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RHS > L15- RTI V > Flashcards

L15- RTI V Flashcards

1
Q

Acute Bronchitis:

  • (1) definition
  • (2) defining Sxs
  • (3) is the most common cause, (4) is second most
  • (5) is the way to distinguish from pneumonia
A

1- inflammation of bronchi due to upper airway infection
2- cough > 5 days lasting 1-3 weeks
3- viruses
4- bacteria
5- pneumonia has systemic symptoms like fever

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2
Q

Croup = (1):

  • (2) typical age of infection
  • (3) list the characteristic Sxs
  • (4) is the most common cause, (5) are other frequent causes
  • (6) is a common complication
A

1- laryngotracheitis, laryngotracheobronchitis (inflammation of larynx, sub-glottic area)
2- 6 mos - 3 yrs
3- inspiratory stridor, ‘barking cough’ in children (hoarseness in older people)
4- HPIV-1
5- RSV, adenovirus
6- secondary bacterial infections

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3
Q

Croup:

  • (1) are the initial typical Sxs
  • (2) is a key associated Sx
  • (3) is the most severe complication
  • (4) is the radiological feature
A

1- non-specific URI sxs
2- mild fever, <40C
3- severe respiratory distress
4- subglottic narrowing of trachea = ‘steeple sign’

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4
Q

list the important Paramyoxviridae by subfamiles

A

1) paramyxovirinae: HPIV-1/3 (respirovirus), HPIV-2/4 (rubulavirus)
2) pneumovirinae: RSV

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5
Q

Paramyxoviridae:

  • (non-/enveloped) (+/-) sense (ss/ds)(DNA/RNA) with (5) nucleocapsid shape
  • replication occurs in (cytoplasm/nucleus)
  • transmitted via (7)
A

(HPIV, RSV)
1-5- enveloped (-) sense ssRNA, helical nucleoocapsid
6- cytoplasmic replication
7- respiratory droplets

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6
Q

List the important VAPs seen in paramyxoviruses, include function

A

F, fusion protein: forms syncytia between cells, allows for travel/spread from cell to cell (HPIV and RSV)

  • HN, hemagglutinin-neuramidase (HPIV only): H for attachement, N for lysis/release
  • G, glycoprotein (RSV only): attachment and cell entry
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7
Q

HPIV infections, list the predisposing factors (hint- 2 main ones, 3 other ones)

A
  • vitA deficiency
  • lack of breast feeding
  • malnutrition
  • overcrowding
  • environmental smoke (infantile exposure) or toxins
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8
Q

HPIV infections:

  • (1) is form of transmission
  • requires a (large/small) inoculating dose
  • (3) incubation period
A

1- respiratory droplets or direct contact with secretions / fomites
2- small dose needed
3- 1-7 days

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9
Q

Croup is mainly caused by…..

A

(laryngotracheitis)

HPIV-1, 2, 3

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10
Q

list the membrane proteins for HPIV, include function (include shape)

A

(spherical shape)
1) F, fusion protein: forms syncytia between cells

2) HN, hemagglutinin-neuramidase: H for attachement, N for lysis/release

3) M, matrix protein: assembly
4) P, phosphoprotein: along with F, induces cell-mediated immune response
5) N, nucleoprotein
6) L, RNA dep. RNA polymerase

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11
Q

HPIC, name the viral protein:

  • (1) syncytium formation
  • (2) immune evasion
  • (3) attachment, entry, and release of virus
  • (4) matrix structural protein, assembly
  • (5) polymerase
A 
1- F, fusion proteins
2- P/F proteins (disrupts IFN production)
3- HN protein
4- M, matrix protein
5- L protein
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12
Q

describe how P/F proteins on HPIV work to evade immune response

A

blocks IFN-α/β production and signaling pathways

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13
Q

Bronchiolitis:

  • (1) definition
  • (2) most affected age group
  • (3) season with highest incidence
  • (4) Sxs followed by (5)
A 
1- inflammation of bronchioles and small bronchi
2- <2y/o
3- fall, winter
4- URI sxs
5- LRT infection w/ inflammation
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14
Q

Bronchiolitis:

  • (1) most common cause
  • (2) other causes
  • (3) list the numerous risk factors
A

1- RSV (respiratory syncytial virus)
2- rhinovirus, HPIV, adenovirus, coronavirus

3- prematurity (<35 wks), low birth weight (<2.5 kg), congenital/cyanotic heart disease, chronic pulmonary disease, passive smoking, overcrowding, daycare

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15
Q

In bronchiolitis, (1) will infect (2) cells causing direct (3). (4) will accumulate as a result of (3), and can lead to (5) complication.

A

1- virus (causal agent)
2- terminal bronchiolar epithelium
3- cell damage and inflammation
4- edema, excess mucus, sloughed epithelial cells
5- small airway obstruction and atelectasis

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16
Q

Bronchiolitis:

  • starts with (1) type Sxs
  • (2) sxs start next, include specifics
  • illness duration depends on (3)
  • (4) is the end result of most infections
A

1- URI sxs (nasal congestion and discharge)
2- LRT infections sxs: fever <101F, cough, respiratory distress (inc RR, retractions, wheezing, crackles), preceding h/o URI
3- age, severity, associated conditions, causative agent
4- self-limiting

17
Q

(1) is the leading cause of LRTIs in infants/young children, mainly causing (2) and (3). Infections by (1) are usually limited by (4). (1) LRTIs are also linked to (5) in infancy, although association remains controversial.

A 
1- RSV
2- bronchiolitis
3- viral pneumonia
4- to respiratory tract
5- subsequent reactive airway disease
18
Q

list the risk factors for RSV infections

A
  • infants < 6 mos
  • immuno-compromised
  • asthma

Infants with: *Down syndrome, underlying lung disease, premature birth (<35 wks), congenital heart disease, passive smoking

19
Q

RSV:

  • (1) family, subfamily, genus
  • (non-/enveloped), (3) capsid shape
  • list important VAPs, (4)
A

1- paramyxoviridiae, pneumovirinae, pneumovirus
2- enveloped, helical nucleocapsid (neg. sense ssRNA, cytoplasm replication)
3:
-F, fusion factor: main viral Ag, forms syncytia between cells
-G glycoprotein: attachment
(NOTE- no HN glycoprotein)

20
Q

RSV enters body via (1) process. (2) are responsible for attachment and fusion to target cells. (3) is the primary site of replication and has a (4) direct effect on (3). It will spread to (5) after (6) days via various mechanism.

A

1- large droplets on hands –> self inoculation to epithelia of nose, eye
2- F/fusion protein, G glycoprotein
3- nasopharyngeal epithelium
4- cytopathic effect => loss of function for (3)
5- LRT
6- 2-5 days

21
Q

It is suggested that ____ is responsible for the immune response to RSV.

A

Tc cells (CD8+)

22
Q

It is thought that (1), (2), (3) are directly responsible for the clinical outcome of RSV infections..

A

1- immunological response

2- anatomy of airway (worse in younger people with already narrow airways)

3- tropism for respiratory epithelium

23
Q

Whooping cough is caused by (1), and is also called (2) cough. It typically occurs in (3) people, where (4) are the normal reservoirs.

A 
1- bordetella pertussis
2- 100 day cough
3- unvaccinated children <10y/o
4- adults
(Note- highly communicable)
24
Q

Bordetella pertussis: (large/small) (thin/thick) Gram(+/-) (cocci/bacillus)

A

small, thin, Gram-, coccobacillus

25
Q

Whooping cough (B. pertussis):

  • (1) incubation period
  • (2) initial stage
  • (3) middle stage
  • (4) last stage
  • (5) communicable period
A 
1- 5-10 days (max 21 days)
2- Catarrhal stage, 1-2 wks (URI Sxs)
3- Paroxysmal stage, 1-6 wks
4- Convalescent stage, wks-mos
5- onset to 3 wks (bacteria is gone, but exotoxin keeps persistent Sxs)
26
Q

Bordetella pertussis virulence factors:

  • (1) responsible for bacterial attachment
  • (2) causes local tissue damage + bacterial proliferation
  • (3) is responsible for systemic toxicity
A

1- Protein Adhesins: pertactin, FHA (filimentous hemagglutinin), fimbria

2- dermonecrotic toxin, tracheal cytotoxin

3- pertussis toxin

27
Q

describe MOA of tracheal cytotoxin and pertussis toxin, how do they relate (B. pertussis)

A

Pertussis: inactivates adenylate cyclase –> inc cAMP –> inc respiratory secretions (mucus)

Tracheal: prevents release of mucus secretions –> trapping it and causing whooping cough

28
Q

Bordetella pertussis must be sampled through (1) because of (2) property. (3) is the required agar because it is a fastidious organism. (4) can also be complete for evaluation of B. pertussis.

A

1- nasopharyngeal swab, or secretions
2- very susceptible to drying
3- charcoal blood agar + cephalosporin (aka Bordet-Gengou)
4- PCR

29
Q

describe the vaccines for bordetella pertussis

A

(DTaP, aP = acellular pertussis)
1) (rarely used) whole cell, formalin inactivated

2) *Acellular components (many): Fha, PT, pertactin, fimbriae-2/3 [lower rates of side effects]

Note- immunity can dec over time

RHS (35 decks)

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