Ch 22 Respiratory Infections Flashcards
What is the Respiratory System divided into?
The Lower + Upper Respiratory System
Collects air, filters dust, pollen, microbes and other contaminants from the air and delivers it to the lower respiratory organs =
Upper Respiratory System
The upper respiratory system is colonized by-
A lot of microbes
Some of the normal microbiome of the upper respiratory system may be-
Opportunistic Pathogens
What’s the fancy word for Strep Throat?
Pharyngitis
What are some things that you would assess from a head to toe assessment for someone with Strep Throat?
Dark Red, Swollen Tonsils Dotted with Pus
Swollen Lymph Nodes Behind Jaw
Fever is a temp above-
100.4 F
What is Strep often accompanied by?
Fever, Malaise, Headache
What is Malaise?
A general feeling of being unwell
What can occur if an infection reaches the lower respiratory tract?
Laryngitis + Bronchitis
What are the complications that can occur 1-3 weeks after Pharyngitis has resolved?
Scarlet Fever
Rheumatic Fever
Acute Glomerulonephritis
Acute Glomerulonephritis are a fancy name for-
Kidney Disease
Inflammation that leads to damage of the heart valves + muscle =
Rheumatic Fever
Toxins trigger fever and rash that begins on chest and spreads across the body; tongue becomes strawberry red. Rash disappears after a week as skin sloughs =
Scarlet Fever
How does Strep Throat spread?
Respirator Droplets (Within 5 feet of another person)
Fomites
Direct Contact (With sores from Impetigo Blisters)
How long is the Incubation Period for Strep Throat?
2-5 Days
Strep Throat occurs most often in the-
Winter and Spring among Elementary + Middle School children
How is Viral Pharyngitis different from normal Pharyngitis?
It has more symptoms (Cough, Runny Nose, etc.) and it’s caused by a virus instead of a bacteria
What is Pharyngitis often confused with?
Viral Pharyngitis
What % of people diagnosed with Strep actually have it?
50%
What does the sure diagnosis of Pharyngitis require?
Serological Testing
What is Serological Testing?
Testing for pt antibotidies to the pathogen in question
What’s an effective treatment for Strep?
Oral Penicillin
Are Sore Throat and Strep Throat the same thing?
Nah
Group A of Streptococcus Bacteria is what causes Strep. If the throat is being bothered by bacteria other than this or by a virus, then it is called a-
Sore Throat
What are the signs and symptoms of Diphteria?
Sore Throat, Localized Pain, Fever.
Presence of a Pseudomembrane that can Obstruct Airways.
The thickened state of the oozing fluid in the throat which is made of intracellular fluid, blood-clotting factors, leukocytes, bacteria and dead cells =
Pseudomembrane
How tough can a Pseudomembrane be?
It may become so tough that it can’t be dislodged without ripping the underlying tissue (Thus causing bleeding)
A Pseudomembrane can lead to-
Suffocation (If it covers the throat opening entirely)
What bacteria causes Diphteria?
Corynebacterium diphtheriae
C. diphtheriae produces-
Diphtheria Toxin
What does Diphteria Toxin do?
Prevents protein synthesis + Causes cell death. Leads to the formation of a Pseudomembrane
How is Diphtheria spread?
Respiratory Droplets or Skin Contact
What types of people is Diphtheria symptomatic in?
Immunocompromised or Unvaccinated Kids
Leading cause of death among unimmunized children =
Diphteria
What vaccine protects against Diphteria?
The DTap
How is Diphtheria treated?
Antitoxin + Antibiotics
What pathogens can cause Pneumonia?
Bacteria, Viruses, Fungi, Protozoa
In general, what is Pneumonia?
Lung Inflammation with Fluid-Filled Alveoli & Bronchioles
What type of Pneumonia is the most serious and also the most frequent in adults?
Bacterial Pneumonia
Pneumococcal Pneumonia Symptoms:
Fever, Chills, Congestion, Cough, Chest Pain, SOB, Tachypnea
Blood enters the lungs, which causes a characteristic rust-colored sputum
What causes Pneumococcal pneumonia?
Inhalation of bacteria from respiratory droplets
How is Pneumococcal pneumonia diagnosed?
By identifying Gram-Positive diplococci in sputum smears
What’s the drug of choice for Pneumococcal Pneumonia?
Penicillin
Pneumococcal Pneumonia makes up what % of cases of bacterial pneumonia?
85%
What types of people does Pneumococcal Pneumonia like to target?
Children, Elderly, AIDs Patients, Diabetics, etc.
What vaccines protect against Pneumococcal Pneumonia?
PCV13 (Given to kids under 2 years old)
PPSV23 (Given to adults that are 65+)
Leading type of Pneumonia in Children and Young Adults =
Primary Atypical (Myoplasmal) Pneumonia
Signs & Symptoms of Mycoplasmal Pneumonia =
Fever, Malaise, Sore Throat, Excessive Sweating
How long might the symptoms of Mycoplasmal Pneumonia last for?
Weeks
What is Mycoplasmal Pneumonia also called?
Walking Pneumonia or Atypical Pneumonia
Name the different Bacterial Pneumonias:
Pneumococcal Pneumonia
Mycoplasmal Pneumonia
Klebsiella Pneumonia
How does Mycoplasmal Pneumonia spread?
Requires prolonged contact with an infected person + Spreads via nasal secretions
Is Mycoplasmal Pneumonia difficult to diagnose?
Yup
How is Mycoplasmal Pneumonia treated?
With Antibiotics
Klebsiella Pneumonia Signs & Symptoms:
Pneumonia Symptoms + Bloody Sputum + Chills
Klebsiella Pneumonia spreads via-
Person to person contact, not through the air
Klebsiella Pneumonia is one of the leading causes of-
Nosocomial Deaths
What does Klebsiella Pneumonia do?
Kills Alveolar Cells + Invades the Blood (Bacteremia)
Klebsiella is diagnosed by using-
Sputum Samples
What is Klebsiella Pneumonia treated with?
Antibiotics
Prevention of Klebsiella Pneumonia includes-
Good antiseptic technique by healthcare workers
Klebsiella Pneumonia is treated with-
Antibiotics
What causes Currant Jelly Sputum?
Klebsiella Pneumonia
Legionnaire’s Disease is a severe form of-
Atypical Pneumonia
What are the signs and symptoms of Legionnaire’s Disease?
Cough + SOB + Fever + Nausea + Vomiting + Confusion + Aches + Shock
10% of patients who get this disease, will die from it:
Legionnaire’s Disease
What is Legionnaire’s Disease caused by?
The bacteria called Legionella pneumophila
How does Legionella pneumophila affect people (Thus causing Legionnaire’s Disease)?
By Contaminating Water Systems
Respiratory disease that’s transmitted from inhalation of water droplets that contain a certain bacteria =
Legionnaire’s Disease
Legionnaire’s Disease is usually transmitted in institutional settings with large, undermaintained water systems like-
Hospitals, large buildings, etc.
(Can include things like hot tubs and fountains too)
Who are the people that are at the greatest amount of risk for Legionnaire’s Disease?
People with underlying lung damage (Smokers, Immunocompromised People, Elderly)
How can you diagnose Legionnaire’s Disease?
Urine Tests + Sputum Analysis aid in diagnosis
How do you treat Legionnaire’d Disease?
Pt’s are often hospitalized + put on ventilators.
Give Antibiotics.
Is there a vaccine available for Legionnaire’s Disease?
There are none
The incubation period for Legionnaire’s Disease is-
2-10 Days
What are the signs and symptoms of Inhalation Anthrax?
Initially resembles a flu.
Progresses to severe coughing, lethargy, shock, and death.
How does Inhalation Anthrax spread?
Doesn’t spread from person to person.
Acquired by contact or inhalation of endospores.
Anthrax is typically considered to be what kind of a disease?
A Zoonotic Disease (Because it’s usually acquired by people who handle animals/animal products.)
Anthrax can be a risk for people other than animal workers, such as-
Mail Carriers, Healthcare Workers, Travelers
Anthrax can be a-
Bioterrorism Agent
How is Inhalation Anthrax diagnosed?
Sputum Inspection
How do you treat Inhalation Anthrax?
Early and aggressive antimicrobial treatment
What % of patients die of Inhalation Anthrax regardless of treatment?
55%
Anthrax vaccine is available for-
Specific People (Usually Military Personnel or Healthcare Workers)
Ingestion of spores from undercooked meat =
GI Anthrax
What % of GI Anthrax cases are fatal if untreated?
50%
GI Anthrax usually occurs how long after exposure?
1-7 Days
What are the symptoms of GI Anthrax?
They vary because it can affect different aspects of the digestive system from the throat to the intestines
What is it called whenever spores break into the skin, germinate into vegetable cells that release toxins, and damage tissue, forming necrotic lesions?
Cutaneous Anthrax
About 90% of people with TB -
Don’t show symptoms
The leading disease killer in the world, incidence has declined in the industrialized world =
Tuberculosis
What are some initial TB symptoms?
Initially limited to minor cough and mild fever (or may be asymptomatic)
TB spreads via-
Inhalation of respiratory droplets
What are the different types of TB?
Primary Tuberculosis
Secondary Tuberculosis
Disseminated Tuberculosis
Primary TB occurs over the course of-
A Few Months
Secondary TB occurs in what % of people?
10%
When the bacteria enter the blood and travel from lungs to other organs to establish infection there =
Disseminated TB
Bacteria infect lungs. As immune cells are drawn in to fight the infection, the bacteria also infect these cells. As more and more immune cells come in, these immune cells wall off the infected immune cells forming a characteristic tubercle (a sort of nodule) =
Primary TB
The bacteria can remain in the tubercles for many years until the individual experiences some sort of stress like a secondary infection, poor nutrition, drug/alcohol abuse, etc. The bacteria burst from the tubercles, reestablishing an active infection =
Secondary TB
One third of the world’s population is infected with-
TB
Secondary TB occurs with people-
With Alcoholism, People who’re Elderly, People who’re Immunocompromised
What type of vaccine is available for TB?
The BCG Vaccine
What can be used to diagnose TB?
The TB Skin Test
Chest X-Ray
Pertussis is the fancy name for-
Whooping Cough
Whooping Cough signs and symptoms =
Initially cold-like, then characteristic cough develops
Pertussis progresses through how many phases? How long is each stage?
4.
Each stage is 1-2 Weeks.
How long are you in the incubation phase of Pertussis?
5-10 days, 21 days at maximum
What are the phases of pertussis in order?
Incubation Period, Catarrhal Stage, Paroxysmal Stage, Convalescent Stage
How long is the Catarrhal Stage of Pertussis?
1-2 Weeks
How long is the Paroxysmal Stage of Pertussis?
1-6 Weeks
How long is the Convalescent Stage of Pertussis?
Weeks to Months
How long are you communicable with Pertussis?
From the start of the Catarrhal Stage to midway through the Paroxysmal Stage
What symptoms do you gain during the Catarrhal Stage of Pertussis?
Low grade fever
Head Cold
Mild Cough
What symptoms do you gain during the Paroxysmal Stage of Pertussis?
Coughing Fits (These can result in Vomiting + Exhaustion).
These coughing fits can be intense enough to bust the blood vessels in your eyes.
40-50 of these fits can occur in a day.
What’s the most common childhood respiratory disease?
Respiratory Syncytial Virus (RSV) Infection
Signs and symptoms of RSV =
Fever + Runny Nose + Coughing in babies or Immunocompromised people
Mild cold-like symptoms in older adults and adults
Leading respiratory killer of infants worldwide =
RSV
Leading cause of Bronchiolitis + Pneumonia in kids under 1 year old =
RSV
RSV can cause some kids to develop Tracheobronchitis, also known as-
Croup
What are the signs and symptoms of Croup?
Breathing Difficulty + Barking Cough
What does RSV cause to form in the lungs?
Syncytia
Large, multinucleated cells formed from the fusion of a virally infected cell with neighboring uninfected cells =
Syncytia
What are some things that can make you acquire RSV?
Close contact with someone infected.
Respiratory droplets are less frequent but still occur.
98% of kids in day care centers get RSV by what age?
3 Years Old
How is RSV diagnosed?
Immunoassay to detect antibodies
Treatment for children with RSV =
Is just supportive
First RSV vaccine approved by FDA in May 2023; for adults 60 and older =
Arexvy
Approved by FDA in May 2023; for use in pregnant people =
Abrysvo
To protect infants: what vaccine was approved in July 2023; is a monoclonal antibody (Protects infants from 8-19 months old; no long-term protection) =
Nirsevimab
Common Cold signs and symptoms =
Sneezing + Runny Nose + Congestion + Sore Throat + Malaise + Cough
Enteroviruses are also called-
Rhiniviruses
Rhinoviruses are highly infective. A single virus can cause illness in what % of pt’s?
50 %
People of all ages are susceptible to the -
Common Cold
What are 2 recently emerging diseases that are caused by Coronavirus Respiratory Syndromes?
SARS (Severe Acute Respiratory Syndrome)
MERS (Middle East Respiratory Syndrome)
What are the signs and symptoms of Coronavirus Respiratory Syndromes?
High Fever, SOB, Difficulty Breathing.
Later, pt’s will develop dry cough and pneumonia.
How do Coronaviruses spread?
Via Respiratory Droplets.
They spread from the lungs to the heart and kidneys.
The diagnosis of coronaviruses is based on-
Signs and symptoms
The treatment for coronaviruses is-
Supportive
Signs and symptoms of Influenza =
Pharyngitis + Congestion + Cough + Muscle Pain
Sudden Fever distinguishes the Flu from the Cold
Compare the Flu to the Cold:
The flu has a higher fever, more severe aches & pains, more severe fatigue.
Nasal congestion and sneezing are rare for the flu, but common for the cold.
How is Influenza transmitted?
Inhalation of respiratory droplets
How long’s the incubation period for the flu?
~1 Day
How long does it take to recover from Influenza?
~ 2 Weeks
The flu can leave a pt susceptible to-
Secondary bacterial infections (like Pneumonia)
Who does Influenza usually effect?
Kids and Adults that are 65+
How do you treat the flu?
Oseltamivir + Zanamivir (Tamiflu) can be given within the first 2 days of infection
How effective are the flu vaccines?
~40-60 % Effective
Signs and symptoms of Measles (Rubeola) =
High fever (103 F), Sore Throat, Headache, Cough, Conjunctivitis
Symptoms appear how long after exposure to Measles?
7-14 Days
What is Rubeola characterized by?
Koplik’s Spots
When do Koplik’s Spots appear? How long do they last? These are what definitively diagnose Measles.
2-3 days after symptoms begin.
They last 1-2 Days.
3-5 days after the initial symptoms of Measles start, what develops?
A Rash
What are some rare complications from Rubeola?
Pneumonia, Encephalitis, Deafness, Blindness, Subcutaneous Sclerosing Panencephalitis
Progressive disease of the nervous system that develops 5-10 years after measles =
Subcutaneous Sclerosing Panencephalitis
What are the signs and symptoms of Subcutaneous Sclerosing Panencephalitis?
Memory Loss + Personality Changes + Muscle Spasms + Blindness + Death
Infects cells of the respiratory tract before spreading throughout body via lymph and blood =
Measles
The presence of Viruses in the blood =
Viremia
Measles are fatal for what % of infected children?
1-3% (But with more Virulent strains, mortality rate can rise to 15%)
How long does it take for a rash caused by Measles to go away?
~A Week
Signs and symptoms of Rubella =
Children develop a mild rash, typically harmless in children, lasts about 3 days
Fever, usually lower than what’s seen with measles
Adults may develop arthritis and encephalitis
Congenital infection can result in birth defects or death of fetus
How does Rubella spread?
Respiratory Droplets (This can spread for 2 weeks before and after the rash)
How do you diagnose Rubella?
Observation of Rash + Serological Testing
What is Serological Testing?
Detection of antibodies to a virus
Chickenpox is highly contagious. What are its signs and symptoms?
Characterized by lesions on the back and trunk that spread across body
Accompanied by fever and chills
Virus becomes latent within sensory nerves
When does Shingles occur?
It follows the reactivation of viruses, usually many years later
What are the signs and symptoms of Shingles?
Lesions are localized to skin along an infected nerve, usually the face or trunk
(Pain may last after lesions have healed)
Varicella-Zoster Virus (VZV) causes-
Shingles + Chickenpox
How does the transmission of Chickenpox and Shingles occur?
Direct contact with virus in skin lesions/liquid from lesions or from inhalation of material from the skin lesion
Infection spreads from the respiratory tract to the skin via blood and lymph =
Chickenpox + Shingles
Chickenpox is usually-
A Mild Disease
Chickenpox occurs mostly for-
Children
What’s the incubation period for Chickenpox?
~2 Weeks
How long are people with Chickenpox usually infectious for before the rash starts?
~2 Days
Chickenpox is more severe for-
Adults
15-20% of people who’ve had Chickenpox will develop-
Shingles
What increases the risk of Shingles?
Age, Stress, Immunosuppression
If a person has Shingles, then they-
Cannot pass it to others, but they can cause a person to contract Chickenpox
How are Chickenpox + Shingles diagnosed?
The inspection of the characteristic lesions
What can be used to treat Shingles?
Acyclovir
Does a Shingles Vaccine exist?
Yes
