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CRRAB II- FINAL > Lower Resp. Micro- Debiel > Flashcards

Lower Resp. Micro- Debiel Flashcards

1
Q

What is the most common cause of community acquired pneumonia?

A

Strep pneumoniae

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2
Q

Sudden onset of chills, fever, dyspnea, productive cough with purulent sputum, PLEURITIC chest pain, tachypnea, decreased breath sounds with dullness to percussion

A

Typical pneumonia

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3
Q

Gradual onset of non-productive cough, dyspnea, more prominent extra-pulmonary signs (headache, sore throat, diarrhea)

A

Atypical pneumonia

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4
Q

What are the four common causes of aytpical pneumonia?

A

Viruses (RSV and Influenza)
Mycoplasma
Chlamydia
Legionella

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5
Q

What type of pneumonia would intra-alveolar exudate indicate?

A

Lobar pneumonia

Usually bacterial

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6
Q

What type of pneumonia would diffuse patchy inflammation of interstitial areas/alveolar walls indicate?

A

Interstitial pneumonia/ Atypical

Usually caused by viruses, mycoplasma, chlamydia, legionella

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7
Q

What is the common causes of post-viral/ secondary?

A

S. aureus

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8
Q

Pneumonia causes associated with IV drug use

A

Staph aureus

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9
Q

Causes of pneumonia associated with post-viral/ secondary infections

A

Staph aureus

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10
Q

Causes of pneumonia commonly seen in alcoholics?

A

S. pneumoniae
Klebsiella pneumoniae
Anaerobes

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11
Q

Causes of pneumonia associated with gross aspiration?

A

Anaerobes

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12
Q

Causes of pneumonia associated with the immunocompromised?

A 
Gram - rods
S. pneumoniae
Fungi
Filamentous bacteria
Pneumocystis jiroveci
Viruses
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13
Q

Most common hospital acquired cause of pneumonia?

A

Gram - rods

Drug resistant staph aureus

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14
Q

Common cause of pneumonia for neonate (birth-6 weeks)

A

Group B strep

E. Coli

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15
Q

Most common causes of pneumonia in children (6 weeks - 18 years)

A

Viruses = RSV
Mycoplasma
Chlamydia
Strep Pneumo

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16
Q

Most common cause of pneumonia in Adults (18-40 years)

A

Mycoplasma
Chlamydia
Strep pneumo

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17
Q

Most common cause of pneumonia in adults (40-65 years)

A

Strep pneumo
H. Flu
Anaerobic bacteria
viruses

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18
Q

Most common cause of pneumonia in the elderly? (older than 65)

A 
Strep pneum
Viruses
Anaerobic bacteria
H. Flu
Gram - rods
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19
Q

What is the most common cause of pneumonia in COPD patients? second most common cause?

A

1: H. Flu

2. M. catarrhalis

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20
Q

Why would you not use a b-lactam antibiotic to kill mycoplasma pneumoniae?

A

They have no cell wall!!! (does not gram stain!)

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21
Q

What is a complication of pneumonia with a mycoplasma pneumoniae infection?

A

B-cells may generate a response where autoantibodies react with RBCs = IgM cold agglutinins

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22
Q

A 1-day old infant developed pneumonia. Probable cause? why? how do you treat it?

A

Strep. agalactiae
It is carried in mother’s genital tract.
Treat with penicillin G

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23
Q

Gram +, B-hemolytic, bacitracin resistant
infects newborns
Can cause pneumonia, meningitis, and sepsis

A

Strep. Agalactiae = Group B strep!

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24
Q

What are the three B-hemolytic organisms?

A 
Staph Aureus
Strep Pyogenes (bacitracin sensitive)
Strep Agalactiae (bacitracin resistant)
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25
Q

Gram + cocci
Catalase -
B-hemolysis
Bacitracin Resistant

A

Strep. Agalactiae

Group B-strep

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26
Q

Gram + cocci
Catalase -
B-hemolysis
Bacitracin Sensitive

A

Strep. Pyogenes

Group A-strep

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27
Q

Treatment for Chlamydiae pneumoniae

A

Doxycycline

28
Q

What is the obligate intracellular parasite that can cause atypical pneumonia common in young adults?

A

Chlamydiae pneumonia

29
Q

What stain do you need to use to visual intra-cytoplasmic inclusion during a chlamydiae pneumonia infection?

A

Giemsa stain

30
Q

What are the two life-forms of chlamydiae?

A

Elementary body = infectious, enters cell via endocytosis, then transforms into reticulate body (extracellular)

Reticulate body: replicates by fission, and reorganizes into elementary bodies (intracellular)

31
Q

What stain do you need to use to visual legionella?

A

Silver stain

32
Q

What media do you need to culture legionella on?

A

Charcoal yeast extract with iron and cysteine

33
Q

Where does legionella like to proliferate?

A

They get phagocytosed by alveolar macrophages, and survive and proliferate in there.

34
Q

Virulence factors of RSV

A

G-surface protein for attachment

F protein causes infected cells to fuse

35
Q

At what age group does Strep Pneumonia become the most common cause of pneumonia?

A

Age 40-65

36
Q 
Gram + diplococci
Catalase -
Alpha hemolytic
Susceptible to optochin
Quellung +
A

Strep Pneumonae

37
Q

What causes “rust-colored” sputum?

A

Strep Pneumoniae

It does alpha hemolysis (only partially lysis RBCs)

38
Q

What organism is associated with alcoholics and aspiration and shows up bright red because it is gamma hemolytic?

A

Klebsiella

39
Q

What kind of agar do you grow H. influenzae on?

A

Chocolate agar

40
Q

If someone has conjunctivitis and it feels like “grains of sand” what are you thinking?

A

Adenovirus

41
Q

Multinucleated giant cells in pneumonia, crusted lesion on lip. What are you thinking?

A

HSV-1

42
Q

What antibody opsonizes microorganisms once they arrive in the alveoli?

A

IgG

43
Q

Does bronchitis cause inflammation in the alveoli?

A

No

44
Q

Peak age for bronchiolitis?

A

2-8 months

45
Q

When are adults infectious with influenza?

A

The day before symptoms begin through 5 days after onset of illness

46
Q

Describe bordatella pertusis.

A

Gram - cocco-bacillus

47
Q

With what bug do you see an increase in lymphocytes (rather than a typical increase in neutrophils with bacterial infection)?

A

B. Pertussis

48
Q

What drug is given in pertussis?

A

Erythromycin

49
Q

Tx for Moraxella catarrhalis?

A

Amoxicillin-clavulanate

50
Q

How does B. pertussis adhere to cilia?

A

Filamentous hemagluttinin

51
Q

Describe the pathogenesis of B. pertussis.

A

Binds epithelium via Filamentous hemagluttinin

AB toxin inactivates Gi proteins. This leads to an increase in cAMP.

Increase in cAMP impairs phagocytosis

52
Q

Describe what happens from the B cell response to Mycoplasma pneumoniae.

A

B cells generate IgM antibodies that react with erythrocytes. Cold agglutination

53
Q

Gram +
Aerobic
Beaded filaments
Weakly acid-fast

Pneumonia or abscesses.
Immunocompromised patients.

A

Nocardia asteroides

54
Q

3 things that cause green sputum?

A

Pseudomonas
Haemophilus
Pneumococcal species

55
Q

How can you differentiate between bronchitis and pneumonia?

A

CXR!!!!!!

Bronchitis will NOT have consolidations or infiltrates as seen in pneumonia

56
Q

Most common cause of bronchiolitis?

A

RSV

57
Q

Which antigenic types of flu cause the epidemics?

A

Type A and B!

Type C is mild disease, rarely causes epidemic, and by age 15 almost everyone has developed antibodies to it

58
Q

What is one way to distinguish influenza infection from the common cold?

A

Common cold is afebrile

Influenza has abrupt onset high fever

59
Q

Who should get a flu vaccine?

A

Everyone over 6 months of age

60
Q

What does B. Pertussis need to be grown on?

A

Bordet-Gengou medium

61
Q

When is someone with the flu infectious?

A

1 day BEFORE symptoms begin through 5 days after onset of illness

62
Q

Describe the difference between antigenic drift and shift

A

Antigenic Drift: occurs when minor changes in antigens occur due to gene mutaiton in influenza virus

Antigenic Shift: occurs when MAJOR changes in antigens occur due to gene reassortment in influenza A virus

63
Q

Which type of influenza virus undergoes antigenic shift?

A

Type A influenza virus

64
Q

Which organism causes rust colored sputum?

A

Strep pneumonia due to the alpha hemolysis

65
Q

Which organisms cause green sputum?

A

Pseudomonas
Haemophilus
Pneumococcal speices

66
Q

Which organism produces red currant jelly sputum?

A

Klebsiella

67
Q

Which organisms causes foul smell/ bad tasting sputum?

A

Anaerobic infections

CRRAB II- FINAL (20 decks)

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