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LRT II & III Flashcards

1
Q

What are the bacteria that fall into the walking or atypical pneumonia category?

A

Mycoplasma pneumoniae
Chlamydophila pneumoniae
Legionella pneumophila

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2
Q

Is the onset abrupt or gradual for atypical pneumonia? What are the associated symptoms?

A

Gradual

fever, HA, fatigue, myalgias, dry cough

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3
Q

What is the treatment for atypical pneumonia?

A

Tetracycline and erythromcin

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4
Q

True or false: you treat atypical pneumonia empirically?

A

True

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5
Q

What is the smallest living bacteria?

A

Mycoplasma pneumoniae

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6
Q

What is mycoplasma pneumoniae’s morpholoy? What is the colony morphology?

A

Morph = pelomorphic

Fried egg appearing colonies

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7
Q

What is in the membrane of mycoplasma pneumoniae that it robs from humans, since it cannot produce it on its own?

A

Sterols

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8
Q

Does mycoplasma pneumoniae have a peptidoglycan layer? What is the significance of this?

A

No, thus cannot use beta lactams or abx that target cell wall

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9
Q

How does mycoplasma pneumoniae spread? How much bacteria is needed to cause disease?

A

Through large droplets, with small number of bacteria needed

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10
Q

What is the other major disease that mycoplasma pneumoniae causes, besides pneumonia?

A

Tracheobronchitis

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11
Q

What is the major virulence factor that mycoplasma pneumoniae produces? What is its function?

A

P1 adhesin–binds to base of cilia, allowing ciliary stasis and cell death

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12
Q

What is the MOA of how mycoplasma causes anemia?

A

IgM produced against mycoplasma is cross reactive with RBCs

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13
Q

What is the best way to diagnose mycoplasma pneumoniae? Which way would you not use?

A

PCR or serology

NOT culture

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14
Q

What is the treatment for mycoplasma pneumoniae?

A

Tetracycline and macrolide

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15
Q

What is the agglutination test?

A

Test to see at what temp RBCs aggutinize at. Normal = 37 C, abnormal = 4 C

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16
Q

Which type of abx do you never use against mycoplasma pneumoniae? Why?

A

Beta lactams, because they do not have a cell wall

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17
Q

What is the prognosis for mycoplasma pneumoniae?

A

Self -limiting in 2 weeks

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18
Q

What can be done to prevent infx with mycoplasma pneumoniae?

A

avoiding it, no vaccine

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19
Q

What is the gram stain, metabolic, and morphology of chlamydophila pneumoniae?

A

Small, gram negaviet obligate intracellular pathogen

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20
Q

What type of pneumoniae does chlamydophila pneumoniae cause (typical or not)?

A

Atypical

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21
Q

How do you diagnose chlamydophila pneumonaie?

A

PCR or ELISA

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22
Q

What is the treatment for chlamydophila pnuemoniae?

A

Tetracyline and a macrolide (same as mycoplasma pneumoniae)

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23
Q

What is significant about the infection process of chlamydophila pneumoniae?

A

Reticulate bodies (non-infx) and elementary bodies (infx)

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24
Q

What is the causative agent of legionnaires disease?

A

Legionella pneumonophila

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25
Q

What are the two diseases that legionella causes?

A

Legionnaires disease, and pontiac fever

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26
Q

What is pontiac fever?

A

Mild, self limiting disease caused by legionella pneumonphila. Much more common.

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27
Q

What is the gram stain and morphology of legionella?

A

Gram negative coccobacilli (inside of cell). Pleomorphic outside cell

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28
Q

Where does legionella pneumophila usually exist?

A

Freshwater lakes, streams, ground water.

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29
Q

How is legionella pneumopha transmitted to humans?

A

Aersols from manmade water supplies, ACs etc

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30
Q

How does legionella infect the body? (What is the cell target?)

A

Targets and attaches to alveolar macrophages, and prevents fusion with lysosome

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31
Q

What is the unique histological characteristic to legionella?

A

Coiling phenomenon inside macrophages

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32
Q

What is the pathogenesis of legionella?

A

Hjacks cell by injecting a ton of toxins. Recruits macrophages to produce itself. Lyses the macrophage

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33
Q

What causes the lung necrosis seen in an infx with legionella?

A

Lysis of macrophage, and emission of bacterial toxins

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34
Q

What are the clinical manifestations of legionnaries disease?

A

Severe, toxic pneumonia
Myalgias
HA/confusion
Rapid fever

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35
Q

Diagnosis of legionella is done how?

A

Leukocytosis with L shift

Direct fluorescent antibody

nucleic acid synthesis

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36
Q

What is the treatment foe Legionnaires disease? What is the abx type that is not effective in treatment?

A

Macrolide or fluoquinolone

NOT beta lactams

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37
Q

What is the gram stain of mycoplasma TB?

A

Weakly gram positive

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38
Q

What is in the cell wall of mycoplasma TB, that is distinct?

A

tons of lipids

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39
Q

What is the stain that can identify TB? How does this work?

A

Acid fast-stains the mycolic acids

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40
Q

What are the 6 components of TB’s cell wall?

A 
Membrane
Peptidoglycan
arabingalactan
Lipoarabinomannin
Plasma membrane
Mycolic acid
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41
Q

True or false: TB has many reservoirs in the environment

A

False–only humans

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42
Q

How is TB spread?

A

Person to person contact

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43
Q

What are the four disease states of TB?

A

Primary
Active
Latent
Reactivation

44
Q

What is the pathogenesis of TB?

A

Taken up by alveolar macrophages, but macrophages cannot degrade them. This causes granuloma formation

45
Q

What is the latent immunity of TB?

A

When TB is effectively walled off in a granuloma

46
Q

What is primary TB? How symptomatic is it?

A

Initial infection, usually asymptomatic

47
Q

What causes TB to reactivate?

A

Immunosuppression for some reason

48
Q

What is the primary cause of damage that TB causes?

A

The immune response

49
Q

What is miliary TB?

A

Disseminated TB infection that looks like millet seeds in tissues

50
Q

What are the symptoms of active TB? Gradual or sudden?

A

Gradual onset of wieght loss, night sweats, hemoptysis

51
Q

What is the major reasons that TB is so widespread?

A

Carriers can be asymptomatic for 2-3 years

52
Q

What are the symptoms of reactivation TB?

A

Similar to primary TB

53
Q

What is a Gohn focus?

A

Calcified granuloma from TB in the lung as seen on CXR

54
Q

What is the Ghon complex?

A

Ghon focus + hilar lymph node calcification

55
Q

What might a CXR show in active TB?

A

CXR may show lobar pneumonia as granuloma falls apart

56
Q

True or false: TB requires reporting

57
Q

What is the lab diagnosis for TB?

A

Mantoux test (PPDs injected into skin)

IFN-gamma release assay

58
Q

What is the vaccine that causes a Mantoux to be positive?

A

BCG vaccine

59
Q

For a pt with a h/o the BCG vaccine, how do you test for TB? What is involved in this test?

A

IFN-gamma release assay

Measure T cell reaction to MTB proteins

60
Q

What is the stain that can be helpful for identifying TB?

A

Acid fast stain

61
Q

Why is culturing TB not as useful as other techniques?

A

Takes 10-21 days

62
Q

What is the treatment for TB?

A

Isoniazid, ethambutol pyrazinamide and rifampin for 2 months, follows by 26 months

63
Q

What is the issue with TB treatment?

A

Hepatotoxic drugs taken for 28 months causes low compliance

64
Q

What is the BCG vaccine? Is it effective against TB?

A

vaccine against mycobacterium bovis. Not effective against TB.

65
Q

What is the consequence of having AIDS and being exposed to TB?

A

Primary infx much more likely, and will progress to secondary faster

66
Q

The nontuberculous mycobateria are (Typical or atypical mycobateria)

67
Q

What is mycobacterium avium intracellulare, and what is the disease it causes?

A

A complex of several mycobacteria that cause infx similar to TB

68
Q

What is mycobacterium kansasii? What is the population that this disease usually infects?

A

Similar to TB. Seen in elderly and COPD pts

69
Q

How do you diagnose mycobacterium kansasii or avium? What is the difference in these two bacterial infx compared to TB?

A

Same diagnosis as TB, but less severe

70
Q

What are the symptoms of laryngitis, tracheitis, and epiglotitis?

A

Hoarseness

Retrosternal burning pain

71
Q

What are the possible complications that can result from laryngitis, tracheitis, and epiglotitis?

A

Airway obstruction, especially in children

72
Q

What is the most likely etiology of laryngitis, tracheitis, and epiglotitis? Which bacteria constitute less common causes?

A

Viral,

Group A Strep, haemophilus influenzae or staph aureus

73
Q

What is the gram stain and morphology of Haemophilus influenzae type B?

A

Gram negative coccobacilli

74
Q

What is the bacteria that requires chocolate agar? What does the agar have that the bacteria needs?

A

Haemophilus influenzae type B,

NAD and hemin

75
Q

Haemophilus influenzae is type based on what?

76
Q

What is the capsule that Haemophilus influenzae type B has made of?

A

polyribosylribitol phosphate (PRP)

77
Q

What is the capsule that nontypable Haemophilus influenzae made of?

A

Nothing– nontypable do not have a capsule

78
Q

Haemophilus influenzae type B usually infects whom?

A

Unvaccinated children

79
Q

What are the three virulence factors that Haemophilus influenzae type B has?

A

LPS
IgA protease
PRP

80
Q

How do you diagnose Haemophilus influenzae type B?

A

Gram stain and culture

81
Q

What is the mortality rate of Haemophilus influenzae type B?

82
Q

What is the treatment for severe cases of Haemophilus influenzae type B? Less severe?

A

Severe = broad spectrum

Not severe = amoxicillin

83
Q

What is the vaccine against Haemophilus influenzae type B made from?

A

Conjugate vaccine to PRP

84
Q

What is the common bacteria that causes acute bronchitis? What is a complication that can arise from this?

A

Mycoplasma pneumoniae

Pneumonia

85
Q

What is the causative agent of whooping cough?

A

Bordetella pertussis

86
Q

What is the gram stain and morphology of pertussis?

A

Gram negative coccobacilli

87
Q

What causes the whooping part of pertussis?

A

Increase respiratory secretions and impaired clearance

88
Q

What is the MOA of pertussis?

A

Adhere to cilia, produce toxins

89
Q

What is the bacteria that require Bordet-Gengou agar?

90
Q

How is pertussis spread?

A

Aersols. Human only.

91
Q

What is the incubation period for pertussis? What are the symptoms during this time?

A

7-10 days, asymptomatic

92
Q

What is the progress of symptoms of pertussis?

A

Nothing to general cold, then whooping cough

93
Q

What are the major adhesion factors that bordatella pertussis produces?

A

Filamentous hemagglutinin
Peractin
Fimbrae

94
Q

What is the MOA of filamentous hemagglutinin that pertussis produces?

A

Binds to epithelial cells

95
Q

What is MOA of the pertusis toxin? What type of toxin is it?

A

AB toxin that activated adenylate cyclase to increase respiratory secretions

96
Q

What are the three major toxins that pertussis has/produces?

A

LPS
Pertussis toxin
Adenylate cyclase activator

97
Q

What are the lab tests available to diagnose pertussis?

A

Culture on bordet-gengou agar

Nucleic acid amp

98
Q

What is the treatment for whooping cough?

A

Supportive + macrolides

99
Q

What are the three active part of the pertussis toxin?

A

Detoxified pertussis toxin

Peractin

Filamentous hemagglutinin

100
Q

Purulent sputum is associated with what infection?

A

Typical pneumonia

101
Q

Scant, watery/mucoid sputum is associated with what infection?

A

Interstitial pneumonia

102
Q

Rust colored sputum is associated with what infection?

A

Strep pneumoniae

103
Q

Thick, currant jelly-like sputum is associated with what infection?

A

Klebsiella pneumoniae

104
Q

Hemoptysis is associated with what infection?

A

TB or lung abscess

105
Q

Foul smelling sputum is associated with what infection?

A

Anaerobic bacterial pneumonia

Microbio (50 decks)

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