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Microbiology > E1- Baterial Pneumonia I > Flashcards

E1- Baterial Pneumonia I Flashcards

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1
Q

What type of pneumonia is an acute infection of the pulmonary parenchyma in a patient who is not immunocompromised and has acquired the infection outside of the hospital?

A

CAP (community acquired pneumonia)

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2
Q

What type of pneumonia occurs 48 hrs or more after admission and did not appear to be incubating at the time of admission or 7-10 days after discharge?

A

HAP (hospital acquired pneumonia)

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3
Q

What type of pneumonia develops more than 48 to 72 hours after an endotracheal intubation?

A

VAP (ventilator associated pneumonia)

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4
Q

What are the common causes of CAP?

A

S. pneumoniae
H. Influenza
K. pneumonia
S. aureus

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5
Q

What is the gold standard for dx of CAP?

A

Presence of an infiltrate on CXR with supportive clinical and microbiology findings

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6
Q

What can be useful for rapid dx of pneumonia?

A

Gram stain of sputum

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7
Q

What two main factors are considered with CAP outpatient treatment?

A

No major comorbidities

No abx in last 3 months

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8
Q

What is pneumonia caused by streptococcus pneumoniae also called?

A

Pneumococcus

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9
Q

What type of media must streptococcus pneumoniae be grown on? Why?

A

Blood because it supplies catalase for organism to survive aerobically

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10
Q

Streptococcus pneumoniae grows poorly with what in the media? Why?

A

Glucose because lactic acidosis builds up

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11
Q

In the growth of streptococcus pneumoniae on blood agar, the breakdown of ____ gives colonies a ____ appearance.

A

Heme

Green

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12
Q

What are the three virulence factors associated with streptococcus pneumoniae?

A

Capsule*
Secretory IgA protease
Pneumolysin

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13
Q

How does the thick polysaccharide capsule increase virulence in streptococcus pneumoniae?

A

Resists opsonization by complement

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14
Q

How does the secretory IgA protease increase virulence in streptococcus pneumoniae?

A

Prevents organism from getting stuck in mucus of upper respiratory tract

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15
Q

How does the pneumolysin increase virulence in streptococcus pneumoniae?

A

Produces cytotoxin

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16
Q

A pt presents with sick appearance, high fever, productive cough, and well-defined consolidation on CXR. What do you suspect?

A

Typical pneumonia

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17
Q

A pt presents with well appearance, low fever, non-productive cough, and non-defined patchy infiltrates on CXR. What do you suspect?

A

Atypical pneumonia

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18
Q

What is clinically the most important a-hemolytic strep?

A

Streptococcus pneumoniae

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19
Q

What is used for stereotyping Streptococcus pneumoniae?

A

Capsule

20
Q

What is responsible for releasing heme on blood agar in Streptococcus pneumoniae?

A

Pneumolysin

21
Q

What virulence factor did Griffith’s experiment show was most important in Streptococcus pneumoniae?

A

Capsule

22
Q

Griffith’s experiment discovered what bacterial capability?

A

Natural competence

23
Q

What is natural competence?

A

The ability of bacterial to uptake DNA from the environment

Strep pneumo can do this intra and interspecies

24
Q

What process is known to cause penicillin resistant Streptococcus pneumoniae?

A

Natural competence

25
Q

What induces the alternative pathway of complement in Streptococcus pneumoniae, leading to tissue damage?

A

Techoic acid and peptidoglycan

26
Q

What induces the classical complement pathway in Streptococcus pneumoniae, leading to tissue damage?

A

Pneumolysin

27
Q

What two vaccines are available for pneumoniae prevention?

A

Pneumovax 23 and Prevnar 13

28
Q

What is a possible complication of pneumococcal pneumonia?

A

Bacteremia

29
Q

Meningitis caused by what organism is more likely to lead to neurologic effects and mortality?

A

Streptococcus pneumoniae

30
Q

How is Streptococcus pneumoniae dx?

A

Gram stain and CXR +/- culture

31
Q

Is Streptococcus pneumoniae gram positive or negative?

A

Gram positive

32
Q

What test is used to dx bacteremia and meningitis?

A

Antigen detection

33
Q

What identifying factors would be noted from a culture with Streptococcus pneumoniae?

A

Green on blood agar (a-hemolytic)

Lysis by bile

34
Q

What is the DOC for Streptococcus pneumoniae?

A

Penicillins (beta-lactam)

35
Q

Is H. flu gram positive or negative? What shape?

A

Gram negative rodes

36
Q

Hib was at one time responsible for 95% of H. flu infections, but that number is now reduced to 2-4%. How did this happen?

A

Hib Vaccine

37
Q

What is a major difference between Streptococcus pneumoniae and H. flu?

A

Streptococcus pneumoniae w/o a capsule are avirulent, but H. flu w/o a capsule are virulent

38
Q

What are the virulence factors of H. flu?

A 
Capsule
LOS
Fimbriae
Neuraminidase
IgA protease
39
Q

How is H. flu dx?

A

Gram stain, CXR, +/- culture, +/- LAT

40
Q

Is Klebsiella pneumoniae gram positive or negative? What shape?

A

Gram negative bacillus

41
Q

What is the # cause of pneumoniae in alcoholics? What is a close second?

A

Streptococcus pneumoniae

Klebsiella pneumoniae

42
Q

What organism is a major source of abx resistance world wide?

A

Klebsiella pneumoniae

43
Q

What are the virulence factors of Klebsiella pneumoniae ?

A

Slime capsule
LPS
Adhesins

44
Q

What organism causes necrotizing CAP that is often fatal even with abx treatment?

A

Klebsiella pneumoniae

45
Q

How is Klebsiella pneumoniae dx?

A

Gram stain, CXR (cavities), culture, currant jelly sputum

Susceptibility

46
Q

What is required for treatment of Klebsiella pneumoniae?

A

Susceptibility testing

47
Q

What type of agar should you use to culture Klebsiella pneumoniae? Why?

A

MacConkey Agar
Selects for gram -
Differentiates b/w lactose +/-

Microbiology (23 decks)

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