Term
| what are the types of upper respiratory infections (7) |
|
Definition
rhinitis
pharyngitis
epiglottitis
sinusitis
laryngitis
laryngotracheobronchitis
non-specific |
|
|
Term
| non-specific URI: main qualification, length, severity, treatment |
|
Definition
no localizing features: signs not specific to a particular location
last 1 week mild, self limiting, usually viral
treatment is symptom based |
|
|
Term
| what are two other names for rhinitis |
|
Definition
| common cold, acute corysa |
|
|
Term
| what are the two most likley causes of the common cold, what are the other 5 causes |
|
Definition
rhinovirus and coronavirus
influenza virus, adenovirus, coxsackievirus, echovirus, parainfluenza |
|
|
Term
| what is the main concern with the common cold, how can you tell |
|
Definition
secondary bacterial infection
cold lasts more than 10-14 days, perscribe antibiotics |
|
|
Term
| what is the general category of bugs the common cold is from, what is the runner up |
|
Definition
90% viruses
occasionally mycoplasma |
|
|
Term
| how long is the incubation for the common cold |
|
Definition
|
|
Term
| what are some signs of rhinitis |
|
Definition
scratchy dry sore throat
nasal congestion
coryza
sneezing
headache, malaise
fever
nasal diacharge |
|
|
Term
| common cold pathophysiology: enterance, changes |
|
Definition
enters through upper respiratory tract
proliferates
inflammatory response in upper airway
mucosal swelling and secretion of serous of mucopurulent exudate |
|
|
Term
| what are 3 complications of the common cold |
|
Definition
otitis media
sinusitis
secondary infection |
|
|
Term
| what are the 3 common agents for a secondary infection to the common cold, what are 4 other agents |
|
Definition
S. aureaus,H. influenzae, Strep
puneomia, strep pharyngitis, bronchitis, croup |
|
|
Term
| when you suspect someone has the common cold what do you need to rule out (3) |
|
Definition
| allergic rhinitis, measles, rubella |
|
|
Term
| rhinovirus: genus, envelope?, capsid shape, RNA type |
|
Definition
picornaviride genus
non enveloped
icosahederap capsid
ssRNA+ |
|
|
Term
| what conditions does rhinovirus need to grow, where is this in the body |
|
Definition
basic, 33C
nose, larg airways, nasopharynx |
|
|
Term
| how is rhinovirus spread (2) |
|
Definition
respiratory secretions
fomites |
|
|
Term
| what happens if someone with asthma gets rhinovirus |
|
Definition
|
|
Term
| what are common signs of a rhinovirus infection |
|
Definition
sneezing, rhinorrhea, nasal obstruction, mild sore throat, headache, malaise
no fever! |
|
|
Term
| how does rhinovirus cause a runny nose |
|
Definition
| infected cells release bradykinin and histamine |
|
|
Term
| when does rhinovirus peak, when does it end |
|
Definition
| peaks at 3-4 days, cough and nasal symptoms persist for 7-10 days |
|
|
Term
|
Definition
usually clinical
could get culture from nasal discharge and do CPR or RT-PCR |
|
|
Term
| rhinovirus treatment and prevention |
|
Definition
| handwashing, disinfectant, treat symptoms |
|
|
Term
| coronavirus: RNA type, shape, envelope? |
|
Definition
enveloped
+RNA
corona club shaped capsid |
|
|
Term
| why does the coronavirus have lots of genetic diversity |
|
Definition
| individual messenger ribonucleic acids (mRNA) are made for each viral protein so it allows more opportunity for recombination |
|
|
Term
| coronavirus: where does it infect and why, who does it infect |
|
Definition
infants and children
epithelial cells in upper respiratory because it likes temps 33-35C |
|
|
Term
| what sinus is the coronavirus most commonly involved with |
|
Definition
|
|
Term
|
Definition
| inflammation of sinus lining |
|
|
Term
| what are the most common causes of sinusitis (5) |
|
Definition
rhinovirus
coronavirus
S. pneumoniae
H. influenza B
staph
rhizopus - immune compormized |
|
|
Term
| why would someone have bacteria causing their sinusitis? |
|
Definition
| it was a secondary infection |
|
|
Term
| why do the normally sterile sinuses become infected? |
|
Definition
| usually secondary infection to rhinigits due to their proximity to the nasopharyngeal area and its normal flora |
|
|
Term
| what are the 6 signs of sinusitis |
|
Definition
mucopurelent rhinorrhea
nasal congestion
facial pain, pressure, fullness
decreases sense of smell |
|
|
Term
| why would rhizopus cause sinusitis in someone? (3) |
|
Definition
diabeteic with ketoacidosis
transplant patient
immune compormized |
|
|
Term
| when should someone be treated with antibiotcs for sinusitis (3) |
|
Definition
| adults that dont improve in 7 days, children that dont improve in 10-14 days, severe symptoms |
|
|
Term
| what is another name for acute pharyngitis |
|
Definition
|
|
Term
| what are the common causes of acute pharyngitis (6) |
|
Definition
accompanies the common cold
rhinovirus
coronavirus
GAS (S. pyogenes)
adenovirus
EBV |
|
|
Term
| Streptococcus pyogenes: stain type, shape, group in strep |
|
Definition
gram positive cocci
group A (lancefied) B hemolytic |
|
|
Term
| what are the 5 virulence factors of S. pyogenes |
|
Definition
M protein
hemolysins- Streptolysin O and S
streptokinase
hyaluronidase
exotoxins |
|
|
Term
| what complications can strep pyogenes cause (2) |
|
Definition
rheumatic fever
glomerulonephritis |
|
|
Term
| how is strep pyogenes tranmitted, how does it stay in the respiratory tract |
|
Definition
transmitted via respiratory droplets
attaches to pharyngeal epithelium with pilli |
|
|
Term
| how does strep pyogenes cause irritation (3) |
|
Definition
| colonies induce inflammation, sore throat, enlarged cervical nodes |
|
|
Term
| how is S. pyogenes diagnosed (3) |
|
Definition
characteristic smell
throat swab: rapid test, blood culture |
|
|
Term
| EBV: enveloped?, genome type, transmission |
|
Definition
enveloped
linear dsDNA
saliva |
|
|
Term
|
Definition
| can cause latent and recurrent infections |
|
|
Term
| where does EBV go in the body (3) |
|
Definition
| epithelial cells of naso and oropharynx and B cells |
|
|
Term
| what is the cause of infectious mononucleosis |
|
Definition
|
|
Term
| what are the signs of infectious mononucleosis (8) |
|
Definition
lymphadenopathy
splenomeagly
sore throat
fever
malaise or fatigue
rash
more mild in kids
neurological complications |
|
|
Term
| what are the signs of chonric mono (5) |
|
Definition
cyclic recurrent disease
tiredness
low grade fever
headache
sore throat |
|
|
Term
|
Definition
apparence of palatal petechiae in the throat
atypical lymphocytes
heterophil antibodies*
EBV specific antibodies |
|
|
Term
| adenovirus: envelope?, genome type, receptor type (2) |
|
Definition
naked
dinear dsDNA
coxackie adenovirus receptor and MHC I |
|
|
Term
| adenovirus transmission (3) |
|
Definition
| respiratory, fecal oral, direct contact |
|
|
Term
| what are the two types of infection adenovirus causes |
|
Definition
lytic infections
chronic infections |
|
|
Term
| where does adenovirus go in the body (3) |
|
Definition
| permissive cells: epithelial cells in oropharynx, respiratory, and enteric organs |
|
|
Term
| how is adenovirus diagnosed |
|
Definition
| dense central intranuclear inclusion (viral DNA and protein) in an infected epithelial cell |
|
|
Term
| what are the two main complications of adenovirus |
|
Definition
| acute respiratory disease and pneumonia and pharyngoconjunctivitis |
|
|
Term
| pharyngoconjunctivits: duration, 5 signs |
|
Definition
flu like: fever, sore throat, coryza, red eyes
pink eye
3-5 days |
|
|
Term
| what serotypes of adenovirus cause acute respiratory distress and pneumonia (3) |
|
Definition
|
|
Term
| what are the respiratory signs of adenovirus (6) |
|
Definition
acute respiratory distress
pneumonia
fever
cough
pharyngitis
cervical adenitis
atypical pneumonia if it progresses |
|
|
Term
| who is the respiratory form of adenovirs normally seen in |
|
Definition
| children, military, college students |
|
|
Term
| who is the most common population to get epiglottis |
|
Definition
|
|
Term
|
Definition
| inflammation of the epiglottis and or subepiglottic tissues surround it |
|
|
Term
| what is the cause of epiglottis |
|
Definition
| H. influenza B penetrates the mucosa and gets into the blood stream |
|
|
Term
| what are the signs of epiglottis (7) |
|
Definition
| abrupt onset, pain, aiway obstruction, dysphagia, respiratory distress, drooling, anxiety |
|
|
Term
| why has there been less epiglottis cases |
|
Definition
|
|
Term
| H. influenza B: stain type |
|
Definition
|
|
Term
| H. influenza B virulence factors (4) and a basic explination for each |
|
Definition
polysaccharide capsule: BEST. identifies serotype. has polyribitol phosphate
pili: allow for colonization
cell wall (LPS)
IgA proteases: break up IgA |
|
|
Term
| what does the influenza vaccine work on |
|
Definition
| polyribitol phosphate in the polysaccharide capsule |
|
|
Term
| what do you need to do when someone comes in with epitlottitis (2) |
|
Definition
maintain airway: endotracheal indubation if needed
radiograph of lateral neck can show enlarged epiglottis |
|
|
Term
| what are the two causes of laryngitis |
|
Definition
| M. TB, corynebacterium diptheriae |
|
|
Term
| how is TB laryngitis acquired |
|
Definition
| sputum from protracted active TB is coughed up |
|
|
Term
| how does corynebacterium cause laryngitis, what complication can this process have |
|
Definition
| exotoxin causes pseudomembrane that can cause obstruction and aspiration in major airways |
|
|
Term
| corynebacterium diptheriae: stain type, shape, reproduction, growth condition |
|
Definition
gram positive rod
club shaped
aerobic
non-spore forming |
|
|
Term
| corynebacterium diptheriae virulence factor, how does it work |
|
Definition
| A-B toxin inhibits protein synthesis by inactivating elongation factor 2 from pseudomebrane making it hard to breathe |
|
|
Term
| how is corynebacterium diptheriae transmitted |
|
Definition
|
|
Term
| what are the three ways corynebacterium diptheriae can present |
|
Definition
cutaneous (usualy in developing countries)
upper respiratory infection
systemic complications |
|
|
Term
| what does the corynebacterium diptheriae exotoxin cause to happen in the body |
|
Definition
necrosis of mucosa
fibrinopurlent exudate
pseudomembrane gray
malaise
sore throat
systemic: myocarditis, recurrent laryngeal nerve palsy |
|
|
Term
| corynebacterium diptheriae diagnosis (3) |
|
Definition
| clinical, culture, PCR to detect toxin (tox gene) |
|
|
Term
| corynebacterium diptheriae: what is it cultured on, how does it work |
|
Definition
cysteine-tellurite blood agar (CTBA)
tellurite inhibits growth of other upper respiratory bacteria dn gram negative rods
corynebacterium diptheriae reduces it making gray black color containing tellurite |
|
|
Term
| corynebacterium diptheriae treatment and prevention (3) |
|
Definition
penicillin/erythromycin
antitoxin
vaccine: DPT |
|
|
Term
| what is another name for laryngotracheobronchitis, what is the causative agent |
|
Definition
|
|
Term
| what are the signs of croup (3) |
|
Definition
inspiratory stridor and harsh persistant cough
occasional: inflammation closes airway causing respiratory failure |
|
|
Term
| what causes the symptoms of croup (2) |
|
Definition
| laryngeal and subepiglottic inflammation |
|
|
Term
| parainfluenza: type of virus, genome type, envelope? |
|
Definition
paramyxovirus
-ssRNA
enveloped |
|
|
Term
| where does parainfluenza go in the body (3), what is the chance it will spread to each area |
|
Definition
| epithelial cells of upper respiratory, 25% spreads to lower respiratory, 2-3% spreads causing severe form laryngotracheobronchitis |
|
|
Term
| how is parainfluenza diagnosed |
|
Definition
| RT-PCR of respiratory secretion |
|
|
Term
|
Definition
hoarsness
seak bark bough
tachypnea
tachycardia
subepiglottal swelling that can close airway |
|
|
Term
| what is the incuvation period or parainfluenza |
|
Definition
|
|
Term
| what are the 6 types of lower respiratory infections |
|
Definition
pertussis
TB
lobar pneumonia
bronchopneumonia
interstitial pneumnia
aspergillosis - opportunistic |
|
|
Term
| bordetella pertussis: aka, stain, shape, growth conditions, transmission |
|
Definition
whooping cough
gram negative
coccabacillus
aerobic
respiratory droplets |
|
|
Term
| who is at the greatest risk for pertussis, why |
|
Definition
| kids less than 1 yo due to lack of immunity |
|
|
Term
| what is the virulence factor of pertussis |
|
Definition
| pertussus toxin (A-B toxin) |
|
|
Term
| what is the incubation time for pertussi |
|
Definition
|
|
Term
| what are the three stagesof pertussis |
|
Definition
cararrhal
paroxysmal
convalescence |
|
|
Term
| where does pertussis go in the body |
|
Definition
| attach and proliferate on cilliated epithelial cells |
|
|
Term
| pertussis incubation time and symptoms |
|
Definition
|
|
Term
| pertussis catarrhal time and symptoms (5) |
|
Definition
1-2 weeks
rhinorhea, malaise, fever, sneezing, anorexia |
|
|
Term
| pertussis paroxysmal time and symptoms (3) |
|
Definition
2-4 weeks
repetitive cough with woppos, vomiting, leukocytes |
|
|
Term
| pertussis convalescent time and symptoms (4) |
|
Definition
diminished cough
secondary complications: pneumonia, seizures, encephalopathy |
|
|
Term
| when is the best time to treat pertussis, why |
|
Definition
| catarrhal phase because the bacteria are in the highest concentration |
|
|
Term
| what media is pertussis cultured on (2) |
|
Definition
| reagan-loew charcoal medium or border-gengous media |
|
|
Term
| how is pertussis diagnosed (3) |
|
Definition
culture
direct immunoflourescence
PCR |
|
|
Term
| how is pertussis treated and prevented |
|
Definition
supportive care
erythromycin or macrolides before paroxysmal phase
DTaP vaccine |
|
|
Term
| how long does th DTaP vaccine last |
|
Definition
|
|
Term
| what is in the DTaP vaccine from pertussis (3) |
|
Definition
| inactivated pertussis toxin, filamentous hemagglutinin, peractin |
|
|
Term
| what does the a in DTaP stand for |
|
Definition
|
|
Term
| mycobacterium TB: growth conditions, shape, reproduction |
|
Definition
non spore forming
aerobic
thin rods |
|
|
Term
|
Definition
facultative intracellular in alveolar macrophages
mycolic acid (antiphagocytic)
inhibit fusion of phagosome with lysosome |
|
|
Term
| how is mycobacterium cultured and stained |
|
Definition
acid fast stain
lowenstein jensen medium |
|
|
Term
| what are the signs of TB in the lungs (4) |
|
Definition
granuloma
tubercles
ghon complex
extrapulmonary tubercles |
|
|
Term
| what are the initial clinical signs of TB |
|
Definition
| malaise, weight loss, cough, night sweats, hemoptysis |
|
|
Term
| why in TB do tubercles form, what are they, what causes them |
|
Definition
| granulomas leave fibrotic calcified scars with a few dormant bacilli |
|
|
Term
|
Definition
| calfified pulmonary tubercles and hilar LNs |
|
|
Term
| what causes extrapulmonary tubercles in TB |
|
Definition
| dissemination of the microbe |
|
|
Term
| why do granulomas form in TB, what is in it, what does this cause clinically |
|
Definition
prevents futher spread of bacteria
dormant TB that can remain in this stage and be reactivated later via immune response |
|
|
Term
| what makes a granuloma (4) |
|
Definition
| necrotic mass surrounded by dense wall of CD4, CD8, NK cells, macrophages |
|
|
Term
| what are the three forms of TB |
|
Definition
primary infection with resolution of progression
reactivation
dissemination (military) TB |
|
|
Term
|
Definition
radiographic evidence of pulmonary disease
positive skin test
lab detection of mycobacterium |
|
|
Term
| what are the 5 initial signs of pheumonias |
|
Definition
| faver, malaise, leukocytosis, fatigue, dyspenia |
|
|
Term
| how can you tell is a pneumonia is bacteria (3) |
|
Definition
productive cough
mucopurlent sputum
hemorrhagic sputum |
|
|
Term
| how can you tell is pneumonia is interstitial (viral/mycobacterial) (2) |
|
Definition
dry cough no expectoration
atypical pneumonia |
|
|
Term
| what causes lobar pneumonia, what causes symptoms |
|
Definition
S. pneumonia
intra-alveolar exudates - may involve entire lobe |
|
|
Term
| S. pneumonae: stain type, shape, 2 features allowing for diagnosis |
|
Definition
gram positive
diplococci
catalase negative
a-hemolytic |
|
|
Term
| S. pneumoniae virulence factors (3) |
|
Definition
polysaccharide capsule
pneumolysin
IgA protease |
|
|
Term
| what is the most common cause of community acquired acute pneumonia |
|
Definition
|
|
Term
| bronchopneumonia: 3 causes, location in lungs, cause of symptoms |
|
Definition
S. aureus, H. influenzae, klebsiella
patchy distribution
inflammatory infiltrates from bronchioles go to adjacent alveoli |
|
|
Term
| who is at risk for S. aureus (5) |
|
Definition
nososomal (usually MRSA)
immune compormised
iv drug users
alcoholic
postviral |
|
|
Term
| what complications can S. aureus cause |
|
Definition
|
|
Term
| H. influenzae: encapsulated?, what disease does it cause (2) |
|
Definition
both encapsulated and unencapuslated
causes CA-pneumonia and bacterial acute exacerbation of COPD |
|
|
Term
| klebsiella pneumoniae: stain type, shape, growth requirements, transmission |
|
Definition
gram negative
rod
ferments lactose
endogenous spread |
|
|
Term
| klebsiella pneumoniae virulence (2) |
|
Definition
|
|
Term
| what does klebsiella pneumoniae do to the body (3) |
|
Definition
necrotic destruction of alveolar spaces
formation of cavities
production of blood tinged sputum |
|
|
Term
| interstitial pneumonia causes (6) |
|
Definition
RSV
adenovirus
infleunza
mycoplasma
legionella
chalmydia |
|
|
Term
| what is the composition of the cell wall of mycoplasma |
|
Definition
| no cell wall, membrane has sterols that come from exogenous sources because bacteria cannot make them |
|
|
Term
| how is Mycoplasma pneumoniae transmitted |
|
Definition
|
|
Term
| mycoplasma pneumoniae: virulence factors (4) |
|
Definition
| P1 adhesin: adheres to respiratory epithelium, inhibits cillia which destories cells, causes sloughing |
|
|
Term
| what conditions does mycoplasma pneumonia cause (2) |
|
Definition
tracheobronchitis
atypical pneumonia (walking pneumonia) |
|
|
Term
| tracheobronchitis: incubation time, signs (5) |
|
Definition
2-3 weeks
low grade fever, malaise, headache, dry non productive cough, pharyngitis |
|
|
Term
| what are the effects of mycoplasma pneumoniae through out the progression of the disease 95) |
|
Definition
loss of cilliated epithelial cells
URT and LRT contaminated and irritated
prolonged cough
superantigen furthers inflammatory response
bronchial passages infiltrated with lymphocytes and plasma cells |
|
|
Term
| how is mycoplasma pneumpniae diagnosed ((3) |
|
Definition
|
|
Term
| what is mycoplasma pneumoniae cultured on, what do they look like |
|
Definition
mulberry shaped colonies on media with sterols
Eaton's agar |
|
|
Term
| how is mycoplasma pneumoniae identified in serology |
|
Definition
| cold agglutins (antibodies bind RBC antigens at 4C |
|
|
Term
| legionella pneumophila: stain type, type of microbe, growth requirements (3), virulence |
|
Definition
gram negative
pleomorphic
obligate aerobe, facultative intracellular
inhibit phagolysosome fusion |
|
|
Term
| what cells does legionella pneumophila live in in the body (2), what about when it isnt in us |
|
Definition
nature: free living amoebae
in us: monocytes, alveolar epithelial cells |
|
|
Term
| how can we get legionella pneumophila, what are three factors that increase risk |
|
Definition
natural bodies of water, ait conditioning cooling towers and consensers, water heaters
contaminated aerosols, biofilms, pipe systems
at risk: smoker, immune compormized, COPD |
|
|
Term
| legionella pneumophila: 3 conditions it causes |
|
Definition
asymptomatic
pontiac fever
legionnaires disease |
|
|
Term
|
Definition
|
|
Term
| legionares disease: clinical, film, histology signs |
|
Definition
severe pneumonia
multilobar
x-ray evidence
inflammation and microabscess in lung tissue |
|
|
Term
| lab diagnosis of legionella pneumophila (3) what agar |
|
Definition
antigens in urine
ailver stain
culture on buffered charcoal yeast extract agar |
|
|
Term
| chlamydophila pneumoniae: stain type, growth requirements, transmission |
|
Definition
gram negative
obligate intracellular
respiratory secretions |
|
|
Term
| chlamydophila pneumoniae signs (2) |
|
Definition
asymptomatic
mild to severe atypical pneumoniae |
|
|
Term
| how can you distinguish chlamydophila pneumoniae from mycoplasma, legionella or viruses |
|
Definition
| giemasa stain for cytoplasmic inclusions in sputum |
|
|
Term
| aspergillus fumignatus: what does it look like |
|
Definition
| monomorphic, branches, septate hyphae with conidial heads branching at acute angles (45deg) |
|
|
Term
| who is at risk of aspergillus fumignatus infection (2) |
|
Definition
| immune compormized and neutropenic patients |
|
|
Term
| aspergillus fumignatus signs |
|
Definition
obstructuve bronchial fungal ball plugs composed of hyphal elements and mucinous material
usually asymptomatic
can lead to pulmonary hemorrhages may need surgical removal |
|
|
Term
| what are the two forms of aspergillus fumignatus infection |
|
Definition
| invasive pulmonary or disseminated aspergillosis |
|
|
Term
| how is aspergillus fumignatus diagnosed (2) |
|
Definition
skin biopsy with stain
CT with halo sign infiltrate around nodular densities, air crescent marks recorvery phase |
|
|
Term
| what is the treatment for aspergillus fumignatus (2) |
|
Definition
aspergilloma - surgery
amphotericin B |
|
|
