Microbiology 14 - Respiratory Tract Infection

Question 1

What pattern of pneumonia is usually produced by streptococcus pneumoniae?

Answer 1

Neatly lobar pneumonia

Question 2

What pattern of haemolyisis does S. pneumonia show?

Answer 2

Alpha haemolysis

Question 3

What are the top 2 organisms that can cause CAP?

Answer 3

S. pneumoniae

H. influenzae

Question 4

What are the 3 most likely organisms to cause CAP in neonates?

Answer 4

E coli
Group B strep
Listeria

Question 5

What are the 3 most likely organisms to cause CAP in 1-6 month olds?

Answer 5

Chlamydia
S. aureus
RSV

Question 6

What are the 2 most likely organisms to cause CAP in 6 month - 5 year olds?

Answer 6

Mycoplasma

Influenza

Question 7

Recall the CURB 65 criteria

Answer 7

Confusion 
Urea > 7
Resp rate > 30
BP <90 systolic/ <60 diastolic
Age > 65

Question 8

How will a CXR appear in bronchitis?

Answer 8

Normal

Question 9

How should bronchitis be managed?

Answer 9

Bronchodilators and antibiotics IF bacterial cause (usually viral)

Question 10

In which patient group is H. influenzae most likely to cause CAP?

Answer 10

Those with a pre-existing lung condition

Question 11

Which cause of CAP is associated with confusion?

Answer 11

Legionella

Question 12

What are the typical symptoms and signs of legionella pneumonia?

Answer 12

Confusion
Abdominal pain
Diarrhoea
Hyponatraemia

Question 13

Why are penicillins ineffective in atypical pneumonia?

Answer 13

Organisms that can cause atypical pneumonia don’t have a cell wall

Question 14

What are the possible extrapulmonary features of atypical pneumonia?

Answer 14

Hepatitis

Hyponatraemia

Question 15

What is the biggest risk factor for coxiella burnetti pneumonia?

Answer 15

Exposure to domestic/ farm animals

Question 16

How is coxiella pneumonia diagnosed?

Answer 16

Serology

Question 17

Which type of atypial pneumonia is spread by birds?

Answer 17

Chlamydia psittaci

Question 18

What imaging is needed to diagnose empyema?

Answer 18

CT

Question 19

How can empyema be treated?

Answer 19

Large chest drain

Question 20

Which type of pneumonia might cause a mild anaemia?

Answer 20

M. tuberculosis

Question 21

What is a hospital-acquired pneumonia?

Answer 21

Pneumonia that develops within 48 hours of being in hospital

Question 22

How can upper and lower respiratory flora be identified and distinguished in HAP?

Answer 22

Bronchial lavage

Question 23

Which organism is the most common cause of HAP?

Answer 23

Enterobactericiae

Question 24

What is the typical CXR appearance of PCP pneumonia?

Answer 24

Bat wing

Question 25

What antibiotic is used to treat PCP pneumonia?

Answer 25

Co-trimoxazole

Question 26

Which patient population is most at-risk of aspergillus pneumonia?

Answer 26

Immunosuppressed (eg prolonged chemo/ HIV)

Question 27

What is the treatment for aspergillus pneumonia?

Answer 27

Amphotericin B

Question 28

Which 2 pneumonia-causing organisms can be tested for in urine?

Answer 28

S. pneumoniae
Legionella
NOTE: only useful in PAIRED samples

Question 29

What is the antibiotic of choice to treat MRSA pneumonia?

Answer 29

Vancomycin

Question 30

What is the antibiotic of choice to treat pseudomonas pneumonia?

Answer 30

Piptazobactam

Question 31

What are the 1st and 2nd line antibiotic therapies for HAP?

Answer 31

1st line: Ceftazidine/ciprofloxacin +/- vancomycin

2nd line: Piptazobactam and vancomycin