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Bacterial Pneumonia 1 Flashcards

1
Q

this type of pneumonia is:

acute
non-immunocompromised pt
acquired outside hospital

A

community acquired pneumonia

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2
Q

this type of pneumonia:

occurs 48hrs after admission with absence of sxs

OR

7-10 days after discharge

A

hospital acquired pneumonia

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3
Q

This type of pneumonia:

develops 48-72+ hours after ET intubation

A

ventilation acquired pneumonia

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4
Q

What organisms commonly cause CAP?

A

S. Pneumo

H. Flu

K. pneumo

S. aureus

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5
Q

What differentiates atypical pneumonia from atypical?

A

“walking pneumonia” generally more gradual, less severe with systemic effects

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6
Q

What is the gold standard diagnostic for CAP?

A

presence of infiltrate on CXR + gram stain of sputum

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7
Q

What two factors would allow CAP to be treated outpatient?

A

no comorbidities

no abx in last 3 months

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8
Q

What is the most important alpha-hemolytic strep species?

A

strep. pneumo

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9
Q

What is the gram stain and morphology of strep. pneumo?

A

G+ diplococci

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10
Q

Strep. pneumo must be grown on blood agar for what reason?

A

blood supplies catalase for aerobic growth

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11
Q

The breakdown of ______ in blood gives strep. pneumo colonies a _______ appearance.

A

heme

green

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12
Q

What three virulence factors are present on strep. pneumo?

A

polysaccharide capsule

IgA protease

pneumolysin

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13
Q

The polysaccharide capsule of strep. pneumo is useful for what scientific process?

A

serotyping

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14
Q

How does strep pneumo’s capsule protect the bacteria from phagocytosis?

A

resists complement opsonization

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15
Q

What prevents strep. pneumo from getting stuck in the mucus of the upper respiratory tract?

A

IgA protease

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16
Q

This is a cytotoxic virulence factor secreted by strep. pneumo that is responsible for release heme on blood agar and forms pores

A

pneumolysin

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17
Q

Strep. pneumo is able to bring DNA in from its own species and from others to help it survive. What is this called?

A

natural competence

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18
Q

What factor contributes to developing penicillin resistant strep. pneumo?

A

natural competence

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19
Q

What three factors cause tissue damage from strep. pneumo?

A

techoic acid and peptidoglycan introducing alternative complement pathway

pneumolysin inducing classical complement

production of H2O2

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20
Q

Where is strep. pneumo colonized, particularly in children and the elderly?

A

nose and nasopharynx

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21
Q

What three conditions do strep. pneumo commonly cause?

A

pneumonia

meningitis

sinusitis

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22
Q

This vaccine against strep. pneumo is recommended for adults over 65 every 5 years.

A

pneumovax 23

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23
Q

This vaccine against strep pneumo covers 80% of most common pneumococcal serotypes in children, and is recommended for any at-risk population, including infants, elderly and immunocompromised

A

prevnar 13

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24
Q

what disease has the following etiology?

slow growing bacteria

plugging of capillaries causing erythrocyte accumulation in alveoli

neutrophil and macrophage response

A

pneumococcal pneumonia

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25
Pneumococcal pneumonia can cause capillaries to get plugged causing erythrocytes to accumulate in alveoli. What clinical sign can result because of this process?
cough with blood in sputum
26
Do sxs of pneumococcal pneumonia arrive rapidly or slowly?
rapidly
27
After beginning abx, pneumococcal pneumonia is typically cleared in __________
2 weeks
28
25-30% of untreated pneumococcal pneumonia leads to _____ and subsequent_______
bacteremia meningitis
29
antigen detection for penumococcal pneumonia tests for presence of pneumococcal C polysaccharide. It is useful in diagnosing _______ and _______
bacteremia meningitis
30
The best test to diagnose pneumococcal pneumonia is...
gram staining sputum
31
Alpha or Beta hemolysis? oxidized Fe in heme appears green
alpha hemolytic
32
Alpha or Beta hemolysis? lysis of RBCs zone of clearing on blood agar
beta hemolytic
33
what streptococcus species is alpha hemolytic?
strep. pneumo
34
What streptococcus species is beta hemolytic?
strep. pyogenes | strep. agalactiae
35
why does culture often fail to identify strep. pneumo in pneumococcal pneumonia?
slow growing, rapidly outgrown by other organisms
36
strep. penumo is ______ in the presence of bile...
lysed
37
what tests are useful in serotyping, and identify capsular polysaccharides?
agglutination tests
38
this organism is a small, pleomorphic G- rod that colonizes the upper respiratory tract of nearly all humans within months after birth...
H. flu
39
H. Flu has _____ rather than LPS
LOS
40
what has limited the spread of h. flu?
Hib vaccine
41
what is the dosing protocol for Hib vaccine?
4 doses total 2, 4, 6, 12-15
42
which strains of h. flu are virulent?
non-encapsulated
43
fimbriae allow h. flu to colonize where?
nasopharynx
44
What two virulence factors are prominent on h. flu?
neuraminidase IgA protease
45
Where does IgA protease break down IgA?
mucosal surface
46
is h. flu neuraminidase the same as flu?
no
47
What diagnostics can confirm H. flu?
CXR Gram stain sputum Isolation/culture
48
what makes isolation of h. flu difficult?
complex growth requirements
49
This H. flu diagnostic... easily achieves definitive results due to reliance on antigen instead of viable bacteria can be used during/after abx
ID-LAT
50
This organism is a non-motile, G- bacillus member of enterobacteriaceae
Klebsiella
51
Klebsiella is capable of causing both _____ and ______
CAP and HAP
52
describe the capsule of klebsiella...
thick, slimy
53
Where is klebsiella normally found as part of the flora?
mouth, skin, intestines
54
Klebsiella can cause pneumonia in what three patient populations?
alcoholics, diabetics, homeless
55
describe klebsiella and abx resistance...
major source of resistance
56
What three virulence factors are present with klebsiella
polysaccharide capsule LPS adhesins
57
This klebsiella virulence factor... limits CAMPs and polymixins blocks C3b, macrophages and neutrophils inhibits inflammatory response...
polysaccharide capsule
58
This klebsiella virulence factor... blocks C3b deposition inhibits inflammation limits macrophage phagocytosis
LPS
59
What types of adhesins are present with klebsiella?
fimbrial and non-fimbrial
60
This disease causes aggressive necrotizing CAP in upper lobes. It has a rapid onset and is often fatal even with abx
klebsiella
61
A patient presents with: rapid onset high fever productive cough with currant jelly sputum what should you expect to see on CXR, and what pathogen caused this?
cavitation on CXR klebsiella
62
What are two diagnostic presentations for klebsiella?
currant jelly sputum CXR showing cavitation
63
What is the mortality rate of klebsiella?
50%
64
Diagnosis of klebsiella is done on what medium?
MacConkey agar

Microbiology (13 decks)

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