Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
66 Cards in this Set
- Front
- Back
Name the common infections of the lower respiratory tract. (5)
|
Bronchitis
Bronchiolitis Influenza Pertussis Pneumonia |
|
What mechanisms does our body employ to fight off respiratory infections?
|
1.) Alveolar macrophages
2.) Complement components 3.) Surfactant lining of alveoli 4.) Phospholipids 5.) IgE, IgG, IgA and Factor B 6.) B and T cells that can illicit response to infections |
|
What are some mechanisms used by bacteria to avoid phagocytosis?
|
1.) capsule production
2.) toxin production 3.) large size 4.) replication inside cells of host 5.) mimicry of host cells |
|
What is the cause of bronchitis? (bacterial or viral) and name some of the causative agents.
|
Usually caused by VIRAL agents, some potential causes are influenza viruses A and B, parainfluenza virus, adenovirus, RSV, rhinovirus, coxsackie A and B virus.
|
|
In what age groups do you usually seen bronchitis?
|
Can be all ages, but most common in younger and older persons
|
|
What is the common presentation of bronchitis?
|
Starts with non-productive cough (may become productive later), chest pain, and fever of 101-102, malaise, headache, sore throat.
|
|
What will chest x-ray show in bronchitis?
|
Normal findings, therefore it can be useful to distinguish pneumonia from bronchitis
|
|
What is the diagnosis of bronchitis based on?
|
Patient symptoms and clinical signs
|
|
What is the treatment for bronchitis in an otherwise healthy person?
|
Supportive treatment
|
|
What is the most common cause of Bronchiolitis?
|
RSV
|
|
What age group is most likely to get bronchiolitis?
|
Infants younger than one year old
|
|
What are the symptoms of bronchiolitis?
|
Early sx include rhinorrhea, cough, and low grade fever, may also include tachypnea and tachycardia, diffuse expiratory wheezing, inspiratory crackles, nasal flaring, vomiting, cyanosis, and hyperinflation of the lungs.
|
|
What are risk factors for getting bronchiolitis?
|
Younger than 6 months of age, bottle feeding, prematurity, exposure to cigarette smoke, and crowded living conditions
|
|
How is bronchiolitis diagnosed?
|
Patient symptoms and clinical signs, use chest x-ray to rule out pneumonia, and can do antigen testing for RSV from nasal washings
|
|
Of the 3 types of Influenza virus, which is most mild?
|
Influenza C
|
|
What are the symptoms of influenza?
|
Abrupt onset of fever (102-104), chills, rigors, headache, congested conjuctiva, extreme prostration with myalgia in back and ribs, and NONPRODUCTIVE COUGH
|
|
In some patients influenza can lead to a secondary bacterial pneumonia infection---what are the main bacteria that cause this secondary infection? (4)
|
1.) Strep. pneumo
2.) Strep. pyogenes 3.) H. infleunzae 4.) Staph. aureus |
|
How do you diagnose influenza?
|
Definitive diagnosis requires lab testing, and include direct antigen detection tests, or rRT-PCR
|
|
What are good ways to differentiate the flu from the common cold or atypical pneumonia?
|
Atypical pneumonia is a gradual process, the flu develops rapidly. As for the cold, the common cold shouldn't cause a fever, whereas the flu will cause fever
|
|
What is the treatment for influenza?
|
Supportive care
|
|
What is antigenic shift and antigenic drift? Which influenza viruses undergo which?
|
Antigenic shift is major changes that can occur with influenza A because it has multiple reservoirs--both humans and other hosts. Antigenic drift is small changes (the reason we need a new vaccine every year) and is seen in Influenza B and C because their only host is humans
|
|
What is the common name for pertussis?
|
Whooping cough
|
|
What is the causative agent of pertussis?
|
Bordetella pertussis
|
|
What type of bacteria is B. pertussis?
|
Gram Negative Cocco-Bacilus
|
|
What are symptoms of pertussis?
|
paroxysms of coughing, and inspiratory "whoop", low grade fever. Vomiting can sometimes occur after a coughing attack
|
|
What toxin does pertussis release? Which part does the binding, which part contains the toxin?
|
AB toxin
B subunit for binding A subunit for toxin |
|
How do you diagnose pertussis?
|
Need lab procedures using nasopharyngeal aspirates plated on Bordet-Gengou medium, or can do immunofluorescent stains on nasal secretions for the bacteria or ELISA tests
|
|
If you do a blood draw on a patient with pertussis, what type of WBC is elevated? How does this differ from most bacterial infections
|
See elevated lymphocytes on blood draw, which is different from most infections where you see an increase in neutrophils
|
|
What antibiotic is useful for pertussis? Is it helpful to give at any point of the infection?
|
Erythromycin is the drug of choice, but it is only helpful in the first stage of infection and won't help shorten the infection once it's entered it's second stage
|
|
What is the clinical presentation of typical pneumonia?
|
SUDDEN onset of chills, fever, dyspnea, and productive cough with purulent sputum (which may be blood tinged), pleuritic chest pain. On physical exa, see fever, tachypnea, tachycardia, and crackles on lung exam
|
|
What does the chest x-ray show in typical pneumonia?
|
Consolidation
|
|
What are the major causes of pneumonia and which is MOST common?
|
Major causes include: strep. pneumo, klebsiella pneumo, H. infleunzae, Moraxella catarrhalis, and Staph. auereus. The MOST common is strep. pneumo
|
|
What is the clinical presentation of atypical pneumonia?
|
GRADUAL onset of non-productive cough and dyspnea, the extrapulmonary signs may be more prominent, such as headache, sore throat, and diarrhea
|
|
What does the chest x-ray show in atypical pneumonia?
|
Patch or interstitial infiltrates with no signs of consolidation
|
|
What are the major causes of atypical pneumonia?(3)
|
1.) Mycoplasma pneumonia "walking pneumo"
2.) Chlamydia pneumonia (in young adults) 3.) Legionella pneumonia ( may occur in healthy or immunocompromised and can be quite severe) |
|
Which pneumonia is most common in HIV patients?
|
Pneumocystis jirovecii
|
|
What illnesses does parainfluenza virus cause?
|
In children croup and pneumonia. In adults the common cold
|
|
Influenza and Parainfluenza virus use HA and NA, what are these and what do they do?
|
HA = viral hemagglutin: helps hold onto cells
NA= neurominidase permits viral spread |
|
How is parainfluenza virus diagnosed?
|
Patient symptoms and lab confirmation through hemaglutination activity from respiratory secretions or serology for anti-HA antibodies
|
|
What is the treatment for croup caused by parainfluenza virus?
|
Supportive care and corticosteroids if needed to help with breathing
|
|
What do rhinoviruses cause?
|
The common cold
|
|
Which virus binds to ICAM-1 on upper respiratory tract epithelial cells?
|
Rhinovirus
|
|
What is the viral cause of hand-foot-mouth disease?
|
Coxsackie A virus, primarily
|
|
What is the clinical presentation of someone infected with adenovirus?
|
Respiratory tract infection (common cold), conjuctivitis, hemorrhagic cystitis, and gastroenteritis
|
|
How does the adenovirus spread?
|
Aerosol, fecal-oral, or direct contact
|
|
How is adenovirus diagnosed?
|
Either isolate virus in cell culture or do serology
|
|
What group gets the adenovirus vaccination?
|
The military
|
|
What are some of the complications that can come from Strep. pyogenes pharyngitis infection?
|
1.) Glomerulonephritis
2.) Rheumatic Fever 3.) Scarlet Fever (if bacteria is infected with phage) |
|
What virulence factors does Strep. pyogenes use to cause infection?
|
1.) Streptokinase (converts plasminogen --> plasmin [fibrinolysis])
2.) M protein (resists phagocytosis) 3.) Hyaluronidase (breaks down connective tissue) 4.) DNase (breaks down DNA) |
|
What kind of bacteria is strep. pyogenes?
|
Gram Positive Cocci, Beta-hemolytic, Bacitracin Sensitive, ASO+, Anti-Streptolysin O antibodies would be present in the patient's serum if infected
|
|
What is the treatment for infection with Strep. pyogenes?
|
Penicillin G
|
|
What group of people are typically diagnosed with Moraxella catarrhalis pneumonia?
|
Patients with COPD. It's the second most common cause behind H. influenza
|
|
What virulence factors does Moraxella catarrhalis use to establish infection?
|
1.) pili (used for attachment)
2.) antigenic variation (to avoid host immune response) 3.) endotoxin 4.) capsule |
|
What is the clinical presentation for a person infected with Moraxella catarrhalis?
|
Otitis media, sinusitis, or pneumonia
|
|
What kind of bacteria is Moraxella catarrhalis?
|
Gram Negative, Aerobic, Oxidase Positive
|
|
How is Moraxella catarrhalis diagnosed?
|
Through biochemical features
1.) hydrolyzes tributryin 2.) produces DNase 3.) reduces nitrite and nitrate 4.) can't ferment sucrose, glucose, maltose, or lactose |
|
What is the treatment for Moraxella catarrhalis?
|
Amoxicillin-clavulanate, second and third generation celphalosporins, or TMP-SMX
|
|
What does it mean for a bacteria to be Quellung positive?
|
The Quellung reaction is a biochemical reaction in which antibodies bind to the bacterial capsule of Streptococcus pneumoniae, Klebsiella pneumoniae, Neisseria meningitidis, Haemophilus influenzae, Escherichia coli, and Salmonella. The antibody reaction allows these species to be visualized under a microscope. If the reaction is positive, the capsule becomes opaque and appears to enlarge.
|
|
How is the diagnosis of Strep. pneumo infection made? (What are its biochemical features)
|
Gram Positive Diplococci, alpha-hemolytic, catalase negative, optochin sensitive, quellung reaction positive
|
|
How is infection with H. influenzae diagnosed? (What are it's biochemical features)
|
Gram negative, requires X factor and NAD (V factor) on chocolate agar
|
|
What is the treatment for infection with H. influenzae?
|
Third generation cephalosporin: Ceftriaxone
|
|
What is the most common cause of meningitis in newborns?
|
Streptococcus agalactiae
|
|
What are the biochemical features of Strep. agalactiae?
|
Gram positive, beta hemolytic, bacitracin resistant
|
|
How is Mycoplasma pneumoniae diagnosed?
|
Presence of cold hemagluttin, no cell wall, fried egg appearance, serology
|
|
What are the biochemical features of Staph aureus that can aid in diagnosis?
|
Gram positive clusters, catalase positive, coagulase positive
|
|
Why can you get multiple 'cold' infections in one year?
|
Because there are over 100 different types of rhinoviruses
|