Infectious Disease Flashcards
What is the scientific name for the common cold?
infectious rhinitis
Is the common cold a bacterial or viral infection?
It is viral
How many causative agents can cause the common cold?
More than 200 possible causative agents
How does the common cold spread?
Through respiratory droplets
What are the 2 most important methods to prevent the spread of infection?
- Hand washing
2. Respiratory hygiene
How is the common cold treated?
Symptomatically
While a patient is infected with the common cold, what, if any, type of secondary infections may occur?
- What is the causative agent?
- What are the symptoms?
- Bacterial Infections
- Streptococci
- Purulent exudate; systemic signs (i.e. fever)
When does sinusitis usually occur? What is the causative agent?
It is usually a bacterial infection; secondary to a cold or allergy
What is the result of sinusitis?
obstruction of paranasal sinuses into the nasal cavity
What is the pressure experienced by patients suffering from sinusitis caused by?
Where is this pressure located?
- Pressure is caused by inflammation
- It is in the sinus cavity
What is the common name for Laryngotracheobronchitis?
- Croup
Who often suffers from croup?
Children ages 1-2 years old
Is Laryngotracheobronchitis bacterial or viral?
Viral
What is the common causative organism for Laryngotracheobronchitis?
Parainfluenza virus and adenoviruses
How does Laryngotracheobronchitis usually manifest itself in the beginning?
It begins as an upper respiratory infection
How does the Laryngotracheobronchitis infection spread through the body?
It starts as an upper respiratory infection.
Spreads to the larynx with inflammation resulting in obstruction.
What causes the “croupy cough”?
Obstruction in the larynx due to inflammation
What sound is heard on inspiration during Laryngotracheobronchitis?
Inspiratory stridor
Does Laryngotracheobronchitis spread to the people around patient zero?
No, it is usually self-limited
What age range usually acquires epiglottitis?
Common in children ages 3-7
What is the mot common causative agent of epiglottitis?
Haemophilus influenzae type B
Does epiglottitis have an insidious onset or a rapid onset?
Rapid onset
What are common symptoms of epiglottitis? (5)
- Fever
- Sore throat
- Drooling
- Difficulty swallowing
- Heightened anxiety
What sitting position is characteristic of epiglottitis?
A tripod position
Where does swelling occur during epiglottitis? (3)
- Larynx
- Supraglottic Area
- Epiglottis
What does the swelling that occurs during epiglottitis cause? (2)
- Airway obstruction
2. Spasm of larynx common if area is touched with instruments
What are the 2 treatments for epiglottitis?
- Oxygen
2. Antimicrobial Therapy
What type of infection is Influenza?
A viral infection
What part of the respiratory system does Influenza affect? (upper or lower respiratory tract)
It can upper and lower respiratory tract
Which secondary infection frequently appears when a patient has influenza?
Viral Pneumonia
What type of virus is the influenza virus?
Which virus group does it belong to?
- RNA Virus
- Myxovirus Group
What are the 3 types of influenza viruses?
- Type A
- Type B
- Type C
Which influenza virus is the most prevalent?
Why is this type so prevalent?
Type A
What cells does the influenza virus enter?
The respiratory mucosa
What does the influenza virus do in the respiratory mucosa?
What could it cause? (2)
It replicates
Inflammation and necrosis
Where could there be inflammation when a patient has influenza? (3)
- Sinuses
- Pharynx
- Auditory Tube
What are the acute clinical manifestations of influenza?
- Systemic signs (3)
- Pain (3)
- Respiratory (2)
- Systemic signs (3)
- Fever
- Chills
- Marked Fatigue
- Pain (3)
- Headache
- Aching pain
- Sore Throat
- Respiratory (2)
- Unproductive cough (dry)
- Nasal congestion
What is the main cause of death during the flu epidemic?
Pneumonia
How many types of treatment are there for influenza? What are those treatments?
- Symptomatic and supportive
2. Antiviral
When would you not treat influenza purely symptomatically/ supportively?
If a bacterial infection develops secondarily
What is the reason for using antiviral drugs? (2)
- May reduce symptoms and duration
2. Reduce the risk of infecting others
What is an example of an antiviral used against influenza?
Tamiflu (oseltamivir)
What preventative measures can be taken in regard to the influenza virus? (2)
- Respiratory Hygiene
2. Vaccination (not recommended to all but it is recommended for most)
What causes Scarlett fever?
Group A Beta Hemolytic Streptococcus
S. pyogenes
What are the 6 symptoms of Scarlett fever?
Systemic (2)
GI (2)
Above the shoulders (2)
- Typical “strawberry tongue”
- Fever, Chills
- Sore throat
- Vomiting
- Abdominal pain
- Malaise
What is the treatment for Scarlett fever?
Antibiotics
What part of the respiratory tract does pneumonia affect?
The Lower Respiratory Tract
What is the classification of pneumonias based on? (4)
- Causative agent
- Anatomical location of infection
- Pathophysiological changes
- Epidemiological data
What are the 3 types of causative agents that could cause pneumonia?
- Viral
- Bacterial
- Fungal
Where could pneumonia be located? (2)
Throughout both lungs
or
Consolidated in one lobe
What pathophysiological changes could occur in pneumonia? (3)
- Changes in interstitial tissue
- Alveolar septae
- Alveoli
Where could someone acquire pneumonia? (The epidemiological data that helps with classification of pneumonia) (2)
- Nosocomial
2. Community- acquired
What is a nosocomial infection?
A hospital - acquired infection
What is another name for Pneumococcal Pneumonia?
Lobar Pneumonia
Is Pneumococcal Pneumonia community acquired or nosocomial?
Who does it usually affect?
- It is community acquired
- young healthy adults
What usually causes pneumococcal pneumonia?
Streptococcus pneumoniae
Where is the infection of pneumococcal pneumonia located in the infected patient?
The infection is localized in one of more lobes
Where is the exudate accumulated in pneumococcal pneumonia patients?
The exudate is in the alveoli
What type of congestion is present in pneumococcal pneumonia?
Vascular congestion
What does the exudate of pneumococcal pneumonia contain?
Is it loose or firm?
Fibrin and it forms a consolidated mass
What color sputum does the exudate in pneumococcal pneumonia produce?
Rusty sputum
Is the pneumococcal pneumonia disease consolidated to solely the lobes it affects or does it spread?
It frequently affects the adjacent pleurae/ the pleural cavity
What is it called when the pneumococcal pneumonia infection spreads to the pleural cavity?
Empyema
Does pneumococcal pneumonia have an insidious or acute onset?
Acute, sudden onset
What are the systemic signs of pneumococcal pneumonia? (4)
- High fever
- Chills
- Fatigue
- Leukocytosis
Define Leukocytosis
an increase in the number of white cells in the blood, especially during an infection.
What symptoms of pneumococcal pneumonia are related to a cough? (3)
- Dyspnea
- Tachypnea
- Productive cough, typically rusty-colored sputum
When listening to the chest of a patient with pneumococcal pneumonia, what do you hear in the lungs? What about the heart?
Lungs: Rales
Heart: tachycardia
Where does a patient with pneumococcal pneumonia feel the pain?
They feel pleural pain
How does a patient with pneumococcal pneumonia act?
They are confused and disoriented
What pattern of infection occurs in bronchopneumonia? Does it affect both lungs or one lung?
Diffuse pattern of infection
It affects both lungs
What is the cause of bronchopneumonia?
Several species of microorganisms may be the cause
What type of exudate forms in bronchopneumonia and where does it form?
Inflammatory exudate forms in the alveoli
Is the onset of bronchopneumonia insidious or acute?
Onset tends to be insidious
What are the 3 symptoms associated with bronchopneumonia?
- Moderate fever
- Cough
- Rales
The cough associated with bronchopneumonia, is it productive?
If so, what type of sputum is it and what color?
Yes, it is associated with purulent sputum. It is usually yellow or green
What type of treatment is often used for bronchopneumonia?
Antibacterial treatment is often used.
What type of pneumonia is caused by Legionella pneumophila?
Legionnaires’ Disease
What type of environment does Legionella pneumophila thrive in?
Warm, moist environments
Is Legionnaires’ Disease community acquired or nosocomial?
It is often a nosocomial infection
In order to ID Legionnaires’ Disease, what is required?
A specific culture medium
What could an untreated infection of Legionnaires’ Disease cause? (4)
- Severe congestion
- Consolidation
- Lung necrosis
- Possibly fatal
What are the two bacterial causes of Primary Atypical Pneumonia?
- Mycoplasma pneumonia
2. Chlamydia
The Primary Atypical Pneumonia caused by Mycoplasma pneumonia is common for which age category?
Older children and young adults
The Primary Atypical Pneumonia caused by Mycoplasma pneumonia is transmitted by ___.
Aerosol
Is the Primary Atypical Pneumonia caused by Mycoplasma pneumonia contagious?
Yes, but not extremely
What is the prominent sign of the Primary Atypical Pneumonia caused by Mycoplasma pneumonia?
A frequent cough
How is the Primary Atypical Pneumonia caused by Mycoplasma pneumonia treated?
Antibiotic therapy
Is Chlamydial pneumonia severe?
No, it is a very mild form of pneumonia. So much so, it often goes undiagnosed.
What are the 3 viral causes of the Primary Atypical Pneumonia?
- Influenza A or B
- Adenoviruses
- Respiratory Syncytial virus (RSV)
Is the cough associated with viral primary atypical pneumonia unproductive or productive?
Unproductive
What are the symptoms associated with viral primary atypical pneumonia?
Upper respiratory (3)
Systemic (2)
Aches (1)
- Unproductive cough
- Hoarseness
- Sore Throat
- Headache
- Mild Fever
- Malaise
What does SARS stand for?
Severe Acute Respiratory Syndrome
What is the causative agent of SARS?
A microbe called: SARS-associated coronavirus
How is SARS transmitted?
Close contact, respiratory droplets
What re the first signs of SARS?
Systemic (2)
GI (2)
Pain (2)
- Fever
- Headache
- Myalgia
- Chills
- Anorexia
- Diarrhea
What are the later signs SARS?
Re: Lungs
Is there a cough, is it productive?
- Dry cough
- Marked dyspnea
- Interstitial congestion
- Hypoxia
What is the treatment for SARS?
Antivirals and glucocorticoids
What are the risk factors for acquiring SARS? (monitored to prevent outbreaks)
- Travel to endemic or epidemic areas
- Close contact with infected person/ Employment involving close contact with the virus
- Presence of a cluster of undiagnosed atypical pneumonia cases
What happens when active SARS cases are identified?
Active cases are quarantined until patient is clear of infection
What causes Tuberculosis (TB)?
Mycobacterium tuberculosis
How is TB transmitted?
It is transmitted by oral droplets from persons with active infection.
TB occurs most frequently in conjunction with (7):
- People living in crowded condition
- Immunodeficiency
- Malnutrition
- Alcoholism
- Conditions of war
- Chronic Disease
- HIV infection
What is M. tuberculosis resistant to?
Drying, many disinfectants
How long can M. tuberculosis survive in dried sputum?
Weeks
What destroys M. tuberculosis? (5)
- UV light
- Heat
- Alcohol
- Glutaraldehyde
- Formaldehyde
What organs does M. tuberculosis normally affect?
Primarily: Lungs
Can also effect: Kidneys and Bones
During the primary infection of M. tuberculosis, if the patients cell-mediated immunity is adequate, what is the first step that the immune system takes?
Bacteria are engulfed by macrophages, this results in local inflammation.
During the primary infection of M. tuberculosis, some bacilli migrate to lymph nodes, what type of hypersensitivity does this illicit?
Type 4 hypersensitivity
During the primary infection of M. tuberculosis, what clusters together to form a granuloma?
Macrophages and T lymphocytes
What is a granuloma containing live bacilli of M. tuberculosis called?
Tubercle
What type necrosis forms in the center of a TB tubercle?
Caseation necrosis occurs in the center of the tubercle
In a healthy person, what happens to the lesions caused by M. tuberculosis?
The lesions calcify
What tool can be used to see the tubercles caused by TB in a live persons chest?
Chest radiograph
What are the TB lesions called when seen on a radiograph?
Ghon complexes
How long can TB bacilli remain viable in a dormant stage?
For years
If a person remains healthy, what happens to the bacilli in the tubercles?
The bacilli remain walled off
What happens during the primary latent TB infection? (4)
- The individual must have been __.
- The individuals disease is active or inactive?
- The individual is symptomatic or asymptomatic?
- The disease is communicable (T/F)
- The individual must have been exposed and infected.
- The individuals disease is inactive
- The individual is asymptomatic
- False: The disease cannot be transmitted
If cell-mediated immunity is inadequate, what does mycobacteria tuberculosis do in the lung tissue?
Mycobacteria reproduce and begin to destroy lung tissue.
T/F
If cell-mediated immunity is inadequate, TB will not be contagious.
False!
What is a secondary or re-infection of TB?
It occurs when a patient has had TB inactive in their body and due to cell-mediated immunity impairment, TB releases itself.
What could cause a patients cell-mediated immunity to become impaired? (4)
- Stress
- Malnutrition
- HIV infection
- Age
Once reactivated, what does TB do in th lungs?
What does this mean for its contagiousness?
It reproduces and infects the lungs.
This form can spread to others, it is contagious.
What happens in Miliary or extrapulmonary TB that is unique?
Early dissemination to other tissues
What age group is usually affected by Miliary or extrapulmonary TB?
It is a rapidly progressive form, more common in children <5y
If lesions are not found in lungs in a patient who has Miliary or extrapulmonary TB, what does that mean for the contagiousness of the TB?
If lesions are not found in the lungs, this TB is not contagious.
What are the 3 common symptoms associated with Miliary or extrapulmonary TB?
- Weight loss
- Failure to thrive
- Other secondary infections (i.e. measles)
During active TB, regardless whether it is primary or secondary, when the organism multiplies what does that cause in the lungs?
Large areas of necrosis, large open areas in the lungs
Define cavitation
Large open areas in the lungs
What does cavitation promote in active TB?
The spread to other parts of the lungs, the infection may spread to the pleural cavity.
During active TB a patient will present with ___. (3)
- Cough
- Positive sputum
- Visible cavitation in radiograph
When is active TB highly infectious?
When there is close personal contact over time.
What diagnostic tests are performed to check for first exposure or primary TB infection?
First exposed is indicated by a positive Tuberculin (skin) test.
What diagnostic tests are performed to look for an active TB infection?
- Acid-fast sputum test
- Chest radiograph
- Sputum culture
What is the treatment for TB?
How much time does the treatment take?
Long term treatment involves a combination of drugs and can last between 6-12 months
What does effective treatment involve?
Monitoring and close follow up. This is very expensive.
In which population is TB becoming a problem? What is the cause?
In the homeless population, due to the sheer fact of being homeless, lack of healthcare, and over-crowding in shelters.
What viral infection has lead to an increase in TB as a secondary infection?
HIV
How has TB evolved to become more prevalent?
There is multidrug resistant TB.
What is histoplasmosis caused by?
Histoplasma capsulatum, a fungus
How is histoplasmosis acquired?
Spore can be inhaled on dust particles
Is Histoplasma capsulatum a primary pathogen or an opportunistic pathogen?
An opportunistic pathogen.
T/F
Often in the first stage of the Histoplasmosis, a patient will be symptomatic.
False:
Often in the first stage of the disease, a patient will be asymptomatic.
In the second stage of histoplasmosis, what happens in the tissues?
Granulomas form and necrosis occurs
What are the 4 symptoms associated with histoplasmosis?
They are mostly systemic
- Cough
- Fatigue
- Fever
4, Night Sweats
What is the treatment for histoplasmosis?
Antifungals
What type of infection is Anthrax?
What causes Anthrax?
Is it gram positive or gram negative?
- Bacterial infection
- Bacillus anthracis
- Gram positive
Regarding Anthrax, What are the symptoms? What respiratory symptoms are present? What does the release of the toxins cause? Is fatality rate low or high?
- Flulike symptoms
- Severe acute respiratory distress
- Due to toxin release, shock occurs.
- High fatality rate
What antimicrobial agent is used against Bacillus anthracis?
Ciprofloxacin
Is there a vaccine available for Anthrax?
Yes, an animal vaccine is available
Who is the anthrax vaccine recommended for?
It is recommended for people working with the organism or in other professions that might cause exposure