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Block 9 Week 3 > HEENT Infections - Hunter > Flashcards

HEENT Infections - Hunter Flashcards

1
Q

what is swimmer’s ear?

A

otitis externa

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2
Q

Swimmer’s ear happens when water gets trapped in what part of the ear?

A

external canal

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3
Q

What are the predisposing factors to getting swimmer’s ear?

A
  1. hi environmental temps
  2. trauma from Q-tip abuse
  3. chronic dermatologic dz (eczema)
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4
Q

what are the most common bugs causing otitis externa?

A

gram-neg bacilli

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5
Q

What is the most common bug cuasing MALIGNANT otitis externa?

A

Pseudomonas aeruginosa

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6
Q

What is the second most common cause of otitis externa?

A

Staph aureus

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7
Q

The fever associated with swimmer’s ear is usually lower than….

A

38.3 C

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8
Q

What are the common clinical presentations of swimmer’s ear?

A

ear pain
itching
discharge
red canal, swollen (otoscopy)

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9
Q

What part of the ear can be painful in swimmer’s ear which makes chewing painful?

A

the pina

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10
Q

What is the standard abx to use for swimmer’s ear?

A

dicloxacillin or ciprofloxacin

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11
Q

less severe cases of swimmer’s ear can use abx eardrops of….

A

ofloxacin

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12
Q

what is the temperature greater than in malignant otitis externa?

A

greater than 38.3 C

must have severe pain and purulent exudate

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13
Q

Malignant otitis media begins as an infx of the external auditory meatus and the patient then develops….

A

otorrhea

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14
Q

Necrotizing infx from malignant otitis externa can spread to what areas?

A

MASTOID BONE
blood vessels
cartilage
brain!

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15
Q

In what types of patients do you see malignant otitis externa?

A

DIABETES; immunosuppresed

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16
Q

What is the Abx for malignant otitis externa?

A

imepenem and refer to ENT

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17
Q

T/F: malignant otitis externa is fatal if untreated

A

true

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18
Q

what percent of kids younger than one year get otitis media?

A

50%

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19
Q

what percent of kids younger than 3 get at least one bout of otitis media?

A

80%

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20
Q

What is the most common Dx in febrile children?

A

otitis media

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21
Q

if a kid presents with purulent conjunctivitis or rhinosinusitis, what should they be examined for?

A

otitis media

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22
Q

Immune deficient people are more likely to have what type of otitis media?

A

recurrent

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23
Q

What are the three most common causes of otitis media?

A

Strep pneumo
nontypeable H. flu
Moraxella catarrhalis

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24
Q

What are the two uncommon causes of otitis media?

A

staph aureus

strep pyogenes

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25
Q

In children younger than (blank) weeks of age, gram-negative bacilli (e.g., Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeurginosa) commonly cause acute otitis media

A

6 weeks

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26
Q

Acute otitis media is usually preceded by an upper respiratory tract (blank) infection

A

viral

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27
Q

A blocked eustachian tube creates negative pressure and produces what type of effusion?

A

serous

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28
Q

What are the definitive criteria for Dx of otitis media?

A
  1. pain
  2. fever
  3. effusion
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29
Q

A tympanic membrane (blank) is an indication of effusion

A

bulge

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30
Q

T/F: most cases of otitis media resolve without abx

A

true

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31
Q

If pts are still symptomatic by day 3 with otitis media, what abx should you start?

A

amoxicillin

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32
Q

da fuck is a hordeola?

A

stye

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33
Q

hordeolas appear as…..

A

acute purulent papules

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34
Q

WHERE do hordeolas occur?

A

lid margin

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35
Q

what is the cause of 90%+ of all hordeola?

A

staph aureus

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36
Q

Hordeola are a complication of what?

A

blepharitis

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37
Q

What is blepharitis?

A

blockage and infection of the Zeiss or Moll sebaceous glands or meibomian glands in the tarsal plate

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38
Q

What is a chalazia?

A

GRANULOMATOUS hordeola that is not painful

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39
Q

T/F: most hordeolas drain spontaneously

A

true

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40
Q

How do you drain an external hordeola?

A

lance it and pluck the nearby lashes

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41
Q

How do you treat an internal hordeola?

A

warm compress

oral dicloxacillin

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42
Q

what prevents hordeola formation?

A

good hygeine

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43
Q

what are the symptoms of orbital cellulitis?

A 
proptosis
ophthalmoplegia
edema
erythema
pain on eye movement
fever, headache, malaise
chemosis, hyperemia of conjunctivia
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44
Q

When should you suspect orbital cellulitis?

A

recent sinus infection

facial trauma/surgery/dental work

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45
Q

What is the most common sinus to cause orbital cellulitis?

A

ethmoid

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46
Q

What are the common pathogens that cause orbital cellulitis?

A

Strep pneumo
staph aureus
H. flu
anaerobes

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47
Q

Which three antibiotics do you use to treat orbital cellulitis?

A

nafcillin
ceftriaxone
metronizadole

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48
Q

10% of orbital cellulitis results in…

A

vision loss

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49
Q

What type of orbital cellulitis is less serious?

A

preseptal/preorbital

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50
Q

What are the serious complications of orbital cellulitis?

A
  1. CAVERNOUS VENOUS THROMBOSIS
  2. brain abscess
  3. meningitis
  4. vision loss
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51
Q

Conjunctivitis is inflamm of….

A

palpebral and bulbar conjunctiva

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52
Q

bugs that cause conjunctivitis also cause…

A

keratitis, resulting in keratoconjunctivitis

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53
Q

what percent of all eye complaints are conjunctivitis?

A

30%

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54
Q

whats the common name for conjunctivitis?

A

pink eye

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55
Q

What are the three most common viral causes of pink eye

A
  1. Adenovirus (most)

2. HSV1/2 (less likely)

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56
Q

which viral pink eye causes more serious keratitis?

A

HSV1/2

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57
Q

Which bugs can cause purulent conjunctivitis?

A
  1. staph aureus
  2. strep pneumo
  3. h. flu
  4. moraxella catarrhalis
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58
Q

What bug causes HYPERpurulent pink eye?

A

Neisseria gonorrhoeae; causes SIG CORNEAL DAMAGE

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59
Q

what bug causes follicular (inclusion) pink eye?

A

chlamydia trachomatis

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60
Q

What is the leading cause of blindness in the world? what causes it?

A

trachoma; chlamydia

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61
Q

N. gonorrhoeae and C. trachomatis can cause conjunctivitis in newborns (blank), which can spread from the conjunctiva and rapidly infect the cornea

A

ophthalmia neonatorum

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62
Q

what are the defense mechanisms of the eye?

A

tearing and lysozyme in tears

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63
Q

what are the symptoms of an overwhelmed eye defense?

A

redness
discharge
irritation

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64
Q

T/F: pink eye is self limited

A

true

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65
Q

ophthalmia neonatorum is acquired in the (blank) and can lead to rapid corneal perforation

A

birth canal

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66
Q

chlamydial pink eye can lead to (blank) causing vision loss

A

scarring – especially in trachoma

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67
Q

follicle formation happens post what types of pink eye?

A

viral and chlamydia

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68
Q

what is injection in pink eye?

A

white sclera turning red from BV dilation

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69
Q

what are the symptoms of pink eye?

A

fullness
BURNING
sensation of “grit/dust” in the eye
lots of tearing

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70
Q

purulent discharge is seen in (viral/bacterial) pink eye

A

bacterial

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71
Q

is vision impaired in pink eye?

A

nope

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72
Q

What do you use to treat viral herpes conjunctivitis?

A

acyclovir

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73
Q

Neisseria ophthalmia neonatorum will present in what time frame after birth?

A

2-3 days

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74
Q

Chlamydia ophthalmia neonatorum will present in what time after birth?

A

4-10 days

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75
Q

In 24 hours, untreated Neisseria ophthalmia neonatorum keratoconjunctivitis can progress to….

A

ulceration or perforation of the cornea

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76
Q

what is the vertical transmission rate from mom to baby of ophthalmia neonatorum?

A

30-50%

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77
Q

what abx do you give for neisseria ophthalmia neonatorum?

A

ceftriaxone

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78
Q

what abx do you give for ophthalmia neonatorum prophylaxis?

A

erythromycin ointment

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79
Q

(blank) presents as mucopurulent keratoconjunctivitis

A

active trachoma

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80
Q

(blank) causes an intensely irritating foreign body sensation and corneal scarring

A

trichiasis

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81
Q

which phase of trichiasis leads to blindness?

A

cicatricial or corneal scarring phase

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82
Q

what actually is trichiasis?

A

in-turned eye lashes

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83
Q

What are the buzz words associated with trichiasis?

A 
in-turned eye lashes
poverty/ poor hygeine
periauricular LAD
light sensitivity
follicular inflamm
eye exudate
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84
Q

Inflamm of the cornea is called..

A

keratitis

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85
Q

Most cases of keratitis also cause..

A

conjunctivitis

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86
Q

T/F: keratitis cna be vision threatening

A

true

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87
Q

What types of bugs can cause keratitis?

A

viruses, bacteria, fungi, or parasites

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88
Q

What are the most common risk factor for microbial keratitis in the US?

A

contact lenses

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89
Q

What are the most common causes of viral keratitis?

A
  1. HSV
  2. VSV
  3. adenovirus
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90
Q

adults tend to get HSV (1/2) keratitis

A

HsV1

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91
Q

neonates tend to get HSV (1/2) viral keratitis

A

HSV 2

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92
Q

What is the MOST common type of bacterial keratitis?

A

Staph aureus

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93
Q

Besides staph aureus, what are the most common causes of bacterial keratitis?

A

strep pneumo
strep pyogenes
H. flu

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94
Q

What are the most common causes of fungal keratitis?

A

aspergillus
Fusarium
Candida

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95
Q

What is the MOST common protozoa that causes keratiis, EPSECIALLY WITH CONTACT LENSES

A

Acanthamoeba

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96
Q

what is the most common bacterial keratitis from contact lenses?

A

Pseudomonas aeurignosa

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97
Q

what is the most common corenal infection in the US?

A

HSV keratitis

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98
Q

Greater than 90% of HSV keratitis are (uni/bi)lateral

A

unilateral

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99
Q

HSV keratitis is spread from oral or genital herpes or from which CN?

A

trigeminal ganglion

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100
Q

HSV keratitis can progress from epithelilal to more serious (blank) involvement

A

stromal

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101
Q

What is the Tx for HSV keratitis?

A

trifluridine drops for 3 weeks; add acyclovir if it persists

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102
Q

What are the two reason why corticosteroids are sued to dampen the inflamm and scarring due to HSV keratitis?

A

pathology is cause by both HSV cytotoxicity AND the immune response

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103
Q

What are the buzzwords associated with HSV keratitis?

A

unilateral eye pain
photophobia
oral/genital herpes
dendritic epithelial defects

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104
Q

the (blank) is the pigmented, vascular middle layer of the eye between the cornea-sclera outer protective layer and the retina

A

uvea

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105
Q

what are the eye structures involved in anterior uveitis?

A 
Eyelids
Cornea
Iris
Pupil
Anterior chamber
posterior chamber
Ciliary body
conjunctiva
106
Q

What are the four general classes of uveitis?

A

autoimmune
infectious
traumatic
idiopathic

107
Q

What percent of cases of uveitis are idiopathic?

A

50%

108
Q

what percent of uveitis is caused by infx?

A

20%

109
Q

what are the two most common infectious causes of uveitis?

A

Herpes

toxoplasmosis

110
Q

what are the symptoms of anterior uveitis?

A 
eye pain
decreased vision
CILIARY FLUSH
cells in the anterior chamber (HYOPYON).
Vitreous has few cells; retina is normal!
111
Q

What are the symptoms of posterior uveitis?

A

PAINLESS loss of vision
few cells in anterior chamber
MANY CELLS in vitreous
LESIONS IN THE RETINA, and/or choroid

112
Q

what are the eye strucutres affected by posterior uveitis?

A

retina
choroid
vitreous body

113
Q

what is endophthalmitis?

A

bacterial or fungal infection of the vitreous or aqueous humor or both

114
Q

What is the cause of most cases of endophthalmitis?

A

exogenous; cataract surgery

115
Q

what are the three types of anterior uveitis?

A

iritis
cyclitis
iridocyclitis

116
Q

What are the three types of posterior uveitis?

A

choroditis
chorioretinitis
retinitis

117
Q

What is the most common cause of panuveitis?

A

treponema pallidum

118
Q

which strucures are involved in panuveitis?

A

ALL uveal structures

119
Q

What are the three most common (bacterial) causes of endopthalmitis?

A

staph aureus
strep
gram negative bacilli

120
Q

what is the most common form of posterior uveitis?

A

toxoplasma chorioentereitis

121
Q

An active, unifocal area of acute chorioretinal inflammation adjacent to an old (blank) suggests toxoplasma chorioretinitis

A

chorioretinal scar

122
Q

(blank) inflammation can be severe in toxoplasma chorioenteritis

A

vitreous

123
Q

what is the mechanism of damage in toxoplasma choroenteritis?

A

T-cell mediated immunopathology

124
Q

Dormant (blanks) cysts can reactivate in the eye

A

bradyzoites

125
Q

In toxoplasma chorioenteritis, vision may be impaired if lesions form within the…

A

macula

126
Q

Transplacental transfer of toxoplasma choroenteritis happens in a third of women infected with…

A

toxoplasma gondii

127
Q

T/f: many cases of toxoplasma chorioenteritis are congenital infxs

A

true

128
Q

What fundoscopic findings do you see with toxoplasma chorioenteritis?

A

whitish-yellow inflammatory lesion near an atrophic, pigmented retinochoroidal scar.

129
Q

What is the Tx for ocular toxoplasmosis?

A

Trimethoprim/sulfamethoxazole, clindamycin, and prednisone

130
Q

how many colds per year doe a kid younger than five get?

A

5-7

131
Q

how many colds per year does an adult get?

A

1-2

132
Q

90% of colds are caused by…..

A 
viruses:
RHINOVIRUS
coronavirus
adenovirus
myxovirus
enterovirus
133
Q

how are colds spread?

A

person to person

134
Q

Rhinovirus enters nasal passages and infect-2s what type of cells?

A

ciliated columnar epithelial cells

135
Q

what protein on nasal mucosa does rhinovirus bind to?

A

ICAM-2

136
Q

Death of host cells leads to inflammation causing what two symptoms?

A

hyperemia and edema

137
Q

What type of snot do you have when you have a viral infx?

A

clear, mucoid

138
Q

When does your snot turn green in a viral infx?

A

mucopurulent with secondary bacterial infx from NORMAL FLORA

139
Q

paranasal sinusitis or otitis media may occur if you block what two structures?

A

sinus ostia

eustachian tubes

140
Q

T/f: rhinoviral colds may turn into bronchitis

A

true

141
Q

T/F: lab culture and serologic testing for viruses is common

A

FALSE

142
Q

What is the Tx for a viral cold?

A

supportive therapy

143
Q

What are the things that make up the dx of a viral infx?

A

symptoms
localization of dz process
time of year

144
Q

What leads to lowering viral spread?

A

HANDWASHING and disinfecting surfaces

145
Q

why do you develop nasal polyps?

A

chronic nasal inflammation

146
Q

Which sinuses are involved and for how long in acute rhinosinusitis?

A

paranasal; no longer than 4 weeks

147
Q

What is the most common cause of rhinosinusitis?

A

resp. viruses

148
Q

T/F: most people recover form acute rhinosinutsitis without medical care

A

true

149
Q

acute rhinosunitis follows what types of infections?

A

COMMON COLD
dental extractions
rhinitis due to allergies

150
Q

what are the most common viral causes of acute rhinosinusitis?

A

rhinovirus
parainfluenza virus
RSV
adenovirus

151
Q

What are the most common secondary bacterial causes of acute rhinosinusitis?

A

Strep pneumo
nontypeable H. flu
Moraxella catarrhalis

152
Q

What are the fungal bugs that immunocompromised pts get that may cause acute rhinosinusitis?

A

Mucor
Rhizopus
Aspergillus

153
Q

t/F: acute rhinosinusitis is dx’d with cultures

A

false; clinical signs

154
Q

What are the symptoms of acute rhinosinusitis?

A

rhinorrhea

facial pressure

155
Q

What level of fever and what type of discharge are seen in acute rhinosinusitis?

A

> 39 C

purulent dischage

156
Q

what are some of the buzzwords associated with acute rhinosinusitis?

A 
maxillary sinus pressure
facial pain
sinus congestion on xray
nasal passage inflammation
purulent discharged
blocked nasal ostium 
gram stain with strep pneumo
157
Q

What are the symptomatic Tx for viral rhinosinusitis?

A
  1. oral hydration
  2. antipyretics, analgesics, decongestants
  3. mucolytics
158
Q

What are the abx you shoud use in bacterial rhinosinusitis?

A

axocillin or cefdinir

TMP/SMA or z-pack in PCN allegies

159
Q

what types of things need to be repaired surgically in bacterial rhinosinusitis?

A

septal deviations
large nasal polyps
foreign bodies

160
Q

what are the important signs in rhinocerebral mucormycosis/

A

BLACK PALATAL ESCHAR
facial pain
headache, lethargy
vision loss, proptosis

161
Q

what is a huge risk factor in rhinocerebral mucormycosis?

A

diabetes

162
Q

What histo test gives you a Dx of what is a huge risk factor in rhinocerebral mucormycosis?

A

fine needle aspirate

163
Q

what do you see on fine needle aspirate in what is a huge risk factor in rhinocerebral mucormycosis?

A

nonseptate hyphae and right angle branching

164
Q

what type of major CNS complication may happen because of rhinocerebral mucormycosis?

A

cavernous venous thrombosis

165
Q

What type of imaging study is useful in the Dx of rhinocerebral mucormycosis?

A

CT

166
Q

Which systemic antifungal should you start immediately in rhinocerebral mucormycosis?

A

Amphotericin B

167
Q

What type of surgery is needed in rhinocerebral mucormycosis?

A

debridement

168
Q

what is the most common cause of pharyngitis?

A

viruses

169
Q

what age group gets strep throat?

A

5-15

170
Q

what bug causes strep throat?

A

strep pyogenes

171
Q

Besides (blank), pharyngitis is self limiting

A

diphtheria

172
Q

What is the most common viral cause of pharyngitis?

A

RHINOVIRUS
ADENOVIRUS
ebv, cmv, hsv, influenza, parainfluenza, corona, entero, hiv

173
Q

What is the most common bacterial cause of pharyngitis?

A

GAS

174
Q

what causes fungal oropharyngitis aka thrush?

A

candida albicans

175
Q

in viral pharyngitis, viruses infect what type of cell?

A

mucosa of the nasopharynx

176
Q

S. pyogenes causing pharyngitis attaches to the mucosal epithelial via…

A

M protein

177
Q

What two factors produced by strep pyogenes aid in its invasion of the mucosa?

A

protease

hyaluronidase

178
Q

what is the most common sequelae after pharyngitis?

A

rheumatic fever

179
Q

what is the clinical presentation of pharynngitis?

A 
fever
cervical LAD
maybe vomiting
no cough, conjunctivits or runny nose
PAIN UPON SWALLOWING
180
Q

What are the lab results that indicate a strep pyogenes pharyngitis?

A

b-hemolytic

bacitracin sensitive

181
Q

what types of symptoms of pharyngitis do kids get?

A

HA
N/V
abd. pain

182
Q

Pharyngitis presents with (blank) erythema with or without exudate.

A

tonsillopharyngeal

183
Q

What are the complications of pharyngitis?

A

rheumatic fever
peritonssilar abscess
cervical LAD
mastoiditis

184
Q

What is the Tx for bacterial pharyngitis?

A

oral PCN V for ten days

185
Q

what are the common methods of Dx for viral pharyngitis?

A

S. pyogenes rapid AG detection test

186
Q

are the rapid Ag detectoin tests as sensitive as cutlures?

A

nope

187
Q

What should you do if rapid strep A is positive?

A

begin Abx

188
Q

what should you do if a rapid strep A test is negative?

A

wait for cultures before beginning Abx

189
Q

What type of sample should you take to culture pharyngitis?

A

throat swab; place on blood agar

190
Q

What are the complicatoins from pharyngitis that we are trying to avoid by using abx?

A

rheumatic fever and suppurative complications

191
Q

T/F: most causes of candidiasis are painful

A

false; painless

192
Q

what two drugs do you use to treat candidiasis?

A

nystatin or clortrimazole

193
Q

How do you manage candidiasis?

A

manage the underlying cause of immunosuppresion

194
Q

how will candidiasis appear in culture?

A

creamy white colonies on SABOURAUD dextrose agar with chlromamphenicol B

195
Q

how will candidiasis look on gram stain?

A

positive, large, oval, budding organisms

196
Q

what is the only known reservoir for diphtheria?

A

humans

197
Q

How is diphtheria transmitted?

A

respiratory droplets and skin contact

198
Q

what does diphtheria look like on gram stain?

A

irregularly staining
gram positive
club-shaped!

199
Q

Only C. diphteriae (blank) for the beta bacteriophage carrying the toxin gene causes diphtheria

A

lysogenic

200
Q

What causes damage to the oropharynx in diphtheria?

A

diphtheria toxin

201
Q

What is the method of damage mediated by diphteria toxin?

A

ADP-ribosylation of eFII, terminating protein synth in mucosal cells

202
Q

What process forms the pseudomembrane in diphtheria?

A

anit-inflamm response to cell death and the dead cells themselves

203
Q

Besides the mouth, what two other areas can diptheria toxin bind to?

A

heart and nerve cells

204
Q

What is a major complicatoin of diphtheria?

A

myocarditis

205
Q

What types of nerves are most sensitive to diptheria toxin?

A

cranial nerves

206
Q

what is the result of CN infx with diphtheria toxin?

A

difficulty in swallowing and nasal regurgitation of liquids; can’t feel the roof of the mouth (palatine palsy)

207
Q

What is the special type of LAD you get with diphtheria?

A

bull neck; regional LAD and edema of the surrounding tissues

208
Q

Describe the respiratory symptoms of diphtheria?

A 
airway obstruction
tachypnea
stridor
cyanosis
fetid breath
209
Q

what are the two methods to assay for diphtheria toxin?

A

Elek immunodiffusion assay

PCR

210
Q

what samples do you use to test for diphtheria toxin?

A

oropharynx swabs (grey pseudomembrane)

211
Q

Where in the hospital do you put someone with diphtheria?

A

isolation

212
Q

what do you give to neutralize diphtheria toxin?

A

antiserum

213
Q

What are the two abx you can use for diphtheria?

A

erythromycin

clindamycin

214
Q

T/F: pts presenting with diptheria should receive the vaccine

A

true; ensures immunity

215
Q

Which diptheria vaccine do we give to kids? to adults?

A

kids: DTaP
adults: DT

216
Q

why is it extra important to manage the airway of young kids?

A

narrower than older kids and adults and will close sooner

217
Q

what is the most common cause of croup?

A

parainfluenza virus

218
Q

What are the viruses that causes laryngitis?

A 
rhinovirus
adenovirus
corona
metapneumo
influenza
219
Q

what are the bacteria that cause laryngitis?

A

Mycoplasma pneumonia

Chlamyophila pneumonia

220
Q

What is the most important cause of epiglottitis?

A

H. flu B

221
Q

infx of the upper airways resulting in edema of the larynx causes (blank) while edema of the larynx, trachea, and bronchi causes (blank)

A

laryngitis

croup

222
Q

what causes the partial airway obstructoin in croup and laryngitis?

A

mucus made by host

223
Q

What effect does laryngitis have on speech?

A

dysphonia (hoarseness)
odynophonia (pain with speaking)
dysphagia

224
Q

In viral croup, narrowing of the (blank) results in inspiratory stridor

A

subglottic trachea

225
Q

(blank) causes the barking cough in viral croup

A

laryngotracheal inflamm

226
Q

Epiglotitis is a (blank) of the epiglottis and surrounding tissue

A

cellulitis

227
Q

describe the croup prodrome

A

mild URI
coryza, nasal congestion, sore throat cough
lasts 2-3 days

228
Q

How do you Dx croup?

A

Clinically;
fever
stridor
barking cough

229
Q

What is the steeple sign on xray?

A

subglottic narrowing in croup

230
Q

What must you rule out before making a Dx of croup?

A

epiglotitis; it’s life threatening

231
Q

why is there now more cases of epiglotitis in adults rather than kids?

A

successful child vax programs!!!

232
Q

T/F: morbidity and mortality of epiglotitis is low

A

false

233
Q

What is the HIGEST PRIORITY when treating epiglotitis?

A

securing the airway

234
Q

Where in the hospital do you put pts with epiglotitis?

A

ICU

235
Q

how high do fevers get in epiglotitis?

A

> 40C

236
Q

What is the triad associated with epiglotitis?

A

drooling
dysphagia
distress

237
Q

what is the thumbrpint sign on xray?

A

swollen epiglottis

238
Q

Epiglotitis cultures are positive in what percent of cases?

A

50-75% in Hflu

239
Q

What is the Tx for epiglotitis?

A
  1. Abx: ceftriaxone

2. corticosteroids for inflamm

240
Q

what causes whooping cough?

A

bordetella pertussis

241
Q

what is the gram stain of pertussis like?

A

gram neg coccobacillus

242
Q

what is the only natural host of pertussis?

A

humans

243
Q

how is pertussis spread?

A

aerosolized droplets

244
Q

In what age group is pertusis most serious?

A

less than 12 months

245
Q

50% of kids with pertussis can be attributed to…

A

adult carriers with chronic cough

246
Q

pertussis inhaled in resp. droplets attaches to the (blank) in the trachea

A

ciliated epithelium

247
Q

What three virulence factors cause damage in pertussis?

A

Pertussis toxin
tracheal cytotoxin
filamentous hemagglutinin

248
Q

Describe the MOA of pertussis toxin?

A

ADP-ribosylates guanine-nucleotide binding protein

249
Q

what causes the cough in pertusis?

A

mucus production

250
Q

What are the neruologic complications of pertussis?

A

hypoxia and intracerebral hemorrhage

251
Q

what part of the pt history is most important when considering pertussis?

A

immunization history

252
Q

The (blank) phase of pertussis looks the same as a URI

A

catarrhal phase

253
Q

The (blank) phase of pertussis begins with sudden episodic coughing for 2-4 weeks

A

paroxysmal

254
Q

What does the pertussis cough sound like on inspiration

A

whooping

255
Q

What are the symptoms of severe pertussis?

A 
hemoptysis
subconjunctival hemorrhage
hernias
seizures
death
256
Q

What type of french sounding medium do you need for pertussis?

A

Bordet Gengou

257
Q

what sample do you use for Dx of pertussis?

A

aspirates

258
Q

Besides cultures, what else do you do to Dx pertussis?

A

serology; will also see sig. lymphocytosis

259
Q

What drug is used to Tx pertussis?

A

erythromycin

260
Q

T/F: erythromycin is most effective when started during the paroxysmal phase

A

false; no effect!

Block 9 Week 3 (8 decks)

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