ENT Infections Flashcards
top two causes of otitis media (if child is not vaccinated, these two are at top of list)
Streptococcus pneumoniae
Haemophilus influenzae type B
most common cause of otitis media in vaccinated children
non-typeable H. influenzae
Ab treatment for otitis media
Amoxicillin
physical treatment for otitis media
tympanostomy tubes
main 2 viruses that cause rhinosinusitis
rhinovirus
influenza
main 2 bacteria that cause rhinosinusitis
S. pneumoniae
H. influenzae
to treat rhinosinusitis
pseudoephedrine(relieves congestion)
amoxicillin (if bacterial)
2 main viruses that cause the common cold (rhinitis/rhinorrhea)
rhinovirus and coronavirus
rhinovirus structure
+ssRNA
naked capsule(stable)
VP1(VAP) binds ICAM-1
what promotes the spread of rhinovirus by increasing ICAM-1 availability
cytokines
why do I always get a cold?
b/c rhinovirus has over 100 serotypes
how to treat and prevent the common cold:
treat sx’s
wash hands
both rhinovirus and coronavirus are limited to what part of body to replicate
URT
(b/c acid labile)
rhinovirus vs coronavirus structure
rhino-naked capsule
corona- enveloped
seal-like barking cough, stridor (high-pitched wheeze); swelling of larynx
Croup
main viral cause of croup
Parainfluenza
to treat croup
dexamethasone (corticosteroid for inflammation)
most common cause of pharyngitis (3 viruses)
EBV, Enterovirus, adenovirus
bacterial cause of pharyngitis
S. pyogenes (Group A Strep)
erythema/edema of pharynx, exudates present, NO COUGH
pharyngitis
cause of mononucleosis; B cell reservoir; dsDNA virus; heterophile Ab +; atypical lymphocytes
EBV
+ ssRNA, not enveloped; this virus can give you rash inside mouth (herpangina)
Enterovirus
dsDNA, non-enveloped; URT; reservoir is public swimming pools; pharyngitis accompanied by conjunctiva
Adenovirus
to diagnose and treat adenovirus
PCR
hand wash
virulence factor of S. pyogenes
M protein
post-strep sequelae
superantigen
post-strep sequellae from group A strep
Rheumatic fever
acute glomerulonephritis
potential consequence of SPE toxin that induces cytokine release
scarlet fever
DNAse produced by strep is used for what
survival in the body
to diagnose strep throat
throat swab
rapid strep test
ELISA
to treat pharyngitis
Penicillin
this disease is produced by a phage toxin and causes grey pseudomembrane on pharynx
diphtheria
to treat C. diphtheriae
penicillin and antitoxin
to prevent diphtheria
vaccine—-toxoid (Ab neutralizing response)
this stage of B. pertussis antibiotics can cure
Catarrhal stage
stage of B. pertussis that has whooping cough and Ab’s won’t help
Paroxysmal stage
stage of B. pertussis where there is a chronic cough and possibility of secondary infections w/ other pathogens
Convalescent stage
gram - rod that inhibits mucocilliary escalator
B. pertussis
2 toxins produced by B. pertussis
- exotoxin (A:B)- ADP ribosylation of GTPase(adenylyl cyclase)–increasing resp. secretions—increases cough
- endotoxin (Lipid A)— binds TLR4 and triggers cytokine storm
to diagnose pertussis
presentation
lymphocytosis
nasal swab
NAAT
to treat Pertussis
Azithromycin (Macrolide)
to prevent pertussis
vaccine (DTaP)
severe sore throat
fever
dysphagia
(sx’s of what)
tonsillitis
main viral cause of tonsillitis
Herpesviruses (HSV, EBV, CMV)
main bacterial cause of tonsillitis
Group A Strep
to treat bacterial tonsillitis
penicillin
REALLY swollen tonsils (caused by bacterial infection)
peritonsillar abscess
how to treat peritonsillar abscess
Ab’s
drain
2 main bacteria that cause peritonsillar abscess
Group A strep
Fusobacterium
A 25 year old presents with ill feeling, painful gums and mouth for 2 days and getting worse. Ulcers on lips and base of tongue
Herpes Viruses
dsDNA virus; enveloped (replicate and bud from nucleus); fever blisters, gingivostomatitis(ulcers)
Herpes Viruses
causes oral lesions
HSV-1
both of these have equal chance of causing genital lesions
HSV-2 and HSV-1
these are used to diagnose_____: PCR
tissue culture
look for multinucleated giant cells
HSV
anti-viral drug used to treat most herpes viruses and MoA
acyclovir: inhibits thymidine kinase
anti-viral drug used to treat CMV
ganciclovir
3 month old and a 48 yr old HIV+ both present to ED with white plaque in the mouth
oral thrush (candida albicans)
NOT true dimorphic yeast, but does change shape in diff. temperature
candida albicans
typically develops when immune system has been compromised
thrush
number 1 cause of candidiasis
Ab therapy—->dybiosis
this fungus can be an early sign of HIV infection (T cells drop below threshold)
thrush
to diagnose thrush:
presentation!!!!
(culture and microscopy)
To treat thrush
Fluconazole
Nystatin
biofilms make this on teeth
plaque
main bacteria found in the oral cavity
Streptococcus mutans
inflammation to gums and around teeth (neutrophils and lymphocytes infiltrate)
gingivitis
acute necrotizing ulcerative gingivitis aka
trench mouth
2 bacteria that cause trench mouth
Fusobacterium
Prevotella
inflammation and infection of ligaments and bones that support teeth (gum recedes)
periodontitis
