Week 1 - Respiratory infections Flashcards
(181 cards)
1
Q
Virus that causes the common cold
A
Rhinovirus
2
Q
Rhinovirus causes symptoms of both upper and lower respiratory tract
A
False, only the upper respiratory tract
3
Q
What type of virus is rhinovirus?
A
Unenveloped (naked) RNA virus; part of the picornaviridae family
4
Q
Rhinovirus is an “acid labile” virus, what does that even mean?
A
That it doesn’t cause GIT symptoms because it can’t survive @ acidic environment
5
Q
Patient presents with fever, rhinorrhea, purulent nasal discharge and cough; they also present with pressure @ head, congestion and loss of smell and taste, who tf virus caused this?
A
Rhinovirus
6
Q
The diagnosis for the common cold/ rhinovirus can only be done with a PCR test
A
False, the diagnosis for rhinovirus is clinical
7
Q
Asthma exacerbations and sometimes bronchiolitis are common symptoms of adenovirus
A
False, these are common in rhinovirus
8
Q
Therapy for the common cold/ rhinovirus
A
- Resting
- Hydration
- Antipyretic (paracetamol) when patient feels like shit
9
Q
Common cold mechanism of transmission
A
Transmitted through secretions
10
Q
Receptors to which rhinovirus binds
A
- LDL-R
- ICAM1
- CDHR-3
11
Q
Most susceptible ppl for rhinovirus
A
- Bbys and elderly
- Immunocompromised
- Respiratory disease: COPD, asthma, cystic fibrosis
12
Q
Where is the ICAM1 receptor rhinovirus adheres to located
A
At CD54 on epithelial cells lining the respiratory tract
13
Q
Types and serotypes of rhinovirus
A
- More than 110 serotypes detected
- RV-A, RV-B and RV-C
14
Q
The only DNA virus that causes respiratory tract infection we saw on this course
A
Adenovirus
15
Q
Clinical symptoms of adenovirus
A
- Respiratory tract infections
- Ocular disease/ CONJUNTIVITIS
- Gastroenteritis + diarrhea sometimes
- Cystitis
- Inflamed adenoids/ lymphoid tissue
16
Q
Mechanism of transmission of adenovirus
A
- Respiratory droplets
- Fecal-oral route
17
Q
Adenovirus causes outbreaks @ daycare and summer camps and stuff like that
A
Yes
18
Q
Types of adenovirus that cause gastroenteritis
A
40 & 41
19
Q
Types of adenovirus that cause cistitis
A
7, 11 & 21
20
Q
Pharyngoconjuntival fever is not a common sign of adenovirus because conjuntivitis isn’t even a sign for adenovirus
A
False, pharyngoconjuntival fever and conjuntivitis are signs and symptoms of adenovirus
21
Q
Why tf is it called adenovirus?
A
Bc it was found @ adenoid tissue
22
Q
Receptors to which adenovirus attaches itself
A
- Dsg-2
- CAR
- CD46
23
Q
Is there a vaccine for adenovirus?
A
Yes, its a live oral vaccine given to the military
24
Q
Epidemic keratoconjuntivitis is caused by which serological adenovirus types?
A
8, 19 & 37
25
HAdV was intended to be used as a vector for?
As gene therapy for Covid-19 vaccines
26
Enveloped, negative-sense, single strand RNA and a segmented genome virus; part of the Orthomyxoviruses
Influenza virus
27
Can influenza cause epidemics?
Yes, it can cause epidemic acute respiratory disease (fever, cough + systemic symptoms)
28
What are the 3 types of influenza virus
A, B and C
29
The constant antigenic evolution of the influenza virus can lead to 2 things called
Shift and Drift
30
Surface antigens present on the capsule of the influenza virus
- Hemagglutinin (HA)
- Neuraminidase (NA)
31
Receptor to which the influenza virus attaches to
Salic acid sugar receptor
32
Where does the influenza virus bind to the silica acid sugar?
@ epithelial cells located in the upper respiratory tract
33
Influenza virus transmission
Person to person: respiratory droplets or indirectly through contaminated surfaces
34
Diagnosis for influenza
- Clinically due to the epidemics
- Characteristic symptoms of cough and fever
- Antigen detection: PCR
- Viral culture
35
When do symptoms start after getting infected with influenza virus?
1 to 4 days later
36
Symptoms of Influenza
- Headache
- Fever
- Runny nose
- Sore throat + dry cough
37
Physical examination characteristics in a patient with influenza
- Conjuntivitis
- Pharyngeal erythema
- Abnormal lung sounds: wheezing, ronchi or crackles
38
Influenza complications include
- Acute otitis media
- Bronchiolitis
- CROUP
- Sinusitis
- Pneumonia (Staph aureus and Strep pneumoniae)
39
Who are at high risk for influenza complications?
- Young children <6 months
- Preggo women
- Adults >65
- Chronic health conditions (heart/ lung disease)
40
Neurologic complications that Influenza can cause in young children <6 months
- Encephalitis
- Febrile seizures
- Reye syndrome if aspirin is taken
41
Treatment for influenza A & B
Oseltamivir (oral): neuraminidase inhibitor
42
Medical profilaxis for influenza A & B
- Oseltamivir
- Zanamivir
43
M2 proton channel inhibitors like Adamantine work wonders because M2 mutations are very rare
Falsee, M2 mutations occur often and lead the virus to become resistant
44
Prevention for influenza
- Vaccines are effective @ preventing influenza
- Inactivated/ live-attenuated vaccines (sprayed)
- Trivalent
- A vaccine is generated every winter season
45
Virus that causes both upper and lower respiratory tract illnesses
RSV: Respiratory Syncytial Virus
46
Where tf did RSV get its name?
It causes cells lining the respiratory tract to merge and cause the cells to transform to a multi-nucleated syncitia
47
Leading cause of bronchiolitis @ infants
RSV
48
RSV signs and symptoms
- Pneumonia (crackeling rales heard)
- Bronchioles (wheezing + damage @ bronchioles)
49
Causes of bronchiolitis
- Edema
- Vasoconstriction
- Obstruction
50
What type of virus is RSV?
- Enveloped non-segmented RNA virus
- Pneumoviridae
- 2 groups: A & B
51
What's the diagnosis for RSV?
- Clinical diagnosis accurate during winter (time of the year), age and symptoms
- $$$: lab culture, PCR or antigen
52
Not being breastfed, being born prematurely and having a neuromuscular disorder are all...
Risk factors for RSV
53
Is there any specific treatment or therapy for RSV?
Supportive treatment (oxygen and fluids)
54
Any experimental treatment for RSV?
Aerosolized Ribavirin @ high risk patients + immunocompromised patients (only @ USA)
55
How does RSV enter the cell?
By merging with the cell membrane
56
G protein @ RSV does what?
G protein stands for glycosylation which helps with antibody avoidance
57
F protein @ RSV does what?
F protein stands for conformational change and helps with infectivity and protection
58
NS1 & NS2 (present in RSV viral structure) inhibit...
IFN 1
59
Who are at risk for RSV
- Babies @ the NICU
- Babies
- Children
60
Mechanism of transmission for RSV
Contact with droplets or contaminated surfaces
61
Other symptoms of RSV
- Fever
- Congestion
- Difficulty breathing
- Acute otitis media
- Rhinorrhea
62
RSV complications include
- Central apnea: short periods of time with NO breathing
- Hypoxia
63
Most common cause of CROUP
Parainfluenza virus
64
Parainfluenza virus is also the second most common cause of...
Acute respiratory infections in children less that 5 years of age
65
Symptoms of parainfluenza virus
Acute respiratory illness
- Colds
- CROUP
- Bronchiolitis (narrow airways)
- Pneumonia
66
CROUP has a specific pulmonary sound, which one is it?
Inspiratory stridor (high pitched, whistling sound)
67
Types of PIV that can infect humans
PIV-1, PIV-2, PIV-3 and PIV-4
68
Seasonal outbreaks of parainfluenza virus are @?
Fall, PIV-1 and PIV-2
69
Which parainfluenza virus type causes outbreaks @ odd number years
PIV-1
70
PIV-1 is also commonly associated with
CROUP in children
71
Which PIV causes annual epidemics @ spring
PIV-3, also severe @ immunocompromised patients and children
72
PIV-4 is the most dramatic and deathly of them all
False, its milder disease that affects both upper and lower respiratory tract (super rare)
73
What type of virus is PIV?
Single-stranded enveloped (lipid membrane) RNA; paramixoviridae family
74
Glycoproteins preset on the viral structure of PIV
- F: fusion
- HN: Hemagglutinin-Neuraminidase
75
PIV virus is such a loser and copies Influenza and uses the same receptor, which one is it?
Sialic acid sugars
76
What test can be done to diagnose PIV
Culture or PCR but $$$
77
An X-ray of the neck will show narrowing of the trachea, what's the name of this "sign"
Steeple sign
78
An X-ray of a patient with pneumonia caused by PIV will show consolidation
True
79
Treatment for the CROUP presented in PIV
Glucocorticoids and nebulized epinephrine @ children
80
Ribavirin & IV immunoglobulins work wonders in PIV
False, efficacy is uncertain
81
Signs and symptoms of CROUP
- Cough: loud barking
- Fast breathing + noisy breathing + wheezing
- Nasal congestion
- Hoarseness @ speech
- Worse @ night
82
Symptoms of bronchiolitis
- Chest congestion
- Clogged and sore throat
- Coughing
- Wheezing
83
Symptoms of pneumonia
- Shortness of breath
- Chest pain
- Productive cough (pus/ bloody sputum)
84
Which types of PIV cause CROUP
Types 1 and 2
85
Which type of PIV causes lower airway damage leading to pneumonia
Type 3
86
Since PIV infection is self-limiting it can be treated with antipyretics and hydration
Correct slay
87
Treatment for bronchiolitis caused by PIV
- Supplemental oxigen
- Fluids
88
Gram + diplococci, lancet shaped and alpha-hemolytic
Streptococcus pneumoniae
89
Most common cause of community-aquired pneumonia
Streptococcus pneumoniae
90
Microscopic characteristics of Streptococcus pneumoniae
- Gram + diplococci
- Polysaccharide outer capsule (virulence factor, serotypes and target for vaccines)
- Peptidoglycan cell wall (purple)
- Non-motile
- Facultative anaerobes
- NO spores
- Catalase negative
91
What type of hemolysis does S. pneumoniae cause on blood agar
Green hemolysis due to the production of hydrogen peroxide
92
Strep pneumoniae is a common cause of
Invasive Pneumococcal Disease
93
Clinical manifestations for pneumococcal disease are divided into 2
- Invasive
- Non-invasive or mucus related
94
Invasive pneumococcal disease can present as
- Meningitis
- Bacteriemia
- Sometimes pneumonia
95
Non-invasive pneumococcal disease can present as
- Pneumonia
- Acute otitis media
- Sinusitis
96
Mechanism of action in which S. pneumonia causes pneumonia
- Adheres to alveolar cells
- Release of pneumolysin
- Destruction of pneumocytes + alveolar capillaries
97
Fever, chills, chest pain and cough are all symptoms of pneumonia
Duh
98
Leading cause of pneumonia and bacterial meningitis @ children
Streptococcus pneumoniae
99
Is the incidence higher @ some ages for Streptococcus pneumoniae?
2 years old and adults > 65 years old
100
Large outbreaks are common whereas small outbreaks are uncommon when it comes to S. pneumoniae
False, the other way around
101
What even is pneumolysin found at S. pneumoniae
Pore forming toxin that causes epithelial and endothelial damage
102
Asymptomatic clinical manifestations of S. pneumoniae
- Otitis media
- Sinusitis
- Pneumonia
103
Symptomatic clinical manifestations of S. pneumoniae
- Bacteriemia
- Meningitis (by crossing the BBB)
- Empyema
- Endocarditis
- Septic arthritis
104
Bacteremia is caused when S. pneumoniae crosses the alveolar capillaries and enters the blood stream, it can lead to sepsis, which group of ppl are more at risk for developing sepsis?
Ppl with spleen problems bc of its important role in immunity (ppl with splenectomy or sickle cell anemia)
105
Other clinical manifestations of S. pneumoniae
Crackles and localized pleural pain
106
Diagnosis for S. pneumoniae
- Cultures of pus, sputum, CSF or peritoneal fluid
- PCR to detect S. pneumoniae DNA
107
Treatment for S. pneumoniae
- Beta-lactam antibiotics
- Resistance for penicillin and derivatives
- Fluroquinolones
- Amoxicillin + Clavulanic acid
- IV treatment (3rd gen cephs): ceftriaxone and cefotaxime
108
Are there any vaccines for S. pneumoniae? If so, mention them:)
2 vaccines provide protection against invasive pneumococcal disease
- PCV13 (polysaccharide-protein vaccine) protects up to 90% recommended for adults
- PCV23 (Conjugate vaccine) protects from 54-81% @ adults recommended in young children
109
S. pneumoniae has a reservoir, where tf?
Nasopharynx
110
Virulance factors present in S. pneumoniae
- Capsular polysaccharides + pili and fimbriae
- Biofilm production
- PspA
- IgA1 protease: toxin that destroys IgA
- Autolysin
- Pneumolysin
111
What the fuck does pneumolysin do
Binds to cholesterol in cell membranes and forms pores; causing cell lysis
112
Individuals at risk for S. pneumoniae
- Infants and elderly
- HIV infection
- Diabetes
- Malignancy
- Alcohol and tobacco use
113
Gram - cocobacillus fastidioso asf
Haemophilus influenzae
114
Micro characteristics of Haemphilus influenzae
- Non motile
- Facultative anaerobic
- Catalase and oxidase +
- Cultivated on chocolate agar bc it has factor V and factor X (white/ transparent colonies)
115
Haemophilus influenzae virulenze factors
- Polysaccharide capsule
- Pili
- Adhesion proteina HMW1 and HMW2
- IgA protease to destruct IgA
116
2 extra virulance factors that only UNENCAPSULATED Haemophilus influenzae has
- Phase variation: allows oligosaccharides to change/ variate; immune system can't remember
- Biofilms
117
With the help of... Haemophilus influenzae can colonize the respiratory tract
Lipooligosaccharides (LOS)
118
Two types of Haemophilus influenzae
- Non-encapsulated
- Encapsulated
119
Encapsulated Haemophilus influenzae has surface antigens, which ones?
A B C D E F
120
Another name unencapsulated Haemophilus influenzae gets is
Non-typable, bc of lack of antigens
121
Which strains of H. influenzae are more known to cause a disease
- Encapsulated type B
- Unencapsulated/ Nontypanble
122
Non-encapsulated Haemophilus influenzae causes...
- Otitis media @ children
- Sinusitis
- Bronchitis
- Exacerbations of COPD @ adults
123
Encapsulated Haemophilus influenzae causes...
Invasive infections like:
- Meningitis
- Epiglotitis
- Septic arthritis
- <6 y/o | type B
- Cellulitis @ face
- Bacteremia
124
What even is epiglottitis
- Swollen epiglottis
- Blockage of airway
- Sore throat
125
Encapsulated H. influenzae type B causes epiglottitis, what are the symptoms?
- Fever
- Sore throat
- Difficulty speaking
- Dyspnea
126
Encapsulated H. influenzae type B can cause meningitis, what are the symptoms present?
- Fever
- Lethargy
- Irritability
- Vomiting
- Sore/stiff neck
- Altered mental state
127
Encapsulated H. influenzae may cause cellulitis, what symptomatology accompanies it?
- Fever
- Warm tender area of erythema @ cheek and periorbital area
128
Patients with epiglottitis can't swallow soooo
They drool
129
Ecologic niche of nontypable Haemophilus influenzae
Human respiratory tract + colonization of nasopharynx
130
Haemophilus influenzae is most common during adulthood
False, its common during childhood and decreases @ adulthood
131
A common characteristic of the growth requirements of Haemophilus influenzae is
Fastidious growth
132
Haemophilus influenzae is not part of the normal flora of the human upper respiratory tract
False, it is
133
Therapy for Haemophilus influenzae type B
Ceftriaxone or cefotaxime
134
Therapy for nontypable Haemophilus influenzae
- Amoxicillin +/- clavulanate
- 3rd and 2nd generation cephalosporins
- Macrolides or quinolones
135
Vaccine for Haemophilus influenzae type B is given @ how many months?
2 months
136
Fever, ear pain and otorrhea are all symptoms of... caused by nontypable H. influenzae
Otitis media
137
Fever, tenderness of affected sinuses and persistent purulent nasal discharge are all symptoms of... caused by nontypable H. influenzae
Sinusitis
138
Gram - diplococcus
Moraxella catarrhalis
139
Common cause of otitis media in children and exacerbations of COPD in adults (besides H. influenzae)
Moraxella catarrhalis
140
Respiratory tract infections that M. catarrhalis can cause in loser kids
- Bronchitis
- Rhinosinusitis
- Laryngitis
141
Microbiological characteristics of Moraxella catarrhalis
- Non-motile
- Non-spore forming
- Aerobic
- Maltose fermentation negative (solution stays red)
- Oxidase +
- Grows well on blood and chocolate agar
142
M. catarrhalis can be moved around the agar without breaking, this means its positive for...
Hokey puck test
143
M. catarrhalis' favorite place for colonization
Nasopharynx + upper respiratory tract (as well as the others:()
144
M. catarrhalis looks like _____ @ the gram stain and culture
Neisseria
145
M. catarrhalis produces...
- Oxidase
- Catalase
- DNAse
146
Can you treat M. catarrhalis with beta-lactam antibiotics
- No, they produce beta-lactamase which means RESISTANCE
- Amoxicilin + calvulanate, Macrolides, Fluroquinolones and Extended spectrum Cephalosporines should do the trick
147
Vaccine for M. catarrhalis is applied at 4 months
False, there isn't even a vaccine
148
M. catarrhalis is an opportunistic bitch
Yuh
149
Mycoplasma pneumoniae causes
Atypical pneumonia
150
Characteristics of M. pneumoniae
- Slower onset & generally milder
- No lobar consolidation
- Lacking cell wall
- Adhesins and adhesion organelle (pathogenesis)
- Fastidious
- Facultative anaerobe
151
List 3 common places someone can get an M. pneumoniae infection... GO
- Children @ school
- Young adults @ uni
- Military recruits
152
Where does Mycoplasma pneumoniae replicate?
Inside the cell... evades immune system
153
Extrapulmonary skin manifestations caused bc M. pneumoniae
- Macopapular vesicular rashes
- Stevens-Johnson Sx.
154
Extrapulmonary cardiac manifestations caused bc M. pneumoniae
- Pericarditis
- Miocarditis
155
Extrapulmonary CNS manifestations caused bc M. pneumoniae
- Encephalitis
- Myelitis
- Radiculopathy
156
Extrapulmonary musculoskeletal manifestations caused bc M. pneumoniae
- Myalgia
- Rhabdomyolysis
- Arthritis
157
Extrapulmonary renal manifestations caused bc M. pneumoniae
- Glomerulonephritis
- Nephrotic syndrome
158
What can aid in the diagnosis of M. pneumoniae
Presence of cold agglutinins
159
Treatment for M. pneumoniae consists of
- Macrolides (azithromycin)
- Tetracyclins (doxycycline)
- Fluroquinolones (maxifloxacin)
160
Lab tests done on someone with pneumonia caused by M. pneumoniae
- CBC @ hospitalized patients
- Blood culture @ patients with failed antimicrobial therapy
- PCR + viral cultures NOT RECOMMENDED
161
Otitis media + fever + other systemic manifestations can be caused by many microorganisms, what is the virulence factor responsible for this?
Capsid (Haemophilus influenzae type b, Streptococcus pneumoniae)
162
Virus that can cause gastrointestinal, respiratory and genitourinary infections
Adenovirus
163
Adenovirus manifestations per system
- Respiratory: common cold, sore throat and pneumonia
- GIT: diarrhea
- Genitourinary: cystitis
164
4 F of the fecal-oral route
- Flies
- Fluids
- Fields
- Fingers
165
Adenovirus attaches itself to the receptor via the "fiber-like" projections it has, what effects does it have on a cellular level?
- Inhibition of DNA synthesis
- Inhibition of the production of proteins
- Cellular lisis
- Inflammatory response from the host
166
Inflammatory response caused by adenovirus
Leukocytes produce pro-inflammatory cytokines and histamine, dilation of blood vessels
167
Upper and lower manifestations of adenovirus
- Upper: infectious rhinitis (common cold), pharyngitis and tonsillitis
- Lower: pneumonia
168
GIT adenovirus infection symptoms
- Fever
- Nausea and vomiting
- Watery diarrhea
169
Conjunctivitis symptoms in regards to an adenovirus infection
- Eye irritation
- Soreness
- Redness
- Photophobia
- Excessive tearing
170
Adenovirus can cause pharyngoconjunctival fever, what signs and symptoms need to be present for it to occur?
- Conjuntivitis
- Fever
- Pharyngitis
- Inflammation of lymph nodes in the neck
171
Disseminated adenovirus infection is more common in
Immunocompromised patients (it has a high mortality rate)
172
Virus that causes "the flu"
Influenza
173
All three types of influenza can infect both humans and animals
False, type B influenza only affects humans
174
Most severe type of lnfluenza
Type A
175
Why can you get sick from influenza year after year? (shift or drift)
Because of the antigenic "drift"
176
Mycoplasma pneumonia may be asymptomatic or have nonspecific symptoms such as:
- Fatigue
- Sore throat
- Mild fever
- Dry hacking cough
177
In comparison to a pneumonia caused by Streptococcus pneumoniae, a pneumonia caused by Mycoplasma pneumonia is (more severe/ milder)
Mild, the patient may actually feel kinda good
178
Atypical pneumonia can also be called
Walking pneumonia
179
Chest X-ray of walking pneumonia looks...
Patchy infiltrates
180
Why are beta lactam antibiotics inefficient in treating Mycoplasma pneumoniae
Bc they don't have a cell wall, use tetracylines or macrolides
181
Agar in which Mycoplasma pneumoniae grows
Eaton's agar, it formes dome-shaped colonies that look like fried eggs (takes 2 to 3 weeks tho)
