MICRO URTI & LRTI - Week 2 Flashcards

1
Q

Diptheria causative agents

A

Corynebacteria diptheriae

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2
Q

Diptheria symptoms

A

o Symptoms: heart & liver damage, necrotic exudate (‘false membrane’ -> respiratory obstruction), inflammation & swelling, enlarged cervical lymph nodes (‘bull neck’).

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3
Q

Diptheria treatment

A

o Treatments: antibiotics, monitor for respiratory obstruction, isolate pt.

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4
Q

Glandular fever causative agents

A

EBV - member of Herpes family.

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5
Q

Glandular fever symptoms

A

o Symptoms: fever, anorexia, lethargy, sore throat, headache, lymphadenopathy, enlarged liver & spleen, hepatitis, rash, jaundice.

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6
Q

Glandular fever spread

A

Saliva exchange

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7
Q

Acute laryngitis symptoms

A

o Symptoms: symptoms of common cold, hoarseness, barking cough

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8
Q

Acute laryngitis treatment

A

o Treatment: voice rest, humidification, pain relief

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9
Q

Laryngotracheobronchitis symptoms

A

Croup
o Symptoms: fever, barking cough, restlessness, stridor, respiratory distress, history of URTI

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10
Q

Laryngotracheobronchitis complications

A

Respiratory obstruction

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11
Q

How is laryngotracheobronchitis diagnosed?

A

Nasopharyngeal swab/nasopharyngeal wash

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12
Q

Laryngotracheobronchitis treatment

A

o Treatment: maintain airway, antibiotics, supportive treatments, oxygen therapy.

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13
Q

Acute epiglottitis causative agents

A

H. influenzae type B

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14
Q

Acute epiglottitis symptoms

A

o Symptoms: fever, irritability, sore throat, difficulty swallowing, drooling, hoarseness, cough, respiratory distress

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15
Q

Acute epiglottitis complications

A

Respiratory obstruction

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16
Q

Acute epiglottitis treatment

A

o Treatment: maintain adequate airway, antibiotics

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17
Q

Otitis externa symptoms

A

o Symptoms: red ear, swollen ear, discharge from ear

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18
Q

Otitis externa complications

A

Severe necrotising infection

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19
Q

Otitis externa severe necrotising infection treatment

A

o Treatment: eardrops w antipseudomonal antibiotics w steroids

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20
Q

Who is most at risk of severe necrotising infection from Otitis externa?

A

Elderly pts, pts w diabetes & immunocompromised pts.

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21
Q

Who is most at risk of severe necrotising infection from Otitis externa?

A

Elderly pts, pts w diabetes & immunocompromised pts.

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22
Q

Otitis externa causative agents

A

o Causative agent: S. aureus, pseudomonas aeruginosa, candida, aspergillus.

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23
Q

Acute Otitis media causative agents

A

o Causative agents: RSV, S. pneumoniae, H. influenzae, Moraxella catarrhalis.

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24
Q

Acute Otitis media symptoms

A

o Symptoms: fever, lethargy, irritability, ear-ache, ear discharge, hearing loss, bulging eardrum

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25
Q

GABHS Pharyngitis causative agent

A

o Causative agents: GA B-haemolytic S. pyogenes

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26
Q

GABHS Pharyngitis symptoms

A

o Symptoms: high fever, chills, enlarged painful tonsils w white pus-filled lesions & exudate, tender cervical lymphadenopathy.

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27
Q

GABHS Pharyngitis Incubation period

A

Rapid onset (overnight)

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28
Q

Suppurative complications of GABHS Pharyngitis

A

Peritonsillar abscess (quinsy), sinusitis, mastoiditis, otitis media.

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29
Q

Non-suppurative complications of GABHS Pharyngitis

A

Scarlet fever, acute glomerulonephritis, rheumatic fever, rheumatic heart disease.

30
Q

Symptoms of scarlet fever

A

Punctate erythematous rash, strawberry tongue.

31
Q

Symptoms of rheumatic fever

A

Granulomas in the heart, myocarditis or pericarditis, subcutaneous nodules, polyarthritis, chorea.

32
Q

What is the most common type of pharyngitis?

A

Viral.

33
Q

Most common symptom/sign of viral pharyngitis?

A

Diffuse rash on oral mucosa.

34
Q

Cause of CF

A

Autosomal recessive disorder involving the CFTR gene.

35
Q

Symptoms & complications of CF

A
  • Symptoms/complications: Meconium illeus , pancreatic insufficiency , lung complications due to thick mucous & build up of bacteria - decreased lung function, cough, fever, pneumonia. Chronic bacterial infection & inflammation -> bronchiectasis , male infertility, clubbing, nasal polyps, allergic bronchopulmonary aspergillosus.
36
Q

Diagnosis of CF

A

Newborn screen sweat test (high Cl-)

37
Q

Causative agents of lobal pneumonia

A

 Lobar pneumonia: S. pneumoniae, S. aureus, H influenzae, K. pneumoniae, Moraxella catarrhalis.

38
Q

Causative agents of atypical pneumonia

A

 Atypical pneumonia: Mycoplasma pneumonia, Chlamydia pneumonia , Legionella pneumophilia , Coxiella burnetti , RSV, influenza, coronavirus, fungi or parasites.

39
Q

What deletion occurs in the CFTR gene to cause CF?

A

508.

40
Q

Function of CFTR

A

Responsible for pumping Cl- ions into secretions -> drawing out of water -> thinning mucous.

41
Q

What is meconium ileus?

A

Trapping of newborn’s first stool in the ileum.

42
Q

Complications of pancreatic insufficiency observed in pts with CF?

A

Thick secretions block pancreatic duct -> no pancreatic enzymes provided to small intestine -> poor weight gain/failure to thrive ->fat malabsorption -> steatorrhea -> digestive enzymes trapped in pancreatic duct degrade cells lining pancreatic duct ->acute pancreatitis/chronic pancreatitis -> insulin dependent diabetes.

43
Q

What opportunistic pathogens are most likely to colonise the CF lung in early childhood/adolescence?

A

Opportunistic S. Aureus & Pseudomonas aeruginosa are most likely to colonise the CF lung in early childhood/adolescence.

44
Q

3 x types of pneumonia (based on acquisition)

A

⦁ Community acquired OR
⦁ Hospital-acquired/nosocomial (e.g., MRSA)
⦁ Aspiration pneumonia

45
Q

What pathogen is most often the cause of community outbreaks of pneumonia post mass gatherings?

A

Legionella pneumonphilia

46
Q

What pathogen is most often the cause of pneumonia in abattoir workers?

A

Coxiella burnetti.

47
Q

Symptoms of pneumonia

A

o Symptoms : dyspnoea, chest pain, productive cough, fatigue, fever

48
Q

Diagnosis of pneumonia

A

o Diagnosis: CXR, dullness to percussion, tactile vocal fremitus, late inspiratory crackles, bronchial breath sounds, respiratory specimens (i.e., expectorated sputum, bronchoscopy specimens, nasopharyngeal aspirate/swab), blood cultures, urine.

49
Q

Affected regions of bronchopneumonia vs atypical/interstitial vs lobal pneumonia

A

⦁ Bronchopneumonia – throughout lungs (incl. bronchioles & alveoli)
⦁ Atypical/interstitial pneumonia – in the interstitium btw alveoli
⦁ Lobar pneumonia – consolidation of a whole lung lobe (e.g., S. Pneumoniae)

50
Q

Clinical presentation of typical vs atypical pneumonia

A

Typical - sudden onset fever, productive cough vs atypical - gradual onset fever, dry cough.

51
Q

Physical examination of typical vs atypical pneumonia

A

Typical - rapid RR, evidence of lung consolidation vs atypical - may show few abnormalities.

52
Q

Sputum observed in typical vs atypical pneumonia

A

Typical - purulent vs atypical - watery/mucopurulent.

53
Q

CXR typical vs atypical pneumonia.

A

Typical - lobar infiltrate, segmental vs atypical - patchy or interstitial infiltrates, often bilateral.

54
Q

Treatment w penicillin for typical vs atypical pneumonia & success.

A

Typical - most respond to penicillin vs atypical - poor response or resistant to penicillin.

55
Q

H vs N protein function.

A

H - binds to target cells sialic acid receptor and helps introduce viral genome into host cell to start the infection.
N - viral release- cleaves sialic acid receptor to release new virions from the infected cell.

56
Q

Causative agent of influenza

A

Influenza virus.

57
Q

Treatment of influenza

A

Neuraminidase inhibitors (incl. osetlamivir, zanamivir, peramivir).

58
Q

Causative agent of acute bronchiolitis

A

Respiratory Syncytial Virus (RSV)

59
Q

Symptoms of acute bronchiolitis (both URTI & LRTI symptoms).

A

o Symptoms: URTI symptoms incl – rhinorrhoea, congestion, sneezing then 1-3 days later LRTI symptoms incl – cough, tachypnea, chest retraction, hypoxaemia.

60
Q

Diagnosis of acute bronchiolitis.

A

Nasopharyngeal aspirate.

61
Q

Complications of acute bronchiolitis.

A

Bronchiolitis, pneumonia, apnoea, otitis media.

62
Q

Causative agent of whooping cough

A

Bordetella Pertussis

63
Q

Symptoms of whooping cough & stages

A

o Symptoms : ‘whooping’ cough, vomiting, fever, tachypnoea, tachycardia.
 Catarrhal stage 1-2wks
 Paroxysmal stage 2-4wks – danger zone for infants (i.e., acute life threatening events: cyanosis, apnoea, lung collapse, secondary pneumoniae, haemorrhage, death).
 Convalescent 1-3wks

64
Q

Diagnosis of whooping cough

A

Nasal swab.

65
Q

Treatment of whooping cough

A

Macrolide antibiotics (only if pt in catarrhal stage), supportive care.

66
Q

Bordetella pertussis microscopy

A

Gram -ve cocco-bacillus.

67
Q

Which phase of whooping cough is most infectious?

A

Catarrhal phase.

68
Q

Symptoms of paroxysmal phase of whooping cough

A

Severe episodic coughing w or w/out vomiting and whoop - inspiratory gasp of air.

69
Q

In which type of pneumonia is bilateral pneumonia more common?

A

Viral/atypical pathogens.

70
Q

Coryzal

A

Acute inflammatory contagious disease involving the URT.

71
Q

Glandular fever diagnosis

A

Atypical lymphocytes in blood under microscopy.

72
Q

What is a differentiating symptom between glandular fever and strep throat?

A

Enlarged liver and spleen in GF.