Wk 7 Intro - Eyes and Respiratory

Question 1

Blepharitis

Answer 1

inflammation of the eyelid.
* Hordeolum “stye” involves the oil gland

Question 2

Dacryocystitis

Answer 2

inflammation of the lacrimal sac - usually from partial or complete obstruction

Question 3

Conjunctivitis

Answer 3

inflammation of the conjunctiva; may extend to eyelids, cornea (keratitis), or sclera (episcleritis)

Question 4

Keratoconjuntivitis

Answer 4

extensive disease involving the conjunctiva and cornea. Progressive keratitis can lead to ulceration, scarring, and blindness

Question 5

Ophthalmia neonatorum

Answer 5

acute, sometimes severe, conjunctivitis or keratoconjunctivitis of newborn infants

Question 6

Endophthalmitis

Answer 6

infection of aqueous or vitreous humor. Rare, may lead to blindness

Question 7

Uveitis

Answer 7

of inflammation of the uveal tract—iris, ciliary body, and choroid. Most are not of infectious origin

Question 8

Chorioretinitis

Answer 8

most common infective involvement of the uveal tract - inflammatory infiltrates seen in the retina. Can lead to destruction of the choroid and inflammation of the optic nerve (optic neuritis) and may extend into the vitreous humor to cause endophthalmitis

Question 9

Eye anatomy

Answer 9

Question 10

Infectious causes of eye disease

Answer 10

Question 11

4 types of pneumonia

Answer 11

1. Lobar: intra-alveolar exudate evolves into a consolidation. Streptococcus pneumoniae most common, but others also possible.
2. Bronchopneumonia: patchy distribution from bronchioles into adjacent alveoli of acute inflammatory infiltrates.
3. Atypical (interstitial) / walking pneumonia: diffuse patchy infiltrates seen on interstitial areas at alveolar walls. Indolent course. Mycoplasma, Chlamydophila, and Legionella are classic organisms. Viral infections can have similar radiographic appearance.
4. Cryptogenic Organizing Pneumonia (previously called BOOP): non- infectious, unknown etiology (thought to be caused by chronic inflammatory diseases or medications)

Question 12

4 types of aspiration syndromes

Answer 12

1. Chemical pneumonitis (gastric acid) – Mendelson syndrome
2. Aspiration pneumonia (bacteria from oral and pharyngeal areas) * Exogenous lipoid pneumonia (mineral or vegetable oil) – rare
3. 2019: E-cigarette associated acute lipoid pneumonia
4. Foreign body aspiration – can lead to acute respiratory emergency

Question 13

5 risk factor categories for aspiration pneumonia

Answer 13

1. decreased consciousness
2. esophageal conditions
3. neurological disorders
4. mechanical
5. other

Question 14

What are 3 causes of atypical/walking pneumonia?

Answer 14

1. Mycoplasma
2. Chlamydophila/Chlamydia psittisi or pneumoniae
3. Legionella

Viral infections look similarly radiographically

Question 15

Aspiration

Answer 15

the inhalation of either oropharyngeal or gastric contents into the lower airways (foreign material into the lungs)

Question 16

Lung abscess

Answer 16

Necrosis of pulmonary parenchyma with localized collection of purulence
* Classically related to aspiration

Question 17

Empyema

Answer 17

when lung abscess involves plueral space

Question 18

Acute vs chronic lung abscess

Answer 18

acute < 1 month
chronic > 1 month

Question 19

Lung abscess etiology

Answer 19

oral cavity anaerobes like Staph aureus
Klebsiella pneumoniae

Question 20

Sx of lung abscess

Answer 20

fever, productive cough, weight loss, diaphoresis

Putrid/sour tasting breath

Question 21

Tx of lung abscess

Answer 21

Abx w/ anaerobic coverage
drainage/surgery

If S. aureus, daptomycin should not be used b/c inactivated by surfactant

Question 22

Immunocompromised host increased infection risk pathogens

Answer 22

*Bacterial:addatypicalorganisms(Nocardia,mycobacteria– both tuberculosis and non-tubercular mycobacteria (NTM), Pseudomonas and other GNRs)

*Fungal:Aspergillus,Cryptococcus(lungsand/orCNS), Pneumocystis (PJP), Mucorales

*Viruses:CMVpneumonitis,HSVandVZVwithtracheitis, influenza and other community-acquired respiratory viruses with more severe complications and secondary infections

*Parasites:Toxoplasma,Strongyloides

Question 23

TB (1 cause) and Endemic/Dimorphic Fungi (4 causes)

Answer 23

• Mycobacterium tuberculosis
• Endemic/Dimorphic Fungi:
• Histoplasma capsulatum
• Blastomyces dermatitidis
• Coccidioides immitis
• Paracoccidioides brasiliensis

Question 24

Droplet illnesses

Answer 24

(spread through close respiratory or mucous membrane contact with respiratory secretions)
* Meningococcal Meningitis
* Pertussis
* Respiratory Viruses

Question 25

Airborne illnesses

Answer 25

(remain infectious over long distances when suspended in the air)
* Tuberculosis
* Measles
* VZV
* SARS-CoV-2

Question 25

Airborne illnesses

Answer 25

(remain infectious over long distances when suspended in the air)
* Tuberculosis
* Measles
* VZV
* SARS-CoV-2

Question 26

TORCH/Congenital infections

Answer 26

=infections acquired in utero (transplacental) or during birth (perinatal)

Question 27

Congenital infection screening in US

Answer 27

HIV, rubella, and syphilis 1st prenatal visit
Chlamydia, gonorrhea, GBS 3rd trimester
Repeat 1st trimester screening in high risk patients

IgM antibodies in the newborn suggest congenital infection (do not cross placenta)

Question 28

Clinical suspicion for TORCHES infection

Answer 28

Labs during pregnancy
* Hydrops fetalis
* Microcephaly
* Seizures
* Cataract
* Hearing loss
* Congenital heart disease
* Hepatosplenomegaly
* Jaundice
* Rash
* Thrombocytopenia

Question 29

Know this

Answer 29