Micro - respiratory infections Flashcards
(152 cards)
1
Q
Morphology of strep pneumo?
A
Lancet-shaped diplococci or short chains
2
Q
How is strep pneumo spread?
A
Contact
3
Q
What are some major risk factors for strep pneumo?
A
Asplenia is big, and the other typical ones
4
Q
What are the major virulence factors of strep pneumo?
A
LPS capsule
Pneumolysin - pore formation
5
Q
Is strep pneumo necrotizing or non-necrotizing?
A
Non
6
Q
What is the OP and IP treatment of strep pneumo?
A
OP: macrolide + doxy
IP: penicillins, or macrolide + B-lactam
7
Q
Otitis media from strep pneumo treatment?
A
amoxicillin
8
Q
What are the two vaccines for strep pneumo?
A
Pneumovac: cargo-based, short-acting
Prevnar: protein conjugate
9
Q
How is yersinia pestis spread?
A
Flea bites
10
Q
Y pestis morphology?
A
Safety pins
11
Q
Y pestis virulence factors
A
Type III secretion system injects effectors that stop phagocytosis
F1 capsule - basis of rapid tests
12
Q
How can Y pestis be definitely diagnosed?
A
F1 capsule serology
13
Q
What is the treatment for Y pestis?
A
Streptomycin; doxy for pneumoic because it’s contagious
14
Q
Is Y pestis contagious?
A
Only the pneumonic form of disease
15
Q
Describe the different types of plague and their unique features
A
Bubonic: painful LAD buboes
Septicemic: worse than bubonic, toxemia, MOF, DIC possible, etc.
Pneumonic: septicemic version disseminates to lungs; CONTAGIOUS, BLOODY AND WATERY sputum
16
Q
Brucella - disease presentation
A
Chronic infection with granulomas in bone and liver; night sweats and long-lasting fever; back pain
17
Q
Brucella phrase
A
Butchers in Brussels get Brucellosis from Bovines with Back Pain and Break Sweats
18
Q
Brucella transmission
A
Raw dairy; handling animals; zoonistic in cows/sheep
19
Q
Coxiella burnetti spread
A
aerosol and animal products
20
Q
Coxiella burnetti associated disease
A
Q fever
21
Q
Q fever S/S
A
Atypical pneumonia 2-4 weeks; sometimes cardiac involvement and liver.
22
Q
Q fever treatment
A
doxycycline for coxi!
23
Q
Which antivirals are NA inhibitors?
A
Zanamivir and oseltamivir
24
Q
Which antivirals are best for flu B?
A
Zanamivir and oseltamivir
25
What does the flu HA protein do?
Facilitate attachment and penetration
26
What does the flu NA protein do?
Destroy receptor by cleaving sialic acid from virion and cell surface
27
What does the flu M2 protein do?
Only in Type A; ion channel involved in uncoating
28
Nocardia - who is most vulnerable?
Chronic lung disease patients; also HIV/chemo; OPPORTUNISTIC
29
Nocardia virulence factors
Catalse and superoxide dismutase
30
Nocardiosis features
Acute inflammation with necrosis and abcessation
Nocardia is Necrotic and comes in through your Nose
31
Nocardia treatment
Cefamandole ('nocardia needs a man')
32
Nocardia habitus
Soil and water
33
Nocardia spread?
Inhalation, not p to p
34
If you ate or inhaled dirt, which pathogens could you potentially contract?
Nocardia (inhalation)
Histoplasma (regional)
Acinetobacter (Asia/Australia)
35
Which fungal infections are considered opportunistic?
Aspergillus, mucormycoses, pneumocysis
36
Which fungal infections are considered systemic?
Histo, blasto, coccidio
37
Histoplasma morphology
Dimorphic yeast with BUMP CONIDIA
38
Where is histo endemic?
MS and OH river valleys
| Central America
39
histoplasma virulence
yeast resists macrophage destruction
40
What parts of the body does histo target?
'Reticuloendothelial system' - lymph, spleen, BM
41
Histoplasmosis presentation
Cough, fever, similar symptoms to TB, potential for renal failure and CNS in immunocompromised
42
Treatment for histoplasmosis
Azole for competent pts; Ampho B then azoles for compromised
43
Blasto spread
Airborne spores
44
Blasto morphology
"Broad-based" budding yeast snowmen
45
Blasto virulence
Yeast form IS susceptible to macrophages (unlike histo)
46
Blasto presentation
Acute pneumonia with PURULENT BROWN/bloody sputum
40% warty skin lesions (cutaneous)
Can spread to prostate
47
Blasto tx
Azole if competent; AmpB+maintenance azole if compromised
48
Coccidioides morphology
Dimorphic spherule (not yeast) that sporulates
49
Coccidioides transmission
sporulation/airborne
50
Coccidioides vulnerable pops
SW US; AAs, AIDS/immunocompromised
51
Coccidioides virulence info
Very infectious; bioweapon
52
Coccidioides disease caused
Valley fever/Coccidiomycosis
Fever, ARTHRALGIA, fatigue, rash; long-lasting fatigue
53
Coccidioides script
Black HIV+ man living in California
54
Aspergillus morphology
45 deg septate hyphae
55
Aspergillus spread
sporulation/airborne
56
Aspergillus tx
Ampho B
57
Zygomycetes morphology
90 deg septate hyphae
58
Zygomycetes buzz words exposure
Tornadoes/disasters
59
Zygomycetes spread
Sporulation/airborne
60
Zycomycetes vulnerable pops
opportunistic/ic'd
61
Zygomycetes tx
Ampho B
62
Zycomycetes distinguishing S/S
severe HA
63
Pneumocystic jerovici morphology
deflated soccer balls
64
Pneumo jerovici who's vulnerable?
Everyone is infected by ~4; AIDS at risk; opportunistic
65
Pneumo jerovici virulence and dx
Can't be cultured; part protozoan so can't use AmpB (cholesterol)
Silver stain to see cysts is Dx
66
Pneumo jerovici tx
Trimethoprim-sulfamethoxazole
67
Coronavirus genome
Non-seg + RNA
68
Flu genome
Segmented - ssRNA
69
Coronavirus spread
P to P through airborne droplets
70
Coronavirus virulence factors
```
S: spike protein - stimulates prod of antibody so important!
HE: hemagg esterase
E - envelope protein
M - membrane p - budding/env formation
N - nucleocapsid p - encapsidation
```
71
Coronavirus diseases
Colds, croup, SARS
72
What are the major causes of croup?
90% viral
Paraflu, flu, adenovirus are major sources, sometimes RSV
73
Coronavirus cold
mild URT, ~15-30% of colds
74
Coronavirus croup - which virus?
HVoC-NL63
75
SARS S/S
High fever, flu-like, GI symptoms
Severe LRTI progressing to pneumonia; targets Typ e II pneumocytes
Eventually, severe ARDS
76
Chlamydia diseases
Psittacosis
Pneumonia (atypical)
Ocular and genital infections
77
Describe the chlamydia life cycle
Biphasic:
- Inert EB enters cell
- Becomes RB which undergoes binary fission
78
Chlamydria morphology
Obligate intracellular parasite dependent on cell for many substances
79
Chlamydia presentation of pneumonia
Mild atypical pneumonia (slow progressing) in adolescents and young adults
HA is an important finding not typical of other pneumonias
80
Chlamydia virulence factors
TTS; tarp; CopN...
81
Chlamydia Dx
IgM titer
82
Chlamydia often has this area of involvement along with pneumonia
Ocular!
83
Legionella morphology
Aerobic G- rods
facultative intracellular parasites
84
Which pathogens are intracellular parasites, either facultative or obligate?
Legionella (facultative)
Chlamydia (obligate)
Brucella (facultative)
Coxiella
85
Legionella spread
Not P to P; through water sources
86
Legionella mech
Replicates in alveolar macrophages; avoids phagolysosome fusion; creates 'special vacuole'
87
Legionella Dx
urine test
88
Legionnaire's disease S/S
Incubates 2-10 days;
HIGH fever
cough, chills
89
Pontiac fever S/S
Flu-like; passes in 2-5 days; incubates 36-48 hours
90
Mycoplasma pneumonia vulnerable pops
LITTLE KIDS 1-5
| And younger > older in general
91
Mycoplasma CAP
5-10% of CAP
GRADUAL, insidious onset of days/weeks
Especially consider if cough of > 3 weeks
92
Adenovirus srpead
Inhalation of droplets from fecal-oral
93
Adenovirus vulnerable pops
Children, military, pools/etc for eye infections
94
Adenovirus virulence factors
Hexon proteins and capsid
95
Which adenovirus serotypes affect GI only?
40, 41
96
Which adenovirus serotypes cause ARD?
4, 7
97
Adenovirus dx
cytopathic effect on culture
98
Adenovirus S/S of respiratory infection
Erythema, cough, fever, sore throat
Ocular: 'sand' in eye, runny nose, fever, sore throat
GI: N/V/D, fever
AdV can persist for several months after acute episode!
99
Acinetobacter gram __
-
100
Acinetobacter vulnerable pops
Australians and Asians with CAP and chronic disease
101
Acinetobacter virulence
Low virulence; apoptosis of laryngeal epithelium via OMP 38
102
Acinetobacter dx
culture
103
Acinetobacter S/S pneumonia
Fever, other typical
chest pain
If cutaneous: orange, bumpy skin
104
Acinetobacter tx
MDR - use meropenem other things....
105
Corynebacterium morphology
chinese letters, G+
106
Corynebacterium virulence
Diptheria toxin:
- B subunit facilitates entry/endocytosis
- A subunit: 1 molecule can kill cell
107
Diphtheria dx
culture
108
Corynebacterium S/S
Colonizes pharynx and forms PSEUDOMEMBRANE and VERY sore throat
Can cause heart issues
109
Which pathogens can potentially involve cardiac damage?
```
diphtheria
Q fever (coxiella)
```
110
Bordetella morphology/char
Fastidious G-
111
Bordetella transmission
Very contagious; P to P!
112
Bordetella virulence factors
Pertussis toxin paralyzes cilia and causes inflammation
FHA: filamentous hemagg
113
Pertussis phases and symptoms
3 phases
1. Catarrhal (low fever, progressive cough)
2. Paroxysmal (wax/wane whoop, fatigue, cyanosis, N/V)
3. Convalescent (recovery, still some cough)
114
Pertussis vaccine
DTaP: acellular
115
Bacillus anthracis morphology
boxcars - the anthrax children
| G+ aerobic SPOREs
116
Anthrax virulence
Non-antigenic capsule
AB toxin:
-B allows receptor binding
-A: two subunits - EF edema factor - swelling; LF lethal factor - disrupts cell signals
117
Inhalational anthrax S/S
Two phases
1. Flu-like symptoms
2. Hemorrhagic mediastinitis with pleural effusion
MEDIASTINAL WIDENING ON CXR
INC UP TO 6 WKS
118
Hantavirus genome
Segmented (-) RNA
119
Hantavirus spread
Aerosolized rodent waste, esp.
DEER MOUSE
'Santa loves reindeer; Hanta loves deer (mice)'
120
Hantavirus virulence
HPS causes PULMONARY CAPILLARY PERMEABILITY - edema edema edema
121
How does the immune system contribute to hantavirus infection pulmonary syndrome?
Lymphos and macros recruited by high viral burden - provokes endothelial overactivation and edema/migration
122
What is the hantavirus 'triplet' of S/S?
Elevated HCT
Thrombocytopenia
Leukocytosis with left shift
123
What are the two stages of hantavirus RDS?
1. Fever and myalgias, NO SIGNS OF TYP URI
| 2. Lots of edema, cough, low BP
124
Hantavirus tx
no specific, but low fluids and use pressors
125
Anthrax tx
Cipro or Doxy IV
126
RSV vulnerables
kids, daycare, premature babies, immunodeficient
127
RSV genome
Enveloped, nonseg (-) RNA
128
RSV virulence
Respiratory tract only
Two envelope proteins -
1. F protein
2. G protein
129
RSV dx
F protein serology
130
RSV S/S
Airway inflammation, necrosis, sloughing, edema, ...
| SEASONAL
131
RSV tx
palvizumab
132
prophylaxis for RSV
ribavirin
133
ALL of the syncytial viruses have this genome
Env nonseg - RNA
134
Actinomyces morphology
Produce hard yellow granules
135
Actinomyces virulence
not highly
136
Actinomyces manifestation areas
Pulmonary, facial, lumpy jaw, GI
137
Actinomycosis S/S
Chest pain w/ inspiration, phlegm, weight loss
138
Actinomycosis tx
Penicillin IV 4-6 wks
139
Rhinovirus genome
Unenv (+) RNA
140
Rhinovirus spread
direct contact
141
Rhinovirus virulence
IRES elements - selective translation of viral
Local inflammation responsible for smyptoms as opposed to virus
Lives long on surface
142
Rhinovirus infection symptoms/Signs
Sore throat -->rhinorrhea/congestion
HA, facial pressure possible
Normal pharynx - no erythema!
Cough and hoarseness possible
143
TB phase 1
droplet of nuclei inhalted
144
TB phase 2
7-21 days post-infection; unrestricted multiplication and macrophage migration
145
TB phase 3
Macrophage activation by T cells
Tuberculin + now
Caseating necrosis begins
146
TB phase 4
MTB grows in weak macrophages and dissemination possible
147
TB phase 5
Caseous liquefication - rapid growth - bronchial necrosis/rupture - everywhhherre
148
TB treatment
Rifampin
Isoniazid
Pyrazinamide
Ethambutol/strepto
149
Francisella morpho
G- non-sporing cocco
150
Francisella S/S
Patchy infiltrates on CXR!!
Ulceroglandular most common -
Fever, chills, HA, exhaustion
SKIN ULCER at bite site
151
Francisella spread
rabbits; fleat bites; dead animals; NOT p to p
152
Francisella tx
streptomycin
