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Y2 BRS (Haroop) > Respiratory infections > Flashcards

Respiratory infections Flashcards

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1
Q

Which symptoms are associated with an upper respiratory tract infection?

A 
A cough
Sneezing
A runny or stuffy nose
A sore throat
headache
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2
Q

Which symptoms are associated with a lower respiratory tract infection?

A 
A “productive” cough - phlegm
Muscle aches
Wheezing
Breathlessness
Fever
Fatigue
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3
Q

Which symptoms are associated with pneumonia?

A

Chest pain
Blue tinting of the lips
Severe fatigue
High Fever

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4
Q

What is a disability adjusted life year?

A

A sum of Years of life lost (YLL) and years lost to disability (YLP)

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5
Q

Which respiratory disease has the greatest DALY?

A

Acute lung infection

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6
Q

Which geographic region has the greatest mortality for respiratory tract infections, in children under the age of 5?

A

South Asia and Sub-Saharan Africa

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7
Q

What is the trend between pneumonia and age?

A

Pneumonia increases with age

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8
Q

What are the demographic and lifestyle risk factors for pneumonia?

A

Age < 2 years or > 65 years
Cigarette smoking
Excess alcohol consumption

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9
Q

What are the social factors for pneumonia?

A

Contact with children aged <15 years
Poverty
Overcrowding

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10
Q

What medications are risk factors for pneumonia?

A

Inhaled corticosteroids
Immunosuppressants (e.g steroids)
Proton pump inhibitors

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11
Q

Which disorders/diseases present a risk factor for pneumonia?

A

COPD, asthma, heart disease, liver disease, diabetes mellitus, HIV, malignancy, hyposplenism, complement or Ig deficiencies, risk factors for aspiration
Previous pneumonia

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12
Q

Which pathogen is most commonly identified in individuals with respiratory illness?

A

Rhinovirus

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13
Q

Which respiratory infection causes the highest annual mortality?

A

Mycobacterium tuberculosis

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14
Q

Which two pathogens are the most common causes of respiratory infection?

A

Human Rhinovirus

Influenza A or B

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15
Q

What are the most common bacterial causes of respiratory infection?

A

Streptococcus pneumoniae
Myxoplasma pneumoniae
Haemophilus Influenzae

Mycobacterium tuberculosis

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16
Q

What are the most common cause of viral respiratory infection?

A 
Influenza A or B virus
Respiratory Syncytial Virus
Human metapneumovirus
Human rhinovirus
Coronavirus
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17
Q

What are the three categories of bacterial pneumonia?

A

1) Community acquired pneumonia
2) Hospital acquired pneumonia
3) Ventilator associated pneumonia

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18
Q

What is the most common community acquired pneumonia?

A

Streptococcus pneumoniae

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19
Q

What type of pneumonia infection is associated with haemophilus influenzae?

A

Typical

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20
Q

What is atypical pneumoniae?

A

Present with slightly different symptoms (some with longer milder symptoms for instance). Atypical pneumonias are often more difficult to culture.

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21
Q

What is administered to individuals with an atypical infection of pneumonia?

A

Penicillin and an additional macrolide

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22
Q

What type of bacteria is streptococcus pneumoniae?

A

Gram-positive, extracellular, opportunistic pathogen

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23
Q

What are the common forms of a hospital acquired pneumonia?

A 
Staphylococcus aureus
Psuedomonas aeruginosa
Klebsiella species
E. Coli
Acinetobacter spp.
Enterobacter spp.
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24
Q

What are the common forms of ventilator associated pneumonia?

A 
Psuedomonas aeruginosa (25%)
Staphylococcus aureus(20%)
Enterobacter
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25
What type of pneumonia is associated with Mycoplasma pneumoniae?
Atypical pneumonia
26
What are the three mechanisms of damage by pneumonia?
Lung injury - arterial hypoxemia Bacteremia Systemic inflammation Lead to organ injury/dysfunction and deterioration
27
What supportive therapy is available for bacterial pneumonia?
Oxygen for hypoxia Fluids for dehydration Analgesia for pain nebulised saline - expectoration
28
How is the severity of pneumonia assessed in an individual?
Urea is measured and. CURB-65 score is calculated
29
What is the mechanism of penicillin in terms of bacterial treatment?
Beta-lactams bind proteins in the bacterial cell wall to prevent transpeptidation
30
Give an example of a macrolide
Clarithromycin
31
What is the mechanism of macrolides in terms of bacterial treatment?
Clarithromycin - bind to bacterial ribosome to prevent protein synthesis
32
Give an example of penicillin
Amoxicillin
33
What is the standard treatment for a CAP with a CURB score of 0?
Amoxicillin or clarithromycin (doxycycline is pen allergic)
34
What antibiotic should be administered in an individual with penicillin resistance?
Doxycycline
35
What should be administered in an individual with a non-severe HAP?
Doxycycline
36
What should be administered in an individual with a CURB score of 1/2?
Amoxicillin + clarithromycin
37
What should be administered in an individual with a CURB of 3-5?
BenzylPenicillin IV + clarithro. PO (or teicoplanin + clarithro.)
38
What should be administered in an individual with a CURB score of 3-5 in a HAP?
tazocin (piperacillin-tazobactam) IV +/- gentamicin IV
39
What is the standard duration of antibiotic treatment in individuals with infections of pneumonia?
5-7 days
40
What is the key to increasing the success of antibiotics?
Time to administration (for every hour in septic shock survival is reduced by 7.9%) Using an effective antibiotic- typical CAPs may respond to penicillins, aytypical require macrolides
41
Which bacteria are commonly associated with the oropharynx?
Haemophilus spp. Staph. aureus Strep. pneumoniae
42
Which bacteria are commonly found in the nose?
Strep. pneumoniae
43
What is a microbiota?
Ecological communities of microbes found inside multi-cellular organisms
44
What is a commensal bacteria?
Microbes that live in a “symbiotic” relationship with their host. Providing vital nutrients to the host in the presence of a suitable ecological niche
45
What is an opportunistic pathogen?
A microbe that takes advantage of a change in conditions (often immuno-suppression).
46
What is a pathobiont?
A microbe that is normally commensal, but if found in the wrong environment (e.g. anatomical site) can cause pathology.
47
What type of bacteria is mycobacterium tuberculosis?
An opportunistic bacterium
48
What is formed in a latent infection of TB?
Granuloma
49
What happens to the granuloma in an active TB infection?
The granuloma matures and caseous necrosis proceeds
50
What is the standard treatment for M TB?
Standard treatment requires a combination of 4 antibiotics for a 6 month period
51
Why is TB a versatile pathogen?
Has a thick cell wall, resistant to uptake of molecules and resistant to degradation to environment
52
What is the mechanism of rifampicin?
Inhibits RNA synthesis
53
Which pathogen is the most common cause of pneumonia?
Streptococcus pneumoniae
54
How many serotypes are there for rhinovirus?
100+
55
How many serotypes exist for respiratory syncytial virus?
2
56
What is a serotype?
viruses which cannot be recognized by serum (antibodies) that recognize another – implications for protective immunity
57
What are the implications of viral induced damage to the epithelium?
1) Loss of cilia 2) Bacterial growth 3) Poor barrier to antigen 4) Loss of chemoreceptors
58
Which immune cells are the initial responders for a respiratory infection?
Neutrophils
59
What molecule does the major group of Rhinoviruses bind onto?
ICAM-1
60
What molecules does the minor group of rhinoviruses bind onto?
Low density lipoprotein family of receptors
61
What molecule does the H1N1 Influenza A virus bind onto?
alpha-2, 6 sialic acids
62
What molecule does the H5N1 avian flu bind onto?
Alpha-2,3 sialic acid
63
What is the distribution of alpha-2 6SA within the respiratory tract?
High frequency within the upper respiratory tract, progressively decreasing downwards.
64
Where does H1N1 typically infect within the respiratory tract?
Upper respiratory tract
65
What is the distribution of alpha2-3SA within the respiratory tract?
High frequency within the lower respiratory tract
66
What does the SARs Cov2 bind onto?
Angiotensin Converting enzyme 2
67
Where are ACE2 predominantly found?
Nasal epithelium | Type 2 pneumocytes
68
Which antigen proteins are exhibited by the RSv?
F and G proteins
69
Which antigen is presented by the influenza virus?
Haemogglutinin
70
What does the RSv bind onto?
Glycosaminoglycans in receptors including IGFR1 and nucleolin
71
What type of immunity is induced by influenza?
Mainly homotypic immunity
72
Why are zoonotic strains highly pathogenic?
There is an absence of prior immunity
73
What factors contribute to causing severe viral disease?
Highly pathogenic strains (zoonotic) Absence of prior immunity -Innate immunodeficiency (IFTM3 gene variant) -B cell (local antibody) T cells 3) Predisposing illness/conditions
74
How many groups of interferons exist?
3 Type 1 Type 2 Type 3
75
What are type 1 interferons?
IFN-Alpha | IFN-Beta
76
What are type-II interferons?
IFN-gamma
77
What are type-III interferons?
IFN-Lambda
78
Which cells produce type-I interferons?
Viral infected cells
79
Which cells produce IFN-gamma?
T-cells, NK cells
80
Which stimulatory genes are induced by the stimulation of IFN receptors?
ISGs, IRF, TLR3 | These directly inhibit viral replication within cells
81
What is the frequency of loss of function mutations in those with life threatening Covid?
Greater frequency of mutations.
82
Which virus is the leading cause of infant hospitalisation in the developed world?
RSv causing RSV bronchiolitis
83
What symptoms are exhibited by a RSv infected infant?
``` Nasal flaring Chest wall retractions Hypoxemia and cyanosis Croupy cough Expiratory wheezing, prolonged expiration, rales and rhonchi Tachypnea and apenic episodes ```

Y2 BRS (Haroop) (62 decks)

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