Bacterial Infections of the Lower Respiratory Tract I

Question 1

Which tends to be more serious, lower respiratory tract infections or upper respiratory tract infections?

Answer 1

lower respiratory tract infections. They are also less common

Question 2

Mucociliary escalator

Answer 2

movement of mucous and trapped particles up the bronchioles, bronchi and trachea to be swallowed

Question 3

What are some things that can impair the function of the mucociliary escalator

Answer 3

viral infection
smoke
EtOH
narcotics

Question 4

Bacterial pneumonia

Answer 4

inflammation of lung as result of bacterial infection

Question 5

Symptoms of bacterial pneumonia

Answer 5

fever, malaise, cough, pleuritic chest pain. crackles upon auscultation

Question 6

What does a chest xray of typical pneumonia look like

Answer 6

one lung appears to be solid, full of bacteria

Question 7

What does a chest xray of atypical pneumonia look like

Answer 7

patchy

entire lobe is not usually full

Question 8

Onset of typical pneumonia

Answer 8

sudden

Question 9

Onset of atypical pneumonia

Answer 9

gradual

Question 10

WBC count of typical pneumonia

Answer 10

elevated with left shift

Question 11

WBC count of atypical pneumonia

Answer 11

often not elevated, but can be

Question 12

What is the most common agent of typical pneumonia

Answer 12

streptococcus pneumoniae

Question 13

What is the most common agent of atypical pneumonia

Answer 13

mycoplasma pneumoniae

Question 14

Pleurisy and consolidation in typical pneumonia?

Answer 14

common

Question 15

pleurisy and consolidation in atypical pneumonia?

Answer 15

rare

Question 16

What is aspiration pneumonia caused by?

Answer 16

introduction of foreign material into the bronchial tree such as saliva, food, vomit

Question 17

Community acquired pneumonia

Answer 17

any pneumonia NOT acquired in a healthcare setting

Question 18

Hospital acquired pneumonia

Answer 18

pneumonia acquired in a healthcare setting

Question 19

What is hospital acquired pneumonia often caused by?

Answer 19

MDR gram negatives

Question 20

streptococcus pneumoniae features

Answer 20

gram positive
diplococci in chains
alpha hemolytic
catalase neg

Question 21

What are the streptoccus pneumoniae virulence factors

Answer 21

surface adhesions, IgA protease, pneumolysin, teichoic acid and peptidoglycan, thick polysaccharide capsule

Question 22

What does surface adhesins do in s. pneumoniae

Answer 22

colonization of pharynx

Question 23

What does IgA protease do in s. pneumoniae

Answer 23

cleaves IgA, prevent clearance

Question 24

What does pneumolysin do in s. pneumoniae?

Answer 24

pore forming toxin
colonization invasion
inflammation
complement activation

Question 25

What does teichoic acid and peptidoglycan do in s. pneumoniae

Answer 25

inflammation

Question 26

What does thcik polysaccharid capsule do in s. pneumoniae

Answer 26

antiphagocytic

Question 27

Symptoms of pneumonoccal pneumonia

Answer 27

rust color sputum preceding by several days of rhinorrhea abrupt spiking fever with chills poor oxygenation

Question 28

What is the result of optochin test for s. pneumoniae pneumonia?

Answer 28

optochin sensitive

Question 29

What can you look for in a urine test for s. pneumoniae pneumonia

Answer 29

test for pneumococcal polysaccharide

Question 30

What is the result of a bile solubility test for s. pneumoniae pneumonia?

Answer 30

positive

Question 31

How can you treat s. pneumoniae

Answer 31

sensitive strains - penicillin macrolide-azithromycon serious cases - azithromycin plus cephalosporin

Question 32

Is there a vaccine for s. pneumoniae?

Answer 32

yes. 23 and 13 valent

Question 33

Characteristics of staphlyoccus aureus

Answer 33

gram positive cocci in clusters catalase positive coagulase positive

Question 34

What are the virulence factors of s. aureus?

Answer 34

coagulase protein A panton-valentine leukocidin

Question 35

What does coagulase do in s. aureus

Answer 35

clotting blood

Question 36

What does protein A do in s. aureus

Answer 36

binds Fc portion of antibody

Question 37

What does PVL do in s. aureus

Answer 37

pore forming cytotoxin | can cause sever necrotizing pneumonia

Question 38

MRSA

Answer 38

resistant to all beta lactams. not necessarily more virulent, just harder to treat

Question 39

How can you treat MRSA

Answer 39

linezolid or vancomycin

Question 40

What is the agent of MRSA

Answer 40

s. aureus

Question 41

How to treat s. aureas pneumonia that's NOT resistant

Answer 41

penicillins/cephalosporins

Question 42

Pneumonia caused by gram neg bacteria

Answer 42

more likely to be HAP | common in aspiration pneumonia

Question 43

Characteristics of gram neg pneumonia

Answer 43

pt generally has an underlying disease foul smelling sputum any love may be affect 1/4 have pleural effusion

Question 44

How do you treat gram neg pneumonia

Answer 44

drug cocktail via IV | aminoglycoside + beta lactam

Question 45

Characteristics of klebsiella pneumoniae

Answer 45

gram neg rod non motile oxidase neg has capsule

Question 46

Symptoms of klebsiella pneumoniae pneumonia

Answer 46

classic pneumonia bloody sputum looks like currant jelly

Question 47

Virulence factors of klebsiella pneumoniae

Answer 47

LPS | capsule

Question 48

How do you treat klebsiella pneumoniae pneumonia

Answer 48

drug cocktail via IV | aminoglycoside + beta lactam

Question 49

How do you prevent klebsiella pneumoniae pneumonia

Answer 49

disinfect encironment | use sterile respiratory equipment

Question 50

Pseudomonas aeruginosa charactersistics

Answer 50

``` gram neg rods flagellated obligate aerobe oxidase positive culture smells like grapes ```

Question 51

Where does pseudomonoas aeruginosa grow

Answer 51

water with minimal nutrients hand soaps dilute antiseptics

Question 52

Predisposing factors for pseudomonoas aeruginosa pneumonia

Answer 52

burn patients immunosuppressive therapy ventilator use cystic fibrosis

Question 53

Virulence factos for pseudomonas aeruginosa

Answer 53

``` toxin A leukocidin phospholipase C capsule pyocyanin pyoverdin ```

Question 54

What does toxin A do in pseudomonoas aeruginosa

Answer 54

ADP-ribosylation of EF-2, hals protein synthesis

Question 55

What does leukocidin do in pseudomonoas aeruginosa

Answer 55

pore forming toxin that targets leukocytes

Question 56

What does phospholipase C do in pseudomonoas aeruginosa

Answer 56

membrane disruption

Question 57

How do you treat pseudomonoas aeruginoa

Answer 57

ticarcillin or piperacillin plus aminoglycoside