Pulmonary Infections- Micro Flashcards
(249 cards)
1
Q
What is the fxn of saliva to prevent infection?
A
Flushes bugs away in the oropharynx
2
Q
What is the fxn of the mucociliary system to prevent infecitons?
A
Traps bugs in the nasopharynx
3
Q
These are invaders that infect a normal healthy respiratory tract.
A
Professional invaders
4
Q
These are invaders that only cause ideases when host defenses are already impaired.
A
Secondary invaders
5
Q
Rhinoviruses- attachement mechanism
A
capsid protein
6
Q
Rhinoviruses- receptor
A
ICAM-1
7
Q
Rhinoviruses- Disease
A
Common cold
8
Q
Rhinoviruses- age predilection
A
Infants and kids
9
Q
Rhinoviruses- time of year infection
A
in fall and spring
10
Q
Coxsackie A- attahcment mechanism
A
capsid protein
11
Q
Coxsackie A- receptor
A
ICAM-1
12
Q
Coxsackie A- Diseases (3)
A
Common cold
herpangina
Hand/foot/mouth
13
Q
Coxsackie A- age predilection
A
Newborns
14
Q
Coxsackie A- season of infection
A
summer
15
Q
Influenza- attachement mechanismm
A
Haemaggluntinin
16
Q
Influenza- receptor
A
neuraminic acid- containing glycoprotein
17
Q
Influenza- disease
A
flu including lower respiratory tract
18
Q
Influenza- age (3)
A
adults- classic flu
kids- asymptomatic –> severe respiratory tract infeciton
elderly- high risk cuz of immunocompromised
19
Q
Influenza- genomic composition
A
8 negative-sense RNA nucleocapsid segments
20
Q
Parainfluenza virus- attachement mechanism
A
viral envelope protein
21
Q
Parainfluenza virus- receptor
A
Glycoside
22
Q
Parainfluenza virus- disease (kids vs adults)
A
Kids- mild disease or croup
Adults- risk for reinfection w/milder Sx
23
Q
Parainfluenza virus- season
A
fall
24
Q
Respiratory Syncytial Virus (RSV)- attachment mechanism
A
G protein
25
Respiratory Syncytial Virus (RSV)- disease (kids)
Lower respiratory tract infection
26
RSV is a paramyxovirus except it lacks what 2 things?
hemagglutinin and neuraminidase activity
27
Coronavirius- attachment mechanism
viral envelope protein
28
Coronavirius- receptor
N-acetyl neuraminic acid receptor
29
Coronavirius- disease in infants/kids (2)
common cold
severe acute respiratory syndrome (SARS)
30
Coronavirius- genome composition
+ ssRNA
31
Adenovirus- attachment mechanism
Penton fiber with viral attachment protein
32
Adenovirus- roceptor
fiber proteins interact with a glycoprotein, some use MHC-I
33
Adenovirus- disease in kids < 14 y/o and crowded areas (3)
Pharyngitis
Conjunctivitis
Bronchitis
34
Adenovirus- genome composition
dsDNA
35
Echovirus- diseases (2) in kids
common cold
aseptic meningitis
36
Echovirus- genome composition
RNA enterovirus from picornaviridae
37
Parainfluenza- virulence
HA, NA
38
Over 50% of common colds are caused by what 2 viruses?
Rhinovirus or coronavirus
39
What do must viruses contain that prevents them from being washed away, thus being able to infect healthy people.
Surface molecules
40
This is the condition of adenovirus in yound kids that can mimic strep (nasal congestion, cough, coryza, malaise, fever, chills, myalgia, and headache).
Acute febrile pharyngitis
41
Who gets the pharyngoconjunctival fever in adenovirus infections?
Older kids
42
What is the manifestation of serotypes 4&7 in adenovirus infections?
Acute respiratory distress (fever, cough, pharyngitis, cervical adenitis)
43
Pertussis-like illness in adenovirus infections is in kids and adults with what condition?
True viral pneumonia
44
What is the common place to get conjunctivitis from adenovirus infections?
Swimming pools
45
This is the condition of adenovirus infections where an occupational hazard of industrial workers leads to conjunctivitis from debris.
Epidemic keratoconjunctivitis
46
Serotypes 40 and 42 of adenovirus can cause what in infants?
Gastroenteritis and diarrhea
47
Who gets intussuseption from adenovirus infections?
children
48
Who gets acute hemorrhagic cystitis with dysuria and hematuria from adenovirus infections?
Young boys
49
Who gets pneumonia and hepatitis from adenovirus infections?
Immunocompromised pts
50
What is the bug toi cause scarlet fever?
S. pyogenes
51
S. pyogenes- virulence (3)
1. avoids phagocytosis (capsule, M-proteins, C5a peptidase)
2. adheres and invades (M proetin, lipteichoic acid, F protein)
3. produces toxins (strep exotoxins, streptolysis S&O, streptokinase, DNAses)
52
S. pyogenes- pathogenesis for scarlet fever
toxin spreads through body and localizes in the skin to induce a punctate erythematous rash
53
S. pyogenes- findings of tongue and body
Tongue- furry --> red
Body- facial erythema --> all over rash except palms and soles
54
S. pyogenes- course of disease
rash for 1 week --> extensive desuqamation
55
This is an indirect complication from Ab's to formed Ag's in the strep pyogenes cell wall.
Rheumatic fever
56
What happens in the heart with rheumatic fever when Ab's cross-react with the sarcollemma and other tissues?
myocarditis or pericarditis
57
What are the granulomas in the heart called in rheumatic fever?
Aschoff nodules
58
What type of hypersensitivity is rheumatic fever?
Type II cytotoxic
59
this is the condition where Ab's combine with strep Ag's and form circulating immune complexes, which then deposit in the glomeruli and cause autoimmune dmg.
Acute glomerulonephritis
60
How long after a sore throat do u see acute acute glomerulonephritis with hematuria?
1-2 weeks
61
What labs show acute glomerulonephritis from strep?
↑ ASO Ab's
62
What type of hypersensitivity rxn is acute glomerulonephritis from strep pyogenes?
Type III
63
What is the causitive agent for parotitis?
Mumps virus (paramxovirus)
64
Mumps- spread
airborne droplets (close contact)
65
After the mumps replicates in local lymphoid tissues, what happens after 7-10 days?
enters the blood and causes a primary viremia and localizes in salivary glands, CNS, testis, pancreas, and ovaries.
66
When to the parotid cells degenerate in a mumps infection?
16-18 days
67
What is the vaccine type for mumps?
live attenuated MMR vaccine
68
What is the viral cause for otitis media?
RSV
69
What are the 2 main bacterial causes for otitis media?
S. pneumoniae
H. influenzae
70
What are the 3 main causes of otitis externa?
S. aureus
Candida albicans
G(-) opportunists (proteus and p. aeruginosa)
71
What is the causitive agent for acute epiglotitis?
H. influenza
| diptheria in 3rd world countries
72
Who get acute epigotitis?
young chilren
73
What is the type of H. influenza to cause severe inflammation and edema, leading to acute epiglotitis?
Capsular type B
74
What are the Sx to acute epiglotitis?
severe dyspnea
75
How do u treat acute epiglotitis?
Antibiotics (cefotaxime, cloramphenicol)
76
Why is acute epiglotitis rarely seen in the US in young kids?
Flu vaccine
77
This is the condition where there is swelling of the mucous membrane, leading to a dry cough and inspiratory stridor.
Croup
78
What are the 3 "S's" for croup?
Stridor
Subglottic swelling
Seal bark cough
79
What is the most common cause of croup?
Parainfluenza virus
80
What forms in the back of the throat in Corynebacterium diptheriae?
grey pseudomembrane
81
What happens to the appearance of the neck in C. diptheriae infections?
looks like a Bull neck
82
What is the virulence factor for C. diptheriae?
AB toxin sends A section in --> ADP ribosylation of EGF2 --> halt of protein synthesis
hey look this was a random ass cardio question.
83
Who is at risk for diptheria? Why?
poor, resource-deprived regions cuz they dont have the TDaP vaccine.
84
What can happen in the heart from C. diptheriae infections?
Myocarditis --> heart failure
85
What can happen in the nerves from C. diptheriae infections?
Polyneuritits- demyelination, esp in IX
86
What is the most common cause of whooping cough?
Bordetella pertussis
87
How is B. pertussis spread?
Aerosol droplets
88
This is the stage from 1-2 weeks of pertussis where there are coldlike Sx.
Catarrhal stage
89
True or False: The catarrhal stage is the most infectious stage for pertussis.
True!
90
This is the stage from 2-4 weeks of pertussis where there are prolonged coughing fits and the whoop.
Paroxysmal stage
91
This is the 3-4 week stage of recovery in pertussis.
Convalescence stage
92
What is the mechanism of action of the pertussis toxin?
AB toxin that ribosylates ADP of EF-2, halting protein synthesis
93
What is the MOA for the adenylate cyclase toxin from pertussis?
↑ cAMP which induces bactericinal effects from increased neutrophil cAMP levels
94
What is the MOA for the tracheal cytotoxin from pertussis?
Murders tracheal epithelial cells
95
What is the MOA for the endotoxin from pertussis?
LDP similiar to G(-) bacteria
96
Which age are u at greatest risk for pertussi infections?
kids < 1
97
Why is whole cell (killed) pertussis vacceines no longer used?
Many side effects and can even lead to enceophalopathy (ouch)
98
What are the 3 components to the acellular toxin for pertussis?
Pertussis toxin + filamentous hemagglutinin + pertactin toxins
99
This is the inflammation of the bronchioles.
Bronchiolitis
100
What is the most common cause of bronchiolitis?
RSV
101
What pts get RSV infections?
kids < 2
102
Where is Sin Nombre Virus (Hantavirus) from?
inhaling infected Rodent feces, saliva, or urine
103
What are the clinical manifestations of hantavirus?
serious pulmonayr and cardiac disease as well as hemorrhagic fever with renal syndrome.
104
Is pneumonia mainly viral or bacterial in kids?
viral
105
What are the 2 main viruses to cause pneumonia in kids?
RSV or parainfluenza
106
Which bud causes interstitial pnemonitis in neonates?
Chlamydia trachmatis
107
This is the bug to cause LOBAR pneumonia.
Strep pneumoniae
108
These are the bugs to cause bronchopneumonia. (5)
S. pneumo, S. aureus, Klebsiella, E. Coli, and pseudomonas
109
These are the 2 bugs to cause lung abscesses.
Bacteriodes and fusobacterium.
110
Typical pneumonia (PNA) is caused by which 2 bugs?
S. pneumo
H. influenza
111
Atypical PNA is caused by what?
Anything not strep or H. influenza:
mycoplasma pneumonia, chlamydophilia pneumonia/psittaci, legionella pneumonphilia, and coxiella burnetti
112
Streptococcus pneumoniae- gram/shape
gram + cocci
113
Streptococcus pneumoniae- infection/Sx
PNA with productive cough
114
True or false- Streptococcus pneumoniae is part of the normal flora of the URT.
True
115
What are the optochin, hemolytic, color of sputum for Streptococcus pneumoniae?
optochin sensitive, alpha hemolytic, rust colored sputum
116
Klebsiella pneumoniae- gram/shape
Gram - rod
117
Klebsiella pneumoniae- Sx
lung inflammation and hemorrhage which leads to thick bloody sputum
118
Klebsiella pneumoniae- color of sputum
red currant jelly sputum
119
Klebsiella pneumoniae- macconky agar color, lactose test, indole test, other labs.
maccokey shows pink, lactose fermenter, indole negative, capsulated, donovan bodies
120
Klebsiella pneumoniae- pt population
alcoholics and homeless due to vomit aspiration
121
Bacillus anthracis- gram/shape
gram + rods
122
Bacillus anthracis- Sx
flu-like, severe respiratory Sx, lower backpain, coughing up blood
123
Bacillus anthracis- transmission
spore inspiration
124
Bacillus anthracis- lab characteristics
spores, medusae head appearance
125
Staphylococcus aureus- gram/shape
Gram + cocci
126
Staphylococcus aureus- Sx
productive cough
127
Staphylococcus aureus- color of sputum, coagulase test
salmon colored sputum, coagulase +
128
Staphylococcus aureus- follow what type of infection
viral
129
Mycoplasma Pneumoniae- gram stain
none- no cell wall.
130
Mycoplasma Pneumoniae- Sx
atypical PNA- dry hacking cough with no bloody sputum
131
Mycoplasma Pneumoniae- transmission
aerosol droplets
132
Mycoplasma Pneumoniae- cold aggutinin test
cold agglutinin +
133
Mycoplasma Pneumoniae- pt population
high schoolers and college kids
134
Chlamydophila pneumoniae- gram/stain
obligate intracellular
135
Chlamydophila pneumoniae- Sx
bronchitis, PNA, sinusitis, atypical PNA
136
Chlamydophila pneumoniae- where are elementary and reticular bodies?
elementary bodies outside cell
reticulate body is replicating inside cell
137
Chlamydophila Psittaci- gram/shape
obligate intracellular
138
Chlamydophila Psittaci- transmission
parrots
139
Coxiella burnetii- gram/shape
Gram - bacillus
140
Coxiella burnetii- transmission
aerosol droplets, from ticks
141
Legionella pneumophila- gram/shape
gram - rod
142
Legionella pneumophila- Sx
Legionairres disease
143
Legionella pneumophila- transmission/sources
air conditioning, plumbing, standing water
144
Legionella pneumophila- agar for growth
Buffered charcoal yeast agar (BCY)
145
Legionella pneumophila- pt population
alcoholic elderly smokers
146
This is the virus that Peaks in Winter months, symptoms include Fever, Runny nose, Cough, Sore throat, and wheeze, and is found mainly in children.
Human metapneumovirus
147
What population gets influenza A?
Birds and animals
148
What population gets Influenza B?
only humans
149
What population gets Influenza C?
Minor disease in animals
150
Which influenza strains have epidemics?
A and B
151
What are the 2 antigens that give infleunza A its unique type?
Hemagglutinin and neuraminidase (like H1N1)
152
What is the genetic composition of influenza?
ssRNA that's segmented
153
This is a sudden change or major change of a virus where the new strain can infect people immune to pre-existing strains (pandemic).
Antigenic shift
"sudden SHIFT of the genome"
154
Which influenza virus has antigenic shift?
influenza A
155
These are small mutations that usually do not affect the individual, and with enough emutations these can add up and re-infect and immunized person.
Antigenic drift
"slow driffffttttttt into a new form..."
156
Which strains of influenza has antigenic drift?
All strains
157
How do you name infleunza strains?
type/location/H type N type
A/Phillipines/82/H3N2
158
Where are the vaccines grown for the influenza vaccines?
Chicken eggs
159
What are the secondary infection that could follow an influenza infection?
Staph aureus (deadly), pneumococci, H. influenzae.
160
Which protein does the influenza virus use to attack to the sialic acid repectors on respiratory epithelial cells?
HA protein
161
What are released from the damaged epithlial cells to cause chills, malaise, fever, aches, runny nose, and cough from influenza?
Cytokines
162
What are bad manifestations in the repiratory tract from influenza infections?
bronchitis and interstitial PNA
163
What are the bad CNS manifestations for influenza infections?
meningitis, encephalomyelitis, polyneuritis and guillain barre
164
Which virus causes SARS?
Coronavirus
165
How do people get coronavirus?
Eating infected animals
166
What are the Sx to SARS?
high fever, cough, SOB, and dyspnea
167
This is the bacteria to cause croup and pneumonia in children, minor upper respiratory illness
Parainfluenza
168
How is mycobacterium tuberculosis transmitted?
aerosol droplets
169
When inhaled, what does M. TB do to spread throughout the body?
Infect macrophages and divide within them.
170
The immune response to TB will activate macrophages and it will try to contain them, forming what in the lungs?
Granulomas
171
Lung lesions with enlarged lymph nodes in TB are called what?
Gohn complex
172
In secondary TB, there is reactivation of dormant mycobacteria from what secondary condition?
AIDS (or other immunocompromised situation)
173
This is the form of TB where there is disseminated TB via lymphatics which can move into other tissues like the kidney or other lobes of the lung.
Miliary TB
174
This is the test where you can find M. tuberculosis even though it has a slow growth and doesnt stain well.
Ziehl-Neelsen stain
175
What is injected into the skin in a PPD?
Purified protein derivative of mycobacterium TB
176
What is the Tx for TB?
Isonazid, rifampicin, ethambutol, or prolonged therapy
177
Which one is acid fast, M. tuberculosis or Nocardial?
TRICK QUESTION. THEY'RE BOTH ACID FAST.
178
So which agar does M. tuberculosis grow on?
Lowenstein Jensen Agar
179
Which is the virulence factor for M. tuberculosis and is characteristic on LJ agar?
Cord factor and shows a characteristic serpentine arrangement.
180
What property of P. aeruginosa is important to cause chronic problems in CF pts?
Its ability to change into a mucoid form, thrive in mucous, and then cause immunologic dmg to the lung
181
Which pts are at risk for polymicrobial or anaerobic PNA?
Pts that aspirate respiratory or gastric secretions from altered consciousness.
182
What is the manifestation from aspirating respiratory or gastric secretions?
Necrotizing PNA, which leads to lung abscesses
183
This is the allergic response to aspergillus Ag in the lungs, occurs with asthma and 10% of CF pts.
Allergic bronchopulmonary Aspergillosis
184
These are large fungal balls of entagled hyphae in the lung cavities, typically in COPD pts.
Aspergilloma
185
What is the Dx criteria for Aspergillus infections? (2)
45 degree acute angled branching hyphae
CXR of fungal ball for aspergilloma
186
What is the most common opportunistic pulmonary infection in HIV-infected individuals?
Pneumocystis jiroveci (formerly P. carinii)
187
When is a HIV+ individual most likely to develop pneumocystis pneumonia (PCP)?
b4 taking antiretroviral therapy
188
This is the pathogenesis of PCP:
Trophic form --> ________ _________ --> _____ --> rupture
Trophic form --> uninucleate sporocyts --> cyst --> rupture
189
What is the stain u can do for the trophic forms of PCP?
Giemsa stain
190
What is the stian u can do for the cyst call for PCP?
GMS (silver) stain
191
What is the drug used for the prophylaxis of PCP?
Trimethoprim-Sulfamethoxazole (TMP-SMZ)
192
What are the 3 nematodes that can migrate through the lungs and break capillaries causing pneumonitis with coughing and wheezing?
Ascaris, Strongyloides, and Hookworms
193
What can schistosome larvae do the lungs?
cause pneumonitis with nodular lesions
194
W. bancrofti and brugia cause lay larvae int he capillaries of the lung, causing what?
Pulmonary eosinophilia
195
What can form in the lungs in an echinococcus granulosus infection?
hydatid cysts
196
This is the oriental lung fluke that can live in the lung and have fibrous cysts.
Paragonimus westermani
197
Histoplasma capsulatum- yeast form
intracellular budding yeast, oval
198
Histoplasma capsulatum- hyphal forms (2)
1. large, thick-walled, spherical with spike-like projections
2. small, oval, with sessile or short stalks
199
Histoplasma capsulatum- where in the world??
Eastern N america, mexico, central and S america
200
Histoplasma capsulatum- reservoir
in the soild with bird/bat droppings
201
Histoplasma capsulatum- acquisition
aersolization
202
Histoplasma capsulatum- people at risk (2)
1. immunocompromised
| 2. kids
203
Histoplasma capsulatum- Sx with low intensity exposure
Asymptomatic pulmonary infection
204
Histoplasma capsulatum- Sx with high intensity exposure
flu-like Sx, medistinal adenopathy and patchy infiltrates, ARDS, medistinal fibrosis
205
Histoplasma capsulatum- chronic Sx
apical cavities and fibrosis
206
Histoplasma capsulatum- subacute disseminated Sx
wt loss, fatigue, oral ulcers and hepatosplenomegaly, anemia, leukopenia, thrombocytopenia
207
Histoplasma capsulatum- acute disseminated Sx
septic-like shock, oral and GI ulcerations and bleeding.
208
Coccidioides immitis- yeast form
Endosporulating spherule
209
Coccidioides immitis- hyphal form
barrel-shaped
210
Coccidioides immitis- culture
appears white-gray, moist, culture at 25 degrees
211
Coccidioides immitis- where in the world??
Southwestern US (CA)
oh noooooooooooooooooooooooo
212
Coccidioides immitis- reservoir
soil from bat and rodent droppings
213
Coccidioides immitis- transmission
inhaled, especially in late summer/fall
214
Coccidioides immitis- risk groups (4)
Filipinos, males, women in 3rd trimester, immunodeficient (AIDS/old/young)
215
Coccidioides immitis- small infection Sx
asymptomatic or self-limited flu-like illness
216
Coccidioides immitis- primary disease Sx
allergic reactions including immune complex formations with erythmeatous macular rash, erythema multiforme, and erythema nodusum.
217
Coccidioides immitis- secondary disease Sx
Nodules, cavitary disease, nonprogressive pulmonary disease, single or multisystem dissemination
218
Paracoccidioides brasiliensis- Yeast form
large, multiple budding yeast at 37 degrees, double refractile walls. "pilot's wheel" morphology
219
Paracoccidioides brasiliensis- hyphal form
Round microconidia and intercalar chlamydospores
220
Paracoccidioides brasiliensis- where in the world???
South america (brazil)
it's in the name lol
221
Paracoccidioides brasiliensis- transmission
inhalation of traumatic inoculation
222
Paracoccidioides brasiliensis- risk groups (3)
1. young kids- get the primary infection
2. older males- get pulmonary form and dissemination
3. immunocompromised- acute progressive form
223
Paracoccidioides brasiliensis- subacute disseminated Sx
big organs, recurrent fungemia
224
Paracoccidioides brasiliensis- chronic pulmonary Sx
persistent cough, purulent sputum,chest pain, wt loss, dyspnea, fever
225
Paracoccidioides brasiliensis- dissemination location
skin, mucosa (painful), lymph nodes, adrenal, liver, spleen, CNS and bones
226
Blastomyces dermatitidis- yeast form
non-encpsulated, grow at 37, spherical, hyaline, multinucleated with thick :double contoured" walls
227
Blastomyces dermatitidis- hyphae form
grows on white-tan filamentous colonies on mycologic media at 25, stain with silver or PAS
228
Blastomyces dermatitidis- where in the world??
N. america (OH and MI river valleys) and africa
229
Blastomyces dermatitidis- reservoir
moist soild with docomposing organic matter
230
Blastomyces dermatitidis- transmission
aerosolization, NO person-person
231
Blastomyces dermatitidis- risk groups
soil workers, dogs, IC pts.
232
Blastomyces dermatitidis- mild/moderate/severe Sx
Mild- flu-like illness
Moderate- PNA with acute onset
Severe- Fulminant ARDS
233
Blastomyces dermatitidis- chronic/subacute Sx
pulmonary mass lesions or fibronodular infiltates
234
Blastomyces dermatitidis- chronic cutaneous involvement
hematogenous dissemination from the lung, popular, ulcerative, crusted, painless, gross-looking lesions on your face, scalp, neck, or hands.
235
Aspergillus- culture characteristics
hyaline molds, many colors, grows on mycologic media lacking cycloheximide
236
Aspergillus- what do u see on microscopy
branched, septae hyphae that produce conidial heads (like a dandelion)
237
Aspergillus- 3 things for staining
PAS, GMS, and gridley
238
Aspergillus- epidemiology
eeeeerywhere
239
Aspergillus- transmission
respiratory tract
240
Mucor- culture
produce gray-brown wooly colonies (the crap on old fruit and shit)
241
Mucor- what do u see on microscopy?
broad, hyaline, septate, irregularly contoured and pleomorphic, rhizoids, sporangiospores with columella (like a lightbulb)
diameter >10 um
242
Mucor- 2 things for staining
H&E and PAS
243
Mucor- epidemiology
eeeeerywherhheherheheeehehehehe
244
Mucor- portal of entry
angioinvasive
245
Which Ab is elevated on labs in allergic aspergillosis?
IgE
246
What are the Sx to invasive pulmonary aspergillosis and disseminated aspergillosis?
dever and pulmonary infiltrates, 70% mortality, angioinvasive nature causes hematogenous dissemination
247
Which patients are at risk for pulmonary zygomycosis infections?
neutropenic pts (low neutrophils)
248
Which patients are at risk for rhinocerebral mucormycosis infections?
pts with metabolic acidosis (diabetic ketoacidosis)
249
This is an acute infection of the nasal cavity, paranasal sinuses, and orbit in diabetics.
Rhinocerebral mucormycosis
