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Microbiology Final Exam > Respiratory System Infections > Flashcards

Respiratory System Infections Flashcards

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1
Q

Streptococcal Pharyngitis

Causative Agent

A

Streptococcus pyogenes
Gram- positive coccus in chains
Beta hemolytic
Group A Streptococcus

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2
Q

Streptococcal Pharyngitis

Symptoms

A

Difficulty swallowing
Fever
Red throat with pus patches
Enlarged tender lymph nodes

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3
Q

Streptococcal Pharyngitis

Epidemiology and Pathogenesis

A

Epidemiology: Spread readily by respiratory droplets
Pathogenesis: Wide variety due to numerous virulence factors

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4
Q

Streptococcal Pharyngitis

Treatment

A

Most recover uneventfully in a week
Strep throat with 10days of antibiotics
Penicillin or Erythromycin are drugs of choice

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5
Q

Streptococcal Pharyngitis

Complications and Secondary Sequelae

A

Complications: Scarlet Fever- erythrogenic toxin enters blood and circles causing red skin and white tongue coating & Quinsy- painful abscesses around tonsils
Secondary Sequelae: (Weeks after infection) Acute glomerulonephritis- skin infections and pharyngitis & Acute Rheumatic Fever- pharyngitis

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6
Q

Diphtheria

Causative Agent

A 
Corynebacterium diphtheria
Variably shaped
Gram- positive
Non-spore forming
Certain strains produced by diphtheria toxin
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7
Q

Diphtheria

Symptoms

A

Mild sore throat, slight fever, fatigue, malaise and dramatic neck swelling
Whitish-greyish pseudomembrane on tonsils or nasal cavity (can detach to larynx and trachea)

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8
Q

Diphtheria

Epidemiology and Pathogenesis

A

Epidemiology: Humans as primary reservoir, Spread by air/ inhalation
Pathogenesis: Little invasive ability, Most strains release toxin, Production of toxin requires lysogenic conversion by bacteriophage, Toxin production in low Iron environments, exotoxin released into bloodstream

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9
Q

Diphtheria

Toxin

A

(A/B Toxin)
Released from bacteria in inactive form
Cleaved into A and B chains
B attaches to membrane and attaches through endocytosis
A is active enzyme that inhibits protein synthesis
Small enzyme amount inhibits protein synthesis through EF-2

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10
Q

Diphtheria

Prevention

A

Disease from toxin absorption
Prevention directed at immunization (DPT)
Immunity wanes after childhood (Booster every 10yrs)

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11
Q

Diphtheria

Treatment

A

Effectiveness depends on early antiserum treatment
Antibiotics to eliminate bacteria (Penicillin and Erythromycin)
1/10 die

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12
Q

Pinkeye, Earache, and Sinus Infections

Causative Agent

A 
Haemophilus influenza (Gram-negative bacillus)
Streptococcus pneumoniae (Gram-positive diplococci; pneumococcus)
Otitis media (Mycoplasma pneumoniae, Streptococcus pyogenes, Staphylococcus aureus)
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13
Q

Pinkeye, Earache, and Sinus Infections

Symptoms

A

Pinkeye: Increased tears and redness of conjunctiva, Swelling eyelids, Sensitivity to bright light, Large pus amount
Sinusitis: Pain and pressure, Tenderness, Headache, Severe malaise
Otitis media: Common in youth, Ear pain, Mild fever, Vomitting, Ear drum rupture

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14
Q

Pinkeye, Earache, and Sinus Infections

Pathogenesis

A

Pinkeye: Few details, Most likely airborne respiratory droplets, Resist destruction by lysoenzyme
Sinusitis: Infection of nasopharynx and spreads to sinuses
Otitis media: Develops time of conjunctivitis diagnosis, Infection of nasal chamber and nasopharynx, Ear drum often bursts

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15
Q

Pinkeye, Earache, and Sinus Infections

Prevention and Treatment

A

Pinkeye: Removal from school, Handwashing, Avoid rubbing/touching, Avoid shared towels; treatment by eyedrops or antibiotics
Sinusitis: No proven preventative measures, Decongestants and Antihistamines discouraged
Otitis media: Pneumococcal vaccine, Treatment by antibiotic therapy and Amoxicillin

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16
Q

Common Cold

Causative Agent

A 
30% to 50% caused by rhinovirus
Member of picornavirus family
Small
Singe stranded RNA
Acid labile
20% cause by coronavirus
Single stranded RNA
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17
Q

Common Cold

Symptoms

A 
Malaise
Scratchy mild sore throat
Runny nose
Cough and hoarseness
Nasal secretion (Initially water and later thick)
Symptoms disappear within week
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18
Q

Common Cold

Epidemiology

A

Humans only source
Close contact necessary
Young children transmit easily
No relationship to cold exposure

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19
Q

Common Cold

Pathogenesis

A

Virus attaches to receptors in respiratory epithelial cells
Injured cells cause inflammation leading to symptoms
Infection halted by inflammatory response, interferon release, and immune response

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20
Q

Common Cold

Prevention and Treatment

A

Prevention: No vaccine, Handwashing, Keep hands away, Avoid crowds
Treatment: Ineffectual antibiotic therapy, Certain antiviral medications show promise, Treatment with over-the-counter medication

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21
Q

Adenoviral Pharyngitis

Causative Agent

A 
Adenovirus
45 types infect humans
Non-enveloped
Double stranded DNA genome
Infectious in environments for long time periods
Transmitted with medical instruments
Inactivated with heat and disinfectants
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22
Q

Adenoviral Pharyngitis

Symptoms

A 
Runny nose
Fever
Sore throat
Tender lymph nodes 
Hemorrhagic conjunctivitis
Mild cough
Infection resolves 1-3weeks
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23
Q

Adenoviral Pharyngitis

Epidemiology

A

Humans only source
Common in school children
Virus spread by respiratory droplets
Epidemic spread by high asymptomatic carriers

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24
Q

Adenoviral Pharyngitis

Pathogenesis

A

Virus infects epithelial cells
Attaches to specific receptors
Cells escape to surface
Cell destruction initiates inflammation
Diff virus affect diff tissues
Adenovirus type 4 causes sore throat and lymph enlargement
Adenovirus type 8 causes extensive eye infection

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25
Adenoviral Pharyngitis | Prevention and Treatment
Same as common cold No treatment Patients recover uneventfully
26
Pneumococcal Pneumonia | Causative agen
``` Streptococcus pneumoniae Gram positive Diplococci Thick polysaccharide capsule No Lancefield grouping ```
27
Pneumococcal Pneumonia | Symptoms
``` Cough Chest pain Runny nose Fever Spuptum production ```
28
Pneumococcal Pneumonia | Epidemiology
30% with encapsulated strain in throat Bacteria rarely reach lung due to mucociliary escalator Risk of pneumonia when escalator is destroyed
29
Pneumococcal Pneumonia | Pathogenesis
Infection develops when inhaled into alveoli Causes inflammatory response Pneumococci that enter bloodstream responsible for Septicemia- infection of bloodstream, Endocarditis- infection of heart valves, and Meningitis- infection of membranes covering brain and spinal cord Complete recovery
30
Pneumococcal Pneumonia | Prevention and Treatment
Prevention by vaccine Immunity in 23 strains Conjugate vaccine against 7 types for infants Antibiotic treatment successful if early (Penicillin and Erythromycin)
31
Klebsiella Pneumonia | Causative Agent
Species of Klebsiella | Primary- Gram-negative, Bacillus, and Encapsulated
32
Klebsiella Pneumonia | Symptoms
Indistinguishable from Pneumococcal Pneumonia Cough, Fever, Chest Pain, Chills, Red sputum 50%-80% Mortality
33
Klebsiella Pneumonia | Epidemiology
Part of normal flora of intestine in small population | Colonization of mouth and throat common in debilitated individuals
34
Klebsiella Pneumonia | Pathogenesis
Organism in mouth and throat Carried to lung with inspired air or mucus Survival in lung by capsule Tissue death (necrotizing) Blood infection leads to abscesses in other tissues
35
Klebsiella Pneumonia | Prevention and Treatment
No specific Disinfect environment Use antimicrobials when necessary
36
Mycoplasmal Pneumonia | Causative Agent
``` Mycoplasma Pneumoniae Small In cell lines Deformed bacteria lacking cell wall Slow growing Aerobic Colonies with distinctive fried egg appearance ```
37
Mycoplasmal Pneumonia | Symptoms
Gradual onset First symptoms- fever, headache, muscle pain, fatigue Later symptoms- dry cough "atypical pneumoniae", "walking pneumonia"
38
Mycoplasmal Pneumonia | Epidemiology
Bacteria spread by aerosolized droplets from respiratory secretions Survive long periods in secretions 1/5 of Bacterial pneumonia Non-permanent immunity
39
Mycoplasmal Pneumonia | Pathogenesis
Small infecting dose Organism attaches to receptors on epithelium Attachement interferes with ciliated cell action Ciliated cells slough off Inflammation initiates thickening of bronchial or alveolar walls (Difficulty breathing)
40
Mycoplasmal Pneumonia | Prevention and Treatment
No practical prevention Avoid crowds Antibiotic treatment will inhibit growth, Penicillin and cell wall inhibitors are ineffectual, Tetracycline and Erythromycin must be given early
41
Whooping Cough | Causative Agent
Bordetella Pertussis | Gram-negative
42
Whooping Cough | Symptoms and Epidemiology
Symptoms: Mild upper respiratory infection with typical paroxysmal coughing Series of hacking coughs with production of copious amounts of mucus that end with respiratory "whoop" as air rushes past narrowed glottis Epidemiology: Spreads via infected respiratory droplets Infectious during runny nose (Decrease with cough) Primarily in infants and children
43
Whooping Cough | Pathogenesis
Enters respiratory tract with inspired air and attaches to ciliated cells via Filamentous Hemagglutinin (Fha) Mucus secretions increases which causes ciliary action to decrease while ciliated cells slough off Cough reflex to clear secretions B. Pertussis toxic products: Pertussis toxin- A/B toxin: increased mucus formation, inhibits leukocyte function, bacterial binding Adenylate cyclase toxin: increased cAMP, mucus Tracheal cytotoxin: no goblet cells from death of ciliated, release of IL-1
44
Whooping Cough | Prevention and Treatment
``` Prevention: Vaccination of infants Prevents disease Treatment: Erythromycin if early Supportive therapy (Oxygen therapy, suction mucus) ```
45
Tuberculosis | Causative Agent
``` Mycobacterium tuberculosis Gram positive cell wall Obligate aerobic rod-shaped bacteria Acid fast Slow growing Resistive ```
46
Tuberculosis | Symptoms
Chronic illness | Weight loss, Fever with night sweats, Chronic cough
47
Tuberculosis | Pathogenesis
Inhalation of airborne organisms Taken up by pulmonary macrophages in lungs Resists destruction with phagocyte (prevents phagosome-lysosome fusion) Activated macrophages can kill bacteria 2-weeks post infection immune reaction results- macrophages fuse to make large multinucleate cells, tubercles Lysis of activated macrophages releases contents Some granulomas contain live organisms
48
Tuberculosis | Epidemiology
Tuberculin Test- Mantoux- Type IV Hypersensitivity | Injection site becomes red and firm
49
Tuberculosis | Prevention and Treatment
Prevention: Vaccination- Bacillus of Calmette, Guerin, BCG from Mycobacterium bovis, partial immunity Treatment: Antibiotic treatment- 2 of more meds, Antibiotics like Rifampin and Isoniazid (INH), therapy prolonged
50
Legionnaire's Disease | Symptoms
Early- headache, muscle ache, rapid temperature rise, confusion, shaking chills, Later- dry cough, sputum production, pleurisy Diarrhea, abdominal pain and vomitting
51
Legionnaire's Disease | Causative agent
Legionella pneumophila | Gram-negative and bacillus
52
Legionnaire's Disease | Epidemiology
Organism widespread in natural warm waters (within Amoeba) Resistant to Chlorine Survives well in water system Person-to-person transmission
53
Legionnaire's Disease | Pathogenesis
Breathing aerosolized contaminated water Resistant healthy smokers Organisms lodge in or near alveoli and stimulate phagocytosis Bacteria release macrophage invasion potentiator (MIP) which aids macrophage entry Necrosis of alveolar cells and inflammatory response causing multiple abscesses, pneumonia and pleurisy Fatal respiratory in 15%
54
Legionnaire's Disease | Prevention and Treatment
Prevention: Focus on equipment to minimize risk of infectious aerosols Adequate disinfection Antibiotic treatment (High dose of erythromycin, Bacteria make beta-lactamase enzyme)
55
Influenza | Causative agent
Influenza A virus Belongs to orthomyxovirus Single stranded RNA virus (divided 8 segments) Spiked envelope- H spike- hemagglutinin (attachment aid) and N spike- neuraminidase (viral spread aid)
56
Influenza | Symptoms
``` Short incubation period (2 days) Headache Fever Muscle Pain Dry Cough Acute symptoms within a week- cough, fatigue, generalized weakness ```
57
Influenza | Pathogenesis
Acquired inhalation of infected respiratory secretions Virus attaches via hemagglutinin spikes (once attached, viral envelope fuses) Mature viruses bud from host cells Infected cells die and slough off Host immunity quickly controls viral spread Small number die from Influenza
58
Influenza | Epidemiology
``` Outbreaks in US every year Periodic pandemics (higher than normal morbidity) Spread by antigenic changes- antigenic drift (minor mutations), minimize effectiveness of immunity; antigenic shift (genetic reassortment) ```
59
Influenza | Prevention and Treatment
Vaccine 80%-90% effective New required each year Antiviral medications 70% to 90% effective (Amantidine and Rimantidine)
60
Respiratory Syncytial Virus Infection | Causative Agent
RSV- part of paramyxovirus, single stranded RNA genome, Enveloped (virus lacks hemagglutinin and neuraminidase)
61
Respiratory Syncytial Virus Infection | Symptoms
``` Incubation period 1-4days Runny nose Coughing Weezing Difficulty breathing Fever Dusky colored skin (poor oxygenation) Croup in older infants ```
62
Respiratory Syncytial Virus Infection | Pathogenesis
``` Enters body through inhalation Infects respiratory epithelium Death of sloughing infected cells Bronchiolitis- responsible for wheezing Inflammation of alveoli leads to secondary pneumonia ```
63
Respiratory Syncytial Virus Infection | Epidemiology and Prevention and Treatment
Epidemiology: Common outbreaks Short-lived immunity recovery Healthy adults and children suffer mild disease but readily spread virus Prevention and Treatment: No vaccine, isolation of sick individual best prevention, no effective antiviral medication
64
Coccidiodes Immitis
(Valley Fever) Endemic in arid regions of Southwest USA and Latin America Dimorphic fungus Transmitted by inhalation of arthrospores Symptoms: asymptomatic, mild pneumonia, spreads lungs to bones and CNS, overall 1% dissemination rate, dissemination most often in immune compromised individuals, resolution lasts in long-term immunity against reinfection
65
Histoplasma Capsulatum
Histoplasmosis (Spelunkers disease) Endemic in central and eastern states, especially Ohio and MS River valley Dimorphic fungus Transmitted inhalation of conidia Symptoms: asymptomatic, mild respiratory symptoms, dissemination in immune compromised individuals
66
Blastomyces Dermatitidis
Blastomycosis Dimorphic fungus Inhalation of conidia Symptoms: chronic granulomatous disease, primary pulmonary stage, dissemination

Microbiology Final Exam (2 decks)

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