Respiratory tract infections and immunity

Question 1

what are the signs and symptoms of upper respiratory infection

Answer 1

cough
sneezing
runny/stuffy nose
sore throat
headache

Question 2

what are the signs and symptoms of lower respiratory tract infection

Answer 2

productive cough - phlegm
muscle ache
wheezing 
breathlessness
fever fatigue

Question 3

what are the signs and symptoms of pneumonia

Answer 3

chest pain
blue tinting of lips
severe fatigue
high fever

Question 4

what is the most common respiratory infection

Answer 4

tuberculosis

Question 5

what does daly stand for

Answer 5

disability adjusted life year

- years of life lost due to disability

Question 6

what is the leading cause of mortality in infants

under 1s/5s

Answer 6

lower respiratory tract infections

Question 7

what are some general risk factors for pneumonia

Answer 7

demographic and life style factors - young and old affected
social factors
medication
medical history
specific factors for certain pathogens e.g animal contact, geographical variations

Question 8

what is the most common causative agent of respiratory infections

Answer 8

human rhinovirus

Question 9

Which respiratory infections causes the highest annual mortality in the average year

Answer 9

tuberculosis

Question 10

what are some common bacterial causative agents

Answer 10

strep pneumoniae
myx pneumoniae
haem flu
tuberculosis

Question 11

what are some common viral causative agents

Answer 11

influenza a/b
respiratory syncytial virus
human metapneumovirus
rhinovirus
corona

Question 12

how does pneumonia cause harm to human lung?

Answer 12

inflammation and swelling of alveolar space where gas exchange takes place
local and systemic inflammation that puts strain on cardiovasc system

Question 13

how to grade potential bacterial pneumonia

Answer 13

crb/curb65 scoring if in hospital:
confusion
resp rate >30 breaths/min
bp < 90 systolic
>65 yrs 

if in hosp
urea >7mmol/l

Question 14

what does a score of 0 mean

Answer 14

likely suitable for home treatment

Question 15

score of 1-2

Answer 15

consider hospital referral

Question 16

score of 3-4

Answer 16

urgent hosp admission

antiobiotics if life threatening

Question 17

what are some forms of supportive treatment for bacterial pneumonia

Answer 17

o2 - for hypoxia
fluids - for dehydration
analgesia - for pain
nebulised salibe
chest physiotherapy?

Question 18

what are some forms of antibiotics to treat bacterial pneumonia

Answer 18

penicillins e.g amoxicillin - beta lactams that bind proteins in bacterial cell wall to prevent transpeptidation

macrolides e.g clarithromycin - bind to bacterial ribosome preventing protein synthesis

Question 19

if curb is 0- 2 and cap what antibiotic recommended

Answer 19

amoxicillin

5-7 days

Question 20

if curb is 3-5 and cap what antibiotic recommended

Answer 20

benzylpenicillin iv and clarithro

Question 21

if curb is 0- 2 and hap what antibiotic recommended

Answer 21

doxycycline

Question 22

can you catch pneumonia?

Answer 22

yes as bacteria found in:
human microbiome
microbiota
commensal

Question 23

why do viral infections result in disease

Answer 23

cellular inflammation
mediator release
local immune memory
damage to epithelium - loss of cilia, bacterial growth, loss of chemoreceptors, poor barrier to antigen

Question 24

what viruses can cause severe disease

Answer 24

highly pathogenic strains - zoonotic
absence of prior immunity
predisposing illness/condition

Question 25

where do most respiratory viruses tend to preferentially adapt to bind to

Answer 25

upper respiratory tract if they have existed in humans for prolonged time

Question 26

how does sars cov2 affect resp

Answer 26

spike protein binds to ace2 which is highly expressed in nose and alveolar cells therefore lots of nasal symptoms and damage and inflammation in alveoli - pneumonia

Question 27

what is role of epithelial cells

Answer 27

first line of defence

Question 28

how do epithelial cells act as first line of defence

Answer 28

``` tight junctions mucous lining and cilial clearance antimicrobials pathogen recognition receptors interferons pathways ```

Question 29

what are serotypes

Answer 29

viruses which cannot be recognised by serum( really antibodies) that recognise another patogen

Question 30

what immunoglobulins are commonly found in nasal cavity

Answer 30

igA 4 receptors homodimer - extremelu stable in protease rich environment

Question 31

what immunoglobulins are commonly found in lungs

Answer 31

igGs | thin walled alveolar space allows transfer of plasma igGs into alveolar space

Question 32

points of flu

Answer 32

no reinfection by same strain | imperfect vaccines

Question 33

rsv points

Answer 33

recurrent reinfection with similar strain | no vaccine

Question 34

saes cov2 points

Answer 34

no prior immunity | newly licensed vaccine

Question 35

what are some signs and symptoms of rsv bronchiolitis in infants

Answer 35

``` nasal flaring chest wall retractions hypoxemia and cyanosis croupy cough expiratory wheezing tachypnea ```

Question 36

what are some risk factors for rsv risk factors

Answer 36

premature birth | congenital heart and lung disease

Question 37

what is the leading cause of infant hospitalisation in developed world

Answer 37

rsv

Question 38

general treatment options for resp infections

Answer 38

supportive therapy e.g oxygen prophylactics - vaccine antivirals therapeutics - anti inflammatory