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Legionella Pneumophilla
G- , Elderly and immune dibilitated
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The common cold strains
- Rhino Virus
- Mastadenovirus
- Coronavirus
- - 200 causative viruses each has multiplke serotypes
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Common Cold Symptoms/Course/Immunity
- Accumulate IgA anitbodies
- Never catch the same cold twice
- 7days
- Sneezing congestion nasla secretions
- Notemp
- Spread to sinuses middle ear
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Inner Ear Infection
- Otis Media
- Bacterial and viral all lood the same Mainly bacterial
- S. Pneumonia (35%)
- H. Influenza (20-30%)
- M. Cataharlis (10-15%)
- S. Pyogenes (8-10%)
- S. Aureus (1-2%)
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Group A Streptococcus
- "GAS"
- Streptokinase- lyse clots to allow spreading
- Streptolysins- cytitoxic to tissues, rbs phagocytes
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Strep Throat
"Pharyngitis"
- Streptococcus Pyogenes
- - Untreated can lead to rheumatic fever and destruction of heart valves
- - Scarlet Fever erythrogenic toxin causes skin blotches
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Diphtheria
- G+ Rod
- Corynebacterium diptheri
- Grayscab- Fibrin, dead tissue, decomposing casues endo toxin
- No antibiotics
- Antitoxin
- Cutaneous Ulcer
- Russia Afganistan
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Lowere Respiratory System Makeup
- Larynx
- Trachea
- Bronchus
- Bronchioles
- Alveoli
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Lowere Respiratory Infections
- Laryngitis- larynx
- Bronchitis- air ways
- Pneumonia- alveoli
- Pleurisy- Pluera
- ALL SHOULD BE STERILE ANYTHING IN LRT IS A PATHOGEN
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Pertussis
"Whooping Cough"
- G- Coccobacillus
- Bordetella Pertussis
- 1-3 weeks incubation
- Cytotoxin hurts ciliated cells
- Catrrhal-- "Common cold symptoms" 1-2 weeks
- Violent Cough Seige- 2-8 Weeks
- Convalesence - 1-2 weeks
- Arythromycin and Azithromycin if given early on can shorten infection length
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Pertussis Treatments
- Acellular Vaccine - Framgmanes in TDP vaccin
- Babies are not protected until they are 18 months of age
- Booster with tentanus
- Sarasota outbreak in 2009
- Jlo
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Psittacosis Pneumonia
- G- intracellular
- Chlamydophilia Psittaci
- Elemetary bodies in bird feces are transmitted through the air
- Fever headache and chills
- Diagnosis through culture
- Tetracyclin only
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Tuberculosis
- Acid Fast Rod
- Mycobacterium Tuberculosis
- Resistatnt to sunlight, drying and disinfectants
- Transmitted my coughing droplets
- Weighloss, night sweats and weakness
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Tuberculosis Skinn Testing
- Tuberculin, Tine, PPD, and Mantaux
- Intradermal injection purrified protein derivative
- T-cell delayed reaction indicates and exposeure to bacillus or vaccine
- Does not mean you have a current infection
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Tuberculosis Diagnosis
- Chest xray for ghone complex "calcified diagnostic ball"
- Negative- no active disease
- Positive- current or past infection
- Sputum with acid fast stain
- 1 AFB is assumed positive
- 6 weeks to grow culture
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Initial TB therapy
- 2 months of 3-4 medications then reasses
- Isoniazid-INH
- Rifampicin
- Pyrazinamide
- Ethambutol
- Streptomycin
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Tuberculosis Maintenance Therapy
- Usually 4-6 months
- INH and rifampicin if sputum is negative
- Change agents depending on culture
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Influenza Antigenic SHIFT
- Changes in H and N combinations
- Reassortment- different strains infect the same cell
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Orthomyxovirus Influenza A
- Hemagluttin spike attatch to host cells- 16 types
- Neuramidase spikes release virus from cell- 9 types
- 144 combinations
- h5n1 "avain flu
- Seasonal flu from se asia
- No season in the tropis
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Influenza Antigenic DRIFT
- Suntypes of strains
- Aviod antibodies
- RNA mutation
- Changes in genes change the H or N surface proteins
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Pandemic
- New strain prevalence
- H1N1- 1918 "spanish flu"
- H2N2-1957 "Asian flu:
- H3N2-1968 "Hong kong"
- H1N1-2009 "SWINE"
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Clinical featurese of influenza
- Chills, fever, heachache, muscle ache
- No intestinal symptoms
- Diagnosisf rom antibodies
- 1% mortality in secondary infections
- Seasona;- Death in ill and elderly
- Pandemic- death in young
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Influenza Vaccine
- 1944 was the first
- 2 most important chosen by FDA
- A]Brisbane]59]2007]H1N1
- A]Brisbane]10]2007]H3N2
- B]Brisbance]60]2008
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Coccidioidomycosis immitis
- Usually mild valley fever
- Transmitted by spore in SW dust storms
- Severe with HIV and can spread to meningitis
- Amphotericin B
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Histoplasma Capsulatum
- Usually mild disease
- Mississippi soil
- Bat and bird feces
- Amphotericin B
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Pneumocystis Pneumonia
- Fungus
- Pnuemoncysit Joroveci
- In normal flora
- Only sick in immuno supressed
- Aveoli fill with froth
- Diagnos CXR
- Treatmena: Pentamidin, Sulfamethaoxazole
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TB vaccine
- "BCG"
- Bacille Calmette Guerin
- Attenuated Mycobacterium Bovis
- Not in US
- Makes a positve ppd
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Blastomyces Dermatitidis
- Mississippi valley
- Most infections are asymptomatic
- Can casue extensive tissue damage
- Amphotericin B
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Fungal Pneumonias
- Histoplasma capsulatum
- Coccidiodomycosis immitus
- Blastomyces dermatitidis
- Aspergillus fumigatus
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Pneumococcal Pneumonia
- Streptococcus Pnuemoniae
- Vaccine capsular agent
- 90 serotypes
- Temp, SOB, Chest pain
- Bleeding alveoli results in a rust colored sputum
- 20% mortality in the elderly
- Definitive with culture
- Bronchial and aveolar invasion
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Mycoplasma Pneumoniae
- G+ pleomorphic
- Walking pnuemonia
- Mild
- All whit CXR
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