export_bacterial lrt infections i

Question 1

Pneumonia

Answer 1

Inflammation of the lung parenchyma with fluid accumulation in the alveoli, which blocks effective gas exchange

Question 2

Features of pneumonia

Answer 2

Fever
Malaise

Cough/sputum

Pleuritic chest pain

Dyspnea

Crackles/rales

Question 3

Common bacteria that cause lobar pneumonia

Answer 3

Strep. pneumoniae
Staph. aureus

H. influenzae

Most Gram-negative bacteria

Question 4

Common bacteria that cause atypical pneumonia

Answer 4

Mycoplasma pneumoniae
Chlamydophila pneumoniae

Legionella pneumophila

Question 5

Typical pneumonia features

Answer 5

Sudden onset
Toxic facies

Productive cough (purulent or bloody sputum)

Frequent pleurisy and consolidation

Left-shift, elevated WBCs

Lobar, dense CXR

Question 6

Atypical pneumonia features

Answer 6

Gradual onset
Well facies

Nonproductive cough (scant, watery sputum)

Rarely have pleurisy or consolidation

Normal WBCs

Patchy CXR

Question 7

Bronchiectasis

Answer 7

Localized, permanent dilation of the bronchi and bronchioles, caused by muscle and elastic tissue damage
Complication of pneumonia

Question 8

Aspiration pneumonia cause

Answer 8

Introduction of foreign material into bronchial tree, such as aspiration of vomit in alcoholics

Question 9

Hospital acquired pneumonia

Answer 9

Nosocomial

Immunocompromised, associated with ventilator use

Question 10

Most frequent cause of HAP

Answer 10

MDR Gram-negatives

Question 11

Sputum analysis to diagnose pneumonia

Answer 11

> 25 PMNs and <10 epithelial cells per 100x field

Question 12

Strep. pneumoiae is also called?

Answer 12

Pneumococcus

Question 13

Pneumococcus virulence factors

Answer 13

Surface adhesins
IgA protease

Pneumolysin

Teichoic acid and peptidoglycan

Polysaccharide capsule

Question 14

Pneumolysin

Answer 14

Pore forming toxin, colonization, invasion, inflammation, and complement activation, etc.

Question 15

Pneumococcal pneumonia presentation

Answer 15

Rust-colored sputum
Preceded by rhinorrhea

Severe, pleuritic chest pain

Question 16

Two diagnostic laboratory tests for pneumococcal pneumonia

Answer 16

Bile solubility positive

Optochin sensitive

Question 17

Treatment for pneumococcal pneumonia

Answer 17

Empiric - penicillin, macrolide-azithromycin, or cephalosporin

Question 18

Diagnostic feature of Staph. aureus

Answer 18

Coagulase positive

Question 19

Virulence factors of Staph. aureus

Answer 19

Coagulase
Protein A

Panton-Valentine leukocidin (pore-forming cytotoxin)

Question 20

MRSA characteristics

Answer 20

Staph. aureus that is methicillin resistant
Resistant to all beta-lactam antibiotics

Not necessarily more virulent, just harder to treat

Question 21

MRSA treatments

Answer 21

Penicillins/cephalosporins if not resistant

Otherwise, linezolid or vancomycin

Question 22

Gram-negative facultative anaerobe that causes pneumonia

Answer 22

Klesiella pneumoniae

Question 23

Gram-negative aerobe that causes pneumonia

Answer 23

Pseudomonas aeruginosa

Question 24

Gram-negative pneumonia treatment

Answer 24

Multiple drug therapy
Prevent emergent antibiotic-resistant strains

Drug synergism

IV drug cocktail

Question 25

Klebsiella pneumoniae characteristics

Answer 25

Gram-negative rod Non-motile Mucoid colonies Beta-lactamases Oxidase negative

Question 26

Virulence factors of Klebsiella pneumoniae

Answer 26

LPS | Capsule

Question 27

Klebsiella pneumoniae treatment

Answer 27

Same as other Gram-negative pneumonias | Increasing rate of antibiotic resistance

Question 28

Pseudomonas aeruginosa

Answer 28

Gram-negative rod Flagellated Obligate aerobe (sugar fermentation negative) Oxidase positive

Question 29

Virulence factors of pseudomonas aeruginosa

Answer 29

Toxin A Leukocidin Phospholipase C Capsule Pyocyanin Pyoverdin

Question 30

Treatment of pseudomonas aeruginosa

Answer 30

Antipseudomonal penicillins | plus an aminoglycoside

Question 31

What other disease does pseudomonas aeruginosa cause particular problems for?

Answer 31

Cystic fibrosis