Diebel: Micro Respiratory Infectious Diseases 2

Question 1

What are infections of the LRT?

Answer 1

Bronchitis
Bronchiolitis
Pneumonia
(pertussis and influenza)

Question 2

What pathogens are associated w/ borncihitis?

Answer 2

MAINLY viral infections

Bacterial secondary infections are possible

Question 3

What pathogens are associated w/ bronchiolitis?

Answer 3

VIRAL infection of INFANTS (RSV)

Question 4

What pathogens are associated w/ influenza?

Answer 4

VIRAL infection that can lead to pneumonia through a bacterial secondary infection

Question 5

What pathogens are associated w/ pertussis?

Answer 5

BACTERIAL infection > 90% of cases are B. pertussis

Question 6

What pathogens are associated w/ pneumonia?

Answer 6

Widely varying causes

Viruses- MC in children
Bacteria
Fungi

Question 7

A pt presents w/ cough, fever and chest pain. What may they have?

Answer 7

Bronchitis

Question 8

What do you often see prior to the onset of bronchitis?

Answer 8

Signs of the common cold

Question 9

Do chest radiographs for bronchitis reveal consolidates or infiltrates?

Answer 9

No

Question 10

What causes bronchitis?

Answer 10

Viral URI that extends DOWN to trachea, bronchi and bronchioles>
hacking COUGH w/ some SPUTUM produciton

Question 11

Does bronchitis involve the alveoli?

Answer 11

NO

Question 12

What population is bronchitis most commonly seen in?

Answer 12

Children and elderly

Question 13

How do you diagnose bronchitis and differentiate it from pneumonia?

Answer 13

Clincial signs and sxs

CXR needed for differentiation

Question 14

How do you tx Bronchitis?

Answer 14

Don’t it’s typically self limiting

Question 15

What do you do if a bronchitis lasts longer than 14 days and a pt has a fever and purulent sputum?

Answer 15

Bacterial identification

Antibiotic treatment (erythromycin and azithromycin)

Question 16

What microorganisms cause bronchitis?

Answer 16

Rhinovirus
Parainfluenza virus
RSV
Influenza A and B
Cox A and B
Adenovirus

Question 17

Rhinovirus

Answer 17

RNA
Nonenveloped
Class IV SS + Nonsegmented

Picornaviridae

Question 18

Paramyxovirus

Answer 18

RNA
Enveloped
Class V SS = Nonsegmented

Paramyxoviridae

Question 19

RSV

Answer 19

RNA
Enveloped
Class V SS - Nonsegmented

Paramyxoviridae
Pneumovirus

Question 20

What is the MCC of penumonia in young children?

Answer 20

RSV

parainfluenza virus

Question 21

Influenza A and B

Answer 21

RNA
Enveloped
Class V SS - Nonsegmented

Orthomyxoviridae

Question 22

Cox A and B

Answer 22

RNA
Nonenveloped
Class V SS + Nonsegmented

Picornaviridae
Enterovirus

Question 23

Adenovirus

Answer 23

DNA
Nonenveloped
Group I DS linear DNA

Adenoviridae

Question 24

What is the MCC of aseptc meningitis?

Answer 24

Cosackie
Echo
Mumps

Question 25

What is the MCC of palm and sole rash?

Answer 25

Syphilis RMSF Cosackie

Question 26

What is the MCC of conjunctivitis?

Answer 26

H inflluenza Adeno S. pneumoniae

Question 27

What bacteria cause bronchitis?

Answer 27

Mycoplasma pneumoniae | Chlamydia pneumoniae

Question 28

Are Myoplasma pneumoniae and chlamydia pneunoniae gram + or -?

Answer 28

Neither!

Question 29

What is the MCC of atypical pneumonia?

Answer 29

Mycoplasma legionella Chlamydia Viruses

Question 30

What ishte MCC of pneumonia in adults?

Answer 30

Mycoplasma C. pneumoniae s. pneumoniae

Question 31

What are two obligate intracellular parasites (require host ATP for energy)? Which replicates w/ inclusion bodies?

Answer 31

Clamydiae--replicates w/ inclusion bodies | Rickettsiae

Question 32

What is bronchiolitis?

Answer 32

Inflammation of the bronchial trees as LOW as the bronchioles but NO alveoli involvement

Question 33

Who does bronchiolitis commonly affect?

Answer 33

Infants younger than 1 year d/t NARROW developing of the airways * typically preceded by a minor viral URI

Question 34

How do you diagnose bronchiolitis?

Answer 34

Clinical signs and sxs and chest x-ray to rule out pneumonia

Question 35

In diagnosing bronchiolitis, how can you rule out pneumonia?

Answer 35

Ag testing for RSV

Question 36

How can you protect pts at risk for bronchiolitis?

Answer 36

Passive immunization w/ anti-RSV antibodies

Question 37

What are the causes of Bronchiolitis? Which is MC?

Answer 37

**RSV Parainfluenza Adeno

Question 38

What are the two distinct symptom phases of pertussis?

Answer 38

Catarrhal stage Second (paroxysmal stage)

Question 39

What characterizes the catarrhal stage of pertussis? How long does it last?

Answer 39

Incubation period of 3-21 days> Stage begins w/ bacteria present in RT and appearance of COLD sxs, esp RUNNY NOSE. 1-2 Weeks

Question 40

What characterizes the second stage of pertussis? What is the danger of uncontrolled coughing?

Answer 40

SEVERE and UNCONTROLLABLE COUGHING It can lead to burst blood vessels in the eyes, vomiting, seizures from small hemorrhages in the brain.

Question 41

What is the convalescent phase of pertussis?

Answer 41

Pertussis bacteria are decreasing and no longer causing ongoing symptoms.

Question 42

What happens to the body during the active stages of Pertussis?

Answer 42

Damage to the CILIA on RT epithelial cells complete recovery takes weeks or even months

Question 43

How long does it take the body to recover from damage caused by pertussis? What can happen during this time?

Answer 43

weeks to months other microorganisms can more easily COLONIZE and cause SECONDARY INFECTIONS

Question 44

What toxins does pertussis have?

Answer 44

AB toxin | tracheal cytotoxin

Question 45

What does the AB toxin do?

Answer 45

Results in high levels of cAMP> Mucous production> blocks airways> coughing spasms

Question 46

What does the tracheal cytotoxin do?

Answer 46

Kills ciliated cells

Question 47

B. Pertussis

Answer 47

Bacteria Gram - Coccobacilli pleomorphic Bordet gengou medium

Question 48

What type of agar is the selective growth for Bordatella?

Answer 48

Bordet gengou

Question 49

What initially causes influenza infection?

Answer 49

Influenza A and B

Question 50

How does influenza infect the larynx mucosa?

Answer 50

Inhaled through aerosols. Infects the LARYNX mucosa via contact of the viral hemagglutinin HA envelope protein with SIALIC ACID on cell surfaces (leads to endocytosis).

Question 51

What permits viral spread of influenza?

Answer 51

The viral neurominidase (NA) envelope protein is important for cleaving HA bound to sialic acid, this permits viral spread.

Question 52

What does replication of Influenza lead to?

Answer 52

Virus replication in host cells can lead to death of the host cell leading to tissue damage and disease. The immune response to infection also contributes to disease via production of IL-1 and IFN-γ.

Question 53

What is antigenic shift?

Answer 53

when MAJOR changes in Ag occur d/t GENE REASSORTMENT in the influenza virus.

Question 54

How does antigenic shift occur?

Answer 54

Susceptible host get infected by two types of viruses. Both are in a single cell and get mixed and matched during replication leading to a NEW virus particle.

Question 55

What is antigenic DRIFT?

Answer 55

When MINOR changes in Ags occur d/t GENE MUTATION.

Question 56

What controls influenza outbreaks?

Answer 56

Immunization

Question 57

Is there a new vaccine for immediate use when strains evolve?

Answer 57

NO it takes 6 months

Question 58

What is pneumonia?

Answer 58

Inflammatory condition of the lung in which FLUID fills the alveoli> diffuse consolidation on CXR

Question 59

What is the MCC of Pneumonia? Other causes?

Answer 59

S. Pneumoniae S agalactiae (Group B strep) N. Asteroides

Question 60

S. Pneumoniae

Answer 60

``` Bacteria Gram + diplococci Catalase - Alpha hemolytic Bile esculin negative optochin susceptible ```

Question 61

What are common causes of pneumonia in adults?

Answer 61

40-65 s. pneumoniae h. influenzae legionella

Question 62

What are common causes of pneumonia in elderly?

Answer 62

>65 s. pneumoniae gram - rods H. influenze

Question 63

What are the MCC of meningitis in 60 year olds?

Answer 63

s. pneumoniae gram - rods listeria

Question 64

What is the MCC of neonatal meningitis?

Answer 64

group B strep e. coli listeria

Question 65

What is unique about nocardia and myocbacteria?

Answer 65

Both have acid fast staining

Question 66

What is unique about nocardia and a. idraelii?

Answer 66

Both resemble FUNGI but only A. israelii forms SULFUR GRANULES only nocardia is ACID FAST

Question 67

S. AGALACTIAE

Answer 67

``` Bacteria gram + cocci catalase - beta hemolytic bacitracin resistant ```

Question 68

N. asteroides

Answer 68

``` Bacteria gram + beaded filaments weakly acid fast obligate aerobe ```

Question 69

A 2-month-old girl suffered from a cough for more than 2 weeks. The patient’s mother became concerned when the child turned blue after a couple of coughing spells that ended with vomiting. She brought her to a pediatrician. The patient had not yet received any vaccinations. She had recently been healthy without any underlying medical problems.

Answer 69

Pertussis

Question 70

Abrupt onset of a high fever, chest pain and brown colored sputum is indicative of what?

Answer 70

Pneumonia caused by klebsiella pneumonia

Question 71

In DECEMBER, a 73-year-old man from a NURSING HOME was brought to the hospital in ARD. He had been in his usual state of health until 10AM the previous day when he SUDDENLY developed fever, chills, muscle aches, cough, and prostration. Several other nursing home residents had developed a similar illness during the previous week. His past history is unremarkable and he had NOT SEEN DOC IN PAST YAER.

Answer 71

SEasonal influenza