5 respiratory diseases Flashcards
what produces aerosols?
speaking, singing, normal breathing
respiratory droplets
largest fall to the ground in a few meters
droplet nuclei sizes
1-4 microns, can travel long distances + reaches the lower respiratory tract
what is the most common site for infections
respiratory tract
what results in more visits to physicians than any other diagnosis
upper respiratory infections
respiratory infections
- usually mild, common, and taken for granted
- immense disease burden have a major economic impact
how many days of restricted activity/ year due to influenza like illnesses
more than 400 million
severe consequences for people with respiratory infections, especially in people
compromised by other diseases
why are respiratory infections so common?
- direct contact with the environment
- continuously exposed to bugs in the air we breathe
- some are highly virulent and may infect a normal person even in small numbers
- most do not cause infection unless other factors interfere with host defenses
air is full of
particulate matter, bacteria, fungi, + viruses
how many breaths / day?
12-20 breaths / min * 60 min * 24 hrs= 17,280 - 28,800 breaths/day
how many influenza particles in a gram or cc of water
100-1000 particles 80-120 nm in diameter so 100 trillion particles in a gram of cc of water
*defense mechanisms of the respiratory tract
- airway + reflexes
- the mucociliary escalator
- alveolar macrophages
airway + reflexes
- changes in direction of airflow
- laryngeal spasm reflex; coughing
the mucociliary escalator
mucus (lysozyme, secretory IgA antibodies) + cilia
-goblet cells secrete mucus w/ antibacterials
cilia
moves mucus in outward direction
as particles stick to your mucus, you can get rid of it through
outward flow
turbinate baffles
traps small particles before it gets to your lungs
lymph tissues
stations where lymphocytes sit and wait to fight infections
alveoli
gas exchange between your blood and air
where are turbinate baffles located
nasal cavity
two main classifications
Upper respiratory infection
lower respiratory infection
upper respiratory infection
above the trachea
lower respiratory infection
below the trachea
*what causes the common cold
rhinovirus
common cold
URI
nasopharynx
rhinovirus + other pathogens
pharyngitis
URI
oropharynx
viruses
strep throat
URI
oropharynx
group A strep
group A strep gram
GRAM POS
infections of the lungs
lower respiratory tract infections
influenza
lung bronchi or alveoli
caused by influenza virus
LRI
strep pneumoniae
lung bronchi
bronchitis
LRI
what causes bronchitis
strep pneumoniae + hemophiilus influenzae
what is more life threatening, LRI or URI
LRI are generally more life threatening
what causes pneumoniae?
streptococcus pneumoniae (person to person)
legionella
environmental source of pneumonia
before antibiotics, what were the top causes of death
pneumonia + tb
what causes pulmonary tuberculosis
mycobacterium tuberculosis
lung abcess
mixed anaerobic + aerobic bacteria
classification of pneumonia syndromes
acute (sudden onset)
subacute or chronic (lasting or reoccuring pneumonia)
acute (sudden onset) acquired?
symptoms progress over a few days
how is acute (sudden onset) pneumonia acquired?
community or hospital/nosocomial acquired
acute (sudden onset) pneumonia that is community acquired
S. pneumoniae= person to person
L. pneumophila= environmental
acute (sudden onset) pneumonia hospital acquired
enteric bacteria or pseudomonas aeruginosa
subacute or chronic
lasting or reoccuring pneumonia
examples of subacute or chronic pneumonia
pulmonary tuberculosis,
fungal pneumonia + lung abcess
subacute or chronic pneumonia - fungal pneumonia
histoplasma, capsulatum
subacute or chronic pneumonia-lung abcess
walled off area to stop infection but organisms stay viable in the access But, the wall can crack and the disease can spread
pneumonia, infection of the
lung parenchyma
pneumonia
may be caused by many different pathogens, sometimes with distinctive clinical manifestations
is pneumonia one disease?
no, it is many diff ones that share a common anatomic location
104 degrees + rust color sputum
strong indicator of bacterial infection
consolidation
alveoli + small airways fill with dense material; lung becomes inelastic
bronchitis
no consolidation
patchy, homogenous, or generalized
ways to describe consolidation
what do you use to treat strep pneumoniae
penicillin
diplococci strep pneumoniae
dark purple; gram pos
gram neg
light pink
pneumolysin*
the most virulence factor in strep pneumoniae
gram pos
no LPS
streptococcus pneumoniae = encounter
person to person, carrier, fomites
streptococcus pneumoniae= entry
inhalation
streptococcus pneumoniae= growth and spread
grows extracellularly
streptococcus pneumoniae = damage
- no endotoxin
- penumolysin=toxin/virulence factor
- acute inflammation = lots of neutrophils
- fluids in the lungs
capsule of streptococcus pneumoniae
allows organism to resist phagocytosis by macrophages
alveoli in infected person with pneumonia
fluid in airsacs
-when it becomes dense, shows up in X-rays
stages in inflammatory process of pneumonia
- alveoli fill with clear fluid
- early consolidation
- late consolidation
4 resolution
pneumonia = 1. alveoli fill with clear fluid
clear, serous fluid, body can’t phagocytose bc of capsule
pneumonia= 2. early consolidation
surrouding capillaries burst so cells are filled with blood
pneumonia= 3. late consolidation
neutrophils are here trying to clear out infection
when can a person suffocate and die during pneumoni
late consolidation
alveolar air spaces in pneumonia
alveolar spaces are filled with purple neutrophils, trying to clear infection, but in process they can cause damage
major dangers of bacterial pneumonia
bacteremia may develop
-organism may spread to other organs (e.g. meninges (meningitis), heart valves (endocarditis)
why do you want to catch pneumonia early?
pneumonia can leak out into bloodstream causing meningitis and endocarditis
now that there are antibiotics, pneumonia
responds quickly to antibiotics and can have complete recovery of the lung
pneumonia
1 person to person (you must inhale into alveolar spaces)
2 extracellular
3 capsule
legioneires disease is caused by what bacteria
legionella pneumophila
what causes legioneires disease
water; aerosols from the AC if it contaminated with legionella
what does legionella colonize?
plumbing systems
what can contaminate dental unit water systems
legionella
legionella= ecounter
contaminated water
legionella= entry
inhalation
is legionella killed by macrophages?
NO, it is taken up, but not killed. It grows inside macrophages
why can’t legionella prevent phagocytosis
it does not have a capsule to prevent phagocytosis
legionella causes damage due
host inflammatory response
is legionella an intracellular organism
yes
legionella gram stain
gram neg with small pink rods
legionella is environmental via
water systems
legionella grows inside macrophages so does it get phagocytosed?
yes, but not killed
if a patient has lung abscess with pus, this is caused by
subacute pneumonia or chronic pneumonia
how can we protect patient from aspirating materials?
use a rubber dam
lung abscess - encounter
own flora
lung abscess entry
aspiration
gradual onset of a lung abscess takes how long?
4 weeks
lung abscess can affect people with what kind of flora
normal flora
actinomyces
gram pos bacilli
what kind of anaerobe is actinomyces?
facultative or obligate anaerobe
how do actinomyces grow?
in chains and appear similar to fungi but are bacteria
actinomyces rate of growth
slow
what is actinomyces associated with in dentistry
periodontitis + caries
polymicrobial infections
multiple species of bacteria or pathogens causing the disease example actinomyces
pulmonary actinomyces
rare infection of the lung
risk factors of pulmonary actinomycosis
poor dental hygiene dental abscess alcohol abuse emphysema scars on the lung
symptoms of pulmonary actinomycosis
chest pain, cough, fever, lethargy, night sweats, shortness of breath, weight loss, infection often develops slowly
tx for pulmonary actinomycosis
IV antibiotics 4-6 weeks
with slow growing organisms, antibiotic tx is very long like tb
6 mos. to a year of tx
actinomycosis , other sites
cervicofacial actinomycosis
abdominal actinomycosis
cervicofacial actinomycosis
lumpy jaw
- most common form of actinomycosis
- poort oral hygiene
- invasive dental procedure
- oral trauma
abdominal actinomycosis
surgery or trauma
pelvic actinomycosis
intrauterine devices
brain abscess
spread from other infected site
pertussis
whooping cough
the only vaccine preventable infection whose incidence is increasing in US
pertussis whoooping cough
increase of pertussis whooping cough is in
adolescents and young adults; asocaited with waning immunity
what vaccines needs boosters
pertussis
how long do people cough for after having pertussis
3 mos of high pitch coughs
what vaccine prevents pertussis
DTAP
Causative agent of pertusssis
bordetella pertussis
bordetella pertussis- gram
gram negative
bordetella pertussis
- produces toxins
- adhere to respiratory epithelium
- toxins immbolize the escalator
brordetella pertussis encounter
- person to person
- organism does not survive well in the environment
- highly contageous
bordetella pertussis entry
inhalation
bordetella pertussis whooping cough stages
after 3 wks, whooping cough begins and lasts up to 2 mos. In adults, the cough may be milder but persists
clinical manifestation of respiratory tract infection dependent upon
causative agent
what causes strep throat and then rheumatic fever
strep pyogenes
viruses mainly in upper respiatory tract
most cases of pharygitis - “srep” throat
bacteria mainly in
otitis media, sinusitis, pharygitis, epiglottis, bronchitis, and pneumonia
fungi and protozoa rarely in normal individuals but important causes of pneumonia in the
immune compromised
what can cause respiratory disease
airborne microorganisms
although open, the respiratory system is
well protected
bacteria have mechanisms to defeat defenses
capsule (growth within macrophages)
what is a risk factor
anything that impairs the defenses
