Lower Respiratory Infections Flashcards
1
Q
Opsonizing Ig in alveoli?
A
IgG
**facilitates ingestion by macrophages
2
Q
Only real way to differentiate between bronchitis and pneumonia?
A
infiltrates or consolidation on CXR
3
Q
Most common cause of bronchiolitis?
A
RSV
4
Q
Age where clinical sx of bronchiolitis develop?
A
infants and young children only
5
Q
Diagnostic test for RSV?
A
nasal washing + antigen test
6
Q
Respigram?
A
Ig reactive with RSV
7
Q
palivizumab
A
humanized monoclonal Ab reactive with RSV
8
Q
Mild type of influenza virus?
A
C
**almost everyone develops immunity by age 15
9
Q
Infectious period for adults with influenza virus?
A
one day before onset of sx –> 5 days after sx onset
10
Q
Sx to differentiate influenza virus from common cold?
A
high fever
11
Q
Characteristic to differentiate influenza from atypical PNA?
A
rapid onset
12
Q
Test for influenza?
A
rRT-PCR
real time reverse transcriptase PCR
13
Q
Whooping cough bug?
A
Bordetella pertusis
Gram -
cocco-bacillus
14
Q
Bordetella pertussis
Gram ?
shape ?
A
Gram -
cocco-bacillus
15
Q
Tissue damaging VF of B pertusis?
A
AB-toxin
16
Q
Atteachment VF of B. pertusis?
A
filamentous hemagglutinin
17
Q
age for most severe pertusis?
A
18
Q
Culture medium for B. pertusis?
A
Bordet-Gengou
19
Q
Unusual WBC finding in pertusis?
A
lymphocytosis (vs high PMNs of other bacterial infx)
20
Q
Tx for pertusis?
A
erythromycin
**not effective after ~2 weeks
21
Q
Most common cause of CAP?
A
Strep pneumoniae
22
Q
Three major bacterial causes of atypical PNA?
A
Mycoplasma
Chlamydia
Legionella
23
Q
Viral cause of PNA in immunocompromised?
A
CMV
24
Q
PNA age group:
Strep agalactiae
E. coli
A
neonates
birth - 6 weeks
25
PNA age group:
RSV
Mycoplasma pneumoniae
Chlamydia pneumoniae
Strep pneumoniae
6 weeks - 18 years
26
PNA age group:
Mycoplasma pneumoniae
Chlamydia pneumoniae
Strep pneumoniae
18 - 40 years
27
PNA age group:
Strep pneumoniae
Haemophilus influenzae
Anaerobes
Viruses
40 - 65 years
28
PNA age group:
Strep pneumoniae
Viruses
Anaerobes
Haemophilus influenzae
Gram (-) rods
>/= 65 yo
29
Most common HAP causes?
Gram (-) rods
S. aureus
30
Most common PNA in immunocompromised:
G - rods
Strep pneumo
fungi
filamentous bacteria
P. jiroveci
viruses
31
PNA causes in alcoholics:
Strep pneumo
Klebsiella pneumoniae
anaerobes
32
PNA in IV drug use:
S. aureus
33
PNA in post viral secondary infx:
S. aureus
34
PNA in chronic steroid use:
Nocardia
35
rhinovirus binds to?
ICAM-1 on resp epithelial cells
36
parainfluenza virus VF forming multinucleated giant cells?
F surface protein
37
croup
parainfluenza virus
38
Influenza virus types with 8 segments of RNA?
A and B
39
Influenza types with no animal reservoir?
B and C
40
What is required for antigenic SHIFT?
animal/human reservoir with simultaneous infx from two different strains of influenza
41
Influenza virus capable of genetic DRIFT and SHIFT:
A
42
Test for influenza?
rapid antigen test on nasopharyngeal swab
43
What is detected on influenza rapid antigen swab?
HA type via RBC agglutination
44
myocarditis
Coxackie B
45
herpangia, hand-foot-mouth disease
Coxackie A
46
Potential vector for gene therapy
Adenovirus
47
Three viruses that utilize hemagglutinin for binding:
influenza
parainfluenza
adenovirus
48
viral conjunctivitis
adenovirus
49
hemorrhagic cystitis
adenovirus
50
S. pyogenes
? hemolytic
bacitracin ?
ASO
Ab present?
Beta-hemolytic
bacitracin sensitive
ASO +
anti-streptolysin O
51
Second most common cause of PNA in pts w COPD?
Moraxella catarrhalis
52
Most common cause of PNA in pts w COPD?
non-typeable H. influenzae
53
attachment VF for M. catarrhalis:
pili
54
M. catarrhalis
Gram ?
VF for inflammatory response
gram -
endotoxin
55
Tx for M. catarrhalis?
amoxicillin-clavulanate
2nd linde: 2nd/3rd gen cephalosporin
56
whooping cough bug
Bordetella pertusis
57
B. pertussis VF's for:
attachment?
impairs phagocytosis?
filamentous hemagglutinin
AB toxin --> increased cAMP
58
Bordet-Gengou
B. pertusis
59
Strep pneumo VFs for:
evading phagocytosis ?
capsule
IgA protease
60
S. pneumo
Optochin ?
? hemolytic
suceptible to optochin
alpha-hemolytic
61
Difference between H. influenzae type B and non-typeable:
HiB is encapsulated --> invasive
NTHi not encapsulated --> local infx
62
X factor and V factor on chocolate agar?
H. influenzae
63
H. influenzae
Gram ?
negative
64
Tx of H. influenzae?
3rd gen ceph
65
prophylaxis for close contacts of H. influenzae?
rifampin
66
RSV attachment VF:
G surface protein
67
Tx of severe RSV?
ribavirin
68
Most common cause of meningitis in newborns?
Strep agalactiae
69
Gram +
neonatal pneumonia
Strep agalactiae
beta-hemolytic
bacitracin resistant
70
"walking pneumonia"
Mycoplasma pneumoniae
71
Cold hemagglutinin
fried egg appearance
pneumonia in young person living in a dorm or similar
how would you treat it?
Mycoplasma pneumoniae
Erythromycin or tetracycline (no cell wall so no beta lactams)
72
intracytoplasmic inclusions on Giemsa stain
Chlamydia pneumoniae
73
Tx for Chlamydia pneumoniae?
Doxycycline
74
Most likely patient for C. pneumoniae infx?
young adult
75
S. aureus VFs for host defense evasion?
protein A
coagulase
hemolysins
leukocidins
76
S. aureus VFs for deeper systemic invasion?
hylauronidase
staphlokinase
lipase
77
Gram + cocci in clusters
S. aureus
78
Naturally inhabits water reservoirs
Legionella pneumophila
79
Silver stain positive
charcoal yeast extract
proliferates inside macrophages
Legionella pneumophila
80
pneumonia in pt with CD4 under 200?
silver stain positive
PCP pneumocyctic pneumonia
Pneumocytis jiroveci
81
beaded, filamentous growth in immunocompromised
can acid fast stain and look like TB
Nocardia asteroides
82
Forms caseous granulomas and PNA w cavitations +/- abcesses in kidney/brain
Gram +
aerobic
beaded filaments
Nocardia asteroides
83
Age group where S. pneumo is less likely cause of PNA?
neonates
birth - 6 weeks
84
Age where you might start seeing H. influenzae as a more common cause of PNA?
> 40
85
Age group less likely to have viral PNA?
18 - 40
86
anti-HA Abs on serology?
Parainfluenza virus
87
Influenza C has ___ segments in RNA.
7
88
Cytokines contributing to Influenza disease process?
IL-1
IFN-gamma
89
SS (+) Nonsegmented
non enveloped
icosahedral
Rhinovirus
90
Helical
enveloped
SS (-)
non segmented
Parainfluenza virus
91
Helical
enveloped
SS (-)
nonsegmented
F-protein --> multinucleated giant cells
RSV
92
Icosahedral
nonenveloped
SS (+) non segmented
Enterovirus
Coxackie A and B
93
DNA
Icosahedral
nonenveloped
liner DS genome
Adenovirus
94
Helical
Enveloped
```
SS (-) segmented
(class V)
```
orthomyxoviridae
Influenza virus A B C
95
Two bacterial causes of conjuntivitis:
H. influenza
S. pneumo
96
Two bacterial causes of bronchitis that are not gram + or -:
Mycoplasma pneumoniae
Chlamydia pneumonia
97
Most common causes of "atypical PNA"
Mycoplasma
Chlamydia
Legionella
viral
98
Obligate intracellular bug that causes PNA and requires host ATP for energy?
Chlamydia
99
Inclusion body replication?
Chlamydia
100
Most common cause of bronchiolitis:
RSV
101
Age group you're thinking about with RSV?
young
**almost everyone becomes immune after early life exposure
102
What does "catarrhal stage" refer to?
post incubation (3-21 days) stage of pertussis
lasts 1-2 weeks
103
What does "paroxysmal stage" refer to?
B. pertusis w/ severe and uncontrollable coughing
104
Regan-Lowe medium?
B. pertusiss
105
What won't work to treat pertusiss?
cephalexin/penicillin
106
G - rods that could cause HAP?
Klebsiella
Pseudomonas?
E. coli?
107
Current Jelly sputum?
Klebsiella
108
Two bugs with positive silver stain?
Legionella
P. jiroveci
109
charcoal yeast
Legionella
110
hydrolyzes tributyrin
M. catarrhalis
111
four ways to Dx M catarahlis
hydrolyzes tributyrin
produces DNase
reduces Nitrite to Nitrate
does NOT ferment sugars
112
presence of cold hemagluttinin
Mycoplasma
113
fried egg
Mycoplasma
114
cysts forming dark oval bodies
P. jiroveci
115
Tx for Nocardia
TMP SMX
