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Flashcards in Infection Deck (62):
1

What is the M/C type of pheumonia?

Streptococcus pneumonia (40%)

2

What is the M/C community acquired infection?

steptococcus pneumonia

3

What location does streptococcus pneumonia like to affect?

lower lobes

4

True or false: cavitations are common in streptococcus pneumonia.

False -- they are rare!

5

Where does streptococcus pyogens like to occur in the chest?

lower lobes

6

What is the M/C type of bronchopneumonia?

Staphylococcus aureus

7

What pop'n is more likely to get staphylococcus aureus pneumonia?

Hospitalized & debilitated patients, spread from endocarditis and intravenous drug users.

8

True or false: air bronchograms are rare in staphylococcus aureus.

True. Remember this is a BRONCHOpneumonia so airways are filled.

9

Which organism is acquired through contact with infected goats/meat & decaying soil/organic matter and can present with hemorrhagic pneumonia?

Bacillus anthracis

10

What is a key radiographic feature of bacillus anthracis pneumonia?

Mediastinal widening from lymphadenopathy -- they get enlarged lymphnodes.

11

Bulging interlobar fissures and current jelly sputum are M/C seen in which chest infection?

Klebsiella (Friedlander's) pneumonia

12

What pop'n is most commonly infected by Klebsiella pneumonia?

Older, alcoholic men & debilitated hospitalized patients

13

What is the M/C location for Klebsiella pneumonia?

Unilateral, posterior aspect of upper lobe or superior portion of lower lobe.

14

Which pneumonia causes round pneumonia in kids?

Streptococcal pneumonia

15

Mycotic aneurysms of abdominal aorta are M/C found with which organism?

Salmonella

16

Haemophilus influenza M/C affects which population?

Kids btwn age 2 months and 3 years.

17

Where within the chest does haemophilus influenza affect?

Bilateral & lower lobes

18

Pneumonia from which organism has a high mortality rate?

Pseudomonas aeruginosa

19

Where does pneumonia from pseudomonas aeruginosa most commonly affect and how does it present on CT?

Bilateral & lower lobes

Tree-in-bud or centrilobular nodules.

20

Which chest infection presents with a shaggy heart sign?

Pertussis (bordetella pertussis)

21

What is the pathomechanism of pertussis?

Abundant intraluminal mucus production causing partial or complete airway obstruction.

22

What is the differential for a shaggy heart sign?

1) Asbestosis (eg. interstitial lung disease)
2) Pertussis
3) Pleural thickening (benign or malignant)

23

Which chest condition is the "steeple sign" affiliated with?

Pertussis or croup

24

What is aspiration pneumonia?

Aspiration of foreign bodies producing airway obstruction --> leads to atelectasis, air trapping, distal pneumonitis or bronchiectasis

25

What are the predisposing risk factors for aspiration pneumonia?

alcohol intoxication, altered consciousness, dysphagia, neuromuscular disorder

26

True or False: Non-tuberculous mycobacterium is less indolent than M tuberculosis?

False - it is more

27

Atypical mycobacterial infection M/C affects what part of the lungs?

Upper lobe

28

What are the radiographic features of non-tb mycobacterium?

Similar to TB (eg. nodular opacities, focal consolidation, cavitaion, fibrosis etc.)

29

What is the difference from how you acquire an atypical mycobacterial infection vs TB?

Atypical --> From the natural environment (eg. water, soil and dust)
TB --> Airborne respiratory disease

30

What are the 2 stages of pulmonary tuberculosis?

Primary & postprimary

31

Which pop'n of patients are most likely to get lymph node involvement with primary pulmonary TB?

Children & immuno-compromised adults

32

What is a renke complex?

lymphadenopathy with Ghon focus

33

How common is it to see mediastinal lymph node calcification in primary TB?

33%

34

What is postprimary TB?

Reactivation of infected regions when host defenses are impaired.

35

What is the cause of bronchogenic spread of postprimary TB?

Spillage of caseous material from cavities into bronchus

36

What does the presence of cavitation in postprimary TB indicate?

Worsening infection

37

Parenchymal involvement in primary TB calcifies in what % of cases?

20%

38

What historical procedure involved the removal of the ribs as a form to treat TB?

Thoracoplasty

39

What historical procedure involved creating a cavity and then stuffing golf balls etc. in the thorax to forcefully collapse the lung as a treatment for TB?

Plombage

40

Which infection is endemic to The San Joaquin Valley?

Coccidioidomycosis

41

What is the prognosis of pulmonary coccidioidomycosis? What is a clinical presentation of this condition?

It is usually self-limiting (~3 weeks).

Clinical:
- mostly asymptomatic (60%)
- erythmatous rash

42

What are the 4 types of pulmonary coccidioidomycosis?

a) Primary/Acute
b) Persistent
c) Chronic progressive
d) Disseminated (<1%)

43

What are some of the obvious differences btwn acute and persistent (or even chronic) coccidioidomycosis?

Acute = calcified; rarely cavitates

Persistent and chronic = rarely calcifies; cavitates quickly

44

What is valley fever?

When coccidioidomycosis presents with erythema nodosum and arthralgia.

45

What areas are endemic to histoplasmosis?

Ohio, Mississippi, St. Lawrence River valleys

46

What are the clinical features of pulmonary histoplasmosis?

Asymptomatic (95-99%)

47

What are the radiographic features of histoplasmosis and where does it commonly occur?

- Multiple, well-defined calcified nodules resembling miliary TB

- occurs in lower lobes

48

What is fibrosing mediastinitis and what are the top 3 common causes for it?

Extension of granulomatous disease to involve the mediastinal tissues causing extensive fibrosis.

M/C/C = histoplasmosis, TB and sarcoidiosis

49

Moniliasis (candidiasis) pneumonia M/C occur in which pop'n?

Immuno-compromised patients (particularly lymphoma or leukemia)

50

Invasive aspergillosis M/C invades which anatomy?

Invasion of pulmonary vasculature (aka Angioinvasive aspergillosis)

51

"Finger-in-glove" appearance occurs in which conditions?

Asthma, allergic aspergillosis (usually with a hx of asthma) & cystic fibrosis

52

What is the M/C/C of aspergilloma? What is the 2nd M/C/C?

1st = cavitary disease from prior TB
2nd = sarcoidosis

53

Actinomycosis normally exists where in the respiratory system?

Oropharynx

54

AIDS and transplate patients are risk patients for developing which pneumonia?

Pneumocystic jiroveci

55

Which infection can cause mandibular osteomyelitis following dental extraction?

Actinomycosis

56

Which bacterial organisms are gram positive?

- streptococcus pneumonia
- streptococcus pyogens
- straphylococcus aureus
- bacillus anthracis

57

Which bacterial organisms are gram negative?

- Friedlander's (klebsiella) pneumonia
- escherichia coli
- salmonella
- proteus
- haemophilus influenzae
- pseudomonas aeruginosa
- bordetella pertussis
- aspiration pneumonia

58

Infants with congenital heart disease or pulmonary brochodysplasia are "at risk" patients for which type of respiratory virus?

Respiratory syncytial virus (RSV)

59

Giant cell (multinucleated giant cells) pneumonia can be see in which pulmonary infections?

- Measles virus
- parainfluenza
- RSV infections

60

Echinococcosis can be asymptomatic unless______

They rupture -- then sx occur.

61

What is the sign of camalote?

aka. Water lily sign = ruptured echinococcal cyst into bronchial tree.

62

Which chest infection affects cystic fibrosis patients and patients on mechanical respirators?

Pseudomonas aeruginosa