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Flashcards in 5 respiratory diseases Deck (132):
1

what produces aerosols?

speaking, singing, normal breathing

2

respiratory droplets

largest fall to the ground in a few meters

3

droplet nuclei sizes

1-4 microns, can travel long distances + reaches the lower respiratory tract

4

what is the most common site for infections

respiratory tract

5

what results in more visits to physicians than any other diagnosis

upper respiratory infections

6

respiratory infections

-usually mild, common, and taken for granted
- immense disease burden have a major economic impact

7

how many days of restricted activity/ year due to influenza like illnesses

more than 400 million

8

severe consequences for people with respiratory infections, especially in people

compromised by other diseases

9

why are respiratory infections so common?

-direct contact with the environment
-continuously exposed to bugs in the air we breathe
- some are highly virulent and may infect a normal person even in small numbers
-most do not cause infection unless other factors interfere with host defenses

10

air is full of

particulate matter, bacteria, fungi, + viruses

11

how many breaths / day?

12-20 breaths / min * 60 min * 24 hrs= 17,280 - 28,800 breaths/day

12

how many influenza particles in a gram or cc of water

100-1000 particles 80-120 nm in diameter so 100 trillion particles in a gram of cc of water

13

*defense mechanisms of the respiratory tract

-airway + reflexes
- the mucociliary escalator
- alveolar macrophages

14

airway + reflexes

-changes in direction of airflow
-laryngeal spasm reflex; coughing

15

the mucociliary escalator

mucus (lysozyme, secretory IgA antibodies) + cilia
-goblet cells secrete mucus w/ antibacterials

16

cilia

moves mucus in outward direction

17

as particles stick to your mucus, you can get rid of it through

outward flow

18

turbinate baffles

traps small particles before it gets to your lungs

19

lymph tissues

stations where lymphocytes sit and wait to fight infections

20

alveoli

gas exchange between your blood and air

21

where are turbinate baffles located

nasal cavity

22

two main classifications

Upper respiratory infection
lower respiratory infection

23

upper respiratory infection

above the trachea

24

lower respiratory infection

below the trachea

25

*what causes the common cold

rhinovirus

26

common cold

URI
nasopharynx
rhinovirus + other pathogens

27

pharyngitis

URI
oropharynx
viruses

28

strep throat

URI
oropharynx
group A strep

29

group A strep gram

GRAM POS

30

infections of the lungs

lower respiratory tract infections

31

influenza

lung bronchi or alveoli
caused by influenza virus
LRI

32

strep pneumoniae

lung bronchi
bronchitis
LRI

33

what causes bronchitis

strep pneumoniae + hemophiilus influenzae

34

what is more life threatening, LRI or URI

LRI are generally more life threatening

35

what causes pneumoniae?

streptococcus pneumoniae (person to person)

36

legionella

environmental source of pneumonia

37

before antibiotics, what were the top causes of death

pneumonia + tb

38

what causes pulmonary tuberculosis

mycobacterium tuberculosis

39

lung abcess

mixed anaerobic + aerobic bacteria

40

classification of pneumonia syndromes

acute (sudden onset)
subacute or chronic (lasting or reoccuring pneumonia)

41

acute (sudden onset) acquired?

symptoms progress over a few days

42

how is acute (sudden onset) pneumonia acquired?

community or hospital/nosocomial acquired

43

acute (sudden onset) pneumonia that is community acquired

S. pneumoniae= person to person
L. pneumophila= environmental

44

acute (sudden onset) pneumonia hospital acquired

enteric bacteria or pseudomonas aeruginosa

45

subacute or chronic

lasting or reoccuring pneumonia

46

examples of subacute or chronic pneumonia

pulmonary tuberculosis,
fungal pneumonia + lung abcess

47

subacute or chronic pneumonia - fungal pneumonia

histoplasma, capsulatum

48

subacute or chronic pneumonia-lung abcess

walled off area to stop infection but organisms stay viable in the access But, the wall can crack and the disease can spread

49

pneumonia, infection of the

lung parenchyma

50

pneumonia

may be caused by many different pathogens, sometimes with distinctive clinical manifestations

51

is pneumonia one disease?

no, it is many diff ones that share a common anatomic location

52

104 degrees + rust color sputum

strong indicator of bacterial infection

53

consolidation

alveoli + small airways fill with dense material; lung becomes inelastic

54

bronchitis

no consolidation

55

patchy, homogenous, or generalized

ways to describe consolidation

56

what do you use to treat strep pneumoniae

penicillin

57

diplococci strep pneumoniae

dark purple; gram pos

58

gram neg

light pink

59

pneumolysin*

the most virulence factor in strep pneumoniae

60

gram pos

no LPS

61

streptococcus pneumoniae = encounter

person to person, carrier, fomites

62

streptococcus pneumoniae= entry

inhalation

63

streptococcus pneumoniae= growth and spread

grows extracellularly

64

streptococcus pneumoniae = damage

-no endotoxin
-penumolysin=toxin/virulence factor
-acute inflammation = lots of neutrophils
-fluids in the lungs

65

capsule of streptococcus pneumoniae

allows organism to resist phagocytosis by macrophages

66

alveoli in infected person with pneumonia

fluid in airsacs
-when it becomes dense, shows up in X-rays

67

stages in inflammatory process of pneumonia

1. alveoli fill with clear fluid
2. early consolidation
3. late consolidation
4 resolution

68

pneumonia = 1. alveoli fill with clear fluid

clear, serous fluid, body can't phagocytose bc of capsule

69

pneumonia= 2. early consolidation

surrouding capillaries burst so cells are filled with blood

70

pneumonia= 3. late consolidation

neutrophils are here trying to clear out infection

71

when can a person suffocate and die during pneumoni

late consolidation

72

alveolar air spaces in pneumonia

alveolar spaces are filled with purple neutrophils, trying to clear infection, but in process they can cause damage

73

major dangers of bacterial pneumonia

bacteremia may develop
-organism may spread to other organs (e.g. meninges (meningitis), heart valves (endocarditis)

74

why do you want to catch pneumonia early?

pneumonia can leak out into bloodstream causing meningitis and endocarditis

75

now that there are antibiotics, pneumonia

responds quickly to antibiotics and can have complete recovery of the lung

76

pneumonia

1 person to person (you must inhale into alveolar spaces)
2 extracellular
3 capsule

77

legioneires disease is caused by what bacteria

legionella pneumophila

78

what causes legioneires disease

water; aerosols from the AC if it contaminated with legionella

79

what does legionella colonize?

plumbing systems

80

what can contaminate dental unit water systems

legionella

81

legionella= ecounter

contaminated water

82

legionella= entry

inhalation

83

is legionella killed by macrophages?

NO, it is taken up, but not killed. It grows inside macrophages

84

why can't legionella prevent phagocytosis

it does not have a capsule to prevent phagocytosis

85

legionella causes damage due

host inflammatory response

86

is legionella an intracellular organism

yes

87

legionella gram stain

gram neg with small pink rods

88

legionella is environmental via

water systems

89

legionella grows inside macrophages so does it get phagocytosed?

yes, but not killed

90

if a patient has lung abscess with pus, this is caused by

subacute pneumonia or chronic pneumonia

91

how can we protect patient from aspirating materials?

use a rubber dam

92

lung abscess - encounter

own flora

93

lung abscess entry

aspiration

94

gradual onset of a lung abscess takes how long?

4 weeks

95

lung abscess can affect people with what kind of flora

normal flora

96

actinomyces

gram pos bacilli

97

what kind of anaerobe is actinomyces?

facultative or obligate anaerobe

98

how do actinomyces grow?

in chains and appear similar to fungi but are bacteria

99

actinomyces rate of growth

slow

100

what is actinomyces associated with in dentistry

periodontitis + caries

101

polymicrobial infections

multiple species of bacteria or pathogens causing the disease example actinomyces

102

pulmonary actinomyces

rare infection of the lung

103

risk factors of pulmonary actinomycosis

poor dental hygiene
dental abscess
alcohol abuse
emphysema
scars on the lung

104

symptoms of pulmonary actinomycosis

chest pain, cough, fever, lethargy, night sweats, shortness of breath, weight loss, infection often develops slowly

105

tx for pulmonary actinomycosis

IV antibiotics 4-6 weeks

106

with slow growing organisms, antibiotic tx is very long like tb

6 mos. to a year of tx

107

actinomycosis , other sites

cervicofacial actinomycosis
abdominal actinomycosis

108

cervicofacial actinomycosis

lumpy jaw
-most common form of actinomycosis
-poort oral hygiene
-invasive dental procedure
-oral trauma

109

abdominal actinomycosis

surgery or trauma

110

pelvic actinomycosis

intrauterine devices

111

brain abscess

spread from other infected site

112

pertussis

whooping cough

113

the only vaccine preventable infection whose incidence is increasing in US

pertussis whoooping cough

114

increase of pertussis whooping cough is in

adolescents and young adults; asocaited with waning immunity

115

what vaccines needs boosters

pertussis

116

how long do people cough for after having pertussis

3 mos of high pitch coughs

117

what vaccine prevents pertussis

DTAP

118

Causative agent of pertusssis

bordetella pertussis

119

bordetella pertussis- gram

gram negative

120

bordetella pertussis

-produces toxins
-adhere to respiratory epithelium
-toxins immbolize the escalator

121

brordetella pertussis encounter

-person to person
-organism does not survive well in the environment
-highly contageous

122

bordetella pertussis entry

inhalation

123

bordetella pertussis whooping cough stages

after 3 wks, whooping cough begins and lasts up to 2 mos. In adults, the cough may be milder but persists

124

clinical manifestation of respiratory tract infection dependent upon

causative agent

125

what causes strep throat and then rheumatic fever

strep pyogenes

126

viruses mainly in upper respiatory tract

most cases of pharygitis - "srep" throat

127

bacteria mainly in

otitis media, sinusitis, pharygitis, epiglottis, bronchitis, and pneumonia

128

fungi and protozoa rarely in normal individuals but important causes of pneumonia in the

immune compromised

129

what can cause respiratory disease

airborne microorganisms

130

although open, the respiratory system is

well protected

131

bacteria have mechanisms to defeat defenses

capsule (growth within macrophages)

132

what is a risk factor

anything that impairs the defenses