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MICR2220 Medical Bacteriology > L10 - Lower Respiratory Tract Infections > Flashcards

L10 - Lower Respiratory Tract Infections Flashcards

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USMLE® Step 1 flashcards
1
Q

Is the LRT sterile?

A

YES

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2
Q

How is the LRT sterile?

A

Mucociliary escalator

Phagocytosis

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3
Q

What is the virulence of LRT pathogens partly dependent on?

A

ability to evade phagocytosis

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4
Q

What are the 3 ways infectious agent gain entry into LRT by?

A

Inhalation of aerosolised material

aspriation of URT commensals - lose gag reflex when drunk

hametogenous spread

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5
Q

what are the 3 types of pneumonia?

A

community-acquired pneumonia

hospital-acquired pneumonia

ventilator-associated pneumonia

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6
Q

What is community acquired pneumonia?

A

2 subtypes

  • acute lobar pneumonia
  • aytpical penumonia
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7
Q

What is hospital-acquired pneumonia?

A

pneumonia when patients are hospitalised for more than 72h

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8
Q

What is ventilator-associated pneumonia?

A

mechaniclly ventilated for more than 48 h

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9
Q

What bacteria infections lead to CA pneumonia in NEONATES?

A

Group B strep

L. monocytogenes

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10
Q

What bacteria infections lead to CA pneumonia in infants?

A

Encapsulated bacteria

C. trachomatis (abuse)

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11
Q

What bacteria infection lead to CA pneumonia in children/young adults?

A

S. pneumoniae
M. pneumoniae
C. pneumoniae

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12
Q

What bacteria infections lead to CA pneumonia in older adults?

A

S. pneumoniae

Legionella spp. (sick building syndrome)

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13
Q

What bacteria cause HA pneumonia?

A

P.aeurginosa

Gram-neg bacilli, MRSA

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14
Q

What bacteria cause HA pneumonia in CF patients?

A

P. aeruginosa

Burkholderia cepacia complex

S. aureus ( unusual nasty version )

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15
Q

What bacteria cause HA pneumonia in AIDS patients?

A

Pneumocystis Jiroveci

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16
Q

What is lobar pneumonia ALMOST always caused by?

A

S. pneumoniae

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17
Q

What are features of S. pneumoniae?

A

Gram-pos coccus

fastidious

a-haemolysis on FBA

18
Q

What is the main cause of Bronchopneumonia?

A

S. aureus

19
Q

What is bronchopneumonia?

A

secondary infection

‘plums and custard’ sputum

20
Q

What are other causes of bronchopneumonia?

A

K. pneumoniae
Coliforms
P. aeruginosa

21
Q

What is necrotising pneumonia caused by?

A

S.aureus elaborating Panton-Valentine Leukocidin

22
Q

What does Panton-Valentine leukocidin do?

A

beta-barrel toxin

inserts in membrane, produces holes in membrane

23
Q

What is Legionnaire’s disease?

A

Legionellla pneumonia - poor staining gram-neg

symptoms resemble flu

can progress systemic

24
Q

Where does legionella thrive?

A

lakes
rivers
ponds

WARM STAGNANT WATER

25
Q

What is atypical pneumonia also called?

A

walking pneumonia

non-cultivable pneumonia

26
Q

What is used to treat atypical pneumonia?

A

Erythromycin

27
Q

How is pneumonia diagnosed CLINICALLY?

A

CURB65 score of severity in CAP

^ score above 3 get admitted to hospital

X-ray

Ultrasound (make sure it’s not empyema)

28
Q

What do pneumonia diagnosis CLINICAL results inform on?

A

EMPIRICAL THERAPY

29
Q

How is pneumonia diagnosed in the lab?

A

sputum

broncho-alveolar lavage

blood culture

urine

NAAT

immunoassay

30
Q

What do results from lab diagnosis inform on?

A

DIRECTED THERAPY

31
Q

What classes as a good sputum?

A

lack of squames

one organism dominates

32
Q

What us chronic bronchitis?

A

overproduction of mucus

typically H. influenzae

secondary bacterial infections complicate reovery

33
Q

What causes Whooping cough?

A

Bordetella pertussis

34
Q

What are the 2 toxins associated with Bordetella pertussis?

A

Pertussis toxin (PT)

Adenylate cyclase toxin (AC)

35
Q

symptoms of whooping cough?

A

adheres to trachea

interferes with mucociliary escalator

paroxysmal coughing

high-pitched inspiration

36
Q

How does PT toxin act?

A

BINARY (AB)

A-subunit binds G proteins

stops cyclicAMP production

blocks recruitment of immune cells

37
Q

How does AC toxin act?

A

BIFUNCTIONAL

Ac domain - produce greater amounts of cAMP = immune evasion

RTX domain - pore within host cell = leakage

38
Q

What is respiratory Tb caused by?

A

M. tuberculosis
M. bovis
M. MAC (immunocompromised)
M. kansasii

39
Q

Where does Tb cause disease?

A

upper lobes

obligate aerobes

40
Q

Symptoms of Tb?

A

night sweats
fever
weight loss

41
Q

How does the immune system restrict spread of Tb?

A

granuloma

42
Q

How is Tb diagnosed in the lab?

A

observe in sputum/BAL

culture

MGIT - see fluorescence when oxygen gets scavenged

NAAT - sensitivity issues

IFN-y release assay - doesn’t distinguish latent from active

MICR2220 Medical Bacteriology (16 decks)

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