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CRRAB II- Week 3 > Diebel: Causative Microorganisms of the URT > Flashcards

Diebel: Causative Microorganisms of the URT Flashcards

1
Q

What is the most common cause of colds?

A

Rhinovirus

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2
Q

What family does rhinovirus belong to?

A

Picornaviridae (small RNA viruses)

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3
Q

What is the clinical presentation of rhinovirus?

A

common cold

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4
Q

How does rhinovirus spread?

A

Contact or aerosol formation

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5
Q

How does rhinovirus initiate infection?

A

Binds to ICAM-1 on URT EPITHELIAL cells>

replicates inside cells and spreads to surrounding tissue w/out killing infected host cells

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6
Q

What causes “disease” w/ rhinovirus?

A

immune response to infection

LOCAL INFLAMMATION>
Exudate and increased ICAM-1 expression>
enhances ability of virus to spread and cause further infection

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7
Q

What can the exudate produced by rhinovirus lead to?

A

It can block airways which can lead to bacterial sinusitis or otitis media.

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8
Q

What type of immunity does an individual w/ rhinovirus acquire?

A

IgA immunity to rhinovirus serotype of the infection

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9
Q

How do you diagnose rhinovirus?

A

pt’s symptoms

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10
Q

How do you treat rhinovirus?

A

supportive care

NO vaccine available

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11
Q

What family do the parainfluenza viruses belong to?

A

Paramyxoviridae

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12
Q

What surface proteins are common to ALL paramyxoviridae viruses and what do they do?

A 
VIRAL FUSION (F) surface proteins>
cause infected cells to form multinucleate giant cells
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13
Q

How does parainfluenza virus cause tissue damage?

A

Cytopathic effects of the virus and immune response to the infection

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14
Q

How does parainfluenza virus present in children?

A

croup (laryngotracheobronchitis)

pneumonia

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15
Q

How does parainfluenza virus present in adults?

A

Common cold (moderately severe)

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16
Q

How is parainfluenza virus passed?

A

Inhaled through aerosols

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17
Q

How does parinfluenza virus infect?

A

Infects the larynx mucosa via contact of the viral hemagglutinin (HA) envelope protein w/ sialic acid on cell surfaces (leads to endocytosis).

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18
Q

What envelope protein is important for cleaving HA bound to sialic acid and permits viral spread?

A

Viral neurominidase (NA)

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19
Q

How does parainfluenza infection lead to narrowing of the lumen and obstruction of inspiration?

A

As the virus spreads downward to the TRACHEAL AND BRONCHIAL epithelium it causes inflammation and swelling of mucous membranes.

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20
Q

Obstruction of inspiration leads to what?

A

Inspiratory stridor

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21
Q

Obstruction of expiration leads to what?

A

barking cough–> croup

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22
Q

How can parainfluenza cause pneumoniae?

A

It can also invade the lower RT

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23
Q

How do you diagnose parainfluenza? What laboratory findings can confirm it?

A

Pts symptoms

Labratory confirmation through hemaglutination activity in respiratory secretions and serology (anti-HA antibodies)

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24
Q

How do you treat parainfluenza?

A

Supportive care (cool mist; oxygen in severe cases)

Corticosteroids

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25
Q

Why is Coronarvirus called coronavirus?

A

Club-shaped viral proteins projecting out of the viral envelope that look like the corona surrounding the sun

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26
Q

What is the second most common causative agent of the common cold?

A

Coronavirus (10-20%)

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27
Q

Is coronavirus indistinguishable from a rhinovirus infection?

A

NO

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28
Q

What is SARS coronavirus?

A

Severe Acute Respiratory Syndrome

Causes a rapidly progressive VIRAL PNEUMONIA

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29
Q

How does a pt w/ SARS present?

A

Fever, dyspnea, cough

can progress to respiratory failure and DEATH

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30
Q

What is the clinical presentation for corona virus?

A

Common cold

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31
Q

How is coronavirus passed?

A

Inhaled through respiratory aerosols that leads to infection of URT cells

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32
Q

What is the incubation period of coronavirus?

A

Asymptomatic 3-day incubation period

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33
Q

Cold symptoms caused by coronavirus last for how many days?

A

6-7 days

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34
Q

How do you diagnose cornoavirus?

A

Pt symptoms

Serological identificaiton possible but lab diganosis rarely perfromed

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35
Q

How do you treat coronoavirus?

A

Supportive care

NO vaccines available

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36
Q

How many RNA segments does Influenza C have and how does this compare to Influenza A and B?

A

7 RNA segments

A and B have 8

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37
Q

How does the virulence of influenza C compare to A?

A

MUCH less virulent, many infections are ASYMPTOMATIC

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38
Q

Is there an animal reservoir for influenza B and C? What does htis mean?

A

NO

NO antigenic shifts

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39
Q

Is influenza C responsive to amantadine or rimatadine?

A

NO

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40
Q

How does influenza C present clinically?

A

common cold

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41
Q

How is influenza C passed?

A

inhaled through aerosols

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42
Q

How does influenza C cause infection?

A

Infects the larynx mucosa via contact of HA envvelope protein w/ sialic acid on cell surface–> endocytosis.

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43
Q

What permits the viral spread of influenza C virus?

A

NA envelope protein>
cleaves HA bound to sialic acid>
viral spread

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44
Q

Viral replication of influenza C in host cells has what consequences?

A

DEATH of host cells>

tissue damage and disease

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45
Q

How does the immune response to influenza C contribute to the disease?

A

IR contributes through production of IL-1 and IFN-y

46
Q

How do you diagnose influenza C?

A

Pt’s sxs

47
Q

How do you get laboratory confirmation of influenza C?

A

Rapid antigen test on a nasophryngeal swab>

culture swab and detect HA type via a RBC agglutination test

48
Q

What is the tx for influenza C?

A

Supportive (acetaminophen, hydration, rest)

No vaccine available for influenza C

49
Q

What causes hand foot and mouth disease?

A

Cox A and B

50
Q

What does hand foot and mouth usually present as?

A

Vesicles on HAND, FEET, MOUTH

USUALLY IN YOUNG CHILDREN

51
Q

What is associated w/ 50% of cases of viral myocardidits?

A

Cox B

52
Q

How does Cox A more commonly present?

A

Herpangia

and hand foot and mouth disease

53
Q

How does Cox B more commonly present?

A

Pleurodynia
myocarditis
pericarditis

54
Q

What sxs are common to both Cox A and B?

A

Aseptic meningitis
paralysis
URI

55
Q

What does Cox virus typically occur?

A

Summer to fall

56
Q

How is Cox transmitted?

A

Fecal oral

aerosal

57
Q

What is the pathogenesis of Cox?

A

GI tract>
infects mucosal epithelial cells>
Replicates and spreads to cause viremia>
infects/destroys other cell types

58
Q

What is the pathogenesis of Cox A?

A

Infects skin and mucosal epithelium>
forms vesicles>
herpangina (red oropharynx vesicles, fever, sore throat)>
hand foot and mouth

59
Q

What is the pathogenesis of Cox B?

A

Infects heart and pleural surfaces>

Pleurodynia, myocarditis, pericarditis

60
Q

What is the pathogenesis for how Cox A and B cause aseptic meningitis and paralysis?

A

Infect MENINGES and ANTERIOR HORN motor neurons>

aseptic meningitis and paryalysis

61
Q

How do you diagnose Cox virus?

A

Isolate virus

serology

62
Q

What is the treatment for Cox virus?

A

Supportive

Symptomatic- anti-inflammatory agents

63
Q

What type of virus is adenovirus and where is it found following infection?

A

Latent virus found in the TONSILLAR ADENOIDS after infection

64
Q

How many serotypes of adenovirus are there?

A

40

65
Q

Are there vaccines for adenovirus?

A

Yes

administered AWAY from the primary site of infection

66
Q

A pt presents with RTI (common cold), conjuntivitis, hemorrhagic cystitis and gastroenteritis. What is causing these symptoms?

A

Adenovirus

67
Q

How does Adenovirus spread?

A

Aerosol
Fecal oral
Direct contact

68
Q

What is the pathogenesis of adenovirus?

A

Binds via HEMMAGGLUTININ>

enters and LYSES MUCOSAL CELLS

69
Q

How does the pathogenesis of adenovirus differ in upper and lower RT?

A

Upper- RHINITIS and sore throat

Lower- Atypical PNEUMONIA

70
Q

How do you diagnose adenovirus?

A

Isolate virus in cell culture

Serology

71
Q

How do you treat adenovirus?

A

Vaccine of live viruses of specific serotypes (Only used in military)

72
Q

Why is treatment mandatory for s. pyognes?

A

Usually SELF LIMITING

but it can cause Rheumatic and glomerulonephritis

73
Q

What VF promote the spread of infection of s. pyogenes and lead to inflammation?

A 
Streptokinase (converts plasminogen to plasmin> fibrinolysis)
M protein (resists phagocytosis)
Hyaluronidase (breaks down CT)
DNase (breaks down DNA)
74
Q

A pt presents w/ PHARYNGITIS, impetigo, ersipelas and cellulitis. What is the causative organism?

A

STREPTOCOCCUS pygoenes

75
Q

How is s. pyogenes transmitted?

A

Part of the normal flora of skin/oropharynx

Transmitted through respiratory droplets

76
Q

How does s. pyogenes cause pharyngitis?

A

Transmitted through respiratory droplets>
bacteria adhere and colonize pharyngeal epithelial cells via PILI on surface of bacteria>
Localized inflammation and SORE THROAT and ENLARGED LYMPH NODES

77
Q

How do you diagnose s. pyogenes?

A 
Throat/skin culture
Gram + cocci
Beta hemolytic
Bacitracin sensitive
ASO +
anti-stretolysin O abs present
78
Q

How do you treat s. pyogenes?

A

Penicillin G

79
Q

What is the second MCC of bacterial pneumonia inpts w/ COPD and nontypeable H influenzae?

A

Moraxella catarrhalis

80
Q

What VFs does Moraxella have?

A

SPECIALIZED PILI allows for attachment of microorganism to mucosal surface

ANTIGENIC VARIATION to evade host IR

ENDOTOXIN

CAPSULE

81
Q

What are the three types of infection that moraxella can cause?

A

otitis media
sinusitis
pneumonia

82
Q

How does moraxella normally colonize?

A

Colonizes the NASOPHARYNX and spreads to the MUCOSAL SURFACES>

Releases ENDOTOXIN>

Inflammatory response

83
Q

How can you diagnose moraxella?

A

Hydrolyzes tributyrin
Produces DNase
Reduces nitrite/nitrate
Dones’t ferment sugars

84
Q

How do you treat moraxella?

A

Amoxicillin-clavulanate
Cephalosporins
TMP-SMX

85
Q

When are DTaP vaccines given?

A

2,4,6 and 18 mos, before starting school and every ten years after that

86
Q

What carries diptheria toxin?

A

PHAGE–> only lysogenic orgs can cause systemic disease

87
Q

How does diptheriae present locally and systemically?

A

Locally- pseudomembrane and AIRWAY OBSTRUCTION

Systemically- myocarditis and polyneuritis

88
Q

How does diptheriae cause airway obstruction?

A

Enters nasopharynx via RESPIRATORY DROPLETS>
creaets gray fibrinous exudate (bacterial cells, WBC, necrotic mucosa)>
Block airways

89
Q

What does the diptheriae secrete? What does this do in the cell?

A

AB toxin that ribosylates EF2 and prevents PROTEIN SYNTEHSIS

90
Q

What is the ultimate toxic affect of diptheria toxin?

A

cardiac issues

NS issues

91
Q

How do you diagnose diptheriae?

A

Gram + rod
aerobic
Black colonies on Potassium tellurite

92
Q

How do you treat diptheriae?

A

Antitoxin
penicillin
erythromyacin

93
Q

What is prophylaxis for diptheriae?

A

DTaP w/ boosters every 10 years

94
Q

What is the major cause of community acquired pneuomonia?

A

s. pneumonaiae

95
Q

What serves as the ags for the pneumovax vaccine?

A

Capsule sugars

96
Q

How does s. pneumoniae present locally?

A

Otits media

LOBAR pneumonia

97
Q

What is the pathogenesis of s. pneumoniae? How do they evade host defenses?

A 
Respiratory droplets>
nasopharynx epitheluim> 
evade host defenses by CAPSULE FORMATION and IgA PROTEASES>
spread to middle ear and SINUSES>
Alveoli> Lobar pneumoniae
98
Q

How do you diagnose s. pneumoniae?

A 
Gram + diplococcic
alpha hemolytic
catalase -
susceptible to optochin
Quelling rxn
99
Q

How do you treat S. pneumoniae?

A

Penicillin/cephalosporins

Preventative- pneumovax vaccine

100
Q

What is the difference between H influenze type B and non-typeable H influenza?

A

H influenza type B- encapsulated and INVASIVE

non-typeable- colonize locally

101
Q

To whom does non-typeable H influenzae pneumonia occur most often?

A

Adults w/ COPD

Recent viral infection

102
Q

How does Haemophilius influenza type B spread?

A 
Infects humans via respiratory droplets>
URT>
local inflammation and EPIGLOTTITIS AND OTITS MEDIA>
invades submucosa and blood stream>
PNEUMONIA
103
Q

How does Haemophilius influenza type B evade host defenses?

A

IgA protease

Capsule

104
Q 
What is the microorganism?
Gram - 
Requires hemin and NAD on chocolate agar
Immunofluorescence
\+ Quelling Test
A

Haemophilus Influenza type B

105
Q

How do you brevent haemophilus influenza and treat it?

A

Hib vacccine

Rifampin for close contacts

Third generation cephalosporin (ceftriaxone)

106
Q

What proteins does RSV use to attach to cells and to fuse infected cells?

A

G proteins- attachment

F protein- fuse cells

107
Q

What is the major respiratory pathogen in young children?

A

RSV–infects everyone by age 3

108
Q

What to conditions present w/ wheezing?

A

Asthma and RSV

109
Q

What is the pathogenesis of RSV?

A

Attaches to bronchiolar/alveolar epitheilum via G protein>
necrosis and iflammation of bronchioles>
mucous obstruction of airway>
bronchiolitis and wheezing

alveoli>
pneumonia

110
Q

What can prevent RSV?

A

Recurrent infectoin builds IgA immunity against futher infection

111
Q

How do you treat RSV?

A

Supportive

Albuterol

Preventative- Synagis

CRRAB II- Week 3 (12 decks)

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