Exam 4-Diseases

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Strep Throat

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*BACTERIAL* UPPER RESPIRATORY
Causative agent: Streptococcus pyogenes; beta hemolytic (causes pus)

Portal of Entry: inhalation/ingestion (i.e.: sharing drinks; droplet transmission)

Signs & Symptoms: Sore red throat often with white, pus follicles on tonsils or back of throat; tenderness of lymph nodes of throat

Pathogenesis: multiple virulence factors (**NOT S. pyogenes on its own!)

Epidemiology: direct contact and droplet infection

Treatment: antibiotics

Other: **untreated cases can subsequently produce rheumatic fever or glomerulonephritis (decreased kidney function) in some patients

Portal of Exit: nose and mouth

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Terms in this set (69)

Strep Throat

Diptheria

*BACTERIAL* UPPER RESPIRATORY
Causative agent: Corynebacterium diptheriae (look like check marks; pleomorphic)

Portal of Entry: Inhalation-nasal cavity or throat

Signs & Symptoms: Sore throat, fever, fatigue and malaise; a white pseudomembrane often forms on the tonsils. Tonsils look gray and dead, with a layer of dead cells over the surface.

Pathogenesis: upper respiratory infection; exotoxin (A-B toxin) is released and absorbed by the body; toxin kills cell by blocking protein synthesis

Epidemiology: inhalation of droplets; direct contact with patient; indirect contact with for mites

Treatment: antitoxin; antibiotics to prevent transmission

Other: prevention is vaccination with diptheria toxoid in a childhood vaccination series with periodic adult boosters

Portal of Exit: respiratory secretions (i.e: coughing, hacking and sneezing)

*classic disease that Standard Precautions knock out*

Pink-eye (conjunctivitis); Earache (otitis media); Sinus infection (sinusitis)

BACTERIAL UPPER RESPIRATORY

Causative agents: Haemophilus influenzae & Streptococcus pneumoniae

Signs & Symptoms:
1.) Pink-eye: increased tears, red and swollen conjunctiva, sensitivity to light, large amounts of pus
2.) Earache: Severe earache, sometimes producing vomiting; sometimes fever
3.)Sinus infection: facial pain and pressure in sinus area, headache, severe malaise, thick green nasal discharge and sometimes pus and blood

Pathogenesis: direct contact and droplet infection of eyes and nose

Epidemiology: carriers can reach 80% in the absence of disease; virulence of bacteria and levels of respiratory viruses are all important factors. If you have another infection, it will make you more likely to develop these diseases. With the development of sinus infections, allergies can trap some pathogens into the tissues

Treatment: strain specific antibiotic drops for pink-eye (2-3 formulations); amoxicillin for the other two (decongestants and antihistamines are NOT recommended, because these diseases are not allergic reactions and the use of these can cause tissues to dry out and get infected better)

Other: Earache is common between 2-5 years, when most become immune to H influenzae; Pink-eye is common in teens; Sinusitis typically occurs in older children and adults

The Common Cold

VIRAL UPPER RESPIRATORY
Causative agent: Rhinovirus (100 or more types)

Signs & Symptoms: Scratchy throat, nasal discharge, malaise, headache, cough

Pathogenesis: upper respiratory specific, prolific reproducers-cell damage produces the nasal discharge and histamine reactions; infection stopped by interferon (type of cytokine), cell-mediated, and humoral immunity

Epidemiology: Inhalation of droplets, direct contact (transfer of mucous)

Treatment: No generally accepted treatment. Can be prevented through handwashing and avoidance

Portal of Exit: nose and mouth

Pneumococcal pneumonia

BACTERIAL LOWER RESPIRATORY
Causative agent: Pneumococcus pneumoniae capsulated (only caused by the capsulated varieties; the more capsulated, the more virulent)

Signs & Symptoms: cough, fever, single shaking chill; rust-colored sputum from degraded blood; shortness of breath; chest pain

Pathogenesis: inhalation of bacteria; colonization of alveoli; incites inflammatory response; plasma, blood, and inflammatory cells fill the alveoli (unable to breathe, may cause permanent lung damage); pain from nerve involvement

Epidemiology: high carrier rates; increased rates from transient or chronic immunocompromised states (including infection by other respiratory viruses) that impair mucocilliary escalator

Treatment: antibiotics; vaccine raised to 23 capsule antigens available (vaccine for pneumonia is for this strain)

Other: affected patients can become dusky in color; untreated patients that survive often regain normal color and their temperature drops after 7-10 days

*Pneumococcal pneumonia is the most common strain of pneumonia; Klebsiella is the most dangerous, causing tissue death, unlike the others (death, permanent damage and sepsis possible; antibiotic resistant) Mycoplasma pneumonia is mild compared to the others, and is known as "walking pneumonia."*

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