Respiratory Flashcards
Pneumonia Interstitial
Afecta el tejido entro los alveolos
Caracteristica de Pneumonias Atipicas
Hospital Acquired Pneumonia (nosocomial)
Onset >48 hrs after admission
Common pathogen causing Pneumonia @Alchoholics
Klebsiella pneumoniae
Bacteria that causes Atypical Pneumonia
Mycoplasma pneumoniae
Chamydiophila penumoniae
Viruses cause what type of Pneumonia
Atypical (interstitial)
Most common pathogens causing nosocomial pneumonia?
Pseudomona
Entereobacteriaceae
Staphylococcus
Streptococcus pneumoniae
Pneumonia with indolent onset
Atypical
Pneumonia with high grade fever
Typical
Pneumonia with extrapulmonary symptoms
Atypical
Pneumonia with NONproductive cough
Atypical
Pneumonia with pleuritic chest pain during breathing
Typical
Auscultation of Lungs @Typical Pneumonia
Crackles (Crepitantes)
T or F: Typical Pneumonia there are NO Bronchial sounds
F
Breath Sounds are _____ @Typical Pneumonia
Diminished
Percusión of lungs @Typical Pneumonia
Dullnes (mate)
= Consolidation
What findings @CBC?
Leukocytosis (>10,000)
T or F: A new pulmonary infiltrate on chest X-ray in a px with classic Pneumonia symptoms doesn’t confirm the diagnosis
F
When is a CT scan indicated @Penumonia?
Inconclusive X-ray
@X-ray: Reticular Opacity + Absent or minimal Consolidation
What type of Pneumonia?
Atypical
@X-ray: Patchy infiltrates scattered through the lungs
Bronchopneumonia
When is a chest X-ray indicated?
Px suspected of having pneumonia
Monotherapy Tx of Pneumonia
Amoxicilin or
Doxycyclina or
Macrolides ( Azythromycin or Clarithromycin)
Tx in an outpatient with comorbilities or risk factors for resistant pathogens?
Combination Therapy: Beta lactam + Doxycyclin or Azythromycin or Clarythromycin
or
Monotherapy + Respiratory Fluoroquinolones (levofloxacin or moxifloxacin)
Tx given at inpatient without comorbilities?
Combination Therapy
Tx given at inpatient with MRSA infection?
Vancomycin or Linezolid
Tx given at inpatient with pseudomonal infection?
Pipercillin + Tazobactam
Cefepime
Cetazamide
Contaminated swimming pool
Adenivirus
Pharyngoconjuntivitis
Adenovirus
Adenovirus serotypes responsible for causing Gastroenteritis?
40-42
Intussuspection @Children
Adenovirus
Hemorragic Cystitis
Adenovirus
Vaccines vs. Adenovirus?
YES
Serotypes 4 and 7, but ONLY for military
_____ is used viral vector at vaccines
Adenovirus
May persist at Lymphoid tissue after primary infection
Adenovirus
Adenovirus: seasonal or year-round
ALL year
How many serotypes @Rhinovirus?
> 100
Respiratory Tract viruses that are NONenveloped?
Adenovirus
Rhinovirus
Infective dose of Rhinovirus
1 particle
Rhinovirus grow best ____ºC
33
Most viral replication of Rhinovirus @______
Nose
Rhinovirus bind to what kind of receptors, found in which type of cells?
ICAM-1
epithelial, fibroblast, B-lymphoid cells
T or F: Rhinovirus survive at surfaces for hours
T
Incidence of Rhinovirus
autumn and late spring
T or F: Rhinovirus infections cause fever
F
Responsibe for 50% of all respiratory tract infections
Rhinovirus
Coronavirus grow best @____ºC
33-35
Coronavirus bind to _______ receptors
ECA-2 (ACE-2) @Lungs
T or F: Coronavirus does NOT survive the GI tract
F
Incubtion period for Coronavirus
10 days
Reservoir: Bats and Camels
Coronavirus
2nd prevalent cause of common cold
Coronavirus
Incidence of Coronavirus
Seasonal @Winter
4 characteristic symptoms @Coronavirus
High grade fever >38ºC
Anosmia
Diarrhea
NO sneezing
Seal Bark Cough
Parainfluenza
T or F: Parainfluenza virus rarely causes viremia
T
Serotypes @Paraincluenza virus
4
1-3 = SEVERE lower respiratory tract infections @Infants
4 = MILD RT infections @Children & Adults
Laryngothracheobronchitis
Parainfluenza
Incidence of Parainfluenza
1 & 2 @autum
3 @ALL year
Subglottal swelling that closes the airway and causes seal bark cough
Croup
Dx diferencial de Croup
Epiglotitis @H.influenza
Tx for Croup
Esteroids
Neubulized Epinephrine
Intubation
______ NOT needs or have Neuraminidase
RSV
_____ glycoprotein can’t bind to sialic acid or RBC
RSV
RT pathogen that induces edema causing wheezing
RSV
The pathological effects of RSV are mainly caused by
Inmunologically mediated cell injury = inflammation
Can cause necrosis of bronchi and bronchioles forming plugs of mucus, fibrin and necrotic material
RSV
Pneumonia that more frequently causes pleural effusion (inflammation of parenchyma)
Bacterial
Leading cause of bronchiolitis @Children
RSV
RSV incidence
Seasonal @winter
Most common cause of FATAL acute RT infection @infants and children
RSV
High Risk Px for serious RSV
Premature babies
Underlying heart disease
Immunocompromised
Tobacco exposure
Impaired Airway Clearance (cystic fibrosis)
_____ needs isolation and PPE
RSV
Tx for RSV
Supportive (admin of O2, IV fluids, neubulized cold steam)
Aerosolized Ribavirin @High Risk Px
RT pathogen that ALWAYS have beta lactamasas
Moraxella Catharralls
T or F: Moraxella no suele causar enfermedad grave más que en inmunocomprometidos
T
30% de las cepas tienen beta lactamasas
H.influenzae
Serotypes @H.influenzae
6
Needs factors V and X to grow
H.infleunzae
Epiglotitis and Bacteremia
H.influenzae
Cultivo para H.influenzae
Agar Chocolate
T or F: H.influenzae NO cuenta con vacunas
F
Walking pneumonia
Mycoplasma pneumoniae
Bacteria that causes atypical pneumonia + secondary complications (neuro, pericarditis, hemolytic anemia, arthritis, mucocutaneous lessions)
Mycoplasma pneumoniae
Cultivo para Mycoplasma pneumoniae
Lowestein Jensen
Tx for Mycoplasma pneumoniae
Macrolides
Factor de virulence en Mycoplasma pneumoniae
Adhesina 1
permite la adhesion y perdida de células epiteliales ciliadas del RT
Serotypes @S.pneumoniae
> 90
Unique component of cell wall @S.pneumoniae
Phosphorylcholine
S.pneumoniae colonizes the _____
Oropharynx
Virulence factors of S.influenzae
Pneumolysin = creates pores and destroyed ciliated and phagocytic cells
Polisacarido capsular
Incidence of S.pneumoniae
Winter
Route of Tranmission of S.pneumoniae
Colonized bacteria that migrate
Airborne droplets
T or F: @S.pneumoniae px usually have symptoms of viral respiratory tract infection 1-3 days prior
T
Serotype of H.influenzae that causes Abcesses
3
RT pathogeen that can cause otitis media
Moraxella
S.pneumoniae
H.infuenzae
T or F: There is NO vaccine vs. S.penumoniae
F
Polisacaridos = > serotipos
Conjugada = > cara + >inmunogenica
Culture for S.pneumoniae
Blood agar
Encapsulated H.influenzae is common cause of
Otitis media @children
Exacerbation of COPD
Solid organ transplant as route of transmission (RTI)
Adenovirus
Myocarditis and Rhabdomyolysis are complications of which RTI
Adenovirus
RTI that causes Tonsilitis and Adenoid infection
Adenovirus
T or F: Adenovirus also causes rhinorrea
T
RTI that if complicated can cause Acute Respiratory Distress Syndrome
Coronavirus
Respiratory Tract Virus that can be transmitted by Fomites
Adenovirus
Rhinovirus
= because they are noneveloped
RTI that causes respiratory distress + inspiratory stridor
Parainfluenza
Tripod position @RTI
Haemophilius influenzae
RTI complication: Morbid Obesity
Influenza Virus
“Flu”
Influenza
Virulence Factor: IgA1 protease
Haemophilius influenzae
RTI that causes Acute Bacterial Rhinosinusitis
Moraxella catarrhalis
IgM cold aglutin response
Mycoplasma pneumoniae