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Respiratory Exam 2 > Lower Respiratory Tract Bacterial Infections > Flashcards

Lower Respiratory Tract Bacterial Infections Flashcards

1
Q

What is a key feature of the lower respiratory tract?

A

It is supposed to be a sterile environment. No microorganisms

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2
Q

Define Acute Bronchitis

A

Inflammation of the bronchioles: results in reduced airflow, encourages mucus accumulation in the lungs, and triggers coughing

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3
Q

Define Chronic Bronchitis

A

Cough and excessive mucus production for at least 3 months over a 2 year period.
Can lead to COPD: infection, smoking, inhalation of dust or fumes from workplace

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4
Q

How do you get bronchitis?

A

Viruses

Bacteria

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5
Q

Can you name 4 bacteria associated with bronchitis? Which one is associated with Acute?

A

Streptococcus pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
Mycoplasma pneumoniae (acute)

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6
Q

Signs and symptoms of Acute Bronchitis

A

Low grade fever
acute cough (may have sputum)
No lung disease, exclude pneumonia

Usually during or following viral infection

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7
Q

Signs and symptoms of Chronic Bronchitis

A

Increased cough, sputum
No evidence of pneumonia

Combination of infection and environmental factors

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8
Q

Bronchitis Treatment

A

Treat the symptoms

If bacterial treat with antibiotics

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9
Q

Define Pneumonia

A

Inflammation of the lungs accompanied by fluid filled alveoli and bronchioles

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10
Q

Most common cause of death in elderly?

A

Pneumonia

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11
Q

How do you get Pneumonia? (3)

A
  1. Aspiration of normal flora
  2. Hematogenous spread from another infection
  3. Inhalation of aerosols
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12
Q

PRODUCTIVE COUGH

Abrupt onset, fever, chills, congestion, SOB, chest pain

A

Signs/Symptoms of Typical Pneumonia

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13
Q

Can you name the #1 cause of Typical Pneumonia?

A

Streptococcus pneumoniae

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14
Q

What bacteria cause Typical Pneumonia? (5)

A 
Streptococcus pneumoniae
Klebsiella pneumoniae
Haemophilus influenzae
Moraxella catarrhalis
Staphylococcus aureus
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15
Q

Tell me about the characteristics of Streptococcus pneumoniae

A

Lobar pneumonia
Gram positives; alpha hemolytic; optochin sensitive
capsule
adhesion
IgA protease
Pneumolysin: responsible for lysing ciliated epithelial cells

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16
Q

fall and winter; CAP
Predisposing factors (viral infection, alcoholism, children, elderly, splenectomy)
Rust colored sputum
microscopy: gram pos cocci and numerous PMNs

A

Typical Pneumonia cause by streptococcus pneumoniae

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17
Q

How do you treat Typical Pneumonia?

Streptococcus pneumoniae

A

Ampicillin
Erythromycin/azithromycin
Vaccine: Pneumovax or Pneumococcal conjugate vaccine

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18
Q

Typical Pneumonia caused by Klebsiella pneumoniae can be described as?

A 
normal flora of the mouth
gram neg
capsule
CAP & HAP
Thick bloody sputum & Currant jelly sputum
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19
Q

Risk factors of Typical Pneumonia Klebsiella pneumoniae

A

Alcoholics, immunocompromised, hospitalized, on a ventilator

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20
Q

Does Klebsiella pneumoniae have a higher or lower mortality rate?

A

Higher mortality than pneumococcal or mycoplasma pneumonia.

Necrosis of the lung and bacteremia and release of LPS

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21
Q

Diagnosis and treatment of Klebsiella pneumoniae?

A

MacConkey agar
Treatment: Gentamicin, ciprofloxacin
Carbapenem resistance: KPC or CRKP

22
Q

Chracteristics of Haemophilus influenzae

A

Short fat rods; Normal flora of the URT

Capsule; Adhesins; Endotoxin

23
Q

Diagnosis of Haemophilus influenzae

A

Microscopy/gram stain
Fastidious
X and V factor on Chocolate agar.

24
Q

Staphylococcus aureus

A

normal flora, sputum: salmon pink
Empyema
Aspiration pneumonia: influenza, very young, elderly, COPD
Hematogenous pneumonia: bacteremia, endocarditis

25
Q 
Severe form of pneumonia
Massive hemoptysis
septic shock
high mortality rate
children and young adults
A

CA-MRSA

26
Q

What makes something an Atypical Pneumonia and name to organisms?

A 
Not seen on gram stain (except legionella)
Mycoplasma pneumoniae
Chlamydophila spp
Legionella pneumophila
Coxiella burnetii
27
Q

fever, headache, malaise, myalgia, nausea, diarrhea
Non-productive cough (no sputum)
dry hacking cough

A

Signs and symptoms of Atypical Pneumonia

28
Q 
Primary Atypical pneumonia
CAP
Excessive sweating
Lasts several weeks to months
Lack of seasonality
Predominant in high school and college age
A

Mycoplasma pneumoniae

29
Q

Mycoplasma Pneumoniae Characteristics & transmission

A

no cell wall
capsule
adhesin : attachment to base of cilia
Inhalation of aerosols

30
Q 
Usually not seen in microscopy
large number of PMNs
Grows slowly in culture (2-6 weeks)
cold agglutinins
PCR
A

Mycoplasma pneumoniae

31
Q

Treatment of Mycoplasma pneumoniae and Chlamydophila pneumoniae

A

Erythromycin/azithromycin

Doxycyclin can also be used.

32
Q

Chlamydophila pneumonias
TWAR
(Respiratory droplets)

A

Characteristics: gram neg, CAP, obligate intracellular bacteria
no organisms
seen large number of pmns, ELISA

2 stages: Elementary body, Reticulate body

symptoms: mild fever, sore throat, malaise, persistent cough, tends to be a mild infection

33
Q

Abrupt onset of fever, headache, pleurisy, chills, myalgia, dry cough
hyponatremia
complications involving GI tract, CNS, liver and kidneys are common

A 
Legionnaires' Disease
gram negatives; intracellular
water cooling towers/air conditioner
BYCE (iron salts and cysteine)
Fluorescent antibody staining: antigen detected in urine
34
Q

RF: Elderly, smokers, chronic pulmonary disease

A

Risk factors of haemophilus Influenzae

35
Q

Large # of PMNs

A

strep pneumoniae
mycoplasma pneumoniae
Chlamydophila pneumoniae

36
Q

Parrot Fever

A

Chamydophila psittaci

37
Q

RF: smokers, COPD, elderly, high alcohol, immunosuppressed, renal transplant, patients

A

RF: Legionella pneumophila

38
Q

What is Pontiac Fever?

A

a less severe form of Legionella pneumonphila

39
Q

Pseudomonas aeruginosa
Staph. Aureus
H. Influenza
Enterics: Enterobacter, Klebsiella, E. Coli, Serratia marcescens

A

HAP- hospital acquired pneumonia

40
Q

Pseudomonas aeruginosa Risk factors

A

Cystic fibrosis: s aureus first and then p. aeruginosa then burkholderia cepacia
Ventilation: p. aeruginosa and burkholderia cepacia

41
Q

Why is pseudomonas aeruginosa hard treat?

A

Resistance to many anti-microbials

42
Q

Risk Factors: Dental work and loss of consciousness

A

Anaerobes

Aspiration of respiratory or gastric materials
Mixture of bacteroides and fusobacterium (necrotizing, lung abscesses, and empyema)

43
Q

How does you treat an anaerobe?

A

metronidazole: 2-4 months

44
Q

Bioterrorism agents

A

Anthrax, Plaque, Q fever, Tularemia, Brucellosis

45
Q

Gram positive
endospores
capsule*
inhalation of endospores

A

Bacillus anthracis

recall anthrax toxin

46
Q

Initially: Sore throat, mild fever, myalgia, cough

After several days: severe coughing, nausea/vomiting, lethargy, confusion, shock, death

A

Bacillus anthracis

Treat with penicillin, doxycyclin, ciprofloxacin

47
Q

fever, chills, cough, difficulty breathing, frothy bloody sputum

A

Pneumonic Plague

Yersinia pestis: gram neg coccobacillus

48
Q

Plague incubation

A 
few hours to 2 days
Inhaled or spread through the blood
Treat with isolation
Begin immediately
Treatment: streptomycin/gentamycin
tetra/doxycyclin
chloramphenicol
49
Q

acute onset, severe headache, nonproductive cough, muscle pain, fever

A

Q fever

Coxiella burnetii: obligate intracellular, gram neg coccobacillus

50
Q

Cattle, sheep, and goats

A

Q fever

Transmitted: inhalation of contaminated dust, unpasteurized milk, occupation

51
Q 
Gram negative coccobacillus
Facultative intracellular
Fastidious
Cysteine glucose blood agar
Buffered charcoal yeast agar
A

Francisella tularensis
inhalation of aerosolized bacteria/ingestion of contaminated water or food/direct contact
treat: streptomycin

Respiratory Exam 2 (6 decks)

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