Long- lRTIs Flashcards
What is bronchitis?
Inflammation of the mucous membrane on the bronchi; most infectious caused by viruses
What is Bronchiolitis?
Inflammation of the bronchioles in infants < 2 years old; caused by viruses
What is pneumonia?
inflammation of the lungs hat causes alveoli to fill with pus and fluid
What causes most cases of Bronchitis?
Viruses
T/F; Bronchitis is a generalized respiratory infection of the large elements of the tracheobronchial tree; doesn’t not extend to alveoli
True
What bacterial is most commonly associated with Bronchitis?
M. Pneumoniae
What are signs and symptoms of Bronchitis?
Hacking productive cough, negative chest X-ray for Pts
What is Chronic Bronchitis, Acute Exacerbation (AECB)?
AECB is a chronic w/ productive sputum
What Cause AECB?
H. influenzae most commonly associated isolate, Most Acute bacterial AECB are smokers w/ COPD
What is Bronchiolitis?
Viral infection of the small elements of the tracheobranchial tree
What causes Bronchiolitis?
RSV
What is Bacterial Pneumonia?
Bacterial infection of the lungs that causes inflamed alveoli to fill with puss and fluid
What does Bacterial Pneumonia do to body?
Infection damages the mucociliary escalator allow pathogens to spread into lower RT
What does Cystic fibrosis impede?
Aspirations
Signs and symptoms of Bacterial Pneumonia? What bacteria causes what?
Typical (Gram + or -) and atypical (do not Gram stain) pneumonias
Lobar pneumonia (S. pneumoniae)
Lung abscess (Klebsiella, S. aureus)
What does typical pneumonia grow on?
grow on blood/chocolate agar and gram stain
What patient group is Pneumococcal Pneumonia is most common?
Highest among elderly and persons with underlying illness
describe the pathogenesis of Typical pneumonias
S. pneumoniae colonizes upper RT. Bacteria is transported by airflow to alveoli
What is Klebsiella pneumonias often associated with?
with alcoholism, High incidence of abscesses and thick, bloody sputum
What bacteria is commonly associated with post-influenza pneumonia? What does it cause if left untreated?
S. aureus, Causes lung necrosis and Abscess
What SPACE organisms cause nosocomial pneumonia?
P. Aeroginosa and A. baumannii
P. aeroginosa commonly associated with ________ in _________ patients?
Chronic lung infection; Cystic fibrosis a patients
How are SPACE bugs manifested?
Increase sputum production with yellow-green pigment and is thick, foul smelling for P. aeruginosa
What vaccine have protected us from the wrath of Hemophilus influenzae?
Hib vaccine has made it an infrequent cause of CAP
What 2 PIDDLY are associated with Influenza?
Hemophilus influenzae and Moraxella catarrhalis
What are Atypicals sneaky bois?
do not gram stain
What is the Atypical Pneumonias antibiotic coverage?
coverage is limited to fluoroquinolone, macrolides and tetracyclines
What is walking pneumoniae RTI in. children caused by?
M. Pneumoniae
How is walking pneumonia infection spread?
can be transmitted without any signs of illness
Chlamydophila (Clamadia) pneumonia causes what?
Pneumonia
What is Legionnaires disease?
L. Pneumophila is waterborne pathogen transmitted in aerosolized form via fountains, air-conditioners.
Legionnaires disease is spread person-person. T/F?
False
What is Community acquired Pneumoniae (CAP)?
Pneumonia developing in patients that have not had contact with a medical facility.
What are some common CAP associated pathogens? What about infants? Adult?
most common and common in adults = S. Pneumoniae
Infants: Virus
What are Hospital acquired Pneumoniae (HAP)?
Pneumonia occurring ≥48 h after admission and person is not carrying infection at the time of admission.
What is Early Onset HAP?
≥ 48hr after admission
What is Late onset HAP?
≥ 120 hr post admission
What is Ventilator-associated pneumonia (VAP)?
A type of HAP that develops ≥ 48hr after endotracheal intubation (Mechanical ventilation)
What is Healthcare associated pneumonia (HCAP)
type of HAP that occurs in a non-hospitalized patients with extensive healthcare contact
What causes TB?
M. Tuberculosis complex, M. Bovis
What causes Leprosy?
M. Leprae
what type of mycobacteria doesn’t cause tuberculosis?
M. Kansasii and M. avium complex
What test can be done to identify Mycobacterium atypical spp?
acid-fast
What does Mycobacterial cell wall contains?
Cell walls contain waxes and fatty acids, especially mycolic acids
What are mycolic acids responsible for in Mycobacteria?
resistant to common antibiotics
Describe pathophysiology of Tuberculous Mycobacteria
Humans are the only reservoir for the M. Tuberculosis.
Mycobacteria infects macrophages.
how is Tuberculous Mycobacteria transmitted?
transmitted when a person inhales aerosols containing the bacilli from an active TB patient
infected macrophages encapsulates into what?
Granuloma and calcified lung lesions
granulomas are the body’s way to do what?
contain the infection
How do granulomas kill TB?
O2 starvation. but some TB become dormant that allows them to survive the granuloma
What is Latent tuberculosis?
asymptomatic and non transmissible disease state.
When does patients have latent tuberculosis?
once all the mycobacterial have been eradicated or contained in granulomas.
When can TB infection comeback?
active TB could comeback if the latent infected pateint’s immune system is weakened. weakening of immunosuppression allow granuloma to dissolve and revived the dormant mycobacteria
how is pulmonary TB spread?
inhalation of airborne particles that contain M. tuberculosis
How do Pulmonary TB spread in the Body?
if the pulmonary immune cells are unable to contain the bacteria, the M. Tuberculosis will consume to multiply over several weeks and can enter blood stream to infection other organs/tissue
What are sign and symptoms of Pulmonary TB?
hemoptysis (Cough up blood), weight loss
What is extrapulmonary TB?
M. tuberculosis may enter bloodstream. Dissmenitated TB mostly in immunocompromised patients.
What is Miliary tuberculosis?
it results when a massive TB inoculum enter the bloodstream and uncontrolled hematogenous spread results.
What can military TB cause
Septic shock
What does M. Leprae cause?
Leprosy (also call end Hanson’s disease)
Where does M. Leprae grows? What does it do to the body?
Grows the best in cool area of the body leading to disfigurement of the facial area and limbs
Tx for M. Leprae
Dapson
How does Dapson work?
it is an inhibitor of folic acid synthesis
What is M.avium complex?
MAC is comprised of M. Avium, M. Intracellular
How is M. Avium infection acquired?
Ingestion (no human-human transmission)
What patients are commonly effected by dissemination of M. Avium?
HIV patients and terminal stages of AIDs patients
What ios the first line therapies for tuberculosis?
Combination oral therapies are used to kill active and latent TB cells
- Isoniazid (INH)
- Rifampin (RIF)
- Pyrazinamide (PZA)
MOA of Isoniazid?
Prodrug that is activated by catalase peroxidase which converts INH into radical acylating agents that consequently inhibits mycolic acid synthesis
What are some of the Adverse reactions of Isoniazid?
Hepatotoxicity, neuropathy
What medication should you add for for patients with neuropathy side effects of Isoniazid?
Pyridoxine (vitamin B6)
MOA of Rifampin?
Inhibitor of mycobacteria RNA polymerase
What is the adverse reaction of Rifampin?
Hepatotoxicity, Orange-discoloration of urine/tears/sweat
Rifampin induces (decrease half-life) what?
CYP450 which could reduce the effectiveness of other medications
MOA of Pyrazinamide
Inhibit mycolic acid synthesis
Adverse reactions of Pyrazinamide?
non-gouty poly arthralgias
What is the second line Tx for tuberculosis?
MDR-TB: TB that is resistant to Isoniazid and Rifampin
Ethionamide
Moa of Ethinamide?
Inhibits Mycolic acid synthesis
Averse reaction of Ethionamide?
Causes major GI toxicity.
