Cau 62: kh.nag gay benh

cua vk ta

* k/nag gay benh va co che gay benh;

Vk ta chi gay benh cho ng trong dkien tu nhien .VK ta xam nhap vao co the theo dg tieu hoa.de xuong ruot non Vk fai vuot qua da day, do pH~3-> VK chet nhanh chong .tren thuc te ,benh ta thuong gap o nhung ng co do acid cua dich vi giam or mat.doi voi nhung ng tiet dich binh thuong thi t/an, nc uong fai co kha nag trung hoa bot acid cua dich vi thi VK ta moi co the gay benh dc.o ruot non Vk bam vao niem mac nhung ko xam nhao sau vao mo ruot va hau nhu ko gay ton thuong cau truc niem mac ruot.Vk ptrien nhanh chong nho pH thich hop,tiet ra doc to ruot LT.doc to ruot gan vao niem mac ruot non lam cho Tb niem mac ruot hap thu Na+, tag tiet nc va CL- gay ra ia chay cap tinh.neu ko dieu tri tich cuc thi b.nhan se chet vi mat nc va cac chat dien giai

* phong

-Dac hieu : o nc ta dug vaccin song giam doc luc 0! Va 0139 dua vao co the theo dg uong ,dug cho nhung ng song trong vung dich ta luu hanh

-ko dac hieu: ve sinh an uong ,su dug nc sach, quan li, xu li phan ,diet ruoi, chan doan som, cach li b.nhan, xu li phan va chat non cua b.nhan, bao vay dap dich

*d tri: q trong nhat la bu nc va chat dien giai, cho uong cresol tg duong so nuoc va chat dien giai bi mat, truyen tinh mach khi can thiet. Vk ta con nhay cam voi nhieu khang sinh-> thuong dug tetracylin, chloramphenicol or doxycyclin.

Cau 63: VK Dich hach

a.K/nang gay benh:

Doc luc cua Y.pestis lien quan den nhieu yeu to:

- Khang nguyen F1(ko chiu nhiet) va cac KN V,U: chi co o nhung chung doc; khi mat cac KN nay, VK dich hach ko con kha nang gay benh cho chuot thi nghiem.

- Sinh sac to o moi truong co hemin va kha nang gap phu do cong.

- Sinh pestisin I va II. Nhung chung sinh pesticin I thuong di kem voi sinh cac yeu to lam tan to huyet va men coagulase.

- Doc to gay doc cho chuot.

- K/nag tong hop purin.

- VK DH la loai da vat chu, hon 300 loai gam nham co the mac benh dich hach. VK xam nhap vao co the chu yeu theo dg da do con trung dot hoac do da co vet say sat tiep xuc truc tiepa voi vat pham co VK. Moi truong trung gian truyen benh la bo chet. Bo chet ki sinh tren chuot, hut mau chuot de song. Khi VK vao da day cua bo chet se tiep tuc nhan len va tao nen 1 khoi ket dinh giong nhu to huyet=> dan dan gay tac nghen ong tieu hoa o fan tien da day. Khi chuot chet, bo chet di tim vat chu moi de hut mau =>ong tieu hoa bi tac nghen =>mau ua lai vat chu =>VK dot nhap vao co the vat chu moi.

- Benh DH o nguoi co 3 the LS; the hach(thuong gap nhat), the phoi va the nhiem khuan huyet; 2 the sau, benh canh LS rat nang, ti le tu vong cao.

- Day chuyen dich te hoc:

Gam nham hoang dai (Bo chet ( Chuot ( Bo chet ( Ng ( Ng.

b/ Phong:

- Ko dac hieu:

- Diet chuot, bo chet => Cat dut day chuyen dich te hoc cua benh. Noi chuot chet hoang loat ma ko giai thich duoc li do fai tien hanh fun thuoc diet bo chet.

+ Khi benh dac hieu xay ra => To chuc uong KS du phong cho ng nha b.nhan, ng dan vung co chuot chet va cac nhan vien y te tiep xuc voi the phoi. Cach I b.nhan, chan doan va dieu tri triet de, dac biet la nhung truong hop nghi ngo dau tien de co co soe quyet dich cac bien phao fong chong khan cap.

- Dac hieu: Chi tiem vaccin cho nhung ng song o vung co chi diem dich te hoc or phai lam nhiem vu o nhung vung do.

- Vaccin ssong: Tiem 1 lan, gay mien dich nhanh (5-7 ngay) va thoi gian mien dich keo dai(6 thang den 1 nam) nhung gay phan ung manh hon.

+ Vaccin chet: Tiem 2 lan, chi mien dich duoc 6 thang.

c/ Dieu tri:VK DH con nhay cam voi nhieu KS, tuy the LS ma dug Streptomycin, tetracyclin va chloramphenicol don le hoac ket hop.