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1Principles of Biomedicine - MD1 > 75 - URT Infections > Flashcards

75 - URT Infections Flashcards

1
Q

Parts of resp tract with normal microbiota

A

Paranasal sinuses

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2
Q

Examples of potentially pathogenic bacteria present in ~50% of normal resp tracts

A 
Viridans strep (greening), 
neisseria spp, 
corynebacterium spp, 
G- anaerobes, 
H influenzae (often without identifiable capsule), 
C albicans, 
strep pneumoniae
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3
Q

Examples of potentially-harmful bacteria present in resp tract of healthy people 1-10% of time

A

Strep pyogenes, meningococci

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4
Q

Uncommon potentially-harmful bacteria in resp system of healthy people

A

Enterobacteria, pseudomonas, C. diphtheriae

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5
Q

Residents of healthy resp system in latent state

A

In lung: P. jirovecii, M. tuberculosis

In lymph nodes, sensory nerves: CMV, HSV, EBV

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6
Q

Effect of diphtheria vaccination on rare diphtheria cases

A

Some rare, non-toxigenic infections of diphtheria, presenting as things like infective endocarditis.
Vaccine is a diphtheria toxoid, so evolutionary advantage to being diphtheriatoxin negative.

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7
Q

PCP

A

Pneumocystis pneumonia (pneumocystic jirovecii)

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8
Q

Why might P. jirovecii be an AIDS-defining illness?

A

Normally controlled with adaptive immunity, perhaps some in body after a mild infection.
When cell-mediated immunity is impaired, becomes a serious infection

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9
Q 
Places in the mouth that bacteria can be found
1
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4
A

1) Nasal washings
2) Saliva
3) Tooth surfaces
4) Gingival scrapings

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10
Q

Are there more anaerobic or aerobic bacteria in the mouth?

A

More anaerobic

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11
Q 
URT syndromes 
1
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6
A 
Common cold
Pharyngitis/tonsilitis
Sinusitis
Otitis media
Epiglottitis
Croup (laryngotracheobronchitis, LTB)
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12
Q

What can rhinoviruses cause?

A

Rhinitis, sometimes pharyngitis

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13
Q

What can parainfluenzaviruses cause?

A

Rhinitis, pharyngitis, laryngitis, tracheitis.

Rarely bronchitis, bronchiolitis, pneumonia

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14
Q

What can H. influenzae cause?

A

Rhinitis, laryngitis, tracheitis, bronchitis, bronchiolitis, pneumonia

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15
Q

Frequent aetiological agents of the common cold

A 
Rhinovirus
Parainfluenzavirus
RSV
Enterovirus
Coronavirus
Human metapneumovirus
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16
Q

Immunity to rhinovirus

A

About 100 different serotypes.

Imperfect immunity

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17
Q

What can influenzavirus cause?

A 
Rhinitis
Pharyngitis
Laryngitis
Tracheitis
Bronchitis
Bronchiolitis
Pneumonia
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18
Q

What can pertissis cause?

A

Laryngitis, tracheitis, bronchitis, bronchiolitis, pneumonia

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19
Q

Effect of cold on resp tract infections

A

No effect on catching rhinovirus, but if you’re already infected can increase likelihood of pneumonia (cold air might inhibit mucociliary elevator)

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20
Q

What can RSV cause?

A

Rhinitis, bronchitis, bronchiolitis, pneumonia

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21
Q

Aetiological agents of pharyngitis/tonsilitis (with nasal involvement)

A

Adenovirus, enterovirus, parainfluenzavirus, influenzavirus

22
Q

When are tonsilectomies performed now?

A

Only when there is a chronic infection of the tonsils

23
Q

What does nasal involvement with an URT imply?

A

Often viral infection if there is nasal involvement

24
Q

Aetiological agents of pharyngitis/tonsilitis (without nasal involvement)

A

Adenovirus, enterovirus, reovirus, influenza.

S. pyogenes, Strep groups C and G

25
Proportion of URT caused by bacteria versus viruses
~10-20% are bacterial. | This is higher in children (~1/3 are bacterial in children)
26
Clinical criteria to distinguish between viral and bacterial URT
Age (children more likely to get bacterial infections) Rash (if rash is present, bacterial) Very hard to tell the difference normally.
27
Effect of treating patient with amoxycillin who has EBV
Rash, so can be labelled as allergic to penicillin. From mild toxicity. Only occurs with active EBV (no rash with latent)
28
Aetiological agents of sinusitis
Primary: Viral (part of common cold syndrome) Secondary: H. influenzae, S. pneumoniae
29
Secondary bacterial invasion of sinuses
After a viral infection, mucociliary elevator can be impaired. Normal commensal bacteria can invade sinuses (H. influenzae, S. pneumoniae
30
Common childhood URT infection
Otitis media (shorter, straighter otitis media)
31
Frequent aetiological agents of otitis media
Pneumococci, H. influenzae, Moraxella catarrhalis.
32
Common cause of otitis media
Secondary bacterial infection with commensal flora
33
Frequent aetiological agent of epiglottitis
H. influenzae type B (not so much anymore, as there is a good HiB vaccine)
34
Important URTs to be able to distinguish between
Croup and epiglottitis. | Croup is harmless, epiglottitis is potentially lethal
35
Which aspect of a URT viral infection impairs mucociliary elevator?
Virus lyses infected epithelial cells, which are ciliated.
36
Visual symptom of otitis media
Bulging, inflamed tympanic membrane
37
URTIs which are good to diagnose with lab
Pharyngitis/tonsillitis if possible | Epiglottitis whenever possible (epiglottitis is rare)
38
URTIs what don't need a lab diagnosis
``` Common cold. Sinusitis (seldom necessary) Otitis media (seldom necessary) Croup (seldom necessary) ```
39
How to diagnose epiglottitis
Without touching epiglottis. Epiglottis is very inflamed in epiglottitis, and touching it makes it worse, increases risk of suffocation. Diagnose radiologically and with a blood culture (it is a systemic infection)
40
What does presence of follicles in tonsillitis tell you?
Nothing.
41
Appearance of mononucleosis in someone's mouth
White membrane over pharynx
42
What's the cause of herpangina
Coxsackievirus. | NOT herpesvirus.
43
Cause of hand, foot and mouth disease
Enterovirus (Coxsackievirus A16)
44
Most important enterovirus
Poliovirus
45
URTI treatment
Mostly supportive
46
Why shouldn't you give aspirin with a cold?
Aspirin is slightly immunosuppressive, increases risk of transmission
47
When is pharyngitis/tonsillitis treated?
When bacterial. Treat to prevent complications
48
Examples of possible complications with group A Strep pharyngitis/tonsillitis
Invasive complications with group A strep Quinsy (peritonsillar abscess) Autoimmune complications (rheumatic endocarditis)
49
Susceptibility of group A strep
100% susceptibility to penicillin G (no sign of developing resistance)
50
When is sinusitis treated?
If very severe
51
When is otitis media treated?
In under two years old, of if infection is prolonged and severe.
52
When is epiglottitis treated?
Always

1Principles of Biomedicine - MD1 (157 decks)

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