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1Principles of Biomedicine - MD1 > 75 - URT Infections > Flashcards

75 - URT Infections Flashcards

1
Q

Parts of resp tract with normal microbiota

A

Paranasal sinuses

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2
Q

Examples of potentially pathogenic bacteria present in ~50% of normal resp tracts

A 
Viridans strep (greening), 
neisseria spp, 
corynebacterium spp, 
G- anaerobes, 
H influenzae (often without identifiable capsule), 
C albicans, 
strep pneumoniae
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3
Q

Examples of potentially-harmful bacteria present in resp tract of healthy people 1-10% of time

A

Strep pyogenes, meningococci

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4
Q

Uncommon potentially-harmful bacteria in resp system of healthy people

A

Enterobacteria, pseudomonas, C. diphtheriae

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5
Q

Residents of healthy resp system in latent state

A

In lung: P. jirovecii, M. tuberculosis

In lymph nodes, sensory nerves: CMV, HSV, EBV

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6
Q

Effect of diphtheria vaccination on rare diphtheria cases

A

Some rare, non-toxigenic infections of diphtheria, presenting as things like infective endocarditis.
Vaccine is a diphtheria toxoid, so evolutionary advantage to being diphtheriatoxin negative.

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7
Q

PCP

A

Pneumocystis pneumonia (pneumocystic jirovecii)

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8
Q

Why might P. jirovecii be an AIDS-defining illness?

A

Normally controlled with adaptive immunity, perhaps some in body after a mild infection.
When cell-mediated immunity is impaired, becomes a serious infection

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9
Q 
Places in the mouth that bacteria can be found
1
2
3
4
A

1) Nasal washings
2) Saliva
3) Tooth surfaces
4) Gingival scrapings

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10
Q

Are there more anaerobic or aerobic bacteria in the mouth?

A

More anaerobic

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11
Q 
URT syndromes 
1
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6
A 
Common cold
Pharyngitis/tonsilitis
Sinusitis
Otitis media
Epiglottitis
Croup (laryngotracheobronchitis, LTB)
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12
Q

What can rhinoviruses cause?

A

Rhinitis, sometimes pharyngitis

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13
Q

What can parainfluenzaviruses cause?

A

Rhinitis, pharyngitis, laryngitis, tracheitis.

Rarely bronchitis, bronchiolitis, pneumonia

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14
Q

What can H. influenzae cause?

A

Rhinitis, laryngitis, tracheitis, bronchitis, bronchiolitis, pneumonia

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15
Q

Frequent aetiological agents of the common cold

A 
Rhinovirus
Parainfluenzavirus
RSV
Enterovirus
Coronavirus
Human metapneumovirus
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16
Q

Immunity to rhinovirus

A

About 100 different serotypes.

Imperfect immunity

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17
Q

What can influenzavirus cause?

A 
Rhinitis
Pharyngitis
Laryngitis
Tracheitis
Bronchitis
Bronchiolitis
Pneumonia
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18
Q

What can pertissis cause?

A

Laryngitis, tracheitis, bronchitis, bronchiolitis, pneumonia

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19
Q

Effect of cold on resp tract infections

A

No effect on catching rhinovirus, but if you’re already infected can increase likelihood of pneumonia (cold air might inhibit mucociliary elevator)

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20
Q

What can RSV cause?

A

Rhinitis, bronchitis, bronchiolitis, pneumonia

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21
Q

Aetiological agents of pharyngitis/tonsilitis (with nasal involvement)

A

Adenovirus, enterovirus, parainfluenzavirus, influenzavirus

22
Q

When are tonsilectomies performed now?

A

Only when there is a chronic infection of the tonsils

23
Q

What does nasal involvement with an URT imply?

A

Often viral infection if there is nasal involvement

24
Q

Aetiological agents of pharyngitis/tonsilitis (without nasal involvement)

A

Adenovirus, enterovirus, reovirus, influenza.

S. pyogenes, Strep groups C and G

25
Q

Proportion of URT caused by bacteria versus viruses

A

~10-20% are bacterial.

This is higher in children (~1/3 are bacterial in children)

26
Q

Clinical criteria to distinguish between viral and bacterial URT

A

Age (children more likely to get bacterial infections)
Rash (if rash is present, bacterial)
Very hard to tell the difference normally.

27
Q

Effect of treating patient with amoxycillin who has EBV

A

Rash, so can be labelled as allergic to penicillin.
From mild toxicity.
Only occurs with active EBV (no rash with latent)

28
Q

Aetiological agents of sinusitis

A

Primary: Viral (part of common cold syndrome)
Secondary: H. influenzae, S. pneumoniae

29
Q

Secondary bacterial invasion of sinuses

A

After a viral infection, mucociliary elevator can be impaired.
Normal commensal bacteria can invade sinuses (H. influenzae, S. pneumoniae

30
Q

Common childhood URT infection

A

Otitis media (shorter, straighter otitis media)

31
Q

Frequent aetiological agents of otitis media

A

Pneumococci, H. influenzae, Moraxella catarrhalis.

32
Q

Common cause of otitis media

A

Secondary bacterial infection with commensal flora

33
Q

Frequent aetiological agent of epiglottitis

A

H. influenzae type B (not so much anymore, as there is a good HiB vaccine)

34
Q

Important URTs to be able to distinguish between

A

Croup and epiglottitis.

Croup is harmless, epiglottitis is potentially lethal

35
Q

Which aspect of a URT viral infection impairs mucociliary elevator?

A

Virus lyses infected epithelial cells, which are ciliated.

36
Q

Visual symptom of otitis media

A

Bulging, inflamed tympanic membrane

37
Q

URTIs which are good to diagnose with lab

A

Pharyngitis/tonsillitis if possible

Epiglottitis whenever possible (epiglottitis is rare)

38
Q

URTIs what don’t need a lab diagnosis

A 
Common cold.
Sinusitis (seldom necessary)
Otitis media (seldom necessary) 
Croup (seldom necessary)
39
Q

How to diagnose epiglottitis

A

Without touching epiglottis.
Epiglottis is very inflamed in epiglottitis, and touching it makes it worse, increases risk of suffocation.

Diagnose radiologically and with a blood culture (it is a systemic infection)

40
Q

What does presence of follicles in tonsillitis tell you?

A

Nothing.

41
Q

Appearance of mononucleosis in someone’s mouth

A

White membrane over pharynx

42
Q

What’s the cause of herpangina

A

Coxsackievirus.

NOT herpesvirus.

43
Q

Cause of hand, foot and mouth disease

A

Enterovirus (Coxsackievirus A16)

44
Q

Most important enterovirus

A

Poliovirus

45
Q

URTI treatment

A

Mostly supportive

46
Q

Why shouldn’t you give aspirin with a cold?

A

Aspirin is slightly immunosuppressive, increases risk of transmission

47
Q

When is pharyngitis/tonsillitis treated?

A

When bacterial. Treat to prevent complications

48
Q

Examples of possible complications with group A Strep pharyngitis/tonsillitis

A

Invasive complications with group A strep
Quinsy (peritonsillar abscess)
Autoimmune complications (rheumatic endocarditis)

49
Q

Susceptibility of group A strep

A

100% susceptibility to penicillin G (no sign of developing resistance)

50
Q

When is sinusitis treated?

A

If very severe

51
Q

When is otitis media treated?

A

In under two years old, of if infection is prolonged and severe.

52
Q

When is epiglottitis treated?

A

Always

1Principles of Biomedicine - MD1 (157 decks)

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