URIs Flashcards

1
Q

What are the components of the upper respiratory system?

A
Conjunctiva
Nasolacrima ducts
Epiglottis
Middle ear
Sinuses and nasal cavity
Pharynx
Larynx
The nose
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2
Q

What does surfactant contain that provides protection from pathogens?

A

IgA
Fibronectin
Surfactant
macrophages

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3
Q

What is the consequence of EtOH, smoke, and narcotis on the cilia of the upper respiratory tract?

A

Inhibits them

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4
Q

What parts of the UR system are not colonized by bacteria? (7)

A
mastoid air cells
middle ear
sinuses
trachea
bronchi
bronchioles
alveoli
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5
Q

True or false: Most healthy individuals have no bacteria in their conjunctiva

A

True

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6
Q

What keeps the conjunctiva usually sterile?

A

Lysozyme and eyelid blinking

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7
Q

What are the normal nose flora? (3)

A

Staphlococcus epidermidis

Staphylcococcus aureus

Corynebacterium spp (diptheroids)

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8
Q

What is the gram stain and morphology of staph?

A

Gram + cocci

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9
Q

What is the gram stain and morphology of strep?

A

Gram + cocci

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10
Q

What is the gram stain and morphology of corynebacterium?

A

Gram + rod

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11
Q

What are the four strep bacteria that are found in the nasopharynx (from the viridans group)? Are these usually pathogenic?

A

S. mutans
S. mitis
S. milleri
S. salivarius

These are not usually pathogenic

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12
Q

What are the three major groups of bacteria that are in the nasopharynx?

A

Strep
Moraxella catarrhalis
Bacteroides

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13
Q

Are strep bacteria aerotolerant?

A

Yes

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14
Q

What is the gram stain and morphology is moraella catarrhalis? Aerobic or anerobic?

A

Gram negative coccobacillus

Aerobic

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15
Q

What does staph aureus look like in tissue?

A

Bunches of grapes

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16
Q

What are the four common pathogens in the nasopharynx, especially in the winter months?

A

Strep penumoniae
Haemophilus influenze
Moraxella catarrhalis

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17
Q

Are strep bacteria catalase negative or positive?

A

Negative

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18
Q

Are staph bacteria catalase negative or positive?

A

Positive

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19
Q

What is group A strep?

A

S. pyogenes

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20
Q

What is group B strep?

A

S. agalactiae

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21
Q

What is group D strep?

A

S. bovis or Enterococcus faecalis

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22
Q

What is the one alpha hemolytic group of strep?

A

Strep Pneumoniae

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23
Q

What is the causative agent of strep throat?

A

Strep pyogenes (group A)

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24
Q

What is the hemolytic result of strep pyogenes?

A

beta

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25
Q

What is the target of a rapid strep test?

A

Cell wall antigen

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26
Q

What does alpha hemolytic mean?

A

Partial hemolysis of blood (green coloration)

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27
Q

What does beta hemolysis mean?

A

Complete hemolysis around colonies (clear zone around colonies)

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28
Q

What does gamma hemolysis mean?

A

No hemolysis

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29
Q

What is the M protein that is on Strep pyogenes?

A

Antiphagocytic essential for virulence (there are 80 serotypes). This degrades C3b

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30
Q

What is the importance of the capsule that some strep pyogenes have?

A

Inhibits phagocytosis and is a virulence factor

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31
Q

Why can someone get infected with strep mutiple times a year?

A

There are 80 serotypes of the virulence factor

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32
Q

What are the superantigens of strep pyogenes?

A

SPE A, B etc, that are the cause of toxic shock syndrome, fever, rash

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33
Q

What is the F protein that strep pyogenes has?

A

Mediates attachment to host cell

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34
Q

Only what disease that S pyogenes causes that is preceeded by a strep throat?

A

Scarlet fever

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35
Q

What is the function of streptolysin O that S. Pyogenes produces? What is this useful for?

A

cytotoxin responsible for beta hemolysis, lyse red and white cells.

Antibodies against streptolysin O useful for diagnosis

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36
Q

What is the function of streptokinase that S.Pyogenes produces?

A

lyses blood clots and facilitates dissemination of bacteria

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37
Q

What is the function of C5a peptidase that Strep Pyogenes produces?

A

enzyme that degrade C5a component of complement, inhibits attraction of phagocytes

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38
Q

Why do we treat strep throat with abx if it would resolve in 7 days anyway?

A

Scarlet fever and rheumatic fever

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39
Q

Why have vaccines been ineffective against Strep throat?

A

80 different serotypes

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40
Q

What is scarlet fever? What is caused by?

A

Redness of skin, and white coating on the tongue

Caused by erytherogenic toxin release

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41
Q

What is acute rheumatic fever? What is it caused by?

A

A cross reaction of our immune response to S. Pyogenes and our own tissues. This causes heart arrhythmias, arthralgias.

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42
Q

What is the treatment for rheumatic fever?

A

Immunosuppressants

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43
Q

Will you have a S. pyogenes infection with rheumatic fever?

A

No, just immune response gone out of whack.

44
Q

What happens when someone had rheumatic fever, and is reexposed to Strep pyogenes?

A

Results in a severe autoimmune reaction

45
Q

What group of strep causes Streptococcal Toxic Shock Syndrome (STSS)? Symptoms?

A

Any group A

nausea, vomiting, diarrhea, hypotension shock and organ failure

46
Q

What causes acute glomerulonephritis after a strep infection? Symptoms?

A

Antibody complexes

Edema, HTN, Hematuria and proteinuria

47
Q

What is the antigen that S. Pyogenes produces, that causes scarlet fever?

A

Erytherotoxin

48
Q

A culture of S.pyogenes will show what type of result on a blood agar (alpha, beta, or gamma)?

A

Beta

49
Q

What are the antibodies that are detected in a strep throat infection?

A

Antistreptolysin-O

50
Q

What is the causative agent of diptheria?

A

Corynebacterium diptheriae

51
Q

What are the symptoms of diptheria?

A

Usual + MASSIVE neck swelling, whitish gray membrane over tonsils, throat, and nasal cavity

52
Q

What is the gram stain and morphology of corynebacterium diphtheriae?

A

gram positive rod

53
Q

What does corynebacterium diphtheriae look like histologically?

A

Chinese letters

54
Q

What is the main virulence factor of diptheria?

A

Diptheria toxin

55
Q

What must happen to diptheria to become pathologic?

A

Has to be lysogenized by a bacteriophage

56
Q

What is the pathogenesis of diptheria?

A

Not invasive, does not enter blood or tissue. The released toxin is absorbed by the bloodstream.

57
Q

What is the gray-white membrane in the throat of diptheria made of?

A

Epithelial cells

58
Q

What explains the targeted virulence of diptheria toxin?

A

B protein receptor are only on heart, kidneys, nerve cells

59
Q

True or false: the diptheia toxin is released in an inactive form

A

True

60
Q

What type of toxin is diptheria toxin?

A

AB exotoxin

61
Q

What is the MOA of diptheria toxin?

A

Binds EF-2 and stops ribosomal action

62
Q

Why is the diptheria toxin so potent?

A

True enzyme that can continue to catalyze after one rxn

63
Q

How can you differentiate between bacterial and viral causes of conjunctivitis?

A

more pus = probably bacteria

64
Q

What are the three main causative agents of conjunctivitis?

A

Haemophilus influenzae
Streptococcus pneumoniae
Moraxella lacunata

65
Q

What is the gram stain and morphology of Haemophilus influenzae?

A

Gram - rod

66
Q

What does haemophilus look like under the microscope?

A

Small, hard to see gram - rods

67
Q

What allows the causative agents of conjunctivits to live in the eye?

A

Destruction of lysozyme

68
Q

What is the treatment for conjunctivitis?

A

Cipro, gentomycin, or eye drops

69
Q

What is the MOA of gentomycin?

A

binds to 30s subunit

70
Q

What are the three main causative agents of OM?

A

Haemophilus influenze
Strep penumoniae
Moraxella catarhallis

71
Q

What is the one strep group that has alpha hemoylsis?

A

Strep pneumoniae

72
Q

What is the cause of the pain of OM?

A

Presse on the stapedius and greater petrosal nerves

73
Q

What causes the transient hearing loss of OM?

A

Fluid behind the ear imparing movement

74
Q

What is the mechanical cause of OM?

A

Movement of bacteria from pharynx to inner ear via eustachian tube

75
Q

What are the three main causative agents of sinusitis?

A

Strep pneumo
Haemophilus influ
Moraxella catarrhalis

76
Q

True or false: Decongestants and antihistamines are generally effective for OM and sinusitis

A

False- can be harmful

77
Q

What does chlamydia cause?

A

trachomatis

78
Q

What is the family of bacteria that are obligate intracellular parasites?

A

Chlamydia

79
Q

What are the elementary bodies of chlamydia?

A

metabolically inactive but infectious forms

80
Q

What are the reticulate bodies of chlamydia?

A

Metabolically active and non infectious form

81
Q

What is the pathogenesis of chlamydia?

A

direct destruction of host cells during replication, and the hos immune response

82
Q

How does chlamydia gain access to the body?

A

Skin abrasions

83
Q

What is the treatment for diptheria?

A

Antiserum for the toxin, erytheromycin and penicillin for the bacteria

84
Q

What is the effect of pacifiers on OM?

A

Increases chances if used beyond age 2

85
Q

What are common complications of OM?

A

Mastoiditis

86
Q

What are the gram staining, morphology, and anerobic/aerobic qualities of H. influenzae?

A

Facultative Gram negative rods

87
Q

Encapsulated H. influenzae causes what diseases?

A

Meningitis
Epitglottis
Cellulits

88
Q

What is the major virulence factor in H. influenzae?

A

Antiphagocytic capsule

89
Q

Why do patients with systemic H. influenzae infection require prompt antimicrobial therapy?

A

because the mortality of patients with untreated meningitis or epiglottitis is 100%

90
Q

What is the treatment of choice for H influenzae?

A

cephalosporins

91
Q

What is the primary prevention approach to treating H. influenzae?

A

Immunization (3 doses before 6 mo)

92
Q

What are the two genera of chlamydia?

A

Chlamydia and Chlamydophila

93
Q

What is the mechanism of infection of chlamydia?

A

Elementary bodies infect phagocytic cells, then turn into reticulate bodies

94
Q

What is the organism that is responsible to trachoma, adult inclusion conjunctivitis, neonatal conjunctivitis, infant pneumonia, and UG infection?

A

Chlamydia trachomatis

95
Q

What type of chlamydia causes adult inclsion conjunctivitis? Symptoms?

A

Same as the sexy ones.

Characterized by mucopurulent discharge, keratitis, corneal infiltrates and some vascularization

96
Q

What is neonatal conjunctivitis caused by? Symptoms?

A

C. trachomatis at birth

Symptoms = eyelid swelling 5-12 days after birth. Causes conjunctival scarring and vascularization (blindness)

97
Q

What is infant pneumonia caused by?

A

Chlamydia serotype

Symptoms = cough and rhinitis 2-3 week post birth

98
Q

What are the three ways C. trachomatis can be diagnosed?

A

1) cytologic, serologic or culture findings,
2) direct detection of C. trachomatis antigen in clinical specimens and
3) C. trachomatis through the use of molecular probes.

99
Q

What is the organism that causes TWAR?

A

Chlamydophila pneumoniae

100
Q

What is the disease caused by chlamydophila pneumoniae?

A

Pneumonia

101
Q

What is the treatment for C. Pneumoniae infection?

A

Macrolides

102
Q

What is the causative agent of psittacosis (parrot fever)? Where is this bacteria usually found?

A

Chlamydia Psittaci–usually found in parrots/other birds

103
Q

What are the symptoms of psittacosis?

A

Edema, thickening of the alveolar wall, infiltration of macrophages, and necrosis

104
Q

What is the treatment for chlamydia trachomatis?

A

azithromycin or doxycycline

105
Q

What is the treatment for chlamydia psitti?

A

Macrolide and tetracycline