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IBI Test 2 > B3-030 CBCL URTI > Flashcards

B3-030 CBCL URTI Flashcards

1
Q

nasopharyngitis is typically caused by

A

rhinovirus

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2
Q

pharyngitis is typically caused by

A

GAS, C. diphtheriae

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3
Q

rhinosinusitis is typically caused by

A

M. catarrhalis

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4
Q

epiglottitis is typically caused by

A

M. catarrhalis, H. flu

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5
Q

lanryngotracheitis is caused by

A

B. pertussis, C. diphteriae, M. catarrhalis

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6
Q

Gram positive, aerobic bacilli

A

Corynebacterium

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7
Q

Gram +, B-hemolytic

A

GAS

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8
Q

Gram - cocci

A

moraxella

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9
Q

gram - bacilli
- growth on MacConkey
aerobic

A

bordetella

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10
Q

Streptococcus is serotyped via

A

Lancefield typing

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11
Q

Beta hemolytic streptococci

A

S. pyogenes (GAS)
S. agalactiae (GBS)

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12
Q

alpha hemolytic streptococci

A

Viridians
S. pneumoniae

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13
Q

gamma hemolytic streptococci

A

enterococcus

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14
Q

S. pyogenes is spread via

A

direct contact or respiratory droplets

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15
Q

a _________ inoculum leads to S. pyogenes infection

A

low

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16
Q

S. pyogenes invades

A

the mucous membranes

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17
Q

respiratory diseases caused by GAS

A

strep
pharyngitis

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18
Q

skin diseases caused by GAS

A

impetigo
erysipelas/cellulitis (dermis)
necrotizing faciitis (subq)

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19
Q

systemic infections caused by GAS

A

bacteremia
rheumatic fever
acute glomerulonephritis
TSS

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20
Q

most common bacterial infection of the throat

A

S. pyogenes

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21
Q

S pyogenes is _______ to differentiate from viral pharyngitis

A

difficult

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22
Q

without treatment, how long will S. pyogenes persist?

A

1-4 weeks

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23
Q

DOC: S. pyogenes

A

penicillins

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24
Q

Scarlet fever is caused by

A

SpeA/C exotoxins

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25
Q

sand paper rash
strawberry tongue
circumoral pallor

A

scarlet fever

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26
Q

scarlet fever can lead to

A

rheumatic fever or glomerulonephritis

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27
Q

impetigo usually occurs in

A

young kids (2-5)

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28
Q

raised, bright red plaques with sharply defined borders

A

erysipelas

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29
Q

TSS can progress to nec fas within

A

24 hours

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30
Q

adhesin virulence factor for S. pyogenes

A

M protein (>160 serotypes)

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31
Q

S. pyogenes possesses a _____________ capsule

A

hyaluronic acid

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32
Q

is the hyaluronic capsule of S. pyogenes antigenic?

A

No

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33
Q

Streptolysin O

A

pore forming toxin, lyses target cells

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34
Q

hyaluronidase is often ___________ in S. pyogenes

A

mutated/inactivated

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35
Q

Spe is a _________ that causes Scarlet fever and TSS

A

superantigen

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36
Q

streptokinases

A

activate plasminogen to dissolve clots

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37
Q

all isolates of S. pyogenes are susceptible to

A

penicillin

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38
Q

DOC strep throat

A

amoxicillin

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39
Q

DOC strep cellulitis

A

penicillin, ceftriaxone

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40
Q

DOC: strep bacteremia/TSS

A

penicillin + clindamycin (suppresses toxin production)

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41
Q

treatment failure of S. pyogenes is due to

A

re-infection
or colonization with a different bacteria that produce beta lactamase (S. aureus)

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42
Q

how to differentiate strep from viral pharyngitis

A

rapid antigen detection test
for group A capsule antigen

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43
Q

if the RADT is negative….

A

culture on SBA

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44
Q

club shaped with “volutin” granules

A

C. diphtheriae

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45
Q

grown on Loffler medium

A

C. diphtheriae

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46
Q

V and L shaped arrangments

A

C. diphtheriae

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47
Q

Diphtheriae toxin is an

A

AB exotoxin

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48
Q

the B subunit of Diphtheriae toxin targets

A

upper respiratory tract
heart
nerve cells

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49
Q

the A subunit of diphtheriae toxin

A

ADP ribosylates EF-2, shutting down protein synthesis

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50
Q

the C. diphtheriae vaccine is a _________ vaccine

A

toxoid

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51
Q

C. diphtheriae vaccine

A

DTap, Td, Tdap

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52
Q

pseudomembranous pharyngitis is cause by

A

C. diphtheriae

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53
Q

sudden onset of malaise, sore throat, low grade fever, exudative pharyngitis

A

C. diphtheriae

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54
Q

grayish pseudomembrane that can lead to asphyxiation

A

C. diphtheriae

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55
Q

“bull neck” cervical lymphadenopathy

A

C. diphtheriae

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56
Q

complications of C. diphtheriae include

A

myocarditis, neuropathies

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57
Q

cutaneous C. diphtheriae causes a

A

non-healing ulcer with a grayish membrane

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58
Q

C. diphtheriae is grown on

A

tellurite containing chocolate agar

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59
Q

tellurite inhibits

A

other URT bacteria

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60
Q

tellurite is reduced by C. diphtheriae, leaving a

A

black pigment

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61
Q

demonstration of toxin by agar diffusion with antitoxin

A

elek test (C. diphtheriae)

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62
Q

treatment of C. diphtheriae

A

immediate administration of antitoxin

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63
Q

does infection with C. diphtheriae generate protective antibodies?

A

no

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64
Q

DOC C. diphtheriae

A

erythromycin or penicillin

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65
Q

boosters of C. diphtheriae are required

A

every 10 years

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66
Q

moraxella catarrhalis is commensal in the

A

nasopharynx

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67
Q

in otherwise healthy, M. catarrhalis causes

A

otitis media
sinusitis
laryngitis

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68
Q

in those with chronic lung disease, M catarrhalis causes

A

bronchitis
pneumonia

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69
Q

small, gram negative coccobacilli in diplococci

A

M. catarrhalis

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70
Q

transmission: M. catarrhalis

A

direct contact, respiratory droplet

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71
Q

adhesins: M catarrhalis

A

pili/fimbriae

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72
Q

endotoxin: M catarrhalis

A

LPS

73
Q

3rd most common cause of otitis media and sinusitis

A

M catarrhalis

74
Q

M. catarrhalis can cause _______ as a complication of balloon angioplasty

A

endocarditis

75
Q

risk factors for M. catarrhalis infection

A

immunodeficiency and chronic respiratory conditions

76
Q

M. catarrhalis looks just like ________ on gram stain

A

neisseria

77
Q

pink-brown coloration of colonies on chocolate agar

A

M. catarrhalis

78
Q

asaccharolytic

A

M. catarrhalis

79
Q

M catarrhalis treatment

A

> 95% penicilin resistant!
use with B lactamase inhibitor

80
Q

M catarrhalis is univerally susceptible to

A

all other antibiotics used for respiratory therapy

81
Q

B. pertussis causes

A

whooping cough

82
Q

B. pertussis binds to

A

ciliated epithelials cells and PMNs

83
Q

adhesins: B pertussis

A

filamentous hemagglutinin (Fha)
pertactin

84
Q

pertussis toxin B subunit

A

binds to glycolipids on ciliated respiratory cells or phagocytes

85
Q

pertussis toxin A subunit

A

ADP ribosylates Gi to increase cAMP levels

86
Q

increased cAMP from the pertussis toxin causes

A

increased respiratory secretion and mucus production —> paroxysmal cough

87
Q

pertussis is highly infectious in the

A

catarrhal stage

88
Q

transmission: B. pertussis

A

respiratory droplets

89
Q

pertussis is mainly seen in children

A

<1

90
Q

pertussis can be seen in adults/adolescents due to

A

waning immunity

**can have classic pertussis or just mild respiratory disease

91
Q

the pertussis vaccine is

A

acellular

92
Q

the pertussis vaccine contain

A

purified proteins

pertussis toxiod, Fha, fimbriae, pertactin

93
Q

DTap is administered

A

under 5

94
Q

Tdap is administered

A

single dose

7-65 years of age

95
Q

macrolides are effective against pertussis in the

A

catarrhal stage

96
Q

three stages of pertussis

A

catarrhal
paroxysmal
convalescent

97
Q

treatment for pertussis after the paroxysmal stage

A

supportive

98
Q

prophylaxis can be administered to close contacts of

A

pertussis

99
Q

pertussis requires a ________ for culture

A

special transport medium

100
Q

B. pertussis can be cultured using a nasopharyngeal swab during the

A

catarrhal stage

101
Q

growth medium for B. pertussis

A

regan-lowe

102
Q

B. pertussis can be diagnosed via PCR or serology in the

A

catarrhal/early paroxysmal stage

103
Q

symptoms of URTI

A

congestion, rhinorrhea, sore throat, cough, fever, fatigue

104
Q

transmission URTI

A

typically contact with RT secretions, incubate 24-72 hrs

105
Q

common, undifferentiated syndrome that is typically benign/self-limiting lasting several to 10 day of the nose, sinuses, pharynx, larynx

A

URTI

106
Q

infection of the bronchi, bronchioles, lung parenchyma

A

LRTI

107
Q

inflammation or infection of bronchi

A

bronchitis

108
Q

inflammation of lung parenchyma with alveolar infiltrate

A

pneumonia

109
Q

transmission: LRTIs

A

mucous membranes, inhalation

110
Q

symptoms: LRTIs

A

cough, shortness of breath, fever

111
Q

RVP

A

respiratory panel

nasal washing and swab

112
Q

adenovirus is [genetic material]

A

dsDNA

113
Q

is adenovirus enveloped

A

no

114
Q

adenovirus is acid

A

stable

115
Q

adenovirus can remain infectious at room air for

A

3 weeks

116
Q

transmission: adenovirus

A

person to person
water
fomites
intruments

117
Q

adenovirus is _______ in the pediatric population

A

endemic

118
Q

symptoms: adenovirus

A

pharyngitis
acute respiratory disease in military recruits
pneumonia
pertussis-like

119
Q

prevention: adenovirus

A

hand hygiene

120
Q

treatment: adenovirus

A

self limiting

cidofovir in immunosuppressed

121
Q

is there a vaccine for adenovirus?

A

yes-available for military recruits

122
Q

metapneumovirus is [genetic material]

A

ss -sense RNA

123
Q

hMPV is transmitted via

A

droplet, fomite

124
Q

hMPV infects

A

type 2 alveolar and bronchiolar cells

125
Q

hMPV is characterized by

A

alveolar and interstitial inflammation in lungs

126
Q

symptoms: hMPV

A

fever, myalgia, rhinorrhea, cough, SOB

127
Q

rhinovirus is a member of the

A

picornavirus family

128
Q

rhinovirus genetic material

A

ss +sense RNA virus

129
Q

implicated in 1/3-1/2 of all colds

A

rhinovirus

130
Q

> 100 serotypes

A

rhinovirus

131
Q

symptoms: rhinovirus

A

rhinorrhea, congestion, cough, scratchy throat, persists 5-7 days

132
Q

rhinovirus can cause the common cold but also

A

otitis media and trigger asthma

133
Q

treatment: rhinovirus, hMPV, common coronvirus

A

supportive
analgesics
antihistamines/decongestants
intranasal cromolyn sodium
intranasal ipratropium

134
Q

parainfluenza has ____ main serotypes

A

4

135
Q

parainfluenza reinfection is

A

common

136
Q

can cause severe disease in hematopoietic stem cell transplants and SOT recipients

A

parainfluenza

137
Q

parainfluenza infects

A

ciliated epithelial cells

138
Q

cause croup, bronchiolitis, pneumonia

A

parainfluenza

139
Q

treatment: croup

A

supportive

140
Q

treatment of parainfluenza in immunocompromised

A

steroids

141
Q

RSV genetic material

A

ss - sense RNA virus

142
Q

is RSV enveloped?

A

yes

143
Q

RSV has two subgroups (A and B) that can

A

circulate at any one time causing an epidemic

144
Q

serious disease in newborns and immunocompromised

A

RSV

145
Q

otitis, croup, bronchiolitis, pneumonia, asthma exacerbation in peds

A

RSV

146
Q

URI fever, sinusitis, asthma, otitis, acute exacerbation of chronic bronchitis, 4% of adult pneumonias

in healthy adults

A

RSV

147
Q

RSV is diagnosed via

A

PCR

148
Q

RSV treatment: healthy people

A

supportive

149
Q

ribavirin aerosolized can treat

A

adults with RSV

150
Q

palivizumab is used for

A

prophylaxis of RSV in at risk newborns

151
Q

“gold standard” for diagnosis of URTI

A

isolation of virus in tissue culture

152
Q

coronavirus genetic material

A

positive sense RNA

153
Q

is coronavirus enveloped?

A

yes

154
Q

alpha coronaviruses cause

A

common cold

155
Q

beta coronaviruses cause

A

MERS
SARS-1
SARS-2

156
Q

MERS-CoV

A

middle east respiratory syndrome identified 2012

157
Q

MERS is transmitted from

A

camels

158
Q

case definition: MERS

A

febrile respiratory illness with radiographic confirmation of ARDS or pneumonia
AND
link with confirmed MERS case or area of endemic

159
Q

treatment: MERS

A

maybe ribavirin

160
Q

prevention: MERS

A

avoid camels :)

hand hygiene
airborne and contact precautions

161
Q

SARS-CoV

A

severe acute respiratory disease identified china 2003

162
Q

SARS-CoV case definition

A

fever
AND
1 or more respiratory symptoms
AND
radiographic evidence of ARDS
AND
no alternate diagnosis
WITH
diagnostic test x2

163
Q

SARS-CoV-2

A

betacoronavirus identified 2019 in china

164
Q

S glycoprotein

A

allows COVID to bind to ACE-2 for viral entry

165
Q

transmission: covid

A

large respiratory droplets, maybe airborne

166
Q

____________ is an important cause of spread of Covid

A

asymptomatic spread

167
Q

covid ranges from

A

mild to severe disease

168
Q

increased risk for severe disease from covid

A

CVD, DM, HTN, lung disease, cancer, CKD, obesity, immunocompromised

169
Q

later imaging of covid shows

A

ground glass infiltrates, pleural thickening, septal thickening

170
Q

poor outcomes from covid can be associated with particular labs

A

elevated LDH, CRP, ferritin, D-dimer, LFTs, etc

171
Q

covid prevention

A

mask, social distancing, handwashing, quarantine

172
Q

covid mrna vaccination

A

pfrizer, moderna

173
Q

covid adenovirus vector vaccine

A

J&J

174
Q

investigational therapy: covid

A

monoclonal antibodies

175
Q

shown to benefit covid treatment

A

dexamethasone
anticoagulation

176
Q

studies show some benefit in covid treatment

A

remdesivir
JAK inhibitors

177
Q

MERS is associated with a

A

high case fatality

178
Q

SAR-CoV-1 did not circulate due to

A

stringent public health efforts

179
Q

treatment of covid: most effective to least

A

prevent>monoclonal ab> remdesivir+steroids+anticoagulants

IBI Test 2 (14 decks)

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