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Respiratory II - Exam 1 > 9-30 Microbiology Review > Flashcards

9-30 Microbiology Review Flashcards

1
Q

What are the clinical manifestations of Bordetella pertussis?

A
  • Clinical Manifestations
  • Onset of symptoms 1-3 weeks after exposure
  • Catarrhal Phase
  • Rhinorrhea, lacrimation, conjunctival injection, low grade fever – lasts days to a week
  • Paroxysmal phase
  • Uncontrollable expirations, followed by gasping inhalation – whooping cough
  • Cough Associated with post cough cyanosis, gagging, and vomiting
  • Lasts up to 4 weeks
  • Convalescent Phase
  • Reduction in frequency and severity of cough can last from weeks to months
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2
Q

What are the complications of Bordetella pertussis?

A

pneumonia

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3
Q

Dx for Bordetella pertussis?

A

nasal swab for culture or PCR

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4
Q

Tx for Bordetella pertussis?

A
  • Treatment
  • Supportive
  • Azithromycin
  • Chemoprophylaxis to control outbreaks
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5
Q

What is the popular name for a Bordetella pertussis infection?

A

whooping cough

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6
Q

How is Bordetella pertussis spread?

A
  • Spread by large droplets
  • Humans are only known reservoir
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7
Q

What kind of germ is Bordetella pertussis?

A

•Gram negative aerobic coccobacillus capsulate

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8
Q

How is Bordetella pertussis infection prevented?

A

•acellular pertussis vaccine

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9
Q

What kind of germ is Klebsiella pneumonia?

A
  • Gram negative, non-motile, capsulate rods
  • Facultative anaerobes
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10
Q

What kinds of infections does Klebsiella pneumonia cause?

A
  • UTI, soft tissue infections, endocarditis, central nervous system infections, and severe bronchopneumonia.
  • Community and hospital acquired pneumonias
  • Cavitary lung lesions
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11
Q

What is pathognomic for Klebsiella pneumonia infection?

A

CURRANT JELLY SPUTUM!!!!

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12
Q

What kinds of infections does Moraxella catarrhalis cause?

A
  • Pneumonia, especially in the elderly
  • Otitis media in young children
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13
Q

What kind of germ is Moraxella catarrhalis? What does it need for culturing?

A
  • Gram negative bacteria that grows well on blood or chocolate agar
  • diplococci
  • Catalase positive
  • Oxidase positive
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14
Q

What kind of germ is Neisseria meningitidis? What does it need for culture?

A
  • Aerobic gram negative kidney shaped diplococci, capsule
  • Oxidase positive,

ferments maltose and glucose

Grows on Thayer-Martin media, chocolate agar

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15
Q

What is the reservoir for Neisseria meningitidis? Transmission?

A
  • Commensal of the human upper respiratory tract
  • Transmitted through close contact via larger respiratory droplets.
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16
Q

Name the clinical manifestations of Neisseria meningitidis.

A
  • Meningitis
  • Septicemia
  • Pneumonia
  • Septic arthritis, pericarditis, chronic bactermia, or conjunctivitis
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17
Q

What do you use to Dx a Neisseria meningitidis infection?

A
  • Gram stain from CSF
  • CSF PCR
  • CSF culture, blood culture, or skin culture
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18
Q

How do you treat a Neisseria meningitidis infection?

A

PCN

3rd gen cephalosporin

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19
Q

How do you prevent Neisseria meningitidis infections?

A
  • Chemoprophylaxis with rifampin in close contacts
  • Meningococcal polysaccharide-protein conjugate vaccines
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20
Q

What is the prognosis for a Neisseria meningitidis infection?

A
  • Untreated systemic disease with 70-90% mortality
  • 10% mortality with treatment
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21
Q

What is the morbidity for a Neisseria meningitidis infection?

A

•Limb loss, hearing loss, long-term neurologic disability

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22
Q

What kind of germ is Pseudomonas aeruginosa? What does it look like in culture?

A
  • Aerobic gram-negative rod
  • Produces pyocyanin on laboratory medium – blue/green pigment
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23
Q

What is the pattern of transmission for Pseudomonas aeruginosa?

A
  • Primarily nosocomial pathogen
  • In hospital can colonize moist surfaces of the axilla, ear, and perineum
  • Isolated from water in sinks, drains, toilets, and showers
  • Even isolated from flowers in patients rooms
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24
Q

What kinds of infections can Pseudomonas aeruginosa cause?

A
  • Hospital acquired pneumonia, Ventilator Associated Pneumonia
  • Community acquired infections related to hot tubs, whirlpools, swimming pools, and extended contact lenses
  • Otitis externa
  • Puncture wounds through tennis shoes
  • Endopthalmitis – complication of eye surgery
  • Endocarditis, from sharing contaminated needles
  • UTI
  • Skin Infections, burns, ecthyma gangrenosum
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25
Q

What increases the susceptibility of a Pseudomonas aeruginosa infection?

A

neutropenia

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26
Q

What kinds of bacterial factors does Pseudomonas aeruginosa secrete?

A

•exotoxins, endotoxins, type III secreted toxins, pili, flagella, proteases, phospholipases, iron-binding proteins, exopolysaccharides, the ability to form biofilms, and elaboration of toxic small molecules such as pyocyanin

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27
Q

What is the Tx for Pseudomonas aeruginosa infection? Rationale?

A
  • Extended spectrum penicillin and aminoglycoside combination
  • Always treat with 2 antibiotics - reduces risk for AB resistance
  • treatment with 1 AB will result in resistant infection
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28
Q

What kind of bacteria is Chlamydophila psittaci?

A

•Gram negative obligate intracellular bacteria

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29
Q

Since Chlamydophila psittaci is an obligate intracell. bact., what cells does it primarily reside in?

A

Macrophages - principal host cell

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30
Q

What kinds of diseases does Chlamydophila psittaci cause?

A
  • Psittacosis - AKA Bird Fancier’s Disease
  • Atypical pneumonia
  • Febrile illness
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31
Q

What is the transmission for Chlamydophila psittaci ?

A

•Aerosolized bird secretions, dust

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32
Q

How is Chlamydophila psittaci infection Dx’ed?

A

serology

CXR will reveal just a generalized interstitial pattern

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33
Q

What is the Tx for Chlamydophila psitacci?

A

•tetracyclines, macrolides, fluoroquinolones

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34
Q

How are Chlamydophila psittaci infections prevented?

A

•30 day quarantine for all imported psittacine birds and their treatment with feed containing chlortetracycline

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35
Q

How many adults are seropositive for Chlamydophila pneumoniae infection? Children?

A
  • 80% of adults are seropositive
  • Common infection in children under 5 years old
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36
Q

What are the Sx of the atypical pneumonia caused by Chlamydophila pneumoniae?

A
  • Incubation several weeks
  • Non productive cough
  • Preceded by nasal congestion, sore throat, and hoarseness
  • Headaches in ½ of patients
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37
Q

What are the signs, tests, and labs consistent with Chlamydophila pneumoniae infection?

A
  • Examination
  • Crackles, rhonchi
  • Chest x-ray
  • Pneumonitis - diffuse interstitial pattern
  • Labs
  • Normal white count
  • Diagnosis
  • Serology
  • Direct detection of organism in respiratory specimens
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38
Q

What kinds of WBC counts are typical for atypical pneumonias? Typical pneumonias?

A

atypical pneumonia = normal WBC count

typical pneumonia = high WBC count

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39
Q

What is the Tx for Chlamydophila pneumoniae?

A
  • Tetracyclines
  • Macrolides
  • Fluoroquinolones
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40
Q

What kind of bacteria is Coxiella burnetii? What kind of cell does it infect?

A

•Gram negative that infects hosts monocytes

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41
Q

What is the reservoir and transmission for Coxiella burnetii?

A
  • Infects mammals, birds, and ticks
  • Mammals infected by aerosols and may shed Coxiella in feces, urine, milk, and birth products
  • Survives in environment and can be spread by the wind
42
Q

What happens after an acute Coxiella burnetii infection? What patients have a higher risk?

A
  • Incompletely eliminated after acute infection
  • Will continue to multiply in immunocompromised patients and endocarditis patients despite high antibody levels
43
Q

What is the popular name for the infection caused by Coxiella Burnetii?

A

Q fever

44
Q

When do major outbreaks of Coxiella burnetti happen?

A

•Major outbreaks have been related to sheep and goats and associated during lambing season (whenever that is)

45
Q

What are the clinical manifestations of Q fever?

A
  • 60% seroconvert without disease
  • 38% self limited disease
  • 2% require diagnostic evaluation
  • Prolonged fever
  • Pneumonia
  • Hepatitis
  • Rash
  • Meningitis, encephalitis, meningoencephalitis, peripheral neuropathy
  • Pericarditis, myocarditis
46
Q

How can Coxiella burnetii cause spontaneous abortions?

A

•Chronic uterine infection may develop in half of patients infected during pregnancy, and may later experience multiple spontaneous abortions

47
Q

What is a serious sequelae related to Q fever?

A
  • Q-fever endocarditis
  • Intermittent fever
  • Vegetations frequently absent
  • Cerebral emboli, renal insufficiency, splenomegaly, hepatomegaly & hepatitis
48
Q

How do you diagnose a Coxiella burnetii infection?

A

serology

49
Q

What is the Tx for Coxiella burnetii infections?

A
  • Doxycycline x 2 weeks in acute cases
  • Doxycycline + hydroxychloroquine(increases phagosomal pH) for 18-36 months for endocarditis - sometimes has to be continued for life
50
Q

What kind of bacteria is Francisella tularensis?

A

•Small aerobic pleomorphic gram-negative bacillus

51
Q

What is the reservoir for Francisella tularensis?

A
  • Tularemia is an infectious zoonosis
  • Many animals harbor infection including rabbits, squirrels, and muskrats
52
Q

What is the transmission for Francisella tularensis?

A

•Humans acquire the infection through direct contact with infected animal tissues, ingestion of contaminated water or meat, the bite of an infected tick or deer fly, or breathing an aerosol of bacteria – not communicated person to person

53
Q

When sending a suspected Francisella tularensis sample to the lab, what should you do?

A

Warn them - this pathogen poses an extreme risk to lab personnel

54
Q

What are the clinical manifestations of Francisella tularensis infection?

A
  • Ulceroglandular
  • Glandular
  • Oculoglandular
  • Typhoidal
  • Oropharyngeal
  • Pneumonic
55
Q

What are the signs and Sxs of the ulceroglandular manifestation of Francisella tularensis?

A
  • Fever and constitutional symptoms
  • Swollen lymph nodes that drain an inoculation site
  • Ulcer formation
  • Sore throat
  • Patchy infiltrates on chest x-ray
56
Q

What are the signs and Sxs of the glandular manifestation of Francisella tularensis?

A
  • Fever
  • Constitutional symptoms
  • Lymphadenopathy
57
Q

What are the signs and Sxs of the typhoidal manifestation of Francisella tularensis?

A

Fever of unknown cause

58
Q

What are the signs and Sxs of the oropharyngeal disease manifestation of Francisella tularensis?

A
  • Uncommon in the United States
  • Mucous membranes of the mouth and pharynx are the portal of entry
  • Contaminated water or food such as inadequately cooked game meat is the source
  • Painful exudative pharyngitis and tonsillitis
  • Pharyngeal ulcers
  • Swollen retropharyngeal and cervical lymph nodes
59
Q

What are the signs and Sxs of the pneumonic disease manifestation of Francisella tularensis?

A
  • Inhalation exposure
  • Fever, malaise, dry cough, substernal discomfort, pleural effusion, dyspnea, and sore throat
  • Chest x-ray with peribronchial infiltrates to bronchopneumonia with effusion
  • Hilar adenopathy
60
Q

What is the Dx for Francisella tularensis?

A

Serology

61
Q

What is the Tx for Francisella tularensis infection?

A
  • Gentamcin or streptomycin
  • Doxycycline
  • Ciprofloxacin
62
Q

What is the prognosis for a Francisella tularensis infection?

A

•When appropriately treated mortality is 1% or less

63
Q

What kind of a germ is Bacillus anthracis? What does it need for culture?

A
  • Spore forming gram-positive non motile rod that is aerobic or facultatively anaerobic, catalase positive, hemolysis negative
  • Grows on sheep agar
  • Soil contaminated with spores
64
Q

What are the reservoirs for Bacillus anthracis? What are the spores present in?

A
  • Zoonotic infection from goats, sheep, cattle, antelope, kudu, pigs, horses, zebu, and other animals.
  • Animal related products include meat, wool, hides, bones, and hair
65
Q

What are the clinical manifestations of inhalation anthrax infection?

A
  • Clinical Manifestations
  • Inhalation
  • Mediastinal adenopathy
  • Mediastinal widening
  • Pleural effusion
  • Rapidly fatal if not treated with multiple antibiotics and pleural drainage
66
Q

What form of Bacillus anthracis infection is most common?

A
  • Cutaneous
  • Most common
67
Q

What are the other types of anthrax infection, in addition to cutaneous and inhalation?

A

GI - oropharyngeal and intestinal

meningeal - nearly always fatal, can occur as complication of inhalation, cutaneous , or gastrointestinal disease

68
Q

How is anthrax infection Dx’ed?

A

Blood culture

69
Q

What is the Tx for Bacillus anthracis infection?

A
  • Multi-drug regimen
  • Pleural drainage
70
Q

What is the prevention for anthrax infections?

A
  • Prevention
  • Vaccination for possible exposure
  • Post-exposure antibiotics
71
Q

What is the prognosis for an anthrax infection?

A
  • 45% mortality of inhalation in 2001 attacks
  • 20% mortality in untreated cutaneous disease
72
Q

What kind of germ is Yersinia pestis? Reservoir?

A
  • Gram negative coccobacillus, microaerophilic, nonmotile, and non spore forming
  • Transmission cycles involve rodents and fleas, which act as vectors.
  • Prairie dogs are a common host
73
Q

What are the clinical manifestations of Plague?

A

Bubonic

Septicemic

Pneumonic

74
Q

What are the signs and Sx’s of Bubonic Plague?

A
  • Swollen, tender lymph nodes (buboes) closest to site of initial infection
  • Fevers, chills, myalgia, arthralgia, headache, malaise, and prostration
  • Untreated patients have continued fever, tachycardia, agitation, confusion, delirium, and convulsions
75
Q

What are the signs and symptoms of septicemic plague?

A
  • Nausea, vomiting, diarrhea, and abdominal pain
  • Disseminated intravascular coagulation
  • Hypotension, renal failure, and obtundation
  • ARDS
76
Q

What are the signs and Sx’s of pneumonic plague?

A
  • Fever, cough, chest discomfort, tachycardia, dyspnea, bacteria laden sputum, chills, headache, myalgias, weakness, and dizziness
  • Respiratory distress, hemoptysis, cardiopulmonary insufficiency, and circulatory collapse
  • Death within 24 hours of symptoms
77
Q

What are the TX’s for Plague?

A
  • Streptomycin for pneumonic plague
  • Tetracyclines for bubonic plague
  • Chloramphenicol for meningitis
78
Q

What kind of germ is Leptospirosis? How is it identified?

A
  • Spirochete with terminal hook
  • Identified on dark field microscopy or silver staining
  • Obligate aerobe
79
Q

What are the clinical manifestations of Leptospirosis?

A
  • Weil’s Disease:
  • Pulmonary Hemorrhage Syndrome
80
Q

What is the reservoir for Leptospirosis?

A
  • Persistent renal carriage from rodents, dogs, pigs, cattle, and sheep
  • Colonizes renal tubules, excreted in urine, and survives for weeks to months in the environment
81
Q

What is the transmission for Leptospirosis?

A

•Penetrates the skin or mucous membranes during contact with contaminated water, soil, or vegetation

82
Q

What are the clinical manifestations for the early phase of Leptospirosis? How long is this time period?

A
  • First 3-7 days
  • Fever, myalgia, and headache
  • Nausea, vomiting, abdominal pain, diarrhea, cough, and photophobia
  • Muscle tenderness
  • Rash
  • Conjunctival suffusion
83
Q

What is the late phase of Leptospirosis called? What signs and Sx’s characterize it?

A
  • Late Phase: Weil’s Disease
  • Jaundice
  • Renal Failure
  • Acute hemorrhage
  • Severe thrombocytopenia
  • GI bleeding
  • Pulmonary Hemorrhage
  • Myocarditis
  • Aseptic meningitis
84
Q

What is the Dx for Leptospirosis?

A

Agglutination test

85
Q

What is the Tx for Leptospirosis?

A
  • Doxycycline
  • Penicillin
86
Q

What is the prevention for Leptospirosis infection?

A

•Doxycycline post-exposure

87
Q

What kind of germ is Haemophilus influenzae? What does it need for culture?

A
  • Encapsulated gram negative pleomorphic rod
  • Aerobic or facultative anaerobic
  • Grows on chocolate agar
  • X(hemin) Factor and V(NAD) Factor
88
Q

What is the reservoir and transmission of Haemophilus influenzae?

A
  • Nasopharynx of adults and children
  • Transmission: respiratory droplets
89
Q

What used to be the most common cause of meningitis in young children?

A

•H influenza type b was most common cause of meningitis in young children prior to effective vaccines

90
Q

What are the clinical manifestations of Haemophilus influenzae infection?

A
  • Meningitis - Type B strains
  • Children under 5 years old and in adults with skull trauma or CSF leaks
  • Epiglottitis
  • Life threatening infection in children that usually occurs in children younger than 5.
  • Symptoms include fever, drooling, dysphagia, and respiratory distress with stridor
  • Course is rapid over a couple of hours
  • Lateral neck film used for diagnosis
  • Pneumonia:
  • Fever, cough, and lobar consolidation
  • Parapneumonic effusion and empyema
  • Diagnosed by blood culture or culture from pleural fluid
  • Smoking – risk factor
  • Bronchitis
  • Risk factor is chronic lung disease ( COPD)
  • Acute Sinusitis
  • Otitis Media
91
Q

How is Haemophilus influenzae infection dx’ed?

A

•Diagnosis made by detecting PRP capsular antigens in CSF

92
Q

What is the Tx for Haemophilus influenzae infection?

A

•3rd generation cephalosporin for meningitis

93
Q

How is infection by Haemophilus influenzae prevented?

A
  • Conjugate capsular polysaccharide-protein vaccine effective for type b disease
  • Antibiotic prophylaxis in nonimmunized household or daycare contacts of patients with H influenza type b
  • Rifampin
94
Q

What is the thumb sign on CXR?

A

swollen epiglottis, sign of epiglottitis due to H. influenzae

95
Q

What kind of a germ is Corynebacterium diptheriae?

A
  • Gram-positive bacillus – club shaped
  • Non-spore forming
  • Aerobic
96
Q

What is the reservoir for Corynebacterium diptheriae?

A

throat and pharynx

97
Q

What is the transmission route for Corynebacterium diptheriae?

A

•Bacterium or phage via respiratory droplets

98
Q

What are the clinical manifestations of respiratory diptheria?

A
  • Incubation of 1-7 days
  • Sore throat, malaise, and fever
  • Pharyngeal erythema followed by tonsillar exudate
  • Exudate changes into a grayish membrane that is tightly adherent and bleeds on attempted removal
  • Cervical adenopathy – Bull Neck
  • Stridor
99
Q

What are some serious complications of respiratory diptheria?

A
  • Extension of membrane can lead to airway obstruction
  • Myocariditis, recurrent laryngeal nerve palsy, and peripheral neuritis
100
Q

What is the Tx of Corynebacterium diphtheriae?

A
  • Erythromycin
  • Antitoxin
101
Q

How is respiratory diptheria prevented?

A

•Vaccination with toxoid vaccine

102
Q
A

Respiratory II - Exam 1 (11 decks)

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