Bacterial Infections of Lower Respiratory Tract III

Question 1

Mycobacteria characteristics

Answer 1

weakly gram positive
acid-fast rods
lipid rich cell wall

Question 2

What is TB caused by

Answer 2

mycobacterium tuberculosis

Question 3

What is the resevoir for mycobacterium tuberculosis

Answer 3

just humans

Question 4

How is the TB spread

Answer 4

respiratory aerosol droplets

Question 5

What are the TB disease states

Answer 5

primary TB
active TB
latent TB
reactivation

Question 6

How does the immune system deal with Mtb

Answer 6

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

Question 7

Latent TB infection

Answer 7

inability of immune system to kill Mtb

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

Question 8

What are the symptoms of primary TB

Answer 8

asymptomatic

Question 9

Who gets active TB

Answer 9

immunocompromised individuals

Question 10

Who gets latent TB

Answer 10

it’s what happens in most individuals

Question 11

How does reactivation TB happen

Answer 11

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

Question 12

How is CMI important in TB

Answer 12

adequate control helps protect the body from TB

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

Question 13

Disseminiated TB infection

Answer 13

known as miliary B or extrapulmonary TB

granuloma formation that occurs at any site in the body

Question 14

Symptoms of active TB

Answer 14

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

Question 15

What are the symptoms of reactivation TB

Answer 15

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

Question 16

Can you spread TB when you are asymptamatic

Answer 16

yes

Question 17

Ghon focus

Answer 17

lung lesion. can contain live Mtb

Question 18

Ghon complex

Answer 18

lung lesion and calcification seen in an affected hilar lymph

Question 19

Chest xray for tb will show

Answer 19

focal infiltration with cavitation

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

Question 20

TB skin test (mantoux)

Answer 20

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

Question 21

IFN-gamma realse assay for TB

Answer 21

what you do for patients who are BCG-vaxed

Question 22

Ziehl-Neelsen/Kinyoun stains for TB

Answer 22

will confirm mycobacterial disease but isn’t specific to TB

Question 23

Nucleic acid amplification tests for TB

Answer 23

specific to TB, but is expensive

Question 24

Culture for TB

Answer 24

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

Question 25

How do you treat TB

Answer 25

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

Question 26

BCG-vax

Answer 26

for TB administered overseas not totally protective

Question 27

What is the relationship between TB and AIDS

Answer 27

primary TB infection is MUCH greater in HIV infected people | reactive risk is way higher too

Question 28

Mycobacterium avium intracellulare

Answer 28

complex of several mycobacteria | pulmonary infection resembling TB in immunocomprised pts

Question 29

Mycobacterium kansasii

Answer 29

more common in elderly | seen in COPD pts

Question 30

Haemophilis inflenzae B characteristics

Answer 30

gram negative coccobacillli | encapsulated

Question 31

Epidemiology of HiB

Answer 31

mostly pediatric | transmission via respiratory droplets or direct contact with respiratory secretions

Question 32

Virulence factors of HiB

Answer 32

LPS IgA protease PRP capsule

Question 33

How do you treat HiB

Answer 33

severe cases - broad spectrum cephalosporin | less severe - amoxicillin

Question 34

How can you prevent HiB

Answer 34

conjugate vaccine

Question 35

What is acture bronchitis caused by

Answer 35

mycoplasma pneumoniae

Question 36

What are the symptoms of acute bronchitis

Answer 36

dry cough

Question 37

Bordetella pertussis characteristics

Answer 37

gram negative coccobacilli

Question 38

Pathologity of bordetella pertussis

Answer 38

adhere to ciliated respiratory mucosa, multiply, produce toxic factors

Question 39

What is the highest stage of infectability of pertussis

Answer 39

catarrhal

Question 40

What are the symptoms of catarrhal stage of pertussis

Answer 40

rhinorrhea, malaise, fever, sneezing, anorexia

Question 41

What are the symptoms of paroxysmal stage of pertussis

Answer 41

repetitive cough with whoops, vomiting, leukocytosis

Question 42

What are the symptoms of convalescent stage of pertussis

Answer 42

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

Question 43

What are the symptoms of the incubation stage of pertussis

Answer 43

none

Question 44

What are the 4 stages of pertussis

Answer 44

incubation, catarrhal, paroxysmal, convalescent

Question 45

What are the virulence factors of pertussis

Answer 45

adhesions (filamentous hemagglutinin) | toxins (pertussis)

Question 46

Why does the whooping cough happen

Answer 46

increased host cAMP, increase in respiratory secretion

Question 47

How do you treat pertussis

Answer 47

supportive therapy, | macrolides (azithromycin, clarithromycin)

Question 48

How do you prevent pertussis

Answer 48

vax with DTaP

Question 49

What does a large amount of blood in sputum signal

Answer 49

TB or lung abscess

Question 50

What does purelent sputum signla

Answer 50

typical pneumonia

Question 51

What does scant, water, mucoid sputum signal

Answer 51

atypical pneumonia

Question 52

What does rust colored sputum signal

Answer 52

streptococcus pneumoniae

Question 53

What does thick, currant jelly like sputum tell you

Answer 53

klebsiella pneumoniae

Question 54

What does foul smelling sputum signal

Answer 54

anaerobia bacterial pneumonia

Question 55

What is the best treatment for hospital acquired pneumonia

Answer 55

ticarcillin and aminoglycoside