Lower Respiratory Infection

Question 1

Where do bacteria that typically cause pneumonia come from?

Answer 1

The normal flora from naso and oropharynx get down into the lungs

Question 2

Viral pneumonias are more common in ________ and rare in _________

Answer 2

children, adults

Question 3

What are some possible problems associated with acute bacterial pneumonia?

Answer 3

Necrotizing pneumotitis
lung abscess
empyema

Question 4

What are the gram positive bacilli oral anaerobic bacteria associated with lower respiratory infections?

Answer 4

Actinomyces, Eubacterium, Leptotrichia

Question 5

what gram negative bacteria can cause pneumonia?

Answer 5

Klebsiella pneumoniae

Question 6

What kind of pneumonia does Legionella pneumophilia cause?

Answer 6

environmentally acquired acute pneumonia

Question 7

The spread of infection into potential space between parietal and visceral pleura is called what?

Answer 7

Empyema- requires drainage as part of management

Question 8

What kind of pneumonia does chlamydophila psittaci cause?

Answer 8

environmentally acquired acute pneumonia

Question 9

Walking pneumonia is primarily associated with what two organisms?

Answer 9

• Mycoplasma pneumoniae (AFB)

- Chlamydophila pneumoniae (G-)

Question 10

Environmentally acquired acute pneumonias are associated with what three organisms?

Answer 10

1-Legionella pneumophilia (G-, legionnaires disease)
2-Coxiella burnetii (G-, Q fever from cow placenta)
3-Chlamydophila psittaci (G-, parakeets and parrots)

Question 11

When is viral pneumonia often seen?

Answer 11

in children and during influenza epidemics

Question 12

What four the categories of oral anaerobic bacteria?

Answer 12

1-Gram positive cocci (peptostreptococcus)
2-Gram-positive bacilli (actinomyces, eubacterium, leptotrichia)
3-Gram negative cocci (Veillonella)
4-Gram-negative bacilli (Fusobacterium, prevotella, porphyromonas)

Question 13

Usually Community acquired, measured in hours to days, with onset of chills, fever and wet cough, pleura pain on inspiration, is characteristic of what?

Answer 13

Typical Acute Pneumonia (caused most often by Streptococcus Pneumoniae, H. influenza until vaccination was developed)

Question 14

What are the two categories of Atypical acute pneumonia?

Answer 14

1-Walking pneumonia
2-Enviornmentally acquired acute pneumonias

*Potentially fatal and require non-beta-lactam antibiotics

Question 15

What three components make up the triad of infectious disease?

Answer 15

1-Host (Defenses/immunities)
2-Environment (Occupation, travel etc.)
3-Pathogen (Bacteria, fungi, mycobacteria etc)

Question 16

What is characteristic of a pulmonary actinomycosis?

Answer 16

• oral flora
• penetrating infection (organism knows no tissue barrier)
• long term treatment (6-12 months)
• penicillin or clindamycin treatment

Question 17

How is acute pneumonia managed?

Answer 17

• Microbiological diagnosis not always possible

- Typically pathogens are known so broad-spectrum antibiotics typically work

Question 18

Aspiration pnumonia can be contracted in the community or the hospital. What kind of bacteria are responsible for each?

Answer 18

gram positive for community and gram negative for hospital

Question 19

What histological change can happen in lobar pneumonia?

Answer 19

Lung “hepatization”. Alveoli fill with neutrophils making it look like liver tissue

Question 20

What kind of pneumonia does Coxiella burnetii cause?

Answer 20

environmentally acquired acute pneumonia

Question 21

After a patient recovers from a chronic pneumonia what could cause the infection to come out of its latent or dormant phase?

Answer 21

Immunosuppresion- causing a second event

Question 22

What are the gram negative bacilli oral anaerobic bacteria associated with lower respiratory infections?

Answer 22

Fusobacterium,
Prevotella,
Porphyromonas

Question 23

What is the gram positive cocci oral anaerobic bacteria associated with lower respiratory infections?

Answer 23

peptostreptococcus

Question 24

Disease lasting weeks to months, with no empiric treatment requiring a bronchoscopy or run biopsy to diagnose is referred to as what?

Answer 24

Chronic pneumonia

*Can be caused by bacteria, mycobacteria, fungi, protozoa and others