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58 Cards in this Set
- Front
- Back
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List 5 Upper Resp. Tract Infections.
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Common Cold Viruses
Group A Streptococci Whooping cough (bordetella pertussis) Diphtheria (Corynebacterium) Uncomplicated influenza virus |
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List 4 Lower Resp. Tract Infections
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Bronchitis
Pneumonia (S. pn) TB (mycobactium) S. Aureus (lung absess) |
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Emerging Infectious Causes of Resp. Illness
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For the following cards pick:
Bacteria Fungi Virus |
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Chlamydophila pneumoniae
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Walking pnemonia
Bacteria caused |
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pneumococcus
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Bacteria caused
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Burkholderia cepacia complex
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Bacteria caused
Note: If a patient with cystic fibrosis needs a lung transplant, yet has BCC, it is pointless to follow through. |
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MDR- TB
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Bacteria caused
Multi Drug Resistant TB |
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CA-MRSA
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Bacteria
community acquired |
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Invasive Group A streptococcal disease
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Bacteria caused
Eats flesh- causes fascial necrosis |
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Legionella
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Bacteria
(hospital acquired respiratory infection) |
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Metapneumovirus
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virus
like flu and croup |
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Bocavirus
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Virus
Croup |
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Sin Nombre
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hontavirus
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H1N1 influenza A
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Virus
Also: Avian influenza, SARS |
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Pencillinum marneffei
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Fungi
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white patchy exudates
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Think pus--- suppurative
Strep |
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List 6 General characterist of Group A Strep
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Gram positive cocci in short chains
Facultative, prefers to grow anaerobically Catalase negative, Beta-hemolytic bacitracin susceptible |
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Describe Group B colonies.
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larger colony
weak hemolysis resistant to bacitracin |
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Describe Group A colonies
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smaller colonies
vast hemolysis susceptible to bacitracin |
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How is Group A Strep transmitted?
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Spread person-to-person most likely via droplets (within 'arms length')
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What age group does Group A target?
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5-15 years old
Think: Children are dirty |
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What seasons does Group A usual present itself?
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Winter and Spring
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Name Group A Strep's most virulent factors. (3)
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*M-protein*
Hyaluronic acid capsule Pyrogenic exotoxin |
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What is M protein?
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A STREP A VIRULENCE FACTOR. antiphagocytic
adhesin cross-reactive antibodies against epitopes. Play an important role in non-suppurative sequelae of GAS pharyngitis and skin infections; over 80 M types: M1 and M3 cause rheumatogenic strains |
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Qualities of Hyaluronic acid capsule
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A STREP A VIRULENCE FACTOR. Antiphagocytic
mucoid appearance degraded by hyaluronidase |
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Pyrogenic exotoxins
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A STREP A VIRULENCE FACTOR. Types A,B,C.
Type A (Spe A) =invasive disease and streptococcal toxic shock syndrome; superantigen |
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Streptococcal pharyngitis
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A Strep A infection.
treatment with penicillin is imp to prevent non-suppurative complications of GAS pharyngitis |
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Scarlet Fever
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GAS pharyngitis with a lacy, flat skin rash (except palms and soles)
pyrogenic exotoxins responsible for rash |
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Pyoderma/impetigo
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skin infection with vesicular lesions and redness.
cause pustular lesions common in summer |
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Streptococcal toxic shock syndrome
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Invasive Group A Strep Disease
recovery of the organism from a sterile site have positive culture and hypotension and 2: coagulaopathy, skin rash, necrotizing fasciitis, kidney, lungs, or liver failure . key virulence factor is Spe A. |
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Sterile sites include:
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blood, pleural, or cerebrospinal fluid.
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Spe. A
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A subtype of Pyrogenic exotoxins
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Non-Suppurative Sequelae
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organism no longer present,but immune response and of toxin is still causing disease.
Ex: Rheumatic fever |
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Rheumatic fever
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NON-SUPPURATIVE SEQUELAE OF GAS.
Antibodies to epitopes on the M protein cause disease state. Antibodies cause cellular damage to both heart muscle and valves. |
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Acute glomerulonephritis
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NON-SUPPURATIVE SEQUELAE OF GAS.
SYMPTOMS: edema, hypertension and smoky or rust-colored urine. Diagnosis is made on clinical grounds. |
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Necrotizing fasciitis
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Invasive GAS Disease
highly cytolytic resulting in extensive necrosis, shock and in as many as 60% of patients, death Chickenpox predisposing factor |
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How do you treat GAS pharyngitis ?
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Penicillin
used primarily to prevent post-streptococcal sequelae shorten the duration of symptoms if given early enough |
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Is there a GAS vaccine available?
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No.
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How to treat GAS when pt is penicillin resistant?
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macrolides
resistance is a problem. 3% are macrolides resistant Europe 20% resistant |
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General characteristics of
Streptococcus Pneumoniae |
gram positive diplococci
facultative catalase negative alpha hemolytic optochin sensitive (P disk +) |
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Leading cause of bacterial pneumonia
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Streptococcus pneumoniae
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Is strep pnemo seasonal?
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Yes, more common in the winter months
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Strep Pneum rate of infection
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May colonize in the upper airway of 5 to 10% of adults and 20 to 40% of children
Disease most common in young and Old: immunodeficient states Asplenic individuals (ie sickle cell) are at increased risk for systemic infections to strep pneumo and other encapsulated bacteria |
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How is S. Pneumoniae transferred?
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Droplets (within an arm's length)
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How many strains of S. Pneun are there?
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7 serotypes (based on polysaccharide capsule)
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S. Pneum's major virulence factor
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antiphagocytic polysaccharide capsule
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Pneumolysin
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cholesterol dependent cytolysin
acts on alveolar and pulmonary endothelial cells up-regulates IL-6: important cytokine mediator of inflammation produced by endothelial cells/macrophages |
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Clinical presentation of Strep Pneumo?
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1)Pneumonia
fluid accumulation in the alveolar spaces causing the lobar pneumonia characteristic of this disease 2) meningitis- GAS is the 2nd leading cause |
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S. Pneumoniea and Penicillin
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Penicillin was the drug of choice for S. pneumoniae.
penicillin resistant pneumococci increasingly common Pen R pneumococci are also frequently resistant to other oral agents such as macrolides and tetracyclines. uncommon: resistance to fluorquinolone antimicrobials is increasing. |
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Polysaccharide Vaccine for S. Pneuoniea in Adults
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Polysaccharide vaccine against 23 serotypes
recommended for those over 65, the immunocompromised, and asplenic individuals. Efficacy ~50 to 90% |
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Conjugated Vaccine for Children (S. Pn)
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only against the 7 most common serotypes that cause 90% of deaths
Efficacy studies have mixed results. |
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Influenza Symptoms
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an acute illness with:
aching muscles dry hacking cough headache |
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Mode of transmission for Influenza?
Cause? |
spreads rapidly from person to person by inhalation of tiny droplets from the exhalations of infected people
caused by a virus which infects the cells lining the air passages |
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Influenza
How many types? Is it conquered yet? |
three types; types A and B are important in human health, especially A
ranks among the greatest of the unconquered epidemic diseases that affect humans |
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Influenza General Characteristics
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lipid envelope with two viral glycoproteins around nucleocapsids.
hypermutator, like most RNA viruses Reversely trx- go back to positive polarity to code protein |
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Name and describe the two glycoproteins found on the surface of Influenza viruses
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hemagglutinin (H or HA) and neuraminidase (N or NA)
Strains are identified by the specific H and N antigen combination (e.g., H3N1) |
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Influenza Epidemiology
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Influenza infections may be endemic, epidemic or pandemic
Epidemics result from antigenic changes ins the SAME virus Pandemics result from the emergence of a NEW influenza virus ONLY occurs in Influenza A |
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Group A Strep most virulent factor?
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Antiphagocytic-ness
Due to polysaccride capsule. |
