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Microbiology test 2 > Lect 12 > Flashcards

Lect 12 Flashcards

1
Q

lobar pneumonia

A

involvement of the entire lobe

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2
Q

what is PNA

A

inflammation of the lung parenchyma

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3
Q

causes of PNA in people with no known predisposing factors

A
  • mycoplasma pneumoniae
  • streptococcus pneumoniae
  • chlamydophila pneumoniae
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4
Q

causes of PNA in alcoholics/vagrants

A
  • streptococcus pneumonia
  • klebsiella pneumoniae
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5
Q

causes of PNA in people with underlying disease

A
  • streptococcus pneumoniae
  • H. influenzae
  • pseudomonas aeruginosa
  • staph. aureus
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6
Q

causes of PNA in people with persons requiring ventilation

A
  • klebsiella pneumoniae
  • pseudomonas aeruginosa
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7
Q

causes of PNA in people with travel/occupational exposure

A

Legionella pneumophila

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8
Q

what is 6th leading cause of death and most common infectious cause of death

A

PNA

  • mortality rate is 25% in infections requiring hospital admission
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9
Q

PNA can be divided into what two groups

A
  • hospital acquired (Nosocomial)
    • develops 72 hours or more following admission
  • community acquired (CAP)
    • develops in people with limited or no contact with medical settings
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10
Q

community acquired PNA can be divded into what two groups

A
  • typical vs atypical
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11
Q

typical CAP involves infection from which organisms

A
  • S. Pneumoniae
  • H. influenzae
  • K. pneumoniae
  • S. aureus
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12
Q

atypical CAP involves infection from which organisms

A
  • zoonotic
  • nonzoonotic
    • chlamydia pneumoniae
    • mycoplasma pneumoniae
    • legionalle pneumoniae
  • usually have extrapulmonary involvement and cause systemic infections
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13
Q

what types of ABx will not work against atypical PNA

A
  • PCN because atypical PNA are unresponsive to B-lactams
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14
Q

clinical presentation

  • sudeen onset
  • sick appearance
  • high temperature (>103)
  • productive cough
  • pleurisy
  • consoldiation on CXR
  • CP, SOB
A

typical bacterial PNA

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15
Q

clinical presentation

  • gradual onset
  • well appearance
  • lower temperature <103
  • non productive cough
  • patchy infiltrates on CXR
  • diarrhea, abd pain
A

atypical bacterial PNA

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16
Q

streptococcus pneumoniae

  • gram status
  • shape
A
  • gram positive
  • lancet shaped diplococcus
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17
Q

streptococcus pneumoniae: typical presentation on blood agar plate

A
  • alpha hemolytic colonies
    • green colored colonies
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18
Q

when does streptococcus pneumoniae occur (season)

A

occurs more colder, wetter months

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19
Q

streptococcus pneumoniae incidence is in what patient populations

A
  • young children
  • adults > 65 yo
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20
Q

reervoir for streptococcus pneumoniae

A

asymptomatic carriers

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21
Q

streptococcus pneumoniae virulence factor (capsule)

A
  • capsule
    • inhibits phagocytosis
    • interferes with complement activity
    • prevents C3b opsonization of the bacteria
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22
Q

streptococcus pneumoniae virulence factors (seen in gram positive bacteria)

A
  • peptidoglycan-teichoic acid complex
    • illicits a significant immune response
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23
Q

virulence factor specific to streptococcus pneumoniae

A
  • Pneumolysin
    • interacts with target cell membrane
    • forms transmembrane pores
    • results in cell lysis
    • activates complement
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24
Q

streptococcus pneumoniae virulence factor: autolysin

A
  • causes lysis of pneumococcus and results in release of pneymolysin and release of other virulence factors
  • in response to antibiotic therapy and stationary phase
  • attempt by organism to dampen host immune response by overwhelming it
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25
Q

how does consolidation form

A
  • pneumococcus enters respiratory tract and multiples in tissue, stimulating immune response
  • fibrinous edema fluid into alveoli followed by red cells and leukocytes
26
Q

clinical presentation

  • sudden onset of fever
  • CP
  • productive cough with rust colored purulent sputum
A

strep pneumoniae = pneumococcus

27
Q

Pneumococcus is sensitive to

A

optochin sensitivity

28
Q

what is the bile solubility test

A
  • bile will lyse S. pneumoniae
  • no effect on other a-hemolytic strep
29
Q

What is the Quellung reaction

A
  • function: to observe capsules
  • If the reaction is positive, the capsule becomes opaque and appears to enlarge
30
Q

how is pneumococcus diagnosed

A
  • agglutination test for capsular polysaccharides
  • genetic probe test
    • looks for S. pneumoniae specific rRNA
31
Q

DOC treatment of pneumococcus

A

Penicillin G

32
Q

prevention against pneumococcus

A
  • vaccines
    • 23-valent capsular polysaccharide vaccine
      • recommended persons > 65 yo
    • 13-valent capsular polysaccharide vaccine
      • >80% infections in childnre < 6 yo
      • accountable for 75% of strains of pcn-resistent pneumococcus
33
Q

klebsiella pneumoniae can cause both

A
  • typical CAP and nosocomial (hospital)
34
Q

Klebsiella pneumoniae

  • gram status
  • shape
  • motility
A
  • gram negative
  • bacillus
  • non-motile
35
Q

where is Klebsiella pneumoniae normally found

A
  • normal flora of mouth, skin, intestines
36
Q

Klebsiella pneumoniae causes pna is what patient populations

A
  • alcoholics
  • persons with DM
37
Q

virulence factors of Klebsiella pneumoniae

A
  • Primary: coated by a thick slimy polysaccharide capsule
    • ​antiphagocytic
    • prevents MAC-mediated lysis
  • adhesins
38
Q

which organism causes an aggressive necrotizing CAP with predilection for the upper lobes; leads to abscess formation and cavitation; often fatal even with Abx treatment

A

Klebsiella pneumoniae

  • causes necrotic destruction of alveolar spaces, inflammation, and hemorrhage in lung
39
Q

clinical presentation

  • acute onset of high fever
  • productive cough with thick, blood tinged currant jelly sputum
A

Klebsiella pneumoniae

40
Q

how is Klebsiella pneumoniae diagnosed

A
  • gram stain
  • currant jelly sputum
  • cxr - cavitation
41
Q

Klebsiella pneumoniae is resistant to what type of abx

A

Klebsiella pneumoniae produces beta lactamase

42
Q

DOC treatment of Klebsiella pneumoniae

A
  • combination
    • aminoglycosides
    • 3rd generation cephalosporin
    • fluoroquinolones
43
Q

mycoplasma pneumoniae causes what type of PNA

A

atypical CAP

44
Q

which organism that causes PNA lacks a cell wall and has a “fried egg” appearance in culture

A

Mycoplasma pneumoniae

45
Q

Mycoplasma pneumoniae have plasma membranes that contain what compound

A

sterols

46
Q

clinical presentation

  • non-productive cough that lasts 1-2 months
  • fevers, crackles, HA, CP
  • relapses are common
A

Mycoplasma pneumoniae

47
Q

virulence factors of Mycoplasma pneumoniae

A
  • hydrogen peroxide
    • damages epithelium
    • prevents clearance of airway and results in colonization of airways
  • evades immune system by fusing to host cell membrane through sterols
48
Q

Mycoplasma pneumoniae can also cause what other conditions

A
  • otitis
  • rhinitis
  • pharyngitis
  • tracheobronchitis
49
Q

Mycoplasma pneumoniae usually affects what age range

A

5-20 yo

50
Q

reservoir of Mycoplasma pneumoniae

A

humans

  • transmitted person to person via respiratory droplets
51
Q

Mycoplasma pneumoniae diagnosis

A
  • CXR: patchy infiltrates
  • sputum culture
  • cold agglutinin assay
52
Q

DOC treatment of Mycoplasma pneumoniae

A
  • azithromycin/tetracycline
53
Q

chlamydophila pneumoniae causes what type of PNA

A

atypical PNA

54
Q

chlamydophila pneumoniae

  • gram
  • motility
  • shape
A
  • gram negative
  • non motile
  • coccoid
55
Q

chlamydophila pneumoniae exists in what two forms

A
  • ** obligate intracellular parasites
  • 2 forms
    • elementary body: infectious form
    • reticulate bodies: intracellular form
56
Q

chlamydophila pneumoniae causes PNA via what process

A
  • result of direct tissue destruction during bacterial replication, in addition to inflammatory response
57
Q

primary immune response to chlamydophila pneumoniae is done via what cell

A

PMNs (immunity is not long lasting)

58
Q

reservoir for chlamydophila pneumoniae

A
  • humans
  • transmitted person to person via respiratory droplets
59
Q

chlamydophila pneumoniae mainly affects what patient population

A

adults >60 yo

60
Q

chlamydophila pneumoniae diagnosis

A

cell culture and microscopy

61
Q

DOC chlamydophila pneumoniae

A
  • tetracycline/erythromycin

Microbiology test 2 (6 decks)

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