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CRRAB II--Wk 6 > Lower Resp Tract Infections > Flashcards

Lower Resp Tract Infections Flashcards

1
Q

Legionella pneumoniae

severity

A

may be severe

CXR looks worse than patient does, though

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2
Q

Bronchiolitis most common bug

A

RSV

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3
Q

Influenza vaccines generally contain

A

2 A strains

1 B strain

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4
Q

Tx of Chlamydia pneumoniae

atypical pneumonia

A

doxycycline

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5
Q

Rust-colored sputum

A

S. pneumoniae

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6
Q

How to differentiate pneumonia from bronchitis or bronchiolitis

A

CXR

clinical differentiation is not reliable

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7
Q

Influenza infectious period

A

1 day before Sx

until 5 days after onset

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8
Q

Filamentous hemagglutinin

A

pertusis

attachment to ciliated cells

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9
Q

Dx of mycoplasma pneumoniae

A

cold hemagglutinin

“fried egg” appearance”

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10
Q

Mycoplasma pneumoniae

manifestiation

A

atypical pneumonia

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11
Q

Sx of influenza

A

abrupt onset of fever

myalgias, prostration (weakness)

non-productive cough

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12
Q

Bordetella pertusis

classification

A

Gram -

Coccobacilli, pleomorphic

Growth on Bordet-Gengou agar or Regan-Lowe medium

B. pertusis

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13
Q

Pathology

Legionella pneumophila

A

naturally in water resivoirs

aerosolized from resp devices or air conditioners

adheres via pili

phagocytosis in marcophages

⇒ survival and proliferation

⇒ macrophages attract neutrophils

⇒ microabcesses

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14
Q

Convalescent stage of pertusis

A

decreased quantity of bacteria

disease ongoing due to cilia and respiratory tract cell damage

secondary infection possible at this stage

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15
Q

Dx of Legionella pneumophilla

A

French legionnaire with silver helmet sitting around charcoal campfire with his iron dagger–he’s no sissy (cysteine)

silver stain

charcoal agar with iron and cysteine

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16
Q

Legionella pneumophila

manifestations

A

Pontiac fever (mild)

Legionnaire’s disease (atypical pneumonia)

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17
Q

Virulence factors in influenza

A

HA (hemaggluitinin)

binds sialic acid on cell surface

NA (neurominidase)

cleaves HA bound to sialic acid

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18
Q

Prevention of bronchiolitis

A

possible with vaccine

RespiGam or palivizumab

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19
Q

How to differentiate viral and bacterial bronchitis

A

CXR

lasting > 14 days

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20
Q

Tx of bacterial bronchitis

A

erythromycin

or

azithromycin

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21
Q

Extrapulmonary signs often present in

A

atypical pneumonia

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22
Q

Hx in typical pneumonia

A

sudden onset fever and chills

dyspnea w/ productive cough

pleuritic chest pain

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23
Q

Red-current jelly sputum

A

Klebsiella

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24
Q

Viral atypical pneumonia population

A

infants and children

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25
Q

Serology in pertusis

A

lymphocytosis (not just leukocytosis)

unusual in a bacterial infection

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26
Q

Causes of bronchitis

A

usually viral

Rhino, Coxsackie A and B, parainfluenza, influenza A/B, adeno, RSV

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27
Q

Chlamydia pneumoniae

stain

A

Giemsa

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28
Q

Tx of pertusis

A

erythromycin in early stages

treatment does not shorten once in paroxysmal stage

does less chance of transmission

treat exposed individuals with prophylaxis

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29
Q

Organisms viral atypical pneumonia

A

RSV, influenza, CMV

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30
Q

Bronchiolitis in infants

A

RSV

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31
Q

Abcesses in kidney and brain seen in

A

Nocardia asteroides

pneumonia

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32
Q

Paroxysmal coughing episodes

A

pertusis

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33
Q

3 big organisms in pneumonia

A

S. pneumoniae

K. pneumoniae

M. catarrhalis

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34
Q

Testing for influenza

A

direct antigen testing

viral culture isolation

RT-PCR

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35
Q

Nocardia asteroides

A

acid-fast organism

cause of bacterial atypical pneumonia

TB-like disease

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36
Q

Tx of Nocardia asteroides

A

TMP-SMX

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37
Q

Mycoplasma pneumoniae

pathology

A

B-cells create antibodies that cross react with RBCs

cold hemagglutinins

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38
Q

Chlamydia pneumoniae

A

young adults

pharyngitis association

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39
Q

Bronchitis etiology

A

viral usually

bacterial if secondary infection

40
Q

Tachypnea, tachycardia, fever

diffuse expiratory wheezing, inspiratory crackles, nasal flairing

vomitting, cyanosis, hyperinflation of lungs

A

bronchiolitis

41
Q

Influenza is bad in

A

women in 3rd trimester

elderly

young

42
Q

Pneumocystis jerovecci

Dx

A

silver stain of induced sputum

dark, oval bodies on silver stain

(cysts)

43
Q

S. agalactiae

manifestations

A

pneumonia

meningitis

sepsis

in newborns from maternal infection

44
Q

Foul-smelling or bad-tasting sputum

A

anaerobic infections

45
Q

Chlamydia pneumoniae

where it likes to live

A

intracellular

(extracellular form is not active)

46
Q

Pertusis manifestations

A

paroxysmal coughing episodes

inspiratory “whoop”

post-tussis (cough) vomiting w/o other apparent cause

47
Q

Stages of pertusis

A

catarrhal stage (minor Sx)

paroxysmal stage (whooping)

convalescent stage (less bacteria, more damage Sx)

48
Q

Seasonal influenza vaccines generally this effective

A

50%

49
Q

Mycoplasma pneumoniae

Tx

A

erythromycin or tetracycline

50
Q

Influenza classification

A

RNA virus

helical nucleocapsid

enveloped

Class V non-segmented

orthomyxoviridae

51
Q

Bad strains of influenza

A

A/B

52
Q

Regan-Lowe medium

A

pertusis

53
Q

Chlamydia pneumoniae

manifestion

A

atypical pneumonia

54
Q

Pertusis toxin

A

AB-toxin

B: binds → endocytosis

A: attack, attaches to ADP-ribosyl to disrupt host cell proteins. inhibits Gi to increase cAMP

⇒ impaired phagocytosis

55
Q

Differentation between TB and Nocardia asteroides

A

Gram +

beaded filaments

weakly acid-fast

obligate aerobe

N. asteroides

56
Q

Herd immunity in pertusis

A

no herd immunity

1 in 20 non-immunized get infected

1 in 500 immunized get infected

57
Q

Pertussis

etiology

A

bacterial infection

58
Q

Tx of bronchiolitis

A

supportive

O2 and electrolyte fluids in severe cases

59
Q

PE in typical pneumonia

A

lung crackles

fever

tachypnea

tachycardia

60
Q

Tx of Pneumocystis jirovecci

A

TMP-SMX

61
Q

Everyone develops immunity to this strain by age 11

A

influenza C

62
Q

Giemsa stain

A

Chlamydia pneumoniae

63
Q

Erythromycin MOA

A

binds 50S ribosomal subunit

64
Q

Influenza viruses replicate

A

intracellularly

65
Q

Bordet-Gengou agar

A

pertusis

66
Q

Bronchiolitis population

A

infants < 1 y/o

due to their small bronchiolar diameters

67
Q

Obstruction in bronchiolitis

A

critical narrowing of bronchioles

due to

debris from dead cells and bronciolar mucosal edema

68
Q

Nocardia asteroides

population

A

immunocompromised

69
Q

Catarrhal stage of pertusis

A

minor cold Sx

most infectious part

70
Q

S. agalactiae

pathogenesis

A

carried by maternal genital tract

produces capsule

can colonize neonate after OB complications

⇒ pneumonia, meningitis, sepsis

71
Q

Antigenic shift occurs in

A

Influenza A

ONLY

72
Q

Antigenic drift occurs in

A

Influenza A/B

73
Q

Prophylaxis for Pneumocystis jirovecci

when

A

CD4+ < 200

74
Q

Agars for pertusis

A

Bordet-Gengou

Regan-Rowe

75
Q

Chlamydia pneumoniae

population

A

young adults

76
Q

Bacterial causes of bronchitis

A

Mycoplasma pneumoniae

(not Gram staining)

Chlamydia pneumoniae

(not Gram staining)

77
Q

Testing for bronchiolitis

A

nasal wash, RSV antigen detection

CXR to rule out pneumonia

78
Q

Tx of S. agalactiae

A

penicillin G

79
Q

Green sputum

A

Pseusomonas

Haemophilus

Pneumococcal

80
Q

Tx of Legionella pneumophila

A

erythromycin

81
Q

Streptococcus agalactiae

classification

A

Gram +

Catalase -

β-hemolytic

bacitracin-resistant

S. agalactiae

(Group B strep)

82
Q

Influenza vaccine recommended for everyone

A

6 mo old and older

83
Q

Common etiology of pneumonia in children

A

viral usually in children

84
Q

Paroxysmal stage of pertusis

A

severe Sx, whooping cough

severe, uncontrolled episodes of coughing, may be followed by emesis

blood vessels in eyes and brain may burst, seizures possible in severe cases

lasts 2-4 weeks

85
Q

Mycoplasma pneumoniae

A

walking pneumonia

86
Q

Acid-fast staining cause of atypical pneumonia

A

Nocardia asteroides

87
Q

Gram +

aerobic

oxidase +

diplococcus

A

M. catarrhalis

88
Q

2nd most common cause of pneumonia in COPD

A

M. Catarrhalis

Gram -

aerobic

oxidase +

diplococcus

89
Q

IgA protease cleaves IgA

virulence factor organism

A

H. influenzae

90
Q

Classification of Hib

A

Gram -

chocolate agar + Factor V and X

Quellung +

91
Q

Tx of Hib

A

ceftriaxone

rifampin for close contacts as prophylaxis

92
Q

Pneumonia in children

organisms

A

RSV

parainfluenza

93
Q

Pneumonia in adults 18-40

organisms

A

M. pneumoniae

C. pneumoniae

S. pneumoniae

94
Q

Pneumonia in adults 40-65

organisms

A

S. pneumoniae

H. influenzae (non-typable)

Legionella

95
Q

Pneumonia in adults >65

organisms

A

S. pneumoniae

Gram - rods

H. influenzae (non-typable)

CRRAB II--Wk 6 (9 decks)

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