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Respiratory diseases Flashcards

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1
Q

Pharyngitis sings and symptoms?

A
  • pain
  • inflammation of throat
  • Reddened and or swollen mucosa

Sore throats caused by bacteria are more painful than those caused by viruses and more likely to be accompanied by fever, headache, and nausea

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2
Q

Pharyngitic causative agents?

A
  • same viruses causing common cold (rhinovirus is common)
  • Can result from mechanical irritation from prolonged shouting or drainage from sinus cavity
  • Most serious cases caused by Streptococcus pyogenes
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3
Q

Pharyngitis via streptococcus pyogenes bacterial characteristics?

A
  • gram positive cocci w/ chain arrangement
  • nonmotile
  • forms capsule and slime layer
  • Facultative anaerobe ferments variety of sugars
  • catalase negate
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4
Q

Pharyngitis via S.pyogenes complications?

A

Scarlet fever: result of infection by S. poygenes that is infected w/ a bacteriophage
- produces erythrogenic toxin
- sandpaper-like rash w/ high fever
- 20% fatality rate when untreated; ~1% treated

Rheumatic fever: due to immunologic cross-reaction between streptococcal M proteins and heart muscle

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5
Q

Pharyngitis via S. pyogenes transmission?

A

transmission via Respiratory droplets or direct contact w/ mucus secretions
- humans = only significant reservoir

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6
Q

Pharyngitis via S. pyogenes epidemiology?

A
  • 30% of sore throats may be caused by S. pyogenes
  • carried as “normal” biota by 15% of population but (usually not spread to others unless active infection is occurring)
  • more than 60 serotypes of S. pyogenes exist and immunity is serotype specific
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7
Q

Pharyngitic via S. pyogenes culture and diagnosis?

A

Rapid diagnostic tests of pharyngeal swab of specimens:
- use antibodies to detect group A streptocci
- High rate of false negative results (must confirm w/ culturing)

Culturing of pharyngeal swab specimens:
- Plater on blood agar
- S. pyogenes causes beta hemolysis
- distinguish from beta-hemolytic group B streptococci and enterococci
- Bacitracin disc test

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8
Q

Pharyngitis via S. pyogenes prevention?

A

no vaccine exists
- prevention through good hand washing, especially after coughing, sneezing, or before preparing food

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9
Q

Pharyngitis via S. pyogenes treatment?

A

Penicillin is most common antibiotic
- cephalexin used for patients w/ penicillin allergy
Most infections resolve on their own but antibiotic treatment needed to prevent serious complications

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10
Q

Influenza signs and symptoms?

A

headache, chills, dry cough, body aches, fever, stuffy nose, extreme fatigue, and sore throat
- begins in upper respiratory tract and can progress to lower tract
- can lead to secondary infections
- occasionally leads to pneumonia

cyclical increase of influenza during the winter months

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11
Q

Influenza causative agent?

A

Influenza A, B, and C viruses
- Orthomyxoviridae family
- Spherical particles
- Lipoprotein envelope studded w/ glycoprotein spikes
- Hemagglutinin (H)
- Neuraminidase (N)
- ssRNA genome (known for its variability)
- 10 genes on 8 separate RNA strands

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12
Q

What is antigenic drift in relation to influenza?

A
  • mutation of H,N glycoprotiens
  • antigens gradually change amino acid composition, resulting in host’s memory cells not recognizing them
  • this is the reason new vaccine is required every year (seasonal vaccine)
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13
Q

What is antigenic shift in relation to influenza?

A
  • RNA exchange between different influenza viruses
  • Occurs during coinfection of host cell
  • more likely to produce pandemic strains
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14
Q

Influenza transmission and epidemiology?

A

Transmission:
- inhalation of virus-laden aerosols and droplets
- indirect contact with fomites
- transmission aided by crowding & poor ventilation
- Drier air of winter facilitates the spread

Epidemiology:
- ~12,000-60,000 deaths annually
- Manly affects very young and very old

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15
Q

Influenza prevention?

A

Vaccination:
- several types of vaccines
- trivalent = contains 3 viruses
- Quadrivalent = containing 4 viruses
- CDC recommends anyone over age of 6 months receive vaccine

New vaccine prospects:
- Target ion-channel proteins to eliminate ALL strains, would not need to be given every year

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16
Q

Influenza treatment?

A

Antivirals
- must be taken early in infection
- Amantadine & rimantadine = Teat and prevent type A
- Zanamiver (Relenza) = treats type A and B
- Oseltamiver (Tamiflu) = seen resistance in 2008-2009

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17
Q

Tuberculosis characteristics?

A

ancient human disease
- reemerged in the mid-80s as a serious threat
- 2.5 billion infected worldwide
Humans are easily infected but resistant to disease development

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18
Q

Tuberculosis primary stage?

A

Primary: (10 bacterial cells = minimum infections dose)

  • bacteria multiply inside macrophages then escape and lead to cell-mediated attack on bacteria
  • Tubercles form in lungs
  • neutrophils release enzymes causing necrotic caseous lesions that heal by calcification
  • T-cell activation seen in tuberulin reaction
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19
Q

Tuberculosis Secondary/reactivation stage?

A

live bacteria can remain dormant then reactivate
- chronic tuberculosis = tubercle expand causing cavities in lungs, and drains into bronchial tubes and upper respiratory tract
-untreated - 60% mortality rate

symptoms:
- violent cough w/ greenish or bloody sputum
- low-grade fever
- Anorexia, weight loss
- extreme fatigue
- night sweats
- chest pain

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20
Q

Tuberculosis causative agents?

A

Mycobacterium tuberculosis
- acid-fact bacillus, strict aerobe, slow growing
- Mycolic acids, waxes in cell walls
- resistance to drying and disinfectants
M. avium infects AIDS patients

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21
Q

Tuberculosis transmission?

A

Transitted through droplets of respiratory mucus suspended in air (can survive for 8 months in fine aerosol particles)
Susceptibility influenced by:
- inadequate nutrition
- Debilitation of the immune system
- poor access to medical care
- lung damage
- genetics

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22
Q

Tuberculosis epidemiology?

A

60% of cases are among foreign-born persons
people working in nursing homes, hospitals, or jails are at higher risk

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23
Q

Tuberculosis culture and diagnosis?

A

Clinical diagnosis techniques:
- Tuberculin testing:
- Mantoux Test
- chest x-ray to look for tubercles
- culture isolation and antimicrobial susceptibility testing

Culture:
- acid-fast staining is used to supplement diagnostic techniques

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23
Q

Tuberculosis prevention?

A
  • limit exposure to infectious airborne particles
  • Patient with active TB is put in isolation in negative pressure rooms
  • Live attenuated vaccine (BCG)
    • not used in US
    • bovine tubercolisis bacterium
    • vaccinated individuals respond positive to TB test
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24
Q

Tuberculosis treatment?

A
  • long course of antibiotics (3-9 months)
  • different antibiotics used if latent v. active
  • often multiple drugs

Noncompliance has resulted in multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB)
- more severe disease and higher mortality rate

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25
Q

Pneumonia characteristics?

A

diseased characterized by anatomical diagnosis
- an inflammatory condition of the lungs in which fluid fills alveoli
- a wide variety of microorganisms can cause pneumonia
- more children die of pneumonia than any other infectious disease
- can be community-acquired or healthcare-associated

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26
Q

Community-acquired pneumonia causative agent?

A

streptococcus pneumoniae
- 40% of community-aquired bacterial cases
Legionella
- less common, serious cause of disease
Mycoplasma pneumoniae & Clamydiophila pneumoniae
- walking pneumonia
Histoplama capsulatum
- fungus that infects many people but causes a pneumonia-like disease in relatively few people
Hantavirus

can also be a secondary effect of influenza

27
Q

Healthcare-associated pneumonia characteristics?

A

up to 1% of hospitalized or institutionalized people experience pneumonia
- most commonly associated w/ mechanical ventilation via endotracheal or tracheostomy tube
- ventilator-associated pneumonia (VAP)
30-50% mortality rate

28
Q

Healthcare-associated pneumonia causative agent?

A
  • MRSA strains staphylococcus aureus
  • Gram-neg bacteria: Klebsiella pneumoniae, enterobactor, E.coli, pseudomonas aeruginosa, and acinetobacter
  • polymicrobial in origin
29
Q

Healthcare-associated pneumonia culture?

A
  • sputum and tracheal swabs are not useful
  • endotracheal tube or bronchoalveolar lavage cultures provide better info but are invasive
  • Antibiotics patient is already receiving may affect the results
30
Q

Healthcare-associated pneumonia treatment?

A

elevation of patients’ heads to 30-45 degree angle helps reduce aspiration of secretions
- Empiric therapy should begin as soon as hospital-associated pneumonia is suspected

31
Q

Healthcare-associated pneumonia prevention?

A
  • good preoperative eduction of patients about the importance of deep breathing; and frequent coughing can reduce postoperative infection rate
  • proper care of mechanical ventilators and respiratory therapy equipment
32
Q

Acute Diarrhea characteristics?

A

Three or more loose stools in a 24-hour period
- often associated with fever, abdominal pain,cramping, nausea, vomiting and dehydration
- 1/3 of all acute diarrhea is transmitted by contaminated food
- most don’t require treatment
- most cases antimicrobial treatment is contraindicated but quick antibiotic treatment is necessary
- most cases identification agent is not performed

33
Q

Foodborne illness causative agents?

A
  • S. aureus
  • Bacillus cereus
  • Clostridium perfrignes
  • nonmicrobial sources (fish, shellfish, mushrooms)
34
Q

Foodborne illness/intoxication signs and symptoms?

A
  • severe nausea and vomitting and diarrhea
  • others who ate same meal also experiencing symptoms
  • onset of symptoms between 1-6 hours
35
Q

Shiga-toxin-producing E. coli (STEC) signs and symptoms?

A
  • spectrum of symptoms from gastroenteritis, fever, to bloody diarrhea
  • hemolytic uremic syndrome (HUS) = severe hemolytic anemia that can cause kidney damage and failure
  • neurological symptoms = blindness, seizure, and stroke
36
Q

STEC pathogenesis and virulence factors?

A
  • virulence from shiga toxin
  • toxin is shared between shigella and E. coli
  • effaces enterocytes in large intestine
37
Q

STEC transmission?

A

ingestion of contaminated or undercooked beef
- could be other foods as well

38
Q

STEC culture and diagnosis?

A
  • confirm infection with stool culture and test for shiga toxin
39
Q

STEC prevention?

A
  • good food hygiene/ fully cooked food because heat kills shiga toxin and E. coli
40
Q

STEC treatment?

A

*Antibiotics are contraindicated bc they can increase pathology by releasing more toxin
- plasma transfusions to dilute toxin in blood

41
Q

Clostridium difficile (C.diff) characteristics?

A
  • Gram + endospore forming rod
  • part of the normal intestinal biome
  • can superinfect large intestine when drugs disrupt normal biota
42
Q

C. diff signs and symptoms?

A
  • severe abdominal cramps
  • fever
  • leukocytosis
  • Pseudomembranous colitis (antibiotic-associated colitis)
    • precipitated by therapy with broad-spectrum antibiotics
43
Q

C. diff pathogenesis?

A
  • colon is inflammed and gradually sloughs off loose, membranelike patches called pseudomembranes consisting of fibrin and cells
  • perforation of secum and death can result if not treated
  • c. diff releases endospores
44
Q

C. diff epidemiology?

A
  • 66% are healthcare-associated
  • 24% of infections occur after patients have been discharged
45
Q

C. diff treatment?

A
  • If patient recieving certain antibiotics for infection and displays c. diff symptoms, antibiotics should be stopped
  • methonidazole used for mild cases
  • vancomycin used for severe cases
  • patient placed in isolation to control infection
46
Q

Rotavirus characteristics?

A

Primary cause of morbitity and mortality resulting from diarrhea
- 50% of all cases

46
Q

Rotavirus characteristics?

A

Primary cause of morbitity and mortality resulting from diarrhea
- 50% of all cases

47
Q

Rotavirus transmission?

A
  • fecal-oral route
  • contaminated food, water, fomites
  • poor sanitation
48
Q

Rotavirus signs and symptoms?

A
  • watery diarrhea
  • fever
  • vomiting
    -dehydration
  • shock
  • damage to intestinal mucosa
    *symptoms vary bases on age, nutritional state, general health, and living conditions
49
Q

Rotavirus epidemiology?

A
  • in adults infection is mild and self-limiting
  • babies 6-24 months that lack maternal antibodies are at the most risk of fatal disease
50
Q

Rotavirus epidemiology?

A
  • in adults infection is mild and self-limiting
  • babies 6-24 months that lack maternal antibodies are at the most risk of fatal disease
51
Q

Norovirus characteristics?

A

2nd most common cause of U.S. hospitalizations from foodborne diseases
- 5X more foodborne illness than salmonella although fewer require hospitalization

52
Q

Norovirus transmission?

A
  • fecal-oral via contaminated food and water
53
Q

Norovirus symptoms?

A
  • profuse, watery diarrhea for 3-5 day duration
  • vomiting and fever
54
Q

Norovirus treatment?

A

rehydration

55
Q

Gastritis and gastric ulcers causative agent?

A

Helicobacter pylori
- curves gram-negative rods
- J. Robin Warren and Barry J. Marshal first isolated the microbe and proved it caused gastritis
- can cause stomach cancer in long term infection

56
Q

Gastritis and gastric ulcers signs and symptoms?

A

gastritis:
- sharp, burning pain in abdomen
Gastric/peptic ulcers:
- lesions in mucosa of stomach or in the uppermost portion of small intestine
- bloody stool and or vomiting in severe cases

  • symptoms often worse at night or when under stress
57
Q

Gastritis and gastric ulcers transmission?

A

H. pylori transmitted via oral-oral or fecal-oral route
- usually acquired early in life and carried asymptomatically until activities begin to damage digestive mucosa
- can also be acquired though water sources

58
Q

Gastritis prevention and treatment?

A
  • over the counter medications offer symptom relief by neutralizing stomach acid
  • antibiotics augmented by acid suppressors
    • clarthroycin or metronidazole are most common
59
Q

Hepatitis characteristics?

A

inflamamtory disease marked by necrosis of hepatocytes and inflammatory response that swells and disrupts liver architecture
- characterized by jaundice - yellowing of skin and eyes by bilirubin accumulation in blood and tissues
- noninfectious conditions causing hepatitis include autoimmune diseases, drugs, and alcohol abuse

60
Q

Hepatitis causative agents?

A
  • cytomegalovirus
  • Epstein-Barr virus
  • Hepatitis A-E viruses
61
Q

Hepatitis C virus characteristics?

A
  • sometimes called the “silent epidemic”
  • can take years to develop symptoms
  • RNA virus in the family Flaviviridae
  • more likely to be chronic than hep. B
62
Q

Hep. C signs and symptoms?

A
  • abdominal pain. fever, loss of appetite, weakness/fatigue, nausea, vomiting, jaundice. dark urine
  • more common to have chronic liver disease even without other symptoms
  • Cancer can result from HCV infection
  • can have severe infection without permanent liver damage
63
Q

Hep. C transmission?

A

commonly transmitted through blood
- blood transfusions
- intravenous drug users
vertical transfer also possible

64
Q

Hep. C prevention and treatment?

A
  • no vaccine
    drug regimen for treatment?
  • sofosbuvir = nucleotide analogy that “fools” the virus DNA polymerase
  • ledipasvir - protease inhibitor

Microbiology (10 decks)

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