B3-030 CBCL URTI Flashcards
1
Q
nasopharyngitis is typically caused by
A
rhinovirus
2
Q
pharyngitis is typically caused by
A
GAS, C. diphtheriae
3
Q
rhinosinusitis is typically caused by
A
M. catarrhalis
4
Q
epiglottitis is typically caused by
A
M. catarrhalis, H. flu
5
Q
lanryngotracheitis is caused by
A
B. pertussis, C. diphteriae, M. catarrhalis
6
Q
Gram positive, aerobic bacilli
A
Corynebacterium
7
Q
Gram +, B-hemolytic
A
GAS
8
Q
Gram - cocci
A
moraxella
9
Q
gram - bacilli
- growth on MacConkey
aerobic
A
bordetella
10
Q
Streptococcus is serotyped via
A
Lancefield typing
11
Q
Beta hemolytic streptococci
A
S. pyogenes (GAS)
S. agalactiae (GBS)
12
Q
alpha hemolytic streptococci
A
Viridians
S. pneumoniae
13
Q
gamma hemolytic streptococci
A
enterococcus
14
Q
S. pyogenes is spread via
A
direct contact or respiratory droplets
15
Q
a _________ inoculum leads to S. pyogenes infection
A
low
16
Q
S. pyogenes invades
A
the mucous membranes
17
Q
respiratory diseases caused by GAS
A
strep
pharyngitis
18
Q
skin diseases caused by GAS
A
impetigo
erysipelas/cellulitis (dermis)
necrotizing faciitis (subq)
19
Q
systemic infections caused by GAS
A
bacteremia
rheumatic fever
acute glomerulonephritis
TSS
20
Q
most common bacterial infection of the throat
A
S. pyogenes
21
Q
S pyogenes is _______ to differentiate from viral pharyngitis
A
difficult
22
Q
without treatment, how long will S. pyogenes persist?
A
1-4 weeks
23
Q
DOC: S. pyogenes
A
penicillins
24
Q
Scarlet fever is caused by
A
SpeA/C exotoxins
25
sand paper rash
strawberry tongue
circumoral pallor
scarlet fever
26
scarlet fever can lead to
rheumatic fever or glomerulonephritis
27
impetigo usually occurs in
young kids (2-5)
28
raised, bright red plaques with sharply defined borders
erysipelas
29
TSS can progress to nec fas within
24 hours
30
adhesin virulence factor for S. pyogenes
M protein (>160 serotypes)
31
S. pyogenes possesses a _____________ capsule
hyaluronic acid
32
is the hyaluronic capsule of S. pyogenes antigenic?
No
33
Streptolysin O
pore forming toxin, lyses target cells
34
hyaluronidase is often ___________ in S. pyogenes
mutated/inactivated
35
Spe is a _________ that causes Scarlet fever and TSS
superantigen
36
streptokinases
activate plasminogen to dissolve clots
37
all isolates of S. pyogenes are susceptible to
penicillin
38
DOC strep throat
amoxicillin
39
DOC strep cellulitis
penicillin, ceftriaxone
40
DOC: strep bacteremia/TSS
penicillin + clindamycin (suppresses toxin production)
41
treatment failure of S. pyogenes is due to
re-infection
or colonization with a different bacteria that produce beta lactamase (S. aureus)
42
how to differentiate strep from viral pharyngitis
rapid antigen detection test
for group A capsule antigen
43
if the RADT is negative....
culture on SBA
44
club shaped with "volutin" granules
C. diphtheriae
45
grown on Loffler medium
C. diphtheriae
46
V and L shaped arrangments
C. diphtheriae
47
Diphtheriae toxin is an
AB exotoxin
48
the B subunit of Diphtheriae toxin targets
upper respiratory tract
heart
nerve cells
49
the A subunit of diphtheriae toxin
ADP ribosylates EF-2, shutting down protein synthesis
50
the C. diphtheriae vaccine is a _________ vaccine
toxoid
51
C. diphtheriae vaccine
DTap, Td, Tdap
52
pseudomembranous pharyngitis is cause by
C. diphtheriae
53
sudden onset of malaise, sore throat, low grade fever, exudative pharyngitis
C. diphtheriae
54
grayish pseudomembrane that can lead to asphyxiation
C. diphtheriae
55
"bull neck" cervical lymphadenopathy
C. diphtheriae
56
complications of C. diphtheriae include
myocarditis, neuropathies
57
cutaneous C. diphtheriae causes a
non-healing ulcer with a grayish membrane
58
C. diphtheriae is grown on
tellurite containing chocolate agar
59
tellurite inhibits
other URT bacteria
60
tellurite is reduced by C. diphtheriae, leaving a
black pigment
61
demonstration of toxin by agar diffusion with antitoxin
elek test (C. diphtheriae)
62
treatment of C. diphtheriae
immediate administration of antitoxin
63
does infection with C. diphtheriae generate protective antibodies?
no
64
DOC C. diphtheriae
erythromycin or penicillin
65
boosters of C. diphtheriae are required
every 10 years
66
moraxella catarrhalis is commensal in the
nasopharynx
67
in otherwise healthy, M. catarrhalis causes
otitis media
sinusitis
laryngitis
68
in those with chronic lung disease, M catarrhalis causes
bronchitis
pneumonia
69
small, gram negative coccobacilli in diplococci
M. catarrhalis
70
transmission: M. catarrhalis
direct contact, respiratory droplet
71
adhesins: M catarrhalis
pili/fimbriae
72
endotoxin: M catarrhalis
LPS
73
3rd most common cause of otitis media and sinusitis
M catarrhalis
74
M. catarrhalis can cause _______ as a complication of balloon angioplasty
endocarditis
75
risk factors for M. catarrhalis infection
immunodeficiency and chronic respiratory conditions
76
M. catarrhalis looks just like ________ on gram stain
neisseria
77
pink-brown coloration of colonies on chocolate agar
M. catarrhalis
78
asaccharolytic
M. catarrhalis
79
M catarrhalis treatment
>95% penicilin resistant!
use with B lactamase inhibitor
80
M catarrhalis is univerally susceptible to
all other antibiotics used for respiratory therapy
81
B. pertussis causes
whooping cough
82
B. pertussis binds to
ciliated epithelials cells and PMNs
83
adhesins: B pertussis
filamentous hemagglutinin (Fha)
pertactin
84
pertussis toxin B subunit
binds to glycolipids on ciliated respiratory cells or phagocytes
85
pertussis toxin A subunit
ADP ribosylates Gi to increase cAMP levels
86
increased cAMP from the pertussis toxin causes
increased respiratory secretion and mucus production ---> paroxysmal cough
87
pertussis is highly infectious in the
catarrhal stage
88
transmission: B. pertussis
respiratory droplets
89
pertussis is mainly seen in children
<1
90
pertussis can be seen in adults/adolescents due to
waning immunity
**can have classic pertussis or just mild respiratory disease
91
the pertussis vaccine is
acellular
92
the pertussis vaccine contain
purified proteins
pertussis toxiod, Fha, fimbriae, pertactin
93
DTap is administered
under 5
94
Tdap is administered
single dose
7-65 years of age
95
macrolides are effective against pertussis in the
catarrhal stage
96
three stages of pertussis
catarrhal
paroxysmal
convalescent
97
treatment for pertussis after the paroxysmal stage
supportive
98
prophylaxis can be administered to close contacts of
pertussis
99
pertussis requires a ________ for culture
special transport medium
100
B. pertussis can be cultured using a nasopharyngeal swab during the
catarrhal stage
101
growth medium for B. pertussis
regan-lowe
102
B. pertussis can be diagnosed via PCR or serology in the
catarrhal/early paroxysmal stage
103
symptoms of URTI
congestion, rhinorrhea, sore throat, cough, fever, fatigue
104
transmission URTI
typically contact with RT secretions, incubate 24-72 hrs
105
common, undifferentiated syndrome that is typically benign/self-limiting lasting several to 10 day of the nose, sinuses, pharynx, larynx
URTI
106
infection of the bronchi, bronchioles, lung parenchyma
LRTI
107
inflammation or infection of bronchi
bronchitis
108
inflammation of lung parenchyma with alveolar infiltrate
pneumonia
109
transmission: LRTIs
mucous membranes, inhalation
110
symptoms: LRTIs
cough, shortness of breath, fever
111
RVP
respiratory panel
nasal washing and swab
112
adenovirus is [genetic material]
dsDNA
113
is adenovirus enveloped
no
114
adenovirus is acid
stable
115
adenovirus can remain infectious at room air for
3 weeks
116
transmission: adenovirus
person to person
water
fomites
intruments
117
adenovirus is _______ in the pediatric population
endemic
118
symptoms: adenovirus
pharyngitis
acute respiratory disease in military recruits
pneumonia
pertussis-like
119
prevention: adenovirus
hand hygiene
120
treatment: adenovirus
self limiting
cidofovir in immunosuppressed
121
is there a vaccine for adenovirus?
yes-available for military recruits
122
metapneumovirus is [genetic material]
ss -sense RNA
123
hMPV is transmitted via
droplet, fomite
124
hMPV infects
type 2 alveolar and bronchiolar cells
125
hMPV is characterized by
alveolar and interstitial inflammation in lungs
126
symptoms: hMPV
fever, myalgia, rhinorrhea, cough, SOB
127
rhinovirus is a member of the
picornavirus family
128
rhinovirus genetic material
ss +sense RNA virus
129
implicated in 1/3-1/2 of all colds
rhinovirus
130
>100 serotypes
rhinovirus
131
symptoms: rhinovirus
rhinorrhea, congestion, cough, scratchy throat, persists 5-7 days
132
rhinovirus can cause the common cold but also
otitis media and trigger asthma
133
treatment: rhinovirus, hMPV, common coronvirus
supportive
analgesics
antihistamines/decongestants
intranasal cromolyn sodium
intranasal ipratropium
134
parainfluenza has ____ main serotypes
4
135
parainfluenza reinfection is
common
136
can cause severe disease in hematopoietic stem cell transplants and SOT recipients
parainfluenza
137
parainfluenza infects
ciliated epithelial cells
138
cause croup, bronchiolitis, pneumonia
parainfluenza
139
treatment: croup
supportive
140
treatment of parainfluenza in immunocompromised
steroids
141
RSV genetic material
ss - sense RNA virus
142
is RSV enveloped?
yes
143
RSV has two subgroups (A and B) that can
circulate at any one time causing an epidemic
144
serious disease in newborns and immunocompromised
RSV
145
otitis, croup, bronchiolitis, pneumonia, asthma exacerbation in peds
RSV
146
URI fever, sinusitis, asthma, otitis, acute exacerbation of chronic bronchitis, 4% of adult pneumonias
in healthy adults
RSV
147
RSV is diagnosed via
PCR
148
RSV treatment: healthy people
supportive
149
ribavirin aerosolized can treat
adults with RSV
150
palivizumab is used for
prophylaxis of RSV in at risk newborns
151
"gold standard" for diagnosis of URTI
isolation of virus in tissue culture
152
coronavirus genetic material
positive sense RNA
153
is coronavirus enveloped?
yes
154
alpha coronaviruses cause
common cold
155
beta coronaviruses cause
MERS
SARS-1
SARS-2
156
MERS-CoV
middle east respiratory syndrome identified 2012
157
MERS is transmitted from
camels
158
case definition: MERS
febrile respiratory illness with radiographic confirmation of ARDS or pneumonia
AND
link with confirmed MERS case or area of endemic
159
treatment: MERS
maybe ribavirin
160
prevention: MERS
avoid camels :)
hand hygiene
airborne and contact precautions
161
SARS-CoV
severe acute respiratory disease identified china 2003
162
SARS-CoV case definition
fever
AND
1 or more respiratory symptoms
AND
radiographic evidence of ARDS
AND
no alternate diagnosis
WITH
diagnostic test x2
163
SARS-CoV-2
betacoronavirus identified 2019 in china
164
S glycoprotein
allows COVID to bind to ACE-2 for viral entry
165
transmission: covid
large respiratory droplets, maybe airborne
166
____________ is an important cause of spread of Covid
asymptomatic spread
167
covid ranges from
mild to severe disease
168
increased risk for severe disease from covid
CVD, DM, HTN, lung disease, cancer, CKD, obesity, immunocompromised
169
later imaging of covid shows
ground glass infiltrates, pleural thickening, septal thickening
170
poor outcomes from covid can be associated with particular labs
elevated LDH, CRP, ferritin, D-dimer, LFTs, etc
171
covid prevention
mask, social distancing, handwashing, quarantine
172
covid mrna vaccination
pfrizer, moderna
173
covid adenovirus vector vaccine
J&J
174
investigational therapy: covid
monoclonal antibodies
175
shown to benefit covid treatment
dexamethasone
anticoagulation
176
studies show some benefit in covid treatment
remdesivir
JAK inhibitors
177
MERS is associated with a
high case fatality
178
SAR-CoV-1 did not circulate due to
stringent public health efforts
179
treatment of covid: most effective to least
prevent>monoclonal ab> remdesivir+steroids+anticoagulants
