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Respiratory II > Micro: Upper Respirator Infections > Flashcards

Micro: Upper Respirator Infections Flashcards

1
Q

List three normal flora of the URT

A

Diptheroids (not C.dip)
Alpha and Gamma Streps
Neisseria spp.

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2
Q

What is the most common infection of the URT seen in ADULTS ?

A

Sinus infections (chronic sinutsitis)

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3
Q

What is/are the most common URT infections seen in Children >

A

Pharyngitis

Acute Otitis Media

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4
Q

What are the three leading risk factors for children with acute otitis media ?

A

Daycare
Sibling with otitis media
Parents who smoke

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5
Q

What are signs of otitis media in children who cannot communicate verbally ?

A 
Crying
Irritability
Anorexia 
Lethargy
TUGGING ON EAR

In older patients:
Vertigo
Fever
tinnitus

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6
Q

What is the most common bacteria associated with Otitis Media ?

A

S. pneumo (50%)

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7
Q

Describe S. pneumo’s profiler pertaining to lab diagnostics and staining

A 
Gram + diplococci
Alpha Hemolytic 
Optochin Sensitive 
Bile Soluble
Encapsulated
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8
Q

What is the major virulence factor associated with S.pneumo ?

A

Polysaccharide Capsule

Evasion of host immune system

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9
Q

PPSV23

A

Polysaccharide vaccine for S.pneumo

Given to all adults 65 and older
certain risk in younger patients

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10
Q

PCV7

PCV23

A

Conjugated (to protein) vaccine for S. pneumo

Given to patients 6 weeks - 71 months. old,
Not recommended for healthy patients
Given to 19 yo + who are IC.

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11
Q

Haemophilus influenza (non-typeable) is the second leading cause of otitis media. Characterize it based on lab findings and diagnostics.

A

Gram - Coccobacillus
Grows on Chocolate agar with Factor V and X (NAD and Hemin)

Typicallly encapsulated

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12
Q

Does the form of H. influenzae which caused otitis media have a capsule ?

A

NO ! Although the main virulence factor for H.influenzae is the capsule, the strain that causes otitis media does not ! (non-typeable)

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13
Q

Descrbe the lab findings and diagnostics for Moraxella catarrhalis. ( another cause of Otitis media)

A

Gram - Diplococci

Betalactamase + ( Major virulence factor break down penicilins etc)

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14
Q

Most external ear infections are caused by which organism ?

A

Pseudomonas aeruginosa

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15
Q

What environmental conditions are associated with higher risk for Pseudomonas infection ?

A

Hot humid climates
Hot tubs (hot tub folliculitis)
Anywhere in which water is abundant.

Pierced ears can lead to necrotizing infections of the ear

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16
Q

Describe the lab diagnostics of Pseudomonas aeruginosa

A 
Gram - Rod
Non-fermenter
Grows on MacKonkey (blood and chocolate)
Oxidase +
Green/blue pigment with a grape like smell.
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17
Q

Describe the epidemiology of Streptococcal Pharyngitis (compare to viral pharyngitis)

A 
Winter/Early Spring
Ages 5-11
Abrupt onset
Fever
Sore throat
ABDOMINAL PAIN, NV
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18
Q

Describe the epidemiology of Viral Pharyngitis

A 
Year long
All Ages
Cold like symptoms (not such an abrupt onset)
Variable febrile state
Mild sore throat
MYALGIA and ARTHRALGIA
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19
Q

Describe the lab diagnostics for S.pyogenes

A

G+ Cocci
Catalase +
Coagulase -
Beta hemolytic

Bacitracin Sensitive.
PYR + (As is enterococcus

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20
Q

What is the main virulence factor for S.pyogenes in regards to Rheumatic Fever and nephritis ?

A

M- Protein

Cross reacts with heart, joint and neural tissue –> Rheumatic symptoms
Can form immune complexes leading to acute glomerulonephritis.

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21
Q

Streptolysin O allows S.pyogenes to lyse what kind of cells ?

A

RBC’s thus making it beta-hemolytic

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22
Q

Describe the physical findings of a Streptococcal pharyngitis

A 
Pharyngeal erythema and exudate*
Tender enlarged anterior cervical nodes*
Palatal petechiae*
tonsillar hypertrophy
Scarlett fever
Absence of cough rhinitis hoarseness conjunctivitis and diarrhea
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23
Q

T or F :Rheumatogenic strains of S.pyogenes can also infect the skin

A

F. Rheumatogenic strains are associated with ARF

pyodermal strains are more associated with Acute Glomerular Nephritis.

24
Q

Rheumatic strains of S.pyogenes have tropism for which host antigens ?

A

Cardiac Myosin
Sarcolemma membrane protein
Synovium
Articular cartilage

25
Q

Aucte post streptococcal glomerulonephritis occurs how many days after pharyngitis occurs ?

A

10 (With nephrogenic strains . Can be pyodermal or pharyngitis.

26
Q

Describe the findings in Nephritis syndrome :

A 
Hematuria (cola-colored)
Proteinuria 
Edema (abdomen, feet, hands)
Hypertension
Fever NV.
27
Q

Diagnosis of S. progenies pharyngitis can be easily achieved by ..

A

Rapid strep test (looks for ASO and Anti-DNase B etc)
Streptozyme test is all inclusive.

No need for culture

28
Q

What virulence factors of S.pyogenes are responsible for Scarlett Fever ?

A

Pyrogenic Exotoxins (A,B,C and F –> Strawberry Tongue and Sandpaper rash

29
Q

Lysogenized strains of S.pyogenes produce two forms or pyrogenic exotoxin that are also super antigens. What are these two ?

A

A and C

30
Q

C.diptheria are gram + rods with club like swellings at the ends known to cause diphtheria. However not all C.dip are capable of causing this disease. What must be present for this to occur ?

A

Presence of the Tox gene.

Carried by prophage that infects cells and passes the gene for diphtheria toxin.

31
Q

C.dip also carry a toxin repressor, DTxR. What is required for this repressor to work ?

A

Iron

Low iron, low repressor ability.

32
Q

What cells does the diphtheria toxin target and how does it achieve its cytoxic activity ?

A

Myocytes

It is an AB toxin, the A portion target EF-2 and halts protein transcription.

33
Q

Describe the signs and symptoms of C.diptheria infection

A

Sort throat

Low grade fever, malaise

Pseudomembrane ( white to begin, then grey with patches of green and black necrosis that bleeds upon touching)

Cervical Adenopathy (bull neck)

34
Q

What should you ask when you suspect a patient may have diphtheria ?

A

Immunized ?

History of travel (or from another country)

35
Q

What type of media will C.dip grow on >

A

Loefflers agar or Tellurite Selective Media

36
Q

Treatment for C.dip includes

A

Anti-toxin immediately followed by
Penicillin or erythromycin.
Re-vacinnation !

37
Q

The vaccine for C.dip produces Ab’s for what product of the bacteria ?

A 
The toxin !
DTaP--> Children get 5 doses.
Tdap--> adolescents.
DT--> No pertussis
Td --> 10 year booster adolescents and adults
38
Q

Epiglottitis

A

Acute severe cellulitis of the epiglottis. A TRUE EMERGENCY !

Abrupt onset
Acute inflammation
Edema and infiltration of PMN’s

39
Q

Causitive agents of Epiglottitis

A

H.influenzae B
S. aureus
S. pneumoniae
S.pyogenes

40
Q

Describe the Lab Diagnostics associated with H.influenzae (asked previously just not in as much detail) which causes epiglottitis

A

Gram - Coccobacilli

Grows on Chocolate Agar (Factor V and X)

Polysaccharide Capsule ( vaccine if for Type B capsule but now Type C and F are common)
   Most important virulence factor 
   Others include IgA protease and endotoxin.
41
Q

Which population is most often associated with H. influenza epiglottitis >

A

Boys age 2-3

42
Q

Describe H.influenzae epiglottitis

A

High fever, sitting forward and drooling “Catchers Stance”
Cherry Red Epiglottis
Tachypnea
Stridor and rhonchi on auscultation

43
Q

What is the main differential difference between epiglottitis due to influenza and parainfluenza ( or pertussis)

A

Barking cough is usually not present in patients with H. influenzae epiglottitis

44
Q

PRP-HbOC

A

Conjugated HiB with nontoxic diphtheria toxin

45
Q

PRP- OMP

A

conjugated with outer membrane protein of neisserria meningitidis

46
Q

PRP-T

A

conjugated with tetanus toxoid

47
Q

PRP-D

A

conjugated with diphtheria toxoid.

48
Q

What is the causative agent of Whooping Cough ?

A

Bortadella pertussis (G -, coccobacillus

49
Q

The B. pertussis virulence factors filamentous hemaglutinin and pert actin allows for binding to which kind of cells ?

A

Cilliated cells in trachea.

50
Q

Pertussis toxin causes what to occur within the cell ?

A

ADP ribosylation of Gi ( inactivates Gi which is usually the break to most Gprotein activities –> increased cAMP production.)

51
Q

Haemophilus aegyticus (aka Koch-Weeks bacillus) causes what ?

A

Conjunctivitis

52
Q

The B.pertussis virulence factor ‘adenylate cyclase toxin’ causes and increase in which process ?

A

conversion of ATP –>cAMP

53
Q

Who is most at risk for contracting pertussis ?

A

Those who are not immunized (90% of patients)

Infants 3-6 months old.

54
Q

What is the media that B.pertussis will best grow on ?

A

Regan Lowe Charcoal Medium

(naspharyngeal aspirate is better than others for this)

55
Q

What is the DOC for B.pertussis ?

A

Erythromycin for 14 days.

56
Q

T or F :Bortadella parapertusis produces pertussis toxin

A

F.

57
Q

Bortadella bronchoseptica is also known as …

A 
kennel cough (in dogs)
Snuffles (in rabbits )

Rarely affects humans

Respiratory II (8 decks)

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