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83 Cards in this Set

  • Front
  • Back
What is the definition of Acute bronchitis?
Inflammatory condition of tracheobronchial tree
When does most acute bronchitis occur?
What are the main symptoms of acute bronchitis?
Persistant cough in the absence of lower repiratory tract infections
What disease is characterized by acute onset of wheezing, hyperaeration, cough, rhinorrhea, tachypnea and respiratory distress within the fist 2 years of life?
What is the most 2 most common cause of bronchiolitis?
RSV and Parainfluenza
What class of virus is RSV part of?
What type of virus is RSV?
Enveloped, ssRNA, negative sense
What RSV surface proteins are involved in infection and pathogenesis?
F (Fusion protein) and G (viral attachment protein)
How is RSV diagnosised?
Nasal wash, direct atigen test, tissue culture
What children are affected by RSV?
Virtually all by ages 2-3
How is RSV spread?
Inoculation of virus occur nose or eye
RSV is most severe in young infants, despite materal antibody. What does this suggest?
Immunologic mechanisms may contribute to pathogenesis
What does RSV infection look like in adults with normal immune function?
Severe cold-like illness, bronchitis, or bronchitis and otitis
What does RSV look like in immunocompromised adults/ elderly people?
severe and mimics the disease seen in children
What treatment is used for RSV?
Supportive care
Aerosol Ribivarin in hospitalized infants
Passive immunizaton
What two type passive immunization for RSV are available for high risk children?
RSVIG (immunoglobulin)
Palivizumab (antibody reactive to F protein)
What type of virus is Parainfluenza?
Paramxyovirus, Single strand, negative RNA
What distiquishes Parainfluenza from other paramxyoviruses?
Presence of envelope glycoprotein neuraminidase and hemagglutinating properties
How does Parainfluenza bind to sialic acid receptors?
Hemagglutinin-neuraminidase (HN) protein
How is Parainfluenza diagnosised?
Nasal wash with DFA for rapid diagnosis
Cell culture gold standard
What is laryngotracheobronchitis?
What is the leading cause of croup?
What range of symptoms can parainfluenza cause?
From common cold to otitis media to URT
What disease is characterized by hoarseness and eepening cough, non productive cough with a striking brass tone?
How long does croup last?
3-4 days but cough may be longer
What is used to treat croup?
What type of virus is Human metapneumovirus?
What is the clinical manifestation of Human metapneumovirus?
Similar to RSV
ranges from asymptomatic to bronchiolitis to pneumonia
What maybe causing severe disease in RSV patients?
Coinfections of RSV and HMPV
How is HMPV diagnosised?
PCR but not routine because genome owned by company

Does not grow on commonly used cell lines
What illness is caused by infection of the lung parenchyma involving the alveoli or interstitium?
What is lobar pneumonia?
Distinct region of lung involved with the most invovement within the alveoli
What is bronchopneumonia?
Pneumonia involving small airways and nearby areas of the lung
What pneumonia involves lung interstitium?
Interstitial pneumonia
How is acute pneumonia diagnosised?
Clinically: patients signs and symptoms and x-ray
Why is it difficult to determine etiologic agent involved in pneumonia?
lots of different agents with different growth requirements and difficult to get specimen
What are common causes of community-acquired pneumonia?
Streptococcus pneumoniae, Haemophilus influenzae, staphlococcus aureus, moraxella catarrhalis, mycoplasma pneumoniae, chlamydophila pneumoniae, Legionella pneumophila, Klebsiella pneumoniae
What are common causes of hospital-acquired pneumonia?
aerobic gram negative bacilli (E. coli, Serratia, Enterobacter, Klebsiella, Pseudomonas aeruginosa) and Staphylococcus aureus
What is the general route of infection for pneumonia?
reach lung, avoid host defenses, multiplication and host response, cleared or patient dies
What is structure of strep. pneumoniae?
Gram postive cocci, catalase negative, pairs or short chains
Why does strep. pneumoniae frequently appear gram negative?
Presence of autolysins
What is the leading cause of community-acquired pneumonia especially in the elderly and immunocomprimised patients?
Strep. pneumoniae
How is strep. pneumoniae spread?
person-to-person via close contact
What does strep. pneumoniae bind to prevent it from being trapped in mucous?
secretory portion of IgA
What two thing allow strep. pneumoniae to avoid phagocytosis?
Capsule and pneumolysin
How does the capsule of strep. pneumoniae aid avoidance of phagocytosis?
high antigenic variablility, binds protein H which then degrades C3b, prevents phagosome from encountering antibody or complement
How does pneumolysin prevent phagocytosis of strep. pneumoniae?
Decrease oxidative burst therefore PMN are not as affective
What mediates the inflammatory response caused by strep. pneumoniae?
Teichoic acid
How does teichoic acid work?
binds to TLR2 which stimulates cytokine release
What organ is critical for recovering for strep. pneumoniae?
What 3 groups of people are at great risk for infection with strep. pneumoniae?
1)loss of splenic function
2)decreased responsiveness to polysaccharide antigens
3)increased rate of decline in serum antibody concentrations
What is the leading cause of bacterial meningitis in US?
Strep. pneumoniae
What complications can arise from strep. pneumoniae?
empyema, bacteremia, meningitis, otitis media and sinusitis
What are the clinical features of strep. pneumoniae?
abrupt onset of fever, shaking chills, chest pain, cough with purulent (and often bloody) sputum, tachypnea and tachycardia
What drug is used to treat strep. pneumoniae?
Penicillin but lots of resistance
What type of hemolytisis does strep. pneumoniae exhibit?
What are the two types of strep. pneumoniae vaccines?
adult (23 capsular polysaccharide types) and child (7 capsular types conjugated to proteins)
What type of bacteria is Haemophilus influenzae?
extracellular, gram negative coccobacilli
What allows haemophilus influenzae to adhere to mucosal epithelial cells?
What is the basis of the Haemophilus influenzae B vaccine?
What does H. influenzae colonize?
pharynx, occ. conjunctiva or genital mucosa
How is H. influenzae spread?
airborne droplets or direct contagion
What is the clinical presentation of non-encapsulated strains of h. influenzae?
exacerbations of chronic bronchitis, otitis media, sinusitis, occasionally pneumonia
What is the clinical presentation of encapsulated strains of h. influenzae?
Pneumonia, epiglottitis, miningitis, cellulitis, septic arthritis
What drugs are used to treat H. influenzae?
third generation cephalosporins
How is H. influenzae diagnosised?
grown on chocolate agar,
gram stain tiny, pleomorphic, gram negative bacilli/coccobacilli
What type of bacteria is Klebsiella pneumoniae?
Extracellular, Gram negative bacilli
Where is Klebsiella pneumoniae normaly found
GI tract
What family is Klebsiela pneumoniae part of?
What subgroup of patients is Klebiella pneumoniae normally found?
Alcoholics and other compromised hosts
What can be used to treat Klebiella pneumoniae?
Pretty much nothing... most is drug resistant
Describe Pseudomonas aeruginosa bacterial characteristics?
Gram negative, oxidase-positive, motile, aerobic organism
Where does Pseudomonas aeruginosa grow?
Name some of the virulence factors used by Pseudomonas aeruginosa.
Fimbriae, Slime, Pyocyanin, proteases, elastases, phospholipase, exoenzymes, hemolysins, Exotoxin A, Endotoxin, Multiple antibiotic resistance
How do fimbriae aid in Pseudomonas aeruginosa virulence?
involved in adherence but do not adhere well to fibronectin
How does slime aid in Pseudomonas aeruginosa virulence?
Acts like capsule and helps make biofilm
Why are patients with cystic fibrosis more succeptible to Pseudomonas aeruginosa?
conditions may switch on gene to make slime
How does the blue green pigment pyocyanin aid in Pseudomonas aeruginosa virulence?
Catalyzes formation of toxic radicals, stimulates IL-8 release
What enzymes produced by Pseudomonas aeruginosa cause tissue damage?
Proteases, elastases, phospholipase, exoenzymes, hemolysins
What kind of heymolysis is seen with Psuedomonas aeruginosa?
How does Exotoxin A aid in Pseudomonas aeruginosa virulence?
functions identical to diptheria exotoxin but less potent
What 5 groups of patients are most suceptible to Pseudomonas aeruginosa?
Burn patients, cystic fibrosis patients, agranulocytic patients, patients with malignancy or prolonged immunosuppressive therapy, patients on repiratory equipment
What does Pseudomonas aeruginosa cause in normal hosts?
Swimmer's ear or folliculitis