Respiratory tract infections and immunity Flashcards

1
Q

what are the signs and symptoms of upper respiratory infection

A
cough
sneezing
runny/stuffy nose
sore throat
headache
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2
Q

what are the signs and symptoms of lower respiratory tract infection

A
productive cough - phlegm
muscle ache
wheezing 
breathlessness
fever fatigue
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3
Q

what are the signs and symptoms of pneumonia

A

chest pain
blue tinting of lips
severe fatigue
high fever

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4
Q

what is the most common respiratory infection

A

tuberculosis

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5
Q

what does daly stand for

A

disability adjusted life year

- years of life lost due to disability

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6
Q

what is the leading cause of mortality in infants

under 1s/5s

A

lower respiratory tract infections

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7
Q

what are some general risk factors for pneumonia

A

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

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8
Q

what is the most common causative agent of respiratory infections

A

human rhinovirus

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9
Q

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

A

tuberculosis

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10
Q

what are some common bacterial causative agents

A

strep pneumoniae
myx pneumoniae
haem flu
tuberculosis

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11
Q

what are some common viral causative agents

A
influenza a/b
respiratory syncytial virus
human metapneumovirus
rhinovirus
corona
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12
Q

how does pneumonia cause harm to human lung?

A

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

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13
Q

how to grade potential bacterial pneumonia

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

if in hosp
urea >7mmol/l

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14
Q

what does a score of 0 mean

A

likely suitable for home treatment

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15
Q

score of 1-2

A

consider hospital referral

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16
Q

score of 3-4

A

urgent hosp admission

antiobiotics if life threatening

17
Q

what are some forms of supportive treatment for bacterial pneumonia

A
o2 - for hypoxia
fluids - for dehydration
analgesia - for pain
nebulised salibe
chest physiotherapy?
18
Q

what are some forms of antibiotics to treat bacterial pneumonia

A

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

19
Q

if curb is 0- 2 and cap what antibiotic recommended

A

amoxicillin

5-7 days

20
Q

if curb is 3-5 and cap what antibiotic recommended

A

benzylpenicillin iv and clarithro

21
Q

if curb is 0- 2 and hap what antibiotic recommended

A

doxycycline

22
Q

can you catch pneumonia?

A

yes as bacteria found in:
human microbiome
microbiota
commensal

23
Q

why do viral infections result in disease

A

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

24
Q

what viruses can cause severe disease

A

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

25
where do most respiratory viruses tend to preferentially adapt to bind to
upper respiratory tract if they have existed in humans for prolonged time
26
how does sars cov2 affect resp
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
27
what is role of epithelial cells
first line of defence
28
how do epithelial cells act as first line of defence
``` tight junctions mucous lining and cilial clearance antimicrobials pathogen recognition receptors interferons pathways ```
29
what are serotypes
viruses which cannot be recognised by serum( really antibodies) that recognise another patogen
30
what immunoglobulins are commonly found in nasal cavity
igA 4 receptors homodimer - extremelu stable in protease rich environment
31
what immunoglobulins are commonly found in lungs
igGs | thin walled alveolar space allows transfer of plasma igGs into alveolar space
32
points of flu
no reinfection by same strain | imperfect vaccines
33
rsv points
recurrent reinfection with similar strain | no vaccine
34
saes cov2 points
no prior immunity | newly licensed vaccine
35
what are some signs and symptoms of rsv bronchiolitis in infants
``` nasal flaring chest wall retractions hypoxemia and cyanosis croupy cough expiratory wheezing tachypnea ```
36
what are some risk factors for rsv risk factors
premature birth | congenital heart and lung disease
37
what is the leading cause of infant hospitalisation in developed world
rsv
38
general treatment options for resp infections
supportive therapy e.g oxygen prophylactics - vaccine antivirals therapeutics - anti inflammatory