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BRS CARDIO & RESPIRATORY > 1b Respiratory Tract Infections and Immunology > Flashcards

1b Respiratory Tract Infections and Immunology Flashcards

1
Q

What are the signs and symptoms of a upper respiratory tract infection?

A

A cough
Sneezing
Runny / Sore Nose
Headache

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2
Q

What are the signs and symptoms of a lower respiratory tract infection?

A

“Productive” cough
Muscle aches
Wheezing
Breathlessness
Fever
Fatigue

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3
Q

What are the signs and symptoms of pneumonia?

A

Chest pain
Blue tinge of the lips
Severe fatigue
High fever

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4
Q

What is DALY?

A

Disability adjusted life year - a sum of the years of life lost and years lost to disability

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5
Q

What happens to the rate of pneumonia with age?

A

Increases

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6
Q

What are the common bacterial causative agents for respiratory infections?

A

Streptococcus pneumoniae
Mycoplasma pneumoniae
Haemophilus Influenzae
Mycobacterium tubercolosis

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7
Q

What are the common viral causative agents for RTI’s?

A

Influenza
Human Rhinovirus
Corona Virus
Respiratory Syncytial Virus

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8
Q

What is CAP and HAP?

A

Community Acquired Pneumonia
Hospital Acquired Pneumonia

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9
Q

What is the most common cause of CAP?

A

Streptococcus pneumoniae

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10
Q

What gram is Streptococcus pneumoniae?

A

gram positive

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11
Q

What type of pathogen is Streptococcus pneumoniae?

A

Extracellular and opportunistic

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12
Q

What is the most common cause of HAP?

A

Staphylococcus aureus

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13
Q

What is bronchitis?

A

Inflammation and swelling of the bronchi

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14
Q

What is bronchiolitis?

A

Inflammation and swelling of the bronchioles

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15
Q

What is pneumonia?

A

Inflammation and swelling of the alveoli

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16
Q

What can pneumonia lead to?

A

Acute Respiratory Distress Syndrome

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17
Q

What is the CRB/CURB-65 scoring system?

A

Used to assess pnemonia severity

Confusion
Respiratory Rate - 30 breaths / minute
Blood Pressure - 90 sys and 60 dia
65 - 65 years or older

In hospital - ass Urea = 7 mmol/L

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18
Q

What is the treatment for a CRB65 score of 0?

A

Home treatment
Antibiotics

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19
Q

What is the treatment for a CRB65 score of 1-2?

A

Consider hospital referral

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20
Q

What is the treatment for a CRB65 score of 3-4?

A

Urgent hospital administration

Empirical antibiotics if life threatening

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21
Q

What are the five supportive treatments for bacterial pneumonia?

A

-Oxygen
-Fluids
-Analgesia
-Nebulised saline may help expectoration (help clear mucus)
-Chest physiotherapy

22
Q

What antibiotics should be used to treat pneumonia?

A

Penicillin eg amoxicillin
Macrolides eg clarithromycin

23
Q

What is meant by the microbiota?

A

ecological communities of the microbes found inside multi-cellular organisms

24
Q

What are commensal bacteria?

A

Microbes that live in a symbiotic relationship with their host = providing vital nutrients to the host in the presence of a suitable ecological niche

25
Q

What is a pathobiont?

A

A microbe which is usually commensal but if found in the wrong environment, can cause pathology

26
Q

Why do viral infections result in disease?

A

Viral infection -> damage to epithelium -> results in cellular inflammation, local immune memory, mediator release, loss of cilia etc etc

27
Q

What causes severe disease?

A

RNA sequence
Viral Load
DNA
Environment

have to consider all factors

28
Q

Why might an infection lead to very severe disease?

A
  • Poor prior immunity (innate/ immunodeficiency)
  • Highly pathogenic strains (zoonotic)
  • Predisposing illness/conditions (frail elderly, COPD, asthma, diabetes, obesity, pregnancy etc)
29
Q

What is the difference in protein binding between H1N1 and H5N1?

A

H1N1 - Haemogglutinin binds 𝛂2,6 sialic acids
H5N1 - Haemogglutinin binds 𝛂2,3 sialic acids

30
Q

Where do viruses like to preferentially bind?

A

Most respiratory viruses can infect cells throughout the respiratory tract, but tend to preferentially adapt to bind cells of the upper respiratory tract if they have existed in humans for a prolonged time

31
Q

Where is there the greatest proportion of 𝛂2,6SA found?

A

In the nasal cavity

32
Q

Where is there the greatest proportion of 𝛂2,3SA found?

A

In the bronchi - lower respiratory tract

33
Q

What is the role of the tight junctions?

A

Prevents systemic infection

34
Q

What is the role of the mucous lining and cilial clearance?

A

– prevents attachment, clears particulates

35
Q

What is the role of the anti-microbials?

A

recognise, neutralise and/or degrade microbes and their products

36
Q

What is the role of the pathogen recognition receptors?

A

recognise pathogens either outside or inside a cell

37
Q

What type of infection activates interferon pathways?

A

Viral infection

38
Q

What does the interferon pathways activate?

A

Promotes upregulation of anti-viral proteins and apoptosis.

39
Q

Which part of the respiratory tract is enriched for IgA?

A

Nasal cavity

40
Q

What do the epithelial cells of the nasal cavity express?

A

ECs express poly IgA receptor, allowing export of IgA to the mucosal surface

41
Q

Which part of the respiratory tract is enriched for IgG’s?

A

Bronchi

42
Q

How are IgG able to enter into the alveolar space?

A

Thin-walled alveolar space allows transfer of plasma IgGs into the alveolar space

43
Q

What are the risk factors for RSV bronchiolitis in infants?

A

Premature birth
Congenital heart and lung disease

44
Q

What are the symptoms and signs of RSV bronchiolitis in infants?

A

Nasal Flaring
Chest wall retractions
Croupy cough
Expiratory Wheezing
Hypoxemia and Cyanosis

45
Q

What are viral supportive therapies that can be done?

A

-Oxygen
-Fluids
-Analgesia
-Nebulised saline may help expectoration (help clear mucus)
-Chest physiotherapy

46
Q

What are some preventative/ prophylactic viral treatments?

A

Vaccines:
- Major surface antigien- spike protein
- Viral vector (e.g. adenovirus vaccine e.g. Oxford/AZ)
- mRNA vaccines (e.g. BioNtech/Pfizer)

47
Q

How does Remdisivir work as an anti-viral?

A

broad spectrum antiviral – blocks RNA-dependent RNA polymerase activity

48
Q

What are some anti-inflammatory drugs?

A

Dexamethasone (steroids)
Tocilizumab (anti-IL-6R) or Sarilumab (anti-IL-6)

49
Q

What is paxlovid and how does it work?

A

Paxlovid – antiviral protease inhibitor (antiviral drug)

50
Q

How do Casirivimab and imdevimab work and what do they treat?

A

Antivirals- monoclonal neutralising antibodies of SARS-CoV-2

51
Q

Viral bronchiolitis is associated with the development of what?

A

Development of asthma

52
Q

What is the most common cause of asthma and COPD exacerbations?

A

Rhinoviruses

BRS CARDIO & RESPIRATORY (26 decks)

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