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Pathology 3001 > Respiratory Tract Infections > Flashcards

Respiratory Tract Infections Flashcards

1
Q

What does rhinovirus cause?

A

Common cold

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2
Q

What does the influenza virus cause?

A

Flu

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3
Q

What causes meningitis?

A

Haemophilus influenza

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4
Q

What bacteria are present in >50% of normal people in the respiratory tract?

A
  • Bacteroides spp
  • Candida albicans
  • Oral streptococci
  • Haemophilus influenza
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5
Q

What bacteria are occasionally present in the respiatory tract (<10% normal people)?

A
  • Streptococcus pyogenes
  • Streptococcus pneumoniae
  • Neisseria meningitidis
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6
Q

What are some of the host defenses in the RT?

A
  • Saliva
  • Mucus
  • Cilia (muco-ciliary escalator/elevator)
  • Nasal secretions
  • ANtimicrobial peptides
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7
Q

What cells produce mucous?

A

Goblet cells

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8
Q

What bacteria causes whooping cough?

A

Bordetella pertussis

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9
Q

What demographic does whooping cough generally target?

A

<5 years old (90% of cases)

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10
Q

What does the catarrhal stage (1 week) of whooping cough include?

A
  • Highly contagious
  • Malaise
  • Mucoid rhinorrhoea
  • Conjunctivitis
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11
Q

What does the paroxysmal stage (1-4 weeks) of whooping cough include?

A
  • Paroxysms of coughing with a classic inspiratory “whoop”

- Lumen of respiratory tract is compromised by mucus secretion and mucosal oedema

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12
Q

How is whooping cough diagnosed?

A
  • By characteristic “whoop”
  • Bacterial isolation from nasopharyngeal swabs
  • NAAT
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13
Q

How is whooping cough treated?

A
  • In catarrhal stage can be treated with erythromycin
  • In paroxysmal stage, antibiotics have no effect
  • Isolationn
  • Supportive care (hospitalisation for infants)
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14
Q

What does bordetella pertussis attach to?

A
  • Attaches and replicates in the ciliated respiratory epithelium, does not invade deeper structures
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15
Q

What kind of bacteria is bordetella pertussis?

A

Gram negative aerobic coccobacilus

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16
Q

What are the toxic factors produced by bordetella pertusis?

A
  • Pertussis toxin (Ptx) (can paralyse cilia)
  • Adenylate cyclase toxin (increases cAMP)
  • Tracheal cytotoxin (kills tracheal cells)
  • Endotoxin (damages cells)
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17
Q

What infections can cause acute bronchitis?

A
  • Rhinovirus
  • Coronovirus
  • Adenovirus
  • Mycoplasma pneumoniae
    Secondary infections
  • Streptococcus pneumoniae
  • Haemophilus influenzae
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18
Q

What is chronic bronchitis characterised by?

A
  • Cough and excessive mucus secretion in tracheobronchial tree
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19
Q

What can cause chronic bronchitis?

A

Anatomical disturbances of the respiratory system

  • Immune deficit: SCID
  • Ciliary deficit: Kartenger syndrome, smoking
  • Excessively thick mucus: CF
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20
Q

What is bronchiolitis?

A
  • Infection of bronchioles
  • Restricted to children <2 years
  • Mainly caused by respiratory syncitial virus
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21
Q

What is the most common cause of infection-related death in the UK and USA?

A

Pneumonia

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22
Q

What can cause pneumonia in neonates/children?

A
  • Mainly viral
  • Streptococcus B
  • E coli
  • Chlamydia trachomatis
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23
Q

What can cause viral pneumonia?

A
  • Influenza virus
  • Measles
  • Coronavirus
  • Parainfluenza virus
  • Respiratory syncytial virus (RSV)
  • Cytomegalovirus (CMV)
  • Adenovirus
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24
Q

What can cause bacterial pneumonia?

A
  • Streptococcus pneumoniae
  • Mycobacterium tuberculosis
  • Haemophilus influenza
  • Pseudomonas aeruginosa
  • Staphylococcus aureus
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25
Q

What atypical pneumonias do not respond to penicillin?

A
  • Mycoplasma pneumoniae
  • Legionella pneumophillia
  • Chlamydia psittaci
  • Chlamydia pneumoniae
  • Coxiella burnetii
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26
Q

What are the different anatomical classifications of pneumonia?

A
  • Lobar pneumonia
  • Bronchopneumonia
  • Interstitial pneumonia
  • Necrotising pneumonia
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27
Q

What is interstitial pneumonia usually a characteristic of?

A

Viral infection

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28
Q

What are the cinical features of streptococcus pneumoniae infection?

A 
- Initially:
Abrupt onset 
Rigors 
Fever 
Malaise 
Tachycardia 
Dry cough 
- Followed by:
Productive cough with rusty sputum 
Spiky temperature 
Lobular consolidation
29
Q

What are the clinical features of mycoplasma pneumoniae?

A
  • Fever
  • Dry cough
  • Dyspnoea
  • Lymphadenopathy
30
Q

What are the clinical features of haemophilus influenza?

A
  • Mainly occurs in children
  • Consolidation or patchy bronchopneumonia
  • Persistant purulent sputum and malaise
31
Q

What bacteria causes Legionnaire’s disease?

A

Legionella pneumophila

32
Q

How is legionella spread?

A

Through aerosols, but not person to person

33
Q

What are the clinical features of legionnaire’s disease?

A
  • Tachypnoea
  • Purulent sputum
  • CXR shows consolidation
34
Q

What type of bacteria is legionnaire’s disease?

A

Gram negative bacillus

35
Q

What does legionella pneumophila secrete?

A

protease causing lung damage

36
Q

How is legionnaire’s disease diagnosed?

A
  • Gram staining of sputum
  • Recognition with stereotype-specific fluorescent antibody
  • Culture of Legionella on cystine yeast extract agar
  • Detection of antigen in urine
  • 4-fold rise in antibody
37
Q

What are the clinical features of measles?

A
  • Fever
  • Runny nose
  • Koplik’s spots - clusters of white lesions
  • Characteristic rash
  • May result in neurological complications
  • Can cause ‘giant cell’ (Hecht’s) pneumonia in the immunocompromised - usually fatal
38
Q

How is measles spread?

A

Via aerosol

39
Q

Where does measles replicate?

A

LRT

40
Q

What kind of virus is measles?

A

Paramyxovirus

41
Q

How long are people incubated for when they have measles?

A

10-14 days

42
Q

How is measles diagnosed?

A
  • Serology for measles-specific IgM
  • Virus isolation
  • Viral RNA detection
43
Q

How is measles treated?

A
  • If severe, ribavirin available

- Antibiotics for secondary bacterial infection

44
Q

What is an endemic?

A

Present in the community at all times; at a relatively low to medium frequency but at a steady state

45
Q

What is an epidemic?

A

Sudden severe outbreak within a region or group

46
Q

What is a pandemic?

A

Occurs when an epidemic becomes widespread and affects a whole region, a continent, or the entire world

47
Q

What are the three types of influenza virus?

A
  • Type A: epidemics and pandemics, animal reservoir
  • Type B: epidemics, no animal hosts
  • Type C: minor respiratory illness
48
Q

What are the type-specific antigens (spikes) on the influenza virus?

A
  • Haemagglutinin (H)

- Neuraminidase (N)

49
Q

What does the segemented single-stranded RNA allow for?

A
  • Reassortment (“shuffling”) which gives rise to novel combinations of H and N antigens
50
Q

How many segments of single-stranded RNA are there in the influenza virus?

A

8

51
Q

What is antigenic drift?

A
  • Small point mutations in the H and N antigens which occur constantly
  • Allows the virus to multiply in individuals with immunity to preceding strains
  • New subtype can re-infect community
  • Occurs with all influenza types
52
Q

What is antigenic shift?

A
  • Sudden major change based on recombination between two different virus strains when they infect the same cell
  • Produces a virus with novel surface glycoproteins
  • New strain can spread through previously immune populations - new pandemic
53
Q

What makes a pandemic?

A
  • Antigenic shift
  • Most people have no immunity
  • Attack rate is high - it spreads rapidly
  • Mortality can be high
54
Q

What kind of virus was swine flu?

A
  • H1N1 virus

- zoonotic

55
Q

Who was affected mostly by swine flu?

A

<40 years as most older people had a degree of immunity against H1N1

56
Q

How is influenza diagnosed?

A 
- Nasopharyngeal apirate 
Direct immunofluorescence 
Culture 
NAAT detection 
- Serology
57
Q

How is influenza treated?

A
  • Amantadine
  • Zanamavir
  • Oseltamivir “Tamiflu”
58
Q

How is influenza managed?

A
  • Rest, warmth, hydration, analgesia
  • Anti-viral treatment within 48hrs has some effect on the duration of fever
  • Antibiotics not given unless secondary bacterial infection suspected
59
Q

How are influenza viruses prevented?

A
  • Killed vaccine has 70% efficacy

- Different strains of antigen used in different years in anticipation of latest strain toemerge

60
Q

What is the influenza vaccine based on?

A
  • The predicted strains
  • Trivalent vaccine
  • Based off of new recombinant methods
61
Q

What does SARS stand for?

A

Severe Acute respiratory syndrome

62
Q

What are the symptoms of SARS?

A
  • Sudden onset of high fever
  • Dry cough
  • Chills and shivering
  • Muscle aches
  • Breathing difficulties
    2002 - 10% fatality rate
63
Q

How was SARS transmitted?

A
  • Droplets
  • Faeces
  • Infected animals
64
Q

How long are individuals with SARS incubated for?

A

2-7 days (10 days max)

65
Q

What is the SARS-associated coronavirus identified by?

A
  • Virus isolation in cell culture
  • Electron microscopy
  • Molecular techniques
66
Q

What does SARS-associated coronovirus look like?

A
  • Enveloped
  • RNA virus
  • Characteristic ‘halo’
  • Receptor for spike protein is ACE2
67
Q

What is given to treat SAR?

A

No specific anti-viral treatment available

  • Ribavirin
  • Corticosteroids
  • Interferons
  • Anti-retroviral therapies e.g protease inhibitors

Whole inactivated virus vaccine has now been developed

68
Q

What fungal infections can cause respiratory infections?

A
  • Apergillus fumigatus

- Pneumocystis jiroveci (asscciated with AIDS)

69
Q

What parasitic infections can cause respiratory tract infections?

A
  • Ascaris
  • Strongyloides
  • Schistosoma
  • Echinococcus granulosus

Pathology 3001 (15 decks)

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