24/25 Upper Respiratory Tract Flashcards

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1
Q

what URT tissues are considered sterile?

A
mastoid air cells
middle ear
sinuses
trachea
bronchi
bronchioles
(conjunctiva)
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2
Q

what are the normal flora of the nose?

A
  1. staph. epidermidis
  2. staph. aureus
  3. corynebacterium
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3
Q

staph. epidermidis gram stain and shape

A

gram positive cocci clusters

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4
Q

staph. areus gram stain and shape

A

gram positive cocci clusters

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5
Q

corynebacterium stain and shape

A

gram positive rod

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6
Q

normal nasopharynx flora

A
  1. streptococcus
  2. viridians group
  3. moraxella catarrhalis
  4. bacteriodes
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7
Q

who is in the viridans group?

A
  • s. mutans
  • s. mitis
  • s. milleri
  • s. salivarius
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8
Q

describe streptococcus

A

gram positive cocci in chains

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9
Q

describe moraxella catarrhalis

A

gram neg, diploid coccobacillus

aerobic

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10
Q

strict anaerobes in the RT?

A

bacteriodes

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11
Q

what pathogens are seen in the nasopharynx in increasing numbers in the winter?

A
  • strep. pneumoniae
  • haemophilus flu
  • neisseria meningitides
  • moraxella catarrhalis
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12
Q

what differentiates strep from staph?

A

strep is catalase negative

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13
Q

group A strep

A

strep. pyogenes

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14
Q

group B strep

A

strep. agalactiae

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15
Q

group D strep

A

strep. bovis and enterococcus faecalis

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16
Q

what is the only alpha hemolytic strep?

A

strep. pneumoniae

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17
Q

what does the rapid strep test target?

A

cell wall antigen

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18
Q

what is associated with m prtn and what is the m prtn?

A

strep. pyogenes

antiphagocytic component essential for virulence (80 serotypes)

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19
Q

does s. pyogenes have a capsule?

A

not in all strains

if it has one it helps to inhibit phagocytosis

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20
Q

what are the super antigens associated with strep. pyogenes?

A

nine proteins that are pyrogenic exotoxins

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21
Q

what is a super antigen

A

causes an upregulation/activation of massive immuen response which causes damage

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22
Q

what 3 diseases are the strep. pyogenes super antigens responsible for?

A
  • scarlet fever
  • toxic shock
  • necrotizing fasciitis
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23
Q

what disease must be proceeded by strep throat?

A

scarlet fever

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24
Q

10 yo female presents with redness of throat, patches of adhering pus, scattered tiny hemorrhages, temperature 38.9C

A

strep. pyogenes

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25
Q

SPE release, redness of skin, desquamation of hands, and a whit coating on the tongue

A

scarlet fever

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26
Q

fever, joint pain, chest pain, rash, skin nodules, uncontrollable jerky movements, acute inflammatory process

A

acute rheumatic fever

27
Q

skin infections, swelling, redness, destruction of tissue inside, SPE release

A

necrotizing fasciitis

28
Q

will getting rid of strep. pyogenes stop acute rheumatic fever?

A

NO- caused by strong immune response to strep. pyogenes super antigens

  • treat with immunosuppression
  • next time pt. sees s. pyogenes will have equal or worse immune response
29
Q

what diseases are directly caused by exotoxin release of strep. pyogenes?

A

scarlet fever and necrotizing fasciitis

30
Q
  • deposition of antigen-antibody complexes in the glomeruli
  • 3-6 wks after strep. pharyngitis or skin infection
  • edema, hypertension, hematuria, proteinuria, decreased serum complement levels
A

acute glomerulonephritis caused by strep. pyogenes

31
Q
  • mild sore throat, slight fever, high fatigue and malaise
  • dramatic neck swelling
  • clotted blood
  • whitish gray membrane on tonsils, throat, nasal cavity
A

diptheria

32
Q

what causes diptheria?

A

corynebacterium diptheriae

33
Q

what does corynebacterium look like under a microscope?

A

gram positive rod (chinese letters)

non-spore forming

34
Q

is diptheria a toxin mediated disease?

A

yes,

- it is controlled by a toxoid vaccine

35
Q

is diptheria invasive?

A

not invasive

toxin is absorbed by the bloodstream

36
Q

how is the diptheria toxin released?

A

inactive in A and B subunit

B binds to host receptor, A inactivates elongation factor 2 –> stops prtn synthesis and induces cell death

37
Q

where is the B subunit receptor of diptheria toxin found within the body?

A

heart
kidneys
nerve cells

38
Q

bacterial v. viral conjunctivitis

A

bacterial has more pus and discharge

39
Q

what are the main two causative agents of bacterial conjunctivitis?

A
  • haemophilus flu

- strep. pneumoniae

40
Q

what are the other three causes of bac. conjunctivitis?

A
  • moraxella lacunata
  • enterobacteria
  • neisseria gonorrhoeae
41
Q

describe haemophilus flu.

A

gram negative rod

42
Q

describe strep. pneumoniae

A

gram positive cocci

43
Q

what is the treatment for bac. conjunctivitis

A

gentamicin or ciprofloxacin

44
Q

for which causative agent of conjunctivitis do we have a vaccine?

A

haemophilus flu. type B

45
Q

what are the 3 most common causative agents of otitis media?

A

strep. pneumoniae
haemophilus flu.
moraxella catarrhalis

46
Q

what are the 3 most common causative agents of sinusitis?

A

strep. pneumoniae
haemophilus flu.
moraxella catarrhalis

47
Q

what type of pneumonia is strep. pneumoniae associated with?

A

lobar pneumonia

48
Q

what type of strep. is associated with meningitis?

A

strep. pneumoniae

49
Q

chlamydia trach. or chlamydophila: obligate intracellular parasite

A

chlamydophila

50
Q

elementary bodies v. reticulate bodies

A

EB-metabolically inactive and infectious

RB- metabolically active, noninfectious forms

51
Q

trachoma, adult inclusion bodies, neonatal conjunctivitis, infant pneumonia

A

chlamydia trachomatis

52
Q

pathogenesis of chlamydia trachoma

A

direct destruction of host cells during replication and the host inflammatory response

53
Q

how does chlamydia trachoma. gain access to cells?

A

minute abrasions or lacerations and then granuloma formation

54
Q

causitive agent of adult inclusion conjunctivitis/acute follicular conjunctivits

A

chlamydia trachomatis

diffuse inflammation, conjunctival scarring, eyelids turn inward

55
Q
  • same serovars associated with genital infections
  • occurs in sexually active adults
  • mucopurulent discharge, keratitis, corneal infiltrates and some vascularization
A

adult inclusion conjunctivitis caused by chlamydia trachomatis

56
Q

5-12 days after birth eyelids swell

- at risk for developing c. trachomatis pneumoia

A

neonatal conjunctivitis caused by c. trachomatis

57
Q

onset 2-3 wks after birth

- bronchitis with a dry cough, afebrile

A

infrant pneumonia caused by c. trachomatis

58
Q

TWAR pathogen

A

chlamydophila pneumoniae

59
Q

only one lobe affected, associated with atherosclerosis

A

chlamydophila pneumoniae

60
Q

16 yo female with cough 3 wks. mild but chronic shortness of breath, persistent cough and noted malaise.
- pet parrots

A

chlamydophila psittaci

61
Q

what do you use to diagnosis c. psittaci?

A

PCR

complement fixation

62
Q

what do you use to treat c. psittaci?

A

macrolides (erythromycin and azithromycin), tetracyclines or levofloxacin for 10-14 days

63
Q

where does c. psittaci spread after infecting the respiratory tract?

A

reticuloendothelial cells in liver and spleen

-multiplies at these sites producing focal necrosis