L12 Bacterial Pneumonias I Flashcards
1
Q
2 anatomic types of pneumonias
A
- lobar pneumonia
2. bronchopenumonia
2
Q
main cause of pneumonia
A
- Bacteria*
others: fungi, viruses, parasites
3
Q
age more likely to get pneumonia
A
> 65 years
4
Q
most common infectious cause of death
A
pneumonia
5
Q
2 types of pneumonia based on where ya get em
A
- hospital acquired
2. community acquired
6
Q
community acquired pneumonia is divided into
A
- typical
2. atypical
7
Q
Typical community acquired pneumonia causes
A
S pneumoniae
H influenzae
K pneumoniae
S aureus
8
Q
Atypical community acquired pneumonia causes
A
Zoonotic
Nonzoonotic
9
Q
Atypical community acquired pneumonia involvement
A
extrapulmonary/systemic
used for clinical diagnosis
10
Q
Beta lactams vs pneumonia
A
not effective against atypical pneumonia
11
Q
3 zoonotic pathogens that cause pneumonia
A
- Chlamydia psittaci
- Fracisella tularensis
- Coxiella burnetii
12
Q
3 non-zoonotic pathogens
A
- Chlamydia pneumoniae
- Mycoplasma pneumoniae
- Legionella pneumoniae
13
Q
Chlamydia psittaci
A
causes psittacosis
zoonotic
14
Q
Fracisella tularensis
A
causes tularemia
zoonotic
15
Q
Coxiella burnetii
A
causes Q fever
zoonotic
16
Q
Chlamydia pneumoniae
A
non-zoonotic
17
Q
Mycoplasma pneumoniae
A
non-zoonotic
18
Q
Legionella pneumoniae
A
non-zoonotic
19
Q
typical pneumonia:
onset
appearance
temperature
A
sudden onset
appear sick
high temps >103
20
Q
atypical pneumonia:
onset
appearance
temperature
A
gradual onset
appear well
lower temps <103
21
Q
typical pneumonia: chills/shaking cough pleurisy CXR other
A
chills common productive cough frequent pleurisy consolidation on CXR chest pain + SOB
22
Q
atypical pneumonia: chills/shaking cough pleurisy CXR other
A
no chills non-productive cough no pleurisy patchy infiltrates, non-defined on CXR body aches, diarrhea, abdominal pain
23
Q
Strep pneumoniae aka
A
pneumococcus
24
Q
Strep pneumonia morphology
A
G+ Lancet shaped diplococcus Alpha hemolytic: greenish colonies optochin sensitivity encapsulated strains are virulent causes typical community acquired pneumoniae 90 serotypes, only some cause disease
25
increase risk of pneumococcal pneumonias
viral infections
| youth or >65 years
26
reservoir of strep pneumo
asymptomatic carriers
| irregular normal flora component
27
the serotypes and vaccines forstrep pneumo are based on
its capsule: major virulence factor
28
the capsule of strep pneumo
inhibits phagocytosis
interferes with complement activity
prevents C3b opsonization of the bacteria
29
receptor that recognizes C3b and C4b on a phagocytic cell
CR1
30
Strep pneumo virulence factors for protection
1. IgA protease
2. Hydrogen peroxide
- causes apoptosis in host cells
- kills competing bacteria
31
Strep pneumo virulence factors for binding
1. Pili
- colonize upper respiratory tract
- activate production of TNF (lots)
2. Surface proteins
- choline binding proteins: adhesion interact with carbodydrates on the surface of pulmonary epithelial cells
32
illicits a significant immune response
peptidoglycan teichoic acid complex found on G+ pathogens
33
Pneumolysin does 2 things
1. interacts with target cell membranes to form pores that cause lysis
2. activates complement
34
2 things in red boxes on a picture of strep pneumo
neuraminidase
hyaluronidase
??? idk ???
35
Autolysin
causes lysis of pneumococcus and results in release of pneumolysin along with host cell apoptosis
36
Autolysin is released _______ as an attempt to _________
in response to antibiotic therapy and stationary phase
-trigger: cell lysis
dampen host immune response
37
local lysis of pneumococcus (ex: abx therapy) results in
the release of virulence factors: autolysin
38
pneumonia disease results from
heightened immune response to strep pneumo multiplication
39
pneumonia spreads systemically by
hematogenous spread through lung's lymph drainage
40
alveoli fill with
fibrous edema fluid
red cells
leukocytes
41
resolution of pneumonia
absorption of fluid
| phagocytosis of remaining cells
42
purulent sputum from pneumonia is _______
rust colored
43
sputum culture of strep pneumo shows
G+ lancet diplococci
44
significant sign of strep pneumo in many cases
bacteremia
45
other diseases pneumococcus is responsible for
otitis media
| sinusitis
46
other diseases pneumococcus is responsible for once it disseminates
bacteremia
meningitis
arthritis
peritonitis
47
on blood agar strep pneumo looks like
small round green, exhibit alpha hemolysis
48
capsules of strep pneumo on culture
are non-staining
49
presumptive diagnosis of strep pneumo
optochin sensitivity on culture
50
confirmation diagnosis of strep pneumo
bile solubility test
| bile lyses strep pneumo but doesn't lyse other alpha hemolytic strep
51
Quellung reaction
to observe capsules of strep pneumo
| mix organism isolated from patient with anti-capsule serum
52
agglutination tests for
capsular polysaccharides
53
genetic probe tests look for
strep pneumo specific rRNA
54
2 strep pneumo vaccines
1. 23 valent capusular polyscaccharide vaccine
- for >65 years old or predisposing factors
2. 13 valent capsular polysaccharide vaccine
- conjugated to a carrier protein --> more immunogenic
- also accounts for penicilline resistant strains
55
klebsiella pneumoniae causes
typical community or *hospital acquired* pneumonia
56
klebsiella pneumoniae morphology
nonmotile
G-
bacillus
slime capsule
57
klebsiella pneumoniae is found in
normal flora of skin, mouth, intestines
58
klebsiella pneumoniae causes illness in
alchoholics
DM
homeless
59
klebsiella pneumoniae can cause
secondary disease in patients with other infections
60
virulence factors of klebsiella pneumoniae
1. *Polysaccharide factor*
-antiphagocytic
-prevents MAC mediated lysis
2. Adhestions
fimbrial or non-fimbrial, have receptor specificity
61
klebsiella pneumoniae pneumonia is
necrotizing --> alveolar desctruction, inflammation, hemorrhage in lungs
predilection for upper lobes
severe illness with rapid onset
often fatal, even with antimicrobial treatment
62
klebsiella pneumoniae symptoms
acute onset of high fever
| productive cough with thick blood tinged sputum
63
currant jelly sputum
klebsiella pneumoniae
64
klebsiella pneumoniae infection can lead to
abcess formation
cavitation
pleuritic chest pain
65
CXR of klebsiella pneumoniae
cavitation
66
culture of klebsiella pneumoniae
mucoid capsule
| G-
67
Haemophilus influenzae morphology
G-
nonmotile
coccobacillus
68
contains LOS in the cell wall
Haemophilus influenzae
69
LOS
lipooligosaccharide, similar to LPS
70
Haemophilus influenzae requires _______ for growth
factors from RBCs
| but do not have hemolytic properties
71
Haemophilus influenzae that has lost its capsule is
non-typeable
| still capable of causing disease
72
Haemophilus influenzae that is considered normal flora
non-typeable
73
Non-typeable Haemophilus influenzae is also prevalent in
debilitated hosts: asthma, COPD, smoking, immunocompromised
| considered opportunistic
74
Haemophilus influenzae that causes pneumonia in infants/children
type B: Hib
75
Non-typeable Haemophilus influenzae causes infection when
there's an imbalance of colonization
76
non-encapsulated Haemophilus influenzae have
adhesions: HAP
| - bind to mucins on the ciliated epithelial cells of the respiratory tract
77
all Haemophilus influenzae causes
loss of cilia, inflammation, sloughing of damaged epithelial cells resulting from secretion of LOS
78
Haemophilus influenzae culture (general)
difficult due to growth requirements
poor isolation rates
morphology depends on medium
79
Haemophilus influenzae identification
gram stain
serological testing to determine if encapsulated
Latex particle agglutination test (LAT)
-relies on antigen, not viable bacteria, used during/after abx treatment
-easier than culture
80
Haemophilus influenzae on chocolate agar
added X (hemin)
added V (NAD)
37 C
enriched CO2 incubator
81
Haemophilus influenzae on blood agar
only grows as satellite phenomenon around other bacteria
| colonies: convex, smooth, pale, gray/transparent
