5 respiratory diseases Flashcards
1
Q
what produces aerosols?
A
speaking, singing, normal breathing
2
Q
respiratory droplets
A
largest fall to the ground in a few meters
3
Q
droplet nuclei sizes
A
1-4 microns, can travel long distances + reaches the lower respiratory tract
4
Q
what is the most common site for infections
A
respiratory tract
5
Q
what results in more visits to physicians than any other diagnosis
A
upper respiratory infections
6
Q
respiratory infections
A
- usually mild, common, and taken for granted
- immense disease burden have a major economic impact
7
Q
how many days of restricted activity/ year due to influenza like illnesses
A
more than 400 million
8
Q
severe consequences for people with respiratory infections, especially in people
A
compromised by other diseases
9
Q
why are respiratory infections so common?
A
- 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
10
Q
air is full of
A
particulate matter, bacteria, fungi, + viruses
11
Q
how many breaths / day?
A
12-20 breaths / min * 60 min * 24 hrs= 17,280 - 28,800 breaths/day
12
Q
how many influenza particles in a gram or cc of water
A
100-1000 particles 80-120 nm in diameter so 100 trillion particles in a gram of cc of water
13
Q
*defense mechanisms of the respiratory tract
A
- airway + reflexes
- the mucociliary escalator
- alveolar macrophages
14
Q
airway + reflexes
A
- changes in direction of airflow
- laryngeal spasm reflex; coughing
15
Q
the mucociliary escalator
A
mucus (lysozyme, secretory IgA antibodies) + cilia
-goblet cells secrete mucus w/ antibacterials
16
Q
cilia
A
moves mucus in outward direction
17
Q
as particles stick to your mucus, you can get rid of it through
A
outward flow
18
Q
turbinate baffles
A
traps small particles before it gets to your lungs
19
Q
lymph tissues
A
stations where lymphocytes sit and wait to fight infections
20
Q
alveoli
A
gas exchange between your blood and air
21
Q
where are turbinate baffles located
A
nasal cavity
22
Q
two main classifications
A
Upper respiratory infection
lower respiratory infection
23
Q
upper respiratory infection
A
above the trachea
24
Q
lower respiratory infection
A
below the trachea
25
*what causes the common cold
rhinovirus
26
common cold
URI
nasopharynx
rhinovirus + other pathogens
27
pharyngitis
URI
oropharynx
viruses
28
strep throat
URI
oropharynx
group A strep
29
group A strep gram
GRAM POS
30
infections of the lungs
lower respiratory tract infections
31
influenza
lung bronchi or alveoli
caused by influenza virus
LRI
32
strep pneumoniae
lung bronchi
bronchitis
LRI
33
what causes bronchitis
strep pneumoniae + hemophiilus influenzae
34
what is more life threatening, LRI or URI
LRI are generally more life threatening
35
what causes pneumoniae?
streptococcus pneumoniae (person to person)
36
legionella
environmental source of pneumonia
37
before antibiotics, what were the top causes of death
pneumonia + tb
38
what causes pulmonary tuberculosis
mycobacterium tuberculosis
39
lung abcess
mixed anaerobic + aerobic bacteria
40
classification of pneumonia syndromes
acute (sudden onset)
| subacute or chronic (lasting or reoccuring pneumonia)
41
acute (sudden onset) acquired?
symptoms progress over a few days
42
how is acute (sudden onset) pneumonia acquired?
community or hospital/nosocomial acquired
43
acute (sudden onset) pneumonia that is community acquired
S. pneumoniae= person to person
| L. pneumophila= environmental
44
acute (sudden onset) pneumonia hospital acquired
enteric bacteria or pseudomonas aeruginosa
45
subacute or chronic
lasting or reoccuring pneumonia
46
examples of subacute or chronic pneumonia
pulmonary tuberculosis,
| fungal pneumonia + lung abcess
47
subacute or chronic pneumonia - fungal pneumonia
histoplasma, capsulatum
48
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
49
pneumonia, infection of the
lung parenchyma
50
pneumonia
may be caused by many different pathogens, sometimes with distinctive clinical manifestations
51
is pneumonia one disease?
no, it is many diff ones that share a common anatomic location
52
104 degrees + rust color sputum
strong indicator of bacterial infection
53
consolidation
alveoli + small airways fill with dense material; lung becomes inelastic
54
bronchitis
no consolidation
55
patchy, homogenous, or generalized
ways to describe consolidation
56
what do you use to treat strep pneumoniae
penicillin
57
diplococci strep pneumoniae
dark purple; gram pos
58
gram neg
light pink
59
pneumolysin*
the most virulence factor in strep pneumoniae
60
gram pos
no LPS
61
streptococcus pneumoniae = encounter
person to person, carrier, fomites
62
streptococcus pneumoniae= entry
inhalation
63
streptococcus pneumoniae= growth and spread
grows extracellularly
64
streptococcus pneumoniae = damage
- no endotoxin
- penumolysin=toxin/virulence factor
- acute inflammation = lots of neutrophils
- fluids in the lungs
65
capsule of streptococcus pneumoniae
allows organism to resist phagocytosis by macrophages
66
alveoli in infected person with pneumonia
fluid in airsacs
| -when it becomes dense, shows up in X-rays
67
stages in inflammatory process of pneumonia
1. alveoli fill with clear fluid
2. early consolidation
3. late consolidation
4 resolution
68
pneumonia = 1. alveoli fill with clear fluid
clear, serous fluid, body can't phagocytose bc of capsule
69
pneumonia= 2. early consolidation
surrouding capillaries burst so cells are filled with blood
70
pneumonia= 3. late consolidation
neutrophils are here trying to clear out infection
71
when can a person suffocate and die during pneumoni
late consolidation
72
alveolar air spaces in pneumonia
alveolar spaces are filled with purple neutrophils, trying to clear infection, but in process they can cause damage
73
major dangers of bacterial pneumonia
bacteremia may develop
| -organism may spread to other organs (e.g. meninges (meningitis), heart valves (endocarditis)
74
why do you want to catch pneumonia early?
pneumonia can leak out into bloodstream causing meningitis and endocarditis
75
now that there are antibiotics, pneumonia
responds quickly to antibiotics and can have complete recovery of the lung
76
pneumonia
1 person to person (you must inhale into alveolar spaces)
2 extracellular
3 capsule
77
legioneires disease is caused by what bacteria
legionella pneumophila
78
what causes legioneires disease
water; aerosols from the AC if it contaminated with legionella
79
what does legionella colonize?
plumbing systems
80
what can contaminate dental unit water systems
legionella
81
legionella= ecounter
contaminated water
82
legionella= entry
inhalation
83
is legionella killed by macrophages?
NO, it is taken up, but not killed. It grows inside macrophages
84
why can't legionella prevent phagocytosis
it does not have a capsule to prevent phagocytosis
85
legionella causes damage due
host inflammatory response
86
is legionella an intracellular organism
yes
87
legionella gram stain
gram neg with small pink rods
88
legionella is environmental via
water systems
89
legionella grows inside macrophages so does it get phagocytosed?
yes, but not killed
90
if a patient has lung abscess with pus, this is caused by
subacute pneumonia or chronic pneumonia
91
how can we protect patient from aspirating materials?
use a rubber dam
92
lung abscess - encounter
own flora
93
lung abscess entry
aspiration
94
gradual onset of a lung abscess takes how long?
4 weeks
95
lung abscess can affect people with what kind of flora
normal flora
96
actinomyces
gram pos bacilli
97
what kind of anaerobe is actinomyces?
facultative or obligate anaerobe
98
how do actinomyces grow?
in chains and appear similar to fungi but are bacteria
99
actinomyces rate of growth
slow
100
what is actinomyces associated with in dentistry
periodontitis + caries
101
polymicrobial infections
multiple species of bacteria or pathogens causing the disease example actinomyces
102
pulmonary actinomyces
rare infection of the lung
103
risk factors of pulmonary actinomycosis
```
poor dental hygiene
dental abscess
alcohol abuse
emphysema
scars on the lung
```
104
symptoms of pulmonary actinomycosis
chest pain, cough, fever, lethargy, night sweats, shortness of breath, weight loss, infection often develops slowly
105
tx for pulmonary actinomycosis
IV antibiotics 4-6 weeks
106
with slow growing organisms, antibiotic tx is very long like tb
6 mos. to a year of tx
107
actinomycosis , other sites
cervicofacial actinomycosis
| abdominal actinomycosis
108
cervicofacial actinomycosis
lumpy jaw
- most common form of actinomycosis
- poort oral hygiene
- invasive dental procedure
- oral trauma
109
abdominal actinomycosis
surgery or trauma
110
pelvic actinomycosis
intrauterine devices
111
brain abscess
spread from other infected site
112
pertussis
whooping cough
113
the only vaccine preventable infection whose incidence is increasing in US
pertussis whoooping cough
114
increase of pertussis whooping cough is in
adolescents and young adults; asocaited with waning immunity
115
what vaccines needs boosters
pertussis
116
how long do people cough for after having pertussis
3 mos of high pitch coughs
117
what vaccine prevents pertussis
DTAP
118
Causative agent of pertusssis
bordetella pertussis
119
bordetella pertussis- gram
gram negative
120
bordetella pertussis
- produces toxins
- adhere to respiratory epithelium
- toxins immbolize the escalator
121
brordetella pertussis encounter
- person to person
- organism does not survive well in the environment
- highly contageous
122
bordetella pertussis entry
inhalation
123
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
124
clinical manifestation of respiratory tract infection dependent upon
causative agent
125
what causes strep throat and then rheumatic fever
strep pyogenes
126
viruses mainly in upper respiatory tract
most cases of pharygitis - "srep" throat
127
bacteria mainly in
otitis media, sinusitis, pharygitis, epiglottis, bronchitis, and pneumonia
128
fungi and protozoa rarely in normal individuals but important causes of pneumonia in the
immune compromised
129
what can cause respiratory disease
airborne microorganisms
130
although open, the respiratory system is
well protected
131
bacteria have mechanisms to defeat defenses
capsule (growth within macrophages)
132
what is a risk factor
anything that impairs the defenses
