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pneumonia organisms Flashcards

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1
Q

what are the three bacteria that cause atypical pneumonia

A

mycoplasma pneumoniae
chlamydia pneumoniae
legionella pneumophila

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2
Q

strep pneumo:
gram stain
capsule and shape
appearance on culture

A 
gram positive
encapsulated diplococcus (lancet-shaped)
alpha-hemolytic=green on blood agar
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3
Q

how can strep pneumo be differentiated from:
strep viridians
staph aureus
other bacteria

A

optochin sensitive
catalase negative
quellung reaction

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4
Q

what are the three virulence factors of strep pneumo

A

capsule
IgA protease
lipoteichoic acid

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5
Q

what bacteria are implicated in aspiration pneumonia

A

strep pneumo

klebsiella

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6
Q

how does pneumonia caused by strep pneumo look on cxr

A

lobar consolidation

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7
Q

which bacteria does rusty sputum indicate

A

strep pneumo

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8
Q

how can diagnosis of strep pneumo be confirmed (2 ways)

A

gram stain and culture

rapid urinary antigen test

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9
Q

staph aureus:
gram stain
capsule

A

gram positive

encapsulated

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10
Q

how can staph aureus be differentiated from
other staphylococci
other cocci

A

coagulase positive

catalase positive

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11
Q

which bacteria are most common causes of HAP

A

staph aureus

pseudomonas

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12
Q

which bacteria are implicated in post-influenza pneumonia?

A

strep pneumo

staph aureus

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13
Q

which bacteria can cause necrotizing pneumonia and lung abscesses

A

staph aureus
klebsiella
Nocardia

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14
Q

how does infection with staph aureus appear on cxr

A

diffuse infiltrates

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15
Q

pseudomonas aeruginosa:
gram stain and shape
2 things on culture

A

gram negative
bacilli
blue-green with grape-like odor

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16
Q

how do you differentiate pseudomonas from other gram negative bacilli

A

does not ferment lactose

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17
Q

what two types of pneumonia is pseudomonas especially responsible for

A

HAP/VAP

CF patients

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18
Q

what are the virulence factors of pseudomonas and their action

A

endotoxin: causes fever and shock

exotoxin A: blocks protein synthesis

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19
Q

which pneumonia-causing bacteria is often seen in burn wound infections?

A

pseudomonas

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20
Q

klebsiella pneumoniae:
gram stain and shape
virulence factor
2 common pathology features

A

gram negative bacilli
capsule
red currant jelly sputum and necrotizing infection

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21
Q

how can klebsiella be differentiated from other gram negative rods

A

ferments lactose and incapable of growth at 10C

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22
Q

what populations are susceptible to klebsiella

A

alcoholics

malnourished

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23
Q

which bacteria is cultured on chocolate agar with factors V (NAD) and X (hematin)

A

haemophilus influenzae

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24
Q

what bacteria are implicated in exarcerbations of COPD

A

haemophilus influenzae

moraxella catarrhalis

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25
haemophilus influenzae: gram stain and shape virulence factor
gram negative coccobacillary | capsule
26
which especially virulent strain of h. influenzae does the vaccine protect against
capsular type B
27
moraxella catarrhalis: gram stain and shape susceptible population
gram negative coccobacillary | elderly, COPD
28
which bacteria is never CAP and essentially only seen in ICU/VAP
acinetobacter baumanii
29
acinetobacter baumanii: gram stain and shape susceptible population
gram negative coccobacillary | patients on mechanical ventilation
30
which bacterial cause of pneumonia lacks cell wall and what does that preclude
mycoplasma pneumoniae use of vancomycin, penicillins, cephalosporins, etc and gram stain
31
what is the most common cause of pneumonia in school aged children and who else?
mycoplasma pneumoniae | military recruits and prisoners
32
what is the virulence factor of mycoplasma pneumoniae
adhesin: | binds to ciliated epithelial cells and reduces ciliary clearance
33
what are three diagnostic tests for mycoplasma pneumoniae?
PCR cold agglutinins grows on Eaton agar
34
what other organs can mycoplasma pneumoniae affect
cardiac and CNS (encephalitis) involvement
35
what causes atypical pneumonia in kids? older adults?
mycoplasma | chlamydia
36
legionella pneumophila: gram stain and shape virulence factors/characteristics
gram negative bacillus prevent phagolysosome fusion in alveolar macrophage cell wall endotoxin
37
what two diseases does legionella cause?
legionnaire's disease: severe atypical pneumo with diarrhea, confusion Pontiac fever: mild flu-like syndrome
38
what organisms can be diagnosed using a urinary antigen test
strep pneumo | legionella
39
how is legionella diagnosed
grows on charcoal yeast with iron and cystein urine antigen test silver stain instead of gram
40
what organism commonly causes hyponatremia with pneumonia?
legionella
41
``` match the genome shape to virus: linear ssRNA helical linear -ssRNA, segmented linear dsDNA pleomorphic linear -ssRNA ```
parainfluenza and human metapneumovirus influenza adenovirus RSV
42
``` how are the following viruses transmitted: influenza RSV adenovirus parainfluenza ```
influenza: airborne respiratory droplets respiratory droplets and direct contact aerosol, fecal-oral, direct contact respiratory droplets
43
describe the pathology of influenza
neuraminidase degrades mucus layer and infections causes necrosis of respiratory epithelium
44
why does influenza cause myalgias
cytokine release from necrosis of respiratory epithelium
45
which viruses can be diagnosed by RT-PCR
influenza and RSV
46
what is Reye's syndrome and which organisms and drug are implicated
influenza/VZV and aspirin | encephalopathy and liver degeneration following the flu
47
what organism is the most important cause of pneumonia and other LRTI in infants
RSV
48
what is the virulence factor for RSV? what is the basis for prevention using palvizumab for prevention?
surface spikes: cause respiratory epithelium cells to fuse forming syncytium palvizumab: antibody against F protein, neutralizes infectivity of virus in premies
49
how does RSV infection present in adults
mild, self-resolving URT infection
50
what are two diagnostic tests for RSV
RT-PCR | rapid antigen test
51
how does RSV present in adults
mild URTI
52
what sometimes follows RSV pneumo in infants
asthma
53
adenovirus commonly causes viral pneumonia in which population?
military recruits
54
what virus can cause atypical pneumonia with diarrhea and vomiting
adenovirus
55
what other illnesses can adenovirus cause?
febrile pharyngitis conjunctivitis hemorrhagic cystitis gastroenteritis
56
what commonly follows pneumo caused by adenovirus
bronchiectasis or bronchiolitis obliterans
57
military recruits get vaccinated against which organism that no one else does? what serotypes are covered?
adenovirus | serotypes 4 and 7
58
what are the virulence factors of parainfluenza virus
F protein neuraminidase hemagluttinin
59
what illnesses do the 4 strains of parainfluenza cause
HPIV-1,2: croup HPIV-3: croup and pneumonia and bronchiolitis HPIV-4: common cold
60
what is croup? what organisms can cause it
URTI with seal-like barking cough and stridor | HPIV-1,2,3, influenza, RSV, HMPV
61
what is infection by human metapneumovirus often mistaken for
RSV, influenza, HPIV
62
where is SARS endemic to and what are distinctive pathologic features?
east asia leukopenia and thrombocytopenia affects middle and lower lobes
63
what is distinctive about the pathology of MERS?
pneumonia and ARDS with hemoptysis | AKI common
64
how does histo show up under microscope?
macros filled with oval yeasts
65
what are 2 pathologic characteristics of histo?
pancytopenia | mouth/GI ulcers
66
what's the most common pathologic feature of blasto? what else happens?
ulcerated, wart-like lesions | -bone, GU, CNS involvement
67
what does blasto look like under microscope?
big, broad-based buds
68
what does coccidioides look like under microscope?
spherules filled with endospores
69
what is a common pathologic feature of coccidioides?
eosinophilia
70
what are 2 common pathologic features of paracoccidioides?
submandibular lymphadenopathy | facial, ulcerated, nodular leasions
71
how does paracoccidioides look under microscope?
pilot wheel configuration: multiple buds
72
what are 3 common pathologic manifestations of aspergillus?
hemoptysis fungus balls allergic aspergillosis: IgE response with expectoration of brownish bronchial plugs
73
how does aspergillus look under microscope?
septate hyphae with acute angle branching | -and radiating conidia
74
what are 2 common pathologic findings in mucormycosis?
frontal lobe abscesses | rhinocerebral sinusitis
75
what 4 conditions is mucormycosis associated with
immunosuppression diabetes iron overload burns
76
how does mucormycosis look under microscope?
non-septate right angle branching hyphae
77
how does pneumocystis appear on microscope (2 things)?
alveoli filled with foamy exudate from cysts | helmet-like cysts on silver stain
78
how is pneumocystis stained?
silver or Giemsa
79
what disease does cryptococcus in immunosuppressed/AIDS
meningitis
80
how does cryptococus appear under microscope?
single narrow-based bud with capsule around it
81
nocardia: gram stain other stain for it appearance on microscope
gram positive weakly acid fast thin branching filaments: fungal appearance
82
what three diseases/pathologies is nocardia responsible for?
1. PNA 2. lung abscesses/empyema 3. brain abscesses
83
rhinovirus: 2 distinct characteristics about growth virulence factor
1. won't replicate below 33C 2. acid labile - binds ICAM-1 on epithelial cells
84
what is the difference between rhinovirus and coronavirus?
corona can cause GI illness
85
bordetella pertussis: gram stain and structure virulence factor common pathologic feature
gram negative coccobacillus AB toxin: increases cAMP lymphocytosis
86
3 stages of infection with pertussis
catarrhal: 2 weeks of mild URTI paroxysmal: 2-3 months of whooping cough convalescent: 1-2 weeks of reduction in cough
87
corynebacterium diphtheriae: gram stain and shape appearance on microscope virulence factor
gram positive bacillus arranged in palisades AB toxin: blocks EF-2/protein synthesis
88
diphtheriae: 3 common pathologic features (besides pseudomembrane)
bull neck: cervical lymphadenopathy cardiac toxicity neurotoxicity
89
how is diphtheria cultured and stained?
Loeffler medium or tellurite plate | methylene blue
90
what three organisms cause otitis media and sinusitis?
1. strep pneumo 2. H flu 3. moraxella
91
what are 2 virulence factors of TB
- cord factor: inhibits macro maturation, induces TNF-alpha release - sulfatides: inhibits phagolysosome fusion (assisted by PKnG protein)
92
how is TB cultured?
lowenstein-jensen agar

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