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Pulm > Upper Respiratory Infections > Flashcards

Upper Respiratory Infections Flashcards

1
Q

Characteristics of the Rhinovirus

A

Picornavirus family

  1. Iscosahedral
  2. non-enveloped postive sense ss linear RNA virus
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2
Q

Transmission and Pathogenesis of Rhinovirus

A
  1. Trasmission:
    - person to person
    - Respiratory droplets
  2. Pathogenesis
    - binds to ICAM-1 on resp. epithelial cells
    - ultimately causes release of chemical mediators of inflammation (Bradykinin and prostaglandins)
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3
Q

Clinical manifestations of the Rhinovirus

A
  1. Incubation period: 2-4 days
  2. Sneezing, nasal discharge, sore throat, cough and headache
  3. Mild chills
  4. Most common cause of common cold; More in Fall and Winter
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4
Q

Dx and Tx of Rhinovirus

A

Dx: Clinical
Tx: Supportive care
- no vaccine

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5
Q

Characteristics of the Coronavirus

A
  1. Helical, enveloped, positive sense. ss linear RNA

2. Second most common cause of the common cold

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6
Q

Clinical manifestations of the Coronavirus

A
  1. outbreaks in winter on a 2-3 year cycle
  2. Does NOT cause LRTIs (except SARS and MERS)
  3. Can cause GI illness. But symptoms of common cold are same as Rhinovirus
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7
Q

Characteristics of Bordetella pertussis

A
  1. Encapsulated
  2. Small Coccobacillary Gram Neg. Rod
  3. A-B toxin (pertussis toxin)
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8
Q

Pathogenesis of Bordetella pertussis

A

A-B toxin:
B - attaches to host cell surface receptor and enable endocytosis

A - stimulates adenylate cyclase by catalyzing the addition of ADP-ribosylation to the inhibitory subunit of the G-protein
=> overactive cAMP-dependent PK activuty

  • impairs phagocytosis and causes dec. cilia activity
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9
Q

Transmission and clinical manifestations of Bordetella pertussis

A

Transmission: Highly contagious airborne droplets

Clin: Whooping Cough

  • Catarrhal stage: 2 wk mild URT symptoms
  • Paroxysmal: 2-3 month of severe cough
  • Convalescent: 1-2 wks reduction in cough
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10
Q

Dx of Bordetella pertussis

A
  1. Nasopharyngeal swab (direct flouro-ab or PCR)
  2. Culture
  3. CBC with striking Lymphocytosis
    - toxin blocks signal transduction needed for lymphocyte to enter lymph. tissie
    * Unique to Bordetella pertussis
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11
Q

Tx of Bordetella pertussis

A

Azithromycin

  • for all individual w/ positive lab Dx
  • also for pts with clinical Dx who have had symptoms for
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12
Q

Prevention of Bordetella pertussis

A

Vaccine (Inactivated toxin)

  • Included within the DTaP (diphtheria, tetanus, acellular pertussis)
  • given: 2, 4, 6, 15-18 month; 4-6 years; and a booster at age 11
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13
Q

Characteristics of Corynebacterium diptheriae

A
  1. GP bacillus

2. Pleomorphic, club-shaped, arranged in palisades, beaded appearance

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14
Q

Pathogenesis of Corynebacterium diptheriae

A

A-B toxin blocks protein synthesis by inactivating elongating factor 2

  • Also induces formation of a pseudomembrane in the throat
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15
Q

Transmission and Clinical manifestations of Corynebacterium diptheriae

A

Trans: Airborne droplets

  • Clin: Gradual onset of…
  • Sore throat, that gets progressively worse
  • Malaise/fatigue/low-grade fever
  • cervical LAD (“bull-neck”)
  • Cardiac dysfunction (Myocarditis) 7-14 days after resp onset
  • neurotox
  • mechanical onstruction
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16
Q

What causes the mechanical obstruction in Diptheriae?

A

Pseudomembrane

  • composed of necrotic fibrin, leukocytes, erythrocytes, epithelial cells, and organisms
  • bleeds with scraping
17
Q

Dx of Diptheria

A
  1. Throat swab culture on Loeffler’s medium, tellurite plate and blood ager
    - gray-black color of tellurium in colony = Dx
    - If C. diphtheriae onculture, either Ab inoculation or Ab-based gel diffusion
    precipitin test is performed to document toxin production.
    PCR for presence of toxin gene also used.
  2. Gram-stain and Methylene blue
18
Q

Prevention and Tx of Diptheria

A
  1. TDaP vaccine
  2. Tx:
    - antitoxin administration
    - Penicillin or erythromycin
    - Do NOT wait for dx. Tx immediately, if suspected
19
Q

What organism most commonly cause Acute Otitis Media?

A
  1. Strep. Pneumoniae
  2. H. influenzae
  3. Moraxella catarrhalis
  • from most to least likely
20
Q

Tx of Acute Otitis Media?

A

First line: Amoxicillin

- Augmentin if recent antibiotic tx or Hx of AOM unresponsive to amoxicillin

21
Q

When does Acute Otitis Media usually occur?

A

Following viral URTI

- due to the colonization of bacteria in the secretions that accumulate from inflammation

22
Q

When does Acute Sinusitis occur? How is it treated?

A

After viral URTI

-Augmentin

23
Q

Causes of Epiglottitis

A
  1. H. influenzae (classically Hi B)
  2. H. parainfluenzae
  3. S. pneumoniae
  4. Group A strep

Pulm (14 decks)

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