URTIs- Cross

Question 1

What kind of virus is the Rhinovirus?

Answer 1

Icosahedral, non-enveloped (+)sense single-stranded linear RNA virus

Question 2

What is the most common cause of URTIs?

Answer 2

Rhinovirus

Question 3

Does Rhinovirus cause GI illness?

Answer 3

No, the virus is acid labile (helps to distinguish between rhinovirus and coronavirus)

Question 4

Transmission of Rhinovirus?

Answer 4

Respiratory droplets; person to person or indirectly by droplets being deposited on surfaces or hands

Question 5

Pathogenesis of Rhinovirus?

Answer 5

Binds to ICAM-1 on respiratory epithelium–> infects the cells

Question 6

Treatment for Rhinovirus?

Answer 6

Supportive

Question 7

What kind of virus is Coronavirus?

Answer 7

Helical, enveloped, (+)sense single-stranded linear RNA virus

Question 8

What disease(s) can Coronavirus cause?

Answer 8

URTI, GI illness, MERS, and SARS

Question 9

Clinically with a URTI, can you distinguish between Rhinovirus and Coronavirus?

Answer 9

No, identical symptoms

Question 10

Describe Bordetella Pertussis (the organism)

Answer 10

Small coccobacillarym, encapsulated gram(-) rod

Question 11

What does Bordetella Pertussis cause?

Answer 11

Whooping Cough

Question 12

Pathogenesis of Bordetella Pertussis?

Answer 12

A-B toxin stimulates adenylate cyclase by catalyzing the addition of ADP-ribosylation to the inhibitory subunit of the G protein complex (Gi)–> overactive adenylate cyclase leads to a rise in cAMP levels and thus overactive cyclic AMP-dependent protein kinase activity–> impaired phagocytosis and cilia activity

Question 13

Transmission of Bordetella Pertussis?

Answer 13

Airborne droplets, highly contagious

Question 14

3 stages of Bordetella Pertussis?

Answer 14

Catarrhal- 2 weeks of mild URT symptoms

Paroxysmal- 2-3 months of severe cough (whooping sound)

Convalescent- 1-2 weeks of reduction in coughing

Question 15

Notable finding on CBC in Bordetella Pertussis?

Answer 15

Lymphocytosis; Bordetella toxin impairs lymphocytic transmigration into lymphoid tissues

Question 16

Diagnosis of Bordetella Pertussis?

Answer 16

Nasopharyngeal swab (PCR) or culture

Question 17

Treatment of Bordetella Pertussis?

Answer 17

Azithromycin for all individuals with (+) lab diagnosis regardless of age/symptoms

Question 18

Prevention of Bordetella Pertussis?

Answer 18

DTaP vaccine

Question 19

Description of Corynebacterium Diphtheriae (organism)

Answer 19

Gram(+) bacillus, pleomorphic, club-shaped, arranged in palisades

Question 20

What does Corynebacterium Diphtheriae cause?

Answer 20

Diphtheria

Question 21

Pathogenesis of Corynebacterium Diphtheriae?

Answer 21

A-B toxin blocks protein synthesis by inactivating EF-2–> decreased protein synthesis (think “DEF-theria)

Question 22

Why will Rhinovirus NOT cause pneumonia?

Answer 22

It doesn’t grow at 37 degrees; that’s why it infects the URT

Question 23

Why isn’t there a vaccine for Rhinovirus?

Answer 23

There are too many serotypes (over 100)

Question 24

Generalized symptoms of Diphtheriae?

Answer 24

Sore throat getting progressively worse; Malaise/fatigue/low-grade fever

Question 25

2 most distinct features of Diphtheriae?

Answer 25

"Bull Neck" (Cervical lymphadenopathy) and pseudomembrane formation in the pharynx

Question 26

Why is the pseudomembrane formation a concern in Diphtheria?

Answer 26

It can cause mechanical obstruction of the airway; it also serves as a platform for bacterial growth and toxin production

Question 27

Diagnosis of Diphtheria?

Answer 27

Throat swab culture on Loeffler's medium, tellurite plate--\> will turn grey black; Blood agar also used

Question 28

2 more specific symptoms seen in Diphtheria (not bull neck or pseudomembrane)

Answer 28

Cardiac dysfunction (Myocarditis) and Neurologic toxicity (especially in cranial nerves) (I know that's a shitty question)

Question 29

Treatment of Diphtheria?

Answer 29

Antitoxin administration AND either PCN/erythromycin

Question 30

Why are children more at risk for Acute Otitis Media?

Answer 30

Their eustachian tubes are shorter, more narrow, and more horizontal than adults (perfect for bacterial incubation)

Question 31

3 bacteria that cause Acute Otitis Media (in decreasing order of prevalence)?

Answer 31

Strep Pneumoniae; Haemophilus Influenzae; Moraxella Catarrhalis

Question 32

Treatment of Acute Otitis Media?

Answer 32

Amoxicillin is 1st line; if patients are unresponsive or had recent abx--\> Augmentin

Question 33

What is Epiglottitis?

Answer 33

Acute inflammation in the supraglottic region of the oropharynx

Question 34

What causes Epiglottitis (decreasing order of prevalence)?

Answer 34

Haemophilus Influenza--\> H.parainfluenzae--\> S.pneumoniae--\>GAS

Question 35

Typical patient that gets Epiglottitis?

Answer 35

Urban male in his 40s

Question 36

Prognosis of Epiglottitis?

Answer 36

Good, unless it goes unrecognized, then airway obstruction can ensue--\> death risk is high

Question 37

Treatment of Epiglottitis?

Answer 37

Ceftriaxone

Question 38

What do you seen on X-ray with Epiglottitis?

Answer 38

Thumb sign; swelling of the larynx