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MICRO > Ch5: URT Chaussee > Flashcards

Ch5: URT Chaussee Flashcards

1
Q

What does upper respiratory mean?

A

Above larynx

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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

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3
Q

Where does RT become aseptic?

A

Alveolar bronchiole

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4
Q

Normal flora has what role in RT?

A

Protects by competing with harmful microbes

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5
Q

What bacteria are in middle ear and sinuses?

A

None, sterile

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6
Q

Normal flora of URT? (50% of people or more)

A
  1. Corynebacteria
  2. Candida albicans
  3. Alpha-hemolytic strep
  4. Strep mutants
  5. Haemophilus influenzae
  6. Neisseria
  7. Non staph aureus staph
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7
Q

Host defenses in URT?

A
  1. Orthogonal structure
  2. Saliva
  3. Mucin and mucus
  4. TLR’s
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8
Q

the orthagonal structure of URT has what effect?

A

Traps microbes

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9
Q

What does saliva contain? 2

A

Lysozyme

Secretory IgA

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10
Q

What does mucus do?

A

Traps microbes from entering LRT.

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11
Q

What sweeps mucus up and out and into stomach?

A

Ciliated epithelial cells

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12
Q

Ciliated epithelial cells + Mucus = ?

A

Mucocilliary escalator

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13
Q

50-70% of sore throats are caused by what in children?

A

Viruses

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14
Q

What symptoms suggest a viral sore throat?

A 
Conjunctivitis
Coryza
Ulcerative lesions
Viral exanthema
Diarrhea
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15
Q

What percentage of adult sore throats are viral?

A

0%

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16
Q

Bacterial causes of pharyngitis?

A
  1. Group A strep:
  2. Group C and G strep
  3. Anaerobes (bacterioides, fusobacterium, spirochetes
  4. Corynebacterium diptherae
  5. Neisseria gonorrhoea
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17
Q

Which bacterial causes of pharyngitis are common?

Infrequent?

A

Group A strep = common

Group C and G strep = infrequent
Neisseria gonorrhea = infrequent

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18
Q

GAS caused pharyngitis has what associations? 3

A

Tonsilitis, scarlet fever, sequelae

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19
Q

What are spirochetes that cause pharyngitis?

What else are they associated with?

A

Borrelia and treponema

Trench mouth

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20
Q

In terms of GAS strep throat
Onset?
Symptoms? (3)

A
  1. Severe pain
  2. Difficulting swallowing
  3. Flu-like
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21
Q

Suppurative sequelae of GAS? 4

A
  1. Peritonsillar abscess
  2. Otitis media, sinusitis, mastoiditis
  3. Scarlet fever
  4. Streptococcal Toxic Shock Syndrome
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22
Q

Scarlet fever encompasses what?

A

Peripheral rash (Maybe strawberry tongue) caused by SPE’s

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23
Q

What is STSS due to?

A

Production of Spe’s that act as superantigens

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24
Q

What happens if GAS is in the blood?

A

Bacteremia and toxigenic disease

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25
Q

Non-suppurative/post infection sequelae to GAS pharyngitis?

A

Acute rheumatic fever: Due to autoimmune

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26
Q

Why does acute rheumatic fever occur?
How long does it take to develop?
What percent of kids get it?

A

M protein mimics cardiac myosin
3 weeks
3%

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27
Q

Clinical diagnosis of ARF is based on what?

A

Jones criteria

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28
Q

ARF typically follows what type of GAS infection?

A

Pharyngeal

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29
Q

What is the Jones criteria requirements for GAS?

A

Evidence of previous GAS infection

2 major or 1 major + 2 minor

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30
Q

Major manifestations of ARF? 5

A
  1. Joints
  2. Heart inflammed
  3. Nodules subcutaneous
  4. Erythema marginatum
  5. Sydenham’s Chorea
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31
Q

Minor manifestations of ARF? 4

A
  1. Previous ARF
  2. Fever
  3. Joints
  4. Acute phase reaction
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32
Q

Laboratory obtained evidnece of previous GAS infection?

A

Anti-streptolysin O test

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33
Q

Besides ARF, what else is a non-suppurative post infection sequlae of GAS?

A

Pediatric Autoimmune Neuropsychiatric Disorders Associated WIth Strep Infections (PANDAS)

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34
Q

What causes PANDAS?

A

Cross reactivity between GAS antigens and neuro tissue

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35
Q

GAS may be responsible for what neuro disorders?

A
  1. OCD

2. Tourettes

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36
Q

Lab diagnosis of GAS? (7)

A
  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
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37
Q

Treatment of all GAS children should be what?

What about adults?

A

Antibiotics

Not so much since usually due to virus

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38
Q

Main drugs for GAS sore throat? (2)

A
  1. Penicillin

2. Erythromycin for kids with allergies

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39
Q

Group C and G strep is what type of hemolytic?

Gram positive?

A

Beta-hemolytic

Gram positive

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40
Q

Habitat of Group C and G strep?

A
  1. Mucosal surfaces like nasopharynx
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41
Q

Transmission of Group C and G?

A

Droplets or direct contact

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42
Q

Do GCS and GGS have M protein?

A

Yes

43
Q

What is the one suppurative of GCS/GGS infection?

What are the two non-suppuratives

A

Pharyngitis

GLomerulonephritis: Group C
ARF: Group C and G

44
Q

Laboratory diagnosis of GCS and GGS?

A
  1. Rapid diagnostic
  2. Beta hemolytic
  3. Gram + cocci in chains
  4. Catalase negative
  5. Bacitracin resistant
  6. PYR Negative
45
Q

Treatment of GCS and GGS? 2

A

Penicillin or macrolides

46
Q

Neisseria gonorrhoeae is what in gram stain?

A

Gram-negative

47
Q

Habitat of neisseria gonorrhoeae?

A

Humans

48
Q

Transmission of N. gonorrhoeae?

A

Sexual contact

49
Q

Lab diagnosis of N. gonorrhoeae is on what medium? 2

A

Chocolate agar or Thayer-Martin agar

50
Q

What is Thayer-martin agar?

A

Chocolate agar + antibiotics for most bacteria and fungi

51
Q

Treatment of N. gonorrhoeae? 2

A
  1. Intramuscular Ceftriaxone

2. Oral azithromycin or doxycycline

52
Q

What is N. gonorrhoeae resistant to?

A

Penicillin and Tetra

53
Q

Acute otitis media is what?

A

Inflammation of mucosa in tympanic cavity

54
Q

What starts AOM?

A

Obstruction or blockage of the Eustachian tube or opening to sinuses

55
Q

Result of obstruction in Eustachian tube or sinuses?

A

Microbial products accumulate –> Inflammation

56
Q

AOM diseases are treated with what?

A

Amoxicillin or cephalosporins

57
Q

Infants and children are susceptible to otitis media why?

A

Eustachian tube is shorter and more linear.

58
Q

Why are infants more susceptible to otitis media?

A

Eustachian tube is shorter and more linear

59
Q

What percentage of otitis media is caused by viruses?

A

50%

60
Q

Common bacterial causes of otitis media?4

A

Haemophilus INfluenzae
Strep Pneuoniae
Moraxella catarrhalis
Strep pyogenes/Staph aureus

61
Q

What is unique of the bacterial causes of otitis media?

A

They are all normal flora of URT

62
Q 
Hemophilus influenzae is gram what? 
Shape? (2)
Respiration? 
Divided into serotypes based on what?
Which is most virulent?
A 
Gram -
Rods or coccobacilli
Facultative anaerobe
6 capsular anaerobes
Type B
63
Q

Habitat of H. influenzae?

A

Humans in throat and skin

64
Q

What type of H. influenzae do people get at birth?

A

Non-encapsulated H. influenzae

65
Q

Transmission of H. influenzae?

A

Respiratory droplets or direct contact

66
Q

VIrulence factors of H. influenzae?

A

Polysaccharide capsule

67
Q

Type B H. influenzae capsule has what important component?

A

Polyribitol phosphate (PRP) that Ab’s attack

68
Q

Infections caused by H. influenzae? 4

A

AOM, meningitis, pneumoniae, acute epiglottis

69
Q

Vaccine against H. influenzae?

A

Yes, protein conjugate virus of PRP linked to a protein like tetanus toxoid or meningococcal outer membrane protein

70
Q

Strep pneumoniae is in what form?
Gram stain?
Hemolytic?
Shape?

A

Encapsulated
Gram +
Alpha hemolytic
Lancet shape in diplococci

71
Q

Habitat of Strep pneumoniae?

A

Human URT

72
Q

Transmission of Strep pneumoniae?

A

Droplets or direct contact

73
Q

Virulence factors of Strep pneumoniae?

A

Polysaccharide capsule

74
Q

Clinical infections of Strep pneumoniae?

A

AOM, meningitis, pneumonia

75
Q

Vaccine for Strep pneumoniae in adults?

In children?

A 
Pneumovac23
Prenavar 13 (PCV 13)
76
Q

Moraxella catarrhalis is gram what?
Metabolism?
Habitat?

A

Negative diplococci
Aerobic
human urt

77
Q

Clinical infections of moraxalla catarhallis

A

Otitis media

Other itis’s

78
Q

Diagnosis of AOM in moraxalla catarhallis?

A
  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
Q

Treatment of AOM?

A

Hold off on antibiotics, aren’t as helpful

80
Q

COmplications of AOM?

A
  1. Permanent damage –> Hearing loss
  2. Mastoiditis
  3. Invasive disease
81
Q

Main antibiotic for AOM?

A

Amoxicillin

82
Q

Otitis externa is known as what?

A

Swimmer’s ear, infection of ear canal

83
Q

Main causes of otitis externa?

A

Staph aureus
Candida albicans
Gram-negatives

84
Q

Acute sinusitis goes for the most amount of time at what?

A

4 weeks

85
Q

Bacterial causes of acute sinusitis? 4

A

S. pneumoniae, H. influenzae, Staph aureus, S. pyogenes

86
Q

Diagnosis of acute sinusitis? 4

A

Prolonged rhinitis
Maxillary toothache
Don’t respond to decongestants
Headache/Fever

87
Q

Treatment for acute sinusitis?

A

Amoxicillin

88
Q

What is acute epiglottitis?

A

Cellulitis and swelling of supraglottic tissue

89
Q

Is acute epiglottitis serious?

A

Life threatening –> Can block trachea

90
Q

Main bacterial causes of acute epiglottitis?

A

H. influenzae = Most in children

S. pneumoniae, GAS, s. aureus

91
Q

Diagnosing acute epiglottis? (2)

A
  1. Scope

2. X-ray

92
Q

Treatment of acute epiglottitis? 4

A

Intubation
Broad spectrum Antibiotics
3rd generation cephalosporin
Steroids

93
Q

Oral candidiasis is caused by what?

A

Candida albicans: Fungus that stains gram positive

94
Q

Habitat of Candida albicans?

A

Humans (mouths of 25-50%) of healthy people

100% of rectums

95
Q

Transmission of Candida albicans?

A

Endogenous: Opportunistic fungal infection

96
Q

Where does Candida albicans cause disease?

A

All organs possibly

97
Q

Treatment of Candida albicans? (2)

A
  1. Flucanazole: Attack ergosterol

2. Nystatin: Insert into fungi membrane

98
Q

Caries is caused by what?

A

Strep mutants

99
Q

What percentage of people have strep mutans?

A

80-90

100
Q

Three components in development of caries?

A
  1. Strep mutans
  2. Sucrose
  3. Susceptible tooth enamel
101
Q

Sucrose is used by strep mutans to form what?

What does this allow for?

A

Glucose polymer

Bacteria can adhere to enamel

102
Q

What else does strep mutans ferment?

Result

A

Sucrose to lactic acid

Demineralize the tooth enamel –> Cavities

103
Q

Periodontal disease includes what species?

A

Actinomyces viscosus, actinobacillus, bacteroides

104
Q

What type of bacteria colonize space between teeth and gingiva?

A

Anaerobes, gram - and LPS

MICRO (22 decks)

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