Ch5: URT Chaussee Flashcards
(104 cards)
1
Q
What does upper respiratory mean?
A
Above larynx
2
Q
How does number of microbes change throughout lung?
A
Very high in the mouth
Decreases as you move down the respiratory tract
None in lungs
3
Q
Where does RT become aseptic?
A
Alveolar bronchiole
4
Q
Normal flora has what role in RT?
A
Protects by competing with harmful microbes
5
Q
What bacteria are in middle ear and sinuses?
A
None, sterile
6
Q
Normal flora of URT? (50% of people or more)
A
- Corynebacteria
- Candida albicans
- Alpha-hemolytic strep
- Strep mutants
- Haemophilus influenzae
- Neisseria
- Non staph aureus staph
7
Q
Host defenses in URT?
A
- Orthogonal structure
- Saliva
- Mucin and mucus
- TLR’s
8
Q
the orthagonal structure of URT has what effect?
A
Traps microbes
9
Q
What does saliva contain? 2
A
Lysozyme
Secretory IgA
10
Q
What does mucus do?
A
Traps microbes from entering LRT.
11
Q
What sweeps mucus up and out and into stomach?
A
Ciliated epithelial cells
12
Q
Ciliated epithelial cells + Mucus = ?
A
Mucocilliary escalator
13
Q
50-70% of sore throats are caused by what in children?
A
Viruses
14
Q
What symptoms suggest a viral sore throat?
A
Conjunctivitis Coryza Ulcerative lesions Viral exanthema Diarrhea
15
Q
What percentage of adult sore throats are viral?
A
0%
16
Q
Bacterial causes of pharyngitis?
A
- Group A strep:
- Group C and G strep
- Anaerobes (bacterioides, fusobacterium, spirochetes
- Corynebacterium diptherae
- Neisseria gonorrhoea
17
Q
Which bacterial causes of pharyngitis are common?
Infrequent?
A
Group A strep = common
Group C and G strep = infrequent
Neisseria gonorrhea = infrequent
18
Q
GAS caused pharyngitis has what associations? 3
A
Tonsilitis, scarlet fever, sequelae
19
Q
What are spirochetes that cause pharyngitis?
What else are they associated with?
A
Borrelia and treponema
Trench mouth
20
Q
In terms of GAS strep throat
Onset?
Symptoms? (3)
A
- Severe pain
- Difficulting swallowing
- Flu-like
21
Q
Suppurative sequelae of GAS? 4
A
- Peritonsillar abscess
- Otitis media, sinusitis, mastoiditis
- Scarlet fever
- Streptococcal Toxic Shock Syndrome
22
Q
Scarlet fever encompasses what?
A
Peripheral rash (Maybe strawberry tongue) caused by SPE’s
23
Q
What is STSS due to?
A
Production of Spe’s that act as superantigens
24
Q
What happens if GAS is in the blood?
A
Bacteremia and toxigenic disease
25
Non-suppurative/post infection sequelae to GAS pharyngitis?
Acute rheumatic fever: Due to autoimmune
26
Why does acute rheumatic fever occur?
How long does it take to develop?
What percent of kids get it?
M protein mimics cardiac myosin
3 weeks
3%
27
Clinical diagnosis of ARF is based on what?
Jones criteria
28
ARF typically follows what type of GAS infection?
Pharyngeal
29
What is the Jones criteria requirements for GAS?
Evidence of previous GAS infection
| 2 major or 1 major + 2 minor
30
Major manifestations of ARF? 5
1. Joints
2. Heart inflammed
3. Nodules subcutaneous
4. Erythema marginatum
5. Sydenham's Chorea
31
Minor manifestations of ARF? 4
1. Previous ARF
2. Fever
3. Joints
4. Acute phase reaction
32
Laboratory obtained evidnece of previous GAS infection?
Anti-streptolysin O test
33
Besides ARF, what else is a non-suppurative post infection sequlae of GAS?
Pediatric Autoimmune Neuropsychiatric Disorders Associated WIth Strep Infections (PANDAS)
34
What causes PANDAS?
Cross reactivity between GAS antigens and neuro tissue
35
GAS may be responsible for what neuro disorders?
1. OCD
| 2. Tourettes
36
Lab diagnosis of GAS? (7)
1. Rapid diagnostic test (Ab's to GAS carb)
2. Culture throat swab
3. Beta-hemolytic
4. Gram positive
5. Catalase negative
6. Bacitracin sensitive
7. Positive PYR test
37
Treatment of all GAS children should be what?
| What about adults?
Antibiotics
| Not so much since usually due to virus
38
Main drugs for GAS sore throat? (2)
1. Penicillin
| 2. Erythromycin for kids with allergies
39
Group C and G strep is what type of hemolytic?
| Gram positive?
Beta-hemolytic
| Gram positive
40
Habitat of Group C and G strep?
1. Mucosal surfaces like nasopharynx
41
Transmission of Group C and G?
Droplets or direct contact
42
Do GCS and GGS have M protein?
Yes
43
What is the one suppurative of GCS/GGS infection?
| What are the two non-suppuratives
Pharyngitis
GLomerulonephritis: Group C
ARF: Group C and G
44
Laboratory diagnosis of GCS and GGS?
1. Rapid diagnostic
2. Beta hemolytic
3. Gram + cocci in chains
4. Catalase negative
5. Bacitracin resistant
6. PYR Negative
45
Treatment of GCS and GGS? 2
Penicillin or macrolides
46
Neisseria gonorrhoeae is what in gram stain?
Gram-negative
47
Habitat of neisseria gonorrhoeae?
Humans
48
Transmission of N. gonorrhoeae?
Sexual contact
49
Lab diagnosis of N. gonorrhoeae is on what medium? 2
Chocolate agar or Thayer-Martin agar
50
What is Thayer-martin agar?
Chocolate agar + antibiotics for most bacteria and fungi
51
Treatment of N. gonorrhoeae? 2
1. Intramuscular Ceftriaxone
| 2. Oral azithromycin or doxycycline
52
What is N. gonorrhoeae resistant to?
Penicillin and Tetra
53
Acute otitis media is what?
Inflammation of mucosa in tympanic cavity
54
What starts AOM?
Obstruction or blockage of the Eustachian tube or opening to sinuses
55
Result of obstruction in Eustachian tube or sinuses?
Microbial products accumulate --> Inflammation
56
AOM diseases are treated with what?
Amoxicillin or cephalosporins
57
Infants and children are susceptible to otitis media why?
Eustachian tube is shorter and more linear.
58
Why are infants more susceptible to otitis media?
Eustachian tube is shorter and more linear
59
What percentage of otitis media is caused by viruses?
50%
60
Common bacterial causes of otitis media?4
Haemophilus INfluenzae
Strep Pneuoniae
Moraxella catarrhalis
Strep pyogenes/Staph aureus
61
What is unique of the bacterial causes of otitis media?
They are all normal flora of URT
62
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Hemophilus influenzae is gram what?
Shape? (2)
Respiration?
Divided into serotypes based on what?
Which is most virulent?
```
```
Gram -
Rods or coccobacilli
Facultative anaerobe
6 capsular anaerobes
Type B
```
63
Habitat of H. influenzae?
Humans in throat and skin
64
What type of H. influenzae do people get at birth?
Non-encapsulated H. influenzae
65
Transmission of H. influenzae?
Respiratory droplets or direct contact
66
VIrulence factors of H. influenzae?
Polysaccharide capsule
67
Type B H. influenzae capsule has what important component?
Polyribitol phosphate (PRP) that Ab's attack
68
Infections caused by H. influenzae? 4
AOM, meningitis, pneumoniae, acute epiglottis
69
Vaccine against H. influenzae?
Yes, protein conjugate virus of PRP linked to a protein like tetanus toxoid or meningococcal outer membrane protein
70
Strep pneumoniae is in what form?
Gram stain?
Hemolytic?
Shape?
Encapsulated
Gram +
Alpha hemolytic
Lancet shape in diplococci
71
Habitat of Strep pneumoniae?
Human URT
72
Transmission of Strep pneumoniae?
Droplets or direct contact
73
Virulence factors of Strep pneumoniae?
Polysaccharide capsule
74
Clinical infections of Strep pneumoniae?
AOM, meningitis, pneumonia
75
Vaccine for Strep pneumoniae in adults?
| In children?
```
Pneumovac23
Prenavar 13 (PCV 13)
```
76
Moraxella catarrhalis is gram what?
Metabolism?
Habitat?
Negative diplococci
Aerobic
human urt
77
Clinical infections of moraxalla catarhallis
Otitis media
| Other itis's
78
Diagnosis of AOM in moraxalla catarhallis?
1. Otoscope --> Bulging tympanic membrane
2. Puff of air on tympanic membrane to see if it can vibrate
3. Tympanometry: measure tone off membrane
79
Treatment of AOM?
Hold off on antibiotics, aren't as helpful
80
COmplications of AOM?
1. Permanent damage --> Hearing loss
2. Mastoiditis
3. Invasive disease
81
Main antibiotic for AOM?
Amoxicillin
82
Otitis externa is known as what?
Swimmer's ear, infection of ear canal
83
Main causes of otitis externa?
Staph aureus
Candida albicans
Gram-negatives
84
Acute sinusitis goes for the most amount of time at what?
4 weeks
85
Bacterial causes of acute sinusitis? 4
S. pneumoniae, H. influenzae, Staph aureus, S. pyogenes
86
Diagnosis of acute sinusitis? 4
Prolonged rhinitis
Maxillary toothache
Don't respond to decongestants
Headache/Fever
87
Treatment for acute sinusitis?
Amoxicillin
88
What is acute epiglottitis?
Cellulitis and swelling of supraglottic tissue
89
Is acute epiglottitis serious?
Life threatening --> Can block trachea
90
Main bacterial causes of acute epiglottitis?
H. influenzae = Most in children
| S. pneumoniae, GAS, s. aureus
91
Diagnosing acute epiglottis? (2)
1. Scope
| 2. X-ray
92
Treatment of acute epiglottitis? 4
Intubation
Broad spectrum Antibiotics
3rd generation cephalosporin
Steroids
93
Oral candidiasis is caused by what?
Candida albicans: Fungus that stains gram positive
94
Habitat of Candida albicans?
Humans (mouths of 25-50%) of healthy people
| 100% of rectums
95
Transmission of Candida albicans?
Endogenous: Opportunistic fungal infection
96
Where does Candida albicans cause disease?
All organs possibly
97
Treatment of Candida albicans? (2)
1. Flucanazole: Attack ergosterol
| 2. Nystatin: Insert into fungi membrane
98
Caries is caused by what?
Strep mutants
99
What percentage of people have strep mutans?
80-90
100
Three components in development of caries?
1. Strep mutans
2. Sucrose
3. Susceptible tooth enamel
101
Sucrose is used by strep mutans to form what?
| What does this allow for?
Glucose polymer
| Bacteria can adhere to enamel
102
What else does strep mutans ferment?
| Result
Sucrose to lactic acid
| Demineralize the tooth enamel --> Cavities
103
Periodontal disease includes what species?
Actinomyces viscosus, actinobacillus, bacteroides
104
What type of bacteria colonize space between teeth and gingiva?
Anaerobes, gram - and LPS
