Lower Respiratory Tract Infections Flashcards Preview

Clinical Pathology > Lower Respiratory Tract Infections > Flashcards

Flashcards in Lower Respiratory Tract Infections Deck (57):
1

Which 3 fungi are common in LRTIs?

Aspergillus
Candida
Pneumocystistis Jroveci

2

Definition of chronic bronchitis

Cough productive of sputum on most days during more than 3 months of 2 successive years

3

Chronic bronchitis is associated with what risk factor?

Smoking

4

Bronchiolitis occurs in which age group?

Paediatrics

5

Causative organism for bronchiolitis

RSV

6

Infection affecting the most distal airways and alveoli- formation of inflammatory exudate

Pneumonia

7

What are the 2 anatomical patterns of pneumonia

Bronchopneumonia
Lobar pneumonia

8

Patchy distribution of pneumonia centred on inflamed bronchioles and bronchi then subsequent spread to surrounding alveoli

Bronchopneumonia

9

Pneumonia affecting a large part, or entire lobe

Lobar Pneumonia

10

Causative organism of lobar pneumonia

S. Pneumoniae

11

4 types of pneumonia based on where it is acquired

Community acquired
Hosptial acquired
-Ventilator acquired
-Aspiration

12

Hospital acquired pneumonia devleops how soon after hospital admission

>48 hrs

13

Organisms that cause pneumonia but are difficult to grow, not sensitive to penicillin and clinical presentation and treatment is different

Atypical organisms

14

Typical organisms causing pneumonia

Streptococcus pneumoniae
Hamophilus influenzae
Moraxella Catarrhalis
S.Aureus
Klebsiella penumoniae

15

Atypical organisms causing pneumonia

Mycoplasms pneumonia
Legionella pneuomphilia
Chlamydophilia pneuomoniae
Chlamydophilia psittaci
Coxiella burnetii

16

Atypical organism causing pneumonia:
Autumn epidemics every 4-8 yrs. Children and young adults. Rare complications include pericarditis, arthritis, ghuillian barre ascending polyneuropathy, peripheral neuropathy

Mycoplasma pneumoniae

17

Atypical organism causing pneumonia:
Mild pneumonia or bronchitis in adolescents and young adults.

Chlamydophila pneumonia

18

Atypical organism causing pneumonia:
Associated with exposure to birds- splenomegaly, rash, hepatitis, haemolytic anaemia and reactive arthritis on presentation.

Chlamydophilia psittaci

19

Atypical organism causing pneumonia:
Colonises water pipes. High fevers, rigors, cough, dyspnoea, vomiting, diarrhoea, confusion

Legionella pneumophilia

20

What are the 2 types of pneumonia that develop from influenza?

Primary viral pneumonia: rare- occurs in patients with pre-existing cardiac and lung disorders.
Secondary bacterial pneumonia: may develop after initial influenza (flu) presentation

21

What is the assessment for disease severity used in pneumonia?

CURB65
Confusion, urea, resp. rate >30, blood pressure 65

22

Antibiotic used to treat typical pneumonia

Amoxicillin or co-amoxiclav

23

Antibiotic used to treat atypical pneumonia

Clarithromycin (lincosamide)

24

Pneumococcal vaccination is what organisms?

Streptococcus pneumoniae

25

Describe the shape of mycobacteria

Slender, bacilli

26

Why are mycobacteria different to all other bacterial genera?

Unusual waxy cell wall (high lipid content)
Slower growing

27

What stains are used to identify mycobacteria?

Ziehl Neelson, phenol auramine

28

Another name for mycobacteria

Acid fast bacilli

29

Mycobacteria:
Intra/extracellular pathogens?
Chronic infections or latent infections?
Longer or shorter course of treatment?

Intra
Latent
Longer

30

What types of mycobateria cause TB?

M.tuberculosis
M.bovis

31

What atypical mycobacteria are associated with HIV?

M avium complex

32

Atypical mycobacteria

M.avium
M.kansasii
M.marium

33

How does M.marium infections present

Fish tank granuloma

34

Common site of primary TB infections?

Periphery of lung midzone

35

Name of the collection of macrophages in the hilar lymph nodes in primary TB where intracellular muliplication takes place

Ghon focus

36

Describe the structure of the tubercles in primary lymph nodes

Granuloma
Cell-mediated immune response
Central area of epitheloid cells and giant cells surrounded by lymphocytes
Central area is caseous encrosis
Fibrosis/calcification of lesions

37

In the acquisition of TB, when will you have a positive tuberculin skin test?

3 months after primary acquisition

38

When is TB reactivated

immunosuppressed

39

Pathogenesis of reactivating TB

Coalescing tubercles, central caseous encrosis and cavity develops in centre- increases organism load- increases risk of tranmission

40

Where does TB classically reactive?

Lung apices (mycobacteria require O2)

41

extra-pulmonary manifestations of TB

-necrotic tubercle erodes into blood vessel. e.g. meningitis. Disseminates to pleura, lymph nodes, kidneys, epididymis, bone, intestines, brain,pericardium etc

42

Diagnosis of TB meningitis

Chest X-ray, Skin testing, interferon y release assay:IGRA

43

Sputum samples for TB diagnosis

3 early morning specimens

44

When is a direct microscopy for acid fast bacilli smear positive?

>5000 organisms per ml sputum

45

Standard treatment for TB

2 months: rifampicin, isoniazid and 2 others
next 4 months: rifampicin, isoniazid

46

Treatment for meningitis TB

12 months therapy

47

Name of the standard treatment for TB

Directly observed therapy short course (DOTS)

48

Multi-drug resistant TB is resistant to what?

Rifampicin and izoniazid

49

Extensive drug resistant TB is resistant to what?

Rifampicin, izoniazind and fluorquinolones

50

Name of the TB skin test

Mantoux tes- tuberculin skin test- positive test if skin indurates (bubble and fibrosed patch develops)- person has acquired TB if >5mm

51

Diagnostic test to look for T cells that recognise TB specific antigens and release gamma interferon

Interferon-gamma release assays

52

What does BCG stand for?

Bacille Calmette Guerin

53

What mycobacteria is given in BCG vaccine?

Strain of M.Bovis

54

What disease is caused by M.leprae?

Leprosy-Hansen's disease

55

Where is M.leprae cultivated?

On the nine banded armadillo

56

2 clinical forms of M. leprae

Tuberculoid- macules/plaques develop on nerves
Lepromatous- subcutaneous tissue accumulation

57

The name of the blood test for TB

Interferon y gamma release assay (IGRA)