Clinical - Pulmonary Bacterial Infections

Question 1

What are the typical findings in streptococcus pneumoniae?

Answer 1

Leukocytosis, rust colored sputum, effusion

CXR shows classic lobar pneumonia

Question 2

When will a staphlyococcus aureus pneumoniae infection occur?

Answer 2

Serve diabetes, immunocompromised, drug abusers, dialysis patients, influenza and measles patients

Question 3

What three pulmonary conditions can cause a pseudomonas aeroginosa infection?

Answer 3

CF, bronchiectasis, COPD

Question 4

What two problems do most patients with haemophilus influenza pneumonia have?

Answer 4

COPD

Alcoholism

Question 5

What three diseases does moraxella catarrhalis cause?

Answer 5

Sinusitis
Otitis
Pneumonia

Question 6

What is the etiology of legionella?

Answer 6

Inhalation of aerosolized organisms
Air conditioning towers
Construction
Infected showers

Question 7

How do legionella patients present?

Answer 7

Pneumonia
Abrupt onset cough, chills, dyspnea, headache
Myalgia, arthralgia, diarrhea, change in mental status

Question 8

What lab values are characteristic of legionella?

Answer 8

Legionella urinary antigen
Positive fluorescent antibody stain
4 fold increase in titer

Question 9

How does mycoplasma pneumonia present?

Answer 9

Cough, fever, pharyngitis, coryza, tracheobronchitis, bullous myringitis

Question 10

What are the lab findings in mycoplasma?

Answer 10

CXR shows unilateral bronchopneumonia and pleural effusion

Cold agglutins

Question 11

What is the clinical presentation of chlamydia pneumoniae?

Answer 11

Pharyngitis, pneumonia, bronchitis, sinusitis

Pharyngeal erythema and wheezing

Question 12

What is the mode of transmission of psittacosis?

Answer 12

Birds

Question 13

What causes Q fever and how is it acquired?

Answer 13

Coxiella burnetii
Contact with cats or farm animals
Inhaled

Question 14

How is francisella tularensis trasnmitted?

Answer 14

Rabbits and bites of ticks or deer flies

Question 15

What are the clinical findings of francisella tularensis?

Answer 15

Cutaneous ulcer and lymphadenopathy
Cough, fever, chest pain
Lower lobe patchy infiltrates and pleural effusion

Question 16

What causes the plague?

Answer 16

Yersinia pestis

Question 17

What are the clinical findings in yersinia?

Answer 17

Bilateral lower lobe alveolar infiltrates
Organisms on Giemsa or fluorescent AB staining
Fever, headache, bubo (groin or axilla), cough

Question 18

How does nocardia present?

Answer 18

Pulmonary alveolar proteinosis, necrotizing pneumonia, lung abscess

Question 19

How does actinomycosis usually present?

Answer 19

Patient has severe dental caries, tissue necrosis, cough, fever, pulmonary lesions, fisula

Question 20

What predisposes to aspiration pneumonia?

Answer 20

Nasogastric tube, anesthesia, coma, seizures, CNS problems, diaphragmatic hernia, TE fistula

Question 21

What is a collection of pus that leads to a cavity formation?

Answer 21

Abscess

Question 22

How does a CXR appear with abscess?

Answer 22

Cavitated lesions and air fluid level

Question 23

What is latent TB?

Answer 23

Positive PPD but not active TB

Question 24

What is miliary TB?

Answer 24

Diffuse presence of small nodules throughout the body

Question 25

How do you treat latent TB?

Answer 25

Isoniazid 300 mg daily or 900 mg biweekly

Rifampin 600 mg daily

Question 26

What is DOT?

Who needs it?

Answer 26

Directly observed therapy

Homeless, alcoholics, IV drug users, AIDS patients, prisoners

Question 27

How does TB present?

Answer 27

Low fever, night sweats, fatigue, weight loss, persistent cough

Question 28

What mycobacteria infects AIDs patients?

Answer 28

Mycobacterium avium complex

Question 29

How do you treat mycobacterium avium complex?

Answer 29

Azithromycin and clarithromycin