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BDS2 BAMS > Respiratory tract infections > Flashcards

Respiratory tract infections Flashcards

1
Q

What kind of infection are most

RTI’s?

A
  • Viral
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2
Q

What is the main problem with RTI’s?

A
  • Secondary infections
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3
Q

In what ways is the nasopharynx very adapted to help prevent infection?

A
  • Saliva - designed to try and absorb viral particles and various bacteria
  • Have lymph nodes - they help to recruit B and T cells
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4
Q

What are the 3 most common infections in the upper respiratory tract?

A
  • Sinusitis
  • Tonsilitis
  • Pharyngitis
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5
Q

What does Streptococcus pyogenes cause?

A
  • Causes 10%-20% of cases of acute pharyngitis
  • Sudden onset, mostly in 5-10yo children
  • Often mild but toxic illness c an be severe
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6
Q

What percentage of tonsillitis/pharyngitis is caused by viruses?

A

about 70%

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7
Q

What viruses can cause the common cold? (4 points)

A
  • Rhinovirus, Adenovirus, Parainfluenza virus, and others
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8
Q

What are examples of 3 viruses that can cause upper RTI’s?

A
  • Rhinovirus = mild symptoms in the common cold
  • Influenza virus = Pharyngitis and lower RTI’s
  • Herpes simplex virus type 1&2 = May be severe, with palatal vesicles or ulcers
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9
Q

What virus causes glandular fever?

A
  • Epstein Barr virus
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10
Q

What % of sore throats are caused by S. pyogenes (group A)?

A

About 25%

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11
Q

What % of children are asymptomatic carriers of Sterptococcal sore throats?

A

15-20%

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12
Q

Does group C&G streptococci ever cause strep sore throats?

A
  • Occasionally
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13
Q

What are examples of Strep virulence factors? (4 points)

A
  • Pyrogenic exotoxins
  • Streptolysins
  • Hyaluronidase
  • M protein
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14
Q

What is hyaluronidase?

A

A family of enzymes that catalyse the degradation of hyaluronic acid

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15
Q

What is M protein?

A
  • A capsule
  • Usually used to surround the organism and prevent desiccation
  • Looks kind of like self protein
  • Attacks cardiac tissue - rheumatic fever
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16
Q

What is rheumatic fever?

A

A possible complication of strep throat infection or scarlet fever that can cause a wide range of secondary symptoms from joint inflammation to heart valve damage

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17
Q

What are possible complications of Strep sore throat? (6 points)

A
  • Peri-tonsillar abscess
  • Otitis media or sinusitis
  • Scarlet fever (immune response to the organism)
  • Rheumatic fever
  • Rheumatic heart disease
  • Acute glomerulonephritis
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18
Q

What is bronchitis?

A
  • Inflammation of the tracheobronchial tree
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19
Q

When does acute bronchitis usually occur?

A
  • During the winter months
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20
Q

What is the common cause of acute bronchitis?

A
  • Most often viral
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21
Q

What makes bronchitis chronic?

A
  • Productive cough on most days during at least 3 months in each of 2 successive years
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22
Q

What % of the population does chronic bronchitis affect?

A

10-25%

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23
Q

What are predisposing factors of chronic bronchitis? (4 points)

A
  • Smoking
  • Infection
  • Air pollution
  • Allergies
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24
Q

What is the common cause of chronic bronchitis?

A
  • Viral & bacterial agents
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25
Q

What is Whooping cough?

A
  • Cough so much till you are sick and cannot stop coughing
  • Takes a lot of energy out of you
  • Produces an exotoxin which stimulates the upper bronchi
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26
Q

What is the organism that causes whooping cough?

A
  • Bordatella pertusis
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27
Q

What can be given to a patient with a RTI? (3 points)

A
  • Decongestants
  • NSAID’s
  • Antibiotics
  • (where appropriate)
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28
Q

Bacteria causes 10% of RTI’s. What are 4 examples of these?

A
  • Bordatella pertussis
  • Mycoplasma pneumoniae
  • Chlamydia pneumoniae
  • Haemophilus influenzae
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29
Q

How often are people infected with Myobacterium tuberculosis?

A
  • New infection every second
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30
Q

How much of the entire global population is infected by myobacterium tuberculosis?

A
  • 1/3 of the entire global population

- 1% of the population infected every year

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31
Q

How many deaths per year are due to myocardium TB?

A
  • 3 million (this is increasing)
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32
Q

What % of deaths of myocardium TB are preventable?

A

25%

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33
Q

What is the treatment of TB?

A
  • Triple therapy - streptomycin, para-aminosalicylic acid & isoniazid
  • Long term - take antibiotic for about 6 months
  • DOTS - Directly Observed Treatment Short course
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34
Q

What is the % cue rate for TB?

A
  • 95%

- Prevents transmission

35
Q

What are some examples of high risk factors of TB?

A
  • HIV infection
  • Injection drug abuse
  • Alcoholism
36
Q

What are some symptoms of TB?

A
  • Malaise
  • Productive cough for more than 3 weeks
  • Headache, fever
  • Weight loss
  • Night sweats
  • Blood in sputum
37
Q

What is pneumonia?

A
  • An inflammatory condition of the lung - especially affecting the microscopic air sacs (alveoli)
38
Q

What is pneumonia typically caused by?

A
  • Infections, but multi-factorial

- Bacteria, viruses, fungi and parasites

39
Q

What are the clinical features of pneumonia? (5 points)

A
  • Sudden or insidious onset
  • Fever, rigors, malaise
  • Shortness of breath, rapid shallow breathing, cyanosis
  • Cough producing purulent sputum
  • Consolidation of lungs, on clinical and radiographic examination
40
Q

What are 4 examples of pathogens that cause community-acquired pneumonia?

A
  • Streptococcus pneumoniae
  • Mycoplasma pneumoniae
  • Haemophilus influenzae
  • Legionella pneumophila
41
Q

What are 4 examples of pathogens that cause hospital acquired pneumonias?

A
  • Staphylococcus aureus
  • Gram-negative bacilli
  • Klebsiella pneumoniae
  • Escherichia coli
42
Q

What is the main causative agent in bacterial pneumonia?

A
  • Streptococcus pneumonia
43
Q

Who does streptococcus pneumonia usually affect? (3 points)

A
  • young, elderly and immuno-compromised
44
Q

How many cases of adult pneumococcal pneumonia occur per year?

A

50,000

45
Q

How many fatalities per year are caused by Streptococcus pneumonia?

A
  • 9000 fatalities
46
Q

How many under 5’s in the UK are admitted to hospital with pneumococcal pneumonia?

A

1 in 200

47
Q

What kind of infection is pneumonia?

A
  • Encapsulated bacterial infection
  • Very good at avoiding the immune system
  • Has a capsule surrounding things
  • Organisms of inflammatory nature = gram positive
48
Q

What does the capsule of the infective agent of pneumonia do? (4 points)

A
  • Covers antibody or C3b bound to bacterial surface
  • Prevents contact between phagocyte receptor and opsonin
  • Binds protein H (targets C3b) for degradation
  • Lessens amount of C3b reaching bacterial surface, opsonising capsule
49
Q

What is the clinical management of pneumonia?

A
  • Antibiotics (plus hospitalisation)

- Vaccination (23 different serotypes)

50
Q

Why are vaccinations becoming a more common way of treating pneumonia?

A
  • Antibiotic therapy is increasingly ineffective due to increasing resistance of isolates
  • Vaccination strategy based on 23 different stereotypes
  • Polysaccharide antigens ineffective at promoting memory - T-cell independent
  • Conjugate vaccines of polysaccharides and proteins appear efficaceous, with proper clinical intervention
51
Q

How is Legionnaire’s disease transmitted? (2 points)

A
  • Inhalation of aerosols from contaminated water

- Aspiration of oropharyngeal colonised bacteria

52
Q

What are the symptoms of Legionnaire’s disease? (4 points)

A

Initially influenza-like which progress to a severe pneumonia

  • Other features include mental confusion, renal failure and GI symptoms
53
Q

What is the drug of choice to treat Legionnaire’s disease?

A

Erythromycin

  • It is unresponsive to penicillin
54
Q

What can prevent hospital-borne pneumonia?

A
  • Toothbrushing
55
Q

What are the 3 types of influenza

A

Type A, B and C

56
Q

What is the size of the influenza virus?

A
  • 80-120nm
57
Q

What 3 types of particles are present in the influenza virus?

A
  • Pleomorphic, spherical and filamentous particles
58
Q

Does the influenza virus contain RNA or DNA?

A
  • Single-stranded RNA
59
Q

The influenza virus has a segmented genome. How many segments are in type A and B?

A
  • 8 segments
60
Q

What 2 things are on the surface of the virion of influenza?

A
  • Hemagglutinin

- Neuraminidase

61
Q

How is the influenza virus classified?

A
  • On the basis of hemagglutinin and neuraminidase
62
Q

How many subtypes of HA and NA are known to exist in the animal strain of influenza?

A
  • 15 of HA

- 9 of NA

63
Q

How many subtypes of HA and NA are known to exist in the human strain of influenza?

A
  • 3 of HA

- 2 of NA

64
Q

Which animal strains of influenza can affect humans?

A
  • HA 5, 7 and 9

- Na 7

65
Q

What is the method of infection and replication of an influenza virus? (6 points) (long answer)

A
  • Virus absorbs to a respiratory epithelial cell by HA spikes and fuses with the membrane
  • The virus is endocytosed into a vacuole and uncoated to release its 8 nucleocapsid segments into the cytoplasm
  • The nucleocapsids are transported into the nucleus. There the (-) sense RNA strand is transcribed into a (+) sense strand that will be translated into viral proteins that make up the caspid and spikes
  • (+) sense RNA is used to synthesize glycoprotein spikes inserted into the host membrane
  • The (+) sense RNA strands are used to synthesise new (-) sense RNA strands. These are assembled into nucleocapsids and transported out of the nucleus to the cell membrane
  • Release of mature virus occurs when viral parts gather at the cell membrane and are budded off with an envelope containing spikes
66
Q

Influenza virus can be transmitted through aerosols. How many virions are present per droplet?

A
  • 100,000 to 1,000,000 virions per droplet
67
Q

Large droplets containing influenza virus are common. What are examples of these? (3 points)

A
  • Sneezing
  • Coughing
  • Contact with Saliva
68
Q

What is a rare form of transmission of the influenza virus?

A
  • Airborne over a long distance
69
Q

What is the incubation period for the influenza virus?

A
  • 18-72 hours
70
Q

What are examples of symptoms of the influenza virus? (9 points)

A
  • Headache
  • Fever
  • (extreme) tiredness
  • Aches (joint)
  • Runny nose
  • Sore throat
  • Aches
  • Coughing
  • Vomiting
71
Q

What is meant by the term ‘prophylaxis’?

A
  • Treatment given or action taken to prevent disease
72
Q

What are 2 examples of prophylaxis that can be used for influenza?

A
  • Hand washing

- Use of masks

73
Q

What are the 3 types of inactivated influenza virus that can be included in a vaccine?

A
  • Whole virus
  • Subvirion
  • Purified surface antigen
  • (only subvirion or purified antigen should be used in children. Any of the 3 can be used in adults)
74
Q

What are 3 examples of categories of people who should receive the influenza virus?

A
  • Women in 2nd or 3rd trimester of pregnancy during flu season
  • Household members of persons in high-risk groups
  • Health care workers and others providing essential community services
75
Q

What are 2 examples of antivirals for influenza?

A
  • Adamantanes and Neuraminidase inhibitors
76
Q

What is an epidemic?

A
  • The occurrence of more cases of a disease than expected in a given area or among a specific group of people over a particular period of time
77
Q

What is a pandemic?

A
  • An epidemic occurring over a very wide area (several countries or continents) and usually affecting a large proportion of the population
78
Q

What are 3 examples of pandemic diseases?

A
  • Cholera
  • AIDS
  • P a ndemic Influenza
79
Q

The influenza virus tends to undergo changes from time to time. What is the name for this?

A
  • Antigenic variation
80
Q

There are 2 types of antigenic variation. What are these?

A
  1. Antigenic shift
  2. Antigenic drift

Changes in the antigenic characteristics of influenza viruses determine the extent and severity of influenza epidemics

81
Q

What is antigenic drift in relation to the influenza virus?

A
  • This term denotes MINOR changes in hemagglutinin and neuraminidase of influenza virus
  • This results from mutation in the RNA segments coding for either the HA or NA
  • This involves no change in serotype; there is merely an alteration in AA sequence of HA or NA leading to change in antigenicity
82
Q

What is antigenic shift in relation to the influenza virus?

A
  • This term denotes MAJOR changes in hemagglutinin and neuraminidase resulting from reassortment of gene segments involving two different influenza viruses
  • When this occurs, worldwide epidemics may be the consequence since the entire population is susceptible to the virus
83
Q

Which type of influenza is the most severe?

A
  • Type A

BDS2 BAMS (57 decks)

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