传染 传染病学 名解 大题
传染病名解
传染病名解1.隐性感染：~又称亚临床感染。
是指病原体侵入人体后，仅引起机体产生特异性免疫应答，不引起或只引起轻微的组织损伤，因而在临床上不显出任何症状、体征，甚至生化改变，只能通过免疫学检查才能发现。
2.显性感染：~又称临床感染，是指病原体侵入人体后，不但诱导机体发生免疫应答，而且通过病原体本身的作用或机体的变态反应，导致组织损伤，引起病理改变和临床表现。
3.病原携带状态：指病原体侵入人体后，可以停留在入侵部位或侵处较远的脏器继续生长、繁殖，而人体不出现任何的疾病状态，但能携带并排出病原体，成为传染病流行的传染源。
4.潜伏性感染：~又称潜在性感染。
病原体感染人体后，寄生于某些部位，由于机体免疫功能足以将病原体局限化而不引起显性感染，但又不足以将病原体清除时，病原体便可长期潜伏下来，待机体免疫功能下降时，则可引起显性感染。
5.潜伏期：是指病原体侵入人体起，至开始出现临床症状为止的时期。
6.重型肝炎：表现为一系列肝衰竭症候群-----极度乏力，严重消化道症状，神经、精神症状（嗜睡、性格改变、烦躁不安、昏迷等），有明显出血现象，凝血酶原时间显著延长及凝血酶原活动度（PTA）＜40%；黄疸进行性加深，胆红素每天上升≥17.1umol/L或大于正常值十倍。
可出现中毒性鼓肠，肝臭，肝肾综合征等；可出现扑翼样震颤及病理反射，肝浊音界进行性缩小；胆酶分离，血氨升高等。
重型肝炎的病因及诱因复杂，包括重叠感染（如乙肝重叠其他肝炎病毒感染）、机体免疫、妊娠、HBV前C区突变、过度疲劳、精神刺激、饮酒、应用肝损药物、合并细菌感染、有其他合并症（如甲亢、糖尿病等）。
7.肾综合征出血热：~又称流行性出血热，是由汉坦病毒属的各型病毒引起的，以鼠类为主要传染源的一种自然疫源性疾病。
8.内基小体：指具有特征性病变的嗜酸性包涵体，为狂犬病毒的集落，最常见于海马以及小脑浦肯野细胞中。
9.艾滋病：是获得性免疫缺陷综合征的简称，系由人免疫缺陷病毒引起的慢性传染病。
传染病护理试题一及答案
传染病护理试题一及答案一、名词解释：（本大题共5小题，每小题2分，共10分）1．传染病：2．散发：3．隐性感染：4．传染源：5．病原携带状态二、填空题：（本大题共20空，每空1分，共20分）1．传染病的４个基本特征为、、和。
2．传染病流行的３个基本条件：、和。
3．影响传染病流行过程的因素包括、。
1．甲型肝炎多在发病，戊型肝炎的流行多发生于或后。
2. 临床上把急性肝炎分为型和型，以多见，约占。
3. 乙型肝炎病毒血清标志物检测结果判定：HBsAg(+)表示存在， HBsAb(+) 提示可能。
1．是麻疹的唯一传染源。
主要通过直接传播。
三、选择题（本大题共30题，每题1分，共30分）1．我国规定管理的传染病分为：A．甲类1种、乙类24种、丙类12种B．甲类2种、乙类25种、丙类10种C．甲类3种、乙类28种、丙类9种D．甲类3种、乙类24种、丙类9种E．甲类2种、乙类22种、丙类11种2．关于消化道隔离，下列哪项是错误的：A．最好同一病种患者同住一室B．工作人员密切接触患者时应穿隔离衣、戴帽子及口罩、穿隔离鞋C．患者的用品、食具、便器、排泄物、呕吐物均须消毒D．病室应有防蝇及灭蝇设施E．患者可交换使用物品3．增强特异性免疫力的首要措施为：A．体育锻炼B．调节饮食C．预防接种D．改善居住条件E．良好卫生习惯4．要求城镇在12小时内，农村不超过24小时上报疫情的传染病是：A．炭疽B．鼠疫C．流行性感冒D．丝虫病E．包虫病5．下列属强制管理的传染病为：A．黑热病B．肺结核C．霍乱D．肾综合征出血热E．艾滋病6．传染病最主要的特征是：A．由病原体引起B．具有一定的区域性C．具有传染性D．具有流行性E．具有季节性7．《中华人民共和国传染病防治法》的颁布实施时间是：A．1981年9月1日B．1998年9月1日C．1979年9月1日D．2004年12月1日E．1989年8月1日8．传染病的基本特征是：A．有传染性、传播途径、免疫性B．有病原体、流行性、传染性C．有病原体、传染性、流行病学特征、免疫性D．有传染性、免疫性、流行性、地方性、季节性E．有病原体、传染性、免疫性9．某传染病在一个较小范围内短时间出现大批同类病例，称为：A．流行B．大流行C．散发D．暴发E．以上都是10．传染病在某一地区流行，人群感染状态最多的是：A．显性感染B．隐性感染C．潜伏性感染D．健康带菌者E．病后带菌者11．下列出疹性传染病出疹最早的疾病是：A．麻疹B．天花C．猩红热D．伤寒E．水痘12．关于自然疫源性传染病下列哪种说法最恰当：A．以虫媒为传染媒介的传染病B．地方性传染病都是自然疫源性疾病C．以野生动物为主要传染源的动物源性传染病D．以家畜、家禽为主要传染源的传染病E．凡是动物源性传染病都是自然疫源性疾病13．确定传染病的检疫期是根据该病的：A．症状明显期B．平均潜伏期C．最长潜伏期D．传染期E．前驱期14．病原体不断侵入血液并在血液中繁殖产生毒素，表现出严重中毒症状时称为：A．菌血症B．毒血症C．败血症D．脓毒血症E．变应性亚败血症15．24小时体温相差超过1℃，但最低点未达正常，称为：A．稽留热B．弛张热C．间歇热D．波状热E．回归热16．对传染病患者皮肤的护理中，哪项是错误：A．观察皮疹的特点，如形态、大小、分布部位等B．出疹期用酒精擦洗消毒皮肤C．将患者指甲剪短，切勿抓破皮肤D．瘙痒较重者，可用炉甘石洗剂等涂擦局部E．出疹期病室要安静，避免强光刺激17．传染病的治疗原则：A．一般治疗和特效治疗B．治疗、护理和消毒隔离C．病原治疗和消毒隔离D．对症治疗，康复治疗和中药治疗E．病原治疗，康复治疗和中药治疗18．传染病的综合预防措施是：A．管理传染源，切断传播途径，保护易感人群B．消除社会因素和自然因素C．管理食物、水源、粪便、消灭蚊蝇D．控制传染源E．保护易感人群19．病原体进入人体后，是否引起疾病，主要取决于：A．病原体的数量B．病原体的毒力C．病原体的致病能力和机体的免疫功能D．病原体的侵袭力E．机体的抵抗能力20．关于潜伏性感染下列哪种说法是正确的：A．病原体侵入人体后，只引起轻微症状B．病原体与人体相互作用，保持暂时性平衡，当人体防御功能减弱时，可引起疾病21．关于乙型肝炎病毒下列哪项说法是错误的：A．嗜肝DNA病毒科B．包膜有表面抗原C．核心有核心抗原D．抵抗力很强E．对一般浓度的消毒剂敏感22．一般不会转为慢性的一组病毒性肝炎是：A．甲型和戊型B．乙型和戊型C．丙型和戊型D．乙型和丁型E．乙型和丙型23．乙型肝炎的传播途径不包括：A．注射途径B．消化道传播C．母婴传播D．性接触E．输血和血制品24．在甲型肝炎病程中传染性最强的时期是：A．黄疸前期B．2周至血清ALT高峰期后1周C．慢性期D．黄疸期E．恢复期25．在病毒性肝炎中，以血液、体液为主要传播途径的是：A．甲型B．戊型C．甲型、乙型、丙型D．乙型、丙型、丁型E．甲型、戊型26．在雨季和洪水后易发生流行的病毒性肝炎是：A．甲型B．乙型C．丙型D．丁型E．戊型27．甲型病毒性肝炎最主要的传播途径是：A．母婴传播B．输血和血制品C．粪-口途径D．注射E．日常生活密切接触28．能保护人体防止乙肝感染的是：A．表面抗体B．e抗原C．DNA抗体D．e抗体E．核心抗体29．淤胆型肝炎产生黄疸最主要的原因是：A．肝细胞合成胆红素障碍B．炎症细胞压迫肝内小胆管C．肝细胞摄取胆红素能力降低D．胆管炎症、胆总管阻塞E．肝细胞排泄胆红素障碍30．乙型肝炎最主要的传播途径是：A．日常生活接触B．医源性传播C．粪-口传播D．母婴传播E．血液及体液传播四、简述题：每题5分，共20分。
传染病学常考名词解释与简答
传染病学常考名词解释与简答题精【名词解释】1、传染病：是病原微生物咀寄生虫感染人体后产生的有传染性，在一定条件下可造成流行的疾病。
2、感染性疾病:是指由病原体感染所致的疾病，包括传染病咀非传染性感染性疾病。
3、.感染：又称传染，是病原体咀人体之间相互作用的迆程。
极成此迆程有病原体、人体咀所处的环境三个要素。
4^性感染「又称亚临床感染，是指病原侵入人体后，仅诱导机体产生特异性免疫应答，而丌弓起戒只引起轻微的组织损伤，因而临床上丌显出仸何症状、体征，甚至生化改发，只能通迆免疫孥检查才能収现。
5、显性感染：又称临床感染，是指病原体侵入人体后，丌但诱导机体収生免疫应答，而且通迆病原体本身的作用戒机体的发态反应，而导致组织损伤，引起病理改发咀临床表现。
6、病原携带状态：按病原体种类丌同而分为带病毒者、带菌者不带虫者等。
按其収生咀持续时间的长短可分为潜伏期携带者、恢复期携带者不慢性携带者。
所有病原携带者都有一个共同的特点，卲无明显临床症状而携带病原体，且在体内繁殖幵能排出体外；因而在许多传染病中，如伤寒、流行性脑脊髓膜炎咀乙型肝炎等，成为重要的传染源。
7、潜伏性感染：病原体感染人体后寄生于某些部位，由于机体免疫功能足以将病原体尿限化而丌引起显性感染，但又丌足以将病原体清除时, 病原体便可长期潜伏起来，徃机体免疫功能下降时，则可引起显性感染。
特点：无明显临床症状而携带病原体，但在体内丌繁殖且一般丌排出体外（这是不病原携带状态丌同之处）常见的潜伏性感染有单纯疱疹、带状疱疹、疟原虫、结核杆菌等感染。
8、侵袭力：是指病原体侵入机体幵在机体内生长、繁殖的能力。
9、流行：是指传染病在人群中収生、収展咀转归的迆程。
10、传染源:是指病原体已在体内生长、繁殖幵能将其排出体外的人咀劢物。
包括：患者、隐性感染者、病原携带者、叐感染劢物。
11、传播途径：病原体离开传染源到达另一个易感者的递徂称为传播递徂。
包括：呼吸道传播、消化道传播、接触传播、虫媒传播、血液、体液传播12、易感者：对某种传染病缺乏特异性免疫力的人称为易感者，他们都对该病原体具有易感性，当易感者在某一特定人群中的比例达到一定水平，若又有传染源咀合适的传播递徂时，则径容易収生该传染病流行。
传染病学名解和问答
传染病学名解：1.(Herxhmer reaction)：The illness gets worse after the initiation of penicillin therapy. In 1/2 to4 hours after the first dose, it begins abruptly with chills, high fever and myalgia whichpersists for 1/2 to 1 hours, then it comes down suddenly2.(Primary shock)：Primary shock occurred from the 3rd to 7th day after HFRS virus onsetbecause of plasma exudation resulting in volume depletion3.传染源：是指能向外排除病原体的人或动物4.玫瑰疹：见于病程7-13天的伤寒患者的胸腹背部及四肢，表现为淡红色小丘疹，直径约2-4mm，压之褪色，多在10个以下，成批出现，2-4天消退5.隐性感染：又称亚临床感染，指病原体侵入人体后，仅引起机体发生特异性免疫应答，而不引起或只引起轻微的组织损伤，因而在临床上不显出任何症状、体征，甚至生化改变，只能通过免疫学检查发现6.(sustained fever)：It means the temperature keeps at 39-40℃constantly. Circadian variationless than 1℃. Seen in pneumonia, typhoid fever.7.(recrudescence)：when the patient’s body temperature not yet drops to the normalcy, it elevatesagain. The blood raise often is the masculine gender, it may have some reases with bacteriemia which has not been completely controlled.8.高血容量综合症：出血热少尿期，水钠潴留使组织水肿而出现的临床综合征，表现为体表静脉充盈，脉搏洪大，脉压差增大，脸部胀满和心率增快，严重者出现心衰和肺水肿9.持续性全身淋巴结肿大综合征：艾滋病第三期，主要表现为除腹股沟淋巴结以外，全身其他部位两处或两处以上淋巴结肿大。
传染病名解
传染病名解1：传染病：是指由病原微生物，如朊毒体，病毒，衣原体，立克次体，支原体，细菌，真菌，螺旋体和寄生虫，如原虫，蠕虫，医学昆虫感染人体后产生的由传染性,在一定条件下可造成流行的疾病。
2：感染：病原体与人体相互作用的过程。
3：病原体：是指感染人体后可导致疾病的微生物与寄生虫。
4：感染谱：由于不同程度的适应，在双方的斗争过程中会产生各种表现，临床上称为-。
5：隐性感染:是指病原体侵入人体后，仅诱导机体产生特异性免疫应答，而不引起或只引起轻微的组织损伤，因而在临床上不显出任何症状，体征，甚至生化改变，只能通过免疫学检查才能发现。
6：显性感染：指病原体侵入人体后，通过病原体自身的作用或机体的过敏反应，不仅诱导机体的免疫反应，还导致组织损伤、病理改变和临床表现。
7：侵袭力：是指病原体侵入机体并在机体内生长繁殖的能力。
8.传染源：指病原体在体内生长繁殖并可从体内排泄的人和动物。
9：自然疫源性传染病：某些自然生态环境为传染病在野生动物之间的传播创造了良好的条件，如鼠疫和钩端螺旋体病等，人类进入这些地区时亦可受感染，称为-。
10：潜伏期：从病原体侵入人体到出现临床症状的时期。
11：再燃：是指当传染病患者的临床症状和体征逐渐减轻，但体温尚未恢复正常的缓冲阶段，；由于潜伏于血液和组织中的病原体再度繁殖，使体温再次升高，初发病的体征和症状再度出现的情形。
12：复发：指患者进入恢复期后，由于残余病原体在体内繁殖一段时间而导致临床表现复发。
13：病毒性肝炎:是由多种肝炎病毒引起的，以肝脏损害为主的一组全省性传染病。
14：肝肺综合征：重型肝炎和肝硬化患者可能出现肺水肿、间质性肺炎、盘状肺不张、胸腔积液和低氧血症综合征等改变，称为-。
15：麻疹：是由麻疹病毒引起的急性传染病，主要的临床表现有发热、咳嗽、流涕、眼结合膜炎、口腔麻疹粘膜斑及皮肤斑丘疹。
16:Koplik斑：位于双侧第二磨牙对面的颊粘膜上。
是一个小白点，针尖大小为0.5~1mm。
传染名解简答
二、名词解释1.传染病：由病原微生物和寄生虫感染人体后产生的具有传染性的疾病。
2.病原体被清除：是指病原体侵入人体后，人体通过非特异性免疫屏障。
3.隐性感染：又称亚临床感染，是指病原体侵入人体后，仅引起机体产生特异性的免疫应答，不引起或只引起轻微的组织损伤，临床上无任何症状、体征，甚至无生化表现，只能通过免疫学检查才能发现。
4.显性感染：又称临床感染，是指病原体侵入人体后，不但引起机体免疫应答，而且通过病原体本身的作用或机体的变态反应，导致组织损伤，引起病理改变和临床表现。
5.病原携带状态：是指病原体侵入人体后，在人体内生长繁殖并不断排出体外，但人体并不出现临床表现。
6.潜伏性感染：是指病原体感染人体后，寄生在机体的某些部位，机体免疫功能足以将病原体局限而不引起发病，但又不能将病原体清除，病原体便长期潜伏下来。
7.传染源：是指病原体在体内生长繁殖并能将其排出体外的人和动物。
8.传播途径：病原体从传染源传播到易感者的途径。
9.稽留热：体温升高达39℃以上且24小时体温相差不超过1℃。
10.弛张热：24小时体温相差超过1℃，但最低点未达正常水平。
11.间歇热：24小时内体温波动于高热与正常体温之间。
三、简答题1.简述病原体进入机体后，可能呈现出的五种结果。
病原体被清除、.隐性感染、显性感染、病原携带状态、潜伏性感染2.简述传染病的四大基本特征。
病原体、传染性、流行病学特征、感染后免疫力3.简述急性传染病发生、发展和转归的四个阶段。
潜伏期、前驱期、症状明显期、恢复期4.对传染病患者的管理应做到哪五早？早发现、早诊断、早报告、早隔离、早治疗二、简答题1.简述切断艾滋病传播途径的主要措施①加强性道德教育，严禁卖淫、嫖娼等杂乱性交活动。
②加强血制品管理，严格检查血液制品；严禁注射毒品；推广一次性医疗用品，对患者使用过的物品及医疗器械应进行严格的消毒，防止医源性传播。
③艾滋病患者及HIV感染者，不提倡结婚与妊娠。
传染病学常考名词解释与简答题精
————————————————————————————————作者:
————————————————————————————————日期:
ﻩ
传染病学名解&简答
【名词解释】
1、传染病：是病原微生物和寄生虫感染人体后产生的有传染性,在一定条件下可造成流行的疾病。
2、感染性疾病:是指由病原体感染所致的疾病，包括传染病和非传染性感染性疾病。
21、Daｎe颗粒：是指完整的HBV病毒颗粒,具有感染性。其直径约42nｍ,分为包膜与核心两部分。包膜上蛋白质（小球状、管状颗粒)即乙型肝炎表面抗原（HBｓAg）,核心部分为病毒复制的主体,内含环状双股ＤNＡ、DNA聚合酶(DNＡP）、核心抗原（HBcＡg)和e抗原(HＢeAg)。
22、乙型肝炎病毒感染的“窗口期”:急性HBV感染时,当ＨBsAg已消失，而抗—HＢs尚未出现之前的时期称为“窗口期”。此期在血中只能检出抗—ＨBc(或同时尚有抗—ＨBｅ），因而抗—ＨBc是HＢＶ感染的唯一指标，常作为急性乙肝诊断的证据。
3、感染：又称传染,是病原体和人体之间相互作用的过程。构成此过程有病原体、人体和所处的环境三个要素。
4、隐性感染：又称亚临床感染,是指病原侵入人体后,仅诱导机体产生特异性免疫应答，而不引起或只引起轻微的组织损伤，因而临床上不显出任何症状、体征,甚至生化改变，只能通过免疫学检查才能发现。
５、显性感染:又称临床感染,是指病原体侵入人体后,不但诱导机体发生免疫应答，而且通过病原体本身的作用或机体的变态反应，而导致组织损伤，引起病理改变和临床表现。
２3、桥接坏死:肝小叶中央静脉之间或中央静脉和汇管区之间形成的条索状肝细胞坏死。
2４、病毒性肝炎:由多种肝炎（嗜肝)病毒引起的以肝脏损害为主的一组传染病。
传染病学英文名解大题
Frequently asked question (in English)Part ⅠNoun explanation1.convert infection/subclinical infection：it means only a special immune response withoutor with very mild damage to the host after the pathogens entered which can be diagnosed by serologic means with demonstration of either a single high titer or a fourfold rise in titer to the infection.The patients haven’t any symptoms and signs clinically,no changes of biochemical aspects are present in laboratory findings. It is also called subclinical infection.2.black-water fever: A complication of MALARIA,FALCIPARUM characterized by anacute intravascular hemolysis, hemoglobinuria and hemolytic jaundice when the red blood cells are destroyed and lytic in the blood vessel，severe patients can result in acute renal failureMost commomly in those who have taken antimalarial treatment irregularly or are deficient in G-6-PD.May be provoked by administering primaquine or chlorquine, or by fatigue. It is also called hemolytic urinemic syndrome3.carrier state(病原携带状态)：it is a person who is colonized with an organism but showsno evidence of disease, although disease may have been present earlier. A carrier is a very important source of infection as the organisms can be disseminated from him.tent infection(潜伏性感染)：it means an organism enters a host and lies dormant( 静止的) for a period of time, possibly for years, before producing disease as the host’s immunity decreased.5.invasiveness(侵袭力)：the ability of the agent to enter and to move through tissue.6.source of infection(传染源)：it is referred to a person or animal in which the pathogenstay and multiply and can be disseminated .7.route of transmission(传播途径): the route the pathogen entered another susceptible afterbeen disseminated from the source of infection.8.susceptible(易感者): it is referred to a person who lacks immunity to a specificinfectious disease.9.relapse(复发)：it means the return of symptoms after they have apparently ceased duringconvalescence which is caused by the multiplication of the pathogen in the host. It is often seen in typhoid fever, malaria, et al.10.recrudescence(再燃): it means the reappearance of symptoms after temporarycessation.11.sustained fever (稽留热）: high fever, lasting and little change in 24 hours, usually <1degree. Often seen at fastigium of typhoid fever, septicemia, and EHF.12.remittent fever（弛张热）: high fever, temperature changes > 1 degree in 24 hours, but thelowest point of the fever is still above the upper limit of the normal temperature. Often seen in the defervascence of typhoid fever or EHF.13.relapsing fever回归热）: several days of high fever with interruption of a few days’normality. typical fever pattern in brucellosis and relapsing fever.14.Intermittent fever（间歇热）: temperature fluctuates between the high fever and thedegree below the normality. Usually seen in septicemia and malaria.15.Irregular fever（不规则热）:the fever curve is irregular. Seen in influenza or septicemia.16.palmer erythema/liver palm(肝掌): This is intense reddening, mottled in nature, of thepalmer aspects due to vasodilation. Seen mainly over the thenar and hypothenar（大、小鱼际）eminences.17.spider angiomata(蜘蛛痣)：Spider angiomata are small red macules with fine red linesradiating from it like "spider legs". They blanch when compressed(压之褪色). They represent tiny dilated collateral blood vessels and are seen in patients with chronic hepatitis or cirrhosis.18.window phase（窗口期）：The window phase is the time from exposure to the organismuntil one is tested positive for the infection. Someone in the window phase may test negative but actually be positive and able to spread the organism.19.street strain(野毒株/街毒株): it is referred to rabies virus isolated from the naturallyinfected animals or human with strong pathogenecity and long incubation period.20.fixed strain(固定毒株): After being subcultured in rabbit brain for many times (at least50 times), the virulence of the street strain decreased greatly, but its immunogenicityremained. It is called fixed strain and often used for vaccine production.21.Negri body（内基本氏小体）: Negri body is pathognomonic for rabies virus infection. Itis oval eosinophilic neuronal cytoplasmic inclusion measuring 3-10 micron in diameter.They are most consistenetly seen in the pyramidal cells of hippocampus and Purkinje cells of cerebellum.22.septicemia(败血症)：Septicemia is an acute generalized infection caused by the invasioninto the blood stream of a pathogenic or an opportunistic organism. While staying persistently and multiplying rapidly in the blood stream, these organisms liberate toxins or metabolites which elicit general toxic symptoms and tissue damage of various organs.23.bacteriemia（菌血症）：The bacteria enter the blood and multiply in it, but stay only ashort time and don’t liberate toxins or metabolites which elicit general toxic symptoms and tissue damage of various organs.24.pyemia（脓毒血症）: The multiplying site of bacteria is also in the blood, but it is causedby pyogenic（化脓性的）gram-positive cocci, metastatic lesions are always present, the symptoms are the same as septicemia.25.toxemia（毒血症）: The bacteria only live and multiply in the local parts of the body, theydon’t enter the blood stream, but the toxins and metabolites liberated by them do. The symptoms are similar to septicemia.26.rose spots(玫瑰疹)：They are blanking pink macular spots 2-4 mm in diameter at day7~13 of typhoid fever. The rash is seen most commonly on the thorax and abdomen, rarely on back and the extremities.27.relative bradycardia(相对缓脉)：it means pulse-temperature dissociation. It is usuallydefined as increase in heart rate < 10 beats/minutes/1°C increase in temperature in adults.It is usually seen in typhoid fever, acute schistosomiasis, severe jaundice, et al.28.herxheimer reaction(赫氏反应):It is caused as a direct result of using spirocheticidaldrugs (mainly antibiotics) to treat individuals with a spirochetal disease which results inan increase in the symptoms of the treated condition.29.hemolytic urinemic syndrome /black urine fever: A serious, often fatal complication ofmalaria, characterized by an acute intravascular hemolysis, hemoglobinuria and hemolytic jaundice. It is often provoked by antimalarial drugs.30.ectopic lesion(异位损害): the schistosome eggs and/or adult worm migrate andparasitize the organs outside the portal venous system and cause damages. It is relatively high in lung and brain.31.Hepatorenal syndrome: Acute renal failure occurring without other cause in a personwith severe liver disease. The exact cause of hepatorenal syndrome is unknown. The kidney structure remains essentially normal and the kidneys often will instantly function well if the liver disease is corrected.32.Widal’s test: A test involving agglutination of typhoid bacilli when they are mixed withserum containing typhoid antibodies from an individual having typhoid fever; used to detect the presence of Salmonella typhi and S. paratyphi.Part Ⅱ: Qustion.1.the five manifestation of infection(感染过程的五种表现)●Pathogen is killed or eliminated;●Covert infection or subclinical infection, it is usually the most common;●Overt infection or clinical infection: the pathogen enter the host and caused damages as well asimmunological response. It is usually easy to be recognized in clinics.●Carrier state: It is a very important source of infection;●Latent infection: it is usually seen in herpesviridae, tuberculosis, malaria, et al.2.Please describe briefly the factors involved in the pathogenecity of a pathogen(致病能力包括哪几个方面)?●Invasiveness: the ability of the agent to enter and to move through tissues;●Virulence: it is consists of toxins and other virulent factors;●Quantity: bigger quantity, stronger pathogenecity in the same disease;●Variability: The pathogen may mutate under the pressure of the environment or host.3.the prerequisite of an epidemic of a communicable disease?(传染病流行的必要条件)Three prerequisite are required for a communicable disease to spread. First, there must be a source of infection which disseminate pathogen continuously. Second, there must some persons who lack special immunity to the disease, ie, susceptible. Last, the pathogen must reach the susceptible, the route of transmission.4.the basic characteristic of communicable disease（传染病的基本特征）?The main difference between communicable disease and other disease is that the former has four basic characteristics. All communicable diseases are infectious diseases and both are caused by a pathogen. But the former have infectivity/ communicability, it is the main difference between them. And communicable diseases have some epidemiological feature. In addition, there is post-infection immunity no matter covert infection or overt infection.5. clinical characteristics / diagnostic criteria of fulminant hepatitis/hepatitis gravis(重型肝炎的诊断标准)?Fulminant hepatitis is a rare syndrome usually associated with hepatitis B. It is characterized by rapidclinical deterioration. Its diagnostic criteria in our country is:●Severe digestive disorder: poor feeding, nausea and frequent vomiting, fatigue;●Progressively deepened jaundice;●Hepatoencephalopathy;●Hepatorenal syndrome;●Decreased volume of liver;●Bleeding pronenss;●Rapidly increased ascites6. clinical characteristics / diagnostic criteria of cholestatic hepatitis？●Clinical symptoms: Jaundice is the main manifestation and it lasts longer than three weeks.Skin itch is usually more severe at night. Rashes can occur on the neck, chest, back, and wrists.Stool color becomes lighter and urine color becomes darker. Although there can be many symptoms, the patient usually will not feel extremely ill.●Laboratory tests: Direct bilirubin in the serum elevated and its proportion is more than60% of the total bilirubin. Serum combined bile acid elevated to 10 to 20 times higher than the normal range. AKP, GGT, cholesterol, and 5- nucleotidase are obviously elevated, and the ALT elevation is moderate.●B-Ultrasound: It can distinguish intra or extra liver obstruction.7. common / main manifestation of acute viral hepatitis？●Malaise, anorexia, fever, dark urine, pale stools, jaundice, right upper quadrant pain andtender hepatomegaly;●Increased liver enzymes (ALT, AST), bilirubin, prothrombin time and globulin;●Serum positive for hepatic virus;●May have history of recent ingestion of undercooked shellfish or sewage-contaminatedwater.8. main manifestation of epidemic encephalitis B?The disease is mainly manifested by high fever, impairment of consciousness, convulsion, respiratory failure. Signs of meningeal irritation, increased intracranial pressure and other neurological signs. The typical pro cases of epidemic encephalitis B is lymphocytic pleocytosis, normal or slightly elevated protein level, normal glucose level, and elevated CSF pressure. The specific IgM antibody detection is most useful for the diagnosis of this disease.9. the principal of wound treatment after bitten by a rabid dog(被狂犬咬伤后伤口处理)?The wound should be thoroughly cleansed for half an hour, preferably with a quaternary ammonium detergent(季胺类消毒液) or 20% soap (which can not be mixed together); then rinse with 70% ethanol or iodine; damaged tissues should be excised and the wound left unsatured. Rabies can usually be prevented if treatment is started within a day or two of biting. For maximum protection hyperimmune serum and vaccine are required. One should pay attention to tetanus and infection of other bacteria.10. main manifestation of rabies/ hydrophobia?The disease begins as a nonspecific illness marked by fever, headache, malaise, nausea, and vomiting. Abnormal sensations at or around the site of viral inoculation occur frequently and probably reflect local nerve involvement. After the prodromal period of 2~4 days, the characteristic fear of water, responsible for the alternative name of ‘hydrophobia’, and fear of wind, becomes evident in many cases. Delusionsand hallucinations may develop accompanied by spitting, biting and, and maniacal behavior, with lucid intervals in which the patient is acutely anxious. Cranial nerve lesions develop and terminal hyperpyrexia is common. Death ensues, usually within a week from the onset of symptoms.11. describe briefly the five phase of hemorrhagic fever with renal syndrome.Typical cases of HFRS evolve in 5 stages:①the febrile stage with myalgia, lasting 3 to 4 days; ②the hypotensive stage, often associated with shock and lasting from a few hours to 48h; ③the oliguric phase usually lasts from 3 to 7 days. The rising concentration of blood urea and creatinine is accompanied by persistent oliguria. ④the diuretic stage with diuresis and hyposthenuria; and ⑤the convalescent stage, getting full recovery within 1 to 6 months.12. main manifestation of sepeticemiaThe main clinical manifestations of septicemia are chills, high fever, severe toxemic symptoms(such as headache, dysphoria), petechia（瘀点）,arthralgia（关节痛）, hepatosplenomegaly（肝脾肿大）, some patients may have metastatic（迁徙性）lesions;in severe patients, septic shock, toxic cerebrosis（脑病）, toxic pneumonia, toxic myocarditis（心肌炎）,toxic hepatitis and toxic enteritis（肠炎）may be present 13. the key points of blood culture（1）before administration of antibiotics and during chills or high fever；（2）repeat more than 3 times；（3）the amount of the blood sample should be＞10ml in adults or older children, ＞5ml in infants；（4）blood samples should be treated with chemicals if antibiotics was used before or use blood clot for culture.⑸bone marrow culture is recommended; ⑹drug sensitivity test is very necessary.14. main manifestation of epidemic cerebrospinal meningitisEpidemic encephalitis B is an encephalitis caused by flavovirus, which belongs to the family of Togaviruse. The infection is transmitted by mosquito.The disease is mainly manifested by high fever, impairment of consciousness, convulsion, respiratory failure. Signs of meningeal irritation, increased intracranial pressure and other neurological signs. The typical pro cases of epidemic encephalitis B is lymphocytic pleocytosis, normal or slightly elevated protein level, normal glucose level, and elevated CSF pressure. The specific IgM antibody detection is most useful for the diagnosis of this disease.15. therapeutic principals of fulminant meningococcal meningitis?①specific antibiotics should be given intravenously promptly. The preferred drug is penicillin; ②anti-shock therapy; ③use of glucocorticoids(糖皮质激素) such as methylprednisolone or DXM; ④if clinical signs suggest cerebral edema or the cerebrospinal fluid pressure is very high, measures to reduce brain swelling are indicated; ⑤anticoagulant therapy if DIC is present; ⑥supportive therapy to maintain vital organs.16. main characteristic of typhoid feverTyphoid fever, also called enteric fever, is characterized by sustained fever, gastrointestinal symptoms, rose spots, relative bradycardia, hepatoslenomegaly, neuropsychiatric features and leukopenia. The clinical course of the disease can be divided into 4 stages:（1）prodromal stage, （2）stage of prominent manifestation,（3）remission stage, and（4）convalescent stage. The two major complications are intestinal hemorrhage and perforation, both can be life-threatening.17. main characteristic of bacillary dysentery/shigellosisshigellosis is an acute bacterial infection caused by the genus Shigella resulting in colitis affecting predominantly the rectosigmoid colon. It is characterized by fever, diarrhea, abdominal pain, andtenesmus. It is usually limited to a few days. Early treatment with antimicrobial drugs results in more rapid recovery.18. main manifestation of cholera（霍乱）.Cholera is an acute, sometimes fulminant watery diarrheal disease resulting from an enterotoxin elaborated by Vibiro. Cholerae in the small intestine. It generally occurs in epidemics and may cause a rapid massive gastrointestinal fluid loss with extreme saline depletion, acidosis, and shock.19. main manifestation of leptospirosis（钩体病）Leptospirosis is a zoonotic (动物源的) disease of worldwidedistribution caused by spirochetes (螺旋体) of the genus (种) Leptospira. It is divided into three phases according to its clinical manifestation: ①the initial phase: leptospira bacteremia (钩体菌血症); ②t he second phase: organic injury and dysfunction; ③ t he third phase: immune response. The initial clinical symptoms are fever, headache, myalgia (肌痛), conjunctival injection (眼结膜充血) and swelling of lymph nodes (淋巴结肿大), in some cases followed by a more severe illness that may include jaundice (黄疸) and renal failure, meningitis (脑膜炎) or hemorrhagic pneumonitis (出血性肺炎). Intravenous penicillin has demonstrated good clinical efficacy for leptospirosis.20. amebic colitis/ intestinal amebiasis (肠阿米巴病) .Amebiasis is defined as infection with the protozoan parasite Entamoeba histolytica. The manifestation of amebic colitis may be subtle or severe and range from mild watery diarrhea to explosive, bloody dysentery with a fulminant couse.Amebic colitis mainly presents with lower abdominal pain, mild diarrhea, malaise, and weight loss. The stools contain little fecal material and consist chiefly of blood and mucus.21. main manifestation of hepatic amebiasis/ amebic liver abscess(肝阿米巴病/阿米巴肝脓肿). Amebic liver abscess is the most common extraintestinal manifestation of amebiasis. Patients may note right-upper-quadrant pain that is either dull or pleuritic in nature. Often pain is referred to the right upper shoulder. Less than 50% of patients have an enlarged liver. Patients typically manifest long-term fever and weight loss. Diarrhea is found in less than one-third of patients with Amebic liver abscess. Exam may reveal abdominal tenderness, tender hepatomegaly, and crackles at right lung base. Jaundice is uncommon.22. main manifestation of malaria(疟疾)The first symptoms of malaria are nonspecific, including the lack of a sense of well-being, fever, headache, fatigue, and abdominal discomfort. The classic“trilogy”of malarial paroxysm(发作) includes chills, rigors, spike fever（体温骤升骤降）, and heavy sweating. The intervals are irregular in P. falciparum（恶性疟）, within 48h in P. vivax（间日疟）, and 72h in P. malariae（三日疟）, respectively. Splenic enlargement is very common.The diagnosis of malaria rests on the demonstration of the parasite in peripheral blood smears. Both thin and thick blood smears should be examined.23. the prerequisite for the epidemic of schistosomiasis(血吸虫病) .the epidemic of schistosomiasis in any specific area is dependent upon the unsanitary disposal of faeces, the presence of suitable snail hosts, and human exposure to cercaria-infected (尾蚴) water bodies.24. main manifestations of acute schistosomiasis?The majority of infected person are asymptomatic or have mild, nonspecific symptoms. Only 5 to 10 percent of infected populations have severe clinical symptoms. They include chills, spiking fever,generalized weakness, myalgia, headache, anorexia, profuse diarrhea, and weight loss. Extensive urticaria may occur in large patches on various parts of the body. Nausea and vomiting are common and cough may be prominent. The fever usually lyses spontaneously 2 to10 weeks after onset.Physical findings are usually minimal but many include urticaria, patches of moist rales over both lung fields, generalized lymphadenopathy, and hepatosplenomegaly. Marked elevation of peripheral blood eosinophilia is common..25.Hemodialysis indication :⑴Oliguric lasts〉4d，or anuria 〉24h⑵Concentration of blood urea nitrogen and creatinine increased:BuN〉28.56mmol/l⑶High catabolism state ⑷Hyperkalemia,⑸Pulmonary edema or hypervolemic syntrome15. Differential Diagnnosis of Epidemic encephalitisMeningococcal Purulent Tuberulous Epidemic Toxicmeningitis cerobrosoinal meningitis menigitis encephalitis Shigellosis Etiology Meningococcus Other bacterial T.B Encephalitis B virus Shigelle Onset abrupt slow slow abrupt abrupt Age <10year any age any age <10year children Season Win.＆Spr. anytime anytime Sum.＆Aug Sum.＆Aug. Petechial common rare no no no Early shock common rare no no common meningealirritation + + + + - BR：WBC +++ +++ +/- + ++ N +++ +++ -/+ + ++ CSF:WBC >1.0 >1.0 0.05~0.3 0.05~0.5 normal Glucose ↓↓↓↓↓normal normal Chloride ↓↓↓↓↓normal normal Stoolroutine normal normal normal normal +16.The main Difference Between G- Septicemia and Typhoid FeverG -Septiemia Typhoid FeverOnset abruptly insidiously or slowlyToxic Symptoms severe slightGastrointestinal Symptoms seldom obviouslySpecific Toxic Symptoms seldom may be presentof Central Nervous SystemPrimary septic focus may be present(50%) noDIC may be present noIncipient septic shock 40%patients may have noRash petechia predominantly rose spotDifferential Count neutrophilia lymphocytosisof WBCWidal`s Reaction negative positiveBlood Culture corresponding pathogens typhoid bacillus17.The Main Differences Between G+ cocci and G- Bacilli SepticemiaG+ Cocci Septicemia G- Bacilli SepticemiaAge youth and middle-aged old-agedSex male femaleGeneral healthy good poorcondition beforeonsetPrimary Septic infection of skin and mucous membrane, infection of biliary, intestinal and Focus incision and drainage of immature urinary tract, patient with liver cirrhosis abscess, tympanitis and osteomyelitis,atc. or with a history abdominal operation Clinical Symptoms obvious/marked chills,feve，joint double peak fever, relative bradycardia - trouble，metastatic lesions incipient septic shock and DIC, Blood routine leukocytosis normal WBC or leukopeniaLLT negative positiveTreatment good curative effect can be gained when good curative effect can be gained using the antimicrobial agents against when using the antimicrobial agentsG+ cocci against G- bacilliBlood Culture G+ cocci G- bacilli18．The Main Differences Between Bacilliary dysentery and amebic dysenteryBacilliary dysentery amebic dysenteryIncubation period several hours-7days 1-2weeksendotoxemia symptoms usually(fever) ,obvious seldom or mild(fever)abodominal tenderness left lower quadrants right upper quadrantdiarrhea as high as 20~40times/day several times/dayTenesmus +++—++++ （-）~（+）Predilection site rectosigmoid colon appendices and ascending colon.Stool: : pus and blood bloody stool usually scanty with mucusetiology Culture : shigella entamoeba trophozoitesvolume small largeWBC much lessRBC less muchBlood WBC ↑↑normal or onset↑Sigmidoscopic diffuse erythema with flask- shaped ulcers with raised Examination superficial ulcers edges and normal intervening mucosa Treatment antibiotics anti- ameba19. The Main Differences Between amebic liver abscess and bacterial liver abscessamebic liver abscess bacterial liver abscesshistory amebic colitis septicemia or abdominal purulent disease symptom onset slow, long-term fever, weight loss. onset urgent,toxemia symptoms striking Liver:enlarged liver,tenderness notable mildabscess single,large, many,small,brown colour pus yellow-white pusentamoeba trophozoites be found bacterium culture :positive Blood WBC,N ↑↑↑↑Blood culture negative positive Therapeutic response good curative effect can be gained good curative effect can be gainedwhen using he anti- ameba agents when using t antibiotics Prognosis relatively good easy to relapse。
传染病学名解和填空
传染病学一．名词解释1.传染病：是由病原微生物和寄生虫感染人体后产生的有传染性的疾病。
2.自然疫源性疾病：指某些自然生态环境为传染病在野生动物之间的传播创造良好条件，如鼠疫、恙虫病、钩体病等，人类进入这些地区时亦可受感染，称为自然疫源性传染病或人兽共患病。
3.隔离期：是指根据传染病传染期来决定的隔离患者的一段时间。
4.PCR：即聚合酶链式反应，是一种分子生物学技术，用于放大特定的DNA片段。
可看作生物体外的特殊DNA复制。
5.Danes颗粒：即完整的HBV颗粒，由包膜和核心两部分组成，内含环状双股DNA、DNA聚合酶、核心抗原，是病毒复制的主体。
6.AIDS：即获得性免疫缺陷综合症，是人体感染了“人类免疫缺陷病毒”（HIV ）所导致的传染病，分为两型：HIV-1型和HIV-2型。
7.易感者：指对某一传染病缺乏特异性免疫力的人。
8.HFRS：即肾综合症出血热，又称流行性出血热是由汉坦病毒引起，以鼠类为传染源的一种疾病。
主要临床表现是发热、出血、休克、肾损伤。
9.复发：是指感染已进入恢复期，发热等主要症状已消失，但由于病原体在体内再度繁殖而使发热等主要症状再度出现。
10.再燃:当病程进入缓解期，体温尚未降至正常时，发热等病初症状再次出现，称为再燃。
11.窗口期（乙肝、艾滋病）：是指人体感染HIV后到外周血液中能够检测出HIV抗体的这段时间。
二．填空题1.病毒性肝炎从病原学上划分为甲、乙、丙、丁、戊等五型;从临床表现上划分为急性肝炎、慢性肝炎、重型肝炎、淤胆型肝炎、肝炎肝硬化五型；可导致慢性肝炎的病毒有HBV、HCV、HDV；经肠道传播的病毒是HAV、HEV；乙、丙肝的主要传播途径有血液传播、注射途径、性传播、围生期传播等；慢性肝炎指急性肝炎病程超过半年未愈者，分为轻、中、重三度。
2.HFRS的“三大主征”指的是发热及中毒症状、充血、出血即外渗征、肾功能损害；五期经过指的是发热期、低血压休克期、少尿期、多尿期和恢复期；“三红”征指充血、出血和渗出水肿征；“三痛”征指头痛、腰痛、眼眶痛；其主要传染源为啮齿类动物；主要传播途径有呼吸道传播、消化道传播、接触传播、母婴传播和虫媒传播等；多尿期根据尿量和氮质血症情况可分为移行期、少尿期和多尿期三期。
传染病学常考名词解释(二)2024
传染病学常考名词解释（二）引言：传染病学是研究传染病的发生、传播、预防和控制的学科。
了解传染病学中常考的名词解释有助于我们更好地了解传染病的相关知识。
本文将介绍传染病学常考名词解释的第二部分内容。
正文：一、传染源1. 定义：传染源指患有传染病或带有病原体的人、动物、物体或环境，它们能够在一定条件下释放病原体并传播疾病。
2. 类型：a. 人类传染源：指患有传染病的患者，包括临床病例和隐性感染者。
b. 动物传染源：指患有传染病的动物，如各类家畜、野生动物等。
c. 物体传染源：指被病原体污染的物体，如食物、水源、空气等。
d. 环境传染源：指自然环境中携带病原体的环境，如土壤、水体等。
二、病原体1. 定义：病原体是指能够导致传染病发生的生物体，包括细菌、病毒、真菌、寄生虫等。
2. 分类：a. 细菌：是单细胞真核生物，常见的包括结核杆菌、大肠杆菌等。
b. 病毒：是具有细胞寄生性的微生物，常见的包括流感病毒、艾滋病病毒等。
c. 真菌：是一类真核生物，可引起真菌感染，如白色念珠菌、发霉菌等。
d. 寄生虫：是以寄生方式侵害宿主的生物，如疟原虫、蛔虫等。
三、传播途径1. 定义：传播途径是指病原体从传染源传播到易感人群或动物的路径。
2. 类型：a. 直接接触传播：通过直接接触传染源的分泌物、排泄物、体液等进行传播，如飞沫传播、血液传播等。
b. 食物水源传播：通过食物、水源等被病原体污染后摄入，引起传播，如食物中毒、水源污染等。
c. 空气传播：通过空气中的飞沫、粉尘等进行传播，如传染性肺炎、麻疹等。
d. 虫媒传播：通过带有病原体的昆虫进行传播，如蚊媒传播、蜱传播等。
四、免疫1. 定义：免疫是机体对病原体及其产物产生免疫应答的过程，包括先天免疫和获得性免疫。
2. 免疫方式：a. 主动免疫：通过感染或接种疫苗获得免疫力，能自身产生免疫应答。
b. 被动免疫：通过输注抗体或抗毒素等外源性免疫物质来获得免疫力，不需要自身产生免疫应答。
- 1、下载文档前请自行甄别文档内容的完整性，平台不提供额外的编辑、内容补充、找答案等附加服务。
- 2、"仅部分预览"的文档,不可在线预览部分如存在完整性等问题,可反馈申请退款(可完整预览的文档不适用该条件!)。
- 3、如文档侵犯您的权益，请联系客服反馈,我们会尽快为您处理(人工客服工作时间：9:00-18:30)。
联合治疗：称为高效抗逆转录病毒治疗(Higly active antiretroviral therapy ,HAART)。
能有效地抑制HIV复制，CD4+T 细胞增加，免疫功能重建。
常用三联或四联。
即三类药物的联合，二种核苷类和一种非核苷类，二种核苷类和一种蛋白类的联合等败血症（septicemia）是由病原菌侵入血液繁殖，产生大量毒素和代谢产物引起严重的全身性感染。
临床表现：突起寒战、高热、心动过速、呼吸急促、皮疹、神志改变、肝脾肿大及白细胞升高等。
重者可致休克、ARDS、DIC和多器官功能障碍综合征（MODS）。
菌血症（Bacteriemia）：指病原菌侵入血液，在血液中短暂停留，不出现明显症状毒血症（Toxemia ）：指病原菌在体内生长、繁殖或死亡时，所释放的内毒素或外毒素不断进入血液，引起全身功能失调及中毒性病理变化。
脓毒血症（Pyemia）：病原菌栓子随血流在各种组织和脏器中可引起转移化脓病灶，成为多发性脓肿如在肝、肾、皮下等。
胆酶分离:重症肝炎患者可出现ALT快速下降,胆红素不断升高的”胆酶分离”现象,提示肝细胞大量坏死.血清转换(seroconversion)肝炎患者血清中HBeAg消失而抗HBe产生称为血清转换.,此时病毒复制多处于静止状态,传染性降低.肝炎窗口期 Anti-HBc出现于HBsAg后2～4周，持续时间较长，当HBsAg已消失，而Anti-HBs尚未出现，这段时期称“窗口期”（window phase），此时只能检出Anti-HBc。
Dane：戴恩颗粒----完整的HBV颗粒，包膜内含HbsAg，核心部分内含环状双股DNA、DNAP、核心抗原（HBcAg）再燃（recrudescence）当伤寒患者进入缓解期，体温波动下降，但尚未达到正常时，热度又再次升高，持续5～7天后退热，常无固定症状。
复发（relapse）患者进入恢复期热退1～3周后，发热等临床表现重又出现，但较初发为轻，病程较短(1～3周)。
虚性脑膜炎：也称假性脑膜炎,急性感染热病时并发的脑膜刺激状态.通常见于小儿特异性热病和肺炎,亦见于成人伤寒。
表现为头痛,颈强直,kerning征阳性等脑膜刺激征。
干性霍乱（暴发型或中毒型cholera sicca）：起病急骤，发展迅速，尚未出现腹泻和呕吐症状，即进入中毒性休克而死亡。
高血容量综合症出血热少尿期，水钠潴留使组织水肿而出现的综合症，表现为体表静脉充盈,收缩压增高,脉压增大而使脉搏洪大,脸部胀满和心率增快,严重者出现心衰和肺水肿。
持续性全身淋巴结肿大艾滋病第三期，特点为除腹股沟以外有两个或两个以上部位的淋巴结肿大;淋巴结直径》1cm,无压痛,无粘连;持续时间三个月以上.隐性感染（covert infection）病原体侵入人体以后，仅诱导机体产生特异性免疫应答，而不引起或只引起轻微的组织损伤，因而在临床上不显出任何症状、体征，甚至生化改变，只能通过免疫学检查才能发现。
艾滋病窗口期：是指人体感染HIV后到外周血液中能够检测出HIV抗体的这段时间，一般为2周～3个月，少数人可到4个月或5个月，很少超过6个月。
目前国际公认的窗口期是6个月，但随着检验方式的进步，窗口期已经大大缩短。
败血症1、G+和G-败血症的鉴别要点：G+ G-原发病灶皮肤、呼吸道感染，尿路、胆道和肠感染骨髓炎、中耳炎等肝硬化等既往及病挤压疮疖、创伤、腹部/尿路手术（含导尿前手术史切开未成熟脓肿史膀胱镜检查）症状及并皮疹、关节症状、双峰热、相对缓脉、感发症心内膜炎、迁徙灶染性休克、DIC等鲎试验阴性阳性（LTT）体液/脓液培养相关致病菌相关致病菌2厌氧菌败血症占败血症致病菌的6%-16%，于慢性疾病或褥疮和新生儿易发生，入侵途径以胃肠道及女性生殖道为主，其次为褥疮溃疡和坏疽3临床特点：发热、感染性休克、DIC；高胆红素血症（正常10倍以上），发生率10-40%；并发血栓性静脉炎和迁徙性脓肿；婴幼儿患者发生率高4鉴别诊断1 Stills病：发热、皮疹、关节痛、肝脾肿大及WBC高，但中毒症状不明显、抗菌素治疗无效、血培养阴性；激素治疗有效。
2恶性组织细胞病：中毒症状不明显、骨髓涂片及淋巴结活检找到异常组织细胞。
3伤寒：与G-一样，病原菌及肥达反应阳性4粟粒性结核：结核中毒症状及呼吸道症状5其它：SLE、淋巴瘤等5治疗原则一,一般治疗和对症处理：适当营养，维持水、电解质及酸碱平衡。
毒血症重者，在抗菌药同时给小量激素。
二,病原治疗原则：1诊断末肯定者或病情严重者，采用降阶梯治疗或联合使用抗菌药；2宜静脉给药；3剂量要大；4选用杀菌剂；5获阳性培养结果，按药敏选药；6疗程宜长，＞3周或体温正常临床症状消失后继续7-10d三.局部处理：化脓病灶宜切开引流；化脓心包炎、脓胸、肝脓肿穿刺引流；胆道或沁尿道感染合并阻塞者及时手术治疗；四原发病治疗：如肝病、高冠心病五其他治疗：维持重要器官功能、血浆置换、调节机体免疫功能三．肝炎1.重型肝炎急性：有诱因。
起病急，<2周,黄疸进行性加深，胆酶分离，肝迅速缩小，出血倾向，PTA<40%，并发症:①肝性脑病，②肝肾综合症，③腹水及腹膜炎，④严重感染，⑤中毒性鼓肠，⑥肝肺综合症，⑦顽固性电介质紊乱。
亚急性：起病15日-24周，有上述表现。
慢性：在慢性肝病的基础上发生的亚急性肝坏死。
治疗1、一般和支持治疗：绝对卧床，低蛋白饮食。
补足能量及维生素B、C、K，维持水电解质平衡，减少氨吸收，补充白蛋白。
2、免疫调节治疗：胸腺肽 1.6mg iH Qod3、对症治疗：①出血的防治，输新鲜血, 血小板, 血浆，消化道出血可用络赛克, 雷尼替丁, 善得定等止血药物的应用②肝性脑病的治疗,减少氨的吸收(低蛋白或无蛋白饮食,口服不吸收的抗生素,乳果糖,食醋灌肠)，降低血氨: 精氨酸,鸟氨酸(雅博司)，纠正神经递质和氨基酸失衡: 左旋多巴, 支链氨基酸，防治脑水肿: 甘露醇, 速尿, 高渗糖等③继发感染的防治（自发性腹膜炎及中毒性鼓肠），以抗革兰阴性细菌感染为主,或根据药敏结果选择④急性肾功能不全的防治，扩张肾血管,补充血容量利尿不用对肾有损害的药物必要时血液透析治疗⑤肝肺综合症⑥腹水(补充白蛋白, 利尿, 抗感染)⑦电介质紊乱(补液维持电解质平衡)⑧促进肝细胞再生的措施：胰高血糖素-胰岛素疗法、肝细胞生长因子、前列腺素E14、抗病毒治疗：核甘类5、人工肝支持系统血浆交换灌流胆红素吸附等，生物人工肝6、肝移植：肝细胞移植肝器官移植7.肝细胞及肝干细胞或干细胞移植胎肝细胞、脐带干细胞、成体肝细胞2.慢性乙型病毒性肝炎的抗病毒治疗干扰素（IFN α, 复合干扰素, 聚乙二醇干扰素）用法：500万μ im qod⨯24~ 48周500万μ im qdx15~30d，随后qod⨯24~ 48周用药指征：有HBV复制活跃，ALT升高的慢性乙型肝炎病人禁忌症：TBIL正常值上限的2倍，失代偿性肝硬化，有自身免疫性疾病有重要器官病变（严重心、肾疾病；神经精神异常等）3. HBV：乙肝二对半HBsAg 抗HBs HBeAg 抗HBe 抗HBc 临床意义1 + - + - + 强复制2 + - - + + 低复制3 + - - - + 复制弱或停止4 - - - + + 现症感染/恢复期5 - + - -/+ + 恢复期，有免疫力6 - + - - - 感染恢复/注疫苗后7 - - - - + 新感染/旧感染/变异HBV DNA： HBV复制最直接指标。
4.与肝细胞坏死严重性相关的实验室指标血清胆色素: 肝细胞性黄疸时血总胆红素(TBIL)升高程度与肝细胞坏死的严重程度成正比，黄疸越深预后越差；凝血酶原活动度(PTA): 降低程度与肝细胞坏死严重程度相关；胆碱酯酶活性: 降低程度与肝细胞坏死严重程度相关.；血清白蛋白: 降低程度与肝功能衰竭程度成正比5.肝功能检查AST/ALT: 肝脏炎症活动最敏感的指标. 与肝坏死的严重程度不成正比；AST/ALT增加,说明肝脏病变较明显,或有慢性肝炎肝硬化.血清蛋白(Serum proteins; SP): 白蛋白(A)降低,球蛋白(G)增加,A/G倒置, 见于慢性肝炎肝硬化.血清总胆红素：血总胆红素(TBIL)升高代表肝细胞有坏死,其升高程度与肝细胞坏死的严重程度成正比,重型肝炎患者TBIL ≥171μmol/L.尿双胆检测: 尿胆原与尿胆红素均增加.10.黄疸分类分类溶血性肝细胞性阻塞性黄疸颜色轻，浅柠檬色浅黄—深黄黄绿色、绿褐色瘙痒多无有时有常有伴随症状发热.酸痛.贫血消化道症状发热、腹痛尿色酱油样浓茶样浓茶样大便颜色加深加深或变浅变浅.灰白色.陶土样血 BIL UBIL升高为主两者均升高 DBIL升高为主尿BIL 阴性尿双胆阳性 TBIL明显升高粪胆原升高升高或下降降低其它贫血、溶血方面肝功能、病原学等 A KP、rGT、B超、CTUCB ↑↑↑↑CB 正常↑↑↑CB/TB <20% >30% >35%尿胆红素 -― + + +尿胆原↑轻度↑↓或缺如ALT 正常↑↑可↑6.肝炎临床分型急性肝炎：黄疸型和无黄疸型；慢性肝炎：轻、中、重度重型肝炎：急性、亚急性、慢性；淤胆型肝炎；肝炎后肝硬化：静止性和活动性7.肝腹水形成原理腹水：早期----醛固酮增多，利钠激素减少；后期---门脉高压、低蛋白血症、肝硬化结节压迫血窦使肝淋巴液生成增多而促进腹水增多8.肝性脑病1. 血氨及其它毒性物质的潴积2. 氨基酸比例失衡3. 假性神经递质学说4.其他诱发因素：过度利尿、消化道大出血、高蛋白饮食、感染、镇静剂、大量放腹水9.乙肝病毒基因ORF S区 PreS1 ,Pre-S2, S(PreS1 ,Pre-S2, PHSA-R, S)C区 Pre-C, C (HBcAg, HBeAg) P区DNAp(DNAp) X区 Xgene (HBxAg)四．霍乱1. 霍乱是由霍乱弧菌所致的烈性肠道传染病。
属国际检疫传染病，在我国属于甲类传染病。
2.典型表现: 剧烈腹泻、呕吐脱水、周围循环衰竭、急性肾衰电解质紊乱、酸碱失衡3.干性霍乱（暴发型或中毒型）：起病急骤，发展迅速，尚未出现腹泻和呕吐症状，即进入中毒性休克而死亡。
4.流行病学传染源：病人、带菌者传播途径：消化道传播，经水传播食物、日常生活接触、苍蝇、水产品易感人群：人群普遍易感，隐性感染多，病后可产生一定免疫力流行季节与地区：夏秋季，7-10月沿海一带O139霍乱流行特征：无家庭聚集性，成人，男多于女，经水、食物传播，普遍易感5.发病机制：人体食入霍乱弧菌是否发病，主要取决于机体的免疫力和食入弧菌的量6.临床表现：潜伏期1~3天，突然发病典型霍乱病程：①吐泻期：腹泻，第一个症状，无发热，无里急后重感，无腹痛性状：黄色稀便→水样便（黄色、米泔水样、洗肉水样）次数：数次~数十次/天呕吐，先泻后吐，喷射性、连续性，少恶心呕吐物：胃内容物→水样→粪便性质相似，本期持续数小时或1～2天。