Bacterial Infections of the Lower Respiratory Tract I Flashcards Preview

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Flashcards in Bacterial Infections of the Lower Respiratory Tract I Deck (57):
1

Which tends to be more serious, lower respiratory tract infections or upper respiratory tract infections?

lower respiratory tract infections. They are also less common

2

Mucociliary escalator

movement of mucous and trapped particles up the bronchioles, bronchi and trachea to be swallowed

3

What are some things that can impair the function of the mucociliary escalator

viral infection
smoke
EtOH
narcotics

4

Bacterial pneumonia

inflammation of lung as result of bacterial infection

5

Symptoms of bacterial pneumonia

fever, malaise, cough, pleuritic chest pain. crackles upon auscultation

6

What does a chest xray of typical pneumonia look like

one lung appears to be solid, full of bacteria

7

What does a chest xray of atypical pneumonia look like

patchy
entire lobe is not usually full

8

Onset of typical pneumonia

sudden

9

Onset of atypical pneumonia

gradual

10

WBC count of typical pneumonia

elevated with left shift

11

WBC count of atypical pneumonia

often not elevated, but can be

12

What is the most common agent of typical pneumonia

streptococcus pneumoniae

13

What is the most common agent of atypical pneumonia

mycoplasma pneumoniae

14

Pleurisy and consolidation in typical pneumonia?

common

15

pleurisy and consolidation in atypical pneumonia?

rare

16

What is aspiration pneumonia caused by?

introduction of foreign material into the bronchial tree such as saliva, food, vomit

17

Community acquired pneumonia

any pneumonia NOT acquired in a healthcare setting

18

Hospital acquired pneumonia

pneumonia acquired in a healthcare setting

19

What is hospital acquired pneumonia often caused by?

MDR gram negatives

20

streptococcus pneumoniae features

gram positive
diplococci in chains
alpha hemolytic
catalase neg

21

What are the streptoccus pneumoniae virulence factors

surface adhesions, IgA protease, pneumolysin, teichoic acid and peptidoglycan, thick polysaccharide capsule

22

What does surface adhesins do in s. pneumoniae

colonization of pharynx

23

What does IgA protease do in s. pneumoniae

cleaves IgA, prevent clearance

24

What does pneumolysin do in s. pneumoniae?

pore forming toxin
colonization invasion
inflammation
complement activation

25

What does teichoic acid and peptidoglycan do in s. pneumoniae

inflammation

26

What does thcik polysaccharid capsule do in s. pneumoniae

antiphagocytic

27

Symptoms of pneumonoccal pneumonia

rust color sputum
preceding by several days of rhinorrhea
abrupt spiking fever with chills
poor oxygenation

28

What is the result of optochin test for s. pneumoniae pneumonia?

optochin sensitive

29

What can you look for in a urine test for s. pneumoniae pneumonia

test for pneumococcal polysaccharide

30

What is the result of a bile solubility test for s. pneumoniae pneumonia?

positive

31

How can you treat s. pneumoniae

sensitive strains - penicillin
macrolide-azithromycon
serious cases - azithromycin plus cephalosporin

32

Is there a vaccine for s. pneumoniae?

yes. 23 and 13 valent

33

Characteristics of staphlyoccus aureus

gram positive cocci in clusters
catalase positive
coagulase positive

34

What are the virulence factors of s. aureus?

coagulase
protein A
panton-valentine leukocidin

35

What does coagulase do in s. aureus

clotting blood

36

What does protein A do in s. aureus

binds Fc portion of antibody

37

What does PVL do in s. aureus

pore forming cytotoxin
can cause sever necrotizing pneumonia

38

MRSA

resistant to all beta lactams. not necessarily more virulent, just harder to treat

39

How can you treat MRSA

linezolid or vancomycin

40

What is the agent of MRSA

s. aureus

41

How to treat s. aureas pneumonia that's NOT resistant

penicillins/cephalosporins

42

Pneumonia caused by gram neg bacteria

more likely to be HAP
common in aspiration pneumonia

43

Characteristics of gram neg pneumonia

pt generally has an underlying disease
foul smelling sputum
any love may be affect
1/4 have pleural effusion

44

How do you treat gram neg pneumonia

drug cocktail via IV
aminoglycoside + beta lactam

45

Characteristics of klebsiella pneumoniae

gram neg rod
non motile
oxidase neg
has capsule

46

Symptoms of klebsiella pneumoniae pneumonia

classic pneumonia
bloody sputum
looks like currant jelly

47

Virulence factors of klebsiella pneumoniae

LPS
capsule

48

How do you treat klebsiella pneumoniae pneumonia

drug cocktail via IV
aminoglycoside + beta lactam

49

How do you prevent klebsiella pneumoniae pneumonia

disinfect encironment
use sterile respiratory equipment

50

Pseudomonas aeruginosa charactersistics

gram neg rods
flagellated
obligate aerobe
oxidase positive
culture smells like grapes

51

Where does pseudomonoas aeruginosa grow

water with minimal nutrients
hand soaps
dilute antiseptics

52

Predisposing factors for pseudomonoas aeruginosa pneumonia

burn patients
immunosuppressive therapy
ventilator use
cystic fibrosis

53

Virulence factos for pseudomonas aeruginosa

toxin A
leukocidin
phospholipase C
capsule
pyocyanin
pyoverdin

54

What does toxin A do in pseudomonoas aeruginosa

ADP-ribosylation of EF-2, hals protein synthesis

55

What does leukocidin do in pseudomonoas aeruginosa

pore forming toxin that targets leukocytes

56

What does phospholipase C do in pseudomonoas aeruginosa

membrane disruption

57

How do you treat pseudomonoas aeruginoa

ticarcillin or piperacillin plus aminoglycoside