Medical microbiology and clinical pneumonia Flashcards
A 55 year old woman presents with breathlessness.
PMH: known diabetic.
SH: smoker 30/day.
What are some differentials at this stage. (4)
Left ventricular failure.
Pleural oedema.
Pleural effusion.
Pneumonia.
Expansion: reduced on right.
Tactile vocal fremitus: reduced on right.
Percussion: stony dull at right base.
Auscultation: reduced breath sounds on right.
What is the most likely diagnosis from this examination.
Right sided pleural effusion.
What is the most useful diagnostic technique for a patient presenting with breathlessness and reduced chest expansion.
CXR.
When faced with a pleural effusion, and you do a pleural tap, what would you find out from sending it to clinical chemistry.
If the effusion was transudate or exudate.
What is the definition of transudate.
protein
What is the definition of exudate.
protein>30g/dl
What is transudate caused by.
It is low protein fluid, usually caused by heart failure.
What is exudate usually caused by.
It is high protein fluid.
Usually caused by infections or cancer.
What does the microbiology lab usually do with a sample. (3)
Microscopy.
Culture.
Sensitivity.
What is involved in microscopy.
Means gram staining for bacteria.
What are the two most likely organisms causing a pleural effusion.
Pneumococcus (strep pneumoniae).
Haemophilus influenzae.
What is present in a gram negative cell wall. (6)
Inner cytoplasmic membrane.
Middle peptidoglycan layer.
Outer membrane with LPS, porins, proteins and lipoproteins.
What is present in a gram positive cell wall. (4)
Inner cytoplasmic membrane.
Outer peptidoglycan membrane with surface proteins, teichoic acid and lipoteichoic acid.
What type of bacteria is strep pneumoniae (pneumococcus). (2)
Gram positive.
Diplococcus.
What type of bacteria is haemophilus influenzae.(2)
Gram negative.
Rod.
