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Microbiology > Bacterial Pneumonia 1 > Flashcards

Bacterial Pneumonia 1 Flashcards

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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
Q

Pneumococcal pneumonia can cause capillaries to get plugged causing erythrocytes to accumulate in alveoli. What clinical sign can result because of this process?

A

cough with blood in sputum

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26
Q

Do sxs of pneumococcal pneumonia arrive rapidly or slowly?

A

rapidly

27
Q

After beginning abx, pneumococcal pneumonia is typically cleared in __________

A

2 weeks

28
Q

25-30% of untreated pneumococcal pneumonia leads to _____ and subsequent_______

A

bacteremia

meningitis

29
Q

antigen detection for penumococcal pneumonia tests for presence of pneumococcal C polysaccharide. It is useful in diagnosing _______ and _______

A

bacteremia

meningitis

30
Q

The best test to diagnose pneumococcal pneumonia is…

A

gram staining sputum

31
Q

Alpha or Beta hemolysis?

oxidized Fe in heme

appears green

A

alpha hemolytic

32
Q

Alpha or Beta hemolysis?

lysis of RBCs

zone of clearing on blood agar

A

beta hemolytic

33
Q

what streptococcus species is alpha hemolytic?

A

strep. pneumo

34
Q

What streptococcus species is beta hemolytic?

A

strep. pyogenes

strep. agalactiae

35
Q

why does culture often fail to identify strep. pneumo in pneumococcal pneumonia?

A

slow growing, rapidly outgrown by other organisms

36
Q

strep. penumo is ______ in the presence of bile…

A

lysed

37
Q

what tests are useful in serotyping, and identify capsular polysaccharides?

A

agglutination tests

38
Q

this organism is a small, pleomorphic G- rod that colonizes the upper respiratory tract of nearly all humans within months after birth…

A

H. flu

39
Q

H. Flu has _____ rather than LPS

A

LOS

40
Q

what has limited the spread of h. flu?

A

Hib vaccine

41
Q

what is the dosing protocol for Hib vaccine?

A

4 doses total

2, 4, 6, 12-15

42
Q

which strains of h. flu are virulent?

A

non-encapsulated

43
Q

fimbriae allow h. flu to colonize where?

A

nasopharynx

44
Q

What two virulence factors are prominent on h. flu?

A

neuraminidase

IgA protease

45
Q

Where does IgA protease break down IgA?

A

mucosal surface

46
Q

is h. flu neuraminidase the same as flu?

A

no

47
Q

What diagnostics can confirm H. flu?

A

CXR

Gram stain sputum

Isolation/culture

48
Q

what makes isolation of h. flu difficult?

A

complex growth requirements

49
Q

This H. flu diagnostic…

easily achieves definitive results due to reliance on antigen instead of viable bacteria

can be used during/after abx

A

ID-LAT

50
Q

This organism is a non-motile, G- bacillus member of enterobacteriaceae

A

Klebsiella

51
Q

Klebsiella is capable of causing both _____ and ______

A

CAP and HAP

52
Q

describe the capsule of klebsiella…

A

thick, slimy

53
Q

Where is klebsiella normally found as part of the flora?

A

mouth, skin, intestines

54
Q

Klebsiella can cause pneumonia in what three patient populations?

A

alcoholics, diabetics, homeless

55
Q

describe klebsiella and abx resistance…

A

major source of resistance

56
Q

What three virulence factors are present with klebsiella

A

polysaccharide capsule

LPS

adhesins

57
Q

This klebsiella virulence factor…

limits CAMPs and polymixins

blocks C3b, macrophages and neutrophils

inhibits inflammatory response…

A

polysaccharide capsule

58
Q

This klebsiella virulence factor…

blocks C3b deposition

inhibits inflammation

limits macrophage phagocytosis

A

LPS

59
Q

What types of adhesins are present with klebsiella?

A

fimbrial and non-fimbrial

60
Q

This disease causes aggressive necrotizing CAP in upper lobes.

It has a rapid onset and is often fatal even with abx

A

klebsiella

61
Q

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?

A

cavitation on CXR

klebsiella

62
Q

What are two diagnostic presentations for klebsiella?

A

currant jelly sputum

CXR showing cavitation

63
Q

What is the mortality rate of klebsiella?

A

50%

64
Q

Diagnosis of klebsiella is done on what medium?

A

MacConkey agar

Microbiology (13 decks)

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