Pneumonia (Exam 5)

True

True or False: pneumonia is a pathological lung condition and not a specific kind of infection

Alveoli

Pneumonia is inflammation of the ___ of the lungs

Accumulation of fluid

Inflammation from pneumonia leads to ______ in the air sacs of the lungs

Gas exchange with blood

Fluid accumulation impacts…

Cardiovascular and respiratory

The shifts in gas exchange cause stress on these systems

Lung cancers, immunological disorders, exposure to certain drugs or chemical irritants

3 non-infectious causes of pneumonia

Pneumonitis

Name for non-infectious pneumonia

2/3; 1/3

The ratio of bacteria vs viral pneumonia is typically ___ to ____ but has become ½ to ½ due to Covid

Fungal and parasitic pneumonias

Pneumonias that are <1% of all cases

HIV/AIDS

People with this are the people who typically get fungal/parasitic infection pneumonia (opportunistic)

Streptococcus pneumoniae

Most common cause of gram + pneumonia

Pneumococcal pneumonia or pneumococcus

Other names for streptococcus pnemoniae

Haemophilus influenzae

Most common cause of gram - pneumonia

H-flu or Hib

Other names for Haemophilus influenzae

Hemophilus influenzae type B (Hib)

Most serious form of H-Flu

Capsules and fibriae

Adhesion structures that both forms of pneumonia create

Fibriae

Allow the bacteria to tightly bind to the respiratory tract

Capsules

Allows the bacteria to adhere to the respiratory tract and block phagocytosis

Pneumolysin

Type 2 toxin that destroys neutrophils and macrophages by opening holes in their cell membrane; also damages the cells of the alveoli leading to inflammation and pneumonia

Primary

S. Pneumoniae is a ____ pathogen

Exotoxins

H. Influenzae does not produce _____

Opportunistic

H. Influenzae is a ____ pathogen

H-flu

Causes inflammation by releasing LPS

Productive (wet) cough, high heart rate, fever with chills, shortness of breath, chest wall pain, flu-like symptoms

Symptoms of pneumonia

Increased mucus production

Productive wet cough is due to a …

Cardiovascular stress

High heart rate is due to …

Inflammatory reactions and/or LPS

Fever with chills is due to…

accumulation of fluid in lungs

Shortness of breath is due to

Inflammation of pleural membranes

Chest wall pain is due to…

Human hosts or carriers

Reservoirs of pneumonia

Nose and throat

Most people are carriers of either bacterium or both in their …

Eyes, nose, mouth

portal of entry for pneumonia

Direct person to person, vehicle transmission (pneumococcal only)

Modes of transmission for pneumonia

Autoinoculation, ventilator-associates contact

Other modes of direct transmission for pneumonia

Autoinoculation

Bacteria in the normal micro biota are brought to the lungs by aspiration after food/drink/stomach contents context micro biota

Respiratory droplets

Portal of exit for pneumonia

Ventilator-associated contact

Normal microbiota of throat shoved to lungs by tube

False

True or False: S. Pneumoniae has susceptibility requirements

Immunosuppressed groups, people who recently had other lung infections, people with chronic lung diseases (COPD)

Host susceptibility for H-flu (groups susceptible)

age, immune status, inhalation of particles, recent respiratory infections, comorbid conditions, conditions that increase risk of aspiration

host factors that increase susceptibility for all types of pneumonia

conditions that cause difficulty swallowing, long term intubation or ventilation, frequent vomiting or gastrointestinal influx

what are some things that can increase risk of aspiration?

one or more

individuals with ______ negative host factors are typically at much higher risk of serious complications of pneumonia

exacerbations of cardiovascular disease, acute respiratory distress, sepsis

examples of serious complications of pneumonia

subunit

what type of vaccine exists for pneumonia?

False

True or False: both bacterial species have a low degree of antigenic variation

True

True or False: Vaccine formulations can only provide immunity to the most common types of antigens

20-23 types depending on vaccine

how many antigens does the pneumococcus vaccine protect against?

just type B

what antigens does the Hib vaccine protect against?

COVID, serious complications of Flu A, RSV

3 most common causes of viral pneumonia hospitalizations

enveloped

RSV is a enveloped or naked virus?

G protein

RSV spike protein

ciliated cells in the upper and lower respiratory tract

where does RSV bind in the body?

variable

the capsid shape of RSV is…

replication of the virus in the air passages causes cytopathic effects, causing accumulation of mucus in the air passages and triggering inflammation which causes more mucus production

two factors in the pathogenesis of RSV

deeper into the lungs

as the severity of an RSV infection increases, the virus moves _______

bronchiolitis

inflammation of the smallest air passages right before the alveoli

mild

most RSV infections are ___ and have the symptoms of a mild upper respiratory tract infection

non-productive cough, rhinitis, sore throat, congestion, fever

symptoms of a mild upper respiratory tract infection

shortness of breath, fast respiration rate, fast heart rate, expiratory wheeze

severe RSV infections with bronchiolitis display symptoms of respiratory distress. What are these symptoms?

human hosts

reservoirs for RSV

eyes, nose, mouth

portal of entry for RSV

direct and vehicle transmission

mode of transmission for RSV

respiratory droplets

portal of exit for RSV

none

host susceptibility requirements for RSV

immunosuppressed, children under 2, elderly over 65 (especially those with respiratory issues)

hosts with high risk factors for serious complications of RSV

transimissibility

RSV is a threat not because of extremely high virulence but because of its ______

under 50

what is the ID50 for RSV?

2

>99% of children will have had RSV at least once by the age of ____

1-2%

severe infections only account for ___ of all infections

so many people get RSV each year that is still a large amount of people having serious complications

why is RSV so bad if only 1-2% have severe infection?

No

are there antiviral medications for RSV?

oxygen supplementation, CPAP breathing support, ventilation

treatment for RSV is limited to supportive care such as…

IV antibodies

to prevent RSV, at risk infants are given ___

subunit

there are now vaccines for RSV. What type are they?

adults over 75, adults 60-74 who are high risk, pregnant women (32-36 weeks)

who should get the RSV vaccine?

74-94%

the RSV vaccines are _____% effective at prevention of severe RSV infection

geometric

what shape is the COVID capsid?

enveloped

is COVID enveloped or naked?

s-protein

what protein does COVID use?

ACE2

what does the S-protein bind to in the body?

viral replication, immune hyperactivity, tissue destruction (of otherwise healthy tissue)

what are the three stages of pathogenesis for COVID?

slowly, in waves of replication

how do the stages of COVID pathogenesis progress?

olfactory and upper respiratory epithelial cells

the initial waves of COVID happen in the _______

deeper into the respiratory tract

subsequent waves of COVID allow the virus to move ______

flu like symptoms

each wave of replication of COVID can trigger ____

cold like symptoms and anosmia

the initial waves of replication of COVID cause what symptoms?

blood vessels and heart

destruction of lung tissue can allow the virus access to the ______

myocarditis and cardiomyopathy

pathogenic cycle of tissue destruction in the heart can result in ____ (COVID)

clotting and sepsis

pathogenic cycle in blood vessels can result in ____ (COVID).

continued slow cycles of replication in other organs

we think that long COVID might be due to…

18 months

COVID has been found in body tissues up to ____ after initial infection

heart, lungs, immune system, pancreas, neurological system, kidneys, spleen, liver, blood vessels, reproductive system

give examples of tissues that have been identified as internal reservoirs of COVID virus?