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30 Cards in this Set
- Front
- Back
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Rhinovirus
virulence? |
Number one cause of common cold (URTI)and pharyngitis
Acid labile and heat stable; naked capsid so it can last outside of a host longer Tx: vaccine not probable due to multiplicity of strains and canyon attachment site Spread by respiratory droplets (hands to face) Most frequent reason for misuse of ABX |
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Coronavirus
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Second major pathogen causing common cold (URTI); SARS
ssRNA, enveloped |
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Adenovirus
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Third major pathogen causing common cold (URTI); also develop persistent infection in lymphoid tissue; *significant in LRTI in kids, acute disease of military recruits, pharyngoconjunctival fever from swimming pools, epidemic keratoconjunctivitis, infantile gastroenteritis
dsDNA, naked icosahedral |
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Streptococcal pharyngitis --> acute rheumatic fever and acute glomerulonephritis
Pathogen, clinical presentation, stain, virulence, treatment |
Pathogen: Streptococcus pyogenes (group A strep)
Clinical Manifestation: sore throat, nausea, vomiting, fever, yellow exudate on tonsils Stain: gram positive cocci in chains, catalase negative, sensitive to BACITRACIN Virulence factors: peptidoglycan layer, streptolysins, M protein Tx: PCN G or PCN V for 10 days |
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Diptheria
Disease, clinical presentation, stain, virulence, treatment |
Pathogen: Corynebacterium diptheriae
Clinical presentation: sore throat, fever, listlessness, tachycardia, weakness, vascular collapse Stain: gram positive rod, 'club shaped' swelling at one end Virulence: exotoxin with A (enters the cytoplasm of the cell and blocks protein synthesis by ribosylating EF2)and B (binding) fragment Tx: PCN **remember the DTP vaccination at 2,4,6 mos followed by boosters at 18mos and 4-6 years |
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Epiglottitis
Pathogen, clinical presentation, stain, virulence, treatment |
Pathogen: haemophilus influenzae
Clinical: difficulty breathing, fever, sore throat, pain on swallowing, inflammation of epiglottitis, 'thumb sign' on x ray, children assume tripod position Stain: small, gram negative, pleomorphic rods Virulence: polysaccharide capsule is antiphagocytic, endotoxin, IgA protease Tx: ceftriaxone (cephalosporin), intubation or tracheostomy ** with emergence of HIB vaccine, invasive disease has declined by 98% |
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Bacterial Tracheitis (Croup)
Pathogen, clinical presentation, stain, virulence, treatment |
Pathogen: Staphylococcus aureus (remember, croup is caused by parainfluenza virus first and then sets the patient up for this bacterial infection)
Clinical presentation: URTI symptoms, ACUTE onset with high fever, stridor and respiratory distress, 'steeple sign' on x ray Stain: gram positive cocci in clusters Virulence: has beta lactamase, heat stable Tx: IV ABX (remember, if you only have the viral part, ABX will not work, you need to use IV steroids) |
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Whooping cough/Pertussis
Pathogen, clinical presentation, stain, virulence, treatment Also discuss the three stages of this disease |
Pathogen: Bordetella pertussis
Clinical Presentation: *paroxysmal cough* leading to respiratory distress Stain: small, gram negative coccobacilli, catalase positive, oxidase positive, aerobic Virulence: pertussis toxin ribosylates G proteins inpairing lymphocytes; adenylate cyclase toxin similar to pertussis toxin, trachea toxin, endotoxin Tx: erythromycin during catarrhal stage **remember we have a vaccine DTAP for this at 2,4,6 months and then boosters Catarrhal phase (most communicable), paroxysmal phase (the cough), convalescent phase |
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Pneumococcal pneumonia/CAP
Pathogen, clinical presentation, stain, virulence, treatment |
Pathogen: streptococcus pneumoniae
Clinical presentation: sudden onset, fever, bed shaking chills, bloody/RUST colored sputum, x ray looks cloudy Stain: gram positive, lancet shaped, diplococci Virulence: pneumolysin is a pore forming cytotoxin that kills WBC, C substance cause inflammation Tx: PCN (this is a beta lactam); for resistant strains use erythromycin, cephalosporin and vancomycin *we have vaccinations: for adults it is Pneumovax and for kids it is Prevnar |
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Bronchiectasis
Pathogen, clinical presentation, stain, virulence, treatment |
Pathogen: usually staphylococcus aureus
Clinical presentation: irreversible dilated and thickened bronchi secondary to severe infections due to impaired mucus clearance or obstruction- this is just like CF Stain: gram positive cocci in clusters Virulence: beta lactamase, heat stable Tx: IV ABX |
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Pneumonia coupled with 'red currant jelly sputum'
Pathogen, clinical presentation/demographics, stain, virulence |
Pathogen: Klebsiella pneumoniae
Clinical: jelly sputum; demographics are homeless, alcoholic, bedridden Stain: gram negative rod Virulence: large polysaccharide capsule |
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Patient on a ventilator for 2 weeks gets pneumonia
Pathogen, clinical presentation, stain |
Pathogen: pseudomonas aeruginosa
Clinical presentation: same as regular pneumonia but pt will be on ventilator or have cystic fibrosis Stain: thin, gram negative rods, oxidase positive |
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Heroin addict recovering from flu
Pathogen, clinical presentation, stain |
Pathogen: staphylococcus aureus
Clinical presentation: same as regular pneumonia but mostly in IV drug users with a recent influenza virus infection Stain: gram positive cocci in clusters |
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What is the major dysfunction in cystic fibrosis?
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sodium chloride channel dysfunction
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Atypical pneumonia: mycoplamsa
Pathogen, clinical presentation, diagnostic lab, treatment What is a hallmark of this bacteria? |
Pathogen: mycoplasma pneumoniae
Clinical presentation: SLOW onset of fever, headache, malaise and nonproductive cough; over a couple weeks interstitial pneumonia develops in unilateral lower lobe Diagnostic lab: cold agglutinins Tx: doxycycline or erythromycin Hallmark: This bacteria has NO cell wall, that is why PCN/beta lactams will not interfere with it because these drugs prevent formation of the cell wall. |
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Atypical pheumonia: Chlamydia
Pathogen and stRain, clinical presentation, treatment |
Pathogen: Chlamydia pneumoniae; this is an OBLIGATE PARASITE; specifically, it is the TWAR strain that is responsible for pneumonia
Clinical presentation: cold symptoms Tx: tetracycline and doxycycline |
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What are the two pathogenic causes of atypical pneumonia?
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Mycoplasma pneumoniae and Chlamydia pneumoniae
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Environmental pneumonia
Pathogen, clinical presentation, stain, virulence, lab detection, treatment Where in the environment can you get this? How can you prevent it? |
Pathogen: legionella pneumophilia
Clinical presentation: Legionaries disease= fever, cough, malaise, chills, dyspnea, headache, delirium, productive cough Stain: fastitious gram negative rods Virulence: cytotoxins DOT (defect in organelle trafficking) and ICM (intracellular multiplicaiton), beta lactamase, endotoxin Lab detection: Urine antigen detection is what we use today Tx: erythromycin Can get it from air conditioning cooling towers, humidifiers, water pipes, showers and faucets. Avoid it by heating water above 60C and chlorine to remove organism. |
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Anthrax
Pathogen, clinical presentation, stain, treatment |
Pathogen: bacillus anthracis
Clinical presentation: (1) initial phase for 1-6 days- mild fever, malaise, myalgia, chest/abdominal pain (2) secondary phase with death in 24 hours- fever, dyspnea, diaphoresis, cyanosis, stridor Also produces painless pruritic papules on hands that ulcerates into a black eschar over time Stain: Large, gram positive rod Tx: ciprofloxacin, doxycycline, penicillin |
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Community Acquired Pneumonia in Childhood
Most common birth to 20 days Most common 3 weeks to 2 months Most common 2 months to 4 years Most common 5 years to 15 years |
Birth to 20 days: group B streptococci (s. agalactiae)
3 weeks to 2 months: chlamydia trachomatis 2 months to 4 years: RSV, parainfluenza, influenza, adenovirus, rhinovirus 5 years to 15 years: mycoplasma pneumoniae, chlamydia pneumoniae |
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Most common pathogen for HAP?
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gram negative rods (like klebsiella, e.coli...)
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Aspiration pneumonia- focus on the rare occasion, not the normal gram negative culprit.
Pathogen, clinical presentation, stain, treatment |
Pathogen: Actinomyces israelii
Clinical presentation: nonproductive cough initially, but when fever hits the cough becomes productive, diffuse chest pain, cachexia Stain: gram positive FILAMENTOUS ROD Tx: PCN |
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Empyema
Pathogen, clinical presentation, stain, treatment |
Pathogen: Nocardia asteroides
Clinical presentation: uhhhh you are sick, you inhaled something from the soil Stain: gram positive branching Tx: sulfonamides |
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Laryngotracheobronchitis (croup- the major, initial cause)
Pathogen, clinical presentation, treatment |
Pathogen: human parainfluenza virus
Clinical presentation: voice loss, inspiratory stridor (will see Steeple's sign), seal bark cough Tx: if stridor is present, get them to the ER, if not take them outside to cooler air, vaporizer |
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Major LOWER respiratory tract infection of INFANTS esp premies (includes bronchitis, bronchiolotis, pneumonia)
Pathogen, clinical presentation, treatment, prevention |
Pathogen: respiratory syncytial virus
Clinical Presentation: persistent coughing, wheezing on expiration, rapid breathing, cyanosis because the airways are narrowed Tx: get them to the ER, mos tof them have to stay in the ICU and are intubated; oxygen therapy, ventilation and ribavirin in severe RSV **there are vaccines under development for RSV aimed at older population RespiGam, palivizumab are used as preventatives |
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What will RSV cause when you are young (infant)?
Older (15 years old)? |
Infant: Pneumonia
15: URTI |
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Hantavirus Pulmonary Syndrome
Pathogen, clinical presentation, spread |
Pathogen: Hantavirus, sin nombre virus
Clinical presentation: pneumonitis, pulmonary edema, pulmonary hemorrhage Spread: vector is deer mouse shit; in CO, NM, AZ and UT commonly |
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Viral Influenza
Pathogen, structure, virulence factors, treatment, prevention |
Pathogen: orthomyxoviruses classified as influenza A, B, C
Structure: ssRNA, functional nucleus required for replication Virulence factors: Hemagglutinin (the attachment protein) and Neuraminidase (enzyme that removes sialic acid to release the virus); extensive damage to ciliated respiraotry epithelium and cytokine storm Treatment: zanamivir, oseltamivir, *sialic acid analogues*, peramivir Prevention: get the vaccine |
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Tuberculosis
Pathogen, stain, virulence factors, clinical presentation, labs, treatment, prevention |
Pathogen: Mycobacterium tuberculosis
Stain: acid fast Virulence: resistance to acid, base and drying, slow growth, cord factor Labs: PPD is gold standard, 10mm after 48 hours Clinical presentation: chronic cough, SOB, mucous, malaise, fatigue, anorexia, weight loss, fever, GOHN COMPLEX on x ray Treatment: combination therapy must be used (StRIPE) Prevention: vaccine, vitamin D |
