Lung

Question 1

Which bacteria cause CAP

Answer 1

Streptococcus pneumonia

Haemophilus influenzae (meningitis, pleomorphic, serotypes a to f, type b is most common encapsulated)

• virulence factors: adhesive pili - dysregulates ciliary beating. Protease that degrades IgA

Moraxella catarrhalis

• COPD exacerbation, pediatric otitis media

S aureus(overlap viral, abscess formation, empyema, IVDU, endocarditis)

L pneumophila

Enterobacteriaceae

M pneumoniae

Chlamydia spp

Coxiella burnetii (Q fever)

Question 2

Which viruses cause CAVP

Answer 2

RSV, PIV, Human MPV (children), Influenza A and B, Adenovirus (military recruits)

Question 3

Which bacteria cause Health care associated pneumonia

Answer 3

MSSA, MRSA, P seruginosa, S pneumoniae

Question 4

Which bacteria cause HAP

Answer 4

GNB, Enterobacteriaceae (Klebsiella spp. Serratia marcescens, E Coli), Pseudomonas spp.
S aureus (MSSA)

Question 5

Aspiration pneumonia is caused by

Answer 5

Anaerobic oral flora (Bacteroides, Prevotella, Fusobacterium, Peptostreptococcus, admixed with aerobic bacteria (S pneumoniae, S aureus, H influenzae, P aeruginosa)

Question 6

Chronic pneumonia is caused by

Answer 6

Nocardia, actinomyces, Granulomatous: Mycobacterium tuberculosis and atypical mycobacteria, H capsulatum, Cimmitis B dermatitidis

Question 7

Mechanisms of pulmonary infections

Answer 7

Aspiration (less cough reflex )

Mucociliary apparatus

Accumulation of secretion

Decreased phagocytic bacteriocidal function of alveolar macrophages

Oedema, congestion

Inadequate innate immunity (germline mutations MyD88 (adaptor protein that links Toll Like receptors to NF-KBB activation), humoral immundeficiency, or congenital and acquired cell-mediated immune defects

Question 8

Necrotizing pneumonia and lung abscess is caused by

Answer 8

Anaerobic bacteria, with or without mixed aerobic infection S aureus, K pneuoniae, Sterptococcus pyogenes,m TIII pneumococcus

Question 9

Pneumonia in the immunocompromised Host is caused by:

Answer 9

Cytomegalovirus
Pneumocystis jirovecii
M avium-intracellulare
Invasive aspergillosis
Invasive candidiasis
Usual bacterial viral and fungal organisms

Question 10

Klebsiella pneumoniae pneumonia is:

Answer 10

(most common GN cause, alcoholics)

Question 11

Pseudomonas pneumonia

Answer 11

nosocomial infections, blood vessels and spreads systemically, CF, neutropenic

Question 12

Legionella pneumophila pneumonia

Answer 12

Legionnaire’s disease and pontiac fever. Flourishes in artificial aquatic environments, such as water cooling towers, spreads through aerosolization; infection causes severe pneumonia in the immunocompromised patient

Question 13

Mycoplasma pneumoniae

Answer 13

Common in children - local epidemics

Question 14

Sequelae of systemic dissemination of pneumonia?

Answer 14

Abscess formation, Systemic dissemination causing endocarditis, meningitis, suppurative arthritis, metastatic abscesses

Question 15

Influenza A viruses live:

Answer 15

humans, pigs, forses, birds

Question 16

Type B and C flu viruses have in common:

Answer 16

They do not mutate so childhood infection gives lifelong antibody mediated protection against future disease

Question 17

Flu virus structure

Answer 17

lipid bilater surface with hemagluttinin (H1,2,3) and Neuraminidase *(N1/2)

Question 18

Clearing an established flu infection requires

Answer 18

Cytotoxic T cells and innate immune responses (macrophage antiifluenza protein Mx1)

Question 19

Flu epidemics occur when

Answer 19

viruses acquire mutations in their hemogglutinin or neuraminidase proteins allow evasion from host antibodies. (antigenic drift)

Question 20

Pandemics occur when

Answer 20

proteins are replaced altogether by recombination of RNA segments with animal viruses (antigenic shift)