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Block 3 Found Sci > 4-Upper Respir Tract Bacteria > Flashcards

4-Upper Respir Tract Bacteria Flashcards

1
Q

upper respiratory tract has

A

conjuctiva + nasolacrimal ducts + middle ear + eustachian tube + nares + nasal cavity + pharynx + sinuses + larynx + epiglottis

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2
Q

URT defenses

A
  1. ciliated epi in conductive airway
  2. mucocillary escalator- impaired by viral infection, smoke, alc, narcotics
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3
Q

normal microbiota in nasal cavity

A
  1. staph epidermidis
  2. staph aureus (MRSA esp healthcare workers)
  3. corynebactterium spp
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4
Q

nasopharynx microbiota

A
  1. Strep pneumoniae
  2. moraxella catarrhalis
  3. notypeable haemophilius influenze

main ones causing dz, all are opportunistic

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5
Q

pharyngitis

A

inflam of pharynx
-usually viral but can be strep pyogenes or cornyne (less common)

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6
Q

streptococci classifications

A

gram + cocci in chains + catalase neg

  1. lancefield serogrouping (A-H)- cell wall carb antigens
  2. hemolysis- alpha, beta, gamma
  3. biochem properties
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7
Q

strep pyogenes diseases

A

aka group A strep (GAS)
1. pharyngitis
2. sequelae (scarlett fever, rheumatic fever, rheumatic heart dz)

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8
Q

strep throat clinical presentation

A
  1. swollen tonsils and uvula (anterior cervical lymphadenopathy)
  2. edema and erythema of pharyngeal
  3. pus (tonsillar exudate)
  4. pain/diff swallowing
  5. fever

spreads by sneezing and coughing, food contaminated by respir droplets

will spont resolve in a week

pharyngitis from S. pyogenes

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9
Q

pyogenes virulence factors

A
  1. M protein- degrades complement
  2. capsule hyaluronic acid- inhibits phagocytosis
  3. strep pyogenic exotoxins- scarlett fever, toxic shock, necrotizing fascilits
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10
Q

diagnose pharyngitis

A
  1. absence of viral pharyngitis (no cough or runny nose, diarrhea)
  2. anterior cervical lymphadenopathy
  3. high temp +100.4
  4. tonsillar exudates/swelling

rapid strep test for lancefield group A antigen + follow up culture

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11
Q

pharyngitis treatment

A

usually antibiotic therapy for S. pyogenes
-avoid crowds

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12
Q

non suppurtive complications pharyngitis

A
  1. scarlett fever
  2. acute rheumatic fever
  3. strep toxic shock
  4. poststrep glomerulonephritis
  5. PANDAS (peds autoimmune neuropsychiatric)

from S. pyogenes

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13
Q

scarlet fever - pyogenes

A

mostly in kids after GAS pharyngitis
-sandpaper rash + strawberry tongue
-no systemic spread only in throat bc exotoxins produced at site of infection

treat antibiotics

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14
Q

acute rheumatic fever

pyogenes

A

two types
1. acute febrile illness- weeks after GAS infections
-arthritis in large joints, carditis/valvulitis, fever
2. neurologic illness-months after GAS infection
-sydenham chorea, no fever or joint symps

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15
Q

acute rheumatic fever treatment

A
  1. antibiotics for GAS or recurrent active infection
  2. anti-inflammatory for arthritis
  3. manage heart dz/failure
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16
Q

acute rheumatic fever mechanism

A

antibodies and T cells activated vs GAS during infection then cross react with host proteins = autoimmune mediated damage
-molecular mimicry

GAS infection absent in new acute rheumatic fever cases

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17
Q

diptheria pharyngitis

A

unique type of pharyngitis from cornye diphtheriae
-toxin mediated

low grade fever + mild sore throat + bull neck (super swollen lymph nodes) + pseudomembrane formation on oro/naso/laryngopharynx
-if untreated lead to kidney fail, myocarditis, death
-pseudomembrane pieces can cause suffocation

18
Q

diptheria exotoxin

A

AB exotoxin carried on lysogenic bacteriophage
-stops protein syn via ADP ribosylation of elongation factor 2

local and systemic manifestations

19
Q

how diptheria spreads

A

aerosol
respir droplet contamin of fomites
-rare in US

20
Q

treating diptheria

A

IV diph antitoxin
-airway management to prevent suffocation
-antibiotics

prevent with DTaP vaccine

21
Q

epiglottitis

A

inflamm swelling of epiglottis
1. acute = haemophilus influenzae serotype B > airway obstruction, high fever, stridor, drooling, muffled voice, severe sore throat, toxic facies
2. subacute = sore throat, diff swallowing, low grade fever, GAS (pyogenes, aureus, pneumoniae)

22
Q

haemophilus influenzae strains

A
  1. typeable strain has capsule (polysac of PRP) types A-F
    -B is most dangerous (HiB)
  2. nontypebale no capsule (NTHi)
23
Q

HiB virulence factors

A

IgA protease
PRP capsule makes antiphagocytic

mostly pediatric esp if unvaccination/improperly vac

spread by drolpets

24
Q

HiB treatment

A

dx by culture and gram stain (looks like chocolate/brown)

-antibiotic therapy but if untreated then death
-prevent by conjugate vaccine but not protect against typeable

25
Q

otitis externa

A

infection and inflamm with auditory canal
-swimmers ear

pseudo aeruginosa, staph aureus
-fungi can also cause (candida albicans, asperigillus)

antibiotic ear drops to treat

26
Q

acute otitis media

A

inflamm of middle ear
-childhood dz huge economic burden and #1 cause of office visits, antibiotics, hearing loss, and surgery with anesthesia for kids

27
Q

why kids more sensitive acute otitis media

A

eustachian tube is short, floppier, more horizontal

28
Q

acute otitis media bacterias

A
  1. strep pneumoniae- normal microbiota, ‘the pneumococcus’
  2. NTHi
  3. moraxella catarrhalis
29
Q

acute otitis media presentation

A
  1. unexplained crying
  2. pulling at ears
  3. otorrhea- pus out ear canal
  4. GI
  5. concurrent/preceding viral URTI
30
Q

acute otitis media risk factors

A

-second hand smoke
-daycare attendance
-seasonality (winter)

31
Q

treatment acute otitis media

A
  1. antibiotics (amoxicillin)
  2. watchful waiting if non severe, older than 2
  3. severe recurrent cases need antibiotics and tympanostomy

prevent by vac for pneumococcal AOM somewhat effective (pneumococcal polysac 23 valent or 13 valent conjugated to diphetheria toxoid)

32
Q

sinusitis/rhinosiusitis

A

inflamm of paranasal sinuses or nasal cavity

strep pneumoniae
NTHi
moraxella catarrhalis

same as otitis media

33
Q

sinusitis dx

A

bacteriology etiology if 10+ days, severe symptoms after 3 days, following an improving viral URT

treat with waiting or antibiotics in severe/worsening

34
Q

conjunctivitis

A

pink eye aka inflamm of conjunctiva

bacterial = purulent discharge
-also viral, allergic, non allergic etiologies

35
Q

acute conjunctivitis

A
  1. common bacterial- eye or nasal secretion from infected
    aureus, pneumoniae, NTHi, moraxella
  2. hyperacute- genitals to eyes
    neisseria gonorrhoeae
36
Q

chronic conjunctivitis

A
  1. adult inclusion- genitals to eyes, STI strains,
  2. trachoma- eye or nasal secretions, non STI stains

both from chlamydia trachomatis

37
Q

neonatal conjunctivitis

A
  1. neonatal inclusion- birth canal, STI strains, mucopurulent discharge
    C. trachomatis
  2. gonococcal conjunctivitis- birth canal
    N. gonorrhoeae
38
Q

chlamydia characteristics

A

medially relevant species
1. chlamydia trachomatis
2. chlamydia psittaci
3. chlamydia pneumoniae

very small obligate intracellular bacteria

39
Q

chlamydia life stages

A
  1. elementary bodies- metabolic inactive, infectious
  2. reticulate bodies- metabolic active, noninfectious
40
Q

chlamydia trachomatis pathogenesis

A

direct destruction of host cells during rep = collateral damage from host infalmm resp

41
Q

treating conjunctivitis

A

adult and neonatal inclusion forms
-antibiotics via ophthalmic drops, ointment, oral

Block 3 Found Sci (60 decks)

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