Exam 3: Diseases of Respiratory System Flashcards
In general, are upper or lower respiratory infections more severe?
lower respiratory infections tend to be more severe
What bacterial disease is characterized by sore throat, difficulty swallowing, fever, malaise, HA, inflam pharynx and has pus pockets (purulent abscesses) covering tonsils?
Strep Throat
What organism causes Strep Throat?
Streptococcus pyogenes
Gram + bacteria
How is Strep Throat spread? What age is MC to get it?
respiratory droplets; ages 5-15
What is the number one cause of pharyngitis?
Strep throat
What three disease may Strep Throat progress to?
- Scarlet Fever
- Rheumatic Fever/Heart disease
- glomerulonephritis
What is given to treat Step Throat? Why?
anitbiotics–> to prevent developing into Rheumatic Fever/Heart Disease
What is another name for Scarlet Fever?
Scarletina
What can develop 1-2 days after pharyngitis often following a strep throat inf. (is involves lysogenized strain of Strep. pyogenes) and have a diffuse rash with a strawberry red tongue?
Scarlet Fever (aka Scarletina)
transmission = respiratory droplets
What organism causes Scarlet Fever (scarletina)? What toxins does it release?
Streptococcus pyogenes
releases Erythrogenic (pyrogenic) toxins
What is characterized by a sore throat, localized pain, fever, pseudomembrane adheres to posterior throat structures?
Diptheria
What can occur in severe cases of Diptheria?
pseudomembrane occludes airway–> resulting in death by suffocation
What organism causes Diptheria? What can it produce? What does it characteristically form?
Corynebacterium diphtheriae –> virulence factor = diphtheria toxin
divides by snapping fission–> forms characteristic palisade arrangement
What is the mode of transmission for Diphtheria?
person to person via respiratory droplets OR skin contact
What is the diagnostic factor for Diphtheria? What was FORMLY used for Dx?
pseudomembrane
formerly used–> Schick Test
How is Diphtheria Tx? Can it be prevented?
antitoxin and antibiotics
in severe cases if blocks airway. surgery may be necessary
Prevention–> Immunization (DTap, TDaP)
What is characterized by pain and pressure of the affected sinus and a HA that worsens with bending forward?
sinusitis
What are the five MC organisms to cause Sinusitis and Otitis Media? Which one is MC to cause sinusitis, what about Otitiis Media?
- Streptococcus pneumoniae (35% of OM)
- Haemophilus influenza b
- Staphylococcus aureus
- Moraxella catarrhalis (most sinusitis)
- Streptococcus pyogenes
What organism is MC cause of Otitis Media? What individuals is Otitis Media MC in?
Streptococcus pneumoniae
children
What organism MC causes Sinusitis? What individuals is sinusitis MC in?
Moraxella catarrhalis
adults
What is the mode of transmission for Sinusitis?
bacteria in pharynx spread to sinuses via the throat
What causes pain in the ears and is spread by bacteria colonizing in the ear after a cold or other respiratory infection? Tx?
Otitis Media
Tx: avoid diary and get adjusted!!!
Is the common cold a bacterial or viral infection? What organisms can cause it from MC to least?
viral: Cause by MC to least:
1. Rhinovirus
2. Coronavirus
3. Adenovirus
T/F. The common cold is a viral infeciton with sneezing, runny nose, congestion, sore throat, malaise, cough, and myalgia.
FALSE—(all is true) except there is NO myalgia–(myalgia is present with influenza though)
What is the MC cause of colds? What is the 2nd MC cause of colds?
- Rhinovirus
- Coronaviruses
(3rd is Adenovirus)
What is the best prevention of the common cold?
Handwashing
How is the common cold spread?
coughing/sneezing, fomites, or person-to-person contact
highly infective
What are the 6 Upper Respiratory disease we talked about?
- Step Throat
- Scarlet Fever (scarletina)
- Diphtheria
- Sinusitis
- Otitis Media
- Common cold (viral)
In general, what has lung inflammation with fluid-filled alveoli and bronchioles?
Bacterial Pneumonias (4 we talked about)
- Pneumococcal Pneumonia (typically pneumonia)
- Mycoplasmal Pneumonia (atypical pneumonia)
- Klebsillea Pneumonia
- “other” bacterial pneumonias
What disease is the most serious and the most frequent in adults?
Bacterial Pneumonias
What is another name for Pneumococcal Pneumonia? What organism causes it?
“Typical Pneumonia” or “The Pneumococcus”
caused by Streptococcus pneumoniae
What is characterized by short, rapid breathing, high fever, cough, and rust-colored sputum, and consolidation an x-ray?
Pneumococcal Pneumonia (typically pneumonia)
consolidation on x-ray = Dx
How is Pneumococcal Pneumonia (typically pneumonia) spread?
inhalation of bacteria
What is another name for Mycoplasmal Pneumonia? What organism causes it?
“atypical pneumonia” or “walking pneumonia”
caused by Mycoplasma pneumoniae (recall no cell wall)
How is Mycoplasmal Pneumonia (atypical/walking pneumonia) spread?
spread by nasal secretions
What type of pneumonia has fever, malaise, sore throat, excessive sweating, consolidation, but could be asymptomatic?
Mycoplasmal Pneumonia (atypical/walking pneumonia)
What type of pneumonia is opportunistic and immuno-compromised individuals are most at risk?
Klebsiella Pneumonia
What has pneumonia symptoms, combined with a thick, blood sputum called “currant jelly sputum”?
Klebsiella Pneumonia
What organism causes Klebsiella Pneumonia and what is its mode of transmission?
Klebsiella pneumonia (bacteria)
spread by normal digestive respiratory microbiota that is an opportunistic infection
What are four other miscellaneous Bacterial Pneumonias (besides the 3 main ones we talked about)?
- Haemophilus influenzae b
- Staphylococcus aureus
- –both similar to Pneumococcal pneumonia - Yersinia pestis–> causes pneumonic plague
- Chlamydophila pneumoniae–> causes pneumonia and bronchitis
What is another name for Ornithosis? What organism causes it?
psittacosis
caused by Chlamydophila psittaci (Gram - bacteria)
What are the symptoms of Ornithosis (psittacosis) and how is it transmitted?
flu-like symptoms w/in 10 days of exposure
- inhalation of aerosolized feces/respiratory secretions; - ingested from fingers/fomites that have contacted inf. birds
- direct beak-to-mouth contact
What causes a fever, chills, nonproductive cough, HA, and pneumonia, and is transmitted from inhalation o bacteria in aerosols from water sources?
Legionnaires’ Disease
What organism causes Legionnaires’ Disease? How is it transmitted? How is most at risk?
Legionella pneumophila
via inhale bacteria in aerosols from water sources
children, elderly, immuno-compromised
What else can Legionella pneumophila cause besides Legionnaires’ Disease?
Pontiac Fever–> non fatal
What are the three types of Tuberculosis (TB) if it is symptomatic? What organism causes them?
- Primary TB
- Secondary TB
- Disseminated TB
Mycobacterium tuberculosis (waxy-myocolic acid cell wall–> VERY anitbiotic resistant)
What individuals is Primary TB most common in?
children
What TB results from the initial infection with M. tuberculosis and forms fibrotic nodules called granulomas or tubercles seen on x-rays?
Primary TB
What is it called when the center of the granuloma/tubercle in Primary TB decays/necroses? What if the center fills with air instead?
decays–> caseous necrosis
fills w/ air–> tuberculous cavity
What is a Ghon’s complex characteristic of? What is it?
Primary TB
tubercle plus lymph node calcification–> can see on x-ray
What is the leading killer of HIV positive individuals?
Tuberculosis (TB)
What is Tuberculosis called when it is in the spine?
Pott’s Disease
What is it called when there is reestablishment of active infection of TB after period of dormancy? Who is the most likely to occur in?
Secondary TB
common in suppressed immune system individuals
What is it called when the TB infection spreads throughout the body via the blood and lymph? What is characteristic of this type of TB?
Disseminated TB
“consumption”– wasting of body from multiple sites
Is Tuberculosis a reemerging disease? Why do we think this is occurring?
yes; due to drug-resistant strains developing–> MDR and XDR
How is tuberculosis spread? What organism causes it? Where in the world is it esp. a pandemic?
respiratory droplets
Mycobacterium tuberculosis (acid-fast)
Africa
How is Tuberculosis Dx?
Tuberculin skin test
tubercles on chest x-rays
What is another name for Pertussis? What organism causes this?
Whooping Cough
Bordetella pertussis (Gram - bacteria)
What are the four phases of Pertussis (whooping cough)?
- incubation (no symptoms)
- catarrhal (rhinorrhea, sneezing, malaise, fever)
- paroxysmal (repetitive cough, whooping noise)
- convalescent (decrease in cough)
What phase of Pertussis (whooping cough) is the repetitive cough with the whoops present?
phase 3: paroxysmal
What age are most cases of Pertussis in? Is it a reemerging disease? How is it Dx?
children
yes
whooping sound
How is Pertussis spread?
(whooping cough)
via airborne droplets–> highly contagious
(not a fatal illness)
What is characterized by stridor, chills, shaking, cyanosis, drooling, difficulty breathing or swallowing, hoarseness and may see in the tripod position?
Epiglottitis
Is Epiglottitis a medical emergency?
YES! call 911
tripod position is indicator–> child sits upright and lean slightly forward to breathe
What organism causes Epiglotitis? How is it transmitted?
Haemophilus influenzae b
person to person; direct contact; or droplet inhalation
(reservoir = livestock)
What is a Cat A bioterrorist threat that causes cold or flu symptoms, then a high fever, difficulty breathing, severe coughing, lethargy, shock, and death? Whats the mortality rate?
Inhalational Anthrax
100% fatal; but w/ early Tx reduce to 50% fatality
What organism causes Inhalational Anthrax? What is the mode of transmission?
Bacillus anthracis (gram + bacteria)
inhalation of endospores (NOT spread person to person)
T/F. Inhalational Anthrax is rare in humans, but has an increased risk due to bioterrorism.
true
What are the 7 bacterial lower respiratory infections we talked about?
- Pneumonia (Pneumococcal, Mycoplasmal, Klebsiella, other)
- Ornithosis
- Legionnaires’ Disease
- TB (Primary, Secondary, Disseminated)
- Pertussis
- Epiglottis
- Inhalational Anthrax
What are the 6 viral lower respiratory infections we talked about?
- Influenza
2, Bronchitis - SARS (Severe Acute Respiratory Syndrome)
- RSV (Respiratory Syncytial Virus Inf.)
- HPS (Hantavirus Pulmonary Syndrome)
- Croup
How are new strains of Influenza created?
mutations in Ha or Na proteins
can occur via
- Antigenic Drift
- Antigenic Shift
What is the difference between Antigenic Drift and Antigenic Shift?
Drift–> small changes to Ha or Na pieces
Shift–> brand new Ha and Na pieces
What lower respiratory infection causes a sudden fever, pharyngitis, congestion, cough, HA, and myalgia?
Influenza
(will be NO vomiting or diarrhea)
(recall: myalgia is NOT present in common cold!!)
What organism causes Influenza?
Influenze virus (Orthomyxovirus)- Type A and B
How is Influenza spread? What are flu patients susceptible to?
inhalation of virus or self-inoculation
susceptible to secondary bacterial infs.
Who is the most at risk group for complications from Influenza?
elderly, children, and inds with chronic diseases
Is there a Tx for Influenza?
yes, but the anti-virals must be administered w/in first 48 hrs of infection (which people usually don’t go see doc when have these symptoms)
Is there a prevention available for Influenza?
Trivalent Flu Vaccine–> but only protective against the strains included in the vaccine (and there are over 200 strains)
What are the 5 famous strains of Influenza we should know about?
- 1918 Spanish Flu* (H1N1)
- 1957 Asian Flu (H2N2)
- 1968 Hong Kong Flu (H3N2)
- 2003 Bird Flu (H5N1)
- 2009 “Swine” Flu* (H1N1)
What famous cases of Influenza is considered an emerging disease? why?
2009 Swine flu–> b/c has same strain- H1N1– as the 1918 Spanish Flu
What flu was in 1918 and lasted 2 years and killed over 50 million people?
Spanish Flu (H1N1)
What flu was in 1957 and lasted 1 year and killed about 2 million people?
Asian Flu (H2N2)
What flu was in 1968 and killed about 1 million people, but was milder?
Hong Kong Flu (H3N2)
What flu was in 2003 and was found in 400 people, but killed 200 of them?
Bird Flu (H5N1)
What flu was in 2009 and is believed to be a descendant of 1918 flue pandemic virus?
Swine Flu (H1N1)
killed more than 18,000 ppl
What lower respiratory disease is characterized by a cough, sore throat, runny nose, nasal congestion, low-grade fever, malaise, wheezing, and has multiple organisms that can cause it?
Bronchitis
What percentage of Bronchitis is viral? What is bacterial?
90% viral
10% bacterial
What are the viral organisms that cause 90% cases of bronchitis?
Rhinovirus
Adenovirus
Influenza Virus
What are the bacterial organism that cause 10% cases of Bronchitis?
Mycoplasma pneumoniae
Chlamydophila pneumonia
Bordetella pertussis
How is Bronchitis spread?
person-to-person via direct and indirect contact
What lower respiratory disease requires BSL-3 and causes a high fever, shortness of breath, difficulty breathing, cough and pneumonia
Severe Acute Respiratory Syndrome (SARS)
What organism causes SARS (severe acute respiratory syndrome)? How is it transmitted?
Coronavirus (SARS virus)
transmitted via large droplets form upper respiratory tract
What disease is a medical emergency that can be fatal, causing bluish skin, intercostal retractions, nasal flaring, and rapid breathing?
Respiratory Syncytial Virus Infection (RSV)
What is the MC lower respiratory childhood disease?
Respiratory Syncytial Virus Infection (RSV)
What organism causes Respiratory Syncytial Virus Infection (RSV)? How is it transmitted?
RSV - Respiratory Syncytial Virus
transmission occurs via fomites, hands, respiratory droplets
What severe fatal infection can Respiratory Syncytial Virus Infection (RSV) cause?
Bronchiolitis
What lower respiratory disease causes a cough, shock, and labored breathing that is OFTEN FATAL, and is considered an emerging disease and requires BSL-4?
Hantavirus Pulmonary Syndrome (HPS)
What organism causes Hantavirus Pulmonary Syndrome (HPS)? How is it transmitted?
Hantavirus
inhalation of virions in dried mouse urine or feces
no Tx
What causes a characteristic “Seal-bark” cough along with inflammation of larynx, trachea, and bronchi?
Croup
What organism causes Croup? How is it transmitted? How is particularly susceptible?
Parainfluenze virus (75% cases)
transmitted via respiratory droplets and person-to-person contact
children
What are the 6 Fungal lower respiratory disease we talked about?
- Coccidiodomycosis (San Joaquin Valley Fever)
- Pulmonary Blastomycosis
- Paracoccidioidomycosis
- Histoplasmosis (Ohio River Valley disease)
- Pneumocystis Pneumonia (PCP)
- Asperigillosis
What fungal disease resembles pneumonia and TB and forms spherules in the lungs that are seen on x-rays and w/o Tx if it spreads to the CNS it can be fatal?
Coccidiodomycosis (aka San Joaquin Valley Fever)
Dx: based on spherules
What organism causes Coccidiodomycosis (San Joaquin Valley Fever)? Who is most at risk?
Coccidioides immitis (fungus)
immunocompromised
How is Coccidiodomycosis (San Joaquin Valley Fever) transmitted?
enters body through inhalation –> dust that coats materials (from Native American pots and blankets) can serve as a vehicle of infection
What fungal disease is mostly asymptomatic; but may have muscle aches, cough, fever, chills, malaise, weight loss (flu-like*) and is an emerging disease?
Pulmonary Blastomycosis
resolves in most people
What organism causes Pulmonary Blastomycosis? How is it transmitted? Where is it an endemic?
Blastomyces dermatitidis (fungus)
inhalation of dust carrying fungal spores
in Southeastern US north to Canada
What disease is similar to blastomycosis and coccidiodomycosis, but have chronic inflammation of mucous membranes causing mouth ulcers?
Paracoccidioidomycosis
What organism causes Paracoccidioidomycosis? How is it transmitted? What is it MC found?
Paracoccidioides brasiliensis (fungus)
enters body through inhalation
in farm workers in endemic areas
What disease is 95% of the time asymptomatic, but often find granulomas on chest x-ray?
Histoplasmosis (aka Ohio River Valley Disease)
We know Histoplasmosis (aka Ohio River Valley Disease) is 95% of the time asymptomatic, but what can occur in the other 5%?
develop clinical histoplasmosis–> coughing w/ bloody sputum or skin lesions
mainly in immunocompromised could occur)
What organism causes Histoplasmosis (aka Ohio River Valley Disease)? How is it transmitted?
Histoplasma capsulatum
humans inhale airborne spores from the soil
What is the MC fungal pathogen INFECTING humans?
Histoplasmosis (aka Ohio River Valley Disease)
recall: MC fungal pathology = candidiasis
Where is Histoplasmosis mostly in the US?
eastern/midwestern US–> esp states along Ohio River Valley and lower Mississippi River)
Where is the fungi found that causes Histoplasmosis (aka Ohio River Valley Disease)? What is the reservoir?
moist soils containing high nitrogen levels, such as from droppings of bats and birds
reservoir = soil (NOT birds)
What disease causes widespread inflammation, fever, difficulty breathing, nonproductive cough, anemia, hypoxia, and fever and is a fungal inf. but resembles protozoa more than fungi?
Pneumocystis Pneumonia (PCP)
What organism causes Pneumocystis Pneumonia (PCP)?
Pneumocystis jirovecii (aka Pneumocystis carinii)– a fungus, but more resembles a protozoa
What inds is Pneumocystis Pneumonia (PCP) common in? How is it spread?
common opportunistic fungal inf in AIDS patients–> inhalation of droplets
presence of disease is almost Dx for AIDS
What disease most commonly only causes allergies and is associated with cereal and grains and nuts?
Aspergillosis
What organism causes Aspergillosis? What can it release?
Aspergillus sp. (fungus)–> releases toxin called Aflatoxin
How is Aspergillosis transmitted? Is it an emerging disease?
inhalation of the fungal spores
yes
