8. Lower Respiratory Flashcards Preview

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Flashcards in 8. Lower Respiratory Deck (56):
1

C. diphtheriae toxin

DT (diphtheria toxin)

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In S. aureus, this toxin acts along with a pore forming cytotoxin

Leucocydin

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Fluid accumulation in the pleural space where the fluid has leaked from the blood and/or lymphatic systems.

Transudate fluid

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Typical age group that gets bronchiolitis

Young children (<2 yrs old)

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3 Bordetella pertussis toxins

- Pertussis toxin (PTx)
- Lethal toxin (dermonecrotic toxin)
- Tracheal cytotoxin

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Most studied toxin in Pseudomonas aeruginosa

Endotoxin A

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Specimen collected for bronchiolitis disagnosis

Nasopharyngeal (NP) washing or swab

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This media is NOT selective, so decontamination + concentration of specimen is done BEFORE inoculation

Lowenstein-Jensen

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What is used for tuberculosis liquefaction

N-acetyl-L-cysteine (mucolytic agent)

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Routine culture set up for LRT specimen (media)

BAP/SS/CO2
CHOC/CO2
MAC

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Specimen is usually not collected for this infection b/c it's NOT treated w/ antibiotics

Acute/chronic bronchitis

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Exceptions to not collecting bronchitis specimens are made for these 3 organisms

What specimen gets collected?

- Influenza
- RSV
- B. pertussis

NP washes/swabs

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In an immunocompetent patient, chronic pneumonia is most often due to?

Mycoplasma tuberculosis

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Fluids from an inflammatory process

Exudate

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5 causative agents of acute/chronic bronchitis

- Respiratory viruses

- Mycoplasma pneumoniae

- Chlamydophila pneumoniae

- H. influenzae

- B. pertussis

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Myalgia is a symptom of this infection (muscle aches and pains)

Bronchitis

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Responsible for S. pneumoniae virulence

Capsule production

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B. pertussis toxin that kills ciliated cells and causes their extrusion from mucosa

Tracheal cytotoxin

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B. pertussis toxin that causes inflammation and localized necrosis adjacent to colonized sites

Lethal toxin

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3 organisms that often accompany anaerobes in aspiration pneumonia

S. aureus
Pseudomonads
Enterobacteriaceae

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7 organisms that express polysaccharide capsules to prevent phagocytosis

"Some Nasty Killers Have Crazy Powers"

- S. pneumo
- N. meningitidis
- K. pneumo
- H. influenzae
- Histoplasma capsulatum
- Cryptococcus neoformans
- mucoid strains of P. aeruginosa

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4 ways respiratory pathogens can enter the lungs

- Invasion
- Inhalation
- Aspiration (oral/gastric)
- Hematogenous

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3 anaerobes that may cause aspiration pneumonia

Prevotella
Porphyromonas
Bacteroides

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GNB adherence factor

Fimbriae

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Acute viral or bacterial inflammation of the larger airways in healthy patients with no history of
recurrent disease

Acute bronchitis

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The causes of this infection are closely related to age of patient

Community-acquired pneumonia

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2 types of specimens that may require special anaerobe media for set up

BAL
pleural fluid

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Diphtheria toxin (DT) adheres preferentially to these 2 types of cells

- CNS cells
- Heart muscle cells

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Pneumonia can be subdivided into categories based on what 3 things?

- Presentation of illness (acute, chronic)

- Clinical setting (community, hospital)

- Type of infecting process (aspiration, viral, bacterial)

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This toxin is made up of 6 subunits

Pertussis toxin
(PT)

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Also called dermonecrotic toxin

Lethal toxin (B. pertussis)

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3 methods of Legionella confirmation

- Latex
- DFA stain
- ELISA

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6 obligate intracellular parasites

- M. tuberculosis
- Legionella pneumophila
- Chlamydophila
- viruses
- Pneumocystis jiroveci
- Histoplasma

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Legionella often require these 2 ingredients to be cultured

L-cysteine
Iron salts

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Lab method of detecting Histoplasma and Blastomyces

DNA probes

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Purpose of a protected bronch brush

Avoid NOF

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Specimen where a staph streak on the primary BAP is appropriate

Sputum

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3 common causes of bronchiolitis

RSV
Parainfluenzae - 'croup'
Influenza

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What is used for tuberculosis decontamination?

2% NaOH (4% for stools + specimens w/ Pseudo)

Buffer to neutralize

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Early symptoms are similar to common cold, then breathing becomes more laboured and cough increases

Bronchiolitis

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Inflammation of lower respiratory tract involving airways and lung parenchyma

Pneumonia

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Produces paintbrush-like heads

Penicillium

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3 unusual pathogens that may cause a BAL to be performed

- fungi
- AFB
- Pneumocystis jiroveci

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4 additional media to set up when there's a possibility of anaerobes

BRUC
CNA
KVLB
THIO

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How to concentrate tuberculosis sputum?

Centrifuge, keep pellet

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What is required to distinguish between bronchitis colonization from infection

Radiographic evidence of pneumonia

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Organism associated with SPA or M7 media (enriched w/ cholesterol)

Mycoplasma

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3 methods of detecting bronchiolitis infection

Rapid detection - staining or ELISA

Viral culture

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Elderly patients are more likely to suffer from this type of community-acquired pneumonia

Aspiration pneumonia

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Adherence factor in staph

Lipoteichoic acid

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Fluid drained from the pleural space

Thoracentesis fluid

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Group A strep adherence factpr

M protein

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Sterile saline is flushed into the lungs, then aspirated back out

Bronchioalveolar lavages (BALs)

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Toxin that destroys WBCs?

Organism it's found in?

Panton-Valentine leukocidin (PVL)

S. aureus

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2 media commonly used to isolate Burkholderia cepacia

BCSA (Burkholderia Cepacia selective agar)

OFPBL (oxidative fermentative polymixin bacitracin lactose agar)

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Helps B. pertussis colonize the cilia of the respiratory epithelium

Pertussis toxin (PT)