Respiratory Infections Flashcards

1
Q

What are some symptoms of upper respiratory tract infection?

A
Cough
Sneezing
Runny/stuffy nose
Sore throat
Headache
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2
Q

What are some symptoms of lower respiratory tract infection?

A
Cough with phlegm
Muscle aches
Wheezing
Breathlessness
Fever
Fatigue
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3
Q

What are some symptoms of pneumonia?

A

Chest pain
Blue tint on lips
Severe fatigue
High fever

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4
Q

How does age have an impact on respiratory infection outcome?

A

Very old people are at much higher risk and have a higher mortality risk
Very young children (eg under 2) also have a much higher risk

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5
Q

What are some risk factors for pneumonia?

A
Very young (under 2)
Very old (over 65)
Smokers
Alcoholics
Inhaled corticosteroids
Immunosupressants
PPIs
COPD/asthma
Heart/liver disease
Diabetes mellitus
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6
Q

What is the most common respiratory illness causing pathogen

A

Rhinovirus

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7
Q

What respiratory illness causing pathogen most commonly causes mortality?

A

Mycobacterium bovis

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8
Q

What are the 2 ways pneumonia can be acquired?

A

Hospital

Community

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9
Q

Describe the characteristics of the pneumonia pathogen?

A

Gram positive
Extracellular
Opportunistic

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10
Q

What is the most common strain of community acquired pneumonia?

A

Streptococcus pneumoniae

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11
Q

What is hospital acquired pneumonia commonly associated with?

A

Ventilators

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12
Q

What is different about atypical pneumonia compared to typical?

A

The pathogens replicate a lot slower than usual and are sometimes more resistant to antibiotics that are commonly given in typical pneumonia

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13
Q

What infection may occur before pneumonia develops?

A

Bronchitis and bronchiolitis

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14
Q

What does pneumonia impair?

A

Gas exchange

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15
Q

What are some mechanisms by which pneumonia has bad outcomes?

A

Lung damage causes hypoxia and respiratory distress syndrome
Bacteremia causes organ infection and eventually sepsis
Systemic inflammation causes sepsis and deterioration

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16
Q

What is the first step in treating bacterial pneumonia?

A

Supportive treatments:
Oxygen for hypoxemia
Fluids for dehydration
Analgesia for pain

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17
Q

What is the second step in treating bacterial pneumonia?

A

Use of antibiotics

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18
Q

What type of antibiotic is penicillin?

A

Beta lactam

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19
Q

How do beta lactams work?

A

They bind to proteins in the cell wall and prevent transpeptidation

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20
Q

How do macrolides work?

A

They prevent protein synthesis by binding to the 50 s ribosomes

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21
Q

How can the success of antibiotics be increased?

A

Increasing the time to administration
Using an antibiotic that is effective (to find this refer to the NICE guidelines)
Give multiple together if needed

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22
Q

Is pneumonia contagious?

A

Not usually but it can be

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23
Q

What is an opportunistic pathogen?

A

A pathogen that takes advantage of a change in conditions eg immunosupression

24
Q

What is a pathbiont?

A

A pathogen that is commensal but when found in the wrong environment (eg anatomical position), can become pathological

25
Q

What does it mean when a pathogen is commensal?

A

When it lives symbiotically in the host

26
Q

How common is latent TB?

A

Very, a lot of respiratory pathogens live in the upper respiratory tract without causing symptoms

27
Q

What is the treatment for TB?

A

A combination of 4 antibiotics for 6 months

28
Q

How is TB adapted to survive as a pathogen?

A

It has a very thick wall thats resistant to external molecules and factors

29
Q

What are some ways viruses cause damage?

A

Cause cellular inflammation
Cause mediator release
They damage the epithelium causing loss of cilia, loss of chemoreceptors, and bacterial growth

30
Q

How does infleunza A act?

A

Haemoglutinin binds to alpha 2,6 sialic acid

31
Q

How does avain flu act?

A

Haemoglutinin binds to alpha 2,3 sialic acids

32
Q

Where does infleunza A normally act?

A

Upper respiratory tract

33
Q

Where does avian flu normally act?

A

Lower respiratory tract

34
Q

What are the 2 groups of rhinovirus and what do they bind to?

A

Minor group binds to ICAM-1

Major group binds to low density lipoprotein

35
Q

How does infection by influenza work regarding strains?

A

There is no reinfection by the same strain

36
Q

How does vaccination for influenza work?

A

Vaccination is annual

It is possible but it isnt perfect

37
Q

How does infection by RSV work regarding strains?

A

The same strain can infect someone multiple times, there are only 2 strains (A and B)

38
Q

How many strains of RSV are there? What are they called?

A

2, A and B

39
Q

How does RSV act?

A

F and G proteins bind glycosaminogylcans in receptors like IGFR1 and nucleolin

40
Q

Where in the respiratory tract are the targets or RSV found?

A

All along the tract

41
Q

How does vaccination for RSV work?

A

There is no vaccine

42
Q

How does age change risk of RSV?

A

Infants and older individuals are at a much higher risk

43
Q

How common is RSV in infants?

A

Its the most common respiratory tract infection in infants and a leading cause of hospitalisation

44
Q

What are signs and symptoms of RSV in kids?

A
Hypoxemia
Cyanosis
Chest wall retractions
Nasal flaring
Expiratory wheezing
Prolonged expiration
45
Q

Infection by influenza can result in different symptom severity even in similar age, ethnicity- why is this?

A

The strain may be highly pathogenic
There may be prior immunity
There may be predisposing illness

46
Q

Out of flu and RSV which has a faster emergence?

A

Flu

47
Q

What is the main difference between infection by the flu vs RSV?

A

The same strain flu can’t infect you twice but the same strain of RSV can

48
Q

What type of molecules are interferons?

A

Cytokines

49
Q

What are the types of interferon and what are they called?

A

Type 1= interferon alpha/bets
Type 2= interferon gamma
Type 3= interferon delta

50
Q

How do interferons work?

A

By inhibiting viral infection

51
Q

What are ISGs?

A

Interferon stimulated genes- they inhibit viral replication inside cells when they are upregulated

52
Q

What cells produce interferons and when?

A

Cells that are infected by viruses when they detect infection

53
Q

What cells provide long term immunity?

A

B cells

54
Q

How does pre existing immunity affect symptoms?

A

It greatly reduces them

55
Q

What does RSV stand for?

A

Respiratory syncytial virus