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51 Cards in this Set
- Front
- Back
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Stages of pertussis
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incubation - 7-10 days
Catarrhal - 7-14 days Paroxysmal - 2-4 weeks Convalescent - 3-4 weeks + |
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Which phase of pertussis includes "whooping"
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paroxysmal
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Pertussis in Adults Accounts for up to ___% of cough illnesses per year
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7
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Pertussis complications (pneumonia and/or hosptitalization) occur in which age group?
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<6 months
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Diagnosis of pertussis?
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by culture- best to use nasopharyngeal aspirate
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What kind of swab should be used to diagnose pertussis?
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use dacron or other non-cotton swab
Cotton swabs contain a fatty acid that is toxic to B. pertussis |
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transport media for Bordatella pertussis?
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Put sample in Regan-Lowe transport media
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agar for culture of bordatella pertussis
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Lab will culture on Bordet-Gengou agar
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DOC for pertussis
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Macrolides
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Pertussis vaccine is Given along with tetanus and diphtheria vaccines
what are the 2 types? |
Whole cell vaccine (TDwP)
Acellular vaccine (TDaP) |
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What age group is getting pertussis lately?
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>25
There has been a general rise in pertussis incidence since 1970s. |
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Tdap vaccines in adolescents aged 11–18 years in place of ________ toxoids (Td) vaccines.
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tetanus and diphtheria
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What is acute inflammation of the tracheobronchial tree called?
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Acute bronchitis
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Bronchitis
Clinical manifestations |
Purulent cough plus or minus:
Fever Malaise Rhinorrhea or nasal congestion Sore throat Wheezing Dyspnea Chest pain Myalgias or arthralgias |
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Viral causes of acute bronchitis
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Influenza, parainfluenza, adenovirus, rhinovirus, and a number of other viruses
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Bacterial causes of acute bronchitis
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Mycoplasma pneumoniae; Chlamydophila pneumoniae; Streptococcus pneumoniae; Haemophilus influenzae; Bordetella pertussis
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____% of acute bronchitis has a non-bacterial cause (ie due to virus or non-infectious)
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>90
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Clinically, with presentation of symptoms like Acute Bronchitis, first rule out what disease?
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pneumonia
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Viral causes of bronchiolitis
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RSV (******)
PIV Influenza Adenovirus Human Metapneumovirus |
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Bacterial cause of bronchiolitis
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M. pneumoniae can cause in older children and adults
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Paramyxoviridae
Most common cause of LRTI in infants and young children (<3) |
Respiratory Syncytial Virus
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Important antigens of RSV
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HN- adsorption
G-also involved in adsorption F-fusion protein |
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Disease associations of RSV
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Bronchiolitis
Pneumonia Colds |
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A Paramyxoviridae that is Clinically and epidemiologically similar to RSV, but Not nearly as common a cause of serious disease as RSV
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Human Metapneumovirus
~100% infection rate in childhood |
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2 strains of RSV that circulate annually
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A and B
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RSV:
Transmitted by what? |
large droplet secretions on hands and fomites
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RSV season:
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winter-spring
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What increases risk of infection with RSV?
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Day care
Infants in households with school aged siblings Exposure to tobacco smoke Lack of breast feeding |
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RSV:
100% infection rate by ___ years of age |
3
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Which group of children is at most risk for RSV mortality?
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infants with congenital heart disease
(37% mortality rate in this group) |
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What component of humoral immunity is most important regarding RSV (but is short lived)
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anti-viral IgA
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Diagnosis of RSV
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Virus isolation
Viral antigen detection (ELISA) |
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RSV:
high risk infants |
Premature infants
Infants with cardiopulmonary disorders Immune suppressed infants |
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Immune globulin products available for prevention of HSV
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Humanized monoclonal antibody against viral F protein (Palivizumab)
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6 viruses causing viral penumonia
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RSV
PIV (parainfluenza) Influenza Adenovirus Metapneumoviruses Hantavirus |
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Viruses are most common cause of pneumonia in what pts
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in young children and are common causes in adults older than 60.
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____ is the most common cause of LRTI in children less than 3
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RSV
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Reservoirs of Hantavirus
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deer mouse, white footed mouse, rice rat, cotton rat
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In the past 14 years, how many cases of Hantavirus infection have there been?
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465
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Points about Hantavirus Pulmonary Syndrome
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Rapidly progressing adult respiratory distress syndrome following mild flu-like illness
Hypotension Bilateral pulmonary infiltrates Hemoconcentration DIC ARDS |
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Diagnosis of Hantavirus
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Clinical manifestations
Serology Virus isolation Viral antigen detection PCR |
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Treatment of Hantavirus Syndrome
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1) Supportive
Oxygenation Vasopressors (Dopamine, dobutamine) Volume replacement 2) Antiviral Ribavirin being investigated |
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People don't get rid of Cytomegalovirus. Where is it?
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Latent in white blood cells and possibly other cells (ie, endothelial cells)
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Symptomatic primary infection of CMV:
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Mononucleosis-like syndrome
Post-transfusion syndrome (but, Most infections and reactivations are asymptomatic) |
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Sequellae of CMV in immunocompromised
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Pneumonia
Chorioretinitis GI disease Encephalitis |
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Diagnosis of CMV Pneumonia
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Virus isolation from lung tissue or bronchial aspirate
CMV antigen detection Histopathology or cytology ***nuclear inclusion bodies with perinuclear halo ***cytoplasmic inclusions |
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Antivirals Effective Against CMV
Interfere with viral ___synthesis |
DNA
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3 Antivirals Effective Against CMV
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Ganciclovir
Nucleoside analogue Cidofovir Nucleoside analogue Foscarnet Pyrophospahte analogue |
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Reactivation of latent CMV can or cannot be prevented ?
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cannot
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Use of _____-IG may prevent development of disease in seronegative at-risk patients (ie transplant)
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CMV
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Prevent primary infection in seronegative immune suppressed by:
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Use of seronegative blood for transfusion
Use of organs from seronegative donors |
