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Unit 2 Micobio > L12 Bacterial Pneumonias I > Flashcards

L12 Bacterial Pneumonias I Flashcards

1
Q

2 anatomic types of pneumonias

A
  1. lobar pneumonia

2. bronchopenumonia

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2
Q

main cause of pneumonia

A
  • Bacteria*

others: fungi, viruses, parasites

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3
Q

age more likely to get pneumonia

A

> 65 years

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4
Q

most common infectious cause of death

A

pneumonia

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5
Q

2 types of pneumonia based on where ya get em

A
  1. hospital acquired

2. community acquired

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6
Q

community acquired pneumonia is divided into

A
  1. typical

2. atypical

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7
Q

Typical community acquired pneumonia causes

A

S pneumoniae
H influenzae
K pneumoniae
S aureus

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8
Q

Atypical community acquired pneumonia causes

A

Zoonotic

Nonzoonotic

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9
Q

Atypical community acquired pneumonia involvement

A

extrapulmonary/systemic

used for clinical diagnosis

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10
Q

Beta lactams vs pneumonia

A

not effective against atypical pneumonia

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11
Q

3 zoonotic pathogens that cause pneumonia

A
  1. Chlamydia psittaci
  2. Fracisella tularensis
  3. Coxiella burnetii
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12
Q

3 non-zoonotic pathogens

A
  1. Chlamydia pneumoniae
  2. Mycoplasma pneumoniae
  3. Legionella pneumoniae
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13
Q

Chlamydia psittaci

A

causes psittacosis

zoonotic

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14
Q

Fracisella tularensis

A

causes tularemia

zoonotic

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15
Q

Coxiella burnetii

A

causes Q fever

zoonotic

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16
Q

Chlamydia pneumoniae

A

non-zoonotic

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17
Q

Mycoplasma pneumoniae

A

non-zoonotic

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18
Q

Legionella pneumoniae

A

non-zoonotic

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19
Q

typical pneumonia:
onset
appearance
temperature

A

sudden onset
appear sick
high temps >103

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20
Q

atypical pneumonia:
onset
appearance
temperature

A

gradual onset
appear well
lower temps <103

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21
Q 
typical pneumonia:
chills/shaking
cough
pleurisy
CXR
other
A 
chills common
productive cough
frequent pleurisy
consolidation on CXR
chest pain + SOB
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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
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23
Q

Strep pneumoniae aka

A

pneumococcus

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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
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25
Q

increase risk of pneumococcal pneumonias

A

viral infections

youth or >65 years

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26
Q

reservoir of strep pneumo

A

asymptomatic carriers

irregular normal flora component

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27
Q

the serotypes and vaccines forstrep pneumo are based on

A

its capsule: major virulence factor

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28
Q

the capsule of strep pneumo

A

inhibits phagocytosis
interferes with complement activity
prevents C3b opsonization of the bacteria

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29
Q

receptor that recognizes C3b and C4b on a phagocytic cell

A

CR1

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30
Q

Strep pneumo virulence factors for protection

A
  1. IgA protease
  2. Hydrogen peroxide
    - causes apoptosis in host cells
    - kills competing bacteria
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31
Q

Strep pneumo virulence factors for binding

A
  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
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32
Q

illicits a significant immune response

A

peptidoglycan teichoic acid complex found on G+ pathogens

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33
Q

Pneumolysin does 2 things

A
  1. interacts with target cell membranes to form pores that cause lysis
  2. activates complement
34
Q

2 things in red boxes on a picture of strep pneumo

A

neuraminidase
hyaluronidase
??? idk ???

35
Q

Autolysin

A

causes lysis of pneumococcus and results in release of pneumolysin along with host cell apoptosis

36
Q

Autolysin is released _______ as an attempt to _________

A

in response to antibiotic therapy and stationary phase
-trigger: cell lysis
dampen host immune response

37
Q

local lysis of pneumococcus (ex: abx therapy) results in

A

the release of virulence factors: autolysin

38
Q

pneumonia disease results from

A

heightened immune response to strep pneumo multiplication

39
Q

pneumonia spreads systemically by

A

hematogenous spread through lung’s lymph drainage

40
Q

alveoli fill with

A

fibrous edema fluid
red cells
leukocytes

41
Q

resolution of pneumonia

A

absorption of fluid

phagocytosis of remaining cells

42
Q

purulent sputum from pneumonia is _______

A

rust colored

43
Q

sputum culture of strep pneumo shows

A

G+ lancet diplococci

44
Q

significant sign of strep pneumo in many cases

A

bacteremia

45
Q

other diseases pneumococcus is responsible for

A

otitis media

sinusitis

46
Q

other diseases pneumococcus is responsible for once it disseminates

A

bacteremia
meningitis
arthritis
peritonitis

47
Q

on blood agar strep pneumo looks like

A

small round green, exhibit alpha hemolysis

48
Q

capsules of strep pneumo on culture

A

are non-staining

49
Q

presumptive diagnosis of strep pneumo

A

optochin sensitivity on culture

50
Q

confirmation diagnosis of strep pneumo

A

bile solubility test

bile lyses strep pneumo but doesn’t lyse other alpha hemolytic strep

51
Q

Quellung reaction

A

to observe capsules of strep pneumo

mix organism isolated from patient with anti-capsule serum

52
Q

agglutination tests for

A

capsular polysaccharides

53
Q

genetic probe tests look for

A

strep pneumo specific rRNA

54
Q

2 strep pneumo vaccines

A
  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
Q

klebsiella pneumoniae causes

A

typical community or hospital acquired pneumonia

56
Q

klebsiella pneumoniae morphology

A

nonmotile
G-
bacillus
slime capsule

57
Q

klebsiella pneumoniae is found in

A

normal flora of skin, mouth, intestines

58
Q

klebsiella pneumoniae causes illness in

A

alchoholics
DM
homeless

59
Q

klebsiella pneumoniae can cause

A

secondary disease in patients with other infections

60
Q

virulence factors of klebsiella pneumoniae

A
  1. Polysaccharide factor
    -antiphagocytic
    -prevents MAC mediated lysis
  2. Adhestions
    fimbrial or non-fimbrial, have receptor specificity
61
Q

klebsiella pneumoniae pneumonia is

A

necrotizing –> alveolar desctruction, inflammation, hemorrhage in lungs
predilection for upper lobes
severe illness with rapid onset
often fatal, even with antimicrobial treatment

62
Q

klebsiella pneumoniae symptoms

A

acute onset of high fever

productive cough with thick blood tinged sputum

63
Q

currant jelly sputum

A

klebsiella pneumoniae

64
Q

klebsiella pneumoniae infection can lead to

A

abcess formation
cavitation
pleuritic chest pain

65
Q

CXR of klebsiella pneumoniae

A

cavitation

66
Q

culture of klebsiella pneumoniae

A

mucoid capsule

G-

67
Q

Haemophilus influenzae morphology

A

G-
nonmotile
coccobacillus

68
Q

contains LOS in the cell wall

A

Haemophilus influenzae

69
Q

LOS

A

lipooligosaccharide, similar to LPS

70
Q

Haemophilus influenzae requires _______ for growth

A

factors from RBCs

but do not have hemolytic properties

71
Q

Haemophilus influenzae that has lost its capsule is

A

non-typeable

still capable of causing disease

72
Q

Haemophilus influenzae that is considered normal flora

A

non-typeable

73
Q

Non-typeable Haemophilus influenzae is also prevalent in

A

debilitated hosts: asthma, COPD, smoking, immunocompromised

considered opportunistic

74
Q

Haemophilus influenzae that causes pneumonia in infants/children

A

type B: Hib

75
Q

Non-typeable Haemophilus influenzae causes infection when

A

there’s an imbalance of colonization

76
Q

non-encapsulated Haemophilus influenzae have

A

adhesions: HAP

- bind to mucins on the ciliated epithelial cells of the respiratory tract

77
Q

all Haemophilus influenzae causes

A

loss of cilia, inflammation, sloughing of damaged epithelial cells resulting from secretion of LOS

78
Q

Haemophilus influenzae culture (general)

A

difficult due to growth requirements
poor isolation rates
morphology depends on medium

79
Q

Haemophilus influenzae identification

A

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
Q

Haemophilus influenzae on chocolate agar

A

added X (hemin)
added V (NAD)
37 C
enriched CO2 incubator

81
Q

Haemophilus influenzae on blood agar

A

only grows as satellite phenomenon around other bacteria

colonies: convex, smooth, pale, gray/transparent

Unit 2 Micobio (9 decks)

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