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Microbiology-HH3 > Respiratory Tract Infections > Flashcards

Respiratory Tract Infections Flashcards

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1
Q

Function of the Upper RS?

A
  • filter air and collect particles
  • non-sterile
  • normal flora, competes with pathogens to help protect us
  • some pathogens can live within normal flora and when it goes to other parts of the body infection can occur
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2
Q

Immune system in the upper RS? Is the upper RS sterile?

A

-large as it is a portal of entry
need strong immune system effects here
-it is non-sterile

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3
Q

Components of the upper RS?

A
  • tonsils, mucous
  • uvula
  • pharynx
  • nasal cavity
  • auditory tube opening
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4
Q

Function of the Lower RS? is it sterile or on-sterile?

A
  • sterile
  • good immune response
  • gas exchange
  • highly vascularized
  • antibodies present at all times
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5
Q

Why is it easy for pathogens to cause systemic infection if located in the lower RS?

A

-highly vascularized, can entry blood plasma easily

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6
Q

What causes cough reflex when you aspirate in the lower RS?

A

-ciliary escalader

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7
Q

Components of the lower RS?

A
  • epiglottis
  • larynx
  • trachea
  • pleurae
  • bronchiole
  • diaphragm
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8
Q

Upper RT infections: Bacterial

A
  • pharyngitis
  • otitis media
  • rhino sinusitis
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9
Q

Causes of pharyngitis? symptoms? how is it treated?

A
  • streptococcus pyogenes
  • sore throat
  • treated with antibiotics if bacterial
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10
Q

Cause of otitis media?

A
  • middle ear infection
  • streptococcus pneumonias
  • already present in middle ear not causing damage, but when immune system is compromised or weakened, host defences change. it can cause damage
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11
Q

Cause of rhino sinusitis?

A
  • infection of sinuses

- haemophilus influenza

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12
Q

Are most URTI bacterial or viral?

A

-most are viral

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13
Q

4 viral URTI’s?

A
  • pharyngitis
  • otitis media
  • rhino sinusitis
  • common cold
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14
Q

Streptococcal Pharyngitis signs and symptoms?

A
  • red pharynx
  • swollen lymph nodes
  • pain during swallowing
  • fever
  • headache
  • bad breath
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15
Q

Rapid strep throat swab?

A
  • 15 can tell whether it is bacterial or viral
  • tells us fast and early so it doesn’t grow into super antigen and turn into scarlet fever, producing damaging effects to the heat and kindeys
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16
Q

Is streptococcus progenies bacterial or viral? what can it produce if it grows rapidly?

A
  • bacterial

- can produce erythrogenic toxins that can damage heart and kidneys

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17
Q

Signs and symptoms of Scarlett fever?

A
  • sandpapery rash on neck and chest and then spreads throughout the body
  • red tongue
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18
Q

Otitis media signs and symptoms? what happens if ear drum ruptures? who are most susceptible to ear infections?

A

-Inflammation and pressur eon ear drum
-ear pain
rupture= earring impairment
-most common in young patients, decrease as you age

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19
Q

Green mucous represents?

A

-bacterial infections

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20
Q

Signs and symptoms of rhino sinusitis? Most common in what age group?

A
  • sinus pain and pressure
  • headache
  • feeling of malaise
  • adult cases
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21
Q

Common bacterial pathogenic microorganism causing otitis media and rhino sinusitis?

A
  • Streptococcus pneumonia
  • 10% of cases (90% are viral causes)
  • more likely to be bacterial if high fever and pus nasal discharge for more than 10 days
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22
Q

Streptococcus pneumoniae?

A
  • main bacterial pathogen
  • infections move from pharynx to sinuses (sore throat) or to middle ear
  • risk of sepsis and meningitis
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23
Q

Are common cold caused by viruses or bacterium? Signs and symptoms?

A

-always viral
-dry congested nasal
scratchy sore throat
-cough for about 1 week
-NO FEVER

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24
Q

common cold: how does it exit? is it contagious

A
  • infects for hours, exits cells through lysis
  • highly contagious
  • caused by multiple viruses
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25
Q

Transmission of the common cold? how to prevent it?

A 
-respiratory droplets
direct contact
-single virus can cause infection
-live on door knobs and handles
-hand washing prevents it
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26
Q

What causes the sore throat with he common cold?

A

-cell lysis when virus leaves the host cells

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27
Q

Is there a fever with the common cold? if there is what is it indicative of?

A
  • no there is no fever

- indicative of bacterial infection present

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28
Q

What is the most common cause of death by infection in the world? 6th leading cause of death in Canada

A

-Pneumonia

29
Q

Pneumonia? Who does it affect the most?

A
  • LRT Infection
  • fluid in bronchioles and alveoli causing dyspnea
  • mainly affects the very young and the very old
  • long staying hospitalized patients can develop it (HAI)
30
Q

When is pneumonia most common?

A
  • fall and winter (times when flu risk is high)

- influenza causes damage to alveoli linings making it susceptible for diseases

31
Q

Pneumococcal pneumonia? what are 75% of people colonized with?

A
  • 85% of community cases
  • 75% of people have stretococcus pneumonia in normal flora, infection develops when it is not cleared by immune system, host defences are down etc.
32
Q

Pneumonia risk factors?

A
  • drug abuse
  • alcoholism
  • HF, DM, AIDS
  • immunosuppressive drug therapies
33
Q

Why are drug addicts and alcoholics at risk for developing pneumonia?

A

-cough reflex is suppressed (innate immune system is impaired), can micro aspirate into the LRT

34
Q

What are 85% of community acquired pneumonia (CAP) caused from?

A

-streptococcus pneumonia which causes pneumococcal pneumonia

35
Q

Leading cause of pneumonia in hospital acquired pneumonia?

A

-gram negative bacterium

36
Q

Common causes of pneumonia in nursing homes?

A
  • S. pneumoniae
  • gram negatives
  • viruses
37
Q

Streptococcus pneumoniae?

A
  • gram positive bacteria
  • coccoid shaped
  • produce adherence factors help bind to pharyngeal epithelia cells
  • can cause endocytosis of the lungs
  • produces cytotoxin (pneumolysin) can induce cell lysis
38
Q

CAP: pneumococcal pneumonia?
Signs and Symptoms?
sputum colour?

A

-transmission by respiratory. dropplets
-S. pneumoniae damages alveolar lining
-RBC and WBC enter lungs
fluid in alveoli and inflammation impair gas exchange
-fever
-chills
-congestion
-cough
-chest pain
-SOB
-sputum= rust coloured from RBC and there is an increased neutrophil count in it as well

39
Q

CAP: mycoplasma pneumoniae?
Signs and Symptoms?
What is it also known as?

A

-primary atypical pneumonia
-dropplet transmission
direct contact
-not seasonality
-young adults mostly
-not associated with S. pneumonia
-damages ciliary escalator, can’t get rid of mucous from RT (adhesions specific for cilia of resp. epithelial cells)
-fever (lower than CAP
-headache
-sore throat
-sweating
-non-progressive cough
-thick sticky mucous
-“walking pneumonia”

40
Q

Viral pneumonia?
2 ways viruses can leads to pneumonia?
Signs and Symptoms?

A 
-influenza diminishes immune system
parainfluenza virus
transmission by respiratory. droplets 
1. primary viral pneumonia 
2. resp. infections followed by bacterial super-infections
-non-productive cough, fever, fatigue, sore throat headaches
-antivirals not effective
-not much we can do
41
Q

How to definitively diagnose pneumonia?

A

-chest X-RAY

42
Q

Chest X-RAY?

A
  • along with signs and symptoms will diagnose pneumonia
  • blackness=air
  • white= fluid/pus
  • no infiltrastes/ pus/fluid= no pneumonia
43
Q

Negative chest X-RAY bust still have pneumonia?

A
  • dehydrated people show low us accumulation in the lungs

- rehydrate the patient then perform chest X-RAY again

44
Q

What tests to look at / for to diagnose pneumonia?

A

-chest x-ray
-signs and symptoms
-determine severity, complications, status of underlying conditions
-arterial blood gas analysis
-CBC
-electrolytes
-renal and liver function tests
-blood cultures
sputum gram stain

45
Q

Mortality rate % for being hospitalized 30 days

A

-15%

46
Q

CURB-65: Confusion Urea Respiratory Rate BP- age of 65?

A
  • measures the severity of the pneumonia
  • points given for confusion, BUN greater than or equal to 19mg, RR greater than 30, systolic pressure less than 90, diastolic less than 60, over the age of 65
47
Q

CURB-65: score of 0,1,2,3,4,5

A 
0=low risk
1=low risk
2=short hospitalization
3=severe pneumonia
4 or 5= sever pneumonia (consider ICU)
48
Q

Empyema?

A

-pus accumulation in pleural cavity

49
Q

Antibiotic therapy for pneumonia? Why should you also administer systemic corticosteroid therapy?

A
  • consider antibiotic exposure in the past 3-6months to help reduce antibiotic resistance
  • find antibiotic responsible for that specific pathogen
  • CST= massive inflammation is harmful to us, corticosteroids reduces rate of mechanical ventilation, respiratory distress, duration of hospitalization
50
Q

3 ways to help prevent pneumonia?

A
  1. hand washing
  2. annual flu vaccine
  3. pneumococcal vaccines (help decrease complications associated with pneumonia
51
Q

When is pneumococcal disease most prevalent in elderly patients? why?

A
  • Holidays/ Christmas
  • family/ lots of contact
  • kids colonized with streptococcus pneumonia can pass it on to susceptible grandparents and they can get sick
52
Q

Efficacy of Pneumococcal Vaccine?

A

-doesn’t prevent pneumonia
-some think it reduced risk of invasive pneumococcal disease
cheap and safe
reduces hospitalization rates
recommended for elderly over the age of 65

53
Q

TB world-wide stats? % of world infected with TB?

A
  • most common infectious cause world wide

- 30% of people have it in the world

54
Q

Mycobacterium TB? How to identify it?

A 
-rod shaped
aerobic bacteria
-need acid fast stain to identify it
-some can survive in acidic and basic conditions
-resistant to dry conditions
-airborne precautions needed
risk fo transmission is high
55
Q

Transmission of TB? # types of 3 TB?

A

airborne droplets

  • inhaled
  • infective dry aerosol droplets can survive up to 8 months
  • dry sputum travels in air longer because it is lighter in weight than wet sputum
  • primary, secondary and disseminated TB
56
Q

Primary TB?

A
  • inhalation and depositing bacilli in lungs
  • 5% of people will develop active TB
  • mostly in children
  • actively sick and infectious
57
Q

Primary Pulmonary TB?

A
  • serious productive cough (blood and sputum)
  • lasts 3 weeks or longer
  • chest pain
  • fatigue
  • weight loss
  • loss of appetite
  • chills
  • fever
  • night sweats
  • positive chest X-RAY and sputum
58
Q

Latent TB?

A
  • 95% get this kind
  • immune system prevents spread of infection
  • asymptomatic
  • negative chest X-RAY
  • present with positive TB test and antibodies present
  • IF NOT TREATED IT CAN DEVELOP INTO ACTIVE TB
59
Q

Isoniazid?

A

-used to treat latent TB for 6-9 months

60
Q

TB skin test? Positive? Negative?

A

TB skin test= antigen injected into skin
-48-72hrs post injection client assessed for reaction
Positive= hard, red selling at site of injection. client infected with TB
Negative= no reaction, latent TB is unlikely
-lacks utility in active TB (thus active TB is screened as negative)

61
Q

Secondary TB? mortality rate if treated vs no treatment?

A
  • latent infection becomes active
  • blood and sputum in productive cough
  • cough lasts 3 weeks or longer
  • chest pain present
  • weakness
  • weight loss
  • chills
  • fever
  • positive chest X-RAY
  • 15% mortality if treated, 55 mortality if untreated
62
Q

Best diagnostic tools for active pulmonary TB?

A
  • early AM sputum
  • induced sputum (saline aerosols)
  • gastric aspirates if no sputum production possible
  • suck out sputum form lungs (less accurate, more invasive)
63
Q

TB: risk of re-activation?

A

5-10%

64
Q

People at risk for TB?

A

-HIV
-infected with TB in last 2 years
-young children and babies
-people who inject illegal drugs
-immunocompromised patients
elderly people

65
Q

Disseminated TB?

A
  • moves from one site of body to another

- brain, spine, kidneys, lymph nodes

66
Q

Consider TB when…?

A
  • unexplained weight loss
  • loss of appetite
  • night sweats
  • fever
  • fatigue
  • non-resolving pneumonia
67
Q

Treatment of TB?

A
  • 6-9 months
  • isoniazid, rifampin, ethambutol, pyrazinamide
  • monitor liver and kidneys for drug toxicity
  • evaluate response to treatment
68
Q

Pneumonia and immunocompromised hosts?

A

-increased risk
-underlying diseases or therapy
bacterial, viral, fungal or parasitic pneumonia

69
Q

What is pneumocystis caused by? mainly associated with what immunosuppressant disease?

A
  • pneumonia caused by yeast-like fungus

- mostly associated with AIDS

Microbiology-HH3 (6 decks)

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