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Micro Exam II > Bacterial Infections of Lower Respiratory Tract III > Flashcards

Bacterial Infections of Lower Respiratory Tract III Flashcards

1
Q

Mycobacteria characteristics

A

weakly gram positive
acid-fast rods
lipid rich cell wall

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2
Q

What is TB caused by

A

mycobacterium tuberculosis

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3
Q

What is the resevoir for mycobacterium tuberculosis

A

just humans

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4
Q

How is the TB spread

A

respiratory aerosol droplets

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5
Q

What are the TB disease states

A

primary TB
active TB
latent TB
reactivation

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6
Q

How does the immune system deal with Mtb

A

alveolar macrophages engulf it
recruits T and NK cells
some alveolar macrophages migrate to hilar lymph nodes

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7
Q

Latent TB infection

A

inability of immune system to kill Mtb

form a granuloma using CD4+, CD8+ and NK cells to prevent further spread

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8
Q

What are the symptoms of primary TB

A

asymptomatic

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9
Q

Who gets active TB

A

immunocompromised individuals

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10
Q

Who gets latent TB

A

it’s what happens in most individuals

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11
Q

How does reactivation TB happen

A

more common in immunocompromised people. Basically you had latent TB and something happens and it gets reactivated

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12
Q

How is CMI important in TB

A

adequate control helps protect the body from TB

inadequate control ends up damaging the lung, and causes most of the damage

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13
Q

Disseminiated TB infection

A

known as miliary B or extrapulmonary TB

granuloma formation that occurs at any site in the body

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14
Q

Symptoms of active TB

A

weight loss, night sweats, cough, with little sputum production.

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15
Q

What are the symptoms of reactivation TB

A

same as active TB, but happens years after the individual was first infected

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16
Q

Can you spread TB when you are asymptamatic

A

yes

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17
Q

Ghon focus

A

lung lesion. can contain live Mtb

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18
Q

Ghon complex

A

lung lesion and calcification seen in an affected hilar lymph

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19
Q

Chest xray for tb will show

A

focal infiltration with cavitation

often in apical posterior segments of the upper lobes of both lungs

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20
Q

TB skin test (mantoux)

A

intradermal injection of PPDs which are dervied from Mt cell envelope
BCG-vaxed people will be positive

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21
Q

IFN-gamma realse assay for TB

A

what you do for patients who are BCG-vaxed

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22
Q

Ziehl-Neelsen/Kinyoun stains for TB

A

will confirm mycobacterial disease but isn’t specific to TB

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23
Q

Nucleic acid amplification tests for TB

A

specific to TB, but is expensive

24
Q

Culture for TB

A

not a great idea because it’s slow and easy to contaminate

25
Q

How do you treat TB

A

isoniazid, ethambutol, pyrazinamide and rifampin for 2 months, then 26 months of INH and rifampin

26
Q

BCG-vax

A

for TB
administered overseas
not totally protective

27
Q

What is the relationship between TB and AIDS

A

primary TB infection is MUCH greater in HIV infected people

reactive risk is way higher too

28
Q

Mycobacterium avium intracellulare

A

complex of several mycobacteria

pulmonary infection resembling TB in immunocomprised pts

29
Q

Mycobacterium kansasii

A

more common in elderly

seen in COPD pts

30
Q

Haemophilis inflenzae B characteristics

A

gram negative coccobacillli

encapsulated

31
Q

Epidemiology of HiB

A

mostly pediatric

transmission via respiratory droplets or direct contact with respiratory secretions

32
Q

Virulence factors of HiB

A

LPS
IgA protease
PRP capsule

33
Q

How do you treat HiB

A

severe cases - broad spectrum cephalosporin

less severe - amoxicillin

34
Q

How can you prevent HiB

A

conjugate vaccine

35
Q

What is acture bronchitis caused by

A

mycoplasma pneumoniae

36
Q

What are the symptoms of acute bronchitis

A

dry cough

37
Q

Bordetella pertussis characteristics

A

gram negative coccobacilli

38
Q

Pathologity of bordetella pertussis

A

adhere to ciliated respiratory mucosa, multiply, produce toxic factors

39
Q

What is the highest stage of infectability of pertussis

A

catarrhal

40
Q

What are the symptoms of catarrhal stage of pertussis

A

rhinorrhea, malaise, fever, sneezing, anorexia

41
Q

What are the symptoms of paroxysmal stage of pertussis

A

repetitive cough with whoops, vomiting, leukocytosis

42
Q

What are the symptoms of convalescent stage of pertussis

A

diminished whoop cough, secondary complications (pneumonia, seizures, encephalopathy)

43
Q

What are the symptoms of the incubation stage of pertussis

A

none

44
Q

What are the 4 stages of pertussis

A

incubation, catarrhal, paroxysmal, convalescent

45
Q

What are the virulence factors of pertussis

A

adhesions (filamentous hemagglutinin)

toxins (pertussis)

46
Q

Why does the whooping cough happen

A

increased host cAMP, increase in respiratory secretion

47
Q

How do you treat pertussis

A

supportive therapy,

macrolides (azithromycin, clarithromycin)

48
Q

How do you prevent pertussis

A

vax with DTaP

49
Q

What does a large amount of blood in sputum signal

A

TB or lung abscess

50
Q

What does purelent sputum signla

A

typical pneumonia

51
Q

What does scant, water, mucoid sputum signal

A

atypical pneumonia

52
Q

What does rust colored sputum signal

A

streptococcus pneumoniae

53
Q

What does thick, currant jelly like sputum tell you

A

klebsiella pneumoniae

54
Q

What does foul smelling sputum signal

A

anaerobia bacterial pneumonia

55
Q

What is the best treatment for hospital acquired pneumonia

A

ticarcillin and aminoglycoside

Micro Exam II (8 decks)

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