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BRS YR2 > Respiratory Tract Infection and Immunity > Flashcards

Respiratory Tract Infection and Immunity Flashcards

1
Q

What are the symptoms of upper respiratory tract infection?

A
  • cough
  • sneezing
  • runny or stuffy nose
  • sore throat
  • headache
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2
Q

What are the symptoms of lower respiratory tract infection?

A
  • a productive cough : phlegm
  • muscle aches
  • wheezing
  • breathlessness
  • fever
  • fatigue
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3
Q

What are the symptoms of pneumonia?

A
  • chest pain
  • blue tinting of lips
  • severe fatigue
  • high fever
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4
Q

What is Disability-adjusted Life Year?

A

sum of Years of Life Lost (YLL) and Years Lost to Disability (YLP)

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5
Q

What is the impact of age on mortality?

A

dramatically increases mortality once age is greater than 70 years

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6
Q

What is the leading cause of death in those younger of 5?

A

malaria, then lower respiratory infections

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7
Q

What are the risk factors of pneumonia?

A
  • age (<2,>65)
  • smoking
  • excess alchol consumption
  • poverty
  • overcrowding
  • contact with those <15
  • inhaled corticosteroids
  • immunosuppresants
  • PPIs
  • COPD, Asthma
  • CVD
  • Lung disease
  • Liver disease
  • diabetes
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8
Q

What are the different forms of pneumonia?

A
  • community acquired pneumonia
  • hospital acquired pneumonia
  • ventilator associated pneumonia
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9
Q

What are the main causes of community acquired pneumonia?

A
  • streptococcus pneumoniae (40-50%)
  • myxoplasma pneumoniae
  • staphlococcus aureus
  • chlamydia pneumoniae
  • haemophilus influenzae
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10
Q

What are the main causes of hospital acquired pneumonia?

A
  • Staphylococcus aureus
  • Pseudomonas aeruginosa
  • Klebsiella species
  • E. Coli
  • Acinetobacter spp.
  • Enterobacter spp.
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11
Q

What are the main causes of ventilator associated pneumonia?

A
  • pseudomonas aeruginosa (20%)
  • staphylococcus aureus (20%)
  • enterobacter
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12
Q

What strains present as ‘walking’ (atypical) pneumonias?

A
  • mycoplasma pneumoniae
  • chlamydia pneumoniae
  • legionella pneumophilia
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13
Q

What are the mechanisms of damage of pneumonia?

A
  • bronchitis
  • bronchiolitis
  • pneumonia
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14
Q

How do you grade potential bacterial pneumonia?

A
  • using the CRB/CURB-65 scoring system
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15
Q

What does CRB/CURB-65 mean?

A
  • Confusion
  • Respiratory rate (>30 breaths/min)
  • Blood pressure (<90 systolic and/or 60mmHg diastolic)
  • 65 (>65 years or older)
    In hospital, add:
  • Urea (7mmol/L)
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16
Q

What is the difference between CRB and CURB-65?

A

CURB-65 is used in hospital, add Urea (7mmol/L)

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17
Q

What are the different classifications for CRB and CURB-65?

A

0 - low severity (home treatment, anitbiotics)
1-2 - moderate severity (hospital referral)
3-4 - high severity (urgent admission, empirical antibiotics)

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18
Q

What are the treatments for bacterial pneumonia?

A
  • supportive therapies

- antibiotics

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19
Q

What are the different supportive therapies are used to treat pneumonia?

A
  • oxygen (for hypoxia)
  • fluids (for dehydration)
  • analgesia (for pain)
  • nebulised saline (for expectoration)
  • chest physiotherapy
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20
Q

What is the impact of the time of administration on survival rate?

A

the earlier the better (<8hours) after admission

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21
Q

Is bacterial pneumonia infectious/contagious?

A
  • most of the bacteria is present in the oropharynx, nose, oral cavity
22
Q

What is an opportunistic pathogen?

A

a microbe that takes advantage of a change in conditions (often immunosuppression)

23
Q

What is a pathobiont?

A

a microbe that is normally commensal, but found in the wrong environment can cause pathology

24
Q

What does cloudiness on the x-ray indicate?

A

fluid in the lungs

25
Q

Why do viral infections result in disease?

A

causes:

  • cellular inflammation (mediator release)
  • damage to epithelium (cilia loss, poor barrier, chemoreceptor loss)
26
Q

What are the factors that cause severe disease?

A
  • highly pathogenic strains
  • absence of prior immunity
  • predisposing illness/conditions
27
Q

What does zoonotic mean?

A

highly pathogenic strains

28
Q

What is viral tropism?

A

the ability of a virus to infect a particular cell

29
Q

What are the features of the respiratory epithelium?

A
  • tight junctions (prevents systemic infection)
  • mucous lining and cilial clearance (clearance and prevents attachment)
  • antimicrobials (recognise and neutralise)
  • pathogen recognition receptors (recognise)
  • interferon pathways (activated by infection, promotes upregulation of anti-viral proteins and apoptosis)
30
Q

What are the most common causes of the common cold?

A
  • rhinovirus
  • coronaviruses
  • influenza
31
Q

What are serotypes?

A

pathogens that cannot be recognised by serum (antibodies) that recognise another pathogen

32
Q

What is antibody mediated immunity?

A

humoral immunity

  • adaptive, dependent on prior exposure
  • B cells differentiate into antibody secreting plasma cells
  • different antibody classes have different biochemical properties and functions
33
Q

What are the characteristics of RSV?

A
  • nasal flaring
  • chest wall retractions
  • hypoxemia and cyanosis
  • croupy cough
  • expiratory wheezing, prolonged expiration
  • tachypnea
34
Q

What is the impact of RSV and its paediatric burden?

A
  • leading cause of infant hospitalisations
  • recurrent re-infection
  • no vaccine
35
Q

What are the treatment options for viral respiratory infections?

A
  • supportive therapy
  • preventative/prophylactic
  • therapeutic
36
Q

What are the different types of vaccines?

A
  • major surface antigen (spike protein)
  • viral vector
  • mRNA vaccine
37
Q

What are the different therapeutic options for viral respiratory infections?

A 
Anti-inflammatory 
- Dexamethasone (steroids)
- Tocilizumab (anti-IL6R)
- Sarilumab (anti-IL6)
Anti-virals
- Remdesivir (broad spectrum)
- Paxlovid (anti-viral protease inhibitor)
- Casirivimab and Imdevimab (monoclonal neutralising)
38
Q

What are the different supportive therapies available for viral respiratory tract infections?

A
  • oxygen (hypoxia)
  • fluids (dehydration)
  • analgesia (pain)
  • nebulised saline
  • chest physiotherapy
39
Q

What is the interplay between viral and bacterial infections?

A

high likely hood of simultaneous viral and bacterial infections

40
Q

What are the common bacterial causes of respiratory infection?

A
  • Streptococcus pneumoniae
  • Myxoplasma pneumonia
  • Haemophilus influenzae
  • Mycobacterium tuberculosis
41
Q

What are the common viral causes of respiratory infection?

A
  • Influenza A or B virus
  • Respiratory Syncytial Virus
  • Human metapneumovirus
  • Human rhinovirus
  • Coronaviruses
42
Q

What is the definition of bronchitis?

A

inflammation or swelling of the bronchi

43
Q

What is the definition of bronchiolitis?

A

inflammation and swelling of the bronchioles

44
Q

What is the effect of pneumonia?

A

inflammation and swelling of the alveoli

45
Q

What is commensal bacteria?

A

microbes that live in a symbiotic relationship with their host

46
Q

What are the risk factors of developing RSV bronchiolitis in infants?

A
  • premature birth

- congenital heart and lung disease

47
Q

What is the nasal cavity enriched with?

A

IgA

48
Q

What is the alveolar space enriched with?

A

IgG

49
Q

What respiratory infection causes the highest annual mortality in the average year?

A

Mycobacterium tuberulosis

50
Q

At what age do humans experience the most frequent respiratory infections?

A

0-10 years old

BRS YR2 (70 decks)

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