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IBI Test 2 > B3-030 - URTI > Flashcards

B3-030 - URTI Flashcards

1
Q

Nasopharyngitis

A

Inflamed nasal and pharyngal passages.
Rhinoviruses: 30-50% chance cause of colds
Also caused by coronaviruses, enteroviruses, adenoviruses, ortho/paramyxoviruses, RSV,mHPV, EBC, bocavirus

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2
Q

Pharyngitis

A

Common “sore throat”
Viral: adenovirus, Influenza viruses, Coxsackie, HSV, EBV, CMV
Bacterial: Group A strep (GAS: sequelae), GCS/GGS, N. gonorrhoeae, C. diphtheria, atypical pneumonia bacteria

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3
Q

Rhinosinusitis

A

Inflammation of nasal mucus membranes
Viral: Rhinovirus, enterovirus, coronavirus, influenze, parainfluenza, RSV, Adenovirus
Bacterial: S. pneumonia, H. Influenza, M. catarrhalis, S. aureas

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4
Q

Epiglottitis

A

Inflammation of the base of tongue
Entirely bacterial: H. influenza type b (Hib), GAS s. pneumonia, M. catarrhalis

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5
Q

Laryngotracheitis

A

An upper airway infection that blocks breathing and has a distinctive barking cough.
Croup: parainfluenza
Whooping cough: B. pertussis
Other bacteria: GAS, C. diphtheria, C. pneumonia, M. pneumonia, M. catarrhalis, H. Influenza

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6
Q

Which branch of the bacterial tree of life does Moraxella fall on?

A

Gram - cocci

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7
Q

Which branch of the bacterial tree of life does Bordetella fall on?

A

Fastidios, gram - rod

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8
Q

Which branch of the bacterial tree of life does Corynbacterium fall on?

A

Acid-fast, gram + rod

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9
Q

Which branch of the bacterial tree of life does Streptococcus fall on?

A

Gram + cocci

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10
Q

Lancefield method

A

Serology typing via surface carbohydrates
Group A/B strep

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11
Q

Group A streptococci (GAS)

A

S. pyogenes, strep throat
Beta-hemolytic

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12
Q

Group B streptococci (GBS)

A

S. agalactiae. Neonatal infections, bacteremia
Beta. hemolytic

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13
Q

Alpha hemolytic streptococcal species

A

Viridians streptococci: S. mutans (dental carries, endocarditis
Strep. pneumonia: pneumonia, otitis, meningitis

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14
Q

Gamma hemolytic streptococcal species

A

Entercoccus

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15
Q

GAS S. pyogenes host

A

Humans are primary host

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16
Q

GAS S. pyogenes transmission

A

Direct contact or respiratory droplets (sneezing and coughing)

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17
Q

(Low or High) inoculum can lead to S. pyogenes infection

A

Low

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18
Q

GAS S. pyogenes invades ______ of new host

A

Mucus mucous membranes

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19
Q

GAS S. pyogenes diseases of Respiratory tract

A

Strep throat and pharyngitis

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20
Q

GAS S. pyogenes diseases of skin

A

Impetigo, Erysipelas/cellulitis (infection of dermis), Necrotizing fasciitis (infection of subcutaneous tissue)

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21
Q

GAS S. pyogenes systemic disease

A

Bacteriemia, Rheumatic fever, acute glomerularnephritis, streptococcal toxic shock syndrome

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22
Q

Most common cause of bacterial infection of the throat

A

GAS S. pyogenes
Difficult to differentiate form viral pharyngitis

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23
Q

__% of people are asymptomatic carriers of GAS S. pyogenes

A

5%

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24
Q

Treatment for Acute streptococcal pharyngitis

A

Pens, 30% are resistant to macrolides

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25
Q

Scarlet fever

A

Complication of GAS pharyngitis
Infecting strain makes SpeA/SpeC exotoxins
Diffuse “sand paper” rash on chest
Raw, strawberry tongue, desquamation
Circumoral pallor (pale skin around mouth)
Can lead to rheumatic fever or glomerularnephritis

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26
Q

GAS Virulence Factors

A

Adhesions:
- M protein: >160 serotypes
- Protein F: binds fibronectin
Lipoteichoic acid (LTA)

Hylauronic acid capsule:
- Makes GAS look like host
- Often inactivates hyalyronidase

Streptolysin O (SLO):
- Pore forming toxin, lyses target cells

Streptococcus pyrogenic exotoxin (Spe):
- Superantigen. Cause of scarlet fever and TSS

Streptokinase:
- activate plasminogen to dissolve clots

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27
Q

Treatment for GAS pharyngitis

A

Strep throat: Amoxicillin
Cellulitis: pens, ceftriazone
Bacteriemia/TSS: Pens + clindamycin

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28
Q

GAS do not produce _____

A

Beta-lactamase

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29
Q

How many cases of “strep throat” turn out to be viral pharyngitis?

A

70-85%

30
Q

Strep Test: Rapid Antigen detection test (RADT) look for ____

A

Group A capsule antigen

31
Q

If RADT is negative, what is the next step

A

Culture on Sheep’s blood agar (more sensitive to ensure the negative wasn’t a false negative)

32
Q

Characteristics of Corynebacterium

A

Related to Nodarcia and Mycobaterium
Gram postive rod
Non-motile, aerobic
Club shaped on Loftier medium
V&L shaped arrangements

33
Q

C. diptheriae is ____ toxic and _____ invasive

A

highly; poorly

34
Q

Diphtheria Toxin B targets

A

Upper resp. Tract
Heart
Nerve cells

35
Q

Diphtheria Toxin A role

A

Subunit of ADP-ribosylates elongation factor
Shuts down protein synthesis

36
Q

What does the diphtheria vaccine consist of?

A

Toxoid (inactivated toxin)
the D in DTaP, Td, and Tdap tests.
(Capital letter means higher dose)

37
Q

Respiratory Diptheria

A

Pseudomembranous Pharyngitis
- Less than 1 week incubation (colonization of pharyngal epithelial cells
Toxin secretion: sudden onset of malasia, sore throat, low-grade fever, exudative pharyngitis
Grayish psudomembrane and Bull neck

38
Q

Grayish psudomembrane

A

Bacteria, lymphocytes, plasma cells, fibrin, dead cells
- hard to dislodge without bleeding
May lead to asphyxiation

39
Q

Complications of respiratory diptheria

A

Myocarditis, neuopathies

40
Q

Cutaneous Diphtheria

A

Skin contact with infected persons
Papule -> non-healing ulcer (with grayish membrane)
Systemic disease due to exotoxin spread

41
Q

Lab diagnosis of C. diphtheria

A

Growth on Tellurite-containing Chocolate agar (inhibits other bacteria)
-Chocolate Agar (laded RBC) is reduced by C. dip and produces black pigment colonies

42
Q

Elek test

A

Demonstration of toxin from C. diphtheria by agar diffusion with antitoxin

43
Q

True of False: PCR can be used to detect C. diphtheria

A

True

44
Q

Prevention/Treatment of C. Diphtheria

A

Vaccination : DTaP with booster every 10 years
Immediate use of antitoxin
DOC: erythromycin or pens

45
Q

Infection of C. diphtheria does not generate _________

A

protective antibodies

46
Q

Where is C. diphtheria endemic

A

Asia, Africa, South America, Haiti, Dominican Republic

47
Q

Monospot test for C. diphtheria will come back

A

negative

48
Q

C. jeikeium

A

Nosocomial skin opportunist
Risk factors: extended hospital stay, antimicrobial therapy, chemotherapy, IV Cath
MDR
Treat with Vancomycin

49
Q

C. urealyticum

A

endogenous UTI pathogen
Urease producer - renal stones
Risk factors: immune suppression, Abx
MDR
Treat with Vancomycin

50
Q

Where is Moraxella catarrhalis found

A

Commensal organism found in the nasopharynx

51
Q

Clinical presentation of Moraxella catarrhalis

A

Healthy individual: OM, sinusitis, Laryngitis
Underlying lung disease: Bronchitis, pneumonia

52
Q

Moraxella catarrhalis Micro-Characteristics

A

Non-motile, Non-fermentative, oxidase +, gram negative
Diplococcus

53
Q

Moraxella catarrhalis Pathogenesis

A

DIrect contact with contaminated secretion (snot) or respiratory droplets
Pili/Fimbriae: adhesion
Endotoxin (LPS)

54
Q

Clinical presentation of Moraxella catarrhalis

A

3rd most common cause of OM, sinusitis
Endocarditis
Risk factors: immunodeficiency, chronic respiratory conditions (COPD, SLE, CF)

55
Q

Moraxella catarrhalis Lab diagnosis

A

Looks just like Nisseria on Gram stain
Pink-brown color on chocolate agar
Does not ferment!!!

56
Q

Moraxella catarrhalis Treatment

A

> 95% resistant to pens (has a B-lactamase) so use Pen + b-lac inhibitor
Can also use macrolides, Fluoroquinolones, tetracyclines
Unable to test for susceptibility

57
Q

Bordetella Micro-characteristics

A

Very small gram negative bacilli, strictly aerobic, non-fermentative

58
Q

Human pathogen of Bordetella

A

B. pertussis (Whooping cough)

59
Q

B. parapertussis

A

mild form of pertussis

60
Q

Bordetella Adhesions and Toxins

A

Adhesions: filamentous hemagglutinin (Fha)
Pertactin

Toxins:
B: binds to glycolipids in ciliated resp cells
A: increase cAMP levels

61
Q

B. pertussis pathogenesis

A
  1. Infection via aerosols
  2. Adhesion to ciliated epi (Fha)
  3. Toxin production - increased cAMP
  4. Inhibits ciliary movement, extrusion of ciliated cells (increased resp secretion and mucus production)
  5. Paroxysmal cough (whooping)
62
Q

Catarrhal stage of B. pertussis

A

Highly infectious
1-2 weeks

63
Q

Paroxysmal stage of B. pertussis

A

Whooping cough
1-6 weeks (can last up to 10 weeks)

64
Q

Convalescent stage of B. Pertussis

A

Susceptible to other infections
2-3 weeks
Recovery is gradual. Coughing lesses but firs of coughing may return

65
Q

B. pertussis epidemiology

A

Humans are the only reservoir (30% carriers)
Transmitted via resp droplets
Mainly pediatric (less than 1 yr)

66
Q

B. pertussis vaccine

A

DtaP (aP = acelular pertussis)
Contains verified proteins of adhesion molecules and toxoid)
Also found in Tdap. Single dose of Tdap after DTaP rounds.

67
Q

Pertussis treatment

A

Macrolides are effective in early stages
PPX for close contacts for 14 days, no matter age or vaccination status
Supportive measures after paroxysmal stage

68
Q

Pertussis Lab

A

Culture: sensitive to drying (either special transport medium to immediate inoculation)
Nasal swap only works for Catarrhal stage (after that, disease is toxin driven)
Growth on Regan-Lowe
DFA - insensitive
PCR: catarrhal/early paroxysmal
Serology: paroxysmal, convalescent

69
Q

Flu vs Covid: Symptoms

A

Both: fever, chills, headache, myalgia, anorexia, cough

Covid only: shortness of breath, loss of smell/taste, nausea, diarrhea

70
Q

Flu vs Covid: Incubation

A

Flu: 1-4 days of illness, 2-5 days viral shedding

Covid: 2-14 days incubation, 2-6 weeks of illness, shedding ending around day 10

71
Q

Flu vs Covid: Transmission

A

Flu and Covid: large droplets mainly, possible fomites or small droplets

72
Q

Flu vs Covid: Complications

A

Both: Viral pneumonia, myocarditis, sepsis/shock

Flu: secondary bac pneumonia, croup, COPD exasperation

Covid: thrombosis/stroke, pulmonary fibrosis

IBI Test 2 (5 decks)

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