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Flashcards in Respiratory Tract Infection Deck (57):
1

What is optochain sensitive?

Streptococcus pneumonia

2

Streptococcus pneumonia is generally what-resistant?

Penicillin resistant

3

Predisposing factors for nosocomial pneumonia

Surgery, intubation, antibiotics, intensive care unit, immunosuppression

4

E. coli and Klebsiella are what?

Coliforms

5

Organisms causing nosocomial pneumonia

Pseudomonas aeruginosa, coliforms (E.coli, Klebsiella)

6

Treatment of severe nosocomial pneumonia

IV amoxicillin, metronidazole and Gentamicin. Step down to oral co-amoxiclav (total 7-10 days treatment)

7

Treatment of non-severe nosocomial pneumonia

Amoxicillin and metronidazole for 7 days

8

Clinical features of legionella pneumophila

Flu-like illness, renal failure, GI symptoms, mental confusion

9

Diagnosis of legionella

Serology, legionella urinary antigen. (PCR test on sputum also available)

10

Treatment for legionnaires disease

Erythromycin/clarithromycin
Fluoroquinolones e.g levofloxacin

11

Treatment of PCP

Cotriamoxazole, pentamidine

12

You would use a bronchoalveolar lavage or identification of cysts in induced sputum to identify what?

PCP. Who gets PCP? AIDS.

13

Organism causing acute epiglottitis?

Haemophilus influenza (gram negative)

14

Chocolate culture with small translucent colonies/ X and V test used to confirm what?

Haemophilus influenza causing actue epiglottitis. H. influenza requires both factors X and V to grow. Diagnosis by blood culture.

15

Treatment for acute epiglottitis?

ITU and ceftriaxone

16

Haemophilus influenze, streptococcus pneumonia and moraxella catarrhalis can cause what?

Exacerbations of COPD (all 3 organisms are present in the normal upper respiratory tract flora)

17

Casual bacteria not good for cystic fibrosis

Haemophilus influenza, staphylococcus aureus, pseudomonas aureginosa, Burkholderia cepacia

18

What can Aspergillus fumigatus cause?

Severe pneumonia/systemic infection/aspergillus (in immunocompromised) Diagnosed by culture

19

What is I.V amphotericin B used to treat?

Aspergillus fumigatus

20

Acid alcohol fast bacilli?

Mycobacterium lawl

21

What grows on Lowenstein-Jensen medium?

Mycobacterium tuberculosis

22

What grows on Bordet-Gengal medium?

Bordatella pertusis

23

Is tuberculosis transmissable between humans?

Yes. The mycobacterial species themselves are not directly transmissable

24

Drawback of Ziehl-Neisson stain

You cannot identify the species or tell what antibiotic they are resistant to. (Remember they appear as red rods on the stain). PCR provides information of species and some on sensitivity.

25

Direct immunofluorescence used for what?

PCP

26

Forms of respiratory infection spread?

Droplet spread, airborne precautions

27

Anti-virals used in treatment of flu

Ozeltamivir, Zanimivir

28

Lab confirmation of Flu

PCR (nasopharyngeal swab, throat swab)
immunofluorescence
antigen detector (near patient)
virus culture

29

What does the killed influenza vaccine contain?

2 influenza A viruses, 1 influenza B virus

30

Other causes of community acquired pneumonia

Mycoplasma pneumonia, Coxiella burnetti, Chlamydia

31

Treatment of community acquired pneumonia

Tetracycline and macrolides (e.g. clarithromycin)

32

Who is affected by community acquired pneumonia?

Young children, old adults (person-person spread)

33

Coxiella burnetti (Q fever) causes what?

Pneumonia, fever

34

Complications of coxiella burnetti (Q fever) ?

Culture negative endocarditis

35

Chlamydia pstittici causes what?

Psittacosis (and this usually presents as pneumonia

36

Clinical presentation of severe bronchiolitis?

Grunting, sternal indrawing. Complications of bronchiolitis include respiratory/cardiac failure

37

Main cause of bronchiolitis?

Respiratory syncitial virus.
Bronchiolitis epidemics common in winter, no vaccine, nosocomial spread in hospitals. passive immunisation has poor efficacy

38

Metapneumovirus symptoms similar to those of?

RSV. (range of severity from mild to requiring ventilation)

39

What may be second only to RSV in bronchiolitis?

Metapneumovirus

40

Laboratory confirmation of metapneumovirus?

PCR

41

What is chlamydia trachomatis?

STI which can cause infantile pneumoniae. (Diagnosis by PCR on urine of mother or by nasal swab of child)

42

What does chlamydia pneumonia cause?

Mostly mild respiratory infections. May be picked up by test for psittacosis.

43

Presentation of Pertussis

Acute tracheobronchitis

44

Acute tracheobronchitis is the clinical presentation of what?

Pertussis

45

Sinusitis and acute bronchitis complications of what?

Coryza

46

Characteristic of diptheria?

Pseudo-membrane

47

Chest X-ray and examination in bronchitis?

Normal. May have transient wheeze

48

When are antibiotics indicated in bronchitis?

When they have underlying lung disease, otherwise they are not indicated.

49

Acute exacerbation of bronchitis symptoms

Wheeze, coarse crackles, may be cyanosed, breathless, ankle oedema (in advanced cases)

50

Treatment of acute exacerbation of chronic bronchitis

Antibiotics (e.g doxycycline or amoxicillin)
Bronchodilators
Short course of steroids in some cases

51

Will you hear crackles and rub in pneumonia?

Yeah man

52

Other severity markers of pneumonia:
Temperature
Cyanosis PaO2
WCC
Multi-lobar involvement

Temperature: 40
Cyanosis: PaO230

53

Chest symptoms may be absent in which kind of pneumonia?

Legionella

54

What is primary influenzal pneumonia?

Complication of influenza. Dry cough, bloody sputum and respiratory failure within 24 hours of initial fever

55

What is secondary bacterial pneumonia?

When you get a new fever on day 7 after your initial (flu) fever

56

Myositis (cardiac and skeletal), encephalitis and depression can be complications of what?

Influenza

57

Benefits of oseltamivir?

Shortens symptoms by 1 day. Reduced use of antibiotics