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Jason's Respiratory Block > Upper & Lower Resp. Infections > Flashcards

Upper & Lower Resp. Infections Flashcards

1
Q

where is the respiratory tract sterile?

A

below the epiglottis

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2
Q

are there anaerobic bacteria in your URT?

A

Yes, small niches but numbers are comparable and even more in some places

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3
Q

Higher number of serotypes of strep are more dangerous? which is the most dangerous?

A

Lower numbers more dangerous: strep ‘3’ is most dangerous

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4
Q

Haemophilus influenza has 6 types: they are:

A

a,b,c,d,f, non typable

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5
Q

How is Haemophilus influenza typed based on?

A

capsule

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6
Q

What is the most common source of infective endocarditis?

A

viridans streptococci

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7
Q

Corynebacterium spp. includes which important disease?

A

diphtheria

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8
Q

occasional URTI (1-10%) caused by?

A

strept pyogenes

meningococci

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9
Q

Will I get meningitis if the meningococci have capsules?

A

YES YOU WILL!!

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10
Q

What is P.Jirovecii(carinii) ?

A

resident yeast-like fungus in latent state in lung

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11
Q

3 examples of viruses that hang around in the nerves/lymph nodes

A

CMV
HSV
EBV

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12
Q

What is croup?

A

laryngo-tracheal bronchitis

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13
Q

pertussis infects which part of resp tract?

A

lower

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14
Q

Where does RSV infect?

A

upper and lower

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15
Q

What time of the year do you get enterovirus more likely?

A

summer

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16
Q

What time of the year do you get rhinovirus more likely?

A

winter

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17
Q

What causes epiglottitis?

A

Haemophilus Influenzae B

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18
Q

If you have a case of pharyngitis/tonsillitis with no nasal involvement, would you treat with antibiotics despite only 1in 5 cases being bacterial?

A

Yes you would. Complications from Group A Strep pyogenes are nasty, could lead to rheumatic fever, septicaemia.

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19
Q

What can happen after 48 hours of RSV infection in the respiratory tract?

A

cilial destruction, secondary commensal bacterial infection

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20
Q

What is a commensal that can cause otitis media?

A

Moraxella catarrhalis

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21
Q

When you you need to make a laboratory diagnosis?

A

epiglottitis, pharyngitis/tonsillitis

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22
Q

How to take collect a sample from epiglottitis?

A

NOT swab.
Blood culture
X-ray

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23
Q

What is herpangina?

A

painful mouth sores in back of throart caused by Coxsackie A virus

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24
Q

white spots on throat = strep?

A

Nope. not necessarily, could be hand foot mouth disease (coxsackie A)

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25
Q

Otitis media in Australia when do you treat?

A

If younger than 2

if older than 2 and lasts for more than 48 hours.

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26
Q

Which URTI is essential to treat?

A

epiglottitis

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27
Q

How to treat Croup if severe?

A

inhaled steroids

28
Q

What does not require antibiotics?

A 
Common cold
sore throat: pharyngitis
sinusitis
laryngitis
croup
acute bronchitis
bronchiolitis
influenza
SARS/MERS
29
Q

What’s a frequent aetiological agent of acute bronchitis?

A

part of viral URTI

30
Q

What’s a frequent aetiological agent of acute exacerbation of chronic bronchitis/emphysema?

A

pneumococci/H. influenzae

31
Q

Why would smokers tend to get acute exacerbation of chronic bronchitis/emphysema?

A

decrease in innate immune system, commensals move in

32
Q

What population mostly gets bronchiolitis?

A

Babies/kids in first few years of life

33
Q

What normally causes bronchiolitis?

A

RSV

34
Q

What’s the theory of RSV?

A

Mother’s RSV antibodies cross placenta, then when baby exposed to RSV, it sets up immune complex inflammation

35
Q

What causes 80% of community, and 50% of hospital acute bacterial pneumonia?

A

pneumococci

36
Q

Which bacteria has the worst prognosis if it’s acute bacterial pneumonia?

A

Klebsiella pneumoniae

37
Q

what vector do you typically get Chlamydophila pneumoiae?

A

zoonosis

38
Q

What is ‘walking pneumonia’?

A

milder course, lasts longer, patchy on x-ray

39
Q

acute bacterial pneumonia severe version presentation?

A

high fever, consolidated lobe of lung via percussion = dull and opaque on x-ray

40
Q

What’s the most common ‘atypical’ pneumonia?

A

mycoplasma, viruses

41
Q

Can you treat mycoplasma with penicillin? Why?

A

Nope. No cell wall for penicillin to act on

42
Q

What is empyema?

A

pus in the pleural space

43
Q

What causes empyema?

A

staph aureus

44
Q

What does histoplasma, aspergillus, pneumocystis cause?

A

‘other’ pneumoniae

45
Q

what are important underlying illnesses re: pneumonia?

A

COPD, AIDS, CF

46
Q

What is legionnaire’s pneumophilia? how do they survive and invade us?

A

live in air conditioning ameoba, hard to grow in lab, they survive in ameobi and then get into our macrophages and survive in us

47
Q

how is occupation important in pneumonia diagnosis? 4 things:

A

animals, hides (anthrax spores), air conditioning, soils

48
Q

Where do you find legionella long-beachy?

A

potting soil in Australia

49
Q

What is pleomorphic? example?

A

takes on different shapes eg. H. influenzae

50
Q

Lab diagnosis of pneumonia, how should you collect sputum?

A

proper cough, not just spitting in the cup

51
Q

When do you use aspiration via bronchoscope?

A

CF

52
Q

when do you use a pleural tap?

A

empyema

53
Q

When to get a lung biopsy?

A

If it’s not responding to initial treatment due to sputum misdirection

54
Q

Can you diagnose pneumonia in the blood?

A

Yes, and if it’s in the blood and you have pneumonia… it’s probably the cause.

55
Q

When would you use a serological diagnosis of pneumonia?

A

if difficulty culturing

56
Q

which organisms would you use a serological diagnosis of pneumonia for?

A

mycoplasma pneumoniae
legionella pneumophila
chlamydophila/chlamydia
coxiella burnetii

57
Q

What causes Q-fever?

A

coxiella burnettii = same family as ricketsia(typhus) and is an obligate intracellular bactera

58
Q

Which type pneumophila is 80% cause of pneumonia? how dx?

A

Type 1. Antigen detection Dx from Urine

59
Q

What are ‘must know’ pathogens for Dx of pneumonia?

A 
SARS
MERS
Avian FLU
Legionella
bioterrorism (anthrax/plague)
community acquired MRSA
60
Q

What are ‘should know’ pathogens for Dx of pneumonia?

A

penicillin G resistant S. pneumoniae

P. aeruginosa

61
Q

What’s the best guess ‘shotgun’ treatment for penumonia?

A

PEnG/amoxycillin + doxycycline/macrolide

62
Q

atypical bugs of pneumonia are all susceptible to what?

A

doxycycline/macrolide

63
Q

who is 23 valent polysaccharide for?

A

Penumococcal vaccines for adults only

64
Q

Why is 23 valent polysaccharide only for adults?

A

children can’t handle 23 capsular types of pneumococcus, so go with 13

65
Q

2 examples of specialised vaccines?

A

anthrax

plague

66
Q

Why conjugate vs. polysaccharide vaccine?

A

conjugate has a polysaccharide antigen attached to a carrier protein to get proper immuno response (memory B)

Jason's Respiratory Block (20 decks)

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