Bacterial Pneumoniae

Question 1

Respiratory tract infections are more frequent than infection of any other organ in the body.

T/F

Answer 1

T

Question 2

Bacterial pneumonia and complications

Pneumonia can be defined as any ______ of the _______.

Answer 2

infection

lung parenchyma

Question 3

Bacterial pneumonia and complications

Pneumonia results when the _______ are impaired or whenever ______ of the host is lowered

Answer 3

defense mechanisms

resistance

Question 4

Factors affecting resistance of host includes:

(acute or chronic?) diseases,
________ deficiency,
treatment with ________ drugs
_____penia,
unusually _____ infections.

Answer 4

Chronic

immunologic

immunosuppressive

leuco

virulent

Question 5

Airways clearing mechanism could be impaired following:

loss of _____ reflex

injured _______ apparatus

interference with _________ of ________ action of alveolar macrophages

pulmonary _______ and ________

accumulation of ________

Answer 5

cough

mucociliary

phagocytic or bactericidal

congestion and oedema

secretion

Question 6

loss of cough reflex (______,______\, drugs, ________ disorder or chest pain)

injured mucociliary apparatus (cigarette smoke, ______ gases, _________ syndrome)

Answer 6

coma, anaesthesia

neuromuscular

Corrosive ; immotile cilia

Question 7

interference with phagocytic or bactericidal action of alveolar macrophages (alcohol, tobacco smoke, _______ or _______________)

accumulation of secretion (_______ and __________)

Answer 7

anoxia, or oxygen intoxication

cystic fibrosis and bronchial obstruction

Question 8

one type of pneumonia predisposes to another type

T/F

Answer 8

T

one type of pneumonia predisposes to another type PARTICULARLY in debilitated patients.

Question 9

The portal of entry for most pneumonia is __________ and many chronic diseases acquire _______ pneumonia.

Answer 9

respiratory tract

terminal

Question 10

Classification of pneumonia based on clinical settings

___________ acquired ____ pneumonia
____________ acquired ____ pneumonia
_______ Pneumonia
___________ pneumonia
_________ pneumonia
_________ Pneumonia and Lung Abscess
Pneumonia in _____________

Answer 10

Community; acute

Community; atypical

Nosocomial

Aspiration

Chronic

Necrotizing

Immunocompromised host

Question 11

Community – Acquired Acute Pneumonia

____________
______________
__________________
___________
______________
 Enterobacteriaceae (________ sp.)

Answer 11

Streptococcus pneumonia

Haemophilus influenza

Moraxella catarrhalis

Staphylococcus aureus

Legionella pneumophilia

kliebsiella

Question 12

B. Community-Acquired Atypical Pneumonia
_________ pneumoniae
_________ spp (c. pneumonae, c. psittaci, c.
trachmatis)
 Coxiella burnetti (__-fever)
 Viruses (_________ virus, ______ virus, _______ A and B, ____virus, _____ virus)

Answer 12

Mycoplasma

Chlamydia

Q

Respiratory syntical; parainfluenza

influenza; SARS; adeno

Question 13

Nosocomial Pneumonia

 Gram-________ rods belonging to ________

_______________

Answer 13

negative; enterobacteriaeciae

Staphyllococus aureus

Question 14

• Bacterial infection typically follows an ——————- infection.

Answer 14

upper respiratory tract viral

Question 15

Bacterial pneumonia

• Risk factors include

:-________ of ages

•(acute or Chronic?) diseases

•Congenital or acquired __________

Decreased or absent ________ (SCD or post splenectomy)

Answer 15

Extreme

Chronic

immune deficiencies

splenic function

Question 16

Bacterial pneumonia

The alveoli are filled with ___________, thus causing ________ of the lung tissue.

Answer 16

inflammatory exudates

consolidation

Question 17

_________ pneumonia –

• It is the most common cause of community- acquired acute pneumonia.

Answer 17

Streptococcus

Question 18

Streptococcus pneumonia –

• Although it responds to _______-based treatment, ________ should be performed prior to drug administration.

Answer 18

penicillin; antibiotic sensitivity

Question 19

Streptococcus pneumonia –

• Examination of gram stained _____ shows numerous bacteria containing ______-shaped ___________.

Answer 19

sputum

lancet

diplococci

Question 20

Pneumococcal vaccines are available for the high risk patients.

T/F

Answer 20

T

Question 21

Haemophilus Influenzae –

• It is a pleomorphic, gram-________ bacteria.

• It is a major cause of life-threatening (acute or chronic?) (upper or lower?) respiratory tract infections and _______ in young children.

Answer 21

negative

Acute ; lower

meningitis

Question 22

Haemophilus Influenzae –

• It is a common cause of _____-acquired pneumonia in (children or adults?) .

Answer 22

community

adults

Question 23

Haemophilus Influenzae –

• The bacterium has _____ on its surface that facilitates binding to the respiratory _____ and produces ______ that degrades _______.

Answer 23

pilli

epithelium

protease

IgA

Question 24

Haemophilus Influenzae –

has a capsule that prevents ________ by ________ and ______ by host cells.

Answer 24

opsonization

complements

phagocytosis

Question 25

Haemophilus Influenzae – It causes _____ media, _____, and ______pneumonia. • It is also a common cause of _________ before the advent of vaccine. • In older adults, it may cause septicaemia, endocarditis, pyelonephritis, cholecystitis and suppurative arthritis.

Answer 25

otitis; sinusitis; broncho suppurative meningitis

Question 26

___________________– The organism is also the commonest cause of acute exacerbation of COPD.

Answer 26

Haemophilus Influenzae

Question 27

Moraxella Catarrhalis – • Along with the ________ and _______, it is one of the three most common cause of _______ in children.

Answer 27

Streptococcus and Haemophilus otitis media

Question 28

Moraxella Catarrhalis – • It is the (first, second , or third?) most common cause of acute exacerbation of COPD.

Answer 28

Second

Question 29

___________________– • It is the most frequent cause of gram-negative bacteria pneumonia.

Answer 29

Kliebsiella Pneumoniae

Question 30

Kliebsiella Pneumoniae It afflicts _______ and ———— people (particularly _________).

Answer 30

debilitated and malnourished alcoholics

Question 31

Psuedomonas Aeruginosa – • It causes _______ infection. • It is frequently associated with _______ and _______ patients.

Answer 31

nosocomial cystic fibrosis and neutropenic

Question 32

Legionella Pneumophilia – • It is an agent of ________ disease. • It flourishes in _______ environment.

Answer 32

Legionnaires aquatic

Question 33

Legionella Pneumophilia – • It is commonly seen in patients with cardiac, renal, immunologic and haematologic diseases. T/F

Answer 33

T

Question 34

Two gross pattern are recognized in bacterial pneumonia - _________ ———- pneumonia and ______ pneumonia

Answer 34

lobular; broncho lobar

Question 35

Lobar pneumonia is a/an (acute or chronic?) bacterial infection resulting in _________ ———— of a (small or large?) portion of a lobe or _________.

Answer 35

Acute fibrinosupurative consolidation Large an entire lobe

Question 36

Four stages are recognized in lobar pneumonia, _________ ____________ ___________ ____________

Answer 36

Congestion red hepatization gray hepatization resolution.

Question 37

Stages of lobar pneumonia In congestive stage, the lung is (light or heavy?) , ______ and (white or red?) . There is vascular ________, _______fluid with few _______ and numerous ______.

Answer 37

Heavy Boggy; red engorgement intra alveolar neutrophils; bacteria

Question 38

Stages of lobar pneumonia Red hepatization is characterized by massive ____________ with _____,_____,______ filling the alveolar spaces. The lobes appear (airy or airless?) , (white or red?) and (loose or firm?) with a _______-like consistency, hence the term hepatization.

Answer 38

confluent exudation red cells, neutrophils and fibrin Airless; red ; firm liver

Question 39

Stages of lobar pneumonia Gray hepatization follows with progressive ________________ and the persistence of _____________ producing a ______________, (wet or dry?) surface.

Answer 39

disintegration of red cells fibrosuppurative exudates graying brown Dry

Question 40

Stages of lobar pneumonia The final stage is _______ in which the ______ within the alveoli undergoes progressive _______ to produce a __________ ingested by ________.

Answer 40

resolution; exudates enzymatic digestion granular debri; macrophages

Question 41

In the resolution stage of lobar pneumonia, _________ reaction to the underlying _______ may be present (pleuritis).

Answer 41

Pleural fibrinous inflammation

Question 42

Bronchopneumonia  produces _______ of ______ of acute suppurative inflammation.  It may involve _____ but it is normally _________ and frequently ______ and _______

Answer 42

patchy areas consolidation one lobe; multilobar bilateral and basal.

Question 43

Bronchopneumonia It appears as slightly (elevated or depressed?) , (wet or dry?) , granular, _______ to _____ lesion with (poorly or well?) delimited margin.

Answer 43

Elevated Dry; gray-red to yellow Poorly

Question 44

Bronchopneumonia The histology shows ___________ – rich exudates that fill the bronchi, bronchioles and adjacent alveolar spaces.

Answer 44

neutrophil

Question 45

Complication of Pneumonia ________ formation – common with type ____ pneumonia &________. ________  organization - convert part of a lung to _________  ________ dissemination – heart valve, pericardium, brain, kidneys, joints, spleen.

Answer 45

Abscess; 3; Kliebsiella empyema solid form bacteraemic

Question 46

Pneumonia: Clinical Course  abrupt onset of (low or high?) fever, chills _____ productive of _____ sputum ___________ occasionally

Answer 46

High cough; mucopurulent haemoptysis

Question 47

Complication of Pneumonia ______ formation ________ ______________

Answer 47

Abscess organization bacteraemic dissemination

Question 48

Three patterns of pneumoniae • ______ •_________ •___________

Answer 48

Lobar Bronchopneumonia Interstitial (atypical)

Question 49

Lobar Pneumonia • Bacteria acquired in ______ •__________ to alveolus • Enter alveolar type ___ cells • Pneumococci multiply in alveolus • Invade ________ • Pass from one alveolus to next through the __________ •________/_________ of lobes

Answer 49

nasopharynx Aerosolized II; alveolar epithelium pores of Cohn Inflammation/consolidation

Question 50

Lobar Pneumonia Can involve entire lung T/F

Answer 50

T

Question 51

Answer with either stage ,1,2,3,or 4 Pneumococci alive Alveolar capillaries dilate Lobes look red Gray, firm lobe Enzymes digests exudate Dying pneumococci RBCs disintegrate Return to normal Exudate of bacteria develops

Answer 51

2 1 2 3 4 3 3 4 1

Question 52

Interstitial Pneumonia • Inflammatory infiltrate of _________ only • More (indolent or aggressive ?) course

Answer 52

alveolar walls indolent

Question 53

Atypical Pneumonia Respiratory distress is (common or rare?) ___________ on chest X-Ray “_________ pneumonia”

Answer 53

Rare Interstitial infiltrates Walking

Question 54

E. coli is a more common cause of adult or neonate pneumonia

Answer 54

Neonate

Question 55

Group B strep is a more common cause of adult or neonate pneumonia

Answer 55

Neonate

Question 56

Bad bugs cause ______ class of pneumonia

Answer 56

Nosocomial acquired

Question 57

Community Acquired PNA Uncomplicated No ________ No recent ______ Low community rates resistance Azithromycin, Clarithromycin, or Doxycycline _______ to _______ course Patient should be afebrile 48-72 hrs and clinically stable

Answer 57

co-morbidities antibiotic use Low ; Three to five day