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

β€œProductive” 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
Myxoplasma 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 bronchiolotis?

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

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

amoxicillin

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19
Q

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

A

Consider hospital referral

Amoxocillin and Clarithromycin

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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

benzylpenicillin IV and claroithromycin

21
Q

What are the three supportive treatments for bacterial pneumonia?

A

Oxygen
Fluids
Analgesia

22
Q

What antibiotics should be used to treat pnuemonia?

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
What is a pathobiont?
A microbe which is usually commensal but if found in the wrong environment, can cause pathology
26
Why do viral infections result in disease?
Viral infection -> damage to epithelium -> results in cellular inflammation, local immune memory, mediator release, loss of cilia etc etc
27
What causes severe disease?
RNA sequence Viral Load DNA Environment have to consider all factors
28
Why might an infection lead to very severe disease?
Poor prior immunity Highly
29
What is the difference in protein binding between H1N1 and H5N1?
H1N1 - Haemogglutinin binds 𝛂2,6 sialic acids H5N1 - Haemogglutinin binds 𝛂2,3 sialic acids
30
Where do viruses like to preferentially bind?
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
Where is there the greatest proportion of 𝛂2,6SA found?
In the nasal cavity
32
Where is there the greatest proportion of 𝛂2,3SA found?
In the bronchi - lower respiratory tract
33
What is the role of the tight junctions?
Prevents systemic infection
34
What is the role of the mucous lining and cilial clearance?
– prevents attachment, clears particulates
35
What is the role of the anti-microbials?
recognise, neutralise and/or degrade microbes and their products
36
What is the role of the pathogen recognition receptors?
recognise pathogens either outside or inside a cell
37
What type of infection activates interferon pathways?
Viral infection
38
What does the interferon pathways activate?
Promotes upregulation of anti-viral proteins and apoptosis.
39
Which part of the respiratory tract is enriched for IgA?
Nasal cavity
40
What do the epithelial cells of the nasal cavity express?
ECs express poly IgA receptor, allowing export of IgA to the mucosal surface
41
Which part of the respiratory tract is enriched for IgG's?
Bronchi
42
How are IgG able to enter into the alveolar space?
Thin-walled alveolar space allows transfer of plasma IgGs into the alveolar space
43
What are the risk factors for RSV bronchiolitis in infants?
Premature birth Congenital heart and lung disease
44
What are the symptoms and signs of RSV bronchiolitis in infants?
Nasal Flaring Chest wall retractions Croupy cough Expiratory Wheezing Hypoxemia and Cyanosis
45
How does Remdisivir work as an anti-viral?
broad spectrum antiviral – blocks RNA-dependent RNA polymerase activity
46
What are some anti-inflammatory drugs?
Dexamethasone (steroids) Tocilizumab (anti-IL-6R) or Sarilumab (anti-IL-6)
47
How does paxlovid work?
Paxlovid – antiviral protease inhibitor
48
Viral bronchiolitis is associated with the development of what?
Development of asthma
49
What is the most common cause of asthma and COPD exacerbations?
Rhinoviruses