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respiratory divided into two parts
upper and lower tract
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upper tract
- mouth
- nose
- nasal cavity
- sinuses
- pharynx
- epiglottis
- larynx
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lower tract
- trachea
- bronchi
- bronchioles
- alveoli
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Most common portal of entry
respiratory tract
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first line of defense- respiratory
- nasal hairs
- cilia (cilia escalator)
- mucus
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second line of defense- respiratory
macrophages
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third line of defense
pathogen specific secretory IgA
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Microbial disease of the upper tract respiratory system
- pharyngitis- pharynx
- rhinitis- common cold, nasal passage
- sinusitis- sinus
- acute otitis media- ear infection, inner ear
- diphtheria- caused by toxins of gram positive bacteria exotoxin, use D tap
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Pharyngitis signs and symptoms
- inflammation of throat
- redden and or swollen mucosa
- swollen tonsils
- foul smelling breath
- white packets visible on walls of throat (streptococcal disease)
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pharyngitis causative agent
- most often by common cold viruses
- fusobacterium necrophorum
- streptococcus pyogenes (group a)
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Streptococcus pyogenes complications of infection ( three types )
- scarlet fever
- rheumatic fever
- glomerulonephritis
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Scarlet fever aka
scarlatina
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Scarlet fever caused by
bacteriophages allows erythrogenic toxin production
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Scarlet fever symptoms
- sand paper like rash
- high fever
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Scarlet fever found in
school aged children
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rheumatic fever caused by
- reaction between streptococci M protein, heart muscle
- due to immune complex occurring. immune system attack leaving long term damage
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rheumatic fever occurs
3 weeks after pharyngitis has subsided
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rheumatic fever damages
to hearth valves, arthritis in joints
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glomerulonephritis- formation
formation of antigen-antibody complexes in the glomeruli
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glomerulonephritis characterized by
nephritis
- toxic shock syndrome
- necortizing fasciitis
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Scarlet fever associated with
strep throat Erythrogenic toxin
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Scarlet fever associated with strep throat Erythrogenic toxin produced by
lysogenized streptococcus pyogenes
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Complications of streptococcus pyogenes infections with rheumatic fever
- affects joints and heart
- causes permanent heart damage called rheumatic heart disease
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rheumatic fever signs/symptoms
- fever
- tender painful joints
- red hot swollen injuries
- small painless nodules beneath the skin
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Diphtheria
Corynebacterium diphtheria- gram positive rod
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Diphtheria toxin produced by
lysogenized C. Diphtheria
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Diphtheria transmission
droplet
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Rhinitis (common cold) causative agent
- over 200 different viruses
- -rhinoviruses ( 99 serotypes )
- -adenoviruses
- -respiratory syncytail virus (RSV)
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Rhinitis transmission
indirect contact, droplet contact
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rhinitis symptoms
- sneezing, runny nose
- scratchy throat, coughing
- low fever in kids
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Sinusitis causative agent
- various viruses
- various bacteria, often mixed infection (viral then bacterial infection 2nd cause)
- various fungi
- allergies, structural abnormalities are common noninfectious causes
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Acute otitis media cause agent
- mixed infection viruses and bacteria
- streptococcus pneumoniae, haemophilus influenzae
- mixed biofilm of bacteria in chronic otitis media
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Acute otitis media prevention
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Acute otitis media treatment
- "watchful waiting"
- antibiotics
- tympanic membrane tubes
- ciliary escalator keeps sterile
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Diphtheria causative agent
- corynebacterium diphtheria
- non spore forming, gram positive, club shaped
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Diphtheria transmission
droplet contact, direct contact, fomites
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Diphtheria virulence factor
- diphtheria exotoxin
- encoded by bacteriophage
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Diphtheria prevention
Diphtheria toxoid vaccine (DTaP)
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Diphtheria treatment
antitoxin plus penicillin or erythromycir
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Bacteria, viruses, and fungi cause
- bronchitis
- bronchiolitis
- pneumonia
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Pertussis (whooping cough) caused by
- bordetella pertussis
- gram negative coccobacillus
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pertussis cytotoxin damages
- ciliated cells
- take long to grow back
- pertussis toxin
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pertussis prevention
by DTaP
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Pertussis stage 1
catarrhal stage, like common cold
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pertussis stage 2
paroxysmal stage- violent coughing sieges
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pertussis stage 3
convalescence stage
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tuberculosis caused by
- mycobacterium tuberculosis
- acid fast rod, has mycolic acid, acid fast- waxy substance so it is a virulence factor, harder for immune system to ingest and attack it
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tuberculosis transmission
from human to human, respiratory transmission
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Pathogenesis of tuberculosis
- 1. tubercle bacilli that reach alveoli of the lungs are ingested by macrophages, but often some survive. infection is present, but no symptoms are present
- 2. tubercle bacilli multiplying in macrophages causes a chemotactic response that brings additional macrophages and other defensive cells to the area, form surrounding layer, and early tubercle.most surrounding macrophages are not successful in destroying bacteria but release cytokine and enzymes that cause lung damaging inflammation
- 3. After few weeks, disease symptoms appear as many of the macrophages die, releasing tubercle bacilli, and forming caseous center in the tubercle. the aerobic tubercle does not grow well in this location. however, many remain dormant (latent TB) and serve as basis for later reactivation of the disease. The disease may be arrested at this stage, ad the lesions become calcified.
- 4. disease symptom appear as a mature tubercle is formed. the disease progresses ar the caseous center enlarges in the process called liquefaction. the caseous center now enlarges and forms air filled tuberculous in which the aerobic bacilli multiple outside the macrophages.
- 5. Liquefaction continues until the tubercle ruptures, allowing bacilli to spill into a bronchiole and thus be disseminated throughout the lungs and then to the circulatory and lymphatic system (burst open, now transmissible through coughing , can get in the blood system)
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Diagnosis of tuberculosis
- tuberculin skin test screening
- positive reaction means exposure, made antibodies against it.
- followed by xray ct exam, acid fast staining of sputum, culturing of bacteria
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treatment of tuberculosis
- prolonged treatment with multiple antibiotics
- vaccines: BCG is live avirulent M bovis, not widely used in the us
- multidrug- resistance mycobacterium tuberculosis is affecting which antibiotics are used to treat tb
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pneumonia caused by
- streptococcus pneumonia- pneumococccal pneumonia
- gram positive encapsulated displococci
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pneumonia symptoms
infected alveoli of lung fill with fluid, interferes with oxygen uptake
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pneumonia treatment
penecillin, flouroquinolones
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pneumonia prevention
pneumococcal vaccine
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mycoplasmal pneumonia
primary atypical pneumonia
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mycoplasmal pneumonia common in
children and young adults
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mycoplasmal pneumonia
pleomorphic, wall-less bacteria
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mycoplasmal pneumonia has no sensitivity to penicillin b/c
it has no cell wall
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mycoplasmal pneumonia symptoms
- chest pain, chills, sore throat
- spread easily in groups, walking pneumonia
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Legionellosis
a typical pneumonia
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Legionellosis caused by
legionella pneumophila, gram negative rod
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Legionellosis found
it lives where water collects and becomes airborne in the wind (ventilation system)
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Legionellosis develop
within a week of inhalation of contaminated droplets
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Legionellosis tend to affect
older men who drink and smoke heavily
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Influenza transmitted
by airborne respiratory droplets, highly communicable acute respiratory infection
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Influenza symptoms
- chill, fever, headache, and muscle aches
- no intestinal symptoms (stomach flu)
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Hemagglutin (H) helps the ______ attach and penetrate host cells
virion
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Neuraminidase (N) helps _______ virions from the host cell after replication and assembly
release
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Spike (hemagglutin, neuraminidase)
- help get in and out influenza
- name influenza according to the spikes they have
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influenza complications
- guillain barre syndrome
- reye syndrome
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complications of influenza- guillain barre syndrome
occurs when body damages its own peripheral nerve cells
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complications of influenza- reye syndrome
- occurs in children who take aspirin to treat pain and fevers
- affects all body systems especially liver, brain
- cellular mitochondria damaged
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respiratory syncytial virus (RSV) affects
commonly affect children under 1 year of age
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respiratory syncytial virus (RSV) infects
the bronchials and alveoli of the lungs, causing cells to fuse together into syncytia
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Fungal infections of lower respiratory system
- histoplasmosis
- coccidioidomycosis
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histoplasmosis caused by
dimorphic histoplasma capsulatum
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histoplasmosis found in
dry dusty soil chicken coops ad bat caves
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histoplasmosis most people sufer
mild influenza like symptoms
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dimorphic
- two body types
- mold with spores, easily to inhale
- yeast inhaled budding
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coccidioidomycosis caused by
coccidiodes immitis
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coccidioidomycosis symptoms
- inhalation of spores causing
- dry hacking cough
- chest pains
- high fever
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coccidioidomycosis rarely infection cause
disseminates to tissues such as meninges of spinal chord
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opportunistic mycoses affect immunocompromised individuals
cryptococcosis
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cryptococcosis caused by
cryptococcus neoformans
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cryptococcus neoformans found in
soil and pigeon droping
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cryptococcus neoformans cells
are inhaled, can (rarely) pass into the blood stream, infecting the brain and meninges
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pneumocystis pneumonia caused by
pneumocystis jiroveci
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pneumocystis pneumonia common infection in
AIDS patients
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Pneumocystis jiroveci has ______ _____ in _____
complex life cycle in the alveoli
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pneumocystis pneumonia transmitted
respiratory droplets
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