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Respiratory Exam 2 > Micro: URT infection > Flashcards

Micro: URT infection Flashcards

1
Q

Most common PCP visit for children and OMM techniques to treat it.

A

Acute Otitis Media (AOM)

  • Auricular Drainage
  • Sphenopalatine Release
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2
Q

Two most common causes of AOM.

A
  1. Strep pneumo

2. Haemophilus influenzae

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3
Q

Major virulence factor for Strep pneumo.

A

Capsule

-causes B cell response

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4
Q

What are the 3 vaccines used for S. pneumo and which groups receive which vaccines?

A

Polysaccharide Vaccine: PPSV23
-given to adults

Conjugate Vaccines: PCV7 and PCV13
-given to children

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5
Q

What is a conjugate vaccine?

A

Attaching a poor polysaccharide organism antigen to a carrier protein .(can be from the same microorganism), Simulating a closer environment to a real infection. It is often given to children (immature immune system) and IC patients because it stimulates a strong immune response for protection with a very low risk of causing actual disease or symptoms.

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6
Q

Why does the Hib vaccine against H. flu not prevent otitis media?

A

The vaccine works against the capsule of H. flu, its main virulence factor. The strain of H flu that causes AOM does not have a capsule.

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7
Q

What is different about AOM caused by S. pneumo vs. H. flu?

A

H. flu is often bilateral and has associated conjunctivitis

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8
Q

How do patients present with epiglottitis caused by H. flu?

A

“catcher’s position”, drooling, not wanting to swallow because it’s painful.
-inspiratory stridor
-expiratory rhonchi
(H flu type B is major cause)

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9
Q

3 virulence factors used by H flu in the pathogenesis of epiglottitis.

A
  1. Capsule (major)
  2. IgA protease
  3. Endotoxin (LPS)
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10
Q

Major cause of Croup and how it’s different from Epiglottits.

A

Parainfluenza virus

  • Epiglottitis is abrupt onset, croup is not
  • no barking cough in epiglottitis
  • drooling and dysphagia in epiglottits
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11
Q

What are the 4 Hib vaccines?

A

All are conjugate vaccines

  1. PRP-HbOC: nontoxic diphtheria toxin
  2. PRP-OMP: outer Neisseria m. membrane protein
  3. PRP-T: tetanus toxoid
  4. PRP-D: diphtheria toxoid (not in infants)
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12
Q

What is a toxoid vs. toxin?

A

A toxoid is a bacterial toxin whose toxicity has been inactivated or suppressed either by chemical or heat treatment, while other properties, typically immunogenicity, are maintained.

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13
Q

Condition caused by Haemophilus aegypticus.

A

Pink Eye

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14
Q

Source of AOM caused by Moraxella c. and one reason why it can be difficult to treat.

A

Part of normal flora.

Almost all produce beta lactamase

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15
Q

Major bug that causes Otitis Externa, swimmers ear (acute diffuse Otitis externa), and invasive (malignant) otitis externa.

A

Pseudomonas

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16
Q

What is malignant or invasive Otitis Externa and who is at risk?

A

It is a severe necrotizing infection that invades cartilage and blood vessels of the pinna.

IC patients are most at risk: elderly, diabetics, AIDS

17
Q

Mechanisms of antibiotic resistance in Pseudomonas.

A
  1. Mutations of porin proteins

2. Beta Lactamase production

18
Q

Main cause of pharyngitis.

A

Viral

19
Q

Main bacterial cause of pharyngitis.

A

Strep pyogenes

20
Q

How can PE differentiate viral from bacterial pharyngitis?

A

Viral: more mild, usually restrictive to nose, mouth, throat

Bacterial: pus, more enlarged lymph nodes, rash, systemic symptoms: abdominal pain, vomiting

21
Q

Virulence Factors of Strep pyogenes.

A

M-protein
SPE
Streptolysin O

22
Q

What is the JONES criteria for diagnosis of Rheumatic Fever?

A 
Joint pain
Carditis
Nodules
Erythema marginatum
Sydenham chorea
23
Q

Symptoms of Nephritic syndrome caused by Strep pyogenes

A

Hematuria, periorbital edema

24
Q

Virulence Factors associated with Nephritic syndrome caused by Strep pyogenes.

A

Immune complex formation and deposition in glomerulus

  • NAPIr protein (nephritis associated plasmin receptor)
  • SPE B
25
Q

What does the ASO titer lab test diagnose?

A

Strep pyogenes infection

-it detects anti-streptolysin O antibodies in blood

26
Q

Virulence factor of C. diphtheriae

A

Toxin

27
Q

How is the diphtheria toxin regulated?

A

Iron levels

-low iron means high toxicity

28
Q

What is the MOA of the diphtheria toxin?

A

Alpha Subunit
-ADP ribosylates (inactivates) Elongation Factor (EF) 2 preventing protein synthesis

Beta Subunit
-allows entry into the cells (especially cardiac and neural tissue which is why you see CN IX and CN X deficits)

29
Q

Distinct URT clinical signs of diphtheria infection.

A

Gray pseudomembrane in oropharynx

Bull Neck

30
Q

Media used to culture C. diphtheriae.

A

Loeffler or Tellurite Agar

ELEK test can be used to identify the diphtheria toxin

31
Q

Treatment for diphtheria.

A 
Penicillin
Antitoxin (will only work on circulating toxin in the blood so it must be administered quickly before it gets into cells)
32
Q

Name and describe the 5 virulence factors for Bordatella pertussis.

A
  1. Filamentous Hemagglutinin: binds cilia
  2. Pertactin: binds cilia
  3. Pertussis Toxin: ADP ribosylation of Gi protein increasing cAMP levels
  4. Adenylate Toxin: activates adenylyl cyclase increasing cAMP levels
  5. Tracheal Cytotoxin: destroys cilia causing cough and IL-1 release
33
Q

Name the 3 phases of a pertussis infection and which is most contagious.

A
  1. Catarrhal Stage: 1-2 weeks (most contagious)
  2. Paroxysmal Stage: 1-6 weeks
  3. Convalescent Stage: 2-3 weeks
34
Q

Difference between the DTP and the DTaP vaccines

A

DTaP does not contain pertussis cells, only virulence factors. The DTP, which contained whole cells had a lot of neurological side effects.

35
Q

What is the difference between DTaP and Tdap vaccines?

A

Any vaccine which upper case letters means that pathogen is a stronger dose vaccine and more likely to cause actual disease. Lower case is weaker and given to immunocompromised patients (pregnant, cancer, transplant)

36
Q

Agar used to diagnose pertussis.

A

Regan Lowe Charcoal Agar

37
Q

Best lab test to diagnose pertussis.

A

PCR

Respiratory Exam 2 (19 decks)

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