Upper and Lower Respiratory Tract Infections Flashcards
Has is pain causes in ottis media?
Fluid build up causes pressure on the tympanic membrane
T/F When the tympanic membrane bursts in response to infection the resolution is better if antibiotics haven’t been used.
True
Which bacteria doesn’t have a cell wall and is the most common cause of atypical pneumonia?
Mycoplasma
What is the main cause of bronchiolitis?
RSV
What are some common causes of Empyema?
Staph. aureus secondary to pneumonia
How does legionella survive within in air conditioning units?
It is eaten by amoebae that are unable to kill them, legionella can also survive in our macrophages.
Is which areas of the URT are there more anaerobes?
Nasal washings
Saliva
What are the most common bacteria present in the URT microbiota?
Viridans streptococci (multiple species),
Neisseria spp. (low grade),
Corynebacterium spp,
Gram -ve anaerobes,
H. influenzae (not type B),
C. albicans
Strep. pneumoniae
What are the common causes of Croup
Parainfluenza virus, influenza A and RSV
What is the cause of Q fever?
Coxiella burnetti for cattle.
What are some common causes of pharyngitis (without nasal involvement)?
Adrenovirus, enterovirus, influenza, reovirus, Strep pyogenes, Strep grp C and G
Which disease is associated with homelessness?
TB
What are the 6 syndromes of the upper respiratory tract?
Pharyngitis/Tonsillitis
Common cold
Ottis Media
Sinusitis
Epiglottitis
Croup
Which disease is spread by birds?
Chlamydophila psittaci
What are some common causes of acute exascerbation of chronic bronchitis?
Pneumococci, H. influenzae
What are some common causes of ottis media?
Strep. pneumoniae, H. influenzae, Moraxella catarrhalis
What is the best guess antibiotics for community acquired pneumonia?
pen-G/amoxycillin + doxycycline/macrolide - usually don’t want to used a bactericidal + doxy however here these two will cover all the bacterial causes of pneumonia
What are some common causes of bronchitis?
Usually part of viral URTI
How can epiglottitis be diagnosed?
Blood sample or Xray. Do not attempt to take sample off the epiglottis!
What are some less common commensals of the URT?
Strept pyogenes, Neisseria meningititis
What are some common causes of the common cold?
Rhinovirus
parainfluenza
RSV
enterovirus (during summer)
Coronavirus
Human metapneumonia virus
Why are babies more susceptible to ottis media?
The eustachian tube is wider - allows bacteria to travel up it from the pharynx (against the action of the cilia membrane)
Which pneumococcal vaccine do you use in adults?
23 valent polysaccaride
What are some common causes of epiglottitis?
H. influenzae type b - Rarely seen now due to the vaccine
Which pathogen is picked up from soil?
Legionella longbeachae - common in Australia
What percentage of cases of pharyngitis (without nasal involvement) are caused by bacteria? What are the bacteria?
20%, Grp A, C and G strep
In which URT syndrome is treatment necessary?
Epiglottitis - essential
Pharyngitis - If bacterial
Sinusitis - If bacterial and severe
Ottis media - if under 2
(children over 2 will have side effects from the treatment than complications from the infection)
For what species is serological testing helpful in diagnosing pneumonia?
Those which are slow to culture including
- Legionella pneumophila
- Mycoplasma pneumoniae
- Chlamydophila and chlamydia
- Coxiella burnetti
After which anatomical structure is the respiratory tract divided?
The epiglottis
Which disease is associated with alcoholism?
Klebsiella
What are the main vaccines for prevent pneumonia?
Influenza vaccine and pneumococcal vaccine
Why must you use a conjugate vaccine for pneumococcus in children?
The conjugate will stimulate a T cell response which will provide help to the B cell mediated antibody protection. This isn’t required in adults.
What disease is caused by a pathogen that colonised air conditioning unit?
Legionnaires disease
What are some common causes of typical pneumonia (inflammation in the alveolar/airways)
Pneumococci, H. influenzae, Staph, Klebsiella, Legionella, TB, Chlamydophila (C. pneumoniae and C. psttaci)
In which URT syndromes is it important to make laboratory diagnosis?
Epiglottitis, Pharyngitis/tonsillitis
What promoted Mr Gram to invent his famous stain?
To differentiate streptococcus and Klebsiella as causes of pneumonia.
What are some common causes of atypical pneumonia (interstitial inflammation)?
Mycoplasma, Chlamydia, M. cattarhalis, Influenza, RSV, adenovirus
What are some common causes of lung abscesses?
Mixed anaerobes, Staph, Klebsiella
What are some common LRT syndromes
Acute bronchitis
Acute exascerbation of chronic bronchitis
Bronchiolitis
Pneumonia
Lung Abscess
Empyema
After which anatomical structure is the respiratory tract supposed to be sterile?
The Larynx
Is the common cold spread more by hands or coughing?
Hands
What factors should be considered when making an aetiological diagnosis?
Community vs hospital acquired
Severity index
Existing illness in the host eg COPD, AIDS, CF
Risk factors like Occupation, travel, homelessness, soils, contact with animals
What are some common causes of pharyngitis (with nasal involvement)?
Adenovirus, enterovirus, parainfluenza virus, influenza
The absence of what indicates a properly collected sputum sample?
Squamous epithelial cells as they come from the URT.
Why it is thought that bronchiolitis only occurs in children under 1 year old?
Maternal ab against RSV react to virus in the baby that causes a inflammatory response that narrows the bronchioles. This causes air trapping and wheeze.
What types of samples are taken for the diagnosis of pneumonia?
Sputum
transtracheal aspirate - avoids passing the URT
Tracheostomy
Endotracheal tube - passes through the URT though
Pleural tap - for empyema
Lung biopsy - used when the patient doesn’t respond to the initial treatment. By needle (radiologist) or during open surgery.
Which pneumococcal vaccine do you use in children?
13 Valent conjugate
What are some must know causes of pneumonia
Influenza - for typing
Legionella - for outbreaks
Community acquired MRSA
Bioterrism agents eg anthrax
SARS, MERS
Should know
Penicillin resistant S. pneumoniae
Gram -ves like P. aeruginosa
What are some common causes of sinusitis?
Primary infection: viral, part of common cold syndrome
Secondary: Haemophila influenzae, Streptococcus pneumoniae
