bacterial pneumonia 1

Question 1

P. aeruginosa gram and shape and oxidase

Answer 1

gram (-) rods. oxidase +

Question 2

P. aeruginosa metabolism

Answer 2

strict aerobes, nonfermenting

Question 3

what does P. aeruginosa produce that distinguishes it from others?

Answer 3

pyocyanin and pyoverdin. this makes the colony look green. also has a glycocalyx

Question 4

where do we find P. aeruginosa

Answer 4

usually free living in the environment but can be found as normal flora or opportunistic

Question 5

what are the growth requirements for P. aeruginosa

Answer 5

minimal. it is also resistant to detergents and disinfectants. very easy to culture.

Question 6

is P. aeruginosa antibiotic resistant.

Answer 6

extremely

Question 7

how is P. aeruginosa contracted?

Answer 7

nosocomial, burns, CF, immunocompromised, catheters, IVs, neonates.

Question 8

most common sites of infection for P. aeruginosa

Answer 8

nosocomial UTI, CF pneumonia, burns, neonate or immunocompromised.

Question 9

rare community acquired P. aeruginosa

Answer 9

endocarditis in IV drugs, folliculitis in hot tubs, osteochondritis from sneaker puncture. corneal infection from contact users.

Question 10

what labs for P. aeruginosa

Answer 10

culture aerobic and anaerobic

Question 11

what to look for when looking for P. aeruginosa

Answer 11

look for pigments, metallic sheen and fruity aroma.

Question 12

treatment for P. aeruginosa infections

Answer 12

need to test for sensitivity, but start ab’s immediately. remove catheters and IV.

Question 13

B. cepacia characteristics

Answer 13

similar to P. aeruginosa but much less pathogenic. less able to infect previously healthy patients. No pyocyanin.

Question 14

B. cepacia growth?

Answer 14

readily grows! highly resistant.

Question 15

who is most at risk for B. cepacia

Answer 15

CF patients! this is the leading cause of CF pneumonia. and forms outbreaks in the CF community.

Question 16

B. cepacia syndrome

Answer 16

accelerated pulmonary course with rapidly-fatal bacteremia

Question 17

what else is B. cepacia responsible for?

Answer 17

IV-assocaited septicemia, catheter associated UTI, wound infections, foot rot in swamp deployed.

Question 18

treatment for B. cepacia for previous healthy?

Answer 18

none.

Question 19

treatment for B. cepacia in CF, Cancer, HIV?

Answer 19

need exotic antibiotics.

Question 20

are there vaccines for B. cepacia

Answer 20

only experimental for CF patients.

Question 21

B. pseudomallei characteristics

Answer 21

similar to aeruginosa. this is developing nation, veterinary disease: melioidosis

Question 22

how is B. pseudomallei transmitted?

Answer 22

contact with contaminated water, soil

Question 23

is B. pseudomallei transmitted human to human?

Answer 23

rarely.

Question 24

what are the symptoms of B. pseudomallei

Answer 24

flulike, muscle tightness and photosensitivity. can progress from acute local infection to septicemia with abscess in all organs. fatal in 7-10 days.

Question 25

how to diagnose B. pseudomallei

Answer 25

culture and gram stain urine, blood, skin lesions. it has a wrinkled colony morphology. PCR and IF tests exist but not normally needed or used. there is usually an abnormal CXR

Question 26

treatment for B. pseudomallei

Answer 26

longterm ceftazidimine

Question 27

B. mallei characteristics

Answer 27

similar to aeruginosa. nonmotile.

Question 28

what is the reservoir for B. mallei

Answer 28

animals. not environmental.

Question 29

who gets B. mallei

Answer 29

developing nations veterinary disease. GLANDERS.

Question 30

what is B. mallei/glanders

Answer 30

this is a rare zoonosis that is transmitted through animal discharge crossing into damaged skin

Question 31

is B. mallei human to human transmissible?

Answer 31

RARE

Question 32

what are the initial symptoms of B. mallei

Answer 32

flulike. but can progress.

Question 33

acute localized infection of B. mallei

Answer 33

nodules at infection site

Question 34

acute pulmonary B. mallei

Answer 34

bronchitis, pneumonia

Question 35

acute septicemia B. mallei

Answer 35

fulminant, multi organ disease.

Question 36

chronic B. mallei infection

Answer 36

this is farcy.

Question 37

diagnosing B. mallei

Answer 37

initially presents as flulike, nodules, bronchitis. septicemia has flushing, cyanosis, disseminated pustules.

Question 38

labs for B. mallei

Answer 38

culture and gram stain blood, urine, skin lesions. PCR and IF exist but not commonly used.

Question 39

treatment for B. mallei

Answer 39

long term amoxicillin and clavulanate. this is reportable to CDC FBI

Question 40

chlamydia pneumonia characteristics (organisms)

Answer 40

there are three organisms C. pneumoniae, C psittaci, C trachomatis. all are slightly different

Question 41

C. pneumoniae feels like what to the patient? does it feel serious to them?

Answer 41

mild or asymptomatic cold like normal infection. this may present as long duration cold that progresses to pneumonia

Question 42

C. pneumoniae on exam

Answer 42

rales, ronchi, fever, HA.

Question 43

C. pneumoniae labs

Answer 43

MIF antibody test. serology and CXR

Question 44

what will the CXR show for C. pneumoniae

Answer 44

single sub segmental infiltrate.

Question 45

treatment for C. pneumoniae

Answer 45

doxy, or erythmycin, azithromycin, clarithromycin, telithromycin

Question 46

C. psittaci found and spread

Answer 46

bird-borne. rare airborne zoonosis

Question 47

C. pneumoniae found and spread?

Answer 47

community acquired, human-borne.

Question 48

C. psittaci symptomology

Answer 48

abrupt onset, may range from asymp. to severe pneumonia. can progress to meningitis, encephalitis, endocarditis.

Question 49

diagnosis of C. psittaci

Answer 49

high fever, nonproductive cough, chest pain, splenomegaly, border spots, and history of exposure to birds.

Question 50

labs for C. psittaci

Answer 50

CF or MIF. serology. CXR consolidation in single lower lobe.

Question 51

treatment of C. psittaci

Answer 51

tetracycline or doxy. or erythromycin

Question 52

c. trachomatis found?

Answer 52

infection at birth

Question 53

c. trachomatis pathogenesis

Answer 53

birth infected infant or severely immunocompromised adult.

Question 54

c. trachomatis diagnosis

Answer 54

nasal obstruction and discharge. conjunctivitis, middle ear abnormality. crackles.

Question 55

labs for c. trachomatis

Answer 55

swab, culture or hybridization. bilateral interstitial infiltrates and hyperinflation.

Question 56

treatment for c. trachomatis

Answer 56

oral erythromycin