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47 Cards in this Set
- Front
- Back
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Give 4 examples of common microbiota found in the respiratory tract |
Bacteroides Spp Candidia albicans Oral streptococci Haemophilus Influenzau
Also but less common Strep Pyogenes Strep pneumoniae Neisseria meningitidis |
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Name the infectious agent(s) that can cause the common cold and the symptoms associated with this infection |
40% = rhinovirus 30% = coronavirus also: coxsackie virus A, echovirus, parainfluenza virus
Symptoms:
Tiredness Pyrexia Malaise Sore throat & pharynx Nasal discharge Sneezing early on |
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Name the infectious agent(s) that can cause otitis and sinusitis and the symptoms associated with these infections |
Respiratory syncytial virus (RSV) Mumps Virus Strep pneumonia (bacterial) Haemophilus Influenzae (bacterial) Bacteroides fragilis
Most common in children, 50% viral origin
Symptoms:
otitis Media
Fever Diarrhoea and vomiting Bulging ear drum and dilated vessels Fluid in middle ear (glue ear) Could cause hearing difficulties and delayed learning development
Otitis externa
staph aureus, candida albicans or pseudomonas aeruginosa favoured, treat with antibiotic eardrops
acute sinusitis
Results in facial pain and local tenderness, treat with ampicillin or amoxycillin |
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Name the infectious agent(s) that can cause acute pharyngitis or tonsillitis |
Viral = Epistein-Barr virus =Cytomegalovirus
Bacterial = streptococcus pyogenes (tonsillitis) |
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What condition(s) may be caused by Cytomegalovirus and describe its key features |
Could cause pharyngitis or tonsilitis
Usually only causes disease when host immunity is reduced, treatment with ganciclovir, foscarnet |
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What virus causes Glandular fever? |
Epistein-Barr virus |
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What are the main features of Epistein-Barr virus and what does it cause? |
Can cause Glandular fever
transmitted by saliva or aerosol and usually occurs in peaks, 1-6 yrs or 14-20 yrs
Replicated specifically in B lymphocytes |
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What are the symptoms of glanular fever and its treatment? |
Fever Headache Malaise Sore throat anorexia palatal petechiae cervical lymphadenopathy splenomegaly mild hepatitis
Not antibiotic treatment!! Should avoid exertion until splenomegaly has resolved |
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Name the infectious agent(s) that can cause Tonsilitis and the symptoms associated with this infection |
Streptococcus pyogenes
occurs mainly in children, spread via aerosol, 15-20% are carriers and susceptible to treatment with penicillin
Symptoms:
Fever Throat pain Enlarged tonsils Tonsillar lymphadenopathy |
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What are the features of Streptococcus pyogenes bacteria |
Group A streptococcus Gram positive cocci in chains Cultured on blood agar and has haemolytic activity Susceptible to penicillin treatment |
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What are the possible consequences of infection by Strep Pyogenes |
Can lead to scarlet fever Peritonsilar abscesses or Quinsy Otitis media / Sinusitis Rheumatic fever Glomerulonephritis |
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Name the infectious agent(s) that can cause Parotitis and the symptoms associated with this infection |
Caused my the Mumps Virus and transmitted via droplet spread and fomites
Features: Fever Malaise headache anorexia trismus severe pain and swelling of parotid glands |
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Name the infectious agent(s) that can cause acute epiglottis and the symptoms associated with this infection |
Caused by Haemophilus influenzae
Young children but reduced by 88% due to Hib vaccine in 1992
Features: High fever Oedema of epiglottis Severe airflow obstruction and breathing difficulties Bacteraemia
This is a severe and life threatening condition, do not take swabs as will worsen condition. required immediate endotracheal intubation and IV antibiotics such as chloramphenicol |
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Describe the key features of Haemophilus influenzae |
Gram negative bacillus
some strains produce B-lactamase and may be ampicillin resistant
H. influenza type B (Hib) has polysaccharide capsule |
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Name the infectious agent(s) that can cause diptheria and the symptoms associated with this infection |
Caused by Corynebacterium diphtheria a human pathogen. Only the toxin producing strain leads to disease -Sub unit A of toxin is responsible for the toxicity - sub unit B is responsible for transporting toxin to receptors -aerosol transmission
Clinical Features:
Sore throat Fever pseudomembrane formation lymphadenopathy oedema of anterior cervical tissue (bull-neck) |
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How could Diptheria be treated and prevented |
Treatment = prompt anti-toxin therapy and antibiotics such as penicillin or erythromycin
Prevention = Vaccine with booster If necessary |
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Name the infectious agent(s) that can cause Laryngitis and Tracheitis and the symptoms associated with this infection |
Usually viral origin -Para influenza virus -Respiratory syncytial virus -Influenza virus -Adenovirus
Adults = Hoarseness and retrosternal pain
Children = dry cough and inspiratory stridor |
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Name the infectious agent(s) that can cause whooping cough and the symptoms associated with this infection |
infectious agent = Bordetella Pertussis
Features
-Catarrhal stage (1 week) = highly contagious, malaise, mucoid rhinorrhoea, conjunctivitis
-Paroxysmal stage (1-4 weeks) = paroxysms of coughing with classic inspiratory whoop -Lumen of the respiratory tract is compromised by mucus secretion and mucosal oedema |
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what is the treatment for whooping cough? |
Erythromycin in catarrhal stage, but antibiotics have no effect in paroxysmal stage
isolation
Vaccination (whole cell vaccine) will prevent infection |
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What infection does Bordetella pertussis cause and describe its key features |
Causes whooping cough (Pertussis)
Gram negative aerobic coccobacillus
Attatches and replicates in the ciliated respiratory epithelium - can do this due to surface component filamentous haemagglutinin
Toxic factors -Pertussis toxin - adenylate cyclase toxin - tracheal cytotoxin - endotoxin |
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Name the infectious agent(s) that can cause acute bronchitis and the symptoms associated with this infection |
Caused by: -Rhinovirus -coronovirus -adenovirus -mycoplasma pneumoniae
secondary infections can occur via -streptococcus pneumonia -heamophilus influenzae
Results in inflammation of the tracheobronchial tree |
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Name the infectious agent(s) that can cause chronic bronchitis and the symptoms associated with this infection |
Same as acute bronchitis
Caused by: -Rhinovirus -coronovirus -adenovirus -mycoplasma pneumoniae
Characterised by a cough and excessive mucus secretion in the tracheobronchial tree
Can be associated with:
Immune deficit: SCID Ciliary deficit: Kartengener syndrome or smoking Excessively thick mucus in cystic fibrosis |
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Describe the key features of bronchiolitis |
Seen in children under 2 Bronchioles have such a narrow bore that an infection can lead to epithelial cell necrosis
Mainly cause by RSV - Respiratory syncytial virus |
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Name the infectious agent(s) that can cause pneumonia |
Mainly bacterial in adults caused by:
-Strep pneumoniae -Mycobacterium tuberculosis -haemophilus influenzae -pseudomonas aeruginosa -staph aureus
Mainly viral in children caused by:
-Influenza virus -Measles -Coronavirus -Parainfluenza virus -RSV -Cytomegalovirus -Adenovirus
Atypical pneumonias - fail to respond to penicillin
-Mycoplasma pneumoniae -legionella pneumophilia -chlamydia pneumoniae -chlamydia psittaci -coxiella burnetii
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What are the clinical features of pneumonia? |
Initially : Rigors, Fever, Malaise, Tachycardia, Dry cough
Followed by: Productive cough with rusty sputum, spiky temperature, lobular consolidation |
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What are the different classifications of pneumonia? |
Lobar : distinct region or lobe of the lung
Bronchopneumonia: duffuse and patchy consolidation associated with the bronchi and bronchioles
Interstitial : invasion of lung interstitium usually viral
Necrotising pneumonia : lung abscesses and destruction of parenchyma occurs
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What causes legionnaires disease? |
Legionella pneumophila |
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What are the features of legionnaires disease? |
Severe systemic infection with pneumonia
Features - Tachypnoea - Purulent sputum - consolidation on chest x-rays
Gram negative bacillus secretes protease which caused lung damage aerosol transmission but not person to preson
Diagnosis : Gram staining of sputum, recognition with fluorescent antibody, culture of legionella on cysteine yeast extract detection of antigen in urine and a 4 times increase in antibody production |
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Name the infectious agent(s) that can cause Measles and the symptoms associated with this infection |
Measles virus - paramyxovirus, spread via aerosol. Replicated in the lower respiratory tract
Features : Runny nose, Fever, Kopliks spots and characteristic rash
Can casue giant cell pneumonia in the immunocompromised which can be fatal and can have neurological complications |
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What treatment is used for measles? |
Its a virus so serology is taken to test for measles specific IgM
If severe then ribavirin can be used, antibiotics for secondary infections
Immunisation highly effective with, live, attenuated vaccine |
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Which antibiotics would you use to treat community acquired pneumonia? |
amoxicillin coamoxiclav doxycycline clarithromycin |
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Which antibiotics are used in atypical pneumonias? |
Just clarithromycin |
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Hospital auired pneumonias can be treated with which antibiotics usually? |
Ceftriaxone Vancomycin Linezolid |
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Describe the key features of the influenza virus |
3 types Type A - causes epidemics and pandemics, animal reservoir Type B - epidemics, no animal hosts Type C - Causes minor respiratory illness
Single stranded RNA is segmented and reassortment gives rise to different combinations of H and N antigen surface spikes
Constantly mutating which results in immunity to virus unlikely to be reached |
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Which form of mutation antigenic drift or shift is most likely to cause the greatest difference in the virus and what are they key features of these two mutations? |
Antigenic shift will cause a greater change to the virus than antigenic drift
Drift = small point mutations in the H and N antigens creating new subtypes not recognised by the host
Shift = sudden major changes based on recombination between two virus strains which invade the same cell. Produces a virus with novel surface proteins |
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Which virus causes swine flu? |
H1N1 virus
attack rate was high but mortality was low as people had a degree of immunity from previous strains in the past |
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What is the treatment for influenza? |
Amantadine
Zanamavir
Oseltamivir
(all antiviral drugs) |
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How is flu (influenza) best managed? |
Rest, warmth, hydration, analgesia
Antiviral treatments within the first 48 hours may have some effect (amantadine, zanamavir, oseltamivir)
Prevention : can be prevented with a killed yearly vaccine - Vaccine has to be redeveloped each year to provide immunity for the predicted strains of the flu likely to be seen that year |
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What does SARS stand for? |
Severe acute respiratory syndrome |
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What are the symptoms associated with SARS? |
High fever, Cough, Shortness of breath, CXR's consistent with pneumonia
Incubation 2-7 days
transmitted via droplets, faeces and infected animals |
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What causes SARS disease? |
SARS-associated coronavirus
identified by isolation in cell culture and molecular and microscopy techniques
-Enveloped -RNA virus
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What is the treatment for SARS disease? |
No specific treatment, can prescribe
-Ribavarin -Corticosteroids -Interferons -Anti-retroviral therapies
A whole inactivated virus vaccine and recombinant vaccine has no been developed |
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What are the clinical features of the different stages of tuberculosis? |
Primary TB -Usually symptomless -May be associated with a cough or wheeze -small transient pleural effusion possibly
Miliary TB -Results from acute diffuse dissemination of bacillus -fatal without treatment
Post-primary TB -Long time for symptom onset -malaise -fever -weight loss -mucoid, purulent or blood stained mucus -pleural effusion |
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What are the common symptoms of TB? |
Night sweats Dry Cough Weakness Weight loss GI problems Poor appetite Fever |
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What does mycobacterium tuberculosis cause and what are the symptoms? |
Causes Tuberculosis
-Its neither gram negative or positive -Human pathogen -Obligate aerobe so found in the upper well ventilated area or the lungs -Spread by inhalation from duct or aerosols -Primarily affects the lungs but can proceed to -Infect other sites such as the GI tract |
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How is TB diagnosed? |
Miliary TB - Miliary shadows will form once they reach 2mm in the lungs on an x-ray -Ziehl-Neelsen stain of sputum positive -Mantoux test may be positive (tuberculin injected intradermally which will cause area to be raised after 48-72 hours if positive) -Transbronchial biopsies
Post-primary TB -Chest X-ray shows patchy shadows in upper zones, loss of volume with fibrosis -Calcification presnt -microbial confirmation should be aquired
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What is the course of treatment for TB? |
Combination therapy - isoniazid, rifampicin, ethambutol, pyrazinamide to prevent emergence of resistance MDRTB is a major problem though!
Prolonged therapy - 6 months minimum to eradicate all slow growing organisms
Prevention - with childhood immunisation = Live attenuated BCG vaccine |
