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Pathology > Infectious Diseases of Resp. System > Flashcards

Infectious Diseases of Resp. System Flashcards

0
Q

most life threatening URT infection and cause

A

epiglotitis<– Haemophilus influenzae

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1
Q

what 2 viruses are associated with rhinitis and sinusitis

A
  1. rhinovirus

2. coronavirus

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2
Q

what should you what out for with rhinitis

A

secondary bacterial infections

virus lowers immune system which makes pt more prone to get bacterial infection

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3
Q

what is the main cause of nonspecific URI

A

virus

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4
Q

characteristic of the common cold

A

benign and self-limiting

can lead to SECONDARY BACTERIAL INFECTION

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5
Q

MOA of rhinitis/common cold

A

pathogen enters URT–> proliferates and cause inflamm response
get acute inflammation of upper airway
pathogen also triggers infiltration of mucus membranes
get serous or muco-purulent exudate

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6
Q

complications of common cold/rhinitis

A
  1. otitis media
  2. sinusitis
  3. SECONDARY INFECTION
    most common=
    1. staph aureus
    2. H. infleunzae
    3. streptococcus
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7
Q

rhinovirus replicates in…

A

non-ciliated epithelial cells of nasopharynx

+ssRNA picornavirus

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8
Q

what temp do Rhinovirus’ grow at

A

33C= cooler temp
33C=temp of the nose and large airways= reason Rhinovirus are noninvasive
body= 37C

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9
Q

what causes the runny nose from common cold/ rhinovirus

A
  1. bradykinin

2. histamine

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10
Q

coronavirus=

A

enveloped +RNA with club-shaped glycoprotein projections

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11
Q

what is the optimal temperature for viral growth

A

33-35C

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12
Q

which sinus is most commonly involved in sinusitis

A

maxillary

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13
Q

sinuses are normally…

A

sterile

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14
Q

what bacteria can cause sinusitis?

A
  1. strept pneumoniae
  2. type B haemophilus influenzae
  3. Staph
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15
Q

which fungi cause sinusitis (normally in immunocompromised pts)

A

Rhizopus
EX: DKA
transplants

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16
Q

what are the 3 major causes of acute pharyngitis/sore throat?

A
  1. group A beta-hemolytic Strept= Strept pyrogenes
  2. adenovirus
  3. EBV
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17
Q

group A beta hemolytic strept are

A

-bacitricin sensitive

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18
Q

virulence factors for group A beta-hemolytic strept= strept pyrogenes

A
  1. M protein= adhesion protein
  2. hemolysins= streptolysin O and S
  3. Streptokinase
  4. hyaluronidase
  5. exotoxins
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19
Q

characteristics of EBV which can cause acute pharyngitis

A
  1. enveloped linear dsDNA virus
  2. can establish latent and recurrent infections
  3. infects
    1. epithelial cells in naso/oropharynx
    2. B cells
  4. transmitted in saliva
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20
Q

EBV–> infectious mononucleosis–> symptoms

A
  1. lymph-adenopathy and spleeno-megaly
  2. SORE THROAT ACCOMPANIED WITH
    HIGH FEVER
    MALAISE
    FATIGUE
    get atypical lymphocytes= HETEROPHIL ANTIBODIES
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21
Q

histologic hallmark of adenovirus–> causes acute pharyngitis

A

central intranuclear inclusions

viral DNA and protein within an infected epithelial cell

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22
Q

adenovirus can also cause

A

pink eye= pharyngo-cojunctivitis

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23
Q

epiglottitis= most life threatening URI is caused by

A

type b Haemophilus influenzae

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24
Q

H. influenzae virulence factors

A 
1. polysaccharide capsule= major
	contains PRP= poly-ribitol phosphate
2. pili--> mediated colonization of oropharynx
3.cell wall components= LPS
4. IgA proteases***
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25
Q

2 causes of laryngitis

A
  1. mycobacterium tuberculosis= acid fast

2. Corynbacterium diphtheriae= non spore forming

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26
Q

virulence factor for C. diphtheriae

A

diphtheria toxin= A-B toxin
inhibits protein synthesis
by inactivating elongation factor 2
exotoxin–> necrosis of mucosal epithelium–> gray pseudomembrane
–> systemic complications like myocarditis

27
Q

what media can you use to identify C. diphtheriae

A

CTBA= cysteine-tellurite blood agar
inhibits growth of more upper resp infection bacteria and gram - rods
if gray and black color(contains tellurite)= C. diphtheriae

28
Q

what is the cause of laryngo-tracheo-bronchitis or Croup

A

parainfluenza

29
Q

symptoms of laryngo-tracheo-bronchitis/croup

A
  1. horseness
  2. seal bark cough
  3. tachpnea
  4. tachcardia
30
Q

common DD for laryngo-tracheo-bronchitis/croup

A

epiglottitis due to H. infleunzae

31
Q

laryngo-tracheo-broncitis can

A

spread to the lower resp tract

32
Q

What are the 4 types of LRI

A
  1. pertussis
  2. tuberculosis
  3. Pneumonias
  4. opportunistic infections
33
Q

Bordetella pertussis

A

gram -

aerobic

34
Q

bordetella pertussis virulence factor

A

pertussis toxin= A-B toxin

35
Q

when do you treat bordetella pertussis

A

during catarrhal phase when bacterial culture is high

this phase lasts 1-2 weeks and is when you first start to see symptoms

36
Q

treatment for bordetella pertussis

A
  1. supportive care
  2. macrolides–> erythromycin
  3. vaccine= DTaP
37
Q

mycobacterium tuberculosis=

A

acid fast nonmotile nonspore forming aerobic rod

38
Q

virulence factors of mycobacterium tuberculosis

A
  1. facultative intracellular
  2. mycolic acid= anti-phagocytic–> acid fast
    • fusion of phagosome with lysosome

multiple in alveolar macrophages

39
Q

what media can be used to grow mycobacterium tuberculosis

A

Lowenstein Jensen medium

40
Q

purpose of a granuloma and when does it form

A

M. tuberculosis–> granulomas

macrophages, NK cells, and CD 4 and 8 T cellswall of bacteria to prevent further spread and keeps bacteria dormant
if immune system wanes, bacteria can reactivate yrs later

41
Q

granulomas cause

A

fibrotic calcified scars

42
Q

what are lower resp tract organism

A

alverolar macrophages–> which is where M. tuberculosis multiplies

43
Q

PPD test is

A

DTH= type 4 hypersensitivity

use chest xray to differentiate ppl who had received the vaccine

44
Q

atypical/ walking pneumonias=

A
  1. mycoplasma= no cell wall
  2. legionella
  3. chlamydia
45
Q

What are the 3 types of pneumonias

A
  1. lobar
  2. broncho-pneumonia
  3. interstitial
46
Q

what causes lobar pneumonia?

A

Strept pneumoniae

47
Q

strept pneumoniae

A

gram + diplo-cocci
cat -
alpha hemolytic= partial hemolysis

48
Q

virulence factors of strept pneumoniae–> lobar pneumonia

A
  1. polysaccharide capsule
  2. PNEUMOLYSIN
  3. IgA protease
49
Q

if hear strept pneumoniae think

A

common cause of COMMUNITY ACQUIRED ACUTE PNEUMONIA

50
Q

bronchopneumonia=

A

acute inflammatory infiltrates from
bronchioles–> adjacent alveoli
patchy distribution

51
Q

3 organisms that cause broncho-pneumonia

A
  1. staph aureus
  2. Haemophilis influenzae
  3. Klebsiella
52
Q

which organism is important with community acquired pneumonia

A

haemophilius influenzae

53
Q

what is the most common bacterial cause of acute exacerbation of COPD

A

Haemophilus influenzae

54
Q

Klebsiella pneumoniae=

A

enterobacteriaceae
gram - rod
LACTOSE FERMENTER–> LIKE E COLI

55
Q

virulence factors for klebsiella pneumoniae= broncho-pneumonia

A
  1. capsule= antiphagocytic

2. endotoxin

56
Q

which organisms have capsule

A

Strept pneumoniae–> lobar pneumoniae
Klebsiella pneumoniae–>broncho-pneumonia
Haemophilus influenza–> broncho-pneumonia
Pseudomonas aeruginosa
Neisseria meningitidis
Cryptococcus neoformans

57
Q

interstitial pneumoniae=

A

diffuse patchy inflammation localized to interstitial areas of alveolar walls

58
Q

interstitial pneumonia is associated with

A

atypical pneumonia= WALKING PNEUMONIA

1. mycoplasma= no cell wall
2. legionella
3. chlamydia
59
Q

virulence factors of mycoplasma pneumoniae= interstitial pneumonia

A 
1. P1 adhesin
	adheres to resp epithelium
		inhibits ciliary action
			so cilia and ciliated epithelial cells are destroyed
				causes sloughing of cells
60
Q

legionella pneumophila= interstitial pneumonia

A

gram -
obligate aerobe
facultative intracellular
-phagolysosome fusion

61
Q

chlamydophila pneumoniae=

A

gram -
obligate intracellular

get:
infectious elementary bodies
non-infectious reticulate bodies

62
Q

how do you determine chlamydophila penumoniae from other atypical pneumonia

A

giema stain for cytoplasmic inclusions in sputum

= blood stain

63
Q

opportunistic lower resp infection=

A

aspergillus fumigatus

64
Q

aspergillus fumigatus=

A

septate, branching hyphae
branch at acute angles= 45 degrees

immunocompromised pts= most at risk

fungal ball–> obstructive bronchial aspergillosis

65
Q

what would a CT scan of the lungs show that would make you think aspergillus fumigatus

A

halo signs= infiltrate surrounding nodular densities

do surgery or amphotericin B

Pathology (6 decks)

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