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Pathology MD3001 > Respiratory Tract Infections 1 > Flashcards

Respiratory Tract Infections 1 Flashcards

1
Q

What do infants under 7 get more respiratory infections?

A

There is a shorter flatter pharyngotympanic tube

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2
Q

What is otitis media?

A

Group of inflammatory diseases which can cause damage hearing and if the infection ruptures then it can travel into the mastoid sinuses.

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3
Q

What are the respiratory innate defences

A
  • Nasal mucus.
  • Ciliated cells,
  • Mucociliary clearance elevator.
  • Alveolar macrophages.
  • Polymorphonuclear leucocytes and,
  • Complement.
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4
Q

What is mucociliary clearance elevator?

A

Particles become trapped in mucus covering the respiratory tract. Ciliary action drags the mucus upwards so material is expectorated. Disruption of this system leads to chronic infections.

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5
Q

What is the common microbiota of the respiratory tract?

A

Candida albicans, oral streptococci and haemophilus influenzae.

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6
Q

What is the occasional microbiota of the resp tract?

A

Streptococcus pyogenes, streptococcus pneumoniae and Neisseria meningitidis

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7
Q

What are microbiota in the latent state in tissues in the respiratory tract?

A

Herpes simplex virus type 1, epstien-barr virus, cytomegalovirus and mycobacterium tuberculosis.

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8
Q

Describe features of the common cold (transmission, causative agents)

A
  • Aerosol or virus-contaminated hands.
  • 40% Rhinoviruses, 30% coronaviruses (less common, coxsackie virus A, echovirus or parainfluenza virus)
  • No vaccine due to different types circulating every year.
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9
Q

What are the clinical features of the common cold?

A
  • Tiredness,
  • Slight pyrexia,
  • Malasie,
  • Sore nose and pharynx,
  • Profuse, watery nasal discharge becoming mucopurulent,
  • sneezing in early stages,
  • Secondary bacterial infection can occur.
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10
Q

What are the causative agents for acute pharyngitis and tonsillitis?

A

Viruses - Epistein-Barr virus and Cytomegalovirus are the most common viral causes. HSV-1, rhinovirus, coronavirus or adenovirus.

Bacteria - Streptococcus pyogenes which is the most common bacterial cause. haemophilus influenzae.

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11
Q

Describe features of cytomeglovirus (CMV)

A
  • Transmission in body secretions and organ transplants.

- Virus can reactivate and cause disease when cell-mediated immunity is compromised.

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12
Q

How do you diagnose CMV

A

Infection - IgM in blood.

CMV pneumonitis - CMV Ag in BAL.

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13
Q

What is the treatment for cytomegalovirus?

A

Ganciclovir, foscarnet or cidofovir.

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14
Q

Describe features Epstein-Barr Virus?

A
  • Replicates specifically in B lymphocytes (CD21 receptor).
  • Causes glandular fever which is transmitted by saliva and aerosol.
  • Normally occurs in 1-6 years old and then 14-20 years old.
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15
Q

What are the clinical features of glandular fever?

A

Fever, headache, malaise, sore throat, anorexia, palatal petechiae, cervical lymphadenopathy and the signs which are specifically common in glandular fever are splenomegaly and mild hepatitis.

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16
Q

How do you diagnose glandular fever?

A

Detecting heterophile antibodies via monospot test or the paul-bunnell test. If neg then consider HIV.

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17
Q

What is the treatment for glandular fever?

A

Not treated with antibiotics and patients should avoid heavy lifting should be avoided to prevent spleen rupture.

18
Q

What are some of the complications of glandular fever?

A

Burkitt’s lymphoma, nasopharyngeal carcinoma and guillain-barre syndrome.

19
Q

Describe some features of tonsillitis

A

Caused by streptococcus pyogenes. Transmission by airborne droplets and contact. It is very susceptible to treatment with penicillin but has increasing resistance to erythromycin and tetracycline.

20
Q

What are some of the clinical features of tonsilitis?

A

Fever, pain in throat, enlargement of tonsils, tonsillar lymphadenopathy.

21
Q

What are some of the features of streptococcus pyogenes

A
  • Group A Streptococcus,
  • Gram positive cocci in chains.
  • Susceptible to treatment with penicillin.
22
Q

What are some of the complications of streptococcus pyogenes?

A
  • Scarlet fever (caused by erythrogenic toxin),
  • Peritonsillar abscess (quinsy),
  • Otitis media/ Sinusitis,
  • Rheumatic heart disease,
  • Glomerulonephritis.
23
Q

What are the clinical features of diphtheria?

A

Sore throat, fever, formation of psudomembrane, lymphadenopathy and oedema of anterior cervical tissue.

24
Q

What is the diagnosis of diptheria?

A

Made on clinical grounds as therapy is usually urgently required

25
Q

What is the treatment for diptheria?

A
  • Prompt anti-toxin therapy administered intramuscularly.
  • Concurrent antibiotics (penicillin or erythromycin).
  • Strict isolation.
26
Q

What is the prevention for diptheria?

A

Childhood immunisation with toxoid vaccine and then boasters if traveling to an endemic area and it has been over ten years since primary vaccination.

27
Q

Describe features of Corynebacterium diphtheriae?

A
  • Only the strains which produce toxins will cause disease.

- They transmit through air-borne droplets.

28
Q

What are the clinical features of parotitis

A

Fever, malaise, headache, anorexia, trismus (jawlock) and severe pain and swelling of the parotid gland.

29
Q

How is parotitis diagnosed and transmitted?

A

Transmitted by droplet spread and fomites. Diagnosis is based on clinical features but IgM serology can be preformed in doubtful cases from saliva, CSF or urine.

30
Q

What is the prevention, treatment and complications of parotitis?

A

Prevention - Active immunisation (MMR vaccine).

Treatment - Mouth care, nutritional and analgesia.

Complications - CNS involvement epididymo-orchitis

31
Q

What is acute epiglottis and its clinical features

A

Inflammation of epiglottis which presents with:

  • High fever.
  • Massive oedema of epiglottis.
  • Severe airflow obstruction resulting in breathing difficulties.
  • Bacteraemia.
32
Q

Describe features of haemophilus influenza

A

Gram negative bacillus. Used to be common cause of acute epiglottis but now due to vaccinations, other pathogens tend cause it.

33
Q

Describe the diagnosis for acute epiglottis

A
  • Don’t examine throat or take throat swabs as this will cause complete obstruction of their airway. Instead blood cultures to isolate H.Influenzae.
34
Q

What is the treatment for acute epiglottis?

A
  • It is an emergency so requires urgent endotracheal intubation and IV antibiotics (chloramphenicol)
35
Q

Describe what causes laryngitis and tracheitis

A
  • This can occur when infections spread down from the URT.

- Common causitive viral pathogens = Parainfluenza virus, influenza virus, respiratory syncytial virus and adenovirus.

36
Q

How does laryngitis and tracheitis present in adults and children

A

Adults - Hoarseness and retrosternal pain.

Children - Dry cough and inspiratory stridor (scary for parents)

37
Q

What are the two clinical stages of whooping cough and describe them.

A

Catarrhal stage (week 1) - Highly contagious, malaise, mucoid rhinorrhoea and conjunctivitis.

Paroxysmal stage (weeks 1-4) - Paroxysms of coughing with inspiratory “whoop”. Lumen of resp tract is compromised by mucus and mucosal oedema.

38
Q

What is the prevention, diagnosis and treatment of whooping cough?

A

Prevent - via vaccination.

Diagnose - Bacterial isolation from nasopharyngeal swabs and NAAT.

Treatment - If in catarrhal stage then antibiotics but in in paroxysmal stage then antibiotics have no effect so isolation and supportive care.

39
Q

What are some features of bordetella pertussis?

A
  • Gram negative aerobic coccobacillus. It attaches to and replicates in the ciliated respiratory epithelium.
  • They produce pertussis toxins, adenylate cyclase toxin, tracheal cytotoxin and endotoxins.
40
Q

Describe features of acute bronchitis

A
  • Inflammation of the tracheobronchial tree.
  • Infection is usually due to; Rhinovirus, coronavirus, adenovirus and mycoplasma pneumoniae.
  • Secondary infection; Streptococcus pneumoniae, haemophilus influenzae.
41
Q

Describe features of chronic bronchitis

A
  • Characterised by cough and excessive mucus secretion in tracheobronchial tree.
  • Occurs with anatomical disturbances of the respiratory system; immune deficit, ciliary deficit and excessively thick mucus.

Pathology MD3001 (20 decks)

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