CRRAB Respiratory Micro - Get in my brain! Flashcards Preview

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Flashcards in CRRAB Respiratory Micro - Get in my brain! Deck (44):
1

Most common viral infection of common cold

Rhinovirus

2

2 most common bacterial pathogens in sinusitis?

Strep Pneumo
H. Influenza

3

Most important pathogens in laryngitis/croup?

Parainfluenza Virus
Respiratory Synctial Virus (RSV)

4

Key Points for common cold:

-Winter most common
-Hundreds of immunologically distinct varieties
-Rhinovirus most common (also adeno,corona)
-stuffiness, headache, sneezing, rhinorrea, sore throat, fever

5

How does Rhinovirus infect cells of nasal passages and pharynx?

attaches to ICAM-1

6

Key Features of Sinusitis:

-Common pathogens are Strep Pneumo and H. Influenza
-Sneezing, rhinorrhea, congestion, post-nasal drip, facial pressure and headache, sore throat, fever, muscle aches
-Aspergillis fumigatus is fungal sinusitis, rare

7

How do you differentiate between viral and bacterial sinusitis?

-Bacterial is likely when moderate symptoms persist over 7 days (or there is facial swelling/tooth pain)
-In kids moderate symptoms must last longer than 10-14 days (or a fever over 102 with facial swelling/pain)

8

How do you treat bacterial sinusitis?

Amoxicillin (augmentin)
or
Azithromycin

9

Strep Pneumonia is a common cause of pneumonia in adults. Name the key feature:
Gram:
Catalase:
Hemolytic:
Special tests:

Strep Pneumo:
Gram ( + )
diplococci
catalase ( - )
alpha hemolytic
Bile-esculin negative
Optochin susceptible

10

What virus is common in military recruits and boarding schools? How does it present?

Adenovirus

Pharyngoconjunctival fever
Acute Respiratory Disease

11

Fever, sore throat, edema, and hyperemia of tonsils and pharyngeal walls in common i both viral and bacterial pharyngitis.
What additional symptoms might suggest viral cause?
Bacterial cause?
Which bacteria?

Viral Cause:
Conjunctivitis
Cough
Hoarseness
Inflammation of mucus membrane
Diarrhea

Bacterial:
Fever and sudden-onset severe swallowing pain
Headache/Nausea/Vomiting
Do rapid-step test for S. Pyogenes

12

How would you treat pharyngitis caused by Strep pyogenes?

Penicillin, or erythromycin for those with penicillin allergy

13

Strep pyogenes special test:
sensitive to what?

Also hemolysis?

Bacitracin sensitive!

Beta-hemolytic

14

Child with flushed face and strawberry tongue following a strep pyogenes infection.

What's the disease?
What is causing it?

Scarlet Fever

Strep pyogenes exotoxins SpeA, SpeB, SpeC, and SpeF

(actually encoded by the bacteriophage, not the bacteria, weird.)

15

So you know that Scarlet Fever needs genes from a bacteriophage. What other bacterial pathogen requires bacteriophage genes to cause virulence.

C. Diptheriae!

16

Where are two places that diptheria can affect outside of the pharynx?

Myocarditis

Neuritis (temporary paralysis of limbs, palate, diaphragm)

"A disease of the heart and the mind too"

17

Bark-like cough, respiratory stridor, general cold sx, fever 38-39C (100-102 F)
What are you thinking?

I am thinking croup/laryngitis!

Cyanosis is late-stage and dangerous

Cool air seems to relieve some symptoms...

18

What is one of the important virulence factors in RSV?

F proteins on viral surface cause cell membranes to merge into one another. (Synctial)

IMPORTANT: Also seen in parainfluenza virus

19

You are surprised to see that one of the partners at your practice has just ordered a potassium tellurite culture. You rush over to talk to him about the case. Why?

Diptheria! Don't see that too often. I'd want to talk to him anyway.

20

Which viral genome that can cause the common cold has a segmented genome?

Influenza C

21

Which virus can cause sever complication o fhemorrhagic cystitis?

Adenovirus

22

Patient with COPD gets bacterial pneumonia. Test reveal the causal bacteria hydrolyzes tributyrin, produces DNase, reduces nitrate and nitrite, and does NOT ferment sucrose, glucose, maltose, or lactose

It's moraxella Cattarrhalis!

(top two for pneumonia after COPD = Non-typeable H. Influenza and M. catarrhalis)

23

How is protein synthesis halted in diptheria?

Ribosylation of EF-2 through diptheria toxin

24

This bacteria is:
-quelling (+)
-a major cause of CAP
-Potentially dangerous for asplenic patients
-Systemically causes meningitis
-alpha hemolytic
-optochin sensitive

Streptococcus Pneumoniae

IF you are asplenic you better get a pneumovax vaccine!
(they can't clear capsuled bacteria)

25

We know strep pneumo is dangerous for asplenic patients, what other organism also is?
HINT: especially causes meningitis in kids!

HiB
Hemophilus Influenza B

Capsule means it is quelling(+)

26

Special way to culture HiB?

Chocolate agar with X,V

27

If you are particularly worried about a high-risk premature infant getting RSV, what should you do?

Synagis (f-antigen) vaccine

28

Child present with hacking cough, fever, and chest pain after a typical cold presentation.
CXR reveals no consolidation and no infiltrates.
Diagnosis?
Treatment?

Dx: Bronchitis

Tx: Erythromycin, or azithromycin

29

Violent coughing spasms that are severe and uncontrollable.
Dx?

Pertussis

30

Special culture for pertussis?
Gram stain?

Bordet Gengou agar

Gram ( - )

31

Which virus undergoes antigenic drift?
at which site?

Influenza

Usually at antobidy binding site

32

Most common pneumonias in 40-65 yo adults:

strep pneumo
h. influenza
legionella

33

Most common pneumonia in elder 65+ adults

Strep Pneumo
Gram - rods
H influenza

34

A 66-year-old man was brought ED for abrupt onset of shaking chills, high fever, and pain on the right side of his chest since prior evening. In the last 24 hours he had experienced sob and a cough that was productive of rust-colored sputum. Diabetic/smoked two ppd, 20 yrs. Had not received any vaccinations in last 20 years.

Sounds like pneumonia. Most common pathogens are Strep Penumo, gram(-) rods, and H. influenza.
(without CXR, can't tell if it's just bronchitis)

If CXR shows upper lobar pneumonia we know strep pneumo (likes making lobar pneumonia)

35

In December, 73-year-old man from nursing home in acute respiratory distress. Usual health until 10AM yesterday when he suddenly developed fever, chills, muscle aches, cough, and prostration. Several others at nursing home developed a similar illness last week. Past hx unremarkable and he did not see a physician in the past year.
Culture is optochin sensitive!

Strep pneumoniae is definitely what we are seeing on the culture.

The history sounds a lot like a Influenza C leading to a secondary pneumonia infection.

Differentiate flu from common cold by higher fever. (he aslo didnt get vaccinated!)

36

Bronchiolitis usually affects what patient population, with what pathogen?

-infants under 1yo
-RSV

-self-limiting disease usually, like bronchitis

37

Classic pneumonia symptoms:

-sudden onset chills, fever, dyspnea, productive cough, purulent (sometimes blood-tinged) sputum.
-tachypnea, tachycardia, lung crackles
-CXR consolidation

38

Method of infection fro parainfluenza virus:

-Infect larynx mucosa through viral hemagluttinin (HA) protein attaching to sialic acid
-Viral neuroaminidase protein permits viral spread by cleaving HA bound to sialic acid

Leads to croup!

39

Infections caused by Coxsackie A and B?

Coxsackie A – herpangina and hand-foot-and-mouth disease

Coxsackie B – pleurodynia, myocarditis, and pericarditis.

Coxsackie A and B – aseptic meningitis, paralysis, and URI cold

40

What kinds of infections caused by step agalactiae?

Main features?

meningitis in newborns

gram+, beta-hemolytic, bacitracin resistant!

Tx with penicillin

41

How do you treat mycoplasma pneumoniae?

erythromycin or tetracycline

42

how do you treat chlamydia pneumoniae?

doxycycline

43

How does legionella avoid destruction by macrophages?

It actually survives and proliferates despite being phagocytosed by macrophages.
Chemoattractants secreted by the infected macrophages is what causes the symptoms seen in Pontiac fever and legionnaire's disease.

44

What would be the best way to treat an AIDS patient who acquires pneumocystic pneumonia?

TMP-SMX or pentamidine