resp tract infection and immunity Flashcards

1
Q

what is DALY – Disability-adjusted Life Year

A

Years of Life Lost (YLL) + Years Lost to Disability (YLP)

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2
Q

common cause of infant mortality in under 1y.o compared to 1-5y.o

A

under 1=LRTI (RSV-Respiratory syncytial virus)

1-5y.o= malaria

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3
Q

risk factors for pneumonia

A

-under 2, over 65
-close contact with kids (<15)
-overcrowding
-ICS
-immunosuppressants
-COPD/Asthma
-animal contact

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4
Q

Causative agents or respiratory infections: bacterial vs viral

A

Bacterial
Streptococcus pneumoniae
TB

Viral
Influenza A or B virus
Respiratory Syncytial Virus

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5
Q

Community acquired pneumonia- cause

A

Bacterial =Streptococcus pneumoniae

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6
Q

what is streptococcus pneumoniae

A

gram +ve
extracellular
opportunistic pathogen

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7
Q

common hospital acquired pneumonia

A

Staphylococcus aureus
Psuedomonas aeruginosa
E. coli
Acinetobacter spp.

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8
Q

Ventilator associated pneumonia
common causes

A

Psuedomonas aeruginosa

Staphylococcus aureus

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9
Q

what is atypical pneumonia

A

-Less frequent
-Mycoplasma pneumoniae
-different symptoms (ie. longer, milder symptoms)

different treatment:
-Penicillins= typical pneumonia,
+macrolides for atypical.

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10
Q

what is pneumonia

A

Inflammation and swelling of the alveoli

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11
Q

grading of potential bacterial pneumonia

A

CURB-65 (1 point each)
Confusion
Urea 7mmol/L+
Resp 30breaths/min+
BP: SBP< 90 OR DBP<60 mmHg
65 y.o +

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12
Q

Grading potential bacterial pneumonia- CURB 65. results meaning

A

0=low severity. Home treatment with Ab

1-2=moderate severity. consider hospital referral

3-4= high severity. Urgent hospital admission-> empirical ab

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13
Q

Treatments for bacterial pneumonia- supportive therapy

A

Oxygen
Fluids
Analgesia
Nebulised saline (may help sputum production)

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14
Q

Treatments for bacterial pneumonia- antibiotics in CAP and duration

A

CURB-65=0
Amoxicillin (or clarithromycin/doxycycline if pen. allergic)

CURB-65=1-2
Amoxicillin + clarithromycin (or clarithro./doxy.)

CURB-65=3-5
benzylpenicillin IV + clarithro. PO

5-7days (7-14 days for atypical)

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15
Q

Treatments for bacterial pneumonia- antibiotics in HAP and duration

A

CURB-65=0
doxycycline PO

CURB-65=1-2
Amoxicillin + clarithromycin (or clarithro./doxy.)

CURB-65=3-5
tazocin IV +/- Gentamycin IV

5-7days

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16
Q

what is Commensal

A

Commensal microorganisms are those that live in a symbiotic relationship with their host, providing benefits to the host without causing harm.

17
Q

what is microbiota

A

collection of microorganisms that make up the ecological communities living inside a multicellular organism, such as humans.

18
Q

what is Human microbiome:

A

100 trillion microbial cells populate our bodies at every barrier surface

19
Q

what is opportunistic pathogen

A

microbe that takes advantage of a change in conditions (often immuno -suppression).

20
Q

what is pathobiont

A

A microbe that is normally commensal, but can cause pathology if found in the wrong environment (e.g. anatomical site)

21
Q

what causes severe disease in viral resp infection

A
  1. highly pathogenic strains (zoonotic)
    2.absence of prior immunity
  2. predisposing illness/conditions- (ie. fail, elderly, COPD)

-RNA sequence
-viral load
-DNA
-Environment

22
Q

viral resp infection- resp Epithelial cells – the target and first line of defence for tight junction, mucous lining and antimicrobials. Explain how

A

Tight junctions – prevents systemic infection

Mucous lining and cilial clearance – prevents attachment, clears particulates

Antimicrobials – recognise, neutralise microbes and their products

23
Q

most common cause of cold- viral resp infection

vs atypical bacteria

A

rhinovirus - in all ages

atypical= mycoplasma

24
Q

what is a serotype

A

unique pathogen strains with outer surface differences that may evade antibodies from other strains

25
where do you find a lot of IgA-plasma cells vs Ig-G
nasal cavity -Epithelial cells express many IgA receptor, allowing export of IgA to the mucosal surface lungs Thin-walled alveolar space allows transfer of plasma IgGs into the alveolar space
26
RSV, compared to Influenza, when does viral load peak
around day 7 in RSV- LATER, compared to around day 3 in influenza
27
Recurrent re-infection with similar strains No vaccine Poor immunogenicity what does this indicate
RSV
28
what does RSV stand for
Respiratory syncytial virus
29
RSV bronchiolitis in infants- symptoms
nasal flaring, cyanosis, croupy cough, expiratory wheeze, chest wall retraction
30
RSV bronchiolitis in infants- risk factors
Premature birth Congenital heart and lung disease
31
RSV treatment-supportive and preventative
supportive therapy: oxygen, fluids, analgesia preventative: vaccine- mRNA
32
therapeutic treatment for RSV
anti-inflammatory -dexamethasone (steroid) anti-viral -remdesivir- broad spectrum antiviral //Paxlovid -monoclonal ab??