28 Bacterial Infections of LRT 1

Question 1

LRT v. URT

• more common?
• more severe?

Answer 1

common= URT
severe= LRT

Question 2

define pneumonia

Answer 2

inflammation of the lung as a result of infection

Question 3

fever, malaise, cough, pleuritic chest pain, dyspnea and potential sputum production. Crackles/rales/crepitations upon auscultation.

Answer 3

bacterial pneumonia

Question 4

bacteria associated with typical/lobar pneumonia

Answer 4

strep. pneumoniae
staph. aureus
haemophilus flu.
most gram neg bacteria

Question 5

bacteria associtaed with atypical/patchy pneumonia

Answer 5

mycoplasma pneumoniae
chlamydophila pneumoniae
legionella pneumophila

Question 6

sudden onset

Answer 6

typical pneumonia

Question 7

toxic facies/ “looks sick”

Answer 7

typical pneumonia

Question 8

nonproductive cough

Answer 8

atypical pneumonia

Question 9

bloody/purulent sputum

Answer 9

typical pneumonia

Question 10

scant/watery sputum

Answer 10

atypical pneumonia

Question 11

higher fever

Answer 11

typical pneumonia

Question 12

pleurisy and consolidation frequently

Answer 12

typical pneumonia

Question 13

rare pleurisy or consildation

Answer 13

atypical pneumonia

Question 14

WBC elevated with a left shift (primarily neutrophils)

Answer 14

typical pneumonia

Question 15

most common cause typical pneumonia

Answer 15

strep. pneumonia

Question 16

most common cause atypical pneumonia

Answer 16

mycoplasma pneumonia

Question 17

sterile effusion into pleural space

Answer 17

pleural effusion (complication of pneumonia)

Question 18

hematologic complications of pneumonia

Answer 18

• anemia with chronic pneumonia
• disseminated intravascular coagulation
• thrombocytopenia

Question 19

chronic complications of pneumonia

Answer 19

• decrease in arterial O2
• weight loss and muscular atrophy
• bronchiectasis (localized irreversible dilation of bronchi)

Question 20

aspiration pneumonia

Answer 20

introduction of foreign material into bronchial tree that carries bacteria in with it

• secondary bacterial pneumonia associated with alcoholics, coma patients and stroke patients

Question 21

define nosocomial

Answer 21

aquired in a healthcare setting

Question 22

gram neg bacteria that commonly cause HAP

Answer 22

pseudomonas qeruinosa
e. coli
klebsiella pneumoniae
acinetobacter spp.
haemophilus flu.

Question 23

gram positive bac that commonly cause HAP

Answer 23

staph. aureus

strep. pneumonia

Question 24

sputum analysis >25 PMNs and <10 epithelial cells per 100X field

Answer 24

indicates pneumonia

Question 25

associated with pneumococcal pneumonia

Answer 25

strep. pneumoniae

Question 26

alpha hemolytic strep

Answer 26

strep. pneumoniae

Question 27

IgA protease

Answer 27

- pneumococcal virulence factor | - cleaves igA, prevents clearance

Question 28

pneumolysin

Answer 28

- pneumococcal virulence factor | - pore forming toxin, colonization, invsion, inflammation, complement activation

Question 29

teichoic acid and peptidoglycan

Answer 29

- pneumococcal virulence factors | - cause inflammation

Question 30

thick peptidoglycan capsule

Answer 30

- pneumococcal virulence factor | - antiphagocytic

Question 31

cough, fever, dyspnea, chest pain, crackles, rust colored sputum - preceeded several days by rhinorrhea - abrupt spiking fever with chills

Answer 31

pneumococcal pneumonia

Question 32

bile solubility positive test results

Answer 32

strep. pneumonia

Question 33

what differentiates strep. pneumonia from s. mutans?

Answer 33

strep. pneumonia is optochin sensitive

Question 34

standard treatment for pneumococcal pneumonia

Answer 34

penicillin or macrolide (azithromycin)

Question 35

treatment for serious cases of pneumococcal pneumonia

Answer 35

azithromycin or cephalosporin

Question 36

prevention to pneumococcal pneumonia

Answer 36

vaccine conjugated to diptheria toxin or polysaccharide

Question 37

burden of pneumococcal pneumonia in children

Answer 37

otitis media bacteremia meningitis death

Question 38

what differentiates staph aureus from other staph?

Answer 38

staph aureus is coagulase positive

Question 39

PVL panton-valentine-leukocidin

Answer 39

virulence factor of staph aureus severe necrotizing pneumonia, bc pore foring cytotoxin

Question 40

antigenic mimicry in staph aureus

Answer 40

protein a binds Fc portion of antibody

Question 41

MRSA

Answer 41

methicillin resistant staph. aureus = resistant to ALL beta lactams (including cephalosporins)

Question 42

treatment of pneumonia due to staph aureus

Answer 42

penicllins/cephalosporins

Question 43

treatment of pneumonia due to MRSA

Answer 43

linezolid or vancomycin

Question 44

more likely to be HAP

Answer 44

pneumonia cuased by gram negative bac

Question 45

top gram negative faculative anaerobe that cuases pneumonia

Answer 45

klebsiella pneumoniae

Question 46

top gram negative aerobe that causes pneumonia

Answer 46

pseudomonas aeruginosa

Question 47

foul smelling sputum

Answer 47

anaerobic bacterial etiology (kelbsiella?)

Question 48

gram negative bacteria pneumonia treatment

Answer 48

aminoglycoside and beta lactam | gentamycin/cephalexin, tobramycin/ampicillin

Question 49

treatment that targets pseudomonas specifically

Answer 49

ticarcillin or piperacillin and amikacin

Question 50

gram neg. rod mucoid colonies (capsule) oxidase negative

Answer 50

klebsiella pneumoniae

Question 51

"currant jelly sputum" | - bloody sputum from necrosis and abscess

Answer 51

klebsiella pneumoniae

Question 52

klebsiella pneumoniae virulence factors

Answer 52

LPS | capsule

Question 53

- gram negative - obligate aerobe - oxidase positive - blue/yellow-green pigment

Answer 53

pseudomonas aeruginosa

Question 54

culture smells of grapes

Answer 54

pseudomonas aeruginosa

Question 55

treatment for psuedomonas aeruginosa

Answer 55

ticarcillin or piperacilin AND aminoglycoside (gentamicin, tobramycin, amikacin)

Question 56

pyocyanin

Answer 56

pseudomonas virulence factor blue compound toxic to host cells

Question 57

pyoverdin

Answer 57

pseudomonoas virulence factor fluorescent green iron uptake prtn

Question 58

most frequent cause of death in CF population

Answer 58

pseudomonas respiratory disease