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Y2 BRS (Haroop) > Respiratory infections > Flashcards

Respiratory infections Flashcards

1
Q

Which symptoms are associated with an upper respiratory tract infection?

A 
A cough
Sneezing
A runny or stuffy nose
A sore throat
headache
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2
Q

Which symptoms are associated with a lower respiratory tract infection?

A 
A “productive” cough - phlegm
Muscle aches
Wheezing
Breathlessness
Fever
Fatigue
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3
Q

Which symptoms are associated with pneumonia?

A

Chest pain
Blue tinting of the lips
Severe fatigue
High Fever

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4
Q

What is a disability adjusted life year?

A

A sum of Years of life lost (YLL) and years lost to disability (YLP)

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5
Q

Which respiratory disease has the greatest DALY?

A

Acute lung infection

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6
Q

Which geographic region has the greatest mortality for respiratory tract infections, in children under the age of 5?

A

South Asia and Sub-Saharan Africa

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7
Q

What is the trend between pneumonia and age?

A

Pneumonia increases with age

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8
Q

What are the demographic and lifestyle risk factors for pneumonia?

A

Age < 2 years or > 65 years
Cigarette smoking
Excess alcohol consumption

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9
Q

What are the social factors for pneumonia?

A

Contact with children aged <15 years
Poverty
Overcrowding

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10
Q

What medications are risk factors for pneumonia?

A

Inhaled corticosteroids
Immunosuppressants (e.g steroids)
Proton pump inhibitors

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11
Q

Which disorders/diseases present a risk factor for pneumonia?

A

COPD, asthma, heart disease, liver disease, diabetes mellitus, HIV, malignancy, hyposplenism, complement or Ig deficiencies, risk factors for aspiration
Previous pneumonia

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12
Q

Which pathogen is most commonly identified in individuals with respiratory illness?

A

Rhinovirus

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13
Q

Which respiratory infection causes the highest annual mortality?

A

Mycobacterium tuberculosis

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14
Q

Which two pathogens are the most common causes of respiratory infection?

A

Human Rhinovirus

Influenza A or B

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15
Q

What are the most common bacterial causes of respiratory infection?

A

Streptococcus pneumoniae
Myxoplasma pneumoniae
Haemophilus Influenzae

Mycobacterium tuberculosis

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16
Q

What are the most common cause of viral respiratory infection?

A 
Influenza A or B virus
Respiratory Syncytial Virus
Human metapneumovirus
Human rhinovirus
Coronavirus
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17
Q

What are the three categories of bacterial pneumonia?

A

1) Community acquired pneumonia
2) Hospital acquired pneumonia
3) Ventilator associated pneumonia

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18
Q

What is the most common community acquired pneumonia?

A

Streptococcus pneumoniae

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19
Q

What type of pneumonia infection is associated with haemophilus influenzae?

A

Typical

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20
Q

What is atypical pneumoniae?

A

Present with slightly different symptoms (some with longer milder symptoms for instance). Atypical pneumonias are often more difficult to culture.

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21
Q

What is administered to individuals with an atypical infection of pneumonia?

A

Penicillin and an additional macrolide

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22
Q

What type of bacteria is streptococcus pneumoniae?

A

Gram-positive, extracellular, opportunistic pathogen

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23
Q

What are the common forms of a hospital acquired pneumonia?

A 
Staphylococcus aureus
Psuedomonas aeruginosa
Klebsiella species
E. Coli
Acinetobacter spp.
Enterobacter spp.
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24
Q

What are the common forms of ventilator associated pneumonia?

A 
Psuedomonas aeruginosa (25%)
Staphylococcus aureus(20%)
Enterobacter
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25
Q

What type of pneumonia is associated with Mycoplasma pneumoniae?

A

Atypical pneumonia

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26
Q

What are the three mechanisms of damage by pneumonia?

A

Lung injury - arterial hypoxemia

Bacteremia

Systemic inflammation

Lead to organ injury/dysfunction and deterioration

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27
Q

What supportive therapy is available for bacterial pneumonia?

A

Oxygen for hypoxia
Fluids for dehydration
Analgesia for pain

nebulised saline - expectoration

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28
Q

How is the severity of pneumonia assessed in an individual?

A

Urea is measured and. CURB-65 score is calculated

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29
Q

What is the mechanism of penicillin in terms of bacterial treatment?

A

Beta-lactams bind proteins in the bacterial cell wall to prevent transpeptidation

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30
Q

Give an example of a macrolide

A

Clarithromycin

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31
Q

What is the mechanism of macrolides in terms of bacterial treatment?

A

Clarithromycin - bind to bacterial ribosome to prevent protein synthesis

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32
Q

Give an example of penicillin

A

Amoxicillin

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33
Q

What is the standard treatment for a CAP with a CURB score of 0?

A

Amoxicillin or clarithromycin (doxycycline is pen allergic)

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34
Q

What antibiotic should be administered in an individual with penicillin resistance?

A

Doxycycline

35
Q

What should be administered in an individual with a non-severe HAP?

A

Doxycycline

36
Q

What should be administered in an individual with a CURB score of 1/2?

A

Amoxicillin + clarithromycin

37
Q

What should be administered in an individual with a CURB of 3-5?

A

BenzylPenicillin IV + clarithro. PO (or teicoplanin + clarithro.)

38
Q

What should be administered in an individual with a CURB score of 3-5 in a HAP?

A

tazocin (piperacillin-tazobactam) IV +/- gentamicin IV

39
Q

What is the standard duration of antibiotic treatment in individuals with infections of pneumonia?

A

5-7 days

40
Q

What is the key to increasing the success of antibiotics?

A

Time to administration (for every hour in septic shock survival is reduced by 7.9%)

Using an effective antibiotic- typical CAPs may respond to penicillins, aytypical require macrolides

41
Q

Which bacteria are commonly associated with the oropharynx?

A

Haemophilus spp.
Staph. aureus
Strep. pneumoniae

42
Q

Which bacteria are commonly found in the nose?

A

Strep. pneumoniae

43
Q

What is a microbiota?

A

Ecological communities of microbes found inside multi-cellular organisms

44
Q

What is a commensal bacteria?

A

Microbes that live in a “symbiotic” relationship with their host. Providing vital nutrients to the host in the presence of a suitable ecological niche

45
Q

What is an opportunistic pathogen?

A

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

46
Q

What is a pathobiont?

A

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

47
Q

What type of bacteria is mycobacterium tuberculosis?

A

An opportunistic bacterium

48
Q

What is formed in a latent infection of TB?

A

Granuloma

49
Q

What happens to the granuloma in an active TB infection?

A

The granuloma matures and caseous necrosis proceeds

50
Q

What is the standard treatment for M TB?

A

Standard treatment requires a combination of 4 antibiotics for a 6 month period

51
Q

Why is TB a versatile pathogen?

A

Has a thick cell wall, resistant to uptake of molecules and resistant to degradation to environment

52
Q

What is the mechanism of rifampicin?

A

Inhibits RNA synthesis

53
Q

Which pathogen is the most common cause of pneumonia?

A

Streptococcus pneumoniae

54
Q

How many serotypes are there for rhinovirus?

A

100+

55
Q

How many serotypes exist for respiratory syncytial virus?

A

2

56
Q

What is a serotype?

A

viruses which cannot be recognized by serum (antibodies) that recognize another – implications for protective immunity

57
Q

What are the implications of viral induced damage to the epithelium?

A

1) Loss of cilia
2) Bacterial growth
3) Poor barrier to antigen
4) Loss of chemoreceptors

58
Q

Which immune cells are the initial responders for a respiratory infection?

A

Neutrophils

59
Q

What molecule does the major group of Rhinoviruses bind onto?

A

ICAM-1

60
Q

What molecules does the minor group of rhinoviruses bind onto?

A

Low density lipoprotein family of receptors

61
Q

What molecule does the H1N1 Influenza A virus bind onto?

A

alpha-2, 6 sialic acids

62
Q

What molecule does the H5N1 avian flu bind onto?

A

Alpha-2,3 sialic acid

63
Q

What is the distribution of alpha-2 6SA within the respiratory tract?

A

High frequency within the upper respiratory tract, progressively decreasing downwards.

64
Q

Where does H1N1 typically infect within the respiratory tract?

A

Upper respiratory tract

65
Q

What is the distribution of alpha2-3SA within the respiratory tract?

A

High frequency within the lower respiratory tract

66
Q

What does the SARs Cov2 bind onto?

A

Angiotensin Converting enzyme 2

67
Q

Where are ACE2 predominantly found?

A

Nasal epithelium

Type 2 pneumocytes

68
Q

Which antigen proteins are exhibited by the RSv?

A

F and G proteins

69
Q

Which antigen is presented by the influenza virus?

A

Haemogglutinin

70
Q

What does the RSv bind onto?

A

Glycosaminoglycans in receptors including IGFR1 and nucleolin

71
Q

What type of immunity is induced by influenza?

A

Mainly homotypic immunity

72
Q

Why are zoonotic strains highly pathogenic?

A

There is an absence of prior immunity

73
Q

What factors contribute to causing severe viral disease?

A

Highly pathogenic strains (zoonotic)

Absence of prior immunity
-Innate immunodeficiency (IFTM3 gene variant)

-B cell (local antibody)

T cells

3) Predisposing illness/conditions

74
Q

How many groups of interferons exist?

A

3
Type 1
Type 2
Type 3

75
Q

What are type 1 interferons?

A

IFN-Alpha

IFN-Beta

76
Q

What are type-II interferons?

A

IFN-gamma

77
Q

What are type-III interferons?

A

IFN-Lambda

78
Q

Which cells produce type-I interferons?

A

Viral infected cells

79
Q

Which cells produce IFN-gamma?

A

T-cells, NK cells

80
Q

Which stimulatory genes are induced by the stimulation of IFN receptors?

A

ISGs, IRF, TLR3

These directly inhibit viral replication within cells

81
Q

What is the frequency of loss of function mutations in those with life threatening Covid?

A

Greater frequency of mutations.

82
Q

Which virus is the leading cause of infant hospitalisation in the developed world?

A

RSv causing RSV bronchiolitis

83
Q

What symptoms are exhibited by a RSv infected infant?

A 
Nasal flaring
Chest wall retractions
Hypoxemia and cyanosis
Croupy cough
Expiratory wheezing, prolonged expiration, rales and rhonchi
Tachypnea and apenic episodes

Y2 BRS (Haroop) (62 decks)

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