Upper and Lower Respiratory Tract Infections Flashcards by Hugh Murray

Has is pain causes in ottis media?

Fluid build up causes pressure on the tympanic membrane

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T/F When the tympanic membrane bursts in response to infection the resolution is better if antibiotics haven’t been used.

True

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Which bacteria doesn’t have a cell wall and is the most common cause of atypical pneumonia?

Mycoplasma

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What is the main cause of bronchiolitis?

RSV

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What are some common causes of Empyema?

Staph. aureus secondary to pneumonia

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How does legionella survive within in air conditioning units?

It is eaten by amoebae that are unable to kill them, legionella can also survive in our macrophages.

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Is which areas of the URT are there more anaerobes?

Nasal washings

Saliva

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What are the most common bacteria present in the URT microbiota?

Viridans streptococci (multiple species),

Neisseria spp. (low grade),

Corynebacterium spp,

Gram -ve anaerobes,

H. influenzae (not type B),

C. albicans

Strep. pneumoniae

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What are the common causes of Croup

Parainfluenza virus, influenza A and RSV

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What is the cause of Q fever?

Coxiella burnetti for cattle.

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What are some common causes of pharyngitis (without nasal involvement)?

Adrenovirus, enterovirus, influenza, reovirus, Strep pyogenes, Strep grp C and G

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Which disease is associated with homelessness?

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What are the 6 syndromes of the upper respiratory tract?

Pharyngitis/Tonsillitis

Common cold

Ottis Media

Sinusitis

Epiglottitis

Croup

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Which disease is spread by birds?

Chlamydophila psittaci

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What are some common causes of acute exascerbation of chronic bronchitis?

Pneumococci, H. influenzae

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What are some common causes of ottis media?

Strep. pneumoniae, H. influenzae, Moraxella catarrhalis

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What is the best guess antibiotics for community acquired pneumonia?

pen-G/amoxycillin + doxycycline/macrolide - usually don’t want to used a bactericidal + doxy however here these two will cover all the bacterial causes of pneumonia

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What are some common causes of bronchitis?

Usually part of viral URTI

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How can epiglottitis be diagnosed?

Blood sample or Xray. Do not attempt to take sample off the epiglottis!

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What are some less common commensals of the URT?

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Strept pyogenes, Neisseria meningititis

What are some common causes of the common cold?

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Rhinovirus

parainfluenza

RSV

enterovirus (during summer)

Coronavirus

Human metapneumonia virus

Why are babies more susceptible to ottis media?

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The eustachian tube is wider - allows bacteria to travel up it from the pharynx (against the action of the cilia membrane)

Which pneumococcal vaccine do you use in adults?

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23 valent polysaccaride

What are some common causes of epiglottitis?

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H. influenzae type b - Rarely seen now due to the vaccine

Which pathogen is picked up from soil?

Legionella longbeachae - common in Australia

What percentage of cases of pharyngitis (without nasal involvement) are caused by bacteria? What are the bacteria?

20%, Grp A, C and G strep

In which URT syndrome is treatment necessary?

Epiglottitis - essential Pharyngitis - If bacterial Sinusitis - If bacterial and severe Ottis media - if under 2 (children over 2 will have side effects from the treatment than complications from the infection)

For what species is serological testing helpful in diagnosing pneumonia?

Those which are slow to culture including - Legionella pneumophila - Mycoplasma pneumoniae - Chlamydophila and chlamydia - Coxiella burnetti

After which anatomical structure is the respiratory tract divided?

The epiglottis

Which disease is associated with alcoholism?

Klebsiella

What are the main vaccines for prevent pneumonia?

Influenza vaccine and pneumococcal vaccine

Why must you use a conjugate vaccine for pneumococcus in children?

The conjugate will stimulate a T cell response which will provide help to the B cell mediated antibody protection. This isn't required in adults.

What disease is caused by a pathogen that colonised air conditioning unit?

Legionnaires disease

What are some common causes of typical pneumonia (inflammation in the alveolar/airways)

Pneumococci, H. influenzae, Staph, Klebsiella, Legionella, TB, Chlamydophila (C. pneumoniae and C. psttaci)

In which URT syndromes is it important to make laboratory diagnosis?

Epiglottitis, Pharyngitis/tonsillitis

What promoted Mr Gram to invent his famous stain?

To differentiate streptococcus and Klebsiella as causes of pneumonia.

What are some common causes of atypical pneumonia (interstitial inflammation)?

Mycoplasma, Chlamydia, M. cattarhalis, Influenza, RSV, adenovirus

What are some common causes of lung abscesses?

Mixed anaerobes, Staph, Klebsiella

What are some common LRT syndromes

Acute bronchitis Acute exascerbation of chronic bronchitis Bronchiolitis Pneumonia Lung Abscess Empyema

After which anatomical structure is the respiratory tract supposed to be sterile?

The Larynx

Is the common cold spread more by hands or coughing?

Hands

What factors should be considered when making an aetiological diagnosis?

Community vs hospital acquired Severity index Existing illness in the host eg COPD, AIDS, CF Risk factors like Occupation, travel, homelessness, soils, contact with animals

What are some common causes of pharyngitis (with nasal involvement)?

Adenovirus, enterovirus, parainfluenza virus, influenza

The absence of what indicates a properly collected sputum sample?

Squamous epithelial cells as they come from the URT.

Why it is thought that bronchiolitis only occurs in children under 1 year old?

Maternal ab against RSV react to virus in the baby that causes a inflammatory response that narrows the bronchioles. This causes air trapping and wheeze.

What types of samples are taken for the diagnosis of pneumonia?

Sputum transtracheal aspirate - avoids passing the URT Tracheostomy Endotracheal tube - passes through the URT though Pleural tap - for empyema Lung biopsy - used when the patient doesn't respond to the initial treatment. By needle (radiologist) or during open surgery.

Which pneumococcal vaccine do you use in children?

13 Valent conjugate

What are some must know causes of pneumonia

Influenza - for typing Legionella - for outbreaks Community acquired MRSA Bioterrism agents eg anthrax SARS, MERS Should know Penicillin resistant S. pneumoniae Gram -ves like P. aeruginosa

What are some common causes of sinusitis?

Primary infection: viral, part of common cold syndrome Secondary: Haemophila influenzae, Streptococcus pneumoniae

Upper and Lower Respiratory Tract Infections Flashcards

(49 cards)