Unit 11 - Upper RTI Flashcards
1
Q
Anatomy of upper respiratory tract
A
- Epiglottis
- Larynx
- Nasal cavity
- Pharynx
2
Q
Anatomy of lower respiratory tract
A
- Trachea
- Bronchi
- Bronchioles
3
Q
Why does rhino virus prefer the upper part of respiratory tract?
A
It thrives in low temperatures
4
Q
How does pertussis cause a RTI?
A
stops ciliary action
5
Q
Lungs are rich in _____
A
macrophages
6
Q
The following are all ____ residents of the respiratory tract:
- Oral streptococci
- Neisseria spp. Branhamella
- Candida albicans
- Streptococcus mutans
A
Common
>50% of normal people
7
Q
The following are all ____ residents of the respiratory tract:
- Streptococcus pyogenes
- Streptococcus pneumoniae
- Neisseria meningitidis
A
Occasional
<10% of normal people
8
Q
The following are all ____ residents of the respiratory tract:
- Corynebacterium diphtheria
- Klebsiella pneumoniae
- Psueodmonas (esp after antibiotics)
- E.coli (esp after antibiotics)
- C. albicans (esp after antibiotics)
A
Uncommon
<1% of normal people
9
Q
The following are all ____ residents of the respiratory tract:
- Pneumonocystis jirovecii
- Mycobacterium tuberculosis
- Cytomegalovirus (CMV)
A
Residents in latent state in tissues (Lung, lymph nodes, etc.)
10
Q
The following are all ____ residents of the respiratory tract:
- Herpes simplex virus
- Epstein-Barr virus
A
Sensory neurone/glands connected to mucosae
11
Q
______ _______ is very common in immunocompromised individuals (such as HIV Pts)
A
Pneumonocystis jirovecii
12
Q
What are the two types of RTI’s?
A
- Restricted to surface
- Spread through body
13
Q
Examples of RTI’s that are restricted to surface
A
- common cold virus
- influenza
- streptococci in throat
- chlamydia (conjunctivitis)
- diphtheria
- pertussis
- candida albicans (thrush)
14
Q
Examples of RTI’s that are spread through the body
A
- measles, mumps, rubella
- EBV, CMV
- Chlamydophilia psittaci
- Q fever
- Cryptococcosis
15
Q
What are the two types of Respiratory Invaders?
A
- Professional invaders
- Secondary invaders
16
Q
______ invaders = infect healthy respiratory tract
A
Professional
17
Q
______ invaders = infect when host defences impaired
A
Secondary
18
Q
Professional invaders require what to infect a healthy respiratory tract?
A
- Adhesion to normal mucosa (in spite of mucocillary system)
- Ability to interfere with cilia
- Ability to resist destruction in alveolar macrophage
- Ability to damage local (mucosal, submucosal) tissues
19
Q
Secondary invaders require what to infect when host defences impaired?
A
- Initial infection and damage by respiratory virus (ex. influenza virus)
- Local defences impaired (ex. cystic fibrosis)
- Chronic bronchitis, local foreign body or tumor
- Depressed immune responses (ex. AIDs, neoplastic disease)
- Depressed resistance (ex. elderly, alcoholism, renal or hepatic disease
20
Q
Rhinitis (common cold) is caused by different types of ____
A
viruses
21
Q
> 50% of common colds are due to ??
A
rhinovirus and coronaviruses
22
Q
What do common colds induce?
A
a flow of virus-rich fluid, rhinorrhea
23
Q
How are common colds transmitted?
A
- Aerosol
- Virus contaminated hands
24
Q
Common colds are ??
A
self-limiting
25
Is there a vaccine for rhinitis (common cold) ?
No vaccine, antigenically diverse group
26
Pharyngitis and Tonsillitis can be caused by ____ or _____
viruses or bacteria
| viruses make up 70% of cases
27
What viruses are the most common cause of pharyngitis and tonsillitis?
- Adenovirus
- CMV
- EBV
28
What is the most common bacteria that causes pharyngitis and tonsillitis?
Streptococus Pyogenes
29
____ is the largest human herpes virus. Multinucleated cell formation and/or intranuclear inclusions give cells distinct appearance.
Cytomegalovirus (CMV)
30
Natural host of CMV?
humans
31
Transmission of CMV?
- saliva
- urine
- blood
- semen
- cervical secretions
32
Describe pathology of CMV?
Initial infection asymptomatic -> lymphoid tissue -> lymph nodes and spleen (via circulation lymphocytes and monocytes)
Virus localizes in epithelial cells in salivary glands (saliva_, kidney (urine), cervix (secretions), and testes (semen) - shedding for months
33
CMV has specific __ and ___ response activated but not entirely clear virus
specific Ab and CMI response
34
CMV infection eventually controlled by ___ mechanisms
CMI
35
CMV: infected cells remain in body for life and can be source of ________ if CMI impaired
reactivation
36
CMV is a successful pathogen if it ??
- Evades immune defences
- Poor target for Tc cells
- Interferes with transport of MHC-1 molecules to cell surface
- Induces expression of FC receptors on cell surface
37
Infants/childs have ___ symptoms with CMV
no
38
Adults have ____ illnesses with CMV
mild
39
Describe the spectrum of symptoms of CMV
Adolescents have a glandular fever-type illness:
- fever
- lethargy
- abnormal lymphocytes and mononucleosis
Primary infection during pregnancy:
- spread through placenta to fetus
- reactivation
- 2nd common cause of mental retardation in babies
40
Vaccines for CMV?
No, but trials are underway
41
What does CMV cause?
- hearing loss
| - poor mental development
42
Natural host of EBV?
humans
43
EBV transmitted by the exchange of ____
saliva
| -infectious mononucleosis, "kissing disease"
44
Describe the two peaks of EBV
1-6 years
| 14-20 years
45
Describe the clinical features of EBV
Immunologically mediated:
- Virus replicates in epithelial cells and B-lymphocytes (attaches to C3d receptor = CD21)
- Virus shed in saliva from infected epithelial cells
- Spreads to B-lymphocytes in local lymphoid tissues (lymph nodes and spleen)
- T-lymphocytes respond to infected B-cells - CIVIL WAR IN BODY OH NO
46
EBV: Clinical features of naturally infected infant/young child
no clinical disease
47
EBV: Clinical features of young adults
- infectious mononucleosis/glandular fever 4-7 weeks after initial infection
- fever, sore throat, petechiae on hard palate, lymphadenopathy, and splenomegaly
- hepatitis
48
Symptoms of EBV
- cytokine release
| - infected B-cells -> polyclonal activation, production of autoantibodies (ex. IgM to erythrocytes)
49
EBV has ___ recovery, but saliva infectious for months
spontaneous
50
Treatment for EBV?
No antivirals in immunocompetent patients
51
Malaria weakens T-cell control of EBV infection and causes ??
Burkitt's lymphoma
52
Burkitt's lymphoma is a problem in ?
parts of Africa and Papua New Guinea
53
When patients ingest nitrosamines (preserved fish) who have EBV, this results in?
Nasopharyngeal carcinoma (EBV DNA in tumor cells)
54
Nasopharyngeal carcinoma is a problem in ?
China and SE Asia
55
What is the most common bacterial cause of pharyngitis and tonsillitis?
Streptococcus pyogenes
56
Streptococcus pyrogens is the most common cause of bacterial pharyngitis and it is important to treat with ______
penicillin
57
Symptoms of Bacterial pharyngitis?
- Sore, red throat; difficulty swallowing
- Sudden fever; malaise; and loss of appetite
- Scarlet fever (characterized by a 'sandpapery' rash, starts on the neck and chest and spreads all over the body, red strawberry tongue, headache, chills, and muscle ache)
- Rheumatic fever (fever, joint pain, knees, ankles, elbows and wrists, joint swelling, possible cardiac problems, chest pain, shortness of breath)
58
Streptococcus pyogenes can cause what two things?
- Rheumatic heart disease
- Acute Glomerunephritis
- Anti-Strep Ab -> circulating immune complex -> deposition in glomeruli
- Activation of complement and coagulation systems, inflammation and blood in urine
59
What is parotitis?
Inflammation of parotid glands (largest of salivary glands)
60
___ is a type of parotitis
Mumps
61
How are the Mumps transmitted?
- Airborne droplets
| - Close contacts
62
Recovery of the Mumps within how long?
1 week
63
Is there a vaccine for mumps?
Yes - MMR
64
Complications with Mumps?
- Meningitis
- Encephalitis
- Pancreatitis
- Hearing loss
65
What is Otitis media?
Infection of the middle ear
66
Otitis media is 50% _____
viral
67
The other bacterial forms of otitis media are caused by?
- S. pneumoniae
- H. influenzae
- S. pyogenes
- M. catarrhalis
- S. aureus
68
Otitis media usually happens to ?
preschool-age patients
69
Early signs of otitis media in children
They are non localized: fever and irritability
70
Later signs of otitis media in children
ear pain, changes in hearing, purulent discharge (late infection)
71
Pathogenesis of Otitis Media?
cleansing function by ciliated epithelium
72
Complications with Otitis media?
damage of the tympanic membrane can lead to hearing loss
73
What is Otitis Externa?
Infection of the outer ear
| *Pathogens are distinct from otitis media
74
External ear canal has bacterial flora similar to skin: ???
- Staphylococcus aureus
- Candid albicans
- Pseudomonas aeruginosa
75
How is otitis externa treated?
antibiotic ear drops
76
Aetiology of acute sinusitis is similar to ___ ____
otitis media
77
Symptoms of acute sinusitis
- facial pain, local tenderness
- prolonged respiratory tract infection (purulent nasal discharge and pain in the face, fever, maxillary sinusitis - headache, pain in upper teeth)
78
Complications with acute sinusitis?
- orbital cellulitis
- osteomyelitis
- meningitis
- brain abscess
79
Epiglottitis: clinical manifestations & pathogenesis?
- edema & inflammation
- airway blockage
- life threatening
80
Epiglottitis is caused by ?
H. influenzae
