MIDTERM LEC 2: PNEUMOCYSTIS SPP. Flashcards

(50 cards)

1
Q

New/current name of Pneumocystis carnii

A

Pneumocystis jirovecii

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2
Q

Primary host of P. wakefieldiae/P. carinii

A

rats (rodents)

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3
Q

Primary host of P. jirovecii

A

humans

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4
Q

P. carinii was originally classified with what protozoa?

A

trypanosome

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5
Q

How was P. carinii reclassified from protozoa to fungi?

A

Through nucleic acid
sequencing (showed it is a fungus)

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6
Q

Pneumocystis spp. most often recovered from humans

A

P. jirovecii

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7
Q

T/F: P. jirovecii is an opportunistic, atypical fungus that
infects immunocompromised hosts

A

true

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8
Q

P. jirovecii mostly manifests as what disease?

A

Pneumocystic Pneumonia (PCP) / Pneumocystis jirovecii pneumonia (PJP)

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9
Q

At what age do most children gain antibodies against pneumocystic pneumonia?

A

2-4 years old

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10
Q

Pneumocystis infection is (asymptomatic/symptomatic?) in immunocompetent patients

A

asymptomatic

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11
Q

Hallmark of PJP/PCP

A

interstitial pneumonitis

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12
Q

The hallmark of PJP, interstitial pneumonitis, is accompanied with

A

a mononuclear infiltrate composed predominantly of plasma cells

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13
Q

Pneumocystis spp. is initially identified as the
causative agent of?

A

interstitial plasma cell pneumonia

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14
Q

In which patients is interstitial plasma cell pneumonia commonly seen?

A

malnourished or premature infants

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15
Q

Which specialized cells does interstitial plasma cell pneumonia target?

A

type I pneumocytes (for gas exchange)

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16
Q

Pneumocystis remained one of the
primary opportunistic infections found in
patients with what type of disease?

A

AIDS

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17
Q

Since what year has Pneumocystis been the primary opportunistic infection of patients with AIDS?

A

since the early 1980s

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18
Q

What are the symptoms of PJP/PCP?

A
  • nonproductive cough (cough with no mucus)
  • difficulty breathing
  • low-grade fever
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19
Q

Range of temperature of low-grade fever

A

37.5°C - 38.3°C

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20
Q

What findings might a chest radiograph of a patient with PJP show?

A

normal or a diffuse interstitial infiltrate

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21
Q

What causes normal or diffuse interstitial infiltrate findings on a chest radiograph?

A

Due to the organism’s immunological response after
it binds to and destroys alveolar cells.

22
Q

Environmental sources or reservoirs of Pneumocystis jirovecii

A
  • soil
  • water
  • airborne particles
  • animal reserviors
23
Q

Mode of transmission of P. jirovecii

A

Inhalation of airborne particles

24
Q

Invasive stage of P. jirovecii

25
Infective stage of P. jirovecii
mature cyst
26
State the developmental stages of Pneumocystis jirovecii from the invasive stage to the infective stage.
trophozoite (trophic form) - precyst - cyst
27
How do trophic forms ASEXUALLY multiply on the surface of the epithelial cells (pneumocytes) lining the lungs?
through binary fission
28
By producing what, do trophic forms SEXUALLY multiply?
producing precyst and then cyst containing spores/intracystic bodies
29
What procedure is used to find cysts and trophozoites in tissue for the laboratory diagnosis of PJP?
open lung biopsy
30
T/F: Pneumocystis spp. can be cultured outside the lungs
false (it cannot be cultured outside the lungs, thus open lung biopsy is needed for diagnosis)
31
Clinical standard specimen for the laboratory diagnosis of PJP
bronchoalveolar lavage (BAL) fluid
32
Least productive specimen
sputum
33
Lavage and sputum specimens are often prepared using what machine
cytocentrifuge
34
Why is cytocentrifuge needed for preparing lavage and sputum specimens?
to decrease bacterial contamination
35
Othe specimens for the laboratory diagnosis of PJP
- transbronchial biopsy - tracheal aspirate - pleural fluid - induced sputum
36
What stain is utilized if cyst wall of Pneumocystis spp. is BARELY VISIBLE
giemsa stain
37
In giemsa stain, what is the color of nuclei?
pink
38
Identify the stain used: Intracystic bodies are seen around the interior of the organism
giemsa stain
39
Identify the stain: Cyst wall stains black
gomori methenamine silver stain
40
What stain detects chitin in the cell wall?
calcoflour white
41
What stain demonstrates punched-out pingpong ball appearance of cyst?
gomori methenamine silver stain
42
Commercially available and widely used stain for Pneumocystis spp.
immunofluorescent monoclonal antibody stain
43
What stain fluoresce with a blue-white color?
calcofluor white
44
Treatment of choice for PJP/PCP
Trimethoprim-sulfamethoxazole (TMP-SMX)
45
Trimethoprim-sulfamethoxazole is also known as?
co-trimoxazole
46
How is TMP-SMX administered to patients?
through a vein or by mouth for 3 weeks
47
Possible side effects after taking TMP-SMX
rash and fever
48
For first line treatment, dapsone is combined with?
pyrimethamine
49
First line of treatment
- Pentamidine isethionate - Dapsone (combined with pyrimethamine) - Aerosolized pentamidine
50
For what purpose do patients with AIDS use aerosolized pentamidine?
for prophylactic treatment