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CRRAB II--Wk 6 > Lower Resp Tract Infections > Flashcards

Lower Resp Tract Infections Flashcards

(95 cards)

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1
Q

Legionella pneumoniae

severity

A

may be severe

CXR looks worse than patient does, though

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2
Q

Bronchiolitis most common bug

A

RSV

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3
Q

Influenza vaccines generally contain

A

2 A strains

1 B strain

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4
Q

Tx of Chlamydia pneumoniae

atypical pneumonia

A

doxycycline

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5
Q

Rust-colored sputum

A

S. pneumoniae

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6
Q

How to differentiate pneumonia from bronchitis or bronchiolitis

A

CXR

clinical differentiation is not reliable

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7
Q

Influenza infectious period

A

1 day before Sx

until 5 days after onset

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8
Q

Filamentous hemagglutinin

A

pertusis

attachment to ciliated cells

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9
Q

Dx of mycoplasma pneumoniae

A

cold hemagglutinin

“fried egg” appearance”

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10
Q

Mycoplasma pneumoniae

manifestiation

A

atypical pneumonia

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11
Q

Sx of influenza

A

abrupt onset of fever

myalgias, prostration (weakness)

non-productive cough

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12
Q

Bordetella pertusis

classification

A

Gram -

Coccobacilli, pleomorphic

Growth on Bordet-Gengou agar or Regan-Lowe medium

B. pertusis

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13
Q

Pathology

Legionella pneumophila

A

naturally in water resivoirs

aerosolized from resp devices or air conditioners

adheres via pili

phagocytosis in marcophages

⇒ survival and proliferation

⇒ macrophages attract neutrophils

⇒ microabcesses

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14
Q

Convalescent stage of pertusis

A

decreased quantity of bacteria

disease ongoing due to cilia and respiratory tract cell damage

secondary infection possible at this stage

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15
Q

Dx of Legionella pneumophilla

A

French legionnaire with silver helmet sitting around charcoal campfire with his iron dagger–he’s no sissy (cysteine)

silver stain

charcoal agar with iron and cysteine

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16
Q

Legionella pneumophila

manifestations

A

Pontiac fever (mild)

Legionnaire’s disease (atypical pneumonia)

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17
Q

Virulence factors in influenza

A

HA (hemaggluitinin)

binds sialic acid on cell surface

NA (neurominidase)

cleaves HA bound to sialic acid

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18
Q

Prevention of bronchiolitis

A

possible with vaccine

RespiGam or palivizumab

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19
Q

How to differentiate viral and bacterial bronchitis

A

CXR

lasting > 14 days

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20
Q

Tx of bacterial bronchitis

A

erythromycin

or

azithromycin

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21
Q

Extrapulmonary signs often present in

A

atypical pneumonia

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22
Q

Hx in typical pneumonia

A

sudden onset fever and chills

dyspnea w/ productive cough

pleuritic chest pain

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23
Q

Red-current jelly sputum

A

Klebsiella

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24
Q

Viral atypical pneumonia population

A

infants and children

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25
Serology in pertusis
lymphocytosis (not just leukocytosis) unusual in a bacterial infection
26
Causes of bronchitis
usually viral Rhino, Coxsackie A and B, parainfluenza, influenza A/B, adeno, RSV
27
Chlamydia pneumoniae stain
Giemsa
28
Tx of pertusis
erythromycin in early stages treatment does not shorten once in paroxysmal stage does less chance of transmission treat exposed individuals with prophylaxis
29
Organisms viral atypical pneumonia
RSV, influenza, CMV
30
Bronchiolitis in infants
RSV
31
Abcesses in kidney and brain seen in
Nocardia asteroides pneumonia
32
Paroxysmal coughing episodes
pertusis
33
3 big organisms in pneumonia
S. pneumoniae K. pneumoniae M. catarrhalis
34
Testing for influenza
direct antigen testing viral culture isolation RT-PCR
35
Nocardia asteroides
acid-fast organism cause of bacterial atypical pneumonia TB-like disease
36
Tx of Nocardia asteroides
TMP-SMX
37
Mycoplasma pneumoniae pathology
B-cells create antibodies that cross react with RBCs cold hemagglutinins
38
Chlamydia pneumoniae
young adults pharyngitis association
39
Bronchitis etiology
viral usually bacterial if secondary infection
40
Tachypnea, tachycardia, fever diffuse expiratory wheezing, inspiratory crackles, nasal flairing vomitting, cyanosis, hyperinflation of lungs
bronchiolitis
41
Influenza is bad in
women in 3rd trimester elderly young
42
Pneumocystis jerovecci Dx
silver stain of induced sputum dark, oval bodies on silver stain (cysts)
43
S. agalactiae manifestations
pneumonia meningitis sepsis **_in newborns_** from maternal infection
44
Foul-smelling or bad-tasting sputum
anaerobic infections
45
Chlamydia pneumoniae where it likes to live
intracellular | (extracellular form is not active)
46
Pertusis manifestations
paroxysmal coughing episodes inspiratory "whoop" post-tussis (cough) vomiting w/o other apparent cause
47
Stages of pertusis
catarrhal stage (minor Sx) paroxysmal stage (whooping) convalescent stage (less bacteria, more damage Sx)
48
Seasonal influenza vaccines generally this effective
50%
49
Mycoplasma pneumoniae Tx
erythromycin or tetracycline
50
Influenza classification
RNA virus helical nucleocapsid enveloped Class V non-segmented orthomyxoviridae
51
Bad strains of influenza
A/B
52
Regan-Lowe medium
pertusis
53
Chlamydia pneumoniae manifestion
atypical pneumonia
54
Pertusis toxin
AB-toxin B: binds → endocytosis A: attack, attaches to ADP-ribosyl to disrupt host cell proteins. inhibits Gi to increase cAMP ⇒ impaired phagocytosis
55
Differentation between TB and Nocardia asteroides
Gram + beaded filaments weakly acid-fast obligate aerobe N. asteroides
56
Herd immunity in pertusis
no herd immunity 1 in 20 non-immunized get infected 1 in 500 immunized get infected
57
Pertussis etiology
bacterial infection
58
Tx of bronchiolitis
supportive O2 and electrolyte fluids in severe cases
59
PE in typical pneumonia
lung crackles fever tachypnea tachycardia
60
Tx of Pneumocystis jirovecci
TMP-SMX
61
Everyone develops immunity to this strain by age 11
influenza C
62
Giemsa stain
Chlamydia pneumoniae
63
Erythromycin MOA
binds 50S ribosomal subunit
64
Influenza viruses replicate
intracellularly
65
Bordet-Gengou agar
pertusis
66
Bronchiolitis population
infants \< 1 y/o due to their small bronchiolar diameters
67
Obstruction in bronchiolitis
critical narrowing of bronchioles due to debris from dead cells and bronciolar mucosal edema
68
Nocardia asteroides population
immunocompromised
69
Catarrhal stage of pertusis
minor cold Sx most infectious part
70
S. agalactiae pathogenesis
carried by maternal genital tract produces capsule can colonize neonate after OB complications ⇒ pneumonia, meningitis, sepsis
71
Antigenic shift occurs in
Influenza A ONLY
72
Antigenic drift occurs in
Influenza A/B
73
Prophylaxis for Pneumocystis jirovecci when
CD4+ \< 200
74
Agars for pertusis
Bordet-Gengou Regan-Rowe
75
Chlamydia pneumoniae population
young adults
76
Bacterial causes of bronchitis
*Mycoplasma pneumoniae* (not Gram staining) *Chlamydia pneumoniae* (not Gram staining)
77
Testing for bronchiolitis
nasal wash, RSV antigen detection CXR to rule out pneumonia
78
Tx of S. agalactiae
penicillin G
79
Green sputum
Pseusomonas Haemophilus Pneumococcal
80
Tx of Legionella pneumophila
erythromycin
81
Streptococcus agalactiae classification
Gram + Catalase - β-hemolytic bacitracin-resistant S. agalactiae (Group B strep)
82
Influenza vaccine recommended for everyone
6 mo old and older
83
Common etiology of pneumonia in children
viral usually in children
84
Paroxysmal stage of pertusis
severe Sx, whooping cough severe, uncontrolled episodes of coughing, may be followed by emesis blood vessels in eyes and brain may burst, seizures possible in severe cases lasts 2-4 weeks
85
Mycoplasma pneumoniae
walking pneumonia
86
Acid-fast staining cause of atypical pneumonia
Nocardia asteroides
87
Gram + aerobic oxidase + diplococcus
M. catarrhalis
88
2nd most common cause of pneumonia in COPD
M. Catarrhalis Gram - aerobic oxidase + diplococcus
89
IgA protease cleaves IgA virulence factor organism
H. influenzae
90
Classification of Hib
Gram - chocolate agar + Factor V and X Quellung +
91
Tx of Hib
ceftriaxone rifampin for close contacts as prophylaxis
92
Pneumonia in children organisms
RSV parainfluenza
93
Pneumonia in adults 18-40 organisms
M. pneumoniae C. pneumoniae S. pneumoniae
94
Pneumonia in adults 40-65 organisms
S. pneumoniae H. influenzae (non-typable) Legionella
95
Pneumonia in adults \>65 organisms
S. pneumoniae Gram - rods H. influenzae (non-typable)

CRRAB II--Wk 6 (9 decks)

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