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Pulmonology > 08.22 - Exotic and Biohazard Pneumonias (Miller) - Questions > Flashcards

08.22 - Exotic and Biohazard Pneumonias (Miller) - Questions Flashcards

(73 cards)

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1
Q

3 important properties of B Anthracis

A

Gram-positive rod; Capsule of d-glutamate; Spore former

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2
Q

D-Glutamate capsule

A

B Anthracis

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3
Q

Transmission of B Anthracis

A

Cutaneous contact with animals; Aerosolized spores

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4
Q

Woolsorter’s Disease

A

B Anthracis

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5
Q

Why does capsule of B Anthracis serve as virulence factor

A

Prevents direct recognition of bacterium via phagocytes

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6
Q

Mortality rate in untreated pulmonary anthrax

A

90-100 %

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7
Q

Timecourse of B Anthracis pnuemonic disease

A

Typically 4-6 days to onset, but can be up to 6 weeks

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8
Q

Symptoms of Pneumonic Anthrax

A

Short prodromal period of cough, fever, aches; Then high fever, dyspnea, hypoxia, tachycardia

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9
Q

Radiology of Pnuemonic Anthrax

A

Widened mediastinum with infiltrates and pleural effusions

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10
Q

Widened mediastinum with infiltrates and pleural effusions

A

Radiology of Pnuemonic Anthrax

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11
Q

Two causes of death in Anthrax

A

Block of pneumonic lymph vessels; Cytokine storm - Septic Shock

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12
Q

Dx of Pneumonic Anthrax

A

Test sample or measure titers

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13
Q

Tx of Pneumonic Anthrax

A

Cipro for up to 60 days

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14
Q

3 important properties of Brucella spp

A

Gram-negative coccobacillus w/out capsule; Intracellular; Livestock resoivoirs

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15
Q

Epidemiology of B Anthracis

A

Worldwide, Cattle and Sheep

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16
Q

Epidemiology of Brucella

A

Everywhere but NA; Contaminated dairy products or animal secretions

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17
Q

Imported dairy from goats in Mexico or Mediterranean

A

Brucella melitensis

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18
Q

Pathogenesis of Brucellosis

A

Localize to reticuloendothelial system; Intracellular; Granuloma formation in lungs, Abscesses

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19
Q

Radiology of Brucellosis

A

Pretty big granulomas in lungs

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20
Q

Symptoms, Signs of Brucellosis

A

Fatigue, Weight Loss, Lymphadenopathy, Organomegaly, Pancytopenia

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21
Q

Fatigue, Weight Loss, Lymphadenopathy, Organomegaly, Pancytopenia

A

Brucellosis

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22
Q

Most frequent complication of Brucellosis

A

Osteomyelitis

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23
Q

Osteomyelitis

A

Most frequent complication of Brucellosis

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24
Q

Timecourse of Brucellosis

A

1-3 week incubation period with acute or gradual onset

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25
Dx of Brucellosis
Rarely cultured; Slide Agglutination Test; Titers
26
Tx of Brucellosis
Tetracycline or Doxy + Rifampin
27
Whitmore's Disease
Burkholderia pseudomallei
28
3 important properties of B pseudmallei
Small, motile gram neg rod; Facultative intracellular; Environmental
29
Epidemiology of B pseudomallei
Southest Asia; Environmental Bac
30
Transmission of B pseudomallei
Inhalation of aerosolized bac from soil; Contaminated water or body fluids
31
Cases of meliodosis spike following
Rains --> Raindrops aerosolize the bac from soil
32
Virulence factors of B pseudomallei
Capusle; Intracellular; Lysis; Actin network; Dormancy
33
Capusle; Intracellular; Lysis; Actin network; Dormancy
Virulence factors of B pseudomallei
34
Timecourse of Meliodosis
Varies, 2-3 days to many years
35
Symptoms and Signs of Meliodosis
Flu-like + Cough; Can mimic TB on CXR
36
CXR of Meliodosis
Can mimic TB: Small nodule and consolidations of upper lobe; Abscesses and cavitations
37
Px of Meliodosis
20-50% mortality even if treated
38
Dx of Meliodosis
Isolation of bac; Titers
39
Tx of Meliodosis
Ceftazidime for 8 weeks - 6 months; Intrinsically resistant to many abx
40
3 important properties of Coxiella Burnetti
Gram neg bacillus; Obligate intracellular parasite; Enzootic (livestock)
41
Epidemiology of Coxiella Burnetti
Almost every country with low incidence
42
Transmission of Coxiella Burnetti
Contaminated viscera of livestock or raw milk; Ticks; Aerosolized spore-like form
43
Q-fever
Coxiella Burnetti
44
Pathogenesis of Q Fever
C burnetti well adapted for survival within macrophages; One of the most infectious human pathogens
45
Timecourse of Q Fever
Acute febrile illness; Atypical pneumonia for 2-4 weeks
46
Signs and Symptoms of Q Fever
Typcially not severe, often resolves w/out tx; Sometimes liver and heart involvement
47
Dx of Q Fever
Titers
48
Tx of Q Fever
Most spontaneously resolve; Doxycycline
49
3 important properties of Francisella tularensis
Pleomorphic Gram neg rod; Obligate intracellular; Two biotypes
50
Transmission of F tularensis
Typically tick or blood-to-blood; Can be aerosol
51
Virulence factors of F tularensis
Atypical LPS not recognized by TLR-4; May produce a capsule; Long period survival in water
52
Pathogenesis of F tularensis
Extremely pathogenic; High mortality if inhaled; Can also disseminate to lungs
53
Signs and Symptoms of F tularensis
Sudden onset flu-like symptoms; Prolonged low-grade fever and adenopathy; Ulceroglandular; CXR - Spotted infiltrates, lobar pneumonia, pleural exudation
54
CXR of F tularensis
Spotted infiltrates in lungs, lobular pneumona, Pleura exudation
55
Dx of F tularensis
No culture; Agglutination tests
56
Tx of F tularensis
Streptomycin
57
3 important properties of Hantavirus
Bunyaviridae; Enveloped, trisegmented, SS, neg-sense RNA virus
58
Epidemiology of HPS
Healthy young adults; Rural areas
59
Symptoms of HPS
Prodrome of flu-like symptoms; Rapid pulmonary edema, severe hypotension, respiratory failure
60
Transmission of Hantavirus (HPS)
Breathing air containing aerosolized rodent excrement
61
CXR of HPS
Distinctive bilateral pulmonary edema; Bilateral intersitial infiltrates
62
Tx of HPS
Early, aggressive intensive support care
63
3 important properties of Yersinia pestis
Gram neg rod; Encapsulated, intracellular; Bipolar (Safety pin) staining
64
Bipolar (safety pin) staining
Yersinia Pestis
65
Epidemiology of Y pestis
Endemic worldwide, but 99% of cases occur in SE Asia
66
Transmission of Y pestis
Rodents via fleas; Strikingly low ID50; Can be person-to-person via aerosol
67
CXR of Y pestis
Lower lung zone airspace disease with bilateral pleural effusions
68
Pathogenesis of Y pestis
Spreads to regional lymph nodes; Disseminates and form abscesses
69
Reasons for the term black death
DIC and Cutaneous hemorrhage
70
Primary life-threatening consequences Y pestis
Septic Shock and Pneumonia
71
Symptoms of plaque
Fever, Headache, Hemoptysis, Dyspnea, Muscle weakness
72
Dx of Y pestis
Smear and culture of blood or pus is best
73
Tx of Y pestis
Streptomycin and Tetracycline

Pulmonology (31 decks)

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