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Flashcards in Lower Resp. Micro- Debiel Deck (67):
1

What is the most common cause of community acquired pneumonia?

Strep pneumoniae

2

Sudden onset of chills, fever, dyspnea, productive cough with purulent sputum, PLEURITIC chest pain, tachypnea, decreased breath sounds with dullness to percussion

Typical pneumonia

3

Gradual onset of non-productive cough, dyspnea, more prominent extra-pulmonary signs (headache, sore throat, diarrhea)

Atypical pneumonia

4

What are the four common causes of aytpical pneumonia?

Viruses (RSV and Influenza)
Mycoplasma
Chlamydia
Legionella

5

What type of pneumonia would intra-alveolar exudate indicate?

Lobar pneumonia
Usually bacterial

6

What type of pneumonia would diffuse patchy inflammation of interstitial areas/alveolar walls indicate?

Interstitial pneumonia/ Atypical
Usually caused by viruses, mycoplasma, chlamydia, legionella

7

What is the common causes of post-viral/ secondary?

S. aureus

8

Pneumonia causes associated with IV drug use

Staph aureus

9

Causes of pneumonia associated with post-viral/ secondary infections

Staph aureus

10

Causes of pneumonia commonly seen in alcoholics?

S. pneumoniae
Klebsiella pneumoniae
Anaerobes

11

Causes of pneumonia associated with gross aspiration?

Anaerobes

12

Causes of pneumonia associated with the immunocompromised?

Gram - rods
S. pneumoniae
Fungi
Filamentous bacteria
Pneumocystis jiroveci
Viruses

13

Most common hospital acquired cause of pneumonia?

Gram - rods
Drug resistant staph aureus

14

Common cause of pneumonia for neonate (birth-6 weeks)

Group B strep
E. Coli

15

Most common causes of pneumonia in children (6 weeks - 18 years)

Viruses = RSV
Mycoplasma
Chlamydia
Strep Pneumo

16

Most common cause of pneumonia in Adults (18-40 years)

Mycoplasma
Chlamydia
Strep pneumo

17

Most common cause of pneumonia in adults (40-65 years)

Strep pneumo
H. Flu
Anaerobic bacteria
viruses

18

Most common cause of pneumonia in the elderly? (older than 65)

Strep pneum
Viruses
Anaerobic bacteria
H. Flu
Gram - rods

19

What is the most common cause of pneumonia in COPD patients? second most common cause?

1: H. Flu
2. M. catarrhalis

20

Why would you not use a b-lactam antibiotic to kill mycoplasma pneumoniae?

They have no cell wall!!! (does not gram stain!)

21

What is a complication of pneumonia with a mycoplasma pneumoniae infection?

B-cells may generate a response where autoantibodies react with RBCs = IgM cold agglutinins

22

A 1-day old infant developed pneumonia. Probable cause? why? how do you treat it?

Strep. agalactiae
It is carried in mother's genital tract.
Treat with penicillin G

23

Gram +, B-hemolytic, bacitracin resistant
infects newborns
Can cause pneumonia, meningitis, and sepsis

Strep. Agalactiae = Group B strep!

24

What are the three B-hemolytic organisms?

Staph Aureus
Strep Pyogenes (bacitracin sensitive)
Strep Agalactiae (bacitracin resistant)

25

Gram + cocci
Catalase -
B-hemolysis
Bacitracin Resistant

Strep. Agalactiae
(Group B-strep)

26

Gram + cocci
Catalase -
B-hemolysis
Bacitracin Sensitive

Strep. Pyogenes
(Group A-strep)

27

Treatment for Chlamydiae pneumoniae

Doxycycline

28

What is the obligate intracellular parasite that can cause atypical pneumonia common in young adults?

Chlamydiae pneumonia

29

What stain do you need to use to visual intra-cytoplasmic inclusion during a chlamydiae pneumonia infection?

Giemsa stain

30

What are the two life-forms of chlamydiae?

Elementary body = infectious, enters cell via endocytosis, then transforms into reticulate body (extracellular)

Reticulate body: replicates by fission, and reorganizes into elementary bodies (intracellular)

31

What stain do you need to use to visual legionella?

Silver stain

32

What media do you need to culture legionella on?

Charcoal yeast extract with iron and cysteine

33

Where does legionella like to proliferate?

They get phagocytosed by alveolar macrophages, and survive and proliferate in there.

34

Virulence factors of RSV

G-surface protein for attachment

F protein causes infected cells to fuse

35

At what age group does Strep Pneumonia become the most common cause of pneumonia?

Age 40-65

36

Gram + diplococci
Catalase -
Alpha hemolytic
Susceptible to optochin
Quellung +

Strep Pneumonae

37

What causes "rust-colored" sputum?

Strep Pneumoniae

It does alpha hemolysis (only partially lysis RBCs)

38

What organism is associated with alcoholics and aspiration and shows up bright red because it is gamma hemolytic?

Klebsiella

39

What kind of agar do you grow H. influenzae on?

Chocolate agar

40

If someone has conjunctivitis and it feels like "grains of sand" what are you thinking?

Adenovirus

41

Multinucleated giant cells in pneumonia, crusted lesion on lip. What are you thinking?

HSV-1

42

What antibody opsonizes microorganisms once they arrive in the alveoli?

IgG

43

Does bronchitis cause inflammation in the alveoli?

No

44

Peak age for bronchiolitis?

2-8 months

45

When are adults infectious with influenza?

The day before symptoms begin through 5 days after onset of illness

46

Describe bordatella pertusis.

Gram - cocco-bacillus

47

With what bug do you see an increase in lymphocytes (rather than a typical increase in neutrophils with bacterial infection)?

B. Pertussis

48

What drug is given in pertussis?

Erythromycin

49

Tx for Moraxella catarrhalis?

Amoxicillin-clavulanate

50

How does B. pertussis adhere to cilia?

Filamentous hemagluttinin

51

Describe the pathogenesis of B. pertussis.

Binds epithelium via Filamentous hemagluttinin

AB toxin inactivates Gi proteins. This leads to an increase in cAMP.

Increase in cAMP impairs phagocytosis

52

Describe what happens from the B cell response to Mycoplasma pneumoniae.

B cells generate IgM antibodies that react with erythrocytes. *Cold agglutination*

53

Gram +
Aerobic
Beaded filaments
Weakly acid-fast

Pneumonia or abscesses.
Immunocompromised patients.

Nocardia asteroides

54

3 things that cause green sputum?

Pseudomonas
Haemophilus
Pneumococcal species

55

How can you differentiate between bronchitis and pneumonia?

CXR!!!!!!

Bronchitis will NOT have consolidations or infiltrates as seen in pneumonia

56

Most common cause of bronchiolitis?

RSV

57

Which antigenic types of flu cause the epidemics?

Type A and B!

Type C is mild disease, rarely causes epidemic, and by age 15 almost everyone has developed antibodies to it

58

What is one way to distinguish influenza infection from the common cold?

Common cold is afebrile

Influenza has abrupt onset high fever

59

Who should get a flu vaccine?

Everyone over 6 months of age

60

What does B. Pertussis need to be grown on?

Bordet-Gengou medium

61

When is someone with the flu infectious?

1 day BEFORE symptoms begin through 5 days after onset of illness

62

Describe the difference between antigenic drift and shift

Antigenic Drift: occurs when minor changes in antigens occur due to gene mutaiton in influenza virus

Antigenic Shift: occurs when MAJOR changes in antigens occur due to gene reassortment in influenza A virus

63

Which type of influenza virus undergoes antigenic shift?

Type A influenza virus

64

Which organism causes rust colored sputum?

Strep pneumonia due to the alpha hemolysis

65

Which organisms cause green sputum?

Pseudomonas
Haemophilus
Pneumococcal speices

66

Which organism produces red currant jelly sputum?

Klebsiella

67

Which organisms causes foul smell/ bad tasting sputum?

Anaerobic infections