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Clinical Pathology > Lower Respiratory Tract Infections > Flashcards

Lower Respiratory Tract Infections Flashcards

1
Q

Which 3 fungi are common in LRTIs?

A

Aspergillus
Candida
Pneumocystistis Jroveci

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2
Q

Definition of chronic bronchitis

A

Cough productive of sputum on most days during more than 3 months of 2 successive years

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3
Q

Chronic bronchitis is associated with what risk factor?

A

Smoking

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4
Q

Bronchiolitis occurs in which age group?

A

Paediatrics

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5
Q

Causative organism for bronchiolitis

A

RSV

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6
Q

Infection affecting the most distal airways and alveoli- formation of inflammatory exudate

A

Pneumonia

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7
Q

What are the 2 anatomical patterns of pneumonia

A

Bronchopneumonia

Lobar pneumonia

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8
Q

Patchy distribution of pneumonia centred on inflamed bronchioles and bronchi then subsequent spread to surrounding alveoli

A

Bronchopneumonia

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9
Q

Pneumonia affecting a large part, or entire lobe

A

Lobar Pneumonia

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10
Q

Causative organism of lobar pneumonia

A

S. Pneumoniae

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11
Q

4 types of pneumonia based on where it is acquired

A

Community acquired
Hosptial acquired
-Ventilator acquired
-Aspiration

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12
Q

Hospital acquired pneumonia devleops how soon after hospital admission

A

> 48 hrs

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13
Q

Organisms that cause pneumonia but are difficult to grow, not sensitive to penicillin and clinical presentation and treatment is different

A

Atypical organisms

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14
Q

Typical organisms causing pneumonia

A 
Streptococcus pneumoniae
Hamophilus influenzae
Moraxella Catarrhalis
S.Aureus
Klebsiella penumoniae
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15
Q

Atypical organisms causing pneumonia

A 
Mycoplasms pneumonia
Legionella pneuomphilia
Chlamydophilia pneuomoniae
Chlamydophilia psittaci
Coxiella burnetii
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16
Q

Atypical organism causing pneumonia:
Autumn epidemics every 4-8 yrs. Children and young adults. Rare complications include pericarditis, arthritis, ghuillian barre ascending polyneuropathy, peripheral neuropathy

A

Mycoplasma pneumoniae

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17
Q

Atypical organism causing pneumonia:

Mild pneumonia or bronchitis in adolescents and young adults.

A

Chlamydophila pneumonia

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18
Q

Atypical organism causing pneumonia:
Associated with exposure to birds- splenomegaly, rash, hepatitis, haemolytic anaemia and reactive arthritis on presentation.

A

Chlamydophilia psittaci

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19
Q

Atypical organism causing pneumonia:

Colonises water pipes. High fevers, rigors, cough, dyspnoea, vomiting, diarrhoea, confusion

A

Legionella pneumophilia

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20
Q

What are the 2 types of pneumonia that develop from influenza?

A

Primary viral pneumonia: rare- occurs in patients with pre-existing cardiac and lung disorders.
Secondary bacterial pneumonia: may develop after initial influenza (flu) presentation

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21
Q

What is the assessment for disease severity used in pneumonia?

A

CURB65

Confusion, urea, resp. rate >30, blood pressure 65

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22
Q

Antibiotic used to treat typical pneumonia

A

Amoxicillin or co-amoxiclav

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23
Q

Antibiotic used to treat atypical pneumonia

A

Clarithromycin (lincosamide)

24
Q

Pneumococcal vaccination is what organisms?

A

Streptococcus pneumoniae

25
Q

Describe the shape of mycobacteria

A

Slender, bacilli

26
Q

Why are mycobacteria different to all other bacterial genera?

A

Unusual waxy cell wall (high lipid content)

Slower growing

27
Q

What stains are used to identify mycobacteria?

A

Ziehl Neelson, phenol auramine

28
Q

Another name for mycobacteria

A

Acid fast bacilli

29
Q

Mycobacteria:
Intra/extracellular pathogens?
Chronic infections or latent infections?
Longer or shorter course of treatment?

A

Intra
Latent
Longer

30
Q

What types of mycobateria cause TB?

A

M.tuberculosis

M.bovis

31
Q

What atypical mycobacteria are associated with HIV?

A

M avium complex

32
Q

Atypical mycobacteria

A

M.avium
M.kansasii
M.marium

33
Q

How does M.marium infections present

A

Fish tank granuloma

34
Q

Common site of primary TB infections?

A

Periphery of lung midzone

35
Q

Name of the collection of macrophages in the hilar lymph nodes in primary TB where intracellular muliplication takes place

A

Ghon focus

36
Q

Describe the structure of the tubercles in primary lymph nodes

A 
Granuloma
Cell-mediated immune response
Central area of epitheloid cells and giant cells surrounded by lymphocytes
Central area is caseous encrosis
Fibrosis/calcification of lesions
37
Q

In the acquisition of TB, when will you have a positive tuberculin skin test?

A

3 months after primary acquisition

38
Q

When is TB reactivated

A

immunosuppressed

39
Q

Pathogenesis of reactivating TB

A

Coalescing tubercles, central caseous encrosis and cavity develops in centre- increases organism load- increases risk of tranmission

40
Q

Where does TB classically reactive?

A

Lung apices (mycobacteria require O2)

41
Q

extra-pulmonary manifestations of TB

A

-necrotic tubercle erodes into blood vessel. e.g. meningitis. Disseminates to pleura, lymph nodes, kidneys, epididymis, bone, intestines, brain,pericardium etc

42
Q

Diagnosis of TB meningitis

A

Chest X-ray, Skin testing, interferon y release assay:IGRA

43
Q

Sputum samples for TB diagnosis

A

3 early morning specimens

44
Q

When is a direct microscopy for acid fast bacilli smear positive?

A

> 5000 organisms per ml sputum

45
Q

Standard treatment for TB

A

2 months: rifampicin, isoniazid and 2 others

next 4 months: rifampicin, isoniazid

46
Q

Treatment for meningitis TB

A

12 months therapy

47
Q

Name of the standard treatment for TB

A

Directly observed therapy short course (DOTS)

48
Q

Multi-drug resistant TB is resistant to what?

A

Rifampicin and izoniazid

49
Q

Extensive drug resistant TB is resistant to what?

A

Rifampicin, izoniazind and fluorquinolones

50
Q

Name of the TB skin test

A

Mantoux tes- tuberculin skin test- positive test if skin indurates (bubble and fibrosed patch develops)- person has acquired TB if >5mm

51
Q

Diagnostic test to look for T cells that recognise TB specific antigens and release gamma interferon

A

Interferon-gamma release assays

52
Q

What does BCG stand for?

A

Bacille Calmette Guerin

53
Q

What mycobacteria is given in BCG vaccine?

A

Strain of M.Bovis

54
Q

What disease is caused by M.leprae?

A

Leprosy-Hansen’s disease

55
Q

Where is M.leprae cultivated?

A

On the nine banded armadillo

56
Q

2 clinical forms of M. leprae

A

Tuberculoid- macules/plaques develop on nerves

Lepromatous- subcutaneous tissue accumulation

57
Q

The name of the blood test for TB

A

Interferon y gamma release assay (IGRA)

Clinical Pathology (53 decks)

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