1
Q
What is this chapter about?
A
Diseases of the respiratory tract.
2
Q
What is avian flu also called?
A
H5N1.
3
Q
How did avian flu become important in humans?
A
It jumped from birds to humans.
4
Q
Why is avian flu considered dangerous?
A
It can jump between species.
5
Q
What special property of flu viruses did the professor mention?
A
Mixing vessel property.
6
Q
What does the mixing vessel property allow flu viruses to do?
A
Mix genomes and recombine.
7
Q
Why is recombination of flu viruses dangerous?
A
It allows the virus to jump from one host group to another.
8
Q
What can happen when flu viruses recombine between animals and humans?
A
Humans can get trapped in the middle.
9
Q
What organization monitors pandemics?
A
World Health Organization
10
Q
What recent disease did the professor mention as being declared a pandemic through WHO monitoring?
A
COVID-19
11
Q
What order will diseases be covered in this chapter?
A
Bacterial diseases first, then viral diseases.
12
Q
What part of the body does streptococcal pharyngitis affect?
A
Upper respiratory tract.
13
Q
How did the professor describe strep throat in general?
A
Very painful and common.
14
Q
What does the throat look like in strep throat?
A
Very red and swollen.
15
Q
What does pharyngitis mean?
A
Red, swollen throat.
16
Q
What yellow finding suggests strep throat is bacterial?
A
Yellowish discharge / accumulation at the back of the tongue.
17
Q
What causes strep throat bacteria to attach to the throat?
A
M protein.
18
Q
What does M protein allow the bacteria to do?
A
Attach to the throat.
19
Q
What does bacterial attachment lead to in strep throat?
A
Local inflammation.
20
Q
Did the professor think fever is a classic feature of strep throat?
A
No.
21
Q
What did the professor say about fever in strep throat?
A
Usually should not have fever unless something else is happening.
22
Q
What other findings may occur with strep throat?
A
Tonsillitis and swollen lymph nodes.
23
Q
Why are swollen lymph nodes important in strep throat?
A
They help distinguish bacterial from viral infection.
24
Q
What is the discharge in strep throat called?
A
Exudate.
25
What does a doctor use to diagnose strep throat?
Throat swab.
26
What can be done with the throat swab sample?
Tested on blood agar.
27
What is the main method of diagnosing strep throat?
Throat swab.
28
What is the first-line treatment for strep throat?
Penicillin.
29
What is an alternative treatment for strep throat?
Erythromycin.
30
What newer penicillins can be used for strep throat?
Ampicillin and amoxicillin.
31
What is the main mechanism of strep throat bacteria?
Attachment to the throat by M proteins.
32
What is scarlet fever?
A sequel to strep throat marked by high fever.
33
Is scarlet fever the same as plain strep throat?
No.
34
When does scarlet fever occur?
After strep throat.
35
What is the main feature that distinguishes scarlet fever?
High fever.
36
What makes scarlet fever worse than plain strep throat?
Production of a powerful exotoxin.
37
Does plain strep throat produce exotoxin?
No.
38
What happens in scarlet fever that does not happen in plain strep throat?
The bacteria become disseminated and toxin-mediated.
39
What can happen if strep bacteria are untreated?
They can enter the blood and spread throughout the body.
40
What symptoms occur in scarlet fever?
Red skin rash, very high fever, strawberry tongue.
41
What is another name for the red swollen tongue in scarlet fever?
Strawberry tongue.
42
What type of exotoxin causes scarlet fever?
Streptococcal pyrogenic exotoxin.
43
What does pyrogenic mean?
Fever-producing.
44
What is another name for the scarlet fever exotoxin family?
Streptococcal family of exotoxin / SP family of exotoxin.
45
What organism is still the root cause of scarlet fever?
GAS / Group A Streptococcus.
46
What is the difference between strep throat and scarlet fever?
Strep throat is local to the throat, while scarlet fever is disseminated and toxin-mediated.
47
According to the professor’s microbiology approach, which disease has no fever and which has fever?
Strep throat has no major fever; scarlet fever has fever.
48
Why might children still show fever with strep throat?
Something else may also be happening, such as otitis media.
49
Is scarlet fever contagious?
Yes, very contagious.
50
What is the treatment for scarlet fever?
Penicillin or its derivatives.
51
What types of antibiotics work for scarlet fever?
Antibiotics that work on gram-positive organisms.
52
What is otitis media?
Middle ear infection.
53
What is the biggest cause of otitis media?
Streptococcus pneumoniae.
54
About what percentage of otitis media cases are caused by Streptococcus pneumoniae?
About 33%.
55
What other bacteria can cause otitis media?
Haemophilus influenzae and Streptococcus pyogenes.
56
How can strep throat lead to otitis media?
Organisms move from the throat into the ear.
57
Why is otitis media common in young children?
Due to the direct connection between the throat and middle ear through the Eustachian tube.
58
What structure connects the middle ear to the throat?
Eustachian tube.
59
Why is otitis media commonly associated with throat infections?
Organisms can travel through the Eustachian tube.
60
Can viruses also move from the respiratory tract to the ear?
Yes.
61
What virus did the professor mention can lead to otitis media?
Respiratory Syncytial Virus.
62
Is otitis media exotoxin-mediated?
No.
63
What other things can lead to otitis media besides throat infections?
Contaminated water, swimming pool water, common cold.
64
Does otitis media usually begin in the middle ear itself?
No
often does not start in middle ear
probably started elsewhere
throat infection or contaminated water brought organisms
65
What is the most emphasized symptom of otitis media?
Extreme pain, very common in children
66
Why is otitis media so painful?
Pus puts pressure on the eardrum.
67
What tool is used to look at the eardrum in otitis media?
Otoscopy.
68
What is the classic otoscopy finding in acute otitis media?
Bulging eardrum.
69
What happens to the eardrum in bacterial otitis media?
More pus and more bulging.
70
What happens to the eardrum in viral otitis media?
Less pus and less bulging.
71
Which upper respiratory diseases are not exotoxin mediated?
Pharyngitis and otitis media.
72
Which upper respiratory disease is always exotoxin mediated?
Scarlet fever.
73
When are diphtheria vaccines given according to the Alberta schedule?
2 months, 4 months, 6 months, 18 months, and just before school.
74
What vaccine series includes diphtheria?
Diphtheria, tetanus, polio, and hep.
75
What vaccine is used for diphtheria?
DTaP.
76
What type of vaccine is the diphtheria vaccine?
Toxoid vaccine.
77
What does toxoid vaccine mean?
The toxin is inactivated.
78
What organism causes diphtheria?
Corynebacterium.
79
Is Corynebacterium gram-positive or gram-negative?
Gram-positive.
80
Is diphtheria exotoxin mediated?
Yes.
81
What exotoxins are produced in diphtheria?
A and B exotoxins.
82
How does diphtheria exotoxin spread through the body?
It circulates in the blood.
83
What does diphtheria exotoxin do to cells?
Inhibits protein synthesis.
84
What happens when protein synthesis is blocked?
Cells die.
85
What are the early symptoms of diphtheria?
Mild fever, sore throat, fatigue.
86
What is the key early sign of diphtheria?
Swollen neck.
87
Is the dramatic swollen neck seen in strep throat?
No.
88
What happens after fluid oozes from the infected throat in diphtheria?
It thickens and forms a false membrane.
89
What color is the diphtheria membrane?
Grayish-white.
90
What parts of the throat can the membrane cover?
Palate, oral cavity, tonsils.
91
Does the diphtheria membrane stick tightly to tissue?
Yes.
92
Why is the diphtheria membrane dangerous?
It can block the airway.
93
What is the major risk from the diphtheria membrane?
Suffocation.
94
What are the early treatments for diphtheria?
Penicillin and erythromycin.
95
What may be needed in severe diphtheria cases?
Tracheostomy or surgical removal.
96
What happens if the diphtheria membrane is removed?
It causes bleeding.
97
Is recovery from diphtheria quick or long?
Long.
98
What happens in the final stage of diphtheria?
Airway becomes completely blocked.
99
What can happen if the airway is completely blocked in diphtheria?
Death.
100
What is the key diagnostic feature of diphtheria?
Grayish-white membrane.
101
What is the most common form of diphtheria?
Pulmonary / upper respiratory form.
102
What is another form of diphtheria besides pulmonary?
Skin form.
103
What does skin diphtheria look like?
Ulcers on skin covered with gray-white membrane.
very hard to treat
104
Why is skin diphtheria hard to treat?
The organism is already in the blood and exotoxins are circulating.
105
In what groups is skin diphtheria more commonly seen?
IV drug users, homeless populations, low socioeconomic groups, poor hygiene conditions.
106
What is the main mechanism of diphtheria exotoxin?
Shuts down protein synthesis, cells cannot survive
107
Why do diphtheria-infected cells die?
They cannot make proteins.
108
What is the gram stain pattern of Corynebacterium?
Palisade arrangement.
109
What is another name for the palisade arrangement?
Picket fence pattern.
110
How are Corynebacterium rods arranged on gram stain?
In lines.
111
What is the most common treatment for the upper respiratory diseases in this chapter?
Penicillin.
112
Stage 1 of Diphtheria
Stage 1
mild fever
sore throat
fatigue (can be severe)
KEY SIGN → swollen neck
very dramatic
NOT seen in strep throat
113
Stage 2 of Diphtheria
Stage 2
fluid oozes from infected throat
fluid thickens
forms false membrane
Features of membrane:
grayish-white
covers:
palate
oral cavity
tonsils
sticks tightly to tissue
Consequences:
blocks airway
suffocation risk
Management:
early:
penicillin
erythromycin
late:
tracheostomy
surgical removal
Important:
removing membrane → causes bleeding
recovery is long
114
Stage 3 of Diphtheria
Stage 3
airway completely blocked
no air reaches lungs
can lead to death
115
What is the first lower respiratory tract disease discussed?
Whooping cough / pertussis.
116
What causes the pathogenicity of pertussis?
Capsule, powerful exotoxin, and endotoxin release.
117
How is pertussis often spread to infants?
By parents.
118
Why are infants especially at risk for pertussis?
They are not fully protected until they have had 3–4 vaccine doses.
119
What is the classic symptom of pertussis?
Whoop sound.
120
How is the pertussis cough different from a normal cough?
It has a whooping sound.
121
How does Bordetella pertussis attach to the airway?
Using its capsule.
122
What exotoxin is produced in pertussis?
Tracheal cytotoxin.
123
What does tracheal cytotoxin destroy?
Ciliated cells of the trachea.
124
What happens when ciliated tracheal cells are destroyed?
Airway function is disrupted.
125
What role do endotoxins play in pertussis?
They contribute to the disease stages.
126
What is stage 1 of pertussis called?
Catarrhal stage.
127
What symptoms occur in the catarrhal stage?
Runny nose and cold-like symptoms.
128
Why is pertussis often missed early on?
It looks like the common cold.
129
What is stage 2 of pertussis called?
Paroxysmal stage
Most important stage
130
What happens during the paroxysmal stage?
Violent coughing fits with a whooping sound.
131
What type of coughing occurs during the paroxysmal stage?
Deep, intense coughing in bouts.
132
What omplications can occur during severe pertussis?
Ruptured blood vessels causing bloodshot eyes.
Broken ribs
Brain hemorrhages.
Seizures (later)
133
Why can pertussis become especially dangerous in children?
Neurological complications may develop.
134
What is stage 3 of pertussis called?
Convalescence (recovery stage)
135
What happens during the convalescence stage?
Healing and regrowth of ciliated cells.
136
How long can recovery from pertussis take?
Weeks to months.
137
What antibiotics are used to treat pertussis?
Penicillin, erythromycin, and macrolides.
138
What vaccine prevents pertussis?
DTaP vaccine.
139
Why are boosters needed for the pertussis vaccine?
It is an acellular vaccine.
140
What date is World TB Day?
March 24.
141
What is the leading cause of death by infectious agent worldwide?
Tuberculosis (TB).
142
Does TB affect only older adults?
No, it affects all ages.
143
Is TB found only in certain countries?
No, it is present worldwide.
144
About how many people globally are affected by TB?
About 1 in 4 people.
145
Which groups are disproportionately affected by TB?
Refugees and people in war zones.
146
What causes tuberculosis?
Tubercle bacilli.
147
What happens in stage 1 TB in a healthy individual?
The innate immune system works and macrophages surround the bacteria.
148
What is the result when macrophages arrest TB infection early?
No symptoms.
149
What happens in stage 2 TB?
Partial immune failure occurs.
150
What forms when TB bacteria become trapped?
A caseous center and a tubercle.
151
What is a tubercle?
A lesion made of trapped bacteria and macrophages.
152
What happens to the tubercle over time?
It becomes calcified.
153
What is the calcified TB lesion called?
Ghon complex.
154
Can a Ghon complex be seen on imaging?
Yes, it is visible on X-ray.
155
Can a Ghon complex remain inactive?
Yes, it can remain dormant.
156
What happens in stage 3 TB?
Complete immune failure occurs.
157
What are other names for stage 3 TB?
Reactivated TB and miliary TB.
158
What happens to the Ghon complex in reactivated TB?
It liquefies.
159
What happens when the Ghon complex liquefies?
Bacteria are released into the airways and bloodstream.
160
What is miliary TB?
Widespread TB where bacteria spread throughout the body.
161
Why is it called miliary TB?
Because the bacteria spread in a millet-shaped pattern.
162
What are the symptoms of severe TB?
Heavy weight loss, productive cough with blood, and extreme fatigue.
163
What is the key identifying symptom of severe TB?
Immense fatigue.
164
What skin test is commonly used for TB?
Mantoux test / tuberculin skin test.
165
What substance is used in the Mantoux test?
PPD (protein derivative).
166
Where is the Mantoux test injected?
Into the forearm.
167
What does a red swelling on the Mantoux test indicate?
Induration and exposure to TB.
168
What does the Mantoux test measure?
Exposure to TB.
169
Why does TB treatment take a long time?
Because TB grows slowly and can remain dormant.
170
About how long does TB treatment usually last?
About 9 months or longer.
171
What is the generation time of TB bacteria?
About 20 hours.
172
What does isoniazid do in TB treatment?
Attacks the cell wall.
173
What does ethambutol target?
Mycolic acid.
174
What are the main first-line TB drugs?
Isoniazid, ethambutol, rifampin, and pyrazinamide.
175
What is the role of pyrazinamide in TB treatment?
Helps prevent resistance.
176
What is a second-line TB drug?
Streptomycin.
177
Should streptomycin be used alone for TB?
No.
178
What other drugs can be used as second-line treatment for TB?
Fluoroquinolones.
179
What does multi-drug resistant TB mean?
First-line drugs fail.
180
What does extensively drug-resistant TB mean?
Second-line drugs also fail.
181
Why is patient compliance very important in TB treatment?
Missing doses allows bacteria to regrow.
182
What did the CDC bus driver case show about TB?
TB can affect anyone.
183
In the CDC case, who was the source of the bus driver’s TB?
A homeless passenger.
184
What type of transmission occurred in the bus driver TB case?
Airborne transmission.
185
What is pneumonia?
Inflammation of the lungs.
186
What happens in the alveoli during pneumonia?
They fill with fluid.
187
What organism most commonly causes typical pneumonia?
Streptococcus pneumoniae.
188
Does Streptococcus pneumoniae have a capsule?
Yes.
189
About how many strains of Streptococcus pneumoniae are there?
About 90 strains.
190
Which groups are more susceptible to typical pneumonia?
COPD patients, diabetics, kidney disease patients, smokers, alcohol users, and HIV patients.
191
What are the main symptoms of typical pneumonia?
High fever, breathing difficulty, chest pain, and rust-colored sputum.
192
Why is sputum rust-colored in pneumonia?
Because it contains blood.
193
What complications can develop from pneumonia?
Septicemia, meningitis, and death.
194
What is atypical pneumonia?
Any pneumonia not caused by Streptococcus pneumoniae.
195
What can cause atypical pneumonia?
Bacteria, viruses, fungi, and protozoa.
196
How does atypical pneumonia usually begin?
More slowly.
197
How does fever in atypical pneumonia compare to typical pneumonia?
Lower fever.
198
How does chest pain in atypical pneumonia compare to typical pneumonia?
Less chest pain.
199
Which atypical pneumonia organism is common in older smokers?
Haemophilus influenzae.
200
What special growth requirement does Haemophilus influenzae have?
Requires blood to grow.
201
What organism causes walking pneumonia?
Mycoplasma.
202
Why is Mycoplasma pneumonia called walking pneumonia?
Because patients often do not need hospitalization.
203
What organism causes Legionnaires’ disease?
Legionella.
204
How is Legionella commonly spread?
Through water.
205
What organism causes Q fever?
Coxiella.
206
How is Coxiella spread according to the lecture?
Through endoscopes.
207
What type of respiratory infection is RSV?
Lower respiratory infection.
208
Is RSV considered typical or atypical pneumonia?
Atypical pneumonia.
209
What are the symptoms of RSV?
Shortness of breath, wheezing, gasping for air, and cough.
210
What lower airway condition does RSV commonly cause?
Bronchiolitis.
211
Is RSV highly contagious?
Yes.
212
How does RSV spread?
Through droplets.
213
Which age group is RSV most common in?
Children.
214
Which older age group is RSV especially dangerous for?
Adults over 55.
215
What prevention is available for RSV in newborns?
Vaccination.
216
What symptom helps distinguish RSV from other atypical pneumonias?
Wheezing.
217
What condition helps distinguish RSV from other atypical pneumonias?
Bronchiolitis.
218
Do other atypical pneumonias usually cause wheezing and bronchiolitis?
No.
219
What is the main feature of pneumonia?
Fluid-filled alveoli.
220
What is the main cause of typical pneumonia?
Streptococcus pneumoniae.
221
What causes atypical pneumonia?
Anything except Streptococcus pneumoniae.
222
Where does strep throat occur?
Upper respiratory tract.
223
What does strep throat look like?
Red swollen throat with yellowish discharge/exudate at the back of the throat.
224
What does yellowish discharge in the throat suggest?
Bacterial infection.
225
How does Streptococcus attach in strep throat?
By M protein.
226
What does the M protein cause?
Local inflammation.
227
Is fever usually a major feature of plain strep throat?
No.
228
In which disease does fever make more sense: plain strep throat or scarlet fever?
Scarlet fever.
229
What other findings can occur with strep throat?
Tonsillitis and swollen lymph nodes.
230
How is strep throat diagnosed?
Throat swab.
231
What is collected with the throat swab?
Exudate.
232
What culture medium can be used to diagnose strep throat?
Blood agar.
233
What is the main treatment for strep throat?
Penicillin.
234
What is an alternative treatment for strep throat?
Erythromycin.
235
What newer penicillins can also be used to treat strep throat?
Ampicillin and amoxicillin.
236
What is scarlet fever related to?
It is a sequel to strep throat.
237
What causes scarlet fever?
Production of a powerful exotoxin.
238
What exotoxin causes scarlet fever?
Streptococcal pyrogenic exotoxin.
239
What does pyrogenic mean?
Fever-producing.
240
What are the main features of scarlet fever?
High fever, disseminated red skin rash, contagiousness, and strawberry tongue.
241
What is strawberry tongue?
Red swollen tongue seen in scarlet fever.
242
Is scarlet fever very contagious?
Yes.
243
What is the main difference between plain strep throat and scarlet fever?
Strep throat is mainly a local throat infection, while scarlet fever is disseminated and toxin-mediated.
244
What is the treatment for scarlet fever?
Penicillin or another antibiotic active against gram-positive organisms.
245
What is otitis media?
Middle ear infection.
246
What is the most common cause of otitis media?
Streptococcus pneumoniae.
247
About what percentage of otitis media cases are caused by Streptococcus pneumoniae?
About 33%.
248
What other organisms can cause otitis media?
Haemophilus influenzae and Streptococcus pyogenes.
249
Why is otitis media especially common in children?
Because the Eustachian tube directly connects the throat to the middle ear.
250
How do organisms reach the middle ear in otitis media?
They move from the throat through the Eustachian tube.
251
Besides throat infections, what else can lead to otitis media?
Contaminated water, swimming pool water, common cold, and RSV spreading from the respiratory tract into the ear.
252
Is otitis media mainly exotoxin-mediated?
No.
253
What is the main symptom of otitis media?
Extreme pain.
254
Why does otitis media cause so much pain?
Pus forms in the middle ear and puts pressure on the eardrum.
255
What does acute bacterial otitis media look like on otoscopy?
Bulging eardrum.
256
What does more pus in otitis media suggest?
Bacterial rather than viral cause.
257
Why is diphtheria considered dangerous?
It is a severe exotoxin-mediated disease that can block the airway and cause death.
258
What organism causes diphtheria?
Corynebacterium.
259
Is Corynebacterium gram-positive or gram-negative?
Gram-positive.
260
Is diphtheria exotoxin-mediated?
Yes.
261
What exotoxins are produced in diphtheria?
A and B exotoxins.
262
What vaccine series includes diphtheria?
DTaP.
263
What is the Alberta schedule for the diphtheria vaccine?
2 months, 4 months, 6 months, 18 months, and before school.
264
What type of vaccine is used for diphtheria?
Toxoid vaccine.
265
What does toxoid vaccine mean?
The toxin is inactivated but still stimulates immunity.
266
What does diphtheria exotoxin do to cells?
It inhibits protein synthesis.
267
Why do diphtheria-infected cells die?
They cannot make proteins.
268
Does diphtheria only affect the throat?
No, the toxin can circulate in the blood.
269
What are the symptoms of early diphtheria?
Mild fever, sore throat, fatigue, and swollen neck.
270
What is the key sign of early diphtheria?
Dramatic swelling of the neck.
271
Is dramatic neck swelling seen in regular strep throat?
No.
272
What happens in stage 2 of diphtheria?
Fluid oozes from the throat and thickens into a false membrane.
273
What areas can the diphtheria membrane cover?
Palate, oral cavity, and tonsils.
274
What color is the diphtheria membrane?
Grayish-white.
275
Why is the diphtheria membrane dangerous?
It can block the airway.
276
What serious complication can happen if the airway is blocked?
Suffocation.
277
What are the early treatments for diphtheria?
Penicillin and erythromycin.
278
What treatment may be needed in severe diphtheria?
Tracheostomy or surgical removal of the membrane.
279
Why is removal of the diphtheria membrane dangerous?
It sticks tightly and removal can cause bleeding.
280
Is recovery from diphtheria quick?
No, recovery is long.
281
What happens in stage 3 diphtheria?
The airway becomes blocked.
282
What can happen if diphtheria completely blocks the airway?
Death.
283
What is the most common form of diphtheria?
Respiratory diphtheria.
284
What happens in respiratory diphtheria?
Gray membrane forms in the upper respiratory tract.
285
What is the skin form of diphtheria?
Ulcers covered with a grayish-white membrane.
286
Why is skin diphtheria harder to treat?
The bacteria are already circulating in the blood.
287
In what populations is skin diphtheria more common?
IV drug users, homeless populations, and people in low socioeconomic conditions.
288
What pattern does Corynebacterium show on gram stain?
Palisade / picket fence arrangement.
289
What does palisade arrangement mean?
Rods aligned like a fence.
290
What causes pertussis?
A bacterium with a capsule, tracheal cytotoxin, and endotoxin.
291
What vaccine protects against pertussis?
DTaP.
292
Is the pertussis vaccine acellular?
Yes.
293
Does the pertussis vaccine require boosters?
Yes.
294
How is pertussis often spread to infants?
By parents.
295
How does pertussis attach to the airway?
Via its capsule.
296
What toxin destroys ciliated cells in pertussis?
Tracheal cytotoxin.
297
What happens when ciliated cells are destroyed?
Airway function is disrupted.
298
What do endotoxins do in pertussis?
Worsen inflammation.
299
What happens in the catarrhal stage of pertussis?
Runny nose and cold-like symptoms.
300
Why is the catarrhal stage often missed?
It looks like a common cold.
301
What is the most severe stage of pertussis?
Paroxysmal stage.
302
What is the hallmark symptom of the paroxysmal stage?
Violent coughing fits with a whoop sound.
303
What eye complication can occur in pertussis?
Bloodshot eyes from ruptured blood vessels.
304
What bone complication can occur in pertussis?
Broken ribs.
305
What brain complications can occur in pertussis?
Brain hemorrhage and seizures.
306
Which group is especially at risk for seizures in pertussis?
Children.
307
What happens during convalescence in pertussis?
Ciliated cells regenerate.
308
How long can pertussis recovery take?
Weeks to months.
309
What antibiotics can treat pertussis?
Penicillin, erythromycin, and macrolides.
310
What organism causes tuberculosis?
Mycobacterium tuberculosis.
311
Why is TB important worldwide?
It is the leading infectious cause of death.
312
Which groups are disproportionately affected by TB?
Refugees and people in war zones.
313
What happens in a healthy person exposed to TB?
Macrophages destroy the bacteria.
314
What happens if TB is only partially controlled?
A tubercle forms.
315
What is the center of a tubercle called?
Caseous center.
316
What happens when a tubercle calcifies?
It becomes a Ghon complex.
317
Can a Ghon complex be seen on X-ray?
Yes.
318
Can a Ghon complex remain dormant?
Yes.
319
What is reactivated TB called?
Miliary TB.
320
What happens in miliary TB?
Bacteria spread everywhere.
321
What are the symptoms of active TB?
Weight loss, productive cough with blood, and extreme fatigue.
322
What is the TB skin test called?
Mantoux test.
323
What is injected during the Mantoux test?
PPD.
324
What does a positive Mantoux test look like?
Induration.
325
Why is a TB baseline test helpful?
It helps track exposure over time.
326
Why does TB treatment take so long?
TB grows slowly.
327
What is the generation time of TB bacteria?
About 20 hours.
328
How long does TB treatment usually last?
About 9 months or longer.
329
What does isoniazid target?
Cell wall.
330
What does ethambutol target?
Mycolic acid.
331
What does rifampin target in TB?
Transcription.
332
What is the role of pyrazinamide?
Prevents resistance.
333
What are second-line TB drugs?
Streptomycin and fluoroquinolones.
334
What does MDR TB mean?
Resistant to first-line drugs.
335
What does XDR TB mean?
Resistant to second-line drugs.
336
Why is patient compliance critical in TB treatment?
Missing doses can cause resistance.
337
What is pneumonia?
Inflammation of the lungs.
338
What happens to the alveoli in pneumonia?
They fill with fluid.
339
What organism causes typical pneumonia?
Streptococcus pneumoniae.
340
Which groups are at higher risk for typical pneumonia?
COPD patients, diabetics, kidney disease patients, smokers, alcohol users, and HIV patients.
341
What are the symptoms of typical pneumonia?
High fever, chest pain, breathing difficulty, and rust-colored sputum.
342
Why is sputum rust-colored in pneumonia?
It contains blood.
343
How is typical pneumonia often identified?
Gram stain.
344
What are the complications of typical pneumonia?
Septicemia and meningitis.
345
What causes atypical pneumonia?
Anything except Streptococcus pneumoniae.
346
What organisms can cause atypical pneumonia?
Bacteria, viruses, fungi, and protozoa.
347
How does atypical pneumonia differ from typical pneumonia?
Slower onset, lower fever, and less chest pain.
348
What atypical pneumonia organism is common in older male smokers?
Haemophilus influenzae.
349
What does Haemophilus influenzae require to grow?
Blood.
350
What organism causes walking pneumonia?
Mycoplasma pneumoniae.
351
Why is it called walking pneumonia?
It is mild and usually does not require hospitalization.
352
What organism causes Legionnaires’ disease?
Legionella.
353
How is Legionella spread?
Through water.
354
What causes Q fever?
Coxiella.
355
How is Q fever spread?
Via contaminated equipment such as endoscopes.
356
What does RSV stand for?
Respiratory Syncytial Virus.
357
Is RSV a typical or atypical pneumonia?
Atypical pneumonia.
358
What part of the respiratory tract does RSV affect?
Lower respiratory tract.
359
What symptoms are common in RSV?
Shortness of breath, wheezing, gasping for air, cough, and bronchiolitis.
360
What two findings strongly suggest RSV?
Wheezing and bronchiolitis.
361
Which groups are most at risk for RSV?
Children and adults over 55.
362
How does RSV spread?
Respiratory droplets.
363
Is RSV highly contagious?
Yes.
364
Is there a vaccine for RSV?
Yes, especially for infants.
365
What pneumococcal vaccine protects against multiple strains?
Prevnar 20.
366
How many serotypes does Prevnar 20 protect against?
20.
367
About how many strains of Streptococcus pneumoniae exist overall?
About 90.
368
Does Prevnar 20 cover every strain of Streptococcus pneumoniae?
No.
369
Who routinely receives pneumococcal vaccination?
Infants.
370
Are pneumococcal vaccine recommendations different for adults?
Yes.
371
What are the key exam features of diphtheria?
Gray membrane, exotoxin, airway obstruction.
372
What are the key exam features of pertussis?
Whoop cough, three stages, toxin destroys cilia.
373
What are the key exam features of TB?
Ghon complex versus miliary TB.
374
What are the key exam features of typical pneumonia?
Streptococcus pneumoniae, high fever, rust-colored sputum.
375
What are the key exam features of atypical pneumonia?
Everything except Streptococcus pneumoniae with milder symptoms.
376
What are the key exam features of RSV?
Wheezing and bronchiolitis.
377
What type of microorganism is the flu virus?
A virion.
378
Why are flu viruses considered dangerous?
They contain all the components of a typical virion.
379
What symptoms are common in influenza?
Chills, fever, conjunctivitis, headaches, and muscle aches.
380
Should intestinal symptoms usually occur with influenza?
No.
381
About how many deaths can occur during a bad flu season in Canada?
Around 3,000–4,000 deaths.
382
Why do flu viruses change every year?
They can mix genomes with other strains.
383
What is the name of the idea that flu strains mix together?
Mixing vessel hypothesis.
384
What can flu viruses mix with?
Avian strains and other flu strains.
385
What is an example of an avian flu strain?
H5N1.
386
Why is avian flu important?
It can mix with human flu strains.
387
What does the mixing vessel hypothesis explain?
Why new flu strains develop.
388
What virus was mentioned as likely originating from bats?
COVID.
389
Does having the flu provide long-term immunity?
No.
390
Why do people need a flu vaccine every year?
Flu strains change each year.
391
How long does it usually take to make a flu vaccine?
Almost a year.
392
What is next year’s flu vaccine based on?
This year’s strain.
393
What is antigenic drift?
Small change in the protein structure of viral spikes.
394
Which flu virus spikes are affected by antigenic drift?
H spikes and N spikes.
395
What causes annual variation in flu strains?
Antigenic drift.
396
What is an example of antigenic drift?
H3N2 drifting away from a previous strain.
397
What kind of changes occur during antigenic drift?
Minor amino acid or protein changes.
398
Why is antigenic drift important?
It changes susceptibility to previous strains.
399
What is the result of antigenic drift?
Annual new strains.
400
What is antigenic shift?
Major change in a virus.
401
What usually causes antigenic shift?
Mixing with another species.
402
What is an example of antigenic shift?
Avian flu H5N1 adapting to humans.
403
What is the main result of antigenic shift?
Pandemics.
404
What disease was mentioned as an example of a major change leading to a pandemic?
COVID.
405
Can pandemics sometimes be stopped before becoming full pandemics?
Yes.
406
What does a full-blown pandemic usually involve?
Major change.
407
How can influenza be diagnosed?
Serological testing and PCR.
408
What does PCR stand for?
Polymerase chain reaction.
409
What does PCR do in flu diagnosis?
Enlarges part of the viral genome.
410
What is the brand name for zanamivir?
Relenza.
411
What is the brand name for oseltamivir?
Tamiflu.
412
What do zanamivir and oseltamivir target?
Neuraminidase spike.
413
What is another name for the neuraminidase spike?
NA spike.
414
What is the mechanism of zanamivir and oseltamivir?
They inhibit neuraminidase.
Microbiology
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