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2B week 1 - lung infection > respiratory tract infections > Flashcards

respiratory tract infections Flashcards

1
Q

what common viruses cause self-limiting URIs (“the cold”)

A

rhinovirus; adenovirus; coronaviruses; influenzaviruses; parainfluenzavirus

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2
Q

what proteins change between influenza subtypes (2)

A

hemagglutin; neuraminidase

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3
Q

what receptors do heamaglutinin bind to on host respiratory epithelial cells

A

sialic acid receptors

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4
Q

what kinds of virus more readily mutates

A

RNA viruses

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5
Q

what is “drift and shift”

A

antigenic drift - small changes (or mutations) in the genes of influenza viruses that can lead to changes in the surface proteins of the virus, the small changes in HA and NA that accumulate over time may result in viruses that are antigenically different, meaning a person’s antibodies bind differently or not at all to the virus, resulting in a loss or reduction in protection against that particular flu virus,an important reason why people can get flu multiple times over the course of their lives;
antigenic shift - an abrupt, major change in a virus, resulting in new HA and/or new HA and NA proteins in flu viruses that infect humans, Shift can happen if a flu virus from an animal population gains the ability to infect humans;
Type A viruses undergo both antigenic drift and shift and are the only flu viruses known to cause pandemics, while flu type B viruses change only by the more gradual process of antigenic drift

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6
Q

what is the S1 spike glycoprotein responsible for

A

virus-host range and cellular response

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7
Q

what is the S2 spike glycoprotein responsible for

A

virus-cell membrane fusion

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8
Q

what gram staining are bacilli normally

A

gram negative

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9
Q

what gram staining are bacilli normally

A

gram negative

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10
Q

what gram staining are cocci normally

A

gram positive

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11
Q

6 ways to classify bacteria

A

morophology; gram staining; growth requirement (aerobic/anerobic); biochem reactions; serotype (A vs B vs D); antibiotic resistance pattern (MSSA, MRSA); rRNA sequence analysis

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12
Q

4 additional important tests for bacteria classification

A

coagulase test; haemolysis; lancefield serotype ( based on carbohydrates present on bacterial wall); lactose fermentation

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13
Q

what are the 2 main pathogenic enterococci

A

E.faccalis; E.falcium

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14
Q

examples of atypical resp bacterial pathogens (5)

A

mycoplasma pneumoniae; mycobacterium tuberulosis; chlamydia pneumoniae; legionella pneumophila

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15
Q

why is mycoplasma atypical

A

no cell wall - so cant give B-lactams; highly pleomorphic

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16
Q

why is legionella pneumophilia atypical

A

does not grow on traditional media; obligate intracellular parasites

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17
Q

where can legionella pneumophilia be acquired from?

A

man-made stagnant water supplies - pipes, hot tubs, cooling towers etc.

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18
Q

what 2 disease can arise from legionella pneumonia and what are their features

A
  1. Pontiac fever - acute, self limiting, fever, chills, headache, sore muscles;
  2. legionnaire’s disease - presentation ranges from a mild cough to severe/fatal pneumonia, death can occur due to multi-organ failure, cough, anorexia, headache, lethargy, blood streaked phlegm
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19
Q

legionella penuophilia morphology

A

grame -ve flagellated bacillus

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20
Q

what information does that lab need when diagnosing an RTI (6)

A

identification; clinical details (symptoms, immunosuppression, duration etc.); antibiotic history; exposure; report destination

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21
Q

when can g-interferon release be used for TB diagnosis

A

testing for latent infection - based on T cell response to TB antigens

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22
Q

streptococcus penumoniae features

A

gram +ve diplococci/short chains; has a capsulre that helps it evade phagocytosis; can adhere to respiratory epithelium; usually only occurs in susceptible pts; childhood vaccination is effective

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23
Q

what can Strep A (a cause of bacterial throat infections) cause (other organ systems)

A

rheumatic heart disease; reactive arthritis; toxic shock syndrome; scarlet fever/strawberry tongue; used to be responsible for childbirth deaths

24
Q

what differentates the different sereotypes of strep (biochem)

A

the N protein found in the outercapsules

25
Q

strep A features (morphology)

A

gram +ve; has pyrogenic exotoxins that cause rash, fever etc.

26
Q

diphteria (corynebacterium diptheria) morphology

A

gram +ve bacillus

27
Q

diptheria symptoms

A

swollen glands; weakness; sore throat; fever; SOB; dysphagia; grey-mucous

28
Q

diptheria MOA (6)

A
  1. spread by droplets and infected sores/ulcers;
  2. toxin produced when the bacillus itself is infected (e.g by a virus)
  3. destroys the epithelial lining of the RT forming a grey coating (pseudomembrane)
  4. pseudomembrane builds up in the airways which can make breathing difficult (fatal)
  5. toxins produces can enter blood stream/brain
  6. give erythromycin to close contact immediately
29
Q

what can cause pharyngitis and what are the symptoms

A

Most cases caused by viruses but can be caused by group A Beta-haemolytic strep., Mycoplasma pneumoniae, or Chlamydophilia Pneumoniae; sore throat and there is erythema of the pharynx, often with the enlargement of the tonsils; self limiting

30
Q

what can cause sinitis and what are the symptoms

A

H.influenzae, Strep. Pneumoniae, Staph. aureus and anaerobic bacteria; Infection of the maxillary sinuses causes facial pain, nasal obstruction and discharge, often accompanied by fever and malaise

31
Q

haemophilus influenzae features

A

opportunistic pathogen - only causes trouble when other factors give it the opportunity (immunosuppression etc.) - otherwise usually resides in the RT of healthy people;

32
Q

what serious symptom can H.influenzae B cause?

A

epiglottitis - blocks airways

33
Q

what causes whooping cough

A

bordetella pertussis

34
Q

whooping cough symptoms

A

intense bouts of coughing that makes it hard to breath - whooping sound when taking in breaths; sore throat; rhinorrea; temperaure

35
Q

bordetella pertussis morophology

A

aerobic, gram -ve bacillus

36
Q

where does fusobacterium inhabit

A

mucous of humans/animals

37
Q

what can fusobacterium cause

A

Lemierres syndrome

38
Q

signs of a fusobacterium infection

A

foul smelling discharge, abscess formation, gas in tissue

39
Q

fusobacterium morphology

A

anerobe; gram -ve, spindle shaped bacilli; often in pairs

40
Q

what lab techniques can be used to check samples for bacteria

A

microscopy; bacterial culture; antigen detection (ELISA); antibody detection

41
Q

what is key in determing how useful a sample will be in testing for cultures

A

the quality - pus, epithelia cells, too much saliva etc.

42
Q

how does vertical transmission of resistance occur

A

bacteria may carry resitance genes in their plasmids/transposers -> selection pressure leads to an evolutionary advantage for resisitant bacteria ->pass resistance onto offspring -> whole colony now populated by resistant bacteria

43
Q

how does horizontal transmission of resistance occur (3)

A

transfer of resistant genes in any of the following ways;
1. conjugation - bacterial cells adhere to each other and plasmids/transposers can be transferred from donor to recipient via sex pilli;
2. transformation - when bacteria die the cells lyse and genetic material is released into the environment -> other bacterias may be able to take this up and incorporate it into their own genome (this is hoe B-lactams often become resistant to);
3. transduction - bacteria infected with a phage -> phae incorporates bacteria DNA and then multiplies ->. bacteria lyse and phage can pass on bacterial DNA to other bacteria it infects

44
Q

what are the 3 β-Lactam classes and give examples

A
  1. penecillins - benzylpenicillin, amoxicillin, piperacillin
  2. cephalosporins - cefotaxime, ceftriaxone, ceftazidime
  3. carbapenems - meropenem, entapenem
45
Q

examples of macrolides/lincosamides

A

erythomyocin; clarithromycin; clindamycin

46
Q

macrolide MOA

A

bind the bacterial 50S ribosomal subunit causing the cessation of bacterial protein synthesis

47
Q

β-Lactam MOA

A

interrupt bacterial cell-wall formation as a result of covalent binding to essential penicillin-binding proteins (PBPs), enzymes that are involved in the terminal steps of peptidoglycan cross-linking in both Gram-negative and Gram-positive bacteria.

48
Q

what are the 3 categories of breakpoint testing

A

susceptible; intermediate; resistant

49
Q

what is antibiotic susceptibilty testing and why is it done

A

specifies effective antibiotic dosage and formulates a profile of empirical therapy - i.e. finds the lowest conc for inhibition; needed to prevent resisitance

50
Q

pH and humidity change along the resp tract

A

pH gradually increases along the resp tract; humidity increase generally occurs in the nasal cavity

51
Q

role of microbiota in RT

A

protective - evidence that it helps stop invading pathogens (S.epidermis shown to destroy biofilms of S.aureus); may have an effect on the morphogenesis

52
Q

examples of bacteria found in the nasal cavity

A

staphylococcus spp.; moraxella spp.; streptococcus spp.

53
Q

examples of bacteria found in the oropharynx

A

streptococcus spp.; veillonella spp. etc.

54
Q

examples of bacteria found in the lungs

A

prevotella spp.; streptococcus spp.; veillonella spp

55
Q

what causes leishmaniasis and how is it spread

A

sand flies; Leishmania parasites are transmitted through the bites of infected female phlebotomine sandflies, which feed on blood to produce eggs

56
Q

what causes Schistosomiasis and how is it spread

A

parasitic worms - considered a neglected tropical disease; live in certain types of freshwater snails, The infectious form of the parasite, known as cercariae, emerge from the snail into
the water -You can become infected when your skin comes in contact with
contaminated freshwater

57
Q

treatment for schistomiasis

A

Praziquantel is taken for 1-2 days to treat infections caused by all
schistosome species

2B week 1 - lung infection (6 decks)

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