MICRO URTI & LRTI - Week 2 Flashcards
Diptheria causative agents
Corynebacteria diptheriae
Diptheria symptoms
o Symptoms: heart & liver damage, necrotic exudate (‘false membrane’ -> respiratory obstruction), inflammation & swelling, enlarged cervical lymph nodes (‘bull neck’).
Diptheria treatment
o Treatments: antibiotics, monitor for respiratory obstruction, isolate pt.
Glandular fever causative agents
EBV - member of Herpes family.
Glandular fever symptoms
o Symptoms: fever, anorexia, lethargy, sore throat, headache, lymphadenopathy, enlarged liver & spleen, hepatitis, rash, jaundice.
Glandular fever spread
Saliva exchange
Acute laryngitis symptoms
o Symptoms: symptoms of common cold, hoarseness, barking cough
Acute laryngitis treatment
o Treatment: voice rest, humidification, pain relief
Laryngotracheobronchitis symptoms
Croup
o Symptoms: fever, barking cough, restlessness, stridor, respiratory distress, history of URTI
Laryngotracheobronchitis complications
Respiratory obstruction
How is laryngotracheobronchitis diagnosed?
Nasopharyngeal swab/nasopharyngeal wash
Laryngotracheobronchitis treatment
o Treatment: maintain airway, antibiotics, supportive treatments, oxygen therapy.
Acute epiglottitis causative agents
H. influenzae type B
Acute epiglottitis symptoms
o Symptoms: fever, irritability, sore throat, difficulty swallowing, drooling, hoarseness, cough, respiratory distress
Acute epiglottitis complications
Respiratory obstruction
Acute epiglottitis treatment
o Treatment: maintain adequate airway, antibiotics
Otitis externa symptoms
o Symptoms: red ear, swollen ear, discharge from ear
Otitis externa complications
Severe necrotising infection
Otitis externa severe necrotising infection treatment
o Treatment: eardrops w antipseudomonal antibiotics w steroids
Who is most at risk of severe necrotising infection from Otitis externa?
Elderly pts, pts w diabetes & immunocompromised pts.
Who is most at risk of severe necrotising infection from Otitis externa?
Elderly pts, pts w diabetes & immunocompromised pts.
Otitis externa causative agents
o Causative agent: S. aureus, pseudomonas aeruginosa, candida, aspergillus.
Acute Otitis media causative agents
o Causative agents: RSV, S. pneumoniae, H. influenzae, Moraxella catarrhalis.
Acute Otitis media symptoms
o Symptoms: fever, lethargy, irritability, ear-ache, ear discharge, hearing loss, bulging eardrum
GABHS Pharyngitis causative agent
o Causative agents: GA B-haemolytic S. pyogenes
GABHS Pharyngitis symptoms
o Symptoms: high fever, chills, enlarged painful tonsils w white pus-filled lesions & exudate, tender cervical lymphadenopathy.
GABHS Pharyngitis Incubation period
Rapid onset (overnight)
Suppurative complications of GABHS Pharyngitis
Peritonsillar abscess (quinsy), sinusitis, mastoiditis, otitis media.
Non-suppurative complications of GABHS Pharyngitis
Scarlet fever, acute glomerulonephritis, rheumatic fever, rheumatic heart disease.
Symptoms of scarlet fever
Punctate erythematous rash, strawberry tongue.
Symptoms of rheumatic fever
Granulomas in the heart, myocarditis or pericarditis, subcutaneous nodules, polyarthritis, chorea.
What is the most common type of pharyngitis?
Viral.
Most common symptom/sign of viral pharyngitis?
Diffuse rash on oral mucosa.
Cause of CF
Autosomal recessive disorder involving the CFTR gene.
Symptoms & complications of CF
- Symptoms/complications: Meconium illeus , pancreatic insufficiency , lung complications due to thick mucous & build up of bacteria - decreased lung function, cough, fever, pneumonia. Chronic bacterial infection & inflammation -> bronchiectasis , male infertility, clubbing, nasal polyps, allergic bronchopulmonary aspergillosus.
Diagnosis of CF
Newborn screen sweat test (high Cl-)
Causative agents of lobal pneumonia
Lobar pneumonia: S. pneumoniae, S. aureus, H influenzae, K. pneumoniae, Moraxella catarrhalis.
Causative agents of atypical pneumonia
Atypical pneumonia: Mycoplasma pneumonia, Chlamydia pneumonia , Legionella pneumophilia , Coxiella burnetti , RSV, influenza, coronavirus, fungi or parasites.
What deletion occurs in the CFTR gene to cause CF?
508.
Function of CFTR
Responsible for pumping Cl- ions into secretions -> drawing out of water -> thinning mucous.
What is meconium ileus?
Trapping of newborn’s first stool in the ileum.
Complications of pancreatic insufficiency observed in pts with CF?
Thick secretions block pancreatic duct -> no pancreatic enzymes provided to small intestine -> poor weight gain/failure to thrive ->fat malabsorption -> steatorrhea -> digestive enzymes trapped in pancreatic duct degrade cells lining pancreatic duct ->acute pancreatitis/chronic pancreatitis -> insulin dependent diabetes.
What opportunistic pathogens are most likely to colonise the CF lung in early childhood/adolescence?
Opportunistic S. Aureus & Pseudomonas aeruginosa are most likely to colonise the CF lung in early childhood/adolescence.
3 x types of pneumonia (based on acquisition)
⦁ Community acquired OR
⦁ Hospital-acquired/nosocomial (e.g., MRSA)
⦁ Aspiration pneumonia
What pathogen is most often the cause of community outbreaks of pneumonia post mass gatherings?
Legionella pneumonphilia
What pathogen is most often the cause of pneumonia in abattoir workers?
Coxiella burnetti.
Symptoms of pneumonia
o Symptoms : dyspnoea, chest pain, productive cough, fatigue, fever
Diagnosis of pneumonia
o Diagnosis: CXR, dullness to percussion, tactile vocal fremitus, late inspiratory crackles, bronchial breath sounds, respiratory specimens (i.e., expectorated sputum, bronchoscopy specimens, nasopharyngeal aspirate/swab), blood cultures, urine.
Affected regions of bronchopneumonia vs atypical/interstitial vs lobal pneumonia
⦁ Bronchopneumonia – throughout lungs (incl. bronchioles & alveoli)
⦁ Atypical/interstitial pneumonia – in the interstitium btw alveoli
⦁ Lobar pneumonia – consolidation of a whole lung lobe (e.g., S. Pneumoniae)
Clinical presentation of typical vs atypical pneumonia
Typical - sudden onset fever, productive cough vs atypical - gradual onset fever, dry cough.
Physical examination of typical vs atypical pneumonia
Typical - rapid RR, evidence of lung consolidation vs atypical - may show few abnormalities.
Sputum observed in typical vs atypical pneumonia
Typical - purulent vs atypical - watery/mucopurulent.
CXR typical vs atypical pneumonia.
Typical - lobar infiltrate, segmental vs atypical - patchy or interstitial infiltrates, often bilateral.
Treatment w penicillin for typical vs atypical pneumonia & success.
Typical - most respond to penicillin vs atypical - poor response or resistant to penicillin.
H vs N protein function.
H - binds to target cells sialic acid receptor and helps introduce viral genome into host cell to start the infection.
N - viral release- cleaves sialic acid receptor to release new virions from the infected cell.
Causative agent of influenza
Influenza virus.
Treatment of influenza
Neuraminidase inhibitors (incl. osetlamivir, zanamivir, peramivir).
Causative agent of acute bronchiolitis
Respiratory Syncytial Virus (RSV)
Symptoms of acute bronchiolitis (both URTI & LRTI symptoms).
o Symptoms: URTI symptoms incl – rhinorrhoea, congestion, sneezing then 1-3 days later LRTI symptoms incl – cough, tachypnea, chest retraction, hypoxaemia.
Diagnosis of acute bronchiolitis.
Nasopharyngeal aspirate.
Complications of acute bronchiolitis.
Bronchiolitis, pneumonia, apnoea, otitis media.
Causative agent of whooping cough
Bordetella Pertussis
Symptoms of whooping cough & stages
o Symptoms : ‘whooping’ cough, vomiting, fever, tachypnoea, tachycardia.
Catarrhal stage 1-2wks
Paroxysmal stage 2-4wks – danger zone for infants (i.e., acute life threatening events: cyanosis, apnoea, lung collapse, secondary pneumoniae, haemorrhage, death).
Convalescent 1-3wks
Diagnosis of whooping cough
Nasal swab.
Treatment of whooping cough
Macrolide antibiotics (only if pt in catarrhal stage), supportive care.
Bordetella pertussis microscopy
Gram -ve cocco-bacillus.
Which phase of whooping cough is most infectious?
Catarrhal phase.
Symptoms of paroxysmal phase of whooping cough
Severe episodic coughing w or w/out vomiting and whoop - inspiratory gasp of air.
In which type of pneumonia is bilateral pneumonia more common?
Viral/atypical pathogens.
Coryzal
Acute inflammatory contagious disease involving the URT.
Glandular fever diagnosis
Atypical lymphocytes in blood under microscopy.
What is a differentiating symptom between glandular fever and strep throat?
Enlarged liver and spleen in GF.
