Brainscape's Knowledge GenomeTM

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


See full index

MHD 1 > L85-L88 > Flashcards

L85-L88 Flashcards

1
Q

Fungi are ___ cells; bacteria are ___ cells.

A

Eukaryotic; prokaryotic

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

What are two unique features of fungi that distinguish them from human eukaryotic cells?

A
  1. Chitin (rigid cell wall)

2. Ergosterol (predominant sterol)

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

What is budding?

A

Asexual fungal reproduction of single-celled yeasts

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

How do fungi with hyphae reproduce?

A

Asexually - bits of the hyphae break off and continue to grow as separate entities, or form stalks containing spores

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

How do fungi produce spores?

A

Sexually - two mating cells from hyphae of different strains fungi can mate by fusing together and forming a spore stalk

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

A solitary yeast cell can morph into either a ___ or ___.

A

Germ tube; blastoconidia

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

What do germ tubes become?

A

True hyphae with septa

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

What do blastoconidia become?

A

Pseudohyphae

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

What is the collective term for a mass of hyphae?

A

Mycelium = mold

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

What is the difference between sporangium and conidiophore?

A

Sporangium: enclosed sac containing spores
Condidiophore: specialized hyphal structure that bear conidia (spores)

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

What are arthroconidia?

A

Small barrel shaped structures that become spores by breaking off from hypha at septation points

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

What are chlamydoconidia?

A

Spores at the end of hyphae; contains stored food

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

What are macro and microconidia?

A

Small and large types of conidia in a fungus

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

What are dimorphic fungi?

A

Fungi that are yeast-like at 35 C and mold-like at 25 C

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

What are 4 important examples of dimorphic fungi?

A
  1. Histoplasma capsulatum
  2. Blastomyces dermatitidis
  3. Coccidioides immitis
  4. Sporothrix schenckii
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How are fungi transmitted?

A
  1. Person-to-person (Athletes’ s foot)
  2. Contact with environment (inhalation of spores, traumatic inoculation)
  3. Contact with animals (poop, skin/hair)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Fungal ___ mediate colonization of epithelial surfaces.

A

Adhesins

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

What are some examples of fungi invading natural barriers?

A
  1. Trauma (rose thorns)
  2. Inhalation of spores (Coccioides in dust)
  3. Breakdown of mucosal barriers (catheters)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are some examples of fungi avoiding phagocytosis?

A
  1. Histoplasma multiply in macrophages

2. Cryptococcus has a capsule

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

What type of host immunity is required to eradicate infection with fungi?

A

Cellular immunity (humoral is not protective)

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

What is the most common opportunistic fungal pathogen?

A

Candida

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

Where is Candida normal flora?

A

GI and GU tracts

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

How does Candida appear in body fluids?

A

Oval budding yeasts

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

How does Candida appear in tissues?

A

Yeasts with pseudohyphae

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

What two species of Candida have germ tubes?

A

C. albicans

C. dubliniensis

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

C. dubliniensis typically infects what patient population?

A

Patients who are HIV-positive

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

Which two species of Candida are resistant to fluconazole?

A

C. glabrata

C. krusei (intrinsic resistance)

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

What type of Candida is associated with UTIs?

A

C. glabrata

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

In addition to adherence to mucosal cells, how does Candida invade the host?

A

Production of lytic enzymes to facilitate invasion of epithelial surfaces

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

What are important host defense mechanisms against Candida?

A
  1. Intact skin
  2. Normal bacterial flora
  3. Recognition of cell wall mannan, which activates the alternate complement pathway and leads to Ab formation
  4. Neutrophils and macrophages
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Mucocutaneous forms of candidiasis are associated with defects in ___, while system spread is generally associated with ___.

A

Cell-mediated immunity; neutropenia

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

What are risk factors for infection with Candida?

A
  1. Antibiotic therapy
  2. Steroids
  3. Decreased T cell function
  4. Diabetes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the major clinical manifestations of Candida?

A
  1. Skin and nail infections
  2. Mucocutaneous infection (thrush)
  3. Vulvovaginal
  4. Chronic mucocutaneous candidiasis (disfiguring rash)
  5. Candida endopthalmitis (blindness)
  6. Candida Esophagitis
  7. Systemic infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is chronic mucocutaneous candidiasis?

A

Hereditary immunodeficiency disorder due to malfunction of T cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are the two forms of Candida endopthalmitis?

A
  1. Exogenous - trauma/surgery leads to direct inoculation of anterior chamber
  2. Endogenous - candidemia with seeding of retina and choroid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

How is Candida albicans diagnosed in the lab?

A
  1. Gram stain - produces clusters of round blastoconidia along the hyphae; can also see pseudo and true hyphae
  2. Calcofluor - white fluorescent brightener that binds chitin
  3. Sabouraud dextrose agar - white to cream-colored, pasty, smooth colonies
  4. Production of germ tube
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Aspergillus is a rapidly growing mold found in ___, ___, and ___.

A

Soil; air; construction dust

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Describe the shape and appearance of Aspergillus.

A

Dichotomous branching (Y-shape, acute angle) and septate hyphae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Discuss the pathogenesis of Aspergillus.

A
  1. Inhale spores.
  2. Spores bind to fibronectin
  3. Inhibition of alternate complement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are the clinical manifestations of Aspergillus?

A
  1. Allergic aspergillosis
  2. Fungal ball
  3. Invasive aspergillosis
  4. Dissemination infection
  5. Angioinvasion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Describe the color and structure of Aspergillus fumigatus.

A

Blue-green and fluffy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

___ refers to angiotropic infection produced by various fungi.

A

Mucormycosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Where are agents of mucormycosis found?

A

Fruit, bread, soil, decaying organic debris

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

The species most commonly associated with mucormycosis is ___.

A

Rhizopus arrhizus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Discuss the pathogenesis and prognosis of infections with R. arrhizus.

A

Invade major blood vessels, cause ischemia/necrosis/infarction, produce black pus

Acute, rapidly fatal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What are some host risk factors for mucormycosis?

A
  1. Acidotic diabetes
  2. Malnourished children
  3. Severe burns
  4. Severe leukopenia
  5. Immunosuppressive disorders
  6. Steroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Discuss the pathogenesis of mucormycosis.

A

Inhalation and deposition of spores in the nasal turbinates or direct inoculation of abraded skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What are the clinical manifestations of mucormycosis?

A
  1. Rhinocerebral mucormycosis
  2. Pulmonary
  3. GI tract
  4. Cutaneous
  5. Dissemination
  6. Periorbital mucormycosis (may invade brain cavity)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What populations most frequently experience rhinocerebral mucormycosis?

A

People with diabetes/ketoacidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

How does rhinocerebral mucormycosis present?

A

Face/eye pain, proptosis, progressive signs of involvement of orbital structures; results in death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What populations most frequently experience pulmonary syndromes related to mucormycosis?

A

People with neutropenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What populations most frequently experience GI syndromes related to mucormycosis?

A

Patients with severe malnutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What are the treatment strategies for mucormycosis?

A
  1. Early diagnosis
  2. Reverse underlying risk factors (immunosuppression, hyperglycemia)
  3. Debridement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

How is mucormycosis diagnosed in the lab?

A
  1. Broad, ribbon-like hyphae with 90 degree irregular branching
  2. Wooly white/grey growth
  3. Characteristic sporangia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Fungal infections of keratinized tissues are typically caused by ___.

A

Dermatophytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is onychomycosis?

A

Nail infections caused by any fungus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Transmission of dermatophytosis requires what?

A

Close personal contact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What are the 3 genera of dermatophytes?

A
  1. Epidermophyton
  2. Microsporum
  3. Trichophyton
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Describe tinea pedis.

A

Athlete’s foot, most common dermatophyte infection

Weeping, peeling lesion between 4th and 5th toes; scaling, fissuring, maceration, erythema, itching, burning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Describe tinea capitis.

A

Dermatophytosis of scalp due to invasion of hair

Hair becomes dull, lusterless, breaks near the follicle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Describe tinea corporis.

A

Dermatophytosis of glabrous skin (face, shoulder, arms)

Classic ringworm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Describe tinea cruris.

A

Infection of groin, perineum, scrotum, perianal area

More common in men

Erythema, pustule formation, hyperpigmentation, itching, burning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Discuss the pathogenesis of dermatophytes.

A

Inoculation via minor trauma, penetration of stratum corneum, proliferation, lateral spread

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

How is dermatophytosis diagnosed in the lab?

A
  1. KOH preparation

2. Examine hair under Wood’s light

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Describe the shape of Cryptococcus neoformans.

A

Round (not oval) with polysaccharide capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Where is C. neoformans found?

A

Worldwide, pigeon poop, soil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

C. gattii is endemic to what locations?

A

SoCal, Mexico, Pacific Northwest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What does a positive skin test for Cryptococcosis indicate?

A

Exposure (not illness)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Discuss the pathogenesis of Cryptococcosis.

A

Inhalation from environment to lungs, from there to CNS

Capsule blocks complement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What are the clinical manifestations of Cryptococcosis?

A

Meningoencephalitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What are the symptoms of meningoencephalitis?

A

Headache, nausea, gait abnormalities, dementia, irritability, CN abnormalities, hydrocephalus, fever, nuchal rigidity, coma, death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What types of skin lesions may be seen in Cryptococcosis?

A

Raised skin lesions with dissemination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

How is Cryptococcosis diagnosed in the lab?

A
  1. Fast growing, soft, mucoid, cream/pink/yellow-brown
  2. Encapsulated yeast in India ink preparation
  3. Standard: flow assay/latex agglutination for Ag detection
  4. Gram stain
  5. GMS
  6. Mucicarmine stain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

How is C. neoformans differentiated from other forms of Cryptococcus?

A

Ability to grow at 37 degrees C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Where is Histoplasma capsulatum found?

A

Soil, bird/bat droppings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Where is H. capsulatum found in the world?

A

OH/Mississippi River Valleys

77
Q

Describe the yeast and mold phases of H. capsulatum.

A

Yeast: found in macrophages
Mold: tuberculate macroconidia

No capsule

78
Q

What are the clinical manifestations of H. capsulatum?

A
  1. Asymptomatic
  2. Pulmonary (infiltrates, lymphadenopathy, cavitating lesion, fever/night sweat/weight loss)
  3. Disseminated
79
Q

Discuss the pathogenesis of H. capsulatum.

A

Conidia inhaled, convert to yeast, which are phagocytosed by macrophages

Infection of RES by yeasts growing in macrophages

80
Q

What is the primary lesions seen in H. capsulatum?

A

Granuloma in the lung

81
Q

How is Histoplasmosis diagnosed?

A
  1. Standard: urine antigen test

Can do skin test and bone marrow culture

82
Q

__ budding yeast cells are typical in H. capsulatum.

A

Intracellular

83
Q

H. capsulatum predominates at the ___ portion of lesions.

84
Q

Describe H. caspulatum at 25 C.

A
  1. Slow growing
  2. Granular to cottony
  3. White, then buff brown
  4. Hyphae are septate and hyaline
  5. Macro and microconidia
85
Q

Describe the yeast and mold forms of Blastomyces dermatitids.

A

Yeast: large thick walled with broad based buds
Mold: not unique

86
Q

Where in the US is Blastomyces dermatitidis found?

A

Central US

87
Q

Blastomyces dermatitidis is associated with ___ and ___.

A

Soil; wood

88
Q

What are the clinical manifestations of Blastomyces dermatitidis?

A
  1. Pulmonary - acute or chronic pneumonia
  2. Skin lesions
  3. Lytic bone lesions
  4. Disseminated disease
89
Q

Describe the appearance of Blastomycoces dermatiditis at 25 C.

A

Membranous texture
White to beige
Septate hyaline hyphae and unbranched short conidiophores

Look like lollipops

90
Q

Describe the appearance of Blastomycoces dermatiditis at 37 C.

A

Appears as budding yeast cells with a double-contoured refractile wall and broad base budding

91
Q

Where in the US is Coccidiodomycosis found?

92
Q

Describe the yeast and mold forms of Coccidiodes.

A

Tissue: spherule filled with endospores
Culture: mold with barrel shaped arthroconidia

93
Q

Which type of Coccidiodes is found in CA and which is found outside CA?

A

In CA: C. immitis

Outside CA: C. posadasii

94
Q

Discuss the pathogenesis of Coccidioides.

A

Inhalation of arthroconidia bypasses upper airway into alveoli

Monocytes ingest; arthroconidia convert to spherules

95
Q

What are the clinical manifestations of Coccidiomycosis?

A

Fever, cough, chest pain, malaise
Dissemination
Erythema nodosum

96
Q

How is Coccidiomycosis diagnosed in the lab?

A
  1. Microscopic exam to detect spherules
  2. Culture - demonstrate alternating arthroconidia
  3. Skin test
  4. Serology
97
Q

What are two causes of subcutaneous mycoses?

A
  1. Sporotrichosis

2. Chromoblastomycosis

98
Q

Describe the yeast and mold forms of Sporothrix schencki.

A

Yeast: cigar-shape
Mold: daisy-like conidiophore

99
Q

Where is Sporothrix schenckii found?

A

Soil, rose thorns, moss

100
Q

What are the clinical manifestations of Sporotrichosis?

A

Papular skin lesions that enlarge and ulcerates, appearance of subcutaneous firm nodules

101
Q

Discuss the pathogenesis of Sporothrix.

A

Inhalation or traumatic inoculation, multiplication, pyogenic/granulomatous response, spread via lymphatics

102
Q

What is a post-traumatic chronic infection of subcutaneous tissue and how does it appear?

A

Chromoblastomycosis; verrucous cauliflower-like papules on lower extremities

103
Q

How does Chromoblastomycosis appear on histology?

A

Copper pennies

104
Q

Only ___% of people infected with TB develop disease in their lifetimes. The remainder have ___ infections.

A

7-10; latent

105
Q

Of those who are infected with TB, ___% of patients with AIDS will develop active disease per ___.

106
Q

Who is at risk for being infected with TB?

A
  1. Close contacts
  2. Foreign-born persons from areas where TB is common
  3. Medically underserved, low income populations
  4. Residents of long-term care facilities
  5. Persons who inject drugs
  6. Migrant farm workers and homeless persons
  7. Occupationally exposed persons
107
Q

Who is at risk for progressing to disease with TB?

A
  1. People with HIV
  2. People who were recently infected with TB
  3. Certain medical conditions
  4. Injection drug use
  5. History of inadequately treated TB
108
Q

How is TB transmitted?

109
Q

True or false - extrapulmonary TB is rarely contagious.

110
Q

Discuss the pathogenesis of TB.

A

Pathogen gains access to alveolar macrophages, proliferates, and spreads via lymph nodes and blood.

111
Q

What is the primary site of lung infection in TB?

A

Ghon focus

112
Q

What is the Ghon focus + mediastinal lymph nodes?

A

Ghon complex

113
Q

What is a calcified Ghon complex?

A

Ranke complex

114
Q

The vast minority of secondary (reactivation) TB disease is ___.

A

Extrapulmonary (most are pulmonary)

115
Q

What is seen on CXR in TB?

A

Upper lung field infiltrates, cavities

116
Q

What are common sites of extrapulmonary TB?

A

Brain, epiphyses of long bones, kidneys, vertebral bodies, lymph nodes

117
Q

In immunocompetent patients, ___% have pulmonary TB. ___% have XPTB. What about patients with AIDS?

A

85; 15

1/3 - pulmonary
1/3 - XPTB
1/3 - both

118
Q

Which type of XPTB is most common in children? Which type is most common in older patients?

A

Children - CNS TB

Older patients - TB pericarditis

119
Q

What is osteomyelitis of the spine (TB)?

A

Pott’s disease

120
Q

What are the groups of non-TB mycobacteria?

A

Group 1: photochromogens
Group 2: scotochromogens
Group 3: nonphotochromogens
Group 4: rapid growers

121
Q

Where is NTM found?

A

Bioaerosols, water, soil

122
Q

What are predisposing conditions for NTM lung disease?

A

Structural lung abnormalities (COPD, bronchiectasis, IPF, chest radiotherapy, congenital cystic abnormalities, previous pulmonary emboli/infarct, recurrent aspiration pneumonia)

123
Q

How does NTM infection contrast with TB?

A
  1. NTM is environmental in origin (not human-to-human)
  2. NTM requires an underlying predisposition
  3. NTM does not have a prolonged latent phase
  4. NTM infections do not disseminate outside the lungs
  5. No skin/Quantiferon testing for NTM
  6. CXR presentations of NTM may differ from TB
124
Q

What are the most common infections in the US?

125
Q

What are the syndromes included under the designation of URI?

A
  1. Rhinitis
  2. Sinusitis
  3. Otitis
  4. Pharyngitis
  5. Laryngotracheitis
  6. Epiglotitis
  7. Bronchitis
126
Q

The vast majority of URIs are ___ and ___.

A

Viral; self-limited

127
Q

Rhinitis refers to a “___.”

A

Runny nose

128
Q

What are some causes of rhinitis?

A

Infections, allergies, over-use of nasal decongestants, systemic disease

129
Q

Infectious rhinitis = “___.”

A

The common cold

130
Q

What are the etiologic agents in the vast majority of infectious rhinitis cases?

131
Q

Acute sinusitis is commonly preceded by ___.

A

Acute or chronic rhinitis

132
Q

What is an important contributor to the pathogenesis of acute sinusitis?

A

Impaired drainage of the sinuses by inflammatory edema of the mucosa

133
Q

What are the clinical symptoms of acute sinusitis?

A

Congestion, sinus tenderness, fevers, purulent nasal drainage

134
Q

90% of acute sinusitis cases are caused by viruses. What are the bacterial causes?

A

Bacteria in the oronasal cavity - S. pneumoniae, H. influenzae, Moraxella, oral anaerobes

135
Q

If there is strong suspicion of bacterial sinusitis, what antibiotics should be given?

A

Ampicillin
Amoxicillin
Bactrim
Augmentin (amoxicillin-clavulanate)

136
Q

How do patients with pharyngitis present?

A

Sore throat and fever

137
Q

70% of pharyngitis cases are caused by viruses. What bacteria can cause this?

A

Group A or B Strep - Strep throat - high fevers and patchy tonsillar exudates

138
Q

Epiglottitis occurs most often in ___. How do they present?

A

Children age 2-7

High fever, sore throat, drooling, sitting upright, signs of systemic toxicity

139
Q

Why might epiglottitis become a medical emergency?

A

Swelling can lead to airway obstruction

140
Q

What can be seen on CXR in epiglottitis?

A

Thumb sign (enlarged epiglottis protruding from the anterior wall of the hypopharynx)

141
Q

What are the most common etiologic organisms of epiglottitis?

A

H. influenzae
GAS
H. parainfluenzae

142
Q

How is epiglottitis treated?

A

Assess/secure airway
Augmentin (amoxicillin-clavulanate)
Unasyn (ampicillin-sulbactam)
3rd gen cephalosporin

143
Q

What is the typical presentation of acute bronchitis?

A

Cough with purulent sputum production for 5+ days

144
Q

Acute bronchitis is most commonly caused by viruses. What are common bacterial agents?

A

Mycoplasma
S. pneumoniae
H. influenzae
B. pertussis

145
Q

What is the treatment for acute bronchitis?

A

Supportive care

Not cough syrups, anti-tussives, or mucolytics (don’t work)

146
Q

What is a lower airway infection/inflammation?

147
Q

What are the 5 possible routes for pathogens to reach the lower airways?

A
  1. Direct inhalation
  2. Aspiration of upper airway contents
  3. Spread along the mucous membrane surface
  4. Hematogenous spread
  5. Direct penetration (rare)
148
Q

What are risk factors for developing pneumonia?

A
  1. Old age
  2. Underlying pulmonary disease
  3. Smoking
  4. Recent viral illness
  5. DM
  6. CKD
  7. Immunodeficiency
149
Q

What are the symptoms of pneumonia?

A

Cough, sputum production, shortness of breath, fever

Elderly patients may not have this typical constellation and may present with mental status changes/not acting quite themselves

150
Q

What are signs of pneumonia on exam?

A

Crackles, rhonchi, increased bronchial breath sounds, vocal fremitus, dullness to percussion over the areas of consolidation, leukocytosis

151
Q

What will CXR show in pneumonia?

A

Focal infiltrate, maybe air bronchograms

152
Q

What is the difference between bronchopneumonia and lobar pneumonia?

A

Bronchpneumonia: patchy, >1 lobe, infection starts in bronchioles and spreads to parenchyma

Lobar: contiguous, 1 lobe, S. pneumo

153
Q

What are the 7 syndromes of pneumonia?

A
  1. Community-acquired bacterial
  2. Community-acquired viral
  3. Nosocomial
  4. Aspiration
  5. Chronic
  6. Necrotizing/abscess
  7. Immunocompromised host
154
Q

What are the common etiologic agents of community acquired bacterial pneumonia?

A

Common: S. pneumo, H. flu, M. catarrhalis, S. aureus

Less common: Mycoplasma pneumoniae, Chlamydia pneumonia, Legionella pneumophilia - cause “walking pneumonia”

155
Q

How is Legionella diagnosed?

A

Urinary antigen

156
Q

How do patients who have community acquired bacterial pneumonia with S. pneumoniae present?

A

Fever, shaking chills (single chill), rusty colored sputum, dyspnea, pleuritic chest pain

157
Q

How is community acquired bacterial pneumonia treated?

A

Outpatient: macrolides or doxycycline
Outpatient with comorbid illness/recent antibiotic therapy - respiratory FQ
Inpatient: macrolid + beta lactam

At least 5 days

158
Q

What are the most common viral causes of pneumonia?

A

Influenza
RSV
Adenovirus
Parainfluenza

159
Q

What are the symptoms of influenza?

A

Fever, cough, headache, sore throat, feel MISERABLE

160
Q

What are the antiviral therapies to treat influenza?

A

Oseltamivir

Zanamivir

161
Q

How do children with community acquired pneumonia present?

A

Tachypnea, fever, mild cough, dyspnea

162
Q

What tends to cause community acquired pneumonia in children under 2?

163
Q

What tends to cause community acquired pneumonia in children 5-10?

A

Mycoplasma

164
Q

What tends to cause community acquired pneumonia in children 10-16?

A

S. pneumoniae, Chlamydia

165
Q

What are the common etiologic agents of nosocomial pneumonia?

A 
K. pneumoniae
E. coli
Enterobacter
Proteus
Serratia
Pseudomonoas
Acinetobacter
MRSA
166
Q

What is the treatment for nosocomial pneumonia?

A

Anti-pseudomonal cephalosporin
Anti-pseudomonal carbapenem
Beta lactam + beta lactamase
Add Vancomycin if MRSA is concerning

167
Q

Who typically gets aspiration pneumonia?

A

Debilitated patients
Loss of gag/swallow reflex
Repeated emesis

168
Q

What organisms are involved in aspiration pneumonia?

A

Polymicrobial - mix of GN aerobes and anaerobes

169
Q

How is aspiration pneumonia treated?

A

Beta lactam + beta lactamase

3rd generation cephalosporin + metronidazole

170
Q

What characterizes chronic pneumonia?

A

Subacute onset of symptoms of 6+ weeks

171
Q

What causes chronic pneumonia?

A

Slow growing organisms (mycobacterium, nocardia, actinomyces)
Endemic fungi (Histoplasmosis, Blastomycosis, Coccidiomycosis)
Coxiella
Tularemia
Obstructed airway

172
Q

What can cause abscess pneumonia?

A

Necrotizing pneumonia (S. aureus, S. pneumo, Klebsiella, Pseudomonas)
Aspiration
Tooth abscess
Septic emboli

173
Q

What bugs can cause abscess pneumonia?

A

Fusobacterium
Bacteroides
Peptostreptococcus
Aerobic/anaerobic strep and GN rods

174
Q

How is abscess pneumonia treated?

A

Piperacillin-tazobactam (Zosyn)
Clindamycin

4-6 weeks

175
Q

What are causes of neutrophil dysfunction?

A

Chemo, leukemia, CGD

176
Q

What organisms lead to pneumonia in people with neutrophil dysfunction?

A

GN rods
Staph
Aspergillus
Candida

177
Q

What are causes of T cell dysfunction?

A

AIDS
T-cell lymphoma
Solid organ transplant
DiGeorge syndrome

178
Q

What organisms lead to pneumonia in people with T cell dysfunction?

A 
CMV
Herpes Simplex Virus
Pneumocystis
Listeria
Candida
Aspergillus
Cryptococcus
Mycobacteria
179
Q

What are causes of B cell dysfunction?

A

Splenectomy
Lymphoma
Myeloma
Gamma globulin deficiency

180
Q

What organisms lead to pneumonia in people with B cell dysfunction?

A 
S. pneumo
H. flu
Neisseria
Klebsiella
E. coli
Giardia
181
Q

Exposure to bat or bird droppings may lead to pneumonia with ___.

A

Histoplasma capsulatum

182
Q

Exposure to birds may lead to pneumonia with ___.

A

Chlamydophila psittaci

183
Q

Exposure to rabbits may lead to pneumonia with ___.

184
Q

Exposure to farm animals may lead to pneumonia with ___.

A

Coxiella burnetti

185
Q

Hotel or cruise ships may lead to pneumonia with ___.

A

Legionella

186
Q

Travel to SW USA may lead to pneumonia with ___.

A

Coccidiosis

187
Q

Structural lung disease may lead to pneumonia with ___.

A

Pseudomonas

188
Q

Alcoholism may lead to pneumonia with ___ or ___.

A

Anaerobes; Klebsiella

MHD 1 (58 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions