Floyd's Illness Quiz

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Questions and Answers

What symptom was NOT reported by Floyd during his illness?

Headache

Difficulty breathing (correct)

Cough

Chills

Which complication was observed in the soldier next to Floyd?

Persistent fever

Complete recovery

Sudden weight gain

Coughing up blood (correct)

What aspect of the respiratory tract is primarily involved in the protection against infections?

Mucociliary escalator (correct)

Diaphragm

Bronchial tubes

Alveolar sacs

What physiological change was noted in the soldier who eventually died next to Floyd?

Blue discoloration of the face Signup and view all the answers

What was the general response of doctors to the illness affecting Floyd and other soldiers?

They were unable to provide effective treatment. Signup and view all the answers

What temperature did Floyd’s fever reach during his illness?

40°C (104°F) Signup and view all the answers

Which of the following is NOT typically associated with upper respiratory infections?

Severe cough Signup and view all the answers

What was the duration before Floyd began to improve from his illness?

2 weeks Signup and view all the answers

What components are included in the upper respiratory tract?

Nasal passages and pharynx Signup and view all the answers

What function do the respiratory tubes serve as air travels to the alveoli?

Warm, moisturize, and remove impurities from the air Signup and view all the answers

What is the role of goblet cells in the respiratory system?

Secrete mucin to create sticky mucus Signup and view all the answers

In Jacob's case, what symptom indicates he likely has a common cold?

Rhinorrhea and nasal congestion Signup and view all the answers

Which of the following was NOT a finding in Jacob's complete blood count (CBC)?

Abnormal white blood cell count Signup and view all the answers

What does the mucociliary escalator primarily do in the lungs?

Keeps the lungs free from microorganisms Signup and view all the answers

Jacob's treatment for his common cold includes which of the following?

Bed rest and over-the-counter medications Signup and view all the answers

What defines a nonproductive cough as experienced by Jacob?

Cough that does not produce sputum Signup and view all the answers

Which group of individuals is most at risk for infections caused by Streptococcus pneumoniae?

The elderly and immunocompromised individuals Signup and view all the answers

What type of vaccine is the pneumococcal polysaccharide vaccine (PPSV) designed to protect against?

Certain serotypes of Streptococcus pneumoniae Signup and view all the answers

What is a defining characteristic of Mycoplasma pneumoniae?

It lacks a rigid cell wall and is filamentous. Signup and view all the answers

How is Legionella pneumophila primarily transmitted?

Via inhalation of contaminated water droplets Signup and view all the answers

What is the most common cause of hospital-acquired pneumonia?

Pseudomonas aeruginosa Signup and view all the answers

What characteristic is true of Mycobacterium tuberculosis?

It is acid-fast and associated with rising cases due to HIV. Signup and view all the answers

Which of the following signs is least associated with Mycoplasma pneumoniae infection?

High-grade fever Signup and view all the answers

What is a unique feature of Legionella pneumophila in terms of its pathogenicity?

It can overcome host immune responses after phagocytosis. Signup and view all the answers

What characterizes primary tuberculosis disease?

A productive cough with sputum, fever, and night sweats Signup and view all the answers

Which mechanism describes how multidrug resistant tuberculosis is spread?

Aerosolizing respiratory secretions Signup and view all the answers

What forms at the infection site in tuberculosis pathogenesis?

Caseous lesions and granulomas Signup and view all the answers

What symptoms might indicate inhalation anthrax in a patient?

Hemoptysis, dyspnea, and chest pain Signup and view all the answers

Why is rapid diagnosis and treatment critical for inhalation anthrax?

Death can occur within 48 hours without treatment Signup and view all the answers

What is true about latent tuberculosis?

The bacilli are contained by the immune system and are not infectious Signup and view all the answers

What type of patient is at highest risk for rapid onset of MDR tuberculosis?

Individuals with HIV Signup and view all the answers

What hallmark finding is associated with Ghon complexes seen on X-rays?

Calcified lesions from tuberculosis infection Signup and view all the answers

Which symptom did Tyrell NOT report in his medical history?

Intravenous drug use Signup and view all the answers

What was the most likely fungal infection indicated in Tyrell's case?

Blastomycosis Signup and view all the answers

Which of the following is NOT a symptom Tyrell experienced upon his current admission?

Nausea Signup and view all the answers

Which treatment was administered to Tyrell for his fungal infection?

Amphotericin B Signup and view all the answers

What was the outcome of the tuberculosis skin test for Tyrell?

Negative for tuberculosis Signup and view all the answers

Where is the portal of entry for fungal respiratory infections?

Respiratory tract Signup and view all the answers

Which of the following correctly describes the environmental conditions associated with fungal infections?

Moist soil and wooded areas along waterways Signup and view all the answers

What best describes the nature of fungal infections of the respiratory tract?

Acquired from the environment Signup and view all the answers

Which fungal infection is also known as Valley Fever?

Coccidioidomycosis Signup and view all the answers

What is the most common clinical manifestation of cryptococcosis in AIDS patients?

Meningoencephalitis Signup and view all the answers

Histoplasmosis is primarily found in which regions of the United States?

Ohio and Mississippi river valleys Signup and view all the answers

Which fungus is described as dimorphic and commonly found in the eastern United States?

Blastomyces dermatitidis Signup and view all the answers

Which of the following diseases is especially concerning for premature infants?

Respiratory syncytial virus (RSV) Signup and view all the answers

What is a common symptom of histoplasmosis?

Erythema nodosum Signup and view all the answers

Which type of fungus can involve various body parts including skin, lungs, and bones?

Cryptococcus neoformans Signup and view all the answers

What is one of the common complications of streptococcal infections?

Autoimmune reactions Signup and view all the answers

Study Notes

Infections of the Respiratory Tract

Chapter 20 of a microbiology textbook, discusses respiratory infections.

Monoclonal Antibody

Nirsevimab, a monoclonal antibody, is 75% effective in infants against respiratory syncytial virus (RSV).
It could be the first immunization against RSV for all infants.

Lavender Spray Illness

Patients in multiple states experienced a rare illness.
The cause was identified as a lavender spray.
The spray, "Lavender & Chamomile With Gemstones", was recalled by Walmart.

Chapter Objectives (Infections of Respiratory Tract)

Relate respiratory tract anatomy and physiology to infectious processes.
Differentiate upper and lower respiratory infections based on symptoms.
Describe pathogenesis mechanisms for major respiratory tract infections.
Relate pathogenic mechanisms to disease prevention.

The Ominous Cough (Scenario 1)

In 1918, a 20-year-old soldier (Floyd) experienced an illness, characterized by severe cough, headache, chills, and fever.
His condition worsened, characterized by delirium and death-like symptoms.

The Ominous Cough (Scenario 2 - Signs and Symptoms)

Floyd experienced terrible cough.
Dark, purplish spots emerged on Floyd's face, followed by his skin turning blue from lack of oxygen.
Floyd demonstrated a cough that included the spitting of blood.

The Ominous Cough (Scenario 3 - Resolution)

After two weeks, Floyd showed signs of improvement.
Many other soldiers, tragically, did not survive.
The cause and prevention of the illness were not known.

Anatomy of the Respiratory Tract (Section 20.1)

Section Objectives:
- List the anatomic differences between upper and lower respiratory tracts.
- Describe the relationship of eyes, ears, and nose with upper airways.
- Explain the role of the mucociliary escalator.
Upper Respiratory Tract: Upper Airways (nasal passages), oral cavity, pharynx, larynx
Lower Respiratory Tract: Alveoli, where oxygen and carbon dioxide exchange, bronchioles to warm, moisturize, and remove impurities.

Anatomy of the Mucociliary Escalator (Section 20.1, part 4)

Keeps lungs free of microorganisms.
Goblet cells create sticky mucus that traps foreign particles.
Cilia help move mucus and trapped substances out of the airways.

Viral Infections of the Respiratory Tract (Section 20.2)

Section Objectives:
- Compare signs and symptoms of upper and lower respiratory infections.
- Describe the role of mutations in influenza pandemics.
- List risk factors for upper and lower respiratory tract infections
- Identify the etiology of major viral infections.

Viral Infections: Common Cold

Most common upper respiratory tract viral infection
200 viral subtypes.
Rhinoviruses are a prominent cause of colds.
- Other causes include Coronaviruses, Influenze, Parainfluenze, RSV

Viral Infections: Viral Sinusitis

Infection of the upper airways.
Inflammation and congestion of the sinuses impede mucus flow.
Sinus congestion often causes headaches associated with colds.

Lower Respiratory Viral Infections

Respiratory Syncytial Virus (RSV):
- Fusion of infected cells forms giant cells (syncytia) with multiple nuclei.
- Transmitted amongst people and affects infants and children younger than a year.
Influenza (Flu):
- Antigenic determinants classify types A, B, and C.
- Type A causes pandemics, type B causes a milder illness
- Type C causes mild disease only.
Pathogenicity Depends on Hemagglutinin (HA), Neuraminidase (NA), M2:
- HA forms spikes that bind to cells.
- NA releases budding viruses from host cells
- M2 releases viral genome into cytoplasm.

Lower Respiratory Viral Infections: Common Cold

A significant number of patients experience mild illness.
General Viral Infections:
- Common cold symptoms, such as headache and runny nose, appear.

Case History: Jacob's Runny Nose

A 5-year-old boy presented with a nonproductive cough, runny nose, nasal congestion, and headache without fever.
Normal blood tests and X-rays led to a diagnosis of a common cold.
Rest and over-the-counter medication were recommended.

Bacterial Infections of the Respiratory Tract (Section 20.3)

Section Objectives:
- List the bacterial etiology of respiratory diseases and their anatomical locations.
- Describe the relationship between host and bacteria that contribute to pathogenesis of respiratory tract infections.
- Compare and contrast clinical presentations of bacterial infections of the respiratory tract.
- Develop a prevention plan for different bacterial respiratory pathogens.

Case History: A Big Pain in a Little Ear

A 2-year-old girl presented with a fever, irritability, pain in the ear, and runny nose.
physical examination showed a red and swollen ear, and a bulging eardrum.
Acute otitis media diagnosed.
Antibiotic treatment was prescribed.

Upper Respiratory Tract Bacterial Infections

Otitis Media (AOM):
- Common diagnosis during pediatric sick visits.
- Symptoms range widely, depending on the type of infection; caused by viruses, Gram-positive and Gram-negative bacteria.
Eustachian Tube: Shorter and horizontal structure in very young children, limiting drainage and increasing the probability of middle-ear infections.

Upper Respiratory Tract Bacterial Infections: Bacterial Sinusitis

A common upper airway infection, often with related conditions like middle-ear and lung infections.
Inflammation and congestion impede mucus flow.
Typical symptoms include pressure behind the eyes, facial pain, and foul-smelling nasal discharge or breath. -Treatment relies largely on antibiotics

Case History: The Contagious Football Player with GAS

A 16-year-old boy presented with sore throat, enlarged and tender lymph nodes, exudate on his tonsils and pharynx, fever, and no cough.
Rapid strep test was inconclusive due to a shortage of test strips.
A diagnosis of strep throat was made empirically, and an antibiotic was administered;
Confirmed results later showed group A streptococcus.

Upper Respiratory Tract Infections: Streptococcus

Related conditions like Pharyngitis, Tonsillitis, Laryngitis, Peritonsillar abscess.
Diagnosis for sore throat includes viral and bacterial etiologies, potentially including infectious mononucleosis or diphtheria.

Streptococcus Sequelae

Pathological issues can follow initial streptococcal infections.
Pathological problems can be linked to the infection's immune response.
These issues often arise from the body's immune system reacting to the bacteria's presence.

Post-Streptococcal Sequelae

Conditions like Acute Rheumatic Fever (ARF) and Glomerulonephritis might develop.
ARF is prevalent in children (ages 4–9) exhibiting high fever. -Complications to the heart, joints, skin, and nervous system are possible. -Glomerulonephritis impacts the kidneys

Case History: The "Bull Neck"

A 3-year-old girl from El Salvador presented with fever, lethargy, breathing difficulties, and swelling in the neck.
Membranous growth was observed in the throat, obstructing the trachea.
The likely cause of her illness was identified as Corynebacterium diphtheriae.

Reemerging Infections: Diphtheria

Infection caused by Corynebacterium diphtheriae, and characterized by sore throat.
Diagnosis requires cultures and antibiotic/antitoxin treatment.

Whooping Cough (Pertussis)

Transmitted through airborne droplets.
Has 3 phases: catarrhal, paroxysmal, convalescent.
Characterized by a "whooping cough" sound during recovery and involves bacteria called Bordetella pertussis.

Lower Respiratory Tract Bacterial Infections

Bronchitis: Inflammation of the bronchi, often self-limiting, and typically characterized by a productive cough (one producing sputum) lasting more than 5 days.
Community-acquired Pneumonia (CAP):
- Infection caused by various bacteria (e.g. Streptococcus pneumoniae, Mycoplasma, Legionella), usually outside hospitals and characterized by symptoms such as shortness of breath and a cough.
- These often affect multiple organ systems.
- Atypical pneumonias involve multiple organ systems, usually produce normal WBC counts, and develop gradually, often mimicking upper respiratory infections.
Hospital-acquired Pneumonia (HAP): Infections contracted while receiving care for other conditions and occurring within a hospital setting, such as hospital-acquired infection.
Tuberculosis (TB): An infection caused by Mycobacterium tuberculosis (an acid-fast bacterium) and is characterized by its progression through inhaling respiratory droplets.

Pneumonia Caused by Select Agents

Bacillus anthracis is a bacterium that may cause inhalational anthrax.
Its spores are inhaled, resulting in a 5-day prodromal phase (with symptoms that include hemoptysis, shortness of breath, chest pain, and nausea).
Anthrax, when left untreated, can lead rapidly to patient death.

Fungal and Parasitic Infections of the Respiratory Tract (Section 20.4)

Section Objectives:
- Identify common etiologies of fungal lower respiratory tract infections.
- Describe the differences between fungal and bacterial lower respiratory tract infections.
- Identify risk factors for fungal infections.

Case History: A Boxer's Fight to Survive

A 35-year-old male boxer presented with cough, fever, night sweats, weight loss, and subcutaneous nodules.
X-ray revealed a right upper lobe infiltrate, suggestive of pneumonia.
The case was determined to likely be a fungal infection (blastomycosis).
Antifungal medicine, such as Amphotericin B, was administered, which resulted in resolution of symptoms.

Fungal Infections: Overview

Fungal infections of the respiratory tract originate from environmental sources, not from other infected people.
Infections often occur in regions with moist environments.
Most common etiologies of fungal lower respiratory infections include coccidioidomycosis, histoplasmosis, blastomycosis, and cryptococcosis.

Clicker Questions and Answers (Note: These are brief summaries)

Clicker Question 1: Streptococcal M proteins mimic human proteins, triggering an autoimmune reaction.
Clicker Question 2: Respiratory syncytial virus (RSV) is a significant concern for premature infants.
Clicker Question 3: Legionella pneumophila, which often contaminates water sources, is the likely cause of atypical pneumonia connected to a shared water fountain.

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Description

Test your knowledge on the symptoms and complications surrounding Floyd's illness. This quiz covers critical aspects such as reported symptoms, physiological changes, and medical responses regarding the respiratory tract during upper respiratory infections. Assess how well you understand these medical scenarios.