8. Lower Respiratory Flashcards
B. pertussis toxin that causes inflammation and localized necrosis adjacent to colonized sites
Lethal toxin
4 additional media to set up when there’s a possibility of anaerobes
BRUC
CNA
KVLB
THIO
3 Bordetella pertussis toxins
- Pertussis toxin (PTx)
- Lethal toxin (dermonecrotic toxin)
- Tracheal cytotoxin
Lab method of detecting Histoplasma and Blastomyces
DNA probes
2 media commonly used to isolate Burkholderia cepacia
BCSA (Burkholderia Cepacia selective agar)
OFPBL (oxidative fermentative polymixin bacitracin lactose agar)
Most studied toxin in Pseudomonas aeruginosa
Endotoxin A
What is used for tuberculosis liquefaction
N-acetyl-L-cysteine (mucolytic agent)
What is used for tuberculosis decontamination?
2% NaOH (4% for stools + specimens w/ Pseudo)
Buffer to neutralize
Specimen is usually not collected for this infection b/c it’s NOT treated w/ antibiotics
Acute/chronic bronchitis
Typical age group that gets bronchiolitis
Young children (<2 yrs old)
Localized, irreversible dilation of parts of the bronchial tree - makes CF infections more hard to treat
Bronchiectasis
Fluids from an inflammatory process
Exudate
What is required to distinguish between bronchitis colonization from infection
Radiographic evidence of pneumonia
Early symptoms are similar to common cold, then breathing becomes more laboured and cough increases
Bronchiolitis
Purpose of a protected bronch brush
Avoid NOF
6 obligate intracellular parasites
- M. tuberculosis
- Legionella pneumophila
- Chlamydophila
- viruses
- Pneumocystis jiroveci
- Histoplasma
7 organisms that express polysaccharide capsules to prevent phagocytosis
“Some Nasty Killers Have Crazy Powers”
- S. pneumo
- N. meningitidis
- K. pneumo
- H. influenzae
- Histoplasma capsulatum
- Cryptococcus neoformans
- mucoid strains of P. aeruginosa
C. diphtheriae toxin
DT (diphtheria toxin)
Inflammation of lower respiratory tract involving airways and lung parenchyma
Pneumonia
This media is NOT selective, so decontamination + concentration of specimen is done BEFORE inoculation
Lowenstein-Jensen
The causes of this infection are closely related to age of patient
Community-acquired pneumonia
Legionella often require these 2 ingredients to be cultured
L-cysteine
Iron salts
Difference between BCA and BCSA media?
BCSA is a pyruvate formula
Toxin that destroys WBCs?
Organism it’s found in?
Panton-Valentine leukocidin (PVL)
S. aureus
3 organisms that often accompany anaerobes in aspiration pneumonia
S. aureus
Pseudomonads
Enterobacteriaceae
2 types of specimens that may require special anaerobe media for set up
BAL
pleural fluid
Sterile saline is flushed into the lungs, then aspirated back out
Bronchioalveolar lavages (BALs)
Routine culture set up for LRT specimen (media)
BAP/SS/CO2
CHOC/CO2
MAC
Reason for S. maltophilia being often confused w/ an Enterobacteriacea
It is oxidase negative
Also called dermonecrotic toxin
Lethal toxin (B. pertussis)
Diphtheria toxin (DT) adheres preferentially to these 2 types of cells
- CNS cells
- Heart muscle cells
Adherence factor in staph
Lipoteichoic acid
Helps B. pertussis colonize the cilia of the respiratory epithelium
Pertussis toxin (PT)
Pneumonia can be subdivided into categories based on what 3 things?
- Presentation of illness (acute, chronic)
- Clinical setting (community, hospital)
- Type of infecting process (aspiration, viral, bacterial)
3 methods of detecting bronchiolitis infection
Rapid detection - staining or ELISA
Viral culture
How to concentrate tuberculosis sputum?
Centrifuge, keep pellet
Produces paintbrush-like heads
Penicillium
Fluid drained from the pleural space
Thoracentesis fluid
5 causative agents of acute/chronic bronchitis
- Respiratory viruses
- Mycoplasma pneumoniae
- Chlamydophila pneumoniae
- H. influenzae
- B. pertussis
3 anaerobes that may cause aspiration pneumonia
Prevotella
Porphyromonas
Bacteroides
4 ways respiratory pathogens can enter the lungs
- Invasion
- Inhalation
- Aspiration (oral/gastric)
- Hematogenous
Organism associated with SPA or M7 media (enriched w/ cholesterol)
Mycoplasma
3 unusual pathogens that may cause a BAL to be performed
- fungi
- AFB
- Pneumocystis jiroveci
Exceptions to not collecting bronchitis specimens are made for these 3 organisms
What specimen gets collected?
- Influenza
- RSV
- B. pertussis
NP washes/swabs
Prominent organism in cystic fibrosis infection (not later stages)
Pseudomonas aeruginosa - mucoid strains
Isolated from sputums of CF patients and is associated w/ a decline in lung function
Stenotrophomonas maltophilia
Specimen collected for bronchiolitis disagnosis
Nasopharyngeal (NP) washing or swab
3 common causes of bronchiolitis
RSV
Parainfluenzae - ‘croup’
Influenza
Antimicrobial found in all 3 B. cepacia media
Polymixin B
Elderly patients are more likely to suffer from this type of community-acquired pneumonia
Aspiration pneumonia
Acute viral or bacterial inflammation of the larger airways in healthy patients with no history of
recurrent disease
Acute bronchitis
In S. aureus, this toxin acts along with a pore forming cytotoxin
Leucocydin
In an immunocompetent patient, chronic pneumonia is most often due to?
Mycoplasma tuberculosis
Lung transplants are ruled out for patients colonized with ______________
Burkholderia cepacia
Fluid accumulation in the pleural space where the fluid has leaked from the blood and/or lymphatic systems.
Transudate fluid
Group A strep adherence factpr
M protein
GNB adherence factor
Fimbriae
B. pertussis toxin that kills ciliated cells and causes their extrusion from mucosa
Tracheal cytotoxin
This toxin is made up of 6 subunits
Pertussis toxin
PT
Myalgia is a symptom of this infection (muscle aches and pains)
Bronchitis
Responsible for S. pneumoniae virulence
Capsule production
Specimen where a staph streak on the primary BAP is appropriate
Sputum
3 methods of Legionella confirmation
- Latex
- DFA stain
- ELISA
