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Semester 2 - Infection models > 1. Community acquired pneumonia > Flashcards

1. Community acquired pneumonia Flashcards

1
Q

what are the 3 common bacterial causes of CAP?

A

streptococcus pneumoniae
haemophilus influenza
staphylococcus aureus

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2
Q

what are the bacterial atypical causes of CAP?

A

o Legionella pneumophila
o Mycoplasma pneumoniae
o Chlamydia pneumoniae
o Chlamydia psittaci

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3
Q

what are the viral causes of CAP?

A

Influenza, Parainfluenza, Respiratory syncytial virus

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4
Q

what is the most common cause of CAP in under 2s?

A

Respiratory syncytial virus

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5
Q

describe the gram stain of streptococcus pneumoniae

A

gram positive
diplococci
short chain

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6
Q

virulence factors of strep pneumoniae

A
  • Capsule = Anti-phagocytic and antigenic

* Pili = Attachment of bacteria to the epithelial cells in the respiratory tract

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7
Q

tests for strep pneumoniae?

A

blood Culture, Nasopharyngeal swab, sputum - green

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8
Q

what are the 2 clinical significance of strep pneumoniae?

A
  • CAP = Bacteria invades RT causing immune response & inflammation
  • Bacterial Meningitis = Bacteria enters blood stream –> Crosses BBB –> Colonises CSF –> Infllammatory response
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9
Q

characteristics of strep pneumoniae?

A

alpha haemolytic

normal flora of nasopharynx

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10
Q

treatment of strep pneumoniae?

A
  • mild: Amoxicillin (doxycycline if allergic to penicillin)
  • moderate: Amoxicillin AND doxycycline (only doxycycline if allergic)
  • severe: Co-amoxiclav and doxycycline (meropenem and doxycycline if penicillin allergic)
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11
Q

what is the action of drugs for strep pneumoniae?

A

all cell wall synthesis inhibitors

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12
Q

describe the gram stain of haemophilia influenzae

A

gram negative

coccobacili

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13
Q

characteristics of haemophilia influenzae?

A
  • Normal flora of URT (Nasopharynx)
  • Transmitted via respiratory droplets
  • Opportunistic Pathogen in Immunocompromised/Children
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14
Q

virulence factors of haemophilia influenzae?

A
  • LPS Capsule–antiphagocytic and antigenic

* IgA Protease exotoxin–allows it to colonise

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15
Q

clinical significances of haemophilia influenzae?

A
  • Spread from initial site of colonisation of UR – Otitis Media, Sinusitis, Epiglottitis and bronchopneumonia
  • Spread into blood and distal sites – Meningitis, Septic arthritis, Cellulitis
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16
Q

investigations for haemophilia influenzae?

A

Culture & Gram Stain

17
Q

treatment for haemophilia influenzae?

A

co-amoxiclav

  • contains clavulonic acid = beta lactamase inhibitor
  • beta lactamase = enzyme used by bacteria such as H influenzae to break down beta lactam antibiotics so resistant to amoxicillin
  • clavulonic acid combined with amoxicillin overcomes this issue
18
Q

symptoms of CAP?

A
  • fever
  • malaise
  • tachypnoea
  • tachycardia
  • cough - productive of sputum
  • SOB
  • pleuritic chest pain
  • vomiting
19
Q

signs of CAP

A
  • consolidation
  • pulmonary oedema
  • crackles on auscultation
  • dull on percussion
20
Q

what host defence mechanisms need to be overcome to lead to pneumonia?

A
  • cough reflex
  • mucociliary escalator
  • IgA, complement, neutrophils and macrophages
  • opsonisation by antibody and complements
21
Q

how is pneumonia transmitted?

A

via respiratory droplets

22
Q

what is pneumonia?

A

Pneumonia is infection of the terminal air sacs (“alveoli”) and tissue of the lung.

23
Q

3 x-ray categories of CAP and how they appear on x rays?

A
  • bronchopneumonia - patchy areas of consolidation throughout lung - around the larger airways
  • lobar pneumonia - consolidation localised to a single lobe
  • atypical/interstitial pneumonia - concentrated in the perihilar region -there is usually no sputum production at presentation. It is usually seen in mycoplasma, legionella, and viral pneumonia
24
Q

investigations of CAP?

A
  • FBC
  • blood culture
  • naso-pharyngeal swab
  • chest x-ray
  • auscultaions
  • percussion
25
Q

describe the stages in pneumonia

A
  1. congestion - days 1-2
    - blood vessels and alveoli fill with excess fluid
  2. red hepatization - days 3-4
    - exudate (RBC, neutrophils and fibrin) fill airspaces making them more solid
    - liver like appearance
  3. grey hepatization - days 5-7
    - colour change - RBCs in exudate break down
  4. resolution - days 8- 3 weeks
    - exudate is digested, ingested by enzymes/macrophages or cough up
26
Q

define CAP?

A

pneumonia (infection of the lung parenchyma seen on chest X-ray) which develops outside the hospital.

Semester 2 - Infection models (13 decks)

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