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IBI Test 2 > B3-030 - URTI > Flashcards

B3-030 - URTI Flashcards

(72 cards)

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1
Q

Nasopharyngitis

A

Inflamed nasal and pharyngal passages.
Rhinoviruses: 30-50% chance cause of colds
Also caused by coronaviruses, enteroviruses, adenoviruses, ortho/paramyxoviruses, RSV,mHPV, EBC, bocavirus

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2
Q

Pharyngitis

A

Common “sore throat”
Viral: adenovirus, Influenza viruses, Coxsackie, HSV, EBV, CMV
Bacterial: Group A strep (GAS: sequelae), GCS/GGS, N. gonorrhoeae, C. diphtheria, atypical pneumonia bacteria

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3
Q

Rhinosinusitis

A

Inflammation of nasal mucus membranes
Viral: Rhinovirus, enterovirus, coronavirus, influenze, parainfluenza, RSV, Adenovirus
Bacterial: S. pneumonia, H. Influenza, M. catarrhalis, S. aureas

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4
Q

Epiglottitis

A

Inflammation of the base of tongue
Entirely bacterial: H. influenza type b (Hib), GAS s. pneumonia, M. catarrhalis

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5
Q

Laryngotracheitis

A

An upper airway infection that blocks breathing and has a distinctive barking cough.
Croup: parainfluenza
Whooping cough: B. pertussis
Other bacteria: GAS, C. diphtheria, C. pneumonia, M. pneumonia, M. catarrhalis, H. Influenza

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6
Q

Which branch of the bacterial tree of life does Moraxella fall on?

A

Gram - cocci

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7
Q

Which branch of the bacterial tree of life does Bordetella fall on?

A

Fastidios, gram - rod

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8
Q

Which branch of the bacterial tree of life does Corynbacterium fall on?

A

Acid-fast, gram + rod

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9
Q

Which branch of the bacterial tree of life does Streptococcus fall on?

A

Gram + cocci

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10
Q

Lancefield method

A

Serology typing via surface carbohydrates
Group A/B strep

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11
Q

Group A streptococci (GAS)

A

S. pyogenes, strep throat
Beta-hemolytic

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12
Q

Group B streptococci (GBS)

A

S. agalactiae. Neonatal infections, bacteremia
Beta. hemolytic

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13
Q

Alpha hemolytic streptococcal species

A

Viridians streptococci: S. mutans (dental carries, endocarditis
Strep. pneumonia: pneumonia, otitis, meningitis

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14
Q

Gamma hemolytic streptococcal species

A

Entercoccus

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15
Q

GAS S. pyogenes host

A

Humans are primary host

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16
Q

GAS S. pyogenes transmission

A

Direct contact or respiratory droplets (sneezing and coughing)

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17
Q

(Low or High) inoculum can lead to S. pyogenes infection

A

Low

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18
Q

GAS S. pyogenes invades ______ of new host

A

Mucus mucous membranes

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19
Q

GAS S. pyogenes diseases of Respiratory tract

A

Strep throat and pharyngitis

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20
Q

GAS S. pyogenes diseases of skin

A

Impetigo, Erysipelas/cellulitis (infection of dermis), Necrotizing fasciitis (infection of subcutaneous tissue)

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21
Q

GAS S. pyogenes systemic disease

A

Bacteriemia, Rheumatic fever, acute glomerularnephritis, streptococcal toxic shock syndrome

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22
Q

Most common cause of bacterial infection of the throat

A

GAS S. pyogenes
Difficult to differentiate form viral pharyngitis

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23
Q

__% of people are asymptomatic carriers of GAS S. pyogenes

A

5%

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24
Q

Treatment for Acute streptococcal pharyngitis

A

Pens, 30% are resistant to macrolides

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25
Scarlet fever
Complication of GAS pharyngitis Infecting strain makes SpeA/SpeC exotoxins Diffuse "sand paper" rash on chest Raw, strawberry tongue, desquamation Circumoral pallor (pale skin around mouth) Can lead to rheumatic fever or glomerularnephritis
26
GAS Virulence Factors
Adhesions: - M protein: >160 serotypes - Protein F: binds fibronectin Lipoteichoic acid (LTA) Hylauronic acid capsule: - Makes GAS look like host - Often inactivates hyalyronidase Streptolysin O (SLO): - Pore forming toxin, lyses target cells Streptococcus pyrogenic exotoxin (Spe): - Superantigen. Cause of scarlet fever and TSS Streptokinase: - activate plasminogen to dissolve clots
27
Treatment for GAS pharyngitis
Strep throat: Amoxicillin Cellulitis: pens, ceftriazone Bacteriemia/TSS: Pens + clindamycin
28
GAS do not produce _____
Beta-lactamase
29
How many cases of "strep throat" turn out to be viral pharyngitis?
70-85%
30
Strep Test: Rapid Antigen detection test (RADT) look for ____
Group A capsule antigen
31
If RADT is negative, what is the next step
Culture on Sheep's blood agar (more sensitive to ensure the negative wasn't a false negative)
32
Characteristics of Corynebacterium
Related to Nodarcia and Mycobaterium Gram postive rod Non-motile, aerobic Club shaped on Loftier medium V&L shaped arrangements
33
C. diptheriae is ____ toxic and _____ invasive
highly; poorly
34
Diphtheria Toxin B targets
Upper resp. Tract Heart Nerve cells
35
Diphtheria Toxin A role
Subunit of ADP-ribosylates elongation factor Shuts down protein synthesis
36
What does the diphtheria vaccine consist of?
Toxoid (inactivated toxin) the D in DTaP, Td, and Tdap tests. (Capital letter means higher dose)
37
Respiratory Diptheria
Pseudomembranous Pharyngitis - Less than 1 week incubation (colonization of pharyngal epithelial cells Toxin secretion: sudden onset of malasia, sore throat, low-grade fever, exudative pharyngitis Grayish psudomembrane and Bull neck
38
Grayish psudomembrane
Bacteria, lymphocytes, plasma cells, fibrin, dead cells - hard to dislodge without bleeding May lead to asphyxiation
39
Complications of respiratory diptheria
Myocarditis, neuopathies
40
Cutaneous Diphtheria
Skin contact with infected persons Papule -> non-healing ulcer (with grayish membrane) Systemic disease due to exotoxin spread
41
Lab diagnosis of C. diphtheria
Growth on Tellurite-containing Chocolate agar (inhibits other bacteria) -Chocolate Agar (laded RBC) is reduced by C. dip and produces black pigment colonies
42
Elek test
Demonstration of toxin from C. diphtheria by agar diffusion with antitoxin
43
True of False: PCR can be used to detect C. diphtheria
True
44
Prevention/Treatment of C. Diphtheria
Vaccination : DTaP with booster every 10 years Immediate use of antitoxin DOC: erythromycin or pens
45
Infection of C. diphtheria does not generate _________
protective antibodies
46
Where is C. diphtheria endemic
Asia, Africa, South America, Haiti, Dominican Republic
47
Monospot test for C. diphtheria will come back
negative
48
C. jeikeium
Nosocomial skin opportunist Risk factors: extended hospital stay, antimicrobial therapy, chemotherapy, IV Cath MDR Treat with Vancomycin
49
C. urealyticum
endogenous UTI pathogen Urease producer - renal stones Risk factors: immune suppression, Abx MDR Treat with Vancomycin
50
Where is Moraxella catarrhalis found
Commensal organism found in the nasopharynx
51
Clinical presentation of Moraxella catarrhalis
Healthy individual: OM, sinusitis, Laryngitis Underlying lung disease: Bronchitis, pneumonia
52
Moraxella catarrhalis Micro-Characteristics
Non-motile, Non-fermentative, oxidase +, gram negative Diplococcus
53
Moraxella catarrhalis Pathogenesis
DIrect contact with contaminated secretion (snot) or respiratory droplets Pili/Fimbriae: adhesion Endotoxin (LPS)
54
Clinical presentation of Moraxella catarrhalis
3rd most common cause of OM, sinusitis Endocarditis Risk factors: immunodeficiency, chronic respiratory conditions (COPD, SLE, CF)
55
Moraxella catarrhalis Lab diagnosis
Looks just like Nisseria on Gram stain Pink-brown color on chocolate agar Does not ferment!!!
56
Moraxella catarrhalis Treatment
>95% resistant to pens (has a B-lactamase) so use Pen + b-lac inhibitor Can also use macrolides, Fluoroquinolones, tetracyclines Unable to test for susceptibility
57
Bordetella Micro-characteristics
Very small gram negative bacilli, strictly aerobic, non-fermentative
58
Human pathogen of Bordetella
B. pertussis (Whooping cough)
59
B. parapertussis
mild form of pertussis
60
Bordetella Adhesions and Toxins
Adhesions: filamentous hemagglutinin (Fha) Pertactin Toxins: B: binds to glycolipids in ciliated resp cells A: increase cAMP levels
61
B. pertussis pathogenesis
1. Infection via aerosols 2. Adhesion to ciliated epi (Fha) 3. Toxin production - increased cAMP 4. Inhibits ciliary movement, extrusion of ciliated cells (increased resp secretion and mucus production) 5. Paroxysmal cough (whooping)
62
Catarrhal stage of B. pertussis
Highly infectious 1-2 weeks
63
Paroxysmal stage of B. pertussis
Whooping cough 1-6 weeks (can last up to 10 weeks)
64
Convalescent stage of B. Pertussis
Susceptible to other infections 2-3 weeks Recovery is gradual. Coughing lesses but firs of coughing may return
65
B. pertussis epidemiology
Humans are the only reservoir (30% carriers) Transmitted via resp droplets Mainly pediatric (less than 1 yr)
66
B. pertussis vaccine
DtaP (aP = acelular pertussis) Contains verified proteins of adhesion molecules and toxoid) Also found in Tdap. Single dose of Tdap after DTaP rounds.
67
Pertussis treatment
Macrolides are effective in early stages PPX for close contacts for 14 days, no matter age or vaccination status Supportive measures after paroxysmal stage
68
Pertussis Lab
Culture: sensitive to drying (either special transport medium to immediate inoculation) Nasal swap only works for Catarrhal stage (after that, disease is toxin driven) Growth on Regan-Lowe DFA - insensitive PCR: catarrhal/early paroxysmal Serology: paroxysmal, convalescent
69
Flu vs Covid: Symptoms
Both: fever, chills, headache, myalgia, anorexia, cough Covid only: shortness of breath, loss of smell/taste, nausea, diarrhea
70
Flu vs Covid: Incubation
Flu: 1-4 days of illness, 2-5 days viral shedding Covid: 2-14 days incubation, 2-6 weeks of illness, shedding ending around day 10
71
Flu vs Covid: Transmission
Flu and Covid: large droplets mainly, possible fomites or small droplets
72
Flu vs Covid: Complications
Both: Viral pneumonia, myocarditis, sepsis/shock Flu: secondary bac pneumonia, croup, COPD exasperation Covid: thrombosis/stroke, pulmonary fibrosis

IBI Test 2 (5 decks)

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