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CRRAB II Week 5 > Respiratory Infectious Disease Pathogens > Flashcards

Respiratory Infectious Disease Pathogens Flashcards

1
Q

What are six microorganisms that cause the common cold (rhinitis)?

A
  • Rhinovirus
  • Paramyxovirus (Parainfluenza virus)
  • Coronavirus
  • Influenza virus A, B, C
  • Coxsackievirus A and B
  • Adenovirus (Mastadenovirus)
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2
Q

What are the most common causes of pneumonia in young children?

A
  • RSV

- Parainfluenza virus

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3
Q

Traits of Rhinovirus:

A
  • RNA virus
  • Icosahedral Nucleocapsid
  • Nonenveloped
  • ss(+) Nonsegmented Genome (Class IV)
  • Picornaviridae
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4
Q

Traits of Paramyxovirus (Parainfluenza virus):

A
  • RNA virus
  • Helical nucleocapsid
  • Enveloped
  • ss(-) Nonsegmented Genome (Class V)
  • Paramyxoviridae
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5
Q

Traits of Coronavirus:

A
  • RNA virus
  • Helical Nucleocapsid
  • Enveloped
  • ss(+) Nonsegmented Genome (Class IV)
  • Coronaviridae
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6
Q

Traits of Influenza virus A, B, C:

A
  • RNA virus
  • Helical Nucleocapsid
  • Enveloped
  • ss(-) Nonsegmented Genome (Class V)
  • Orthomyxoviridae
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7
Q

Traits of Coxsackievirus A + B:

A
  • RNA virus
  • Icosahedral Nucleocapsid
  • Noneveloped
  • ss(+) Nonsegmented Genome (Class IV)
  • Picornaviridae
  • Enterovirus
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8
Q

Traits of Adenovirus (Mastadenovirus):

A
  • DNA virus
  • Icosahedral Nucleocapsid
  • Non-enveloped
  • DS linear DNA (Group I)
  • Adenoviridae
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9
Q

What are the most common causes of aseptic meningitis?

A
  • Coxsackievirus
  • Echovirus
  • Mumps virus
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10
Q

What are the most common causes of palm and sole rash?

A
  • Syphilis
  • RMSF
  • Coxsackievirus
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11
Q

What are the most common causes of conjunctivitis?

A
  1. H. influenza
  2. Adenoviruses
  3. S. pneumoniae
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12
Q

Traits of Strep. pneumoniae:

A
  • Bacteria
  • Gram (+)
  • Diplococci
  • Catalase (-)
  • Alpha-hemolytic
  • Bile-Esculin Negative
  • Optochin Susceptible
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13
Q

Traits of H. influenzae:

A
  • Bacteria
  • Gram (-)
  • Coccobacilli, Pleomorphic
  • X & V Factors required
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14
Q

What are the common causes of pneumonia in adults (40-65 yrs)?

A
  • S. pneumoniae
  • H. influenzae
  • Legionella
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15
Q

What are the common causes of pneumonia in elderly (>65 yrs)?

A
  • S. pneumoniae
  • Gram (-) rods
  • H. influenzae
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16
Q

What are the most common causes of meningitis in 60+ yrs?

A
  • S. pneumoniae
  • Gram (-) rods
  • Listeria
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17
Q

What are the most common causes of meningitis in children aged 6 months to 6 years?

A

-S. pneumoniae
-N. meningitidis
-H. influenzae type B
(rate decreasing with use of Hib vaccine)

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18
Q

Traits of S. pyogenes:

A
  • Bacteria
  • Gram (+)
  • Cocci
  • Catalase (-)
  • Beta hemolytic
  • Bacitracin sensitive
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19
Q

Traits of C. diphtheriae:

A
  • Bacteria
  • Gram (+)
  • Bacilli
  • Non-spore forming
  • Non-motile
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20
Q

What can happen when Strep. pyogenes causes infection at other sites?

A

Scarlet Fever!

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21
Q

How does S. pyogenes cause Scarlet Fever?

A

Certain strains of S. pyogenes can cause scarlet fever by secreting certain streptococcal pyogenic exotoxins (sea, speA and speC). These toxins are super antigens.

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22
Q

What does the tongue and cheeks look like in Scarlet Fever?

A

Tongue - “strawberry” appearance with white patch in the center
Red cheeks/face

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23
Q

Why don’t many adults get Scarlet Fever?

A

Most adults develop immunity so its much more prevalent in children.

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24
Q

What reaction does catalase initiate? Why would a bacteria be catalase +?

A

O2 + H2O2 –> 2H2O + O2

-Aerobic bacteria need to get rid of oxygen radicals and they do this with catalase!

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25
Q

What is Corynebacterium commonly known as?

A

Diphtheria

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26
Q

What is Diphtheria toxin and where does it come from?

A
  • A-B exotoxin (A-Active, B-Binding)

- Comes from genes from a lysogenized phage

27
Q

What does Corynebacterium look like in the throat? What population is it often seen in?

A

Grayish, solid-looking film

-Often seen in immigrants

28
Q

What happens if the A-B exotoxin reaches the blood stream?

A

It can cause myocarditis (heart failure) and neuritis (temporary paralysis of the limbs, soft palate, and diaphragm)

29
Q

What vaccine is effective against Corynebacterium?

A

Diphtheria, Tetanus and Pertussis (DTaP)

30
Q

Traits of Corynebacterium diphtheriae:

A
  • Bacteria
  • Gram (+)
  • Bacilli
  • Non-spore forming
  • Non-motile
31
Q

In what population is Croup most common?

A

Kids ages 2-6!

32
Q

How do patients with viral croup or laryngotracheobronchitis usually present?

A
  • Fever of 38-39C (100.4-102.2F)
  • Restlessness
  • Shortness of breath
33
Q

How does Croup begin (what symptoms)?

A

Mild URTI with general cold-like symptoms, nasal congestion, sore throat, and cough that lasts 2-3 days.

34
Q

What follows the intimal 2-3 days of Croup symptoms?

A

Harsh, “bark-like” cough.

35
Q

What usually occurs at night and can awake an infected child from sleep?

A

-Respiratory stridor (noisy breathing)

36
Q

What symptoms occur in children with severe croup?

A

Children have primarily inspiratory stridor at rest with nasal flaring and suprasternal and intercostal retractions

37
Q

What symptoms may be a result of hypoxemia in Croup?

A
  • Lethargy

- Agitation

38
Q

What are other warning signs of severe respiratory disease in Croup?

A

Tachypnea & tachycardia out of proportion to the presence of fever, lethargy, pallor and hypotonia (decreased muscle tone)

39
Q

What is a late and ominous sign in Croup?

A

Cyanosis!!

40
Q

When do Croup symptoms usually peak and resolve?

A

Peak over 3-5 days

Resolve within 4-7 days

41
Q

What is the usual means of spread of all types of croup?

A

Person-to-person contact

42
Q

What groups are most susceptible to Viral Croup?

A
  • Young children (typically children 6 months to 3 years (she says 6))
  • Boys are more likely to develop
43
Q

When does viral croup occur most often?

A

Late fall and early winter

44
Q

What do outcomes of viral croup depend on?

A
  • How ill the patient is
  • Age of patient
  • Adequacy of treatment
45
Q

What are complications in severe cases of viral croup?

A

-Crust exudates resulting in obstruction of airways, segmental atelectasis (complete or partial collapse of lung), PTX, obstructive mediastinal emphysema, and bronchopneumonia

46
Q

What pathogen can cause viral croup anytime of the year?

A

Parainfluenza

47
Q

When does influenza virus and respiratory syncytial virus infections (Croup) tend to occur more often?

A

During winter and early spring

48
Q

What therapy is needed for Croup?

A
  • Typically self-limiting infections
  • Symptomatic therapy is all that is needed
  • Moderate to severe cases may require supportive treatment
49
Q

What are the most common causes of pneumonia in VERY YOUNG children?

A
  • RSV

- Parainfluenza virus

50
Q

Traits of Respiratory Syncytial Virus (RSV):

A
  • Virus
  • Helical Nucleocapsid
  • Enveloped
  • ss(-) Nonsegmented
  • Paramyxoviridae
  • Pneumovirus
51
Q

What can RSV cause on gram stain?

A

Syncytium: multinucleate cells that can result from multiple cell fusions of uninuclear cells!

52
Q

How does RSV cause Syncytium?

A

F proteins on the surface of the virus cause the cell membranes on nearby cells to fuse.
-Virus also gains entry into cell via F proteins

53
Q

How does the prevalence of Epiglottitis compare to croup?

A

RARE compared to croup!

-Approx 0.97-3.1 cases per 100,000 people

54
Q

What is important to remember about Epiglottitis?

A

LIFE THREATENING!!

55
Q

What causes Epiglottitis?

A

Beta-hemolytic Streptococci –> group A (most frequent), B, C or Haemophilus influenzae type b (Hib), but possibly others.

56
Q

What is the most URGENT treatment for Epiglottis?

A

If resp. distress is present, priority one is to secure the airway!!

57
Q

What is the typical antibiotic treatment for Epiglottitis?

A

Broad-spectrum second- or third-generation cephalosporins in combination with penicillinase-resitstant penicillin is typical empiric therapy

58
Q

What is the difference between Epiglottitis and Croup?

A
  • Epiglottitis is sudden onset while Croup is gradual
  • Drooling is present with Epiglottitis!
  • Epiglottitis has a high fever and Croup has a low fever
  • Croup has a cough!
59
Q

What does she have?
-Woman, runny nose, sneezing, irritable throat, slight fever. Similar symptoms every year. Symptoms go away in a week except nasal discharge.

A

Common cold - no treatment.

60
Q

What does she have?

Father with baby girl in ED. High fever, nasal discharge, barking cough. No inspiratory stridor.

A

Croup
Since no inspiratory stridor, no corticosteroids. Assures father it will go away in a few days. No real respiratory distress. Sent away without treatment.

61
Q

What does she have?
Young, immigrant girl. Sore throat, difficulties breathing and swallowing. Voice nasaly and large gray mucous film noted in oropharynx. Patient has slight paralysis of tongue. BP low.

A

Diptheria
Start immediate treatment!
-Order a potassium tellurite culture to confirm C. diptheriae
-Drugs: Give Antitoxin plus penicillin or erythromycin

62
Q

What is the significance of the Potassium Tellurite test (for diphtheria)?

A

Corynebacteria and some other species reduce TeO32- to elemental Te, which stains the bacteria black!

63
Q

What does he have?
8 year old. Sore throat, difficulty swallowing, fever for 5 days. Extensive red rash on neck, groin, armpit (axillae), bright red lingual papillae superimposed on white coat exudative tonsillitis and cervical lymphadenopathy.
-Bacitracin sensitive
-Beta hemolytic on blood agar.

A

Strep. pyogenes pharyngitis!

CRRAB II Week 5 (12 decks)

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