Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Microbiology Exam 3 > L23-30 > Flashcards

L23-30 Flashcards

You may prefer our related Brainscape-certified flashcards:
Biology 101 flashcards
1
Q

pulmonary edema

A

is either cardiogenic or non-cardiogenic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

pulmonary embolism

A

should be suspected if pt has new or worsening dyspnea, chest pain, sustained hypotension, w/o alternative obvious cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pneumonitis

A

inflammation of lung parenchyma due to chemical exposure, infectious agent, allergic response, or autoimmune disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Aspiration pneumonitis

A

inhalation of vomitus due to marked disturbance in consciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pneumonia

A

inflammatory response of the lung due to infection, associated with specific lung sounds and x-ray findings, may result in respiratory compromise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ARDS

A

a condition involving acute onset, impaired oxygenation with the PaO2/FiO2 ratio < 200, bilateral pulmonary infiltrates on CXR and pulmonary artery occlusion pressure of <18mmHg, no evidence of legated left arterial pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

ALI

A

same as ARDS but PaO2/FiO2 ratio < 300

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

CAP incidence

A

5M cases/yr in US

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

CAP is the _______ leading cause of death in the US

A

6th

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

elderly CAP patient has __________________ after being discharged

A

significant functional decline in daily living; even up to 6mo post-discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

_____% of hospitalized CAP patients released from hospital die within 1 year; _______% of elderly

A

25% ; 33% of elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Aspiration

A

common mechanisms for organisms to get in lung; compromise of natural defenses of tracheobronchial tee allows pt’s saliva + oropharyngeal organism to reach alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Common agents that reach the lung via aspiration

A

streptococcus pneumoniae, klebsiella pneumoniae, oral anaerobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Most common cause of CAP and HAP?

A

aspiration of streptococcus pneumoniae, klebsiella pneumoniae, oral anaerobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Inhalation of aerosols

A

common mechanisms for organisms to get in lung; organisms from another person or an environmental source are inhaled

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Common aerosol agents

A

M. tuberculosis, virus, mycoplasma pneumoniae, chlamydia pneumoniae, fungi (environment), legionella (environment)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Hematogenous Dissemination

A

Spread from a contiguous site or from another site via the blood i.e. staphylococcus aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

3 categories of pneumonia

A

CAP, HAP, HCAP (health-care-associated)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

___% of CAP is treated outpatient

A

80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Major reason for transfer of patient from nursing home to hospital

A

pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Lobar/consolidation pneumonia most likely etiological agents

A

extracellular bacteria or fungal agent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Host-compromised pneumonia most likely etiological agents

A

certain bacterial strains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Atypical (interstitial) pneumonia (close populations) most likely etiological agents

A

Mycoplasma, chlamydia, viral, ureaplasma, legionella, pneumocystis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Chronic pneumonia nodules or abscess/cavitations most likely etiological agents

A

Anaerobes, M. tuberculosis, fungi, Nocardiae, actinomycosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Lobar/Consolidation/Typical pneumonia general mechanism

A

extracellular agent colonizes alveolar sac lining surface, results in serous fluid collection, RBC’s -> rapid multiplication of agent with subsequent infiltration by WBCs displacing air form sac-> white out on CXR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

CBC for Lobar/Consolidation/Typical pneumonia

A

predominantly PMN infiltrate, peripheral leukocytosis (elevated WBC with band forms/left-shift)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Interstitial, Atypical, Patchy pneumonia general mechanism

A

agent replicates in interstitium or lung parenchyma -> inflammation of site -> “lacy” appearance on CXR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

CBC for Interstitial pneumonia

A

Predominant monocyte-macrophage infiltrate (due to INTRAcellular pathogen and virus), peripheral blood leukocyte count remains normal or only slightly elevated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Chronic pneumonia (2-3w -> months) labs (CXR, CBC)

A

CXR: pulmonary nodules (coin-like), abscess, or consolidation; nodule or consolidation: macrophage infiltrates, abscess: PMN elevation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

CAP is caused by

A

aspiration of endogenous flora or inhalation of certain etiologic agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

CAP predisposing factors

A

defective in immune system, impaired respiratory or cardiac function, closed population, increased risk of aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Increased risk of aspiration

A

loss of ciliated mucous escalator or impaired gag reflex due to: antecedent viral infection, drug abuse, deep sleep, cigarette smoker, neuro problems (stroke, coma, seizure)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

HAP in compromised host is caused by

A

aspiration of endogenous flora or bacteremia that seeds lung

34
Q

HAP in compromised host predisposing factors

A

duration of hospital stay (GPR -> GNR), neuro problems (increased aspiration risk), bacteremia that seeds lung (burn patients)

35
Q

HAP iatrogenic is caused by

A

aspiration of endogenous flora or bacteremia that seeds lung

36
Q

HAP iatrogenic predisposing factors

A

anesthesia or narcotic use (increased risk of aspiration), catheterization (bacteremia), use of hospital equipment (ventilator), Abx therapy/chemotherapy

37
Q

VAP etiologic agents

A

S. aureus, S. pneumoniae, H. influenzae, P. aeruginosa, Acinetobacter, enteric bacteria

38
Q

VAP has highest ___________ of any pneumonia

A

mortality rate

39
Q

VAP mechanism

A

secretions around endotracheal tube, can occur within 2 days of ventilator

40
Q

HCAP (health-care associated pneumonia) are CAP patients with at least 1/5 of the following

A

hospitalized for >48hr < 3 mo ago
Lived in nursing home < 3 mo ago
Received outpatient infusion therapy < 1 mo ago
Family member with known MDR-pathogen

41
Q

HCAP patients are treated like

A

HAP patients

42
Q

CAP likely etiologic agents

A

s. pneumoniae, mycoplasma, chlamydia, virus, s. aureus, klebsiella, haemophilus influenzae, legionella

43
Q

HAP or HCAP likely etiologic agents

A

Klebsiella, s. aureus, pseudomonas aeruginosa, acinetobacter, legionella, s. pneumoniae

44
Q

Manifestations of Acute bacterial pneumonia (typical lobar pneumonia)

A

sudden onset, rapid progression of fever, chills, productive cough, chest pains, lobar presentation, tachycardia, tachypnea, leukocytosis (PMN - EC)

45
Q

Manifestations of Atypical pneumonia

A

subacute onset, interstitial involvement on CXR, MINIMAL productive cough, fever, chest pain, or leukocytosis

46
Q

Walking pneumonia

A

atypical pneumonia - mycoplasma

47
Q

Manifestations of chronic pneumonia

A

subacute onset (weeks - months), FUO

48
Q

Pediatric population and neutropenic population vary because they

A

will have a non-productive cough

49
Q

Geriatric population vary because they

A

may ONLY complain of muscle weakness, malaise, disorientation, falling

50
Q

Diagnosis may require

A

CXR, sputum collection, FOB (IC), needle aspiration (anaerobes), pleural fluid, lung biopsy

51
Q

Sputum must be

A

> 25 neutrophils, <10-25 epithelial cells

52
Q

Foul-smelling sputum =

A

anaerobes

53
Q

Induced sputum is required for

A

atypical or chronic (non-productive cough)

54
Q

WBC with predominant PMN =

A

EC bacteria

55
Q

WBC with predominant macrophages =

A

IC bacteria

56
Q

WBC with predominant lymphocytes =

A

viral

57
Q

Lack peptidoglycan

A

Mycoplasma, Ureaplasma

58
Q

Obligate intracellular pathogens

A

Chlamydia, Chlamydophila, Coxiella, viruses

59
Q

Facultative Intracellular pathogens

A

MTB and Legionella

60
Q

MRD-MTB

A

resistant to rifampin and INH

61
Q

XDR-MTB

A

resistant to isoniazid and rifampin, and at least 3/6 SLDs

62
Q

DRSP

A

strep. pneumo resistant to penicillin and others

63
Q

MDRS-P

A

strep. pneumo resistant to 3 or more classes of Abx

64
Q

MRSA

A

staph. aureus resistant to methicillin

65
Q

VISA

A

S. aureus resistant to vancomycin

66
Q

CRKP

A

Klebsiella resistant to ceftazidime

67
Q

CRPA

A

p. aeruginosa resistant to ceftazidime

68
Q

Reye’s Syndrome

A

Child with infection of influenza virus type B or Chickenpox + aspirin

69
Q

Primary complication of flu

A

Abx use –> pneumonia

70
Q

Abx prophylaxis for pneumonia

A

Do not do this - it will do more harm than good

71
Q

3 vaccines to reduce carriage of pneumonal agents

A

Hib, pertussis, PVR-13 S. pneumoniae

72
Q

Pure polysaccharide vaccines exist for

A

S. pneumoniae (23-valent) pneumovax

73
Q

Pure polysaccharide vaccines are

A

type II T-independent

74
Q

Pneumovax vaccine type

A

type II T-independent -> IgM induction but no class switch, short-lasting immunity

75
Q

Pneumovax recommended age

A

> 2 y/o

76
Q

Vaccines with T-dependent ag that reduce bronchiolitis/LRT/pneumonia

A

Diphtheria, Hib, pertussis, flu vaccine, Prenevar (S. pneumo PVR7/13 valent), measles, MTB

77
Q

T-dependent ag vaccines are

A

T-dependent, resulting in class switch for long-term immunity

78
Q

RSV prevention

A

passive immunization with anti-rev monoclonal antibodies (palivizumab)

79
Q

antiviral for influenzavirus

A

neuraminidase inhibitor

80
Q

antiviral for RSV

A

ribavirin

Microbiology Exam 3 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions