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Pulmonary Microbiology > Respiratory Pathogens Overview > Flashcards

Respiratory Pathogens Overview Flashcards

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1
Q

What is the most common source of illness?

A

Respiratory infections, which are common and serious

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2
Q

What are the 4 mechanical defenses against respiratory tract infections?

A
  1. Saliva containse lysozyme that flushes away microbes
  2. Mucociliary system traps microbes in the nasopharynx
  3. Mucociliary escalator of the lungs traps and pushes microbes up toward the larynx
  4. Microbe binding properties are important
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3
Q

What are the normal flora of the upper respiratory tract? (7)

A

URT is colonized by a number of normal floral organisms:

  1. Oral streptococci
  2. Corynebacteria
  3. Bacteriodes
  4. Anaerobic cocci
  5. Candida albicans
  6. Streptococcus mutans
  7. Haemophilus influenzae
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4
Q

What the normal flora of the lower respiratory tract?

A

Trick question, LRT is typically STERILE

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5
Q

What is another name for ear infections?

A

otitis media

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6
Q

Acute otitis media and sinusitis (OM and S) are most common in who?

A

Infants and young children, with 80% having experienced at least one by age 3.

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7
Q

More than 50% of OM and S infections are caused by what type of pathogen? Especially what specific type?

A

More than 50% of the infections are viral, especially respiratory syncytial virus (RSV)

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8
Q

What are the most common bacterial sources of OM and S?

A

Strep pnemoniae and Haemophilus influenzae

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9
Q

How are OM and S treated?

A

B/c of increasing antibiotic resistance, treatment leans towards symptomatic in many parts of the world, but antibiotics are often prescribed in the US before a bacterial agent is suspected.

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10
Q

80% of URT infections are caused by what? What do these commonly result in?

A

80% of URTI’s are caused by viruses. In these infections, it is common to see VESICLES or ULCERATED LESIONS

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11
Q

Bacterial URT infections lead to what?

A

inflammatory exudates and hemorrhages

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12
Q

What type of microbe almost exclusively causes rhinitis?

A

Rhinitis is almost exclusively viral. Bacteria rarely cause colds.

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13
Q

What are the most common specific causes of rhinitis?

A

1&2)Rhinoviruses (more than 100 serotypes) and Coronaviruses cause more than 50% of common colds. Other viruses causing rhinitis include:

3) Adenovirus
4) Parainfluenza virus (paraflu)
5) Influenza virus (flu)
6) RSV

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14
Q

About 70% of Pharyngitis (sore throat) cases are caused by what?

A

viruses

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15
Q

What types of viruses cause pharyngitis (sore throats)?

A

Most common 5 are:
Adenovirus, Rhinovirus, Coronavirus, Paraflu, Flu
Other viral causes:
1. Herpesviruses (HSV) 2. Coxsackie A virus
3. EBV

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16
Q

What is the major bacterial agent that causes pharyngitis? Other bacterial causes?

A

Group A Strep (Strep pyogenes) is the major one.

Others include Nisseria gonorrhoeae, Corynebacterium diptheriae

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17
Q

Diptheria is characterized by what?

A

A severe sore throat and fever sometimes accompanied by a pseudomembrane composed of necrotic tissue, immune cells, and bacteria.

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18
Q

Diptheria can be life-threatening by causing what?

A

by causing respiratory obstruction

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19
Q

If the toxin of C. diptheriae reaches the blood stream, it can cause what?

A

Acute myocarditis

20
Q

How is diagnosis of pharyngitis done? What is the purpose of this diagnosis?

A

Throat swabs for culture; the purpose of diagnosis is to determine if the causal agent is bacterial. (identification is usually not made for viral infections, except for unusually severe cases, b/c virus-specific therapy is rare)

21
Q

In Dx of pharyngitis, special culture media is needed for what bacteria? What else is important to take into consideration?

A

C diptheriae and N gonorrhoeae;
It is important to recognize that some bacteria ( S pneumo, S aureus, H influenzae) may be colonizers and not the cause of pharyngitis.

22
Q

Laryngitis and its more severe form, Croup, are more than 90% of the time caused by what? Which ones specfically?

A

Viruses; mostly Paraflu, flu, adenovirus, and sometimes RSV

23
Q

What are 3 bacterial agents that can cause laryngitis?

A
  1. GAS
  2. H flu
  3. S aureus
24
Q

Bronchitis is characterized by what signs/symptoms? (3)

A

mild fever, productive cough, and fatigue

25
Q

What causes 80% of bronchitis? Which ones specifically?

A

Viruses, with Paraflu, flu, adenovirus, RSV (and measles) leading the way

26
Q

What are bacterial causes of bronchitis? (4)

A
  1. Most importanty: Bordetella pertussis
  2. H influenzae
  3. Mycoplasma pneumoniae
  4. Chlamydia pneumoniae
27
Q

What does Bordetella percussis cause? In Who? What is that? Has its prevalence increased or decreased recently? Why?

A

BP leads to whooping cough, which is an acute bronchitis in infants and young children.
There has been a recent increase in whooping cough incidence due to reduced vaccination rates.

28
Q

In bronchitis, what is used to Dx pertussis and viral infections? What is used to Dx C pneumoniae and M pneumoniae?

A

Throat cultures are used to Dx pertussis and viral infections, while serology is required for M pneumoniae and C pneumoniae

29
Q

Signs and symptoms of pneumonia? (6)

A

chills, high fever, productive cough (sputum production), chest pain, sweating, respiratory distress

30
Q

What are the 3 routes by which a person can acquire pneumonia?

A
  1. inhalation
  2. aspiration
  3. blood-borne
31
Q

The etiology of acute pneumonia is very _______? What does this mean specifically?

A

Age specific; 80% of pneumonias in infants and young children are viral, but only 10-20% of adult pneumonias are viral.

32
Q

What are common viral causes of acute pneumonia? (7)

A

Flu, paraflu, adenovirus, RSV (infants and elderly), SARS-CoV, MERS, metapneumovirus

33
Q

RSV causes pneumonia in what type of people?

A

infants and elderly

34
Q

What type of viral infection, in particular, can produce life-threatening acute pneumonia, even in healthy young adults? It makes them prone to what?

A

Influenza infection; it can make patients prone to subsequent bacterial acute pneumonia

35
Q

What is the most common bacterial cause of acute pneumonia? Other bacterial causes include?

A

Most common: Strep pneumoniae (pneumococcus)

Others: S aureus, H influenze, anaerobes (aspiration)

36
Q

What are fungal sources of acute pneumonia?

A

Candida and Aspergillis spp

37
Q

What is atypical pneumonia?

A

When the course of presentation differs from that typical of pneumococcal pneumonia and from which a microbe that is not S pneumo is cultured

38
Q

What are causes of pneumonia in compromised patients?

A

a) Ps, aeruginosa, anaerobes, Klebsiella pneumoniae

b) Candida, Aspergillis, Pneumocystis

39
Q

Chronic pneumonia is rarely caused by what?

A

rarely caused by viruses

40
Q

What is a typical bacterial cause of chronic pneumonia?

A

Tuberculosis

41
Q

What fungal pathogens are common sources of chronic pneumonia?

A

Histoplasma capsulatum, Blastomyces dermatitidis, and Coccidioides immitis

42
Q

Diagnosis of pneumonia is often dependent on what?

A

microscopic examination and culture of sputum, but quality of sputum is essential (lots of PMNs good, lots of epithelial cells bad)

43
Q

How does mycobacterium tuberculosis cause chronic pneumonia?

A

Primary TB is often asymptomatic. It is the reactivated form that leads to chronic pneumonia

44
Q

Chronic pneumonia due to TB is characterized by what?

A

fever, malaise, night sweats, weight loss, and bloody sputum

45
Q

Reactivation of TB occurs how often and is most common in who?

A

Reactivation occurs in about 10% of cases and is seen more often in men over 50

46
Q

Reactivation of TB follows what? What brings this on?

A

Reactivation follows immunosuppression brought on by alcoholism, malnutrition, diabetes, or old age.

47
Q

What does untreated TB lead to?

A

Untreated TB will disseminate and ultimately lead to fatal meningitis (consumption)

Pulmonary Microbiology (4 decks)

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