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IBI Test 2 Leesy > B3.030 - Upper Respiratory Infections > Flashcards

B3.030 - Upper Respiratory Infections Flashcards

1
Q

Describe where S. pyogenes is on the tree

A

Gram +
Catalase -
Aerobic +
Beta hemolytic

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2
Q

Describe where Corynebacterium are on the tree

A

Gram + Bacilli

Aerobic +

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3
Q

Describe where Moraxella are on the tree

A

Gram - Cocci

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4
Q

Describe where Bordatella are on the tree

A

Gram - bacilli
Growth on McConkey -
Oxygen tolerance +

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5
Q

What are the primary host of GAS

A

humans

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6
Q

How is S. pyogenes transmitted

A

respiratory droplets

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7
Q

How does S. pyogenes infect

A

Low inoculum, invaves mucous membranes

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8
Q

What diseases does GAS cause in the respiratory tract

A

Strep

Pharyngitis

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9
Q

What does GAS cause in the skin

A

Impetigo
Erysipelas/Cellulitis
Necrotizing fasciitis

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10
Q

What does GAS cause systemically

A

Bacteremia
Rheumatic fever
Acute glomerulonephritis
Strep Toxic Shock Syndrome

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11
Q

What is the most common bacterial infection of the throat

A

Acute streptococcal pharyngitis

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12
Q

Strep pharyngitis is hard to differentiate from what

A

viral pharyngtitis

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13
Q

How long does Strep pyogens persist without treatment

A

1-4 weeks

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14
Q

How is strep pharyngitis treated

A

penicillins

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15
Q

What is scarlet fever a complication of

A

GAS pharyngitis

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16
Q

What produces scarlet fever

A

Spe A and SpeC

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17
Q

Describe the chest rash caused by scarlet fever

A

sand paper like

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18
Q

what are symptoms of scarlet fever

A

Diffuse rash on chest
Raw strawberry tongue
Circumoral pallor

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19
Q

What are GAS virulence factors that help it early in disease process

A

Adhesins (M protein) >160 serotypes

Hyalonuric acid capsule prevents phagocytosis

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20
Q

What are later GAS virulence factors

A

SLO
Hyaluronidase
Spe
Streptokinases

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21
Q

What is SLO

A

pore forming toxin that lyses target cells

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22
Q

What is Spe

A

Key in superantigen infections
Scarlet fever
Toxic shock syndrome

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23
Q

What do streptokinases do

A

activate plasminogen to dissolve clots

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24
Q

how is Strep pyogenes treated

A

Penicillins

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25
Q

How is the strep throat treated

A

amoxacillin

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26
Q

How is the cellulitis treated

A

Penicillin with ceftriaxone

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27
Q

How is bacteremia due to GAS treated

A

Penecillin and clindomycin (suppresses toxin production

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28
Q

Recurrent disease/ treatment failure of GAS is due to

A

Reinfection

Colonization with different bacteria that produce beta lactamase

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29
Q

How is strep diagnosed

A

RADT detecting Group A capsule antigen

Culture if RADT is negative bc its more sensitive

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30
Q

Describe Corynebacterium diptheriae

A 
Gram + rod
non motile
aerobic
Club shaped 
V and L shaped arrangments
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31
Q

How is are the club shaped granules visualized

A

using Loffler medium

32
Q

describe the diphtheria toxin

A

A-B exotoxin

33
Q

The B subunit targets what

A

Upper respiratory tract
Heart
Nerve cells

34
Q

What causes a shutdown of protein synthesis in diptheria

A

a subunit ADP ribosylates elongation factor

35
Q

What is the inactive form of toxin called and what is it used for

A

toxoid, for DTaP vaccine

36
Q

What is caused in the throat by diphtheria

A

psuedomembranous pharyngitis

37
Q

What is the <1 week activity of diphtheria toxin

A

incubation and colonization of pharyngeal epithelial cells

38
Q

What happens upon diphtheria toxin release

A

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

39
Q

What is characteristic of pseudomembranous pharyngitis

A

grayish pseudomembrane

40
Q

what are is the grayish pseudomembrane made of in diphtheria

A 
bacteria
lymphocytes
plasma cells
fibirn
dead cells
41
Q

what are complications of the grayish pseudomembrane caused by diphtheria

A

asphyxiation

hard to dislodge without bleeding

42
Q

what is bull neck associated with

A

diphtheria causing cervical adenitis and edema

43
Q

what are more serious complications of respiratory diphtheria

A

myocarditis

neuropathies

44
Q

What is cutaneous diphtheria

A

papule –> non healing ulcer with grayish membrane –> systemic disease due to toxin spread

45
Q

how is diphtheria diagnosed

A

Tellurite containing differential
Chocolate agar
Elek test
PCR by CDC

46
Q

What is the chocolate agar used for

A

inhibits other respiratory tract bacteria, is reduced causing black pigment

47
Q

what is an elek test

A

demostration of toxin by agar diffusion with antitoxin

48
Q

What is the toxin treated with in DTap

A

Formalin

49
Q

when is the DTap and Tdap vaccine reccommended

A

2,4.6.15.18mo, 4-6 years

Boosters every 10 years

50
Q

how is diptheria treated

A

immediate administration of antitoxin
DOC:
Erythromycin or penecillin

51
Q

does a diphtheria infection create antibodies to it

A

no

52
Q

Where is moraxella commesal to

A

nasopharynx

53
Q

clinical presentation of moraxella

A

otitis media
sinusitis
laryngitis

54
Q

Clinical presentation of moraxella with underlying chronic lung disease

A

bronchitis

pneumonia

55
Q

describe moraxella

A

gram - small coccobacilli

Dipmococcus

56
Q

describe the transmission of moraxella

A

direct contact with contaminated secretions

respiratory droplets

57
Q

what do the pili and fimbriae of moraxella help with

A

adhesion

58
Q

what endotoxin does moraxella have

A

LPS

59
Q

What are the more serious clinical presentations of moraxella

A

endocarditis

60
Q

how is moraxella diagnosed

A

look like neisseria on gram stain

pink brown coloration of colonies on chocolate agar, not apparent on blood agar

61
Q

why is moraxella asaccharolytic

A

does not produce acid from glucose, maltose, lactose or sucrose

62
Q

what is the treatment of moraxella

A

penecillin with beta lactamase inhibitor

63
Q

moraxella are universally susceptible to what

A

all other antibiotics used for respiratory therapy

64
Q

describe bordetella

A

strictly aerobic non fermenting

small gram - bacilli/coccobacilli

65
Q

what does bordetella cause

A

whooping cough

66
Q

what adhesins does bordetella use

A

Fha
Pertactin
promote binding to ciliated epithelial cells, PMNs

67
Q

What is the bordetella toxin

A

AB5

B subunits bind ot glycolipidson cilliated respiratrory cells or phagocytes

68
Q

what does the A subunit of the bordetella toxin do

A

ADP ribosylates Gi to increase cAMP levels

69
Q

what are the 3 stages of bordetella

A
  1. catarrhal - highly infectious
  2. paroxymal 0 1-6 wks whooping cough v exhausting
  3. convalescent 0 susceptible to other resp infections
70
Q

how is bordetella transmitted

A

respiratory droplets

71
Q

what is the DTap Vaccine cotained of

A 
purified proteins
Pertussus toxoid
Fha
fimbriae
pertactin
72
Q

what do the letters in Tdap stand for

A

Tetanus toxoid
reduced diphtheria
acellular pertussis

73
Q

what are the current Tdap recommendations

A 
DTap: 2,4,5,15-18 mo, 4-5 years
Single does of Tdap therafter 
7-10 years if not fully vaccinated
11-18 years if not immunized
19-65 years if not already immunized
74
Q

treatment of pertussis

A

macrolides in early stages
prophylaxis macrolides as well
supportive measure after paroxysmal stage

75
Q

how is pertussis diagnosed

A 
culture in special transport medium
nasopharingeal swab/aspirate during catarrhal stage
speacial growth on Regan-Lowe
DFA
PCR
serology for paroxixmal/convalescent

IBI Test 2 Leesy (13 decks)

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