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Week 1 - Respiratory infections Flashcards

1
Q

Virus that causes the common cold

A

Rhinovirus

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2
Q

Rhinovirus causes symptoms of both upper and lower respiratory tract

A

False, only the upper respiratory tract

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3
Q

What type of virus is rhinovirus?

A

Unenveloped (naked) RNA virus; part of the picornaviridae family

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4
Q

Rhinovirus is an “acid labile” virus, what does that even mean?

A

That it doesn’t cause GIT symptoms because it can’t survive @ acidic environment

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5
Q

Patient presents with fever, rhinorrhea, purulent nasal discharge and cough; they also present with pressure @ head, congestion and loss of smell and taste, who tf virus caused this?

A

Rhinovirus

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6
Q

The diagnosis for the common cold/ rhinovirus can only be done with a PCR test

A

False, the diagnosis for rhinovirus is clinical

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7
Q

Asthma exacerbations and sometimes bronchiolitis are common symptoms of adenovirus

A

False, these are common in rhinovirus

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8
Q

Therapy for the common cold/ rhinovirus

A
  • Resting
  • Hydration
  • Antipyretic (paracetamol) when patient feels like shit
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9
Q

Common cold mechanism of transmission

A

Transmitted through secretions

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10
Q

Receptors to which rhinovirus binds

A
  • LDL-R
  • ICAM1
  • CDHR-3
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11
Q

Most susceptible ppl for rhinovirus

A
  • Bbys and elderly
  • Immunocompromised
  • Respiratory disease: COPD, asthma, cystic fibrosis
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12
Q

Where is the ICAM1 receptor rhinovirus adheres to located

A

At CD54 on epithelial cells lining the respiratory tract

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13
Q

Types and serotypes of rhinovirus

A
  • More than 110 serotypes detected
  • RV-A, RV-B and RV-C
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14
Q

The only DNA virus that causes respiratory tract infection we saw on this course

A

Adenovirus

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15
Q

Clinical symptoms of adenovirus

A
  • Respiratory tract infections
  • Ocular disease/ CONJUNTIVITIS
  • Gastroenteritis + diarrhea sometimes
  • Cystitis
  • Inflamed adenoids/ lymphoid tissue
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16
Q

Mechanism of transmission of adenovirus

A
  • Respiratory droplets
  • Fecal-oral route
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17
Q

Adenovirus causes outbreaks @ daycare and summer camps and stuff like that

A

Yes

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18
Q

Types of adenovirus that cause gastroenteritis

A

40 & 41

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19
Q

Types of adenovirus that cause cistitis

A

7, 11 & 21

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20
Q

Pharyngoconjuntival fever is not a common sign of adenovirus because conjuntivitis isn’t even a sign for adenovirus

A

False, pharyngoconjuntival fever and conjuntivitis are signs and symptoms of adenovirus

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21
Q

Why tf is it called adenovirus?

A

Bc it was found @ adenoid tissue

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22
Q

Receptors to which adenovirus attaches itself

A
  • Dsg-2
  • CAR
  • CD46
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23
Q

Is there a vaccine for adenovirus?

A

Yes, its a live oral vaccine given to the military

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24
Q

Epidemic keratoconjuntivitis is caused by which serological adenovirus types?

A

8, 19 & 37

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25
Q

HAdV was intended to be used as a vector for?

A

As gene therapy for Covid-19 vaccines

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26
Q

Enveloped, negative-sense, single strand RNA and a segmented genome virus; part of the Orthomyxoviruses

A

Influenza virus

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27
Q

Can influenza cause epidemics?

A

Yes, it can cause epidemic acute respiratory disease (fever, cough + systemic symptoms)

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28
Q

What are the 3 types of influenza virus

A

A, B and C

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29
Q

The constant antigenic evolution of the influenza virus can lead to 2 things called

A

Shift and Drift

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30
Q

Surface antigens present on the capsule of the influenza virus

A
  • Hemagglutinin (HA)
  • Neuraminidase (NA)
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31
Q

Receptor to which the influenza virus attaches to

A

Salic acid sugar receptor

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32
Q

Where does the influenza virus bind to the silica acid sugar?

A

@ epithelial cells located in the upper respiratory tract

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33
Q

Influenza virus transmission

A

Person to person: respiratory droplets or indirectly through contaminated surfaces

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34
Q

Diagnosis for influenza

A
  • Clinically due to the epidemics
  • Characteristic symptoms of cough and fever
  • Antigen detection: PCR
  • Viral culture
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35
Q

When do symptoms start after getting infected with influenza virus?

A

1 to 4 days later

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36
Q

Symptoms of Influenza

A
  • Headache
  • Fever
  • Runny nose
  • Sore throat + dry cough
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37
Q

Physical examination characteristics in a patient with influenza

A
  • Conjuntivitis
  • Pharyngeal erythema
  • Abnormal lung sounds: wheezing, ronchi or crackles
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38
Q

Influenza complications include

A
  • Acute otitis media
  • Bronchiolitis
  • CROUP
  • Sinusitis
  • Pneumonia (Staph aureus and Strep pneumoniae)
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39
Q

Who are at high risk for influenza complications?

A
  • Young children <6 months
  • Preggo women
  • Adults >65
  • Chronic health conditions (heart/ lung disease)
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40
Q

Neurologic complications that Influenza can cause in young children <6 months

A
  • Encephalitis
  • Febrile seizures
  • Reye syndrome if aspirin is taken
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41
Q

Treatment for influenza A & B

A

Oseltamivir (oral): neuraminidase inhibitor

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42
Q

Medical profilaxis for influenza A & B

A
  • Oseltamivir
  • Zanamivir
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43
Q

M2 proton channel inhibitors like Adamantine work wonders because M2 mutations are very rare

A

Falsee, M2 mutations occur often and lead the virus to become resistant

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44
Q

Prevention for influenza

A
  • Vaccines are effective @ preventing influenza
  • Inactivated/ live-attenuated vaccines (sprayed)
  • Trivalent
  • A vaccine is generated every winter season
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45
Q

Virus that causes both upper and lower respiratory tract illnesses

A

RSV: Respiratory Syncytial Virus

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46
Q

Where tf did RSV get its name?

A

It causes cells lining the respiratory tract to merge and cause the cells to transform to a multi-nucleated syncitia

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47
Q

Leading cause of bronchiolitis @ infants

A

RSV

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48
Q

RSV signs and symptoms

A
  • Pneumonia (crackeling rales heard)
  • Bronchioles (wheezing + damage @ bronchioles)
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49
Q

Causes of bronchiolitis

A
  • Edema
  • Vasoconstriction
  • Obstruction
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50
Q

What type of virus is RSV?

A
  • Enveloped non-segmented RNA virus
  • Pneumoviridae
  • 2 groups: A & B
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51
Q

What’s the diagnosis for RSV?

A
  • Clinical diagnosis accurate during winter (time of the year), age and symptoms
  • $$$: lab culture, PCR or antigen
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52
Q

Not being breastfed, being born prematurely and having a neuromuscular disorder are all…

A

Risk factors for RSV

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53
Q

Is there any specific treatment or therapy for RSV?

A

Supportive treatment (oxygen and fluids)

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54
Q

Any experimental treatment for RSV?

A

Aerosolized Ribavirin @ high risk patients + immunocompromised patients (only @ USA)

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55
Q

How does RSV enter the cell?

A

By merging with the cell membrane

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56
Q

G protein @ RSV does what?

A

G protein stands for glycosylation which helps with antibody avoidance

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57
Q

F protein @ RSV does what?

A

F protein stands for conformational change and helps with infectivity and protection

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58
Q

NS1 & NS2 (present in RSV viral structure) inhibit…

A

IFN 1

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59
Q

Who are at risk for RSV

A
  • Babies @ the NICU
  • Babies
  • Children
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60
Q

Mechanism of transmission for RSV

A

Contact with droplets or contaminated surfaces

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61
Q

Other symptoms of RSV

A
  • Fever
  • Congestion
  • Difficulty breathing
  • Acute otitis media
  • Rhinorrhea
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62
Q

RSV complications include

A
  • Central apnea: short periods of time with NO breathing
  • Hypoxia
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63
Q

Most common cause of CROUP

A

Parainfluenza virus

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64
Q

Parainfluenza virus is also the second most common cause of…

A

Acute respiratory infections in children less that 5 years of age

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65
Q

Symptoms of parainfluenza virus

A

Acute respiratory illness
- Colds
- CROUP
- Bronchiolitis (narrow airways)
- Pneumonia

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66
Q

CROUP has a specific pulmonary sound, which one is it?

A

Inspiratory stridor (high pitched, whistling sound)

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67
Q

Types of PIV that can infect humans

A

PIV-1, PIV-2, PIV-3 and PIV-4

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68
Q

Seasonal outbreaks of parainfluenza virus are @?

A

Fall, PIV-1 and PIV-2

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69
Q

Which parainfluenza virus type causes outbreaks @ odd number years

A

PIV-1

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70
Q

PIV-1 is also commonly associated with

A

CROUP in children

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71
Q

Which PIV causes annual epidemics @ spring

A

PIV-3, also severe @ immunocompromised patients and children

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72
Q

PIV-4 is the most dramatic and deathly of them all

A

False, its milder disease that affects both upper and lower respiratory tract (super rare)

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73
Q

What type of virus is PIV?

A

Single-stranded enveloped (lipid membrane) RNA; paramixoviridae family

74
Q

Glycoproteins preset on the viral structure of PIV

A
  • F: fusion
  • HN: Hemagglutinin-Neuraminidase
75
Q

PIV virus is such a loser and copies Influenza and uses the same receptor, which one is it?

A

Sialic acid sugars

76
Q

What test can be done to diagnose PIV

A

Culture or PCR but $$$

77
Q

An X-ray of the neck will show narrowing of the trachea, what’s the name of this “sign”

A

Steeple sign

78
Q

An X-ray of a patient with pneumonia caused by PIV will show consolidation

79
Q

Treatment for the CROUP presented in PIV

A

Glucocorticoids and nebulized epinephrine @ children

80
Q

Ribavirin & IV immunoglobulins work wonders in PIV

A

False, efficacy is uncertain

81
Q

Signs and symptoms of CROUP

A
  • Cough: loud barking
  • Fast breathing + noisy breathing + wheezing
  • Nasal congestion
  • Hoarseness @ speech
  • Worse @ night
82
Q

Symptoms of bronchiolitis

A
  • Chest congestion
  • Clogged and sore throat
  • Coughing
  • Wheezing
83
Q

Symptoms of pneumonia

A
  • Shortness of breath
  • Chest pain
  • Productive cough (pus/ bloody sputum)
84
Q

Which types of PIV cause CROUP

A

Types 1 and 2

85
Q

Which type of PIV causes lower airway damage leading to pneumonia

86
Q

Since PIV infection is self-limiting it can be treated with antipyretics and hydration

A

Correct slay

87
Q

Treatment for bronchiolitis caused by PIV

A
  • Supplemental oxigen
  • Fluids
88
Q

Gram + diplococci, lancet shaped and alpha-hemolytic

A

Streptococcus pneumoniae

89
Q

Most common cause of community-aquired pneumonia

A

Streptococcus pneumoniae

90
Q

Microscopic characteristics of Streptococcus pneumoniae

A
  • Gram + diplococci
  • Polysaccharide outer capsule (virulence factor, serotypes and target for vaccines)
  • Peptidoglycan cell wall (purple)
  • Non-motile
  • Facultative anaerobes
  • NO spores
  • Catalase negative
91
Q

What type of hemolysis does S. pneumoniae cause on blood agar

A

Green hemolysis due to the production of hydrogen peroxide

92
Q

Strep pneumoniae is a common cause of

A

Invasive Pneumococcal Disease

93
Q

Clinical manifestations for pneumococcal disease are divided into 2

A
  • Invasive
  • Non-invasive or mucus related
94
Q

Invasive pneumococcal disease can present as

A
  • Meningitis
  • Bacteriemia
  • Sometimes pneumonia
95
Q

Non-invasive pneumococcal disease can present as

A
  • Pneumonia
  • Acute otitis media
  • Sinusitis
96
Q

Mechanism of action in which S. pneumonia causes pneumonia

A
  • Adheres to alveolar cells
  • Release of pneumolysin
  • Destruction of pneumocytes + alveolar capillaries
97
Q

Fever, chills, chest pain and cough are all symptoms of pneumonia

98
Q

Leading cause of pneumonia and bacterial meningitis @ children

A

Streptococcus pneumoniae

99
Q

Is the incidence higher @ some ages for Streptococcus pneumoniae?

A

2 years old and adults > 65 years old

100
Q

Large outbreaks are common whereas small outbreaks are uncommon when it comes to S. pneumoniae

A

False, the other way around

101
Q

What even is pneumolysin found at S. pneumoniae

A

Pore forming toxin that causes epithelial and endothelial damage

102
Q

Asymptomatic clinical manifestations of S. pneumoniae

A
  • Otitis media
  • Sinusitis
  • Pneumonia
103
Q

Symptomatic clinical manifestations of S. pneumoniae

A
  • Bacteriemia
  • Meningitis (by crossing the BBB)
  • Empyema
  • Endocarditis
  • Septic arthritis
104
Q

Bacteremia is caused when S. pneumoniae crosses the alveolar capillaries and enters the blood stream, it can lead to sepsis, which group of ppl are more at risk for developing sepsis?

A

Ppl with spleen problems bc of its important role in immunity (ppl with splenectomy or sickle cell anemia)

105
Q

Other clinical manifestations of S. pneumoniae

A

Crackles and localized pleural pain

106
Q

Diagnosis for S. pneumoniae

A
  • Cultures of pus, sputum, CSF or peritoneal fluid
  • PCR to detect S. pneumoniae DNA
107
Q

Treatment for S. pneumoniae

A
  • Beta-lactam antibiotics
  • Resistance for penicillin and derivatives
  • Fluroquinolones
  • Amoxicillin + Clavulanic acid
  • IV treatment (3rd gen cephs): ceftriaxone and cefotaxime
108
Q

Are there any vaccines for S. pneumoniae? If so, mention them:)

A

2 vaccines provide protection against invasive pneumococcal disease
- PCV13 (polysaccharide-protein vaccine) protects up to 90% recommended for adults
- PCV23 (Conjugate vaccine) protects from 54-81% @ adults recommended in young children

109
Q

S. pneumoniae has a reservoir, where tf?

A

Nasopharynx

110
Q

Virulance factors present in S. pneumoniae

A
  • Capsular polysaccharides + pili and fimbriae
  • Biofilm production
  • PspA
  • IgA1 protease: toxin that destroys IgA
  • Autolysin
  • Pneumolysin
111
Q

What the fuck does pneumolysin do

A

Binds to cholesterol in cell membranes and forms pores; causing cell lysis

112
Q

Individuals at risk for S. pneumoniae

A
  • Infants and elderly
  • HIV infection
  • Diabetes
  • Malignancy
  • Alcohol and tobacco use
113
Q

Gram - cocobacillus fastidioso asf

A

Haemophilus influenzae

114
Q

Micro characteristics of Haemphilus influenzae

A
  • Non motile
  • Facultative anaerobic
  • Catalase and oxidase +
  • Cultivated on chocolate agar bc it has factor V and factor X (white/ transparent colonies)
115
Q

Haemophilus influenzae virulenze factors

A
  • Polysaccharide capsule
  • Pili
  • Adhesion proteina HMW1 and HMW2
  • IgA protease to destruct IgA
116
Q

2 extra virulance factors that only UNENCAPSULATED Haemophilus influenzae has

A
  • Phase variation: allows oligosaccharides to change/ variate; immune system can’t remember
  • Biofilms
117
Q

With the help of… Haemophilus influenzae can colonize the respiratory tract

A

Lipooligosaccharides (LOS)

118
Q

Two types of Haemophilus influenzae

A
  • Non-encapsulated
  • Encapsulated
119
Q

Encapsulated Haemophilus influenzae has surface antigens, which ones?

A

A B C D E F

120
Q

Another name unencapsulated Haemophilus influenzae gets is

A

Non-typable, bc of lack of antigens

121
Q

Which strains of H. influenzae are more known to cause a disease

A
  • Encapsulated type B
  • Unencapsulated/ Nontypanble
122
Q

Non-encapsulated Haemophilus influenzae causes…

A
  • Otitis media @ children
  • Sinusitis
  • Bronchitis
  • Exacerbations of COPD @ adults
123
Q

Encapsulated Haemophilus influenzae causes…

A

Invasive infections like:
- Meningitis
- Epiglotitis
- Septic arthritis
- <6 y/o | type B
- Cellulitis @ face
- Bacteremia

124
Q

What even is epiglottitis

A
  • Swollen epiglottis
  • Blockage of airway
  • Sore throat
125
Q

Encapsulated H. influenzae type B causes epiglottitis, what are the symptoms?

A
  • Fever
  • Sore throat
  • Difficulty speaking
  • Dyspnea
126
Q

Encapsulated H. influenzae type B can cause meningitis, what are the symptoms present?

A
  • Fever
  • Lethargy
  • Irritability
  • Vomiting
  • Sore/stiff neck
  • Altered mental state
127
Q

Encapsulated H. influenzae may cause cellulitis, what symptomatology accompanies it?

A
  • Fever
  • Warm tender area of erythema @ cheek and periorbital area
128
Q

Patients with epiglottitis can’t swallow soooo

A

They drool

129
Q

Ecologic niche of nontypable Haemophilus influenzae

A

Human respiratory tract + colonization of nasopharynx

130
Q

Haemophilus influenzae is most common during adulthood

A

False, its common during childhood and decreases @ adulthood

131
Q

A common characteristic of the growth requirements of Haemophilus influenzae is

A

Fastidious growth

132
Q

Haemophilus influenzae is not part of the normal flora of the human upper respiratory tract

A

False, it is

133
Q

Therapy for Haemophilus influenzae type B

A

Ceftriaxone or cefotaxime

134
Q

Therapy for nontypable Haemophilus influenzae

A
  • Amoxicillin +/- clavulanate
  • 3rd and 2nd generation cephalosporins
  • Macrolides or quinolones
135
Q

Vaccine for Haemophilus influenzae type B is given @ how many months?

136
Q

Fever, ear pain and otorrhea are all symptoms of… caused by nontypable H. influenzae

A

Otitis media

137
Q

Fever, tenderness of affected sinuses and persistent purulent nasal discharge are all symptoms of… caused by nontypable H. influenzae

138
Q

Gram - diplococcus

A

Moraxella catarrhalis

139
Q

Common cause of otitis media in children and exacerbations of COPD in adults (besides H. influenzae)

A

Moraxella catarrhalis

140
Q

Respiratory tract infections that M. catarrhalis can cause in loser kids

A
  • Bronchitis
  • Rhinosinusitis
  • Laryngitis
141
Q

Microbiological characteristics of Moraxella catarrhalis

A
  • Non-motile
  • Non-spore forming
  • Aerobic
  • Maltose fermentation negative (solution stays red)
  • Oxidase +
  • Grows well on blood and chocolate agar
142
Q

M. catarrhalis can be moved around the agar without breaking, this means its positive for…

A

Hokey puck test

143
Q

M. catarrhalis’ favorite place for colonization

A

Nasopharynx + upper respiratory tract (as well as the others:()

144
Q

M. catarrhalis looks like _____ @ the gram stain and culture

145
Q

M. catarrhalis produces…

A
  • Oxidase
  • Catalase
  • DNAse
146
Q

Can you treat M. catarrhalis with beta-lactam antibiotics

A
  • No, they produce beta-lactamase which means RESISTANCE
  • Amoxicilin + calvulanate, Macrolides, Fluroquinolones and Extended spectrum Cephalosporines should do the trick
147
Q

Vaccine for M. catarrhalis is applied at 4 months

A

False, there isn’t even a vaccine

148
Q

M. catarrhalis is an opportunistic bitch

149
Q

Mycoplasma pneumoniae causes

A

Atypical pneumonia

150
Q

Characteristics of M. pneumoniae

A
  • Slower onset & generally milder
  • No lobar consolidation
  • Lacking cell wall
  • Adhesins and adhesion organelle (pathogenesis)
  • Fastidious
  • Facultative anaerobe
151
Q

List 3 common places someone can get an M. pneumoniae infection… GO

A
  • Children @ school
  • Young adults @ uni
  • Military recruits
152
Q

Where does Mycoplasma pneumoniae replicate?

A

Inside the cell… evades immune system

153
Q

Extrapulmonary skin manifestations caused bc M. pneumoniae

A
  • Macopapular vesicular rashes
  • Stevens-Johnson Sx.
154
Q

Extrapulmonary cardiac manifestations caused bc M. pneumoniae

A
  • Pericarditis
  • Miocarditis
155
Q

Extrapulmonary CNS manifestations caused bc M. pneumoniae

A
  • Encephalitis
  • Myelitis
  • Radiculopathy
156
Q

Extrapulmonary musculoskeletal manifestations caused bc M. pneumoniae

A
  • Myalgia
  • Rhabdomyolysis
  • Arthritis
157
Q

Extrapulmonary renal manifestations caused bc M. pneumoniae

A
  • Glomerulonephritis
  • Nephrotic syndrome
158
Q

What can aid in the diagnosis of M. pneumoniae

A

Presence of cold agglutinins

159
Q

Treatment for M. pneumoniae consists of

A
  • Macrolides (azithromycin)
  • Tetracyclins (doxycycline)
  • Fluroquinolones (maxifloxacin)
160
Q

Lab tests done on someone with pneumonia caused by M. pneumoniae

A
  • CBC @ hospitalized patients
  • Blood culture @ patients with failed antimicrobial therapy
  • PCR + viral cultures NOT RECOMMENDED
161
Q

Otitis media + fever + other systemic manifestations can be caused by many microorganisms, what is the virulence factor responsible for this?

A

Capsid (Haemophilus influenzae type b, Streptococcus pneumoniae)

162
Q

Virus that can cause gastrointestinal, respiratory and genitourinary infections

A

Adenovirus

163
Q

Adenovirus manifestations per system

A
  • Respiratory: common cold, sore throat and pneumonia
  • GIT: diarrhea
  • Genitourinary: cystitis
164
Q

4 F of the fecal-oral route

A
  • Flies
  • Fluids
  • Fields
  • Fingers
165
Q

Adenovirus attaches itself to the receptor via the “fiber-like” projections it has, what effects does it have on a cellular level?

A
  • Inhibition of DNA synthesis
  • Inhibition of the production of proteins
  • Cellular lisis
  • Inflammatory response from the host
166
Q

Inflammatory response caused by adenovirus

A

Leukocytes produce pro-inflammatory cytokines and histamine, dilation of blood vessels

167
Q

Upper and lower manifestations of adenovirus

A
  • Upper: infectious rhinitis (common cold), pharyngitis and tonsillitis
  • Lower: pneumonia
168
Q

GIT adenovirus infection symptoms

A
  • Fever
  • Nausea and vomiting
  • Watery diarrhea
169
Q

Conjunctivitis symptoms in regards to an adenovirus infection

A
  • Eye irritation
  • Soreness
  • Redness
  • Photophobia
  • Excessive tearing
170
Q

Adenovirus can cause pharyngoconjunctival fever, what signs and symptoms need to be present for it to occur?

A
  • Conjuntivitis
  • Fever
  • Pharyngitis
  • Inflammation of lymph nodes in the neck
171
Q

Disseminated adenovirus infection is more common in

A

Immunocompromised patients (it has a high mortality rate)

172
Q

Virus that causes “the flu”

173
Q

All three types of influenza can infect both humans and animals

A

False, type B influenza only affects humans

174
Q

Most severe type of lnfluenza

175
Q

Why can you get sick from influenza year after year? (shift or drift)

A

Because of the antigenic “drift”

176
Q

Mycoplasma pneumonia may be asymptomatic or have nonspecific symptoms such as:

A
  • Fatigue
  • Sore throat
  • Mild fever
  • Dry hacking cough
177
Q

In comparison to a pneumonia caused by Streptococcus pneumoniae, a pneumonia caused by Mycoplasma pneumonia is (more severe/ milder)

A

Mild, the patient may actually feel kinda good

178
Q

Atypical pneumonia can also be called

A

Walking pneumonia

179
Q

Chest X-ray of walking pneumonia looks…

A

Patchy infiltrates

180
Q

Why are beta lactam antibiotics inefficient in treating Mycoplasma pneumoniae

A

Bc they don’t have a cell wall, use tetracylines or macrolides

181
Q

Agar in which Mycoplasma pneumoniae grows

A

Eaton’s agar, it formes dome-shaped colonies that look like fried eggs (takes 2 to 3 weeks tho)

Infectious Disease Pathophysiology (4 decks)

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