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2015-04-07 12:09:00

intro to health
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  1. respiratory divided into two parts
    upper and lower tract
  2. upper tract
    • mouth
    • nose
    • nasal cavity
    • sinuses
    • pharynx
    • epiglottis
    • larynx
  3. lower tract
    • trachea
    • bronchi
    • bronchioles
    • alveoli
  4. Most common portal of entry
    respiratory tract
  5. first line of defense- respiratory
    • nasal hairs
    • cilia (cilia escalator)
    • mucus
  6. second line of defense- respiratory
  7. third line of defense
    pathogen specific secretory IgA
  8. 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
  9. 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)
  10. pharyngitis causative agent
    • most often by common cold viruses
    • fusobacterium necrophorum
    • streptococcus pyogenes (group a)
  11. Streptococcus pyogenes complications of infection ( three types )
    • scarlet fever
    • rheumatic fever
    • glomerulonephritis
  12. Scarlet fever aka
  13. Scarlet fever caused by
    bacteriophages allows erythrogenic toxin production
  14. Scarlet fever symptoms
    • sand paper like rash
    • high fever
  15. Scarlet fever found in
    school aged children
  16. rheumatic fever caused by
    • reaction between streptococci M protein, heart muscle
    • due to immune complex occurring. immune system attack leaving long term damage
  17. rheumatic fever occurs
    3 weeks after pharyngitis has subsided
  18. rheumatic fever damages
    to hearth valves, arthritis in joints
  19. glomerulonephritis- formation
    formation of antigen-antibody complexes in the glomeruli
  20. glomerulonephritis characterized by

    • toxic shock syndrome
    • necortizing fasciitis
  21. Scarlet fever associated with
    strep throat Erythrogenic toxin
  22. Scarlet fever associated with strep throat Erythrogenic toxin produced by
    lysogenized streptococcus pyogenes
  23. Complications of streptococcus pyogenes infections with rheumatic fever
    • affects joints and heart
    • causes permanent heart damage called rheumatic heart disease
  24. rheumatic fever signs/symptoms
    • fever
    • tender painful joints
    • red hot swollen injuries
    • small painless nodules beneath the skin
  25. Diphtheria
    Corynebacterium diphtheria- gram positive rod
  26. Diphtheria toxin produced by
    lysogenized C. Diphtheria
  27. Diphtheria transmission
  28. Rhinitis (common cold) causative agent
    • over 200 different viruses
    • -rhinoviruses ( 99 serotypes )
    • -adenoviruses
    • -respiratory syncytail virus (RSV)
  29. Rhinitis transmission
    indirect contact, droplet contact
  30. rhinitis symptoms
    • sneezing, runny nose
    • scratchy throat, coughing
    • low fever in kids
  31. 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
  32. Acute otitis media cause agent
    • mixed infection viruses and bacteria
    • streptococcus pneumoniae, haemophilus influenzae
    • mixed biofilm of bacteria in chronic otitis media
  33. Acute otitis media prevention
    • vaccine
    • prevnar
    • HIB
  34. Acute otitis media treatment
    • "watchful waiting"
    • antibiotics
    • tympanic membrane tubes
    • ciliary escalator keeps sterile
  35. Diphtheria causative agent
    • corynebacterium diphtheria
    • non spore forming, gram positive, club shaped
  36. Diphtheria transmission
    droplet contact, direct contact, fomites
  37. Diphtheria virulence factor
    • diphtheria exotoxin
    • encoded by bacteriophage
  38. Diphtheria prevention
    Diphtheria toxoid vaccine (DTaP)
  39. Diphtheria treatment
    antitoxin plus penicillin or erythromycir
  40. Bacteria, viruses, and fungi cause
    • bronchitis
    • bronchiolitis
    • pneumonia
  41. Pertussis (whooping cough) caused by
    • bordetella pertussis
    • gram negative coccobacillus
  42. pertussis cytotoxin damages
    • ciliated cells 
    • take long to grow back
    • pertussis toxin
  43. pertussis prevention
    by DTaP
  44. Pertussis stage 1
    catarrhal stage, like common cold
  45. pertussis stage 2
    paroxysmal stage- violent coughing sieges
  46. pertussis stage 3
    convalescence stage
  47. 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
  48. tuberculosis transmission
    from human to human, respiratory transmission
  49. 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)
  50. 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
  51. 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
  52. pneumonia caused by
    • streptococcus pneumonia- pneumococccal pneumonia
    • gram positive encapsulated displococci
  53. pneumonia symptoms
    infected alveoli of lung fill with fluid, interferes with oxygen uptake
  54. pneumonia treatment
    penecillin, flouroquinolones
  55. pneumonia prevention
    pneumococcal vaccine
  56. mycoplasmal pneumonia
    primary atypical pneumonia
  57. mycoplasmal pneumonia common in
    children and young adults
  58. mycoplasmal pneumonia
    pleomorphic, wall-less bacteria
  59. mycoplasmal pneumonia has no sensitivity to penicillin b/c
    it has no cell wall
  60. mycoplasmal pneumonia symptoms
    • chest pain, chills, sore throat
    • spread easily in groups, walking pneumonia
  61. Legionellosis
    a typical pneumonia
  62. Legionellosis caused by
    legionella pneumophila, gram negative rod
  63. Legionellosis found
    it lives where water collects and becomes airborne in the wind (ventilation system)
  64. Legionellosis develop
    within a week of inhalation of contaminated droplets
  65. Legionellosis tend to affect
    older men who drink and smoke heavily
  66. Influenza transmitted
    by airborne respiratory droplets, highly communicable acute respiratory infection
  67. Influenza symptoms
    • chill, fever, headache, and muscle aches
    • no intestinal symptoms (stomach flu)
  68. Hemagglutin (H) helps the ______ attach and penetrate host cells
  69. Neuraminidase (N) helps _______ virions from the host cell after replication and assembly
  70. Spike (hemagglutin, neuraminidase)
    • help get in and out influenza
    • name influenza according to the spikes they have
  71. influenza complications
    • guillain barre syndrome
    • reye syndrome
  72. complications of influenza- guillain barre syndrome
    occurs when body damages its own peripheral nerve cells
  73. 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
  74. respiratory syncytial virus (RSV) affects
    commonly affect children under 1 year of age
  75. respiratory syncytial virus (RSV) infects
    the bronchials and alveoli of the lungs, causing cells to fuse together into syncytia
  76. Fungal infections of lower respiratory system
    • histoplasmosis
    • coccidioidomycosis
  77. histoplasmosis caused by
    dimorphic histoplasma capsulatum
  78. histoplasmosis found in
    dry dusty soil chicken coops ad bat caves
  79. histoplasmosis most people sufer
    mild influenza like symptoms
  80. dimorphic
    • two body types
    • mold with spores, easily to inhale
    • yeast inhaled budding
  81. coccidioidomycosis caused by
    coccidiodes immitis
  82. coccidioidomycosis symptoms
    • inhalation of spores causing
    • dry hacking cough
    • chest pains
    • high fever
  83. coccidioidomycosis rarely infection cause
    disseminates to tissues such as meninges of spinal chord
  84. opportunistic mycoses affect immunocompromised individuals
  85. cryptococcosis  caused by
    cryptococcus neoformans
  86. cryptococcus neoformans found in
    soil and pigeon droping
  87. cryptococcus neoformans cells
    are inhaled, can (rarely) pass into the blood stream, infecting the brain and meninges
  88. pneumocystis pneumonia caused by
    pneumocystis jiroveci
  89. pneumocystis pneumonia common infection in
    AIDS patients
  90. Pneumocystis jiroveci has ______ _____ in _____
    complex life cycle in the alveoli
  91. pneumocystis pneumonia transmitted
    respiratory droplets