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Respiratory > Pertussis > Flashcards

Pertussis Flashcards

1
Q

Bordetella pertussis characteristics

A

negative, coccobacilli, encapsulated, obligate aerobe

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2
Q

What does pertussis adhere to in the nasopharynx?

A

Ciliated epithelial cells

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3
Q

Bordetella pertussis epidemoiology

A

All age groups affected (<1 years old most - non-immunized)

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4
Q

How is pertussis transmitted?

A

Respiratory aerosol droplets

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5
Q

Bordetella pertussis pathogenesis and virulence factors

A

Attachment
FHA (filamentous hemagglutinin): mediates adherence to ciliated epithelial cells
Fimbriae
Pertactin

Toxins
TCT (tracheal cytotoxin)
ACT (adenylate cyclase toxin)
PTX (pertussis toxin - type IV secreted AB)

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6
Q

TCT

A

Inhibits DNA synthesis in epithelial cells

Leads to epithelial cell necrosis and disruption of ciliary elevator

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7
Q

ACT

A

-Affects AC activity to catalyze ATP to cAMP»causes localized edema through loosening of the tissues and alters host response»inhibits PMN/macrophage phagocytosis and chemotaxis

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8
Q

PTX

A

AB5 structural arrangement that covalently adds and ADP-ribose to G alpha i»inhibition of inhibitory G protein results in adenylyl cyclase activity»increased cAMP

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9
Q

Effects of pertussis toxin

A

Acts on beta cells of pancreatic islets (hyperinsulinemia, hypoglycemia), lymphocytosis, inhibition of chemotaxis at macrophage

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10
Q

3 stages of pertussis disease

A

Catarrhal - nonspecific symptoms, 1-2 weeks, highly infectious
Paroxysmal - duration 2-10 weeks, most damage, whooping cough (can cause cyanosis, sub-conjunctival hemorrhage, bulging eyes, protrusion of tongue, distension of neck veins), vomiting and exhaustion, lymphocytosis, NO ANTIBIOTICS
Convalescence - diminished coughing fits, secondary complications (pneumonia, seizures, encephalopathy)

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11
Q

How does erythromycin increase GI motility?

A

It is a receptor agonist for motilin, which promotes gastric emptying

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12
Q

Side effects of macrolides

A
  • Increase GI motility
  • Hypertrophic pyloric stenosis (erythromycin)
  • Arrhythmia (erythromycin)
  • Inhibit CYP450 (except azithromycin)
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13
Q

SMX MOA

A

Inhibit dihydropteroate synthase

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14
Q

TMP MOA

A

Inhibit dihydrofolate reductase

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15
Q

SMX+TMP use

A
  • MSSA and MRSA (mild to moderate)
  • UTI
  • Respiratory tract infections
  • Otitis media
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16
Q

Sulfa drug allergies most drastic

A

Steven Johnson syndrome (toxic epidermal necrolysis)

17
Q

SMX+TMP major side effects

A

Hematological disorders (hemolytic anemia in G6PD), kernicterus in newborns

18
Q

When are the function of passive immunizations?

A
  • When immediate protection is required
  • Immunodeficiencies – hypo or agammaglobulinemias
  • Antibody-mediated protection in the fetus and from breast milk
19
Q

What are two examples of artificial passive immunizations?

A
  • Antitoxins, antiserums, antivenoms

- IVIG

20
Q

What are disadvantages to artificial passive immunizations?

A

No memory, transient immunity, type III hypersensitivity reactions

21
Q

What are general vaccine characteristics?

A
  • Targeting natural mode of infection is most effective
  • Live organism most effective
  • Inducing long-lasting memory is most effective
22
Q

What are characteristics of live attenuated vaccine?

A
  • induce good cell-mediated immunity and antibody response
  • reversion to wild-type/virulent
  • unsafe in immunocompromised individuals
  • adjuvants not usually required
23
Q

What are characteristics of inactivated vaccines?

A
  • weak to moderate antibody response
  • safe for immunocompromised
  • adjuvants usually required
  • no reversion to virulent form
24
Q

What are the components of subunit vaccines?

A

Non-toxin protein, toxoid, polysaccharide, conjugate

25
Q

What is the immunological response of conjugate vaccines?

A

Class-switched antibody and memory cell production

26
Q

What is the mechanism of conjugate vaccines?

A

Polysaccharide, a T-independent antigen, is recognized by B-cell Ig

The B-cell internalized the conjugate and presents peptide on MHCII, including the T-cell epitope

Costimulation occurs, class switching occurs, and B-cell secrete capsule-specific antibody and differentiate to memory B cells

27
Q

What are the types of adjuvants?

A 
Alum salts - depot effect, Ab and Th2 response
AS04 - Th1 and Ab response
MF59 - Th1 and Th2 response
AS03 - Ab response
virosomes - Ab and CD8+ response
CpG1018 - Ab response

Respiratory (9 decks)

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