pan encephalitis micro cephaly
Investigations
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189
Virus isolation
lesion virus
Inculsion bodies virus Inclusion bodies implanted
Inclusion bodies skin lesion
Treatment
acyclovir
doses CNS manifestations CNS infection Must be 3 weeks
varicella herpes herpes simplex type 2 birth canal
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190
Infection Dr. Abo El -Asrar varicella Herpes Main causative organism herpes simplex type two
varicella chicken pox
chicken pox eruption Type 2 virus the same pattern
Neonatal infection
Neonatology Infection
neoborn Immunity immunity newborn Immune cells still immature T cells still immature B cells still immature macrophages immature natural killer cells still immature complement system still immature
Infection
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natural barrier
191
Infection Dr. Abo El -Asrar PH of the stomach PH of the stomach marked acidity
PH stomach acidity PH
organism Infection
catch up stomach catch up
gut
Immune sysem organism feeding gut natural barrier acidic PH of the stomach acidic PH of the stomach very low
Predisposing factors risk factors neonatal infection membranes
Premature rupture
neonatology pre mature rupture of the membrane
rupture of membranes
12 18
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192
Contamination
rupture of membranes Induction of delivery within 12 hours It is the ideal time 18 Infection catch up
vaginal examination premature rupture of membranes absolutely contraindicated
Once vaginal Vaginal examination Induction of delivery
Premature labor preterm Infection preterm passive immunity
liable to infection tansplacental immuneglobulins
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193
Immune system
gastric PH liable for neonatal infection Preterm
hetero fever Hetero fever Infection
placenta
Infection
urinary tract infection cystitis Pyelonephritis Pyelonephritis cystitis
Organism pus cells urnie
birth canal contamination catch up
amionitic fluid
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chorioamionitis Inflammation
194
Infected
Intra venous line IV line infection control
gangrene
thrombophelbitis
Infected Infection IV line
resuscitation resuscitation Umblical catheter Infection

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195
Infection Dr. Abo El -Asrar IV line source of infection
Intra partum asphyxia Intra partum asphyxia
monitoring Monitoring vaginal examination rupture membranes Monitor lead scalp Monitor
Lead
PH blood gases Heart rate
manipulation contaminated contamination liable Infection
Causative organsim
Infection transplacental Infection transplacental infection transplacental STORCH
birth canal
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196
Infection Dr. Abo El -Asrar birth canal birth canal commensal catch up
Normal commensal group B beta hemolytic streptococci vagina streptococcal viridans Mouth Immune compromised
vagina
E.coli Normal commensal Monilia vagina
humid area excess water Monilia infection is so common
gonorrhea
vaginal secretion chalmydia trachomatis
herpes simplex Hepatitis B vaginal Secretion catch up
staph
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197
breast abscess staph organism
staph pneumonia staph pneumonia infection E.Coli is so common GIT Commensal E.Coli contamination Feco oral E.Coli mastoid
Infection
Nowadays umblical stump contamination
Mode of infection
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198
birth canal
transplacental passage
Clinically
neonatal infection infection non specific manifestations effect of toxins centrally
Infection
centers
toxins
feeding center
toxins Suppression
gastritis infection chemoreceptor trigger zone GIT
central effect
fungal
Diarrhea Organism bacterial viral
bone marrow even purpura pallor

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199
Infection Dr. Abo El -Asrar hemolysis infection Pallor jaundice Infection jaundice hepatitis hemolysis
cyanosis cyanosis toxemia respiratory depression cyanosis slow irregular respiration sepsis toxic or viral myocarditis heart failure
sepsis Pneumoina Infection chest infection cyanosis
pneumonia
associated with dyspnea
specific specific
septic focus tachypnea

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200
Infection Dr. Abo El -Asrar working ala nasi
hand writing
specific
septic focus tachypnea working ala nasi Intercostal and subcostal retraction bronchial breathing fine crepitation pneumonia
X-ray pneumonia
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201
limitation of movement
swollen red and hot tender arthritis
meningitis signs of meningeal irritation bulging fontanelle drowsiness projectile vomiting convulsions what ever the causes focus
Neonatal infection
Investigations
Investigations CBC CBC Polymorph leucocytes
viral infection Lymphocytosis
Immature WBCs
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202
severe infection immature WBCs
platelets bone marrow depression bone marrow
WBCs count It is a good sign
Infection WBCs pan cytopenia The good or bad sign bad sign bone marrow bone marrow depression
Neonatal infection feverish is a good sign Immunity
feverish very gave sign !!!!!!! bad sign severe sepsis C-reactive protein
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203
Infection Dr. Abo El -Asrar Positive infection culture and sensitivity dyspnea sputum culture
diarrhea stool culture
blood culture bulging fontanelle Lumbar puncture culture Intra uterine growth retardation cataract Micro ophthalmia STORCH infection screening STORCH Herpes syphilis skin lesion swab
treatment
Antibiotic therapy according to culture and sensitivity
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204
viral anti
Immune globulins general condition immune globulins Immune globulins general immunity exchange transfusion exchange transfusion organism toxins thrombocytopenia anemia
Immune globulins immunity
exchange transfusion
urinary system
urinary tract infection

urniary tract infection UTI Newborn Infant
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205
Infection Dr. Abo El -Asrar un circumcised circumcision circumcision
circumcision circumcision
un circumcised boy liable for UTI Un circumcised Incidence of UTI
childhood Incidence urethera Urethera perineum ascending route urinary system
Cauastive organsim
urinary system most common gram negative bacteria Most common gram negative bacteria gram negative bacteria
UTI
pseudo monas
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E.Coli
206
so rare
viral gram positive urinary system
Route of infection
route of infection most common ascending route ascending route organism urethera urinary system
Perinum
Newborn hematogenous septic focus organism urinary system septic focus UTI urinary system ascending route Hematogenous Newborn
Risk factors
risk factors for UTI
UTI
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risk factor
207
Infection Dr. Abo El -Asrar urethera Perineum urinary system Infection
un circumcised boy
retention of urine Urinary system pathway Obstruction retention of urine infection retained urine
vesico ureteric reflex urinary bladder wall ureter wall of the bladder Muscles trigone wall of the bladder contraction ureter contraction of the bladder ureter urine
wall Lumen wall Urinary bladder Ureter
Ureter wall
contraction Urine
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208
urine
bladder
Ureter bladder
cystitis cystitis Infection dysuria
vesico ureteric reflex
obstruction Obstructive uropathy
fibrosis
stricture
urethera
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209
Infection Dr. Abo El -Asrar Hernia common hernia inguinal hernia
supra pupic pain
Hematuria cystitis
contamination
contaminated
So common
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210
15
repeated UTI sonar IVP palin X-ray recurrent UTI
oxyurisis pin worm
speciality Neck
UTI
pityriasis alba
anorexia
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211
Pin worm 12 perineum severe itching severe eggs eggs
abrasion secondary infection ascending through the urethera Infection
repeated UTI You must exclude infection of pin worm
uropathic bladder paraplegia neurologic insult nerogenic bladder retention repeated infection
Clinically
Pyelonephritis cystitis asymptomatic bacteruria Pyelonephritis inflammation
pelvis of the kidney
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212
infant infant
Renal colic
rhinitis
pyelonephritis fever You must palpate the loin kidney plapation
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213
Infection Dr. Abo El -Asrar kidney palpation Marked tenderness loin Pyelonephritis nausea and vomiting manifestations of toxemia vomiting nausea diarrhea UTI UTI UTI
secondary gastroentritis secondary gastroeneritis
secondary gastroenteritis
Weight loss toxemia Jaundice toxemia Hemolysis hepatitis What ever
children and adolescent children and adolescent
Fever of unknown origin
Loin pain Loin pain

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214
Infection Dr. Abo El -Asrar marked tenderness flanks other manifestations toxemia
cystitis cystitis
cystitis vasularity bladder cystitis fever low grade fever
dysuria
Marked dysuria
bladder Inflammation spinal cord false signals

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215
Infection Dr. Abo El -Asrar full bladder
spinal cord
signals
bladder
Urine
Incontinence
Nocturnal enuresis
Page |
216
Hematuria supra pubic region marked tenderness Palpation
Investigations
Investigations
circumcision in females
circumcision in female illegal
Page |
217
Page |
218
Page |
219
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220
Investigations Investigations CBC neutrophils lecocytosis bacteria common Urine analysis Pus cells Over one hundred Acute infection normal pus cells High power field 5 cells 2
accepted
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221
pus cells acute infection
pus cells
RBCs Hematuria
Urine UTI
PH PH acidic
proteus infection
alkaline Infection UTI
alkaline
PH
urine culture and sensitivity culture
mid stream Mid stream urine analysis urine analysis and culture urine analysis culture
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222
wash
Post prandial
Urine analysis
Page |
223
Infection Dr. Abo El -Asrar urethera wash
stream full steralization perineum
genitalia
urine analysis culture
Page |
224
Infection Dr. Abo El -Asrar Liable for contamination
contamination Supra pubic aspiration supra pubic region bladder
sample
collection
urine culture and sensitivity
urine culture and sensitivity UTI colony 100 UTI UTI specific pathogen
gram negative pathogen colony UTI asymtomatic symptomatic colony symptoms
UTI
specific pathogens Manifestations UTI
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225
Infection Dr. Abo El -Asrar UTI Manifestations blood culture fever renal function
Plain X-ray Radio opaque stones precipitating factor abdominal sonar hydronephrosis urinary system anomalies
Stool analysis To exclude the pin worm stool analysis Pin worm To exclude Repeated UTI
Treatment
cystitis cystitis according to culture and sensitivity doses

Page |
226
Infection Dr. Abo El -Asrar doses
pyelonephrititis 3rd generation cephalosporin
ampicillin
3rd generation
parentral Oral form nowadays Oral form spelling
oral form
Page |
227
Infection Dr. Abo El -Asrar urinary system Urinary system renal blood flow urinary system wash
urine acidic juices
PH
acidic urine
acidification
alkaline media acidic media
acidic urine organism alkalinization of the urine urine alkalinization acidification Except
underlying etiology
reflex uropathic bladder
You must treat the underlying etiology
UTI prophylaxis recurrent UTI UTI

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228
Infection Dr. Abo El -Asrar vesico ureteric reflex neurogenic bladder
Urinary tract stasis Urinary tract obstruction anatomical defects urinary system
Infection
full dose
prophylaxis full dose
cystitis pyelonephritis dose
Page |
229
Urine culture
urine culture urine sterile growth
culture sterile
Urine
just follow up follow up urine culture
repeated urine culture
Immunization
Active immunization active immunity passive
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230
antibody antibody
active active active natural artificial
artificial
natural infection vaccine
active immunization antibody
artificial vaccine natural infection natural infection Infection life long immunity For life Memory cells antibody for life protection
solid long immunity
rubella
MMR mumps Measles MMR natural infection vaccine Natural infection
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231
Infection Dr. Abo El -Asrar short term immunity organisms
antigenicity pattern
virus short term immunity scarlet fever
toxins
scarlet fever anti neutralizing antibody erythrogenic toxins for life Permenant immunity scarlet fever scarlet fever rash
Immune system organism antibody short term
M protein
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232
scarlet fever strain sore throat fever erythrogenic rash Scarlet fever
artificial vaccination
passive immunization Protection
passive Natural Artificial
passive Passive trans placental infection immunity natural Immune globulins
Infection
can protect her baby
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233
Infection Dr. Abo El -Asrar T.B. Whooping cough whooping cough Ig M
artificial immue globulins chemoprphylaxis Infection
vaccination
Vaccination
obligatory vaccine vaccine
vaccination vaccination vaccine Infection Infection vaccine
nature of the vaccine Live attenuated Killed toxoid genetic engineering
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234
route of administration dose
side effect
whooping cough cell mediated immunity placenta
TB TB
passive immunity whooping cough
cell mediated immunity
immune globulins Whooping cough Ig M immune globulins Ig G placenta
BCG
Nature Live attenuated vaccine route of administration Intra dermal ID dose 0.1
deltoid
insertion
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235
deltoid
BCG scar Insertion
BCG scar
deltoid Insertion
sole sole scar scar sole scar
BCG
BCG
BCG Immunity for life booster dose
positive
tuberculin vaccine is valid
Page |
236
tuberculin negative once You must repeat the vaccine
There is tuberculin negative BCG scar
BCG
tuberclous scar BCG scar BCG still BCG contra indication contra indication BCG Live attenuated live attenuated Absoultely contra indicated in immune deficient vaccine chicken pox Live attenuated vaccine immune deficient chicken pox Live attenuated Ohterwise Immune compromised immune deficiency BCG tuberculin positive
Page |
BCG
237
immune infection severe local reaction BCG
measles infection Measles infection cell mediated immunity suppression Measles cell mediated immunity suppression fluminant reaction
contra indication
side effects side effects Local reaction
local suppuration
sinus
extended Lymph nodes

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238
Infection Dr. Abo El -Asrar axilla cold abscess enlarged axillary lymph nodes cold abscess BCG Oral BCG oral BCG Live attenuated oral It is very effective vaccine
scar
Oral BCG
tuberculin test tuberculin positive
complication Recorded up till now
oral BCG 1200 1200 BCG TB
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239
Infection Dr. Abo El -Asrar Polio vaccine Live attenuated killed type Sabin vaccine salk vaccine
sabin
Oral Intra musclar sabin
Immunity active immunity passive immunity active immunity natural Infection diseases Immune system
natural infection
antibodies antibodies
Memory cells
Memory cells antibodies for life protective MMR rubella Mumps measles
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240
Infection Dr. Abo El -Asrar natural infection
Immune system long life immunity target Organism antigenic pattern
virus strain Immunity strain antigenic vaccine Natural infection strain short term immunity dual immune response scarlet fever M protein strepto cocci antibodies Immune system strepto coccal strain scarlet fever erythrogenic toxins erythrogenic toxins antibodies strepto coccal strain antibody for life short term immunity erythrogenic toxins
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241
Infection Dr. Abo El -Asrar Long term immunity for life
scarlet fever once per life strain rash
strain local manifestation strepto cocci sore throat tonsillitis Otitis media rash
active immunity natural infection vaccination
Passive immunity Passive immunity Immune system natural
immune protective mechanism through the placenta
Immune globulins immune globulins G placenta Ig M whooping cough whooping cough whooping cough
long lasting immunity
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242
bordetella pertusis
antibody Para pertusis antibody Ig M Immune response Ig G Ig M Ig M Ig G Shift Ig M placenta whooping cough
whooping cough
protection
transplacental antibodies since birth whooping cough
artificial protective mechanism viral infection immune globulins bacterial infection chemo prophylaxis vaccination obligatory vaccine Obligatory vaccine
vaccine written
vaccine
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243
Infection Dr. Abo El -Asrar vaccine Live attenuated killed organism toxoid genetic engineering route of administration Polio oral MMR subcutaneous Measles Hepatitis Intra muscular DPT route of administation dose
salk vaccine
Obligatory vaccine
vaccine
side effects
BCG vaccine
vaccines Powder BCG vial Powder BCG vial
Live attenuated vaccine pathogenic bacteria
BCG TB bacillus attenuation
Page |
244
Infection Dr. Abo El -Asrar BCG vaccine
Intra dermal dermis bullae
Intra dermal
dose Intra dermal
0.1
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245
tuberculin test Infection catch up
tuberculin test negative tuberculin test BCG BCG
BCG Once tuberculin test tuberculin test negative BCG Is not valid Protective mechanism BCG booster dose negative Tuberculin test
contra indication BCG tuberculin test positive tuberculin test positive immune commpetent sensitization infection Immune system BCG positive tuberculin test
BCG TB bacilli
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246
Infection Dr. Abo El -Asrar extensive local Lymph adenitis Lymph nodes contra indication side effects
Even
Live attenuated vaccine Live attenuated vaccine organism live attenuated vaccine immune deficient course chicken pox main indication Live attenuated Manifestations of chicken pox infection
Immune deficient
Measles attack of measles BCG Measles suppression
cell mediated immunity
Measles
cell mediated immunity Immune deficient live attenuated vaccine
suppression
side effects side effects Local suppuration
healing by scar
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Caseous material
247
Infection Dr. Abo El -Asrar reaction Is a good sign
Your child is immune competent
local reaction valid Immune system Immune response extensive local suppuration scar It is a good sign
Intra dermal
subcutaneous subcutaneous through the lymphatic drainage organism axillary lymph nodes
axillary lymph nodes enlarged Matted together cold abscess tuberculosis axillary lymphadenopathy cold abscess subcutaneous Intra dermal Immune deficient
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248
Infection Dr. Abo El -Asrar Intra dermal Organism lymphatic system extensive lymphadenitis cold abscess INH therapy INH therapy axillary lymphadenopathy
Oral BCG intra dermal countries Not available preservation time vaccination
technology vaccine
Live attenuated intra dermal
oral
first week of life
Page |
249
tuberculin test vaccine Oral Local multiplication
mucosa
Tuberculin test tuberculin test negative BCG tuberculin test
tuberculin test
side effects reported vaccine immune reaction
vaccines
Polio vaccine
Polio vaccine live attenuated Sabin salk
salk vaccine
sabin
Nature of the vaccine vaccine Live attenuated sabin Killed vaccine salk live attenuated Killed vaccine
Page |
sabin salk
250
Oral
sabin
vaccine oral
80 vaccination 18 15 target
mass vaccination
salk vaccine IM IM contamination
mass
sabin
Intra muscular
Page |
salk vaccine
251
Infection Dr. Abo El -Asrar salk vaccine polio vaccine salk salk vaccine
salk vaccine Intra muscular
sabin
salk immune compromised Immune compromised Immune compromised contact
Leukemia
Say
Immune deficiency
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252
Infection Dr. Abo El -Asrar sabin salk sabin Immune compromised salk 11 salk vaccine
Immune compromised immune deficiency
sabin vaccine salk vaccine
sabin Live attenuated oropharyngeal secretion oropharyngeal stool vaccine live attenuated virus feco oral droplet Leukemia polio Immune deficiency salk vaccine
cortisone
sabin salk vaccine
contraindication
Page |
253
Infection Dr. Abo El -Asrar live attenuated sabin
Immune compromised child Immune compromised contacts
salk vaccine attack of fever epidemics of polio IM epidemics of polio IM IM Paralytic polio abortive polio Intra muscular fever manifestations fever Non paralytic polio paralytic polio epidemics of polio myelititis abortive
side effects Live attenuated sabin Polio myelitis Immune compromised Immune compromised Polio
polio
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254
Paralysis
fetus fetus
transmission to immune deficient contacts
salk vaccine epidemics of polio abortive non paralytic polio Paralytic polio Intra muscular side effects Intra muscular injection Intra muscular injection osteomyelitis Pyogenic arthritis what ever
bone
vaccine
DPT vaccine
DPT DPT toxoid killed bacteria tetanus pertusis
toxoid tetanus killed bacteria
pertusis
route of administration Intra muscular thigh

Page |
255
Infection Dr. Abo El -Asrar quadriceps Intra muscular
thigh
dose
Indication
Page |
256
DT Pertusis Pertusis severe encephalitis Pertusis
contra indication pertusis encephalitis History of convulsion
febrile convulsion
epilpsy DPT
epilpsy
DT epilpsy
epidemics of polio fever abortive polio Intra muscular paralytic polio
peripheral neuropathy
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257
Infection Dr. Abo El -Asrar peripheral neuropathy
DPT DT Pertusis
DPT DT side effects encephalitis Neuritis Pericipitation Pertusis polio Intra muscular Local intra muscular complications abscess formation contamination vaccine
Hepatitis vaccine
hepatitis B vaccine is obligatory vaccine date of birth hepatitis B vaccine Obligatory
hepatitis A vaccine hepatitis A vaccine hepatitis A vaccine hepatitis A vaccine
adult Hepatitis A Is Fulminant hepatitis
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258
Infection Dr. Abo El -Asrar adult Nothing hepatitis A vaccine hepatitis A Hepatitis A virus it is not obligatory in egypt hepatitis B vaccine obligatory Hepatitis A
DNA Genetic engineering hepatitis B surface antigen
Immune response positive Negative titer free hepatitis B surface antigen Positive infection Infected Hepatitis B surface antigen
Intra muscular
Page |
259
zero zero
Say
hepatitis B vaccine
contraindication
contraindication no side effects vaccine vaccine
MMR vaccine
MMR vaccine Live attenuated vaccine an obligatory vaccine in Egypt MMR Nowadays MMR
booster dose measles
Page |
260
Immune globulins
MMR
Immune globulins G Protection Live attenuated
vaccine
virus
Immune globulins role obligatory
Measles obligatory MMR
booster dose
18 12 dose subcutaneous
Page |
261
Infection Dr. Abo El -Asrar contra indications Live attenuated vaccine Immune compromised measles active tuberculosis Measles vaccines measles infection Measles infection measles vaccines cell mediated immunity suppression active tuberculosis MMR febrile Polio myelitis side effects Immune compromised encephalitis TB infection activation TB Immune compromised Measles measles rash advantages of MMR vaccines measles natural infection MMR
manifestations
rubella
Mumps
fever Infection
natural infection Manifestations so mild
convalescent period spreading Incidience of complications

Page |
262
Infection Dr. Abo El -Asrar Natural infection
Meningitis
dry type
wet type
Polio Paralytic polio
bulbar wet type Spinal dry type respiratory complications wet type of respiratory complications bulbar affection repeated aspiration and chocking secretion wet type pneumonia dry type intercostal muscles diaphragmatic Paralysis respiratory center
secretion Meningitis meninges Inflammation Meninges Inflammation
Page |
263
Infection Dr. Abo El -Asrar meningitis aseptic meningitis septic meningitis
septic meningitis
septic meningitis septic meningitis bacteria Organism group B birth canal commensal birth canal commensal commensal E.Coli
females
perineal region
H. Influenza strepto coccal pneumonea Nisseria meningitidis
Nisseria
strepto coccal
age organism meningtitis aseptic CSF Lumbar puncture virus virus

Page |
pus
264
leptospirosis
toxoplasma syphilis Meningitis encephalitis
Non infectous cause Leukemic infiltration Leukemia Meninges meningitis Lymphoma arsenic Lymph Post vaccincation Pertusis vaccine Intra thecal injection chemmotherapy lumbar puncture Infection meningitis
Clinically
Meningitis rules
meningitis
features of increased intra cranial pressure features of increased intra cranial pressure
High pitched cry
Irritable
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265
morphia
blurring of vision
blurring of vision
Projectile vomiting fever disturbed level of consciousness
change of level of consciousness signs of meningeal irritation Polio
severe headache
severe
neck stiffness
blurring of vision
projectile vomiting and fever

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266
Infection Dr. Abo El -Asrar coma drowsiness and even
Meningeo coccal meningitis rash
babies
drwosiness high arched back high pitched cry disturbed level of consciousness and coma
signs of meningeal irritation neck rigidity neck rigitiy
sternum
chin
positive
Burdziniski sign
kering's sign
Page |
267
Infection Dr. Abo El -Asrar Positive spelling
meningitis meningitis Lumbar puncture Lumbar puncture manifestations of increased intra cranial tension Lumbar puncture chemotherapy Increased intra cranial tension cerebellum Herniation
inter vertebral space
level plapation L4 and L5 L3 and L 4 spinal cord spinal trauma Needle Inter vertebral space needle
CSF
Page |
268
Normal CSF lumbar puncture cardio respiratory distress trauma respiratory failure
tension
cerebellum
herniation
needle
Infection Level dermitis abscess
infection
Lumbar puncture
clear
Page |
Colorless
269
Infection Dr. Abo El -Asrar tension tension Jet flow
mild tension Normal tension tension
Lumbar puncture lumbar puncture
57
1000 lumbar puncture
2800 lumbar puncture Intra thecal very critical diagnostic Chemotherapeutic injection lumbar puncture traumatic
Page |
270
score
Under general anesthesia
Under screen
Lumbar puncture
Lumbar puncture
tension Lumbar puncture
lumbar puncture cytology culture and sensitivity chemistry of Cl , glucose , LDH
bacterial meningitis
viral brain abscess
Page |
271
Infection Dr. Abo El -Asrar bacterial meningitis CSF viral Normal tension 80 50
80 100 tension 50 viral mild Increase
50
bacterial High tension
viral meningitis
clear
5 cells
leucocytes total leucocytic count CSF High power field
cells
viral bacterial cells bacteria viral neutrophils Lymphocytes
Neutrophils Lymphocytes
bacterial meningitis
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272
viral meningitis
Mild protein raising
viral viral consumption bacterial meningitis
Normal glucose consumption bacterial consumed
culture blood culture meningeo coccal meningitis Organism meningitis in general can isolate the organism through the blood culture CBC Leucocytosis bacterial Polymorph viral lymphocytosis
Leucocytic count low Meningitis Prognosis is so bad sepsis good sign bad sign leucocytic count leucocytic count
Complication
complications
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273
Infection Dr. Abo El -Asrar water house spelling supra renal hemorrhage supra renal hemorrhage addisonian crisis DIC skin DIC bleeding DIC
Neurological complication Neurological quadriplegia attack ataxia attack transverse myelitis attack cerebellum Herniation attack subdural effusion Hydrocephalus neurological symptoms
subdural effusion
subdural effusion subdural effusion pneumococcal infection H. Infleunza capsulated organism subdural effusion suspect
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274
Infection Dr. Abo El -Asrar meningitis conscious level general condition
tension fever bulging fontanelle tension
focal neurological signs weakness One limb convulsion focal signs what ever skull circumference skull circumference subdural effusion complicated pneumo coccal infection H. Infleunza
Treatment
manifestations of increased intra cranial pressure manifestations of increased intra cranial pressure antibiotics
Increased intracranial tension brain dehydrating measures antibiotic cortisone Lasix mannitol
Page |
275
cortisone cortisone Meningitis
brain edema Anti inflammatory antibiotic therapy bacteria Lysis Lysis of bacteria inflammatory mediators brain edema Meningitis corticosteriod is mandtory
Increased intra cranial tension brain dehydrating measures antibiotics
antibiotics according to culture and sensitivity sensitivity culture third generation cephalosporin chloramphincol chloramphincol depression bone marrow third generation cephalosporin
organism antibiotic
written antibiotic according to culture and sensitivity
Page |
276
H. infleunza
Un complicated
strepto coccal pneumonae
Nisseria meningitidis
gram negative
H. Infleunza strepto coccal Nisseria meningitidis gram negative bacilli
Prevention prevention is chemoprophylaxis H. infleunza vaccine vaccine rifampicin rifampicin
vaccine
Nisseria meningitidis rifampicin vaccine Meningeo coccal vaccine
strepto coccal pneumonae vaccination chemoprphylaxis contacts Just isolation

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277
Infection Dr. Abo El -Asrar Meningitis Prognosis Is excellent prognosis within 48 hours an excellent prognosis
Tuberculosis
tuberculosis T.B.
Causative organism
Mycobacterium tuberculosis
Route of infection
droplet infection
Source of infection
cases
Incubation period
Infectivity period
Infectious bacterial 3 negative sputum cultures Pulmonary tuberculosis
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T.B.
278
renal tuberculosis contamination sputum Infection
pulmonary T.B. adult spreading of infection child spreading of infection adult
Hygiene
Clinically
primary tuberculosis primary tuberculosis Infection mycobacterium tuberculosis
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279
Infection Dr. Abo El -Asrar primary complex pathology organism immune system Local reaction
Organism
Lymphatic drainage draining lymph node juglo digastric lymph nodes primary tonsillar complex
Lymph nodes T.B. bacilli Immune system antigenic pattern Infection Localization
Primary tonsillar complex
primary pulmonary complex Organism droplet infection airway right bronchus right lung trachea right continuity right bronchus
bronchus lower part of the upper lobe Upper part of the lower lobe local reaction Sub pleural Local granulomatous lung tissue sub pleural
Ghon's focus pleural reaction pleurisy

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280
Primary pulmonary complex
38
anorexia
cough
Pleurisy chest pain localized chest pain
Local reaction Organism draining lymph nodes hilar mediastinal lymph nodes mediastinal lymphadenitis mediastinal lymphadenitis esophagus dysphagia trachea brassy cough
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281
Infection Dr. Abo El -Asrar recurrent laryngeal nerve hoarsness of voice Mediastinal compression symptoms
Mediastinal lymph nodes
Level of T2 vertebrae bronchial breathing Normal positive spine sign positive
positive spine sign hoarseness of voice dysphagia brassy cough Mediastinal lymph nodes enlargement allergic reaction primary tuberculosis allergic reaction erythema nodosum erythema nodosum intra dermal
chin of the tibia
exclude parasitic infestation first tuberculosis second
secondary tuberculosis TB
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282
Infection Dr. Abo El -Asrar TB Immunity primary TB nephrotic syndrome corticosteroid
Lymphoma Immune system primary focus reactivation
Leukemia
reactivation bacilli Immune system Immune system TB bacilli at the site of reactivation
light local reaction Lymphatic system Lymph nodes
Immune system Organism extensive local reaction
extensive local reaction
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283
Infection Dr. Abo El -Asrar caseous material caseous material cavity formation extensive local destructive reaction
draining lymmph nodes Pressure manifestation draining lymph nodes very very low
reaction
manifestation of tuberculous toxemia night fever Night sweating Loss of weight anorexia
caseous material abscess
huge amount of sputum caseous cavity caseous material dry Productive cough cough
main symptoms of pulmonary tuberculosis fatigue

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284
Infection Dr. Abo El -Asrar Loss of weight chest pain Lung hemoptysis night sweating GERD TB toxemia pallor extra pulmonary extra pulmonary TB
lung
extra pulmonary manifestations of TB
CNS
TB CNS
tuberculoma Meningitis
typical meningitis brain Local reaction tuberculoma tuberculoma CNS
choroid tubercle
disseminated TB choroid
Lymph nodes tuberculous lymph adenopathy
pleura pleural effusion Heart pericardial effusion bones pott's disease vertebrae tuberculous arthitis Joint
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285
Infection Dr. Abo El -Asrar genito urinary system Kidney TB infection GIT
extra pulmonary Lung pleural effusion TB pleural effusion Lung TB tuberculous reaction lung TB caseous material pleura cavity effusion pleura tuberculous osteomyelitis pleura TB pleural effusion Mediastinal lymph nodes pleural effusion What ever rupture subpleural focus caseous lymph nodes osteomyelitis
pleural effusion usually unilateral TB Unilateral pleural effusion
Mild or moderate effusion

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286
Infection Dr. Abo El -Asrar massive effusion manifestation of pleural effusion chest pleural effusion respiratory distress affected side limitation of movement Limitation of movement massive effusion bluge
diminished
palpation massive trachea TVF
Percussion stony dullness auscultation diminished air entry
Pleural exam
Pleural tap lumbar puncture excess protein glucose LDH TB bacilli culture
pericardial effusion
pericardial effusion Tuberculous pericardial effusion Pericardial pericardial sac collection pericaridal effusion X ray flask shaped apperance cardiomegaly
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287
Infection Dr. Abo El -Asrar TB bacilli pleura Lymph nodes Lung What ever TB pericardial effusion miliary TB Immune compromised TB bacilli bacteria vein blood stream vein two organs
TB diagnostic choroid tubercle fundus examination
systemic dissemination
choroid tubercle
signs of miliary TB Lymph nodes Liver and spleen Meningitis Peritonitis skin fundus
choroid tubercle diagnostic in fundus examination
congenital TB Infection infection

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288
Infection Dr. Abo El -Asrar respiratory distress neonatal infection respiratory distress cold TB fever Failure to thrive Splenomegaly Lymphadenopathy
antiboitics Not responding to ordinary antiboitics
tuberculin test Negative positive immunity extra pulmonary Lymph nodes Lymph nodes Lymph nodes Lymph nodes cortex Lymph nodes cortex Lymph nodes enlarged Lymph nodes tender firm matted together
matted together matted together Matted matted
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289
Infection Dr. Abo El -Asrar TB lymphadenopathy prognosis
others lymph nodes
spreading
Immunity resolution necrosis caseation sinus TB meningitis Meningitis tuberculoma space occupying lesion
sinus formation
brain
Investigations
TB Investigations tuberculous X-ray X-ray cavitation caseation Medial lobe collapse pleural effusion pericardial effusion chest X-ray mediastinal lymph nodes chest TB chest X- ray specific for TB
tuberculin test tuberculin test TB bacilli antigenic part purified protein derivitives TB bacilli antigenic part
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290
Infection Dr. Abo El -Asrar 0.1 5 unit 0.1 5 unit 0.1 unit intra dermal forearm
vaccine Local reaction redness induration Induration diameter tuberculin negative
repeat the vaccine again Positive Negative
Positive
tuberculin test tuberculin test
tuberculous
diagnostic TB bacilli Natural infection
tuberculin test vaccine
tuberculin test tuberculous
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291
Infection Dr. Abo El -Asrar TB diagnostic tuberculin test sero conversion sero conversion tuberculin test negative Positive
BCG vaccine history of vaccine tuberculous
BCG scar shoulder tuberculin positive tuberculous
tuberculous tuberculin test negative cell mediated immunity tuberculin test tuberculous tuberculin negative vaccine
false negative of tuberculin false negative tuberuclin expired Material
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292
dermis
bad technique Non experienced examiner test
infection positive tuberculin tuberculin Incubation period pre allergic state pre allergic disease Incubation period Negative tuberculin test cell mediated immunity supression infection
Measles Leukemia Lymphoma Immune suppressant drugs
INH therapy INH INH INH
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293
Infection
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294

Infection

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Infection Dr.

Infection Dr. Abo El -Asrar

skeleton source of infection

droplet infection parentral infection sex

Infection Dr. Abo El -Asrar

feco oral droplet parentral .. Incubation period

Incubation period Incubation period

incubation period incubation period

scarlet fever diphtheria Incubation period 6 2 scarlet fever measles T.B.

golden rules Prevention

Infection Dr. Abo El -Asrar

avoidance of exposure to sources of infection

droplet infection Avoidance of exposure to sources of infection

Immunization Immunization passive active passive immunization

viral infection Immunoglobulin bacterial infection

bacterial infection meningitis chemo prophylaxis rifampcin anti toxins

Infection Dr. Abo El -Asrar

active immunization vaccine

vaccine vaccination Immunization

Infection differential diagnosis of skin rash

Differential diagnosis of skin rash

Just discoloration of the skin surface of the skin discolored macule

Infection Dr. Abo El -Asrar Pus Pustule Pustule vesicle crust

skin rash Fever and rash

Infection Dr. Abo El -Asrar

fever measles high grade fever high grade fever 38.5

Infection Dr. Abo El -Asrar

febrile convulsion Even acute onset of fever

rhinitis High grade fever

40 anti pyretic Measles

patho gnomonic sign

rash rash 40 38.5 high grade fever Low grade fever

gradually rash maculo papular rash hair line

neck nipple line

hair line nipple line 24 fever 38.5

extended trunk mid thigh rash mid thigh 38

Infection Dr. Abo El -Asrar Maculo papular rash

sole sole sole palm sole

rash rash sequence Hair line neck rash maximum rash

rash rash rash

Infection Dr. Abo El -Asrar branny desquamation rash

branny desquamation dorsum of the hand dorsum of the foot

branny desquamation Palm branny desquamation dorsum surface palmer surface

rash measles patho gnomonic sign measles

Koplik's spots rash

Kopliks spots eruptic stage

Infection Dr. Abo El -Asrar

rash Koplik's spots

Maculo papular rash rubella

History rash macul papular rash hair line

maculo papular rash hair line

Infection Dr. Abo El -Asrar measles

post auricular Lymph nodes

congenital rubella syndrome scarlet fever

scarlet fever High grade fever sore throat sore throat

streptococci antibiotic streptococci toxins feverish still

tonsillitis follicular tonsillitis antibiotic

Infection Dr. Abo El -Asrar streptococcal infection antibiotic therapy

circum oral pallor

Infection Dr. Abo El -Asrar

vaso dilated capillaries Pressure

vaso dilated capillaries

palm and sole