Microbiology of Respiratory Tract Infections Flashcards

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1
Q

How does the flu clinically present?

A
Fever
Malaise
Myalgia
Headaches
Cough 
Prostration
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2
Q

What is the aetiology of classical flu?

A

Influenza A or B virus

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3
Q

What is the aetiology of ‘flu-like’ illness?

A

Parainfluenza viruses & many others

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4
Q

Haemophilus influenza bacteria is a _______ invader

A

secondary

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5
Q

When does primary influenzal pneumonia occur mostly and who is affected?

A

Most during pandemic years
Can be disease of young adults
Hight mortality

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6
Q

In which demographic is secondary bacterial pneumonia most common?

A

Elderly
Infants
Debilitated
Those with pre-existing disease

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7
Q

Secondary bacterial pneumonia is a cause of ______ in all influenzal epidemics

A

mortality

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8
Q

What most commonly causes secondary bacterial pneumonia?

A

Haemophilus influenza

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9
Q

Flu is treated ______

A

symptomatically

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10
Q

Which antivirals can be used to treat flu?

A

Oseltamivir

Tanamivir

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11
Q

What are the requirements to prescribe an antiviral for flu?

A

Only when there is a risk of complication of when the flu is circulating / sometimes given prophylactically

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12
Q

Epidemiologically, when does flu occur?

A

Winter season

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13
Q

What does antigenic drift mean?

A

Epidemics in association with minor mutations in the surface proteins of the virus

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14
Q

What does antigenic shift mean?

A

Pandemics with rare, unpredictable, influenza A that come from an animal reservoir/mixing vessel

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15
Q

What does endemic mean?

A

Occurs naturally in a population

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16
Q

What does epidemic mean?

A

Outbreak of unexpected size (more than one area or country)

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17
Q

What is a pandemic?

A

Global distribution of disease

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18
Q

What about a flu pandemic/epidemic is often incorrectly predicted?

A

Site of origin

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19
Q

What makes up the name of a virus?

A
Virus type
Geographic origin
Strain number
Year of isolation
Surface proteins / Antigens
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20
Q

Influenza A H5N1 is a highly ________ _____ flu with observed _____ - _______ transmission and high mortality with less ready _____-______ transmission

A

pathogenic
avian
bird - human
human - human

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21
Q

Lab confirmation of influenza can occur by which methods?

A

Direct detection by PCR
Antigen detection
Immunofluorescence
Virus culture

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22
Q

How would a sample for lab confirmation of influenza by PCR be obtained?

A

Nasopharyngeal swabs in virus transport medium
Throat swabs in virus transport medium
Other respiratory samples

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23
Q

Between direct detection of virus of PCR and Antigen detection, which is better?

A

Direct detection

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24
Q

What are the methods to prevent flu via vaccine?

A

Killed virus

Live attenuated vaccine

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25
Q

How is a killed virus produced for vaccination against flu?

A

Virus cultured > inactivated > combined with adjacent

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26
Q

What does a killed virus vaccine against flu contain?

A

2 influenza A

1 influenza B

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27
Q

How is given a killed virus vaccine against flu?

A

High-risk adults for complications
Hearth care workers
Children aged 6 months - 2 years at risk of complications

28
Q

How is a live attenuated vaccine against flu administered?

A

Intra-nasally

29
Q

Who is offered a live attenuated vaccine against flu?

A

Primary and aged 2-5 children

30
Q

In which age group is the live attenuated vaccine against flu more effective than killed virus?

A

Children and young adults aged 2-17

31
Q

What does the protective efficacy of the flu vaccine depend on?

A

Vaccine to circulating virus match

32
Q

Why is the protective efficacy of the flu vaccine never greater than 70%?

A

Because the strains constantly change

33
Q

When is influenza most common?

A

In winter

34
Q

When is parainfluenza 1 most prevalent?

A

Summer

35
Q

When is Rhinovirus species A most common?

A

Found year-round

36
Q

How can pneumonia caused by Mycoplasma pneumonia, Coxiella burnetti, or Chlamydia be treated?

A

All respond to tetracycline and macrocodes (e.g. clarithromycin)

37
Q

Mortality through mycoplasma pneumonia, coxiella bunetti or chlamydia induced pneumonia is typically ____ than classical bacterial penumonia

A

lower

38
Q

How can Mycoplasma pneumonia, coxiella brunette or Chlamydia be confirmed in the lab?

A
Serology (actue / convalescent bloods to lab in gold-top vacutainers)
Virus detection (PCR on respiratory swabs or secretions - only Mycoplasma in Tayside)
39
Q

Mycoplasma pneumoniae is a common cause of _____-______ _____ and has it’s highest incidence in ____________

A

Community-Acquired pneumonia

Children ü young adults

40
Q

How is mycoplasma pneumoniae transmitted?

A

Person - Person

41
Q

Coxiella brunetti curasse _____/______ of unknown origin

A

pneumonia / pyrexia

42
Q

What is pyrexia?

A

Fever / Raised temperature

43
Q

What does Chlamydophila psittaci cause?

A

Psittacosis (usually presents as pneumonia)

44
Q

What do Coxiella burnetti and Chlamoydophila psittaci have in common?

A

Uncommon sporadic zoonosis

45
Q

Where is chlamoydophila psittaci caught from?

A

Pet birds

46
Q

What is the clinical presentation of bronchiolitis?

A

1st or 2nd year of life
Fever
Cough
Wheeze

47
Q

What does the clinical presentation of bronchiolitis in severe cases include?

A

Grunting
Low PaO2
Intercostal or sternal in-drawing

48
Q

What are the possible complications of bronchiolitis?

A

Respiratory and cardiac failure

49
Q

What are the risk factors for developing complications of bronchiolitis?

A

Premature birth

Pre-existing respiratory or cardiac disease

50
Q

What is the aetiology of bronchiolitis?

A
(resp.) Syncytial virus (most common, > 80%)
Human rhinovirus
Parainfluenza
Human metapneumovirus
Coronavirus 
Adenovirus
Influenza virus 
Enterovirus
51
Q

How can aetiology of bronchiolitis be confirmed in the lab?

A

PCR on that / perusal swabs

52
Q

How is bronchiolitis treated?

A

Supportively

53
Q

What is the epidemiology of bronchiolitis?

A

Epidemics every winter

Very common

54
Q

How is bronchiolitis controlled?

A

No vaccine
Nosocomial spread in hospital wards
Passive immunisation > poor efficacy/cost-effectiveness

55
Q

What is the epidemiology of metapneumovirus?

A

Most children positive by age 5
Found in wide age range
World-wide distribution
Winter seasonality

56
Q

Metapneumovirus may be second to respiratory virus in ______

A

bronchiolitis

57
Q

Metapneumovirus causes similar symptoms as RSV in _______

A

children and adults

58
Q

How is metapneumovirus confirmed in the lab?

A

PCR

59
Q

What is sampled to confirm metapneumovirus in the lab?

A

samples by throat swabs in viral transport medium
Bronchoalveolar lavage
Endotracheal aspirate

60
Q

What current panels are run for PCR for lab confirmation of pneumonia?

A
Flu A and B 
Parainfluenza 1-4
4 coronavirus species 
Metapneumovirus 
Adenovirus 
RSV
Rhinovirus 
Mycoplasma pneumonia
61
Q

Chlamydia trachomitis is an STI that can cause _____ _____

A

infantile pneumonia

62
Q

How is infantile pneumonia caused by chlamdia trachomitis diagnosed?

A

PCR on urine from mother or child pernasal/throat swabs

63
Q

How is Chlamoydophila pneumoniae transmitted?

A

Person - person

64
Q

How is chlamoydophila pneumoniae picked up?

A

Possibly by test for Psittacosis

65
Q

Where is MERS CoV most common?

A

Saudi Arabia

66
Q

What does MERS CoV stand for?

A

Middle East Respiratory Syndrome coronavirus

67
Q

What is the fatality rate of MERS CoV?

A

35%