InfDis of Respiratory Tract – Flashcards
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| nasal congestion, pressure above the nose or in the forehead, feeling of headache or toothache, facial swelling/ tenderness common -Discharge appears opaque with a white, brown, green, or yellow color CC: viral, bacterial, or fungal |
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| sinusitis |
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| 2 common causes of acute otitis media? |
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| Strep Pneumoniae, H. influenzae |
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| How is acute otitis media treated? |
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| "watchful waiting" for 72 hours, Beta Lactams/ vaccination (Prevnar, Pneumovax, HiB) |
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| Fusobacterium Necroforum that causes pharyngitis is treated with what can it lead to? |
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| Penicillin, Cefuroxime can lead to Lemierre's syndrome |
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| Pharyngitis caused by Strep Pyogenes (GAS) is treated with? |
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| Penicillin plus Augmintin (anti Beta Lactamase) |
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| rare condition in which bacteria spreads from the throat to the tinterior jugular vein in the neck. clumps of bacteria then travel through the bloodstream to the lungs, joints, and bones. Can be treated with antibiotics but fatal if now diagnosed correctly and quickly. |
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| Lemierre's syndrome |
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| erythrogenic toxin production -sandpaper-like rash and high fever, common in school-age children |
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| scarlet fever (aka scarlatina) |
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| -damage to heart valves and circulatory system, arthritis in multiple joints -X-rxn between streptococcal M protein and heart muscle -occurs ~3 weeks after pharyngitis has subsided |
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| Rheumatic fever |
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| -characterized by nephritis and kidney function/failure -formation of antigen-antibody complexes in the glomeruli (T3HS) |
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| glomerulonephritis |
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| -has a gram stain of "chinese character" or XY pattern -forms black colonies on Tinsdale Agar |
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| corynebacterium diphtheriae (gram + rod) |
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| -URT with sore throat, lack of appetite, low-grade fever -pseudomembrain forms on tonsils or pharynx |
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| diphtheria |
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| symptoms of systemic diphtheria? |
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| extreme fatigue, dementia, and eventual deal that looks very much like a myocardial infarction |
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| treatment of diphtheria? |
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| PEN or ERY plus anti-toxin and vaccine (DPT) |
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| -name of disease comes from sound patient makes as he or she tries to grab a breath between uncontrollable bouts of coughing (paroxysms) -violent coughing spasms can result in burst blood vessels in the eyes, vomiting, cracked ribs |
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| Pertussis (Whooping cough) |
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| -stage of pertussis in which the bacteria present in resp tract cause what appear to be cold symptoms, most notably a runny nose -last 1-2 weeks |
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| catarrhal stage |
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| the stage in which numbers of bacteria are decreasing and no longer cause ongoing symptoms (recovery period), but the patient is particularly susceptible to other respiratory infections |
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| convalescent |
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| treatment of pertussis? |
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| erythromycin, DPT vaccine |
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| how is pertussis transmissible? |
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| aerosol |
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| -symptoms mimic common cold but as inf progresses. inflam of URT voicebox and windpipe can spread to affect bronchi -leads to barking sound or hoarseness -when very swollen, "stridor" squeaking noise upon inhalation -may be worse at night or when upset/crying |
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| croup |
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| CC of croup? |
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| parainfluenza virus |
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| steeple sign (narrowing or trachea) is sign of? |
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| Croup |
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| treat croup by? |
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| treat symptoms and monitor airflow/breathing, cool mist humidifiers and outdoors |
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| symtoms: fever lasting ~3 days, rhinitis, pharyngitis, otitis -may see "blueing" from airway inflammation -serious inf give rise to symptoms of croup like coughing, wheezing, dyspnea, rales |
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| Respiratory syncytial virus |
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| treatment of RSV? |
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| mild inf are self limiting but severe inf may need admission for O2, IV fluids, ventilation, and antivirals (Ribavirin) |
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| Dx RSV? |
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| bronchial/nasal wash to find syncytial cells (giant multinucleated cells) |
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| symptoms: rapid onset, headache, chills, dry cough, body aches, fever, stuffy nose, and sore throat from draining -extreme fatigue can last a few days/weeks |
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| Influenza |
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| what is responsible for the systemic symptoms of the flu? |
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| cell breakdown products 'cytokine storm' -also sloughing of cells into airway and inflammation |
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| this vaccine is: -3-5 dif viruses resembling variants predicted in the coming flu season, 70-90% effective against those strains -for anyone over the age of six months -standard side effects & risks |
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| inactivated seasonal vaccine ("the injection") |
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| flu vaccine: -stimulates secretory immunity -for persons between ages of 5 and 49 |
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| live attenuated seasonal vaccine (FluMist) |
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| flu vaccine: 2-3 viruses, efficacy is protective, but % is unknown -ages 5-60 -higher side effects, same risks, less antigen -thimersal (Hg) free |
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| intradermal version vaccine (Fluzone ID) |
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| Symptoms similar to influenza: rapid onset headache, chills, dry cough, body aches, fever, stuffy nose, and sore throat -common in children and older adults -acute resp. tract inf that is found commonly as influenza neg. and rsv neg |
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| Metapneumovirus |
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| begins with mild cough/resp/cold like symptoms to swift respiratory collapse -eventual progression to LRT and pneumonia or pneumonia like symptoms -can be accompanied by diarrhea |
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| SARS (15% mortality rate) MERS (50% mortality rate) |
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| Sudden Acute Respiratory Syndrome and Middle East Respiratory Syndrome are both what kinda viruses? |
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| Coronaviruses |
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| this type of TB is seen in lower, central areas of lungs as granulomas |
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| primary TB |
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| this type of TB reveals extensive infiltration in the upper lungs/bronchi and marked tubercules |
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| secondary TB |
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| Cytokine release from T cells results in __________ and spread out of lungs to other places. (Talking about TV=B) |
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| Caseous (liquifying) necr |
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| TB -flulike w/ mild fever -tests positive for PPD, negative for CXR -not highly contagious -initial infection that is controlled and goes dormant |
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| primary TB |
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| TB -Fever, coughing with blood-tinged sputum, night sweats, weight loss -"consumption" -Positive for PPD and CXR -active infection, contagious, reactivations |
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| Secondary TB |
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| spread of M. TB out of lungs to other tissues, destrucitve lesions in spine or other bone structures, humps, etc |
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| Miliary (disseminated) TB |
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| How is TB treated? |
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| long term treatment: Rifampin, Isoniazid, Pyrazinamide, Ethambutol, Streptomycin, Aminoglycosides |
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| Begins with upper resp tract symptoms (runny nose, congestion, often fever), onset of lung symptoms follows: chest pain, fever, cough, discolored sputum -inflammatory condition of the lung in which fluid fills the alveoli |
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| pneumonia |
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| T/FAlost any bacteria can be a cause of pneumonia |
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| true |
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| -Most common cause of community acquired pneumonia -Gram (+) lancet shaped diplococci -small mucoid colonies with a-hemolysis what is ittreatment? |
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| streptococcus pneumoniae, treatment: cephalosporins |
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| Common causes of community acquired pneumonia? |
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| strep pneumo, H influenzae, Neisseria spp, E. coli, S. aureus |
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| causes pneumonia, bloodstream infections, wound or surgical site infections via ventilators or IV catheters -has been associated with high rates of morbidity and mortality, particularly among persons with prolonged hospitalization -healthy people usually do not get infections from it |
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| Klebsiella pneumoniae (CRKP) |
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| what is different about CRKP? (appearance /characteristics of the organism itself) |
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| it's from normal flora of gut and feces and it is sticky and stretches like "pizza cheese" |
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| How is CRKP treated typically if the bacteria are resistant to other antibiotics? |
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| Carbapenem |
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| cause of walking pneumonia.. symptoms may range from asymptomatic to mild cough and malaise to fever, muscle ache, severe fatigue, etc. -gram not applicable -VFs OBLIGATE INTRAcellular what is ittreatment? |
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| chlamydia pneumoniae, treat with macrolides or tetracyclines |
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| causes walking pneumonia -no cell wall -smallest free-living bacterium -OBLIGATE EXTRAcellular, TIP adhesion structure -colonies are very sow growing and resemble "fried eggs" what is ittreatment? |
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| Mycoplasma pneumoniae, treat with macrolides or tetracyclines |
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| Common fungal pneumonia -"the black mold" can be normal flora or opportunistic pathogen -most common in AIDS patients -causes pneumonia, lung infection -appearance of black lesions -appearance "septate branching hyphae" or "lightning and broccoli" |
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| aspergillus fumigatus |
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| common cause of fungal pneumonia -most cases begin cold-like but progress to uncontrolled -often has lower sputum than other pneumonias -recent large increase in AIDS patients -appearance "crushed ping pong balls" aka flat on one side... hollow looking.. dark outline jelly lookin |
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| Pneumocystis Jirovecii (pneumocystis pneumonia PCP) |
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| common cause of fungal pneumonia acquired from bird droppings, bat caves, some soil locations -endemic -cayses lung mycosis with progression to pneumonia disease -many cases are asymptomatic cold-like -appears as small oval budding yeasts inside macrophages -lung disease can apear as "snowstorm" CXR -suspect disseminated histoplasmosis in HIV cases (unexplained fever, hepatosplenomegaly, generalized lymoadenopathy, abmnormal liver functions, yadayada) |
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| Histoplasma capsulatum |
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| headache, fever, chills, non-roductive cough- multifocal necrotizing pneumonia [productive cough, chest pain, vominting, confusion/delerium, diarrhea] -- shock, MOF, death.. mortality rate ~50% -gram (-) what is it/treatment? |
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| Legionnnaires Disease caused by legionella pneumophila, treat with immediate antibiotics and environmental control/sourcing |
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| this CC of deadly pneumonia (~50% MR) lives in water, A/C cooling towers, water storage, sprinkler systems--- chlorine resistant transmission= water aerosol.. no person to person |
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| legionella pneumophila |
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| causes flu-like symptoms and vomiting, other GI symptoms.. short febrile prodrome lasting 3-5 days.. some patients report back pain and abdominal pain, typical findings on initial presentation inclyde fever, tachypnea, tachycardia -brief recovery period, then rapid respiratory failure as hemorrhagic disease -cytokine storm, large edema formation due to masive immune response, swamps lungs -even with aggressive treatment, ~40% MR -Spread by rodent droppings, but person to person eventually reported |
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| hantavirus |
