24/25 Upper Respiratory Tract

Question 1

what URT tissues are considered sterile?

Answer 1

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

Question 2

what are the normal flora of the nose?

Answer 2

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

Question 3

staph. epidermidis gram stain and shape

Answer 3

gram positive cocci clusters

Question 4

staph. areus gram stain and shape

Answer 4

gram positive cocci clusters

Question 5

corynebacterium stain and shape

Answer 5

gram positive rod

Question 6

normal nasopharynx flora

Answer 6

1. streptococcus
2. viridians group
3. moraxella catarrhalis
4. bacteriodes

Question 7

who is in the viridans group?

Answer 7

• s. mutans
• s. mitis
• s. milleri
• s. salivarius

Question 8

describe streptococcus

Answer 8

gram positive cocci in chains

Question 9

describe moraxella catarrhalis

Answer 9

gram neg, diploid coccobacillus

aerobic

Question 10

strict anaerobes in the RT?

Answer 10

bacteriodes

Question 11

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

Answer 11

• strep. pneumoniae
• haemophilus flu
• neisseria meningitides
• moraxella catarrhalis

Question 12

what differentiates strep from staph?

Answer 12

strep is catalase negative

Question 13

group A strep

Answer 13

strep. pyogenes

Question 14

group B strep

Answer 14

strep. agalactiae

Question 15

group D strep

Answer 15

strep. bovis and enterococcus faecalis

Question 16

what is the only alpha hemolytic strep?

Answer 16

strep. pneumoniae

Question 17

what does the rapid strep test target?

Answer 17

cell wall antigen

Question 18

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

Answer 18

strep. pyogenes

antiphagocytic component essential for virulence (80 serotypes)

Question 19

does s. pyogenes have a capsule?

Answer 19

not in all strains

if it has one it helps to inhibit phagocytosis

Question 20

what are the super antigens associated with strep. pyogenes?

Answer 20

nine proteins that are pyrogenic exotoxins

Question 21

what is a super antigen

Answer 21

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

Question 22

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

Answer 22

• scarlet fever
• toxic shock
• necrotizing fasciitis

Question 23

what disease must be proceeded by strep throat?

Answer 23

scarlet fever

Question 24

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

Answer 24

strep. pyogenes

Question 25

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

Answer 25

scarlet fever

Question 26

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

Answer 26

acute rheumatic fever

Question 27

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

Answer 27

necrotizing fasciitis

Question 28

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

Answer 28

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

Question 29

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

Answer 29

scarlet fever and necrotizing fasciitis

Question 30

- 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

Answer 30

acute glomerulonephritis caused by strep. pyogenes

Question 31

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

Answer 31

diptheria

Question 32

what causes diptheria?

Answer 32

corynebacterium diptheriae

Question 33

what does corynebacterium look like under a microscope?

Answer 33

gram positive rod (chinese letters) non-spore forming

Question 34

is diptheria a toxin mediated disease?

Answer 34

yes, | - it is controlled by a toxoid vaccine

Question 35

is diptheria invasive?

Answer 35

not invasive toxin is absorbed by the bloodstream

Question 36

how is the diptheria toxin released?

Answer 36

inactive in A and B subunit B binds to host receptor, A inactivates elongation factor 2 --> stops prtn synthesis and induces cell death

Question 37

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

Answer 37

heart kidneys nerve cells

Question 38

bacterial v. viral conjunctivitis

Answer 38

bacterial has more pus and discharge

Question 39

what are the main two causative agents of bacterial conjunctivitis?

Answer 39

- haemophilus flu | - strep. pneumoniae

Question 40

what are the other three causes of bac. conjunctivitis?

Answer 40

- moraxella lacunata - enterobacteria - neisseria gonorrhoeae

Question 41

describe haemophilus flu.

Answer 41

gram negative rod

Question 42

describe strep. pneumoniae

Answer 42

gram positive cocci

Question 43

what is the treatment for bac. conjunctivitis

Answer 43

gentamicin or ciprofloxacin

Question 44

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

Answer 44

haemophilus flu. type B

Question 45

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

Answer 45

strep. pneumoniae haemophilus flu. moraxella catarrhalis

Question 46

what are the 3 most common causative agents of sinusitis?

Answer 46

strep. pneumoniae haemophilus flu. moraxella catarrhalis

Question 47

what type of pneumonia is strep. pneumoniae associated with?

Answer 47

lobar pneumonia

Question 48

what type of strep. is associated with meningitis?

Answer 48

strep. pneumoniae

Question 49

chlamydia trach. or chlamydophila: obligate intracellular parasite

Answer 49

chlamydophila

Question 50

elementary bodies v. reticulate bodies

Answer 50

EB-metabolically inactive and infectious | RB- metabolically active, noninfectious forms

Question 51

trachoma, adult inclusion bodies, neonatal conjunctivitis, infant pneumonia

Answer 51

chlamydia trachomatis

Question 52

pathogenesis of chlamydia trachoma

Answer 52

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

Question 53

how does chlamydia trachoma. gain access to cells?

Answer 53

minute abrasions or lacerations and then granuloma formation

Question 54

causitive agent of adult inclusion conjunctivitis/acute follicular conjunctivits

Answer 54

chlamydia trachomatis | diffuse inflammation, conjunctival scarring, eyelids turn inward

Question 55

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

Answer 55

adult inclusion conjunctivitis caused by chlamydia trachomatis

Question 56

5-12 days after birth eyelids swell | - at risk for developing c. trachomatis pneumoia

Answer 56

neonatal conjunctivitis caused by c. trachomatis

Question 57

onset 2-3 wks after birth | - bronchitis with a dry cough, afebrile

Answer 57

infrant pneumonia caused by c. trachomatis

Question 58

TWAR pathogen

Answer 58

chlamydophila pneumoniae

Question 59

only one lobe affected, associated with atherosclerosis

Answer 59

chlamydophila pneumoniae

Question 60

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

Answer 60

chlamydophila psittaci

Question 61

what do you use to diagnosis c. psittaci?

Answer 61

PCR | complement fixation

Question 62

what do you use to treat c. psittaci?

Answer 62

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

Question 63

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

Answer 63

reticuloendothelial cells in liver and spleen | -multiplies at these sites producing focal necrosis