Pneumonia,Endocarditis

Question 1

MCC of community acquired pneumonia.

Answer 1

Streptococcus pneumoniae (pneumococcus)

Question 2

S.pneumoniae features. (3)

Answer 2

• Lobar pneumonia
• Bacteremia
• Pharyngeal colonization (5-10% of Adults)

Question 3

Major cause of Hospital Acquired Pneumonia.

Answer 3

S. aureus

Question 4

S. aureas pneumonia:

-Gross feature

Answer 4

Necrotizing pneumonia with cavitation

Question 5

Organism that causes Bronchopneumonia (especially in COPD patients).

Answer 5

Haemophilus influenzae

most isolates are nontypeable strains

Question 6

2 organisms associated with Acute Exacerbation of COPD.

Answer 6

• Haemophilus influenzae

- Moraxella catarrhalis

Question 7

Organism ass. w/ exposure to aeroslized particles (construction associated dust, hot tub, cooling systems).

Answer 7

Legionella pneumophila

Question 8

Features of Legionnaires’ disease. (5)

Answer 8

• Atypical pneumonia w/ HIGH Fever
• Hyponatremia
• Renal dysfunction
• Diarrhea
• CNS effects

Question 9

Features of Pontiac Fever:

Answer 9

flulike illness without pneumonia

Question 10

Pneumonia - Animal Exposure:

-Cattle, Cats

Answer 10

Coxiella burnetii

Question 11

Pneumonia - Animal Exposure:

-Birds

Answer 11

• Chlamydophila psittaci
• Cryptococcus neoformans
• Histoplasma capsulatum (bats, pigeons)

Question 12

Pneumonia - Animal Exposure:

-Mouse urine and feces

Answer 12

Hantavirus

Question 13

Pneumonia - Animal Exposure:

-Rabbits

Answer 13

Francisella tularensis

Question 14

Organisms in Brochiectasis/CF. (3)

Answer 14

• Pseudomonas aeruginosa
• Burkholderia cepacia
• S. aureus

Question 15

Atypical (“walking”) pneumonia organisms. (2)

Answer 15

• Mycoplasma pneumonia

- Chlamydia pneumonia

Question 16

Aspiration pneumonia organisms. (5)

Answer 16

• Strep pneumo
• S. aureus
• H. influenzae
• Enterobacteriaceae
• P. aeruginosa

Question 17

What syndrome/virus emerged in “4 corners” region of New Mexico?

Answer 17

Hantavirus Pulmonary Syndrome (HPS)

-Sin Nombre virus

Question 18

Hantavirus vector.

Answer 18

Deer mouse (sheds in urine and feces)

Question 19

Hantavirus Pulmonary Syndrome:

• Clinical feature
• P.smear

Answer 19

-Flulike prodrome followed by ARDS

P.Smear:

• Thrombocytopenia
• Neutrophilia w/o toxic grans
• Erythrocytosis
• Immunoblastic lymphocytosis

Question 20

MCC of croup.

Answer 20

Parainfluenza virus

Question 21

MCC of bronchiolitis in children.

Answer 21

RSV

Question 22

2nd MCC of bronchiolitis in children.

Answer 22

Human metapneumovirus

Question 23

Severe Acute Respiratory Syndrome (SARS):

• Virus
• Geographic location
• Clinical feature

Answer 23

• SARS coronavirus (SARS-CoV)
• Emerged in China
• Flulike prodrome followed by ARDS

Question 24

MCC of native valve endocarditis.

Answer 24

S. aureus

usually affects Left-Sided valves

Question 25

Which valve is infected in IV drug abusers?

Answer 25

Tricuspid (right-sided)

Question 26

MCC of endocarditis in patient with underlying valvular damage.

Answer 26

Streptococci

-Viridans streptococci (particularly)

Question 27

Organism ass. w/ endocarditis in patient with colorectal carcinoma.

Answer 27

Strep Bovis

Question 28

Prosthetic valve endocarditis organisms.

Answer 28

• S. epidermidis (within 2 months to 1 yr)
• S. aureus (within 2 months to 1 yr)
• Gram Negative bacilli (within 2 months)

Question 29

Noninfectious endocarditis. (3)

Answer 29

• Libman-Sacks
• Marantic (nonbacterial thrombotic)
• Carcinoid heart syndrome

Question 30

Blood culture negative endocarditis (BCNE). (6)

Answer 30

• Coxiella burnetii
• Bartonella
• Chlamydia
• Legionella
• Tropheryma whipplei
• HACEK organisms

Question 31

“HACEK” organisms.

Answer 31

• Haemophilus spp.
• Aggregatibacter spp.
• Cardiobacterium spp. (C. hominis, C. valvarum)
• Eikenella corrodens
• Kingella spp.