ALL Flashcards
methenamine silver stain is used primarily to visualize
pneumocystic carinii
elevated cold agglutinins are associated with
mycoplasma pneumoniae
Positive Quellung reaction and optochin-sensitive organism?
streptococcus pneumoniae
The most common agent causing pneumonia and bronchitis in children < 1yr is
RSV
The appropriate treatment for RSV is
ribaviron
Skin test positive reactions are mediated by _______, and are a
T cells (CD4+ Th cell, memory cell -> effector cell, release cytokine -> macrophage activation); delayed Type IV hypersensitivity reaction
CD4+ Th1 cells are important in directing the immune response against
fungi and intracellular pathogens
CD4+ Th1 cells release ___________ which causes
IFN-gamma; macrophage activation
alpha-hemolytic agent of LRTI
streptococcus pneumoniae
cause of a widened mediastinum
bacillus anthracis
the only human pathogen with a polypeptide capsule
bacillus anthracis
Facultative intracellular AFB`
nocardiae, mycobacterium
cell wall-less and lack peptidoglycan
mycoplasma and ureaplasma
Most common cause of croup
Parainfluenza virus
Most common cause of bronchitis in neonates
bacterial - streptococcus agalctiae
Most common cause of adult acute bronchitis
viral - influenza virus
Most common cause of acute exacerbation of chronic bronchitis
Haemophilus influenza (NTHi), followed by moraxella and s. pneumoniae
Guillain Barre syndrome may result from a complication due to what agent/s
influenza virus, chlamydia
Chlamydia psittaci exposure is associated with
poultry exposure
In tuberculosis infections, the principle form of defense to fight off infection is
CMI, leading to a granuloma formation
Fever, SOB, bilateral infiltrates, and “hat-shaped” organisms visible on silver stain within the foamy alveolar exudate, this patient most likely has
pneumocystis carinii pneumonia
Agent with GPC, encapsulated, lancet-shaped, diplococci
streptococcus pneumoniae
Agent described by budding yeast and pseudohyphae
candida albicans
Agent described as mold with nonseptate hyphae
Mucor
Uncontrolled diabetic with chronic sinusitis, a likely agent is
Mucor
Agent describe as mold with septate hyphae
Aspergillosis
Alcohol, ARD, lobar consolidation of left lower lung, a likely agent is
klebsiella pneumoniae
Alcoholic, exposure to contaminated air conditioner
legionella
Most common cause of pneumonia in young adults
Mycoplasma pneumoniae
What agent is associated with empyema formation
staphylococcus aureus
Barking cough with hoarseness in a young child, the likely agent is
Croup - parainfluenza virus (paramyxovirus family)
Common agent of STDs
Chlamydia trachomatis
Agents that are OBLIGATE aerobes
MTB, Nocardia, and Pseudomonas aeruginosa
Agents that are OBLIGATE anaerobes
Actinomyces
Encapsulated agents of LRTI
Streptococcus pneumoniae, HiB, Klebsiella
Catalase positive agents of LRTI
Staph aureus, pseudomonas aeruginosa, aspergillus
Prevnar vs pneumovax
Pneumovax: 23-valent polysaccharide vaccine, no class switching or memory Prevnar: 7/13-valent, conjugated vaccine for memory and Ig switching
Blue-green sputum or colony
pseudomonas aeruginosa
Protein A
staph. aureus; prevents opsonization and phagocytosis by binding Fc of IgG
Exotoxin A
C. diptheriae and Pseudomonas aeruginosa; inactivates elongation factor 2
Whooping cough agent
Bordetella pertussis
Green ring around colonies on blood agar indicates
alpha-hemolytic bacteria, streptococcus pneumoniae
Clear ring around colonies on blood agar likely indicates
beta-hemolytic bacteria, staphylococcus aureus
Streptococcus pneumoniae is the most common cause of
MOPS: Meningitis, Otitis media, Pneumonia, Sinusitis
“Rusty” sputum likely indicates
Streptococcus pneumoniae
Woolsorter’s disease
pulmonary anthrax
Cord factor is associated with what agent
MTB
Fermentors
Klebsiella
Epiglottitis primary agent
Haemophilus influenzae
Legionnaires Disease
severe pneumonia, GI, and CNS symptoms
Charcoal yeast extract culture, think
Legionella
Agent associated with burn wounds
pseudomonas aeruginosa
Pneumonia in Cystic Fibrosis patients is likely due to
pseudomonas aeruginosa
Red currant jelly sputum
Klebsiella
Elementary Bodies and Reticulate Bodies
Reticulate bodies are actively replicating form in Chlamydia
Cytoplasmic inclusions on Giemsa Stain
Chlamydia
Outbreaks of pneumonia in military recruits
Mycoplasma pneumoniae
Diabetic with pneumonia, likely agents
klebsiella or mucor
Mississippi-Ohio river valley + bird/bat droppings
Histoplasa capsulatum
Spherule is pathognomonic for
Coccidiodomycosis
facultative intracellular Fungus
Histoplasma capsulatum
thick-walled large yeast cells
Blastomycosis dermatiditis
SW US, construction, summer
Coccidiodomycosis
Central US (chicago) near lakes and rivers
Blastomycosis dermatiditis
Hyphae with Acute angle branching
Aspergillosis
Irregular, broad, nonseptate hyphae
Mucor
History of Asthma or CF
Aspergillus -> allergic bronchopulmonary aspergillosis
History of properly treated TB
Aspergillomas -> fungal ball
Immunocompromised + interstitial pneumonia with disc-shaped yeast
pneumocystis jiroveci
Oval yeast in macrophages
Histoplasma capsulatum
Ground glass attenuation or CT halo
invasive aspergillosis
end stage AIDS patient with Tuberculosis like disease
MAC (mycobacterium avium complex)
Severely neutropenic patient is likely to get
aspergillus, candida
Mycolic acids
Mycobacterium (MTB), basis of INH therapy
Amphotericin is a __________ and works by
anti-fungal, binds ergosterols -> leaky cell membrane -> cell death
Influenza A and B treatment
zanamivir, oseltamivir
CMV treatment
ganciclovir
Top 5 agents causing VAP
S. aureus, s. pneumoniae, HiB, p. aeruginosa, acinetobacter
Atelectasis, how can you tell on a Xray
loss of airspace, anatomy shift toward, crowding of ribs, elevated diaphragm
Sputum sample requirements
> 25 neutrophils, <10-25 epithelial cells
Staining for fungal agents involves
KOH
Parasitic form of fungus
yeast or spherule
Infectious form of fungus
generally mold -> spores
What would be more effective in a flu outbreak?
not vaccine, since incubation is shorter than immune response; oseltamivir and zanamivir
Pneumolysin
virulant factor of streptococcus pneumoniae
bile/deoxycholate soluble
streptococcus pneumoniae
Grows on MacConkey agar
acinetobacter baumanii
abx resistant islands found in
acinetobacter baumanii
Wounded soldiers
Acinetobacter baumanii
Pyocyanin
pseudomonas aeruginosa
Abscesses on CT show clear
air-fluid level
_____________ destroy conidia, __________ destroy hyphae
macrophages; PMN
Fe overload state predisposes a pt to
aspergillosis and mucormycoses
Histoplasmin
CF test with mycelial Ag
Estrogen binding protein
Coccidioides
unilateral abdominal LAD
DMAC in AIDS pt
Common agent in AECB/COPD
Hib
Common agent in secondary bacterial inf in fluenza
Hib
Common bacterial agent found in tracheitis
Hib
Primary agent of pharyngitis
ADV
Top 3 most common causes of LRTI in children
RSV, PIV, and ADV
Pharyngoconjunctival fever
pharyngitis in summer, + periauricular LAD + conjunctivitis
Pertussis treatment
Macrolides
Vaccines that reduce carriage for pneumonia
Prenvar, Hib, pertussis
Hyperinflation, atelectasis, hilar adenopathy, parahilar peribronchial infiltrates are diagnostic for
viral pneumonia