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40 Cards in this Set

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Defense Mechanisms of Respiratory
A. The nasal cavity has a mucociliary lining. The inside of the nose is lined with hair which act to filter larger particles. Mucus which collect particles not filtered by nasal hairs.
B. The adenoids and tonsils are lymphoid organs in the upper respiratory tract in the back of the throat.
C. A layer of mucus and ciliated cells covers the lower portion of the lower respiratory tract. Pathogens are trapped in the mucus layer and are driven upwards by ciliary action to the back of the throat.
What is the ciliary elevator
the ciliary action that drives pathogens upwards to the back of the throat
What are some evasion of Defense Mechanisms
1. the microorganism must avoid being caught up in the mucus layers of the upper respiratory tract, being transported to the back of the throat, and eventually being swallowed.
2. If the invader has avoided the physical defense mechanisms of the upper respiratory tract, and is deposited in the lower respiratory tract or lung, it must either avoid phagocytosis, or be able to survive and multiply in the phagocytic cell.
What are some Mechanisms used to initiate disease
1. Bacterial adherence factors(F&M proteins of S.pyrogenes)
2. Extracellular toxins(diptheria toxin)
3. Intracellular growth in host tissue(i.e. chlamydia, viruses)
4. Evasion of host defense mechanisms(capsules and M protein of S.pyrogenes,etc. H.influenzae by inhibiting phagocytosis)
What are some URI
Common cold, Pharyngitis & Tonsilitis, Sinusitis & Otitis Media
What are some Airway Infections
Diptheria, whooping cough, Laryngo-Tracheo Bronchitis (croup), Influenza, Bronchitis, Bronchiolitis
What are some lower respiratory tract infections
Pneumonia & Bronchopneumonia, pulmonary tuberculosis
Why are bacterial infections so important
because they can be life-threatening and are treatable with antiobiotics
Why are viruses not as dangerous
because they are self limiting
What is the common cold mostly caused by
viruses
what causes sinusitis
bacteria, S.pneumoniae and H.influenza
What causes Pharyngitis
90% viruses, but important bacteria are S.pyogenes adn C.diptheriae
what causes bronchitis, tracheobronchitis, bronchiolitis, and croup
mostly viral
what causes pnuemonia
large number of bacterial infections in adults
What are some different types of Upper Respiratory Tract infections
Pharyngitis
common cold
acute laryngitis
otitis media
sinusitus
epiglottitis
diptheria
whooping cough
mumps
croup
what are the names of microorganisms that cause Pharyngitis
Adenovirus
Herpes Simplex Virus
Coxsackieviruses
Epstein-Barr Virus
S. pyrogenes
Corynebacterium diphtheriae
Neisseria gonorrheae (rare)
what are the names of microorganisms that cause the common cold
Rhinoviruses
Coronaviruses
Adenoviruses
Myxoviruses
Echoviruses
Coxsackie viruses
Mycoplasma pneumoniae
Chlamydophila pneumoniae
what are the names of microorganisms that cause sinusitis
Streptococcus pneumoniae
Haemophilus influenza
Moraxella Catarrhalis
what are the names of microorganisms that cause diptheria
Corynebacterium diptheriae
what are the names of microorganisms that cause Otitis Media
Steptococcus pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
Respiratory Syncytial Virus
Rhinovirus
what are the names of microorganisms that cause Whooping cough
Bordetella pertussis
what are the names of microorganisms that cause Epiglottitis
Heamophilus influenza
what are the names of microorganisms that cause croup
Parainfluenza viruses
Respiratory Syncytial Virus
What are some of the normal flora components of the oral, nose, and throat
-Streptococci (non-hemolytic and alpha-hemolytic)
-Staphylococci (S. epidermidis, S.aureus)
Lactobacilli
Bacteroides
Corynebacteria
Actinomyces
Mycoplasmas
Fungi, yeasts
Viruses
what are the signs and symptoms of pharyngitis
sore throat
pain when swallowing
fever
enlarged lymph nodes in the neck
runny nose and postnasal drip
headache
diffuculty breathing (rare)
What is the cause of about 40% of the cases of Pharyngitis
Acute viral pharyngitis
caused by:
adenovirus
rhinovirus
parainfluenza virus
coxsackieviruses
coronavirus
what is the cause of about 30% of the cases of Pharyngitis
Acute bacterial pharyngitis
Group A beta-hemolytic strep(S.pyrogenes)
Neisseria gonorrheae (rare)
Corynebacterium diptheriae
Haemophilus influenzae
Moraxella catarrhalis
Group C and G streptococci(rare)
what is the cause of the other 30% of pharyngitis cases
no isolated pathogens
what are some of the complications and sequelae of strep throat
complications:
scarlet fever
bacteremia and streptococcal toxic shock syndrome
Sequelae:
Rheumatic fever
Glomerulnephritis
What is the morphology of strep pyrogenes, where it inhabites and how it consumes oxygen
Gram Positive cocci
.5-1.25 micrometers diameter
Facultative anaerobe
extracellular
normal habitat is upper resp. tract
What is the Epidemiology of S. pyrogenes
15-20% URT colonization in healthy children and adults(asymptomatic carriage)
Acute disease-15%adult,30%pediatric
pharyngitis-respiratory droplet spread
How can one obtain S. pyrogenes
Crowded conditions (daycare)
Specific groups at risk for scarlet fever/rheumatic fever
What are some of the virulence factors of S. pyrogenes
M Protein(50 serotypes) and lipoteichoic acid attachment
GroupA-specific carbohydrate
Capsule- hyaluronic acid
Enzyme- hyaluronidase
Pyrogenic-(erythrogenic)exotoxins
What is the definition of the clinical disease of Pharyngitis
Abrupt onset: sore throat, fever, malaise, and headache
Posterior pharynx: erythematous, cervical lymphadenopathy
-50% have pharyngeal or tonsillar exudates
-may be confused with viral pharyngitis which may also present with exudates
Diagnosis requires cultures or serology (rapid test)
What is Scarlet Fever
A complication of streptococcal pharyngitis
Lysogenized strep species
-pyrogenic (erythrogenic)exotoxin
what are the symptoms of scarlet fever and the onset of symptoms
Symptoms occur 1-2 days after onset of pharyngitis,and last 5-7 days followed by desquamation
-Diffuse erythematous rash on upper chest spreads to extremities;blanches w/ pressure; in skin folds (Pastia's Lines), "sandpaper" feel
-white&red "strawberry tongue"
-high fever, nausea and vomiting in serious cases
What is Rheumatic Fever
Considered an autoimmune sequela to untreated and/or asymptomatic pharyngitis.
When does Rheumatic fever occur
2-3 weeks after pharyngitis
What are the symptoms of Rheumatic fever
Inflammatory changes in heart, joints, blood vessels, and subcutaneous tissues,
fever, rash, carditis, and arthritis
Endocarditis, Pericarditis, Myocarditis
What do you use to diagnose Rheumatic fever and is it preventable
Use the Jones Criteria to diagnose
Preventable if patient is treated within 10 days of the start of pharyngitis