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Mucosal Surfaces > 25- H Infleunzae > Flashcards

25- H Infleunzae Flashcards

1
Q

Are they always gram - cocci

A

No can be filamentous too

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2
Q

Which acute resp infections does it cause

A

Bronchitis, pneumonia

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3
Q

Which urt major thing can it cause other than sinusitis etc

A

Epiglottitis

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4
Q

What does it cause mainly in children 3-3 years old

A

Meningitis/ inflammation of the meninges

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5
Q

Can it be seen in healthy

A

Yes as an opportunist

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6
Q

What does it need to grow in and why

A

Blood agar for factor x and v

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7
Q

What is fsctor x

A

Haemin- it’s required for cytochrome c and fe enzymes of the bacteria

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8
Q

What is factor v

A

Nad / nad phosphate needed for oxidation reduction processea

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9
Q

Does it need co2

A

No but there is a 5-10% increase in growth

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10
Q

Why is agar usually heated

A

To release nadases which increases factor v and then heat also allows rbc to release factor x haemin

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11
Q

How is it diagnosed in rare cases

A

Microscopy or biochemical tests

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12
Q

What is given without diagnosis

A

Antibiotics to treat general infection

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13
Q

Give examples of some biochemical tests

A

Catalase positive and oxidase positive

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14
Q

How many types of capsulated hi are there

A

6- a to f (b most invasive)

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15
Q

Which polymer capsule does b have

A

Poly ribosyl ribitol phosphate (in the hib vaccine)

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16
Q

How many biotypes are there based on biochemical tests and which most common

A

8

1-3 most common

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17
Q

Which type is most invasive

A

Type 1, b hi

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18
Q

There are 2 types of infection. Invasive and non invasive/respiratory. What causes invasive

A

90% type b, 10% non capsulated , 1% e and f

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19
Q

What are non invasive most common in

A

90% occurs in children eg meningitis, pneumonia, sepsis

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20
Q

What causes 90% of non invasive in adults and children eg otitis, sinusitis, epiglottitis

A

Non capulsated

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21
Q

Which other pathogens can cause invasive infection (demuri)

A

Viral infections

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22
Q

What sort of vaccine is hib

A

Conjugated to increase TD responses as polysaccharide don’t produce good responses in children

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23
Q

What after vaccine causes meningitis in children

A

Non capsulated

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24
Q

When would invasive infections occur in adults whcih is v rare eg pneumonia

A

If immunocomprised or have chronic infections or malignancy

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25
Q

Since adults have good b ab what can cause these rarely

A

E and o types

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26
Q

Why are neonates below 2 months not at risk of invasive eg meningitis

A

IgG transfer from placenta against capsules

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27
Q

When does systemic usually occur/ how

A

Penetration of submucosa after eg disruption like smoking, viral pathogens. Causes transepithelial migration into blood stream ie bacteraemia

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28
Q

Why is capsule of hib important for virulence

A

Evades phagocytosis and complement mediated lysis

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29
Q

What are the meninges

A

3 connective layers covering the csf brain and spine

30
Q

What are the 3 layers

A

Dura mater (outer)
Arachnoid mater
Pia mater

31
Q

Why is it more common in children

A

Small distance between sinuses and bbb/meninges

32
Q

Where is the csf encased in meninges

A

The subarachnoid space

33
Q

What is aseptic meningitis

A

Meningitis caused by viruses (most common)

34
Q

Give some characteristics of viral meningitis

A

More lymphocytes than neutrophils , no glucose reduction and less inflammatory proteins in csf

35
Q

What do you call bacterial meningitis and some characteristics

A

Purulent

Causes neutrophil increase, reduced glucose in csf as bacteria use it, also 10x more inflam proteins in csf

36
Q

What are some symptoms

A

Rashes, very high fever, neck pain, headaches, lethargy , joint pain

37
Q

What is the lumbar puncture diagnostic test

A

Spinal needle inserted into the L3/4 space and collect csf to detect eg levels of inflam cells, protein levels in csf

38
Q

What is the carriage % in healthy of non capsulated vs capsulated

A

25-80% non capsulated in nasopharynx vs 5-10% of capsulated

39
Q

Which environment factors associated with meningitis spread in children mainly

A

Winter months , low socioeconomic backrounds

40
Q

What is the mortality rate of meningitis and long term effects

A

5% other than that can cause neurological disease, seizures, hearing loss sometimes

41
Q

What % did the hib reduce disease in under 5

A

By 95%

42
Q

Due to increases in 1999 what was offered since

A

Booster to 6months- 4 years of age

43
Q

Since 2006 what is the conjugate given with

A

Meningococcus vaccine

44
Q

Diagnosis is rarely given so what antibiotics given

A

Ceftriaxone

45
Q

What is epiglottitis caused by and what age most common (non invasive disease)

A

1-6 years

Causes by hi b

46
Q

What shouldn’t be done if suspected epiglottitis

A

No lying down as it falls over trachea, also don’t inspect throat as can cause spasm closing airways

47
Q

What are given to stop airway closing/ treatment

A

Tube inserted and iv antibiotics given and oxygen if low respiratory

48
Q

What are non type able hi. Nthi

A

Primarily mucosal pathogen causing resp issues and also things like otitis media

49
Q

What resp issues do nthi cause

A

Bronchitis/copd exacerbation

Also bronchiectasis and cf

50
Q

How do they attack and colonise

A

Bind mucosa via adhesins/pili and stop ciliary function

51
Q

How do they evade immune system

A

Iga proteases, microcolony formation, ag drift

52
Q

Which invasive system do they have to colonise phagocytes and lung parenchyma

A

T3ss

53
Q

What causes the dysbiotic from commensalism to pathogen

A

Smoking, viruses , aspirations, ag drift/mutations

54
Q

Why is ceftriaxone given and not penecillin

A

20% of strains have b lactamase

55
Q

Which article discusses hi diagnosis and interaction with viruses

A

Slack 2015

56
Q

Why are PCR assays /capsular serotyping used instead of horse blood agar to study them more often

A

Some don’t have haemolytic effects

57
Q

Which virus is related to nthi exacerbation eg during copd

A

Rv

58
Q

How

A

Can upregulste adhesion proteins on epi cells for invasion eg Icam1 and also impair neutrophil protection from nthi

59
Q

Which article discusses nthi and copd/airways

A

Su et Al 2018

60
Q

What do they upreg which converts it from commensalism

A

Pathogenicity islands eg for invasion and attachment and iga proteases

61
Q

What do nthi form during otitis media

A

Biofilms

62
Q

What on epi cells which causes integrity is reduced in copd and caused by nthi

A

E cadherin

63
Q

Which tlr do they induce during copd and cause inflammation via nfkb

A

Tlr 2

64
Q

Why does smoking allow more nthi in things like copd

A

Impairs the phagocytosis of nthi and the t and B cells against it

65
Q

Which article talks about haemophilia and meningitis invasion

A

Hauser et Al 2018

66
Q

What allows better adherence to cells of resp tract

A

Fimbriae

67
Q

How do hib pass through to blood steam if not through cell invasion

A

Paracellular

68
Q

How does hib and hif enter brain

A

Choroid plexus

69
Q

On what side

A

Baso lateral side which is side facing the blood stream

70
Q

Other than evading immune system what does hib and hif capsule allow in blood stream

A

Rapid replication

71
Q

How like other capsulated eg neisseria and pneumoniae can they penetrate epi cells much better

A

By shedding their capsule in resp tract

Mucosal Surfaces (33 decks)

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