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Micro > URI > Flashcards

URI Flashcards

1
Q

Signs and Symptoms of Acute Respiratory disease

A 
Pt may say- I have a cold
congestion
cough
soar throat
runny nose
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2
Q

How long does the dz last in children? in adults?

A

7-10 days in children

2-5 days in adults

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3
Q

Etiologic agents of acute respiratory dz

A

Rhinovirus, coronnavirus, adenovirus, parainfluenza virus, conjuctivitia
LRI- pathogens
RSV, human metapneumovirus, influenza, human bocavirus, mycoplasma or chlamydia

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4
Q

Complications of the common cold

A 
LOBES
L- LRI
O- Otitis media
B- bacterial super infection
E- exacterbations of existing conditions ie Asthma/ COPD
S- sinusitis
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5
Q

Diagnosis of the common cold

A

presumptive cold but can do rapid test which is ELISA to look for RSV and influenza

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6
Q

Treatment of the common cold

A

generally nothing has been proven to work, honey
RSV- ribavirin
Influenza A- HA inhibitbors and NA inhbitors
Influenza A/B- NA ihibitors

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7
Q

Prevention of the common cold, how do you prevent RSV and in who

A

isolation
hand washing
in the case of RSV w/ monoclonal Ab in high risk premies

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8
Q

Epidemiology of the common cold

A

seasonal disease most often seen in children, direct contact or droplet spread

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9
Q

pharyngitis=

A

strep throat, assoc with Mono

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10
Q

symptoms of strep throat

A 
soar throat
dysphagia
erythematous pharynx
LAD
fever
EXUDATE
if it is caused by GAS pt will have N/V
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11
Q

Etiology of Strep throat

A 
most common causes are viral
adenovirus- pink eye
EBV
GAS
HIV
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12
Q

complications of EBV

A

splenic rupture
nasopharyngeal carcinoma in Chinese people
burkits lymphoma in african children

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13
Q

Diagnosis of EBV

A

mono spot test- heterophile test

atypical lymphocytes

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14
Q

Treatment of EBV

A

steroids if if is inflammatory otherwise nothing

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15
Q

prevention of EBV

A

nothing

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16
Q

EBV epidemiology

A

mostly seen in pts 12-24 yrs old

frequently have concominant infection with GAS

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17
Q

GAS complications

A

Rhematic fever
Scarlet fever
glomerulonephritis

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18
Q

Diagnosis of GAS

A

rapid strep test
ASO
scarlet fever and strawberry tongue

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19
Q

treatment of GAS

A

10 day course of PCN

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20
Q

prevention of GAS

A

tonsilectomy

check others in the household

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21
Q

epidemiology of GAS

A

6-12, children can be asymptomatic carriers and only 1/3 of the cases have exudate

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22
Q

Otitis media=

A

ear infection

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23
Q

Otitis media- pathology

A

tube blockage (virus) with a superimposed nasopharyngeal infection –> pressure –> pain

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24
Q

Otitis media- symptoms

A

otalgia, URI, fever, decreased hearing, drainage

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25
Q

appearance of TM in OM

A

bulging
red
loose land marks
Blebs on the TM indicate a viral infection

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26
Q

OM etiology- acute

A

sterile
strep penumonia
H.influenza- non typeable
moraxella catarrhalis

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27
Q

OM etiology- chronic

A

pseudomonas, staphlycoccocus, anaerobes

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28
Q

OM complications

A

learning disability, hearing loss, meningitis, mastoiditis, serous otitis, perforation of TM

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29
Q

OM dx

A

presumptive diagnosis
typanocentesis- in newborns and with chronic infection
Myringotomy- ear tube

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30
Q

OM tx

A

amoxicillin w/ w/o clavulonic acid
cephlasporins
TMP- SMX
myringotomy relieve the pressure and may prevent perforation

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31
Q

OM prevention

A

vaccination
allergy tx= edema and blockage of eustashian tubes
remove the tonsils and the adenoids

32
Q

OM epidemiology

A

CHILDREN, 2/3 before their 2nd birthday

33
Q

SInusitis pathology

A

Sinus blockage from a viral infection, allergy, anatomical –> distal bacterial infection –> pressure –> pain

34
Q

Sinusitis Symptoms

A 
sinus pressure
head ache
fever
rhinorrhea
Otitis media
There is no translumination
35
Q

Sinusitis etiology

A

same as OM
acute= S. Pneuno, non typeable H.Flu, moraxella catarhallis.
Chronic= staph, pseudomonas, anaerobic

36
Q

Sinusitis complications

A

chronic sinusisitis, osteomyelitis, meningitis

37
Q

diagnosis of sinusistis

A

presumptive

x ray

38
Q

tx of sinusitis

A

antibiotics for strep pneumo or H. flu, S. Aureus, or anaerobes

39
Q

prevention of sinusitis

A

decongenstants, allergy tx, correct anatomic problem

40
Q

epidemiology of sinusitis

A

occurs in adults
adult equivalent of OM
occurs with URI or allergies

41
Q

Epiglottitis symptoms

A

barking cough, stridor, chocking sensation, sore throat, drooling, swollen epiglottis and neck, TOXIC

42
Q

patient position in epiglotitis

A

sitting up and leaning forward

43
Q

epiglottitis- etiology

A

parainfluenza virus
GAS
H.flu
strep penumo

44
Q

epiglottitis- complications

A

airway obstruction

45
Q

epiglottitis dx

A

lateral neck xray with thumb sign
blood cultures- bacteremia
throat culture

46
Q

epiglottitis- tx

A

preserve the airway

3rd gen cephalosporin- ampicillin or sulbactam

47
Q

epiglottitis- prevention

A

vaccine against H. flu B

48
Q

epiglottitis- epidemiology

A

nonimmuminized kids and adult with poor immunization status

49
Q

Pertussis causes what disease

A

whooping cough

50
Q

what are the 3 stages of pertussis

A

CPR
catarrhal- rhinorrhea
Paroxysmal- cough/ whoop
Recovery/ Convaslescent- getting better

51
Q

Etiologic agents of whooping cough

A

Bortadella Pertussis

52
Q

Complications of Whooping Cough

A

Respiratory compromise

secondary bacterial infection- otitis media or pneumonia

53
Q

Dx of whooping cough

A

Clinical
Culture
Fluorescent Ab stain
PCR

54
Q

Tx of whooping cough

A

supportive care and erythromycin

55
Q

Prevention of whooping cough

A

DTap

56
Q

Epidemiology of whooping cough

A

Because there is a vaccine you see it in non immunized people.
Adults require a booster shot

57
Q

What tissues does Diptheria affect

A

Throat, Heart, and Nerves

58
Q

What are the symptoms of Diphtheria

A 
Grey Pseudomembrane in the throat
fever
malaise
LAD
pahryngitis
59
Q

What are the etiologic agents of Diphtheria

A

Corynobacterium diptheria- produces a toxin that binds to EF2

60
Q

What are the complications of Diphtheria

A

Myocardititis –> arrhythmia’s and heart failure

Myelin degeneration leading to palsy and paralysis

61
Q

How is Diphtheria Dx

A

Clinically

with a culture

62
Q

Diphtheria- Tx

A

Anti Toxin
PCN
supportive

63
Q

Diphtheria prevention

A

DTaP

64
Q

Diphtheria- epidemiology

A

Non immunized patients

always investigate close contacts

65
Q

H. Flu structure

A

Gram negative
Pleiomorphic- coccobacilliary
non motile
non spore forming

66
Q

H. Flu virulence factors

A

H. Flu type B has a polyribositol polysacharide capsule
there are capsulte types A-F
the capsule is antiphagocytic and used for typing
it also has pilli and IgA proteases.
B is the most important type

67
Q

H. Flu Epidemiology

A 
MOPES
Meningitis
Otitis
Penumonia
Epiglottitis
Sepsis
It can cause these things (esp pneumonia) secondary to a viral infection
68
Q

H. influenza- immunity

A

We develop Ab’s against the polysacharide capsule

69
Q

H. Influenza prevention

A

H. Flu type B has an anti capsular vaccine
this doesn’t work for children under 2, so there is a conjugate vaccine that they get at 2 mos and in a series of 3-4 injections which has been very successful

70
Q

H. influenza- Req’d growth factors

A

H. Flu requires 2 growth factors
V: NAD from lysed RBC
X: Hematin
“a mother goes to the 5 and dime store when her child is sick with H.Flu)

71
Q

H. Flu- how are they antibiotic resistant

A

20-25% of H.Flu have a plasmid that carries antibiotic resistance to ampicillin.
So tx is a 3rd gen cephalosporin.

72
Q

H. Flu- most suscceptable population and why

A

between 6 months and 24 months we dont have maternal Abs to protect us and our immune system hasn’t developed to the point where it can make Ab’s against polysacharides

73
Q

Why do we get infections several times

A

many pathogens have different serotypes and so we get infected one with one serotype and then again by a different type

74
Q

what types of bacterial infections are people without a spleen more likely to get

A

Strep Pneumonia and HiB

75
Q

4 factors that make strep more likely

A

1) Tonsilar exudates
2) Tender anterior cervical LN
3) Absence of a cough
4) Hx of fever

Micro (10 decks)

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