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Craab 2.5 > Micro- Upper respiratory > Flashcards

Micro- Upper respiratory Flashcards

1
Q

What are 3 ways of which bacteria can cause dz?

A
  1. Toxin production
  2. Host immune response
  3. bacterial proliferation and invasion
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2
Q

What are 3 ways which viruses can cause dz?

A
  1. Cytopathic effect
  2. Host immune response
  3. Tumorgenesis
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3
Q

What are some common pathogens that cause otitis media?

A
  1. Step pneumoniae
  2. Haemophilus influenzae
  3. other bacteria
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4
Q

What are some common pathogens that cause sinusitis?

A

Various bacteria and fungi

  • S pneumonia and H influenzae
  • 2’ bacterial infection
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5
Q

What are some common pathogens that cause Rhinitis?

A

over 200 viruses

AKA common cold
- mostly viruses

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6
Q

What are some common pathogens that cause pharyngitis?

A
  • Strep pneumoniae
  • fusobacterium necrophorum
  • viruses
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7
Q

What are some common pathogens that cause Pneumonia?

A
  1. Strep pneumoniae
  2. Legionella
  3. Mycoplasma pneumoniae
  4. Hantavirus
  5. Histoplasma capsulatum
  6. Pneumocytis jiroveci
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8
Q

What are some common pathogens that cause whooping cough?

A

Bordetella pertussis

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9
Q

What are some common pathogens that cause TB?

A

Mycobacterium tuberculosis

- mycobacterium avium complex

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10
Q

What are the Upper respiratory infections? URT?

A

Otitis externa/media

  • rhinitis
  • pharyngitis
  • epiglottitis
  • laryngitis/croup
  • Sinusitis

Get sick TODAY

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11
Q

What are some lower respiratory tract infections? LRT?

A

Bronchitis

  • bronchiolitis
  • influenza
  • pneumonia
  • TB

Get sx’s next WEEK

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12
Q

What are some normal biota of the respiratory system?

A

Moraxella, nonhemolytic and alpha hemolytic steptococci

  • Corynebacterium and other diphtheroids
  • Candida albicans
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13
Q

What could show up on respiratory culture as normal biota?

A
  • Strep pyogenes/ pneumoniae
  • H. influenza
  • N meningiditis
  • S. aureus
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14
Q

What are the respiratory systems defenses?

A
  1. Mucociliary lining
  2. Change direction of airway from sinuses to pharynx
  3. Alveolar macs
  4. Ciliary elevator
  5. Normal flora competition
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15
Q

What virulence factors doe the mucociliary lining have?

A

Lysozyme
Lactoferrin
IgA

Exact same as urogenital mucosa

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16
Q

What are the 2 obstacles microbes must overcome to initiate infection?

A
  • Avoid being swallowed

- avoid phagocytosis

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17
Q

What are the purpose of the nasal chonchae?

A

Cause air to become turbulent and swirl.

  • causes air to touch mucous membranes and this traps microbes
  • anything not filtered by nasal hairs
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18
Q

What is the mucociliary escalator?

A
  1. Mucus producing goblets

2. Ciliated epithelium

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19
Q

What does smoking do to the mucociliary escalator?

A

Paralyzes it

  • infect these cells and you can cause dz
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20
Q

How do microbes start colonization?

A

adherence factos and immune evasion factors

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21
Q

What percent of vires cause pharyngitis?

A

90%

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22
Q

What is the common cause of the common cold?

A

Rhinitis

  • 100-200 rhinoviruses
  • 50 adenoviruses
  • several Coronoaviruses
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23
Q

When is adenovirus more common?

A

Summer

- otherwise common cold is more common in winter

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24
Q

What are the initial progression of sx’s of the common cold?

A

Nasal stuffiness, sneezing and HA

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25
Q

What are the initial progression of sx’s of the common cold?

A

Nasal Cavity with fluid

  • Tiredness
  • watery eyes
  • sore and scratchy throat
  • slight F
  • Anorexia
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26
Q

Where must the common cold settle in order to causes cough?

A

Lower respiratory tract

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27
Q

What are some possible complications with the common cold?

A

2’ bacterial infections by normal flora–> purulent nasal secretions

  • Sinus blockages–> sinusitis or otitis media
  • access to LRT–> bronchitis
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28
Q

What is the tree for Rhino virus?

A

RNA virus–> Isoahedral nucleocapsid–> Nonenveloped –> SS + (4)–> Non-segmented–> picornaviridae

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29
Q

What is the tree for coronavirus?

A

RNA virus–> helical nucleocapsid–> envelope–> SS + (4)–> nonsegemented–> coronaviridae

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30
Q

What is a common adherence factor for rhinovirus?

A

ICAM-1

  • 2-5 days sx peak
  • 14 days post cells are completely regenerated
  • cause ciliated epithelial cells get destroyed
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31
Q

What is the most common cause of conjunctivitis?

A

Adenoviruses

- summer time and cold symptoms with conjunctivitis think this virus

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32
Q

What is the tree for influenza A and B?

A

RNA virus–> Helical nucleocapsid–> enveloped–> SS - (5)–> Segmented
–> orthomyxoviridae

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33
Q

What is the tree for coxsackievirus A and B?

A

RNA virus–> icosahedral nuclocapsid–> Non-enveloped–> SS + (4)–> Picornaviridae–> enterovirus

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34
Q

What is the tree for Parainfluenza virus (paramyoxvirus)?

A

All same but paramyxoviridae

35
Q

What is the tree for Adenovirus (Mastadenovirus)?

A

DNA virus–> Icosahedral nucleocapsid–> enveloped–> DS linear (1)–> adenoviridae

36
Q

What is another term for sinusitis?

A

Rhinosinusitis

37
Q

What is the definition of acute rhinosinusitis?

A

Inflammation and infection of mucosa of nasal passages and at least one of the paranasal sinuses

  • NO- longer than 4 weeks
  • URI predisposes
38
Q

What are sx’s of rhinosinusitis?

A

Sneezing

  • rhinorrhea, nasal congestion,
  • post nasal drip
  • aural fullness
  • facial pressure
  • Ha
  • ST
  • Cough
  • Fever
  • Muscle aches
39
Q

What do bacterial sinus infections follow?

A

Common cold
Dental extractions
Allergic rhinitis
- 2% of adults and 10% of children

40
Q

When is sinusitis most common?

A

winter

41
Q

How long do sx’s usually last with sinusitis?

A

5-7 days

- mostly viral

42
Q

What is the dx for acute bacterial sinusitis?

A
  • beyond 7 days
  • facial swelling or tooth pain
  • longer in kids like 10-14 days
  • kids get fever
43
Q

are antibiotics recommended for bacterial sinusitis?

A

Yes

44
Q

What the 2 most common cause of bacterial sinusitis?

A

Strep Pneumonia

H Influenzae

45
Q

What re some other causes of bacterial sinusitis?

A

Step pyogenes
S aureus
Morexella catarrhalis

46
Q

can you get a fungal sinusitis? How often what causes it?

A

Yes but rare

  • Aspergillus fumigatus
  • usually dx after antibiotics fail.
  • immunocompetent is to physically remove the fungus
47
Q

What do you treat acute bacterial sinusitis with?

A

Augmentin

Azithromycin

48
Q

What is the only thing to shorten the severity of the sinusitis?

A

Nasal saline washes and steam

  • can also try NSAIDS, decongestants and mucolytics
49
Q

What are some facts about pharyngitis?

A

Common worldwide

  • winter and spring
  • self limiting
  • viruses most common
  • person to person
50
Q

What is the most common pathogen of bacterial acute pharyngitis?

A

Strep pyogenes

51
Q

What percent of both adults and children cause viral pharyngitis?

A

90 and 60-75%

52
Q

What are the virulence factors for step pyogenes?

A 
M protein
Lipoteichoic acid
Fibronectin binding protein
Capsule has hyaluronic acid
Protease
Hylauronidase
53
Q

What does hyaluronic acid do for strep pyrogenes?

A

Inhibits phagocytosis

54
Q

what are common findings with person with pharyngitis either bacterial or viral?

A

ST
F
Edema
Hyperemia

55
Q

What sx’s strongly suggest viral pharyngitis?

A 
Conjunctivitis
Cough
Hoareness
Inflammation of MM
Diarrhea
56
Q

What re some sx’s of bacterial pharyngitis?

A
  • F
  • Severe pain (sudden onset ST)
  • HA
  • N
  • V
  • AP
57
Q

What can one find on PE with bacterial pharyngitis?

A

Red tonsils with exudate

-enlarged and tender cervical LN’s

58
Q

What does the rapid strep test look for?

A

Ag detection

59
Q

How do we treat bacterial and viral pharyngitis?

A

Penicillin or erythromycin

Symptomatic with NSAIDs and warm saline gargles

60
Q

What is the tree for Strep pyogenes?

A

Bacteria–> gram +–> cocci–> catalase neg–> Beta-hemolytic–> bacitracin sensitive

61
Q

What can cause scarlet fever?

A

ssa
speA
speC

  • toxins that are superantigens
62
Q

What is catalase?

A

Turns peroxide and o2 into water and o2

- gives you bubbles

63
Q

What is peroxidase?

A

turns peroxide and O2 into water

64
Q

What is the tree for diphtheria?

A

Bacteria–> gram +–> bacilli–> non-spore forming–> non-motile

65
Q

What sx’s is diptheria infection similar to?

A

Pharyngitis but also:

  • Nasal discharge
  • malaise
  • Difficulty breathing/rapid breathing
66
Q

What is unique to diphtheria on PE?

A

Thick grey membrane covering the back of the throat

67
Q

What toxin does diphtheria have?

A

A B toxin

Binding and active toxin which prevents protein elongation

68
Q

What is croup?

A

Bark like cough with a fever of 38-39

  • Restlessness
  • SOB
69
Q

how does it present?

A

usually with cold like sx’s amd a bark like cough 2-3 days later

70
Q

what is common finding on PE for Croup?

A

Inspiratory stridor at nest with nasal flaring and intercostal retractions
- usually at night

71
Q

What are some other sx’s of croup?

A

Lethargy or agitation

  • hypoxia
  • tachyphea and cardia
  • fever
  • pallor
  • hypotonia
  • cyanosis
72
Q

What is the prognosis of croup?

A

peak at 3-5 days and resolve in 4-7 days

73
Q

Who gets croup?

A

Children from ages 6 months to 3 years

  • F»>M
  • late fall and early winter
74
Q

What causes croup?

A
  • Parainfluenza virus at any time of year
  • influenza virus winter and early spring
  • Respiratory syncytial virus in winter and early spring
75
Q

What is the treatment for croup? what do you do if this doesn’t work?

A

Symptomatic treatment

  • try corticosteroids and nebulized epi
  • O2 with ventilation support
76
Q

What is the tree for respiratory syncytial virus?

A

Virus–> helical nucleocapsit–> enveloped–> SS neg–> Nonsegmented–> Paramyxoviridae–> pneumovirus

77
Q

What is a syncytium?

A

Multinucleated cell that can result from multiple cell fusions of uninuclear cells

78
Q

What is the virulence factor for RSV?

A

F proteins–> surface protein

- cause nearby cell membranes to fuse

79
Q

What is palivizumab?

A

Monoclonal ab (IgG1k) produced by recombinant DNA to attack A antigenic site of F protein

80
Q

Who gets epiglottis?

A

Most often in children

81
Q

What usually cause epiglottis?

A

beta-hemolytic steptococci–> group a, b and c

- H. Influenzae type B

82
Q

What is the treatment for epiglottitis?

A

secure airway

-Broad spec with 2’ or 3’ gen cephalospirings with penicllinase resitant penicillins

83
Q

How doe we type H influenzae?

A

Capsule

- A thru F

84
Q

how can one diff from croup and epiglottis?

A

Drooling and super sudden onset in epiglottis

Craab 2.5 (8 decks)

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