micro 3

Question 1

typical pneumonia is caused by bacteria that

Answer 1

not intrinsically resistant to beta lactams

can be grown on lab media

Question 2

what two MO can cause pneumonia without R/F

Answer 2

H.Influenza and S.Pneumonia

Question 3

what are the R/F that cause pneumonia in MO

Answer 3

Hospital admission 
old age 
aspiration 
background of lung disease 
immunocomprimise

Question 4

important things about s.aureus

what is MRSA AND MSSA treated with

Answer 4

cavitary, abcessing and pneumatocele
MRSA :
MSSA: FLucloxacillin
MRS; Vancomycin

Question 5

important things about M. catarrhalis

treatment too

Answer 5

oxidase positive and diplococcus

augmentin (clavulunic acid / amoxacillin)

Question 6

what are enterobacterales members

Answer 6

k.pneumonia and E.coli

Question 7

MDR organisms of enterobacterales and what is the treatment for each

Answer 7

AmpC and ESBL :temocillin and meropenem

CRE : high dose meropenem and ceftazidime/avibactam

Question 8

pseudomonas aeroginosa imp things

Answer 8

oxidase positive
non fermenter
motile

Question 9

virulence factors of p. aeroginosa

Answer 9

adhesins and toxins and enzymes :
lasA and lasB Elastase 
phospholipase C 
Exotoxin A (ETA)
Exoenzyme T and S 
Alkaline protease

Question 10

what are the diffusable pigments of p. aeroginosa

Answer 10

pyocyanin ; blue, ROS production
pyoverdin ; green , siderophore to bind to iron and release virulence factors
pyomelanin; dark brown
pyorubin; red brown

Question 11

what are the clinical features of pseudomonas

Answer 11

lung ; necrotizing bronchopneumonia
skin ; burn colonization , hot tub folliculitis , ecythema gangrenosum and hot foot syndrome
eyes ; corneal ulcers or keratitis following corneal injury
ear; malignant otitis externa
swimmers ear (otitis externa)
chronic otitis media

Question 12

why can pseudomonas be easily identified

Answer 12

positive oxidase result
pigment production
grape like odor

Question 13

how is p. aeroginosa resistant

Answer 13

enzymatic inactivation
impermeability
efflux pumps

Question 14

how to treat pseudomonas and MDR type

Answer 14

normal ; piperacillin / tazobactam (tazocin )
or ceftazidime
MDR ; ceftolozane / tazobactam

Question 15

Burkholderia charac.

Answer 15

non fermenter
motile
gram negative bacili
oxidase negative

Question 16

types of Burkholderia and brief explain

Answer 16

B. cepacia complex (BCC) : genomovars cause infection in CF patients and CGD patients
B.pseudomallei : meliodosis cause necrotizing pneumonia

Question 17

treatment option for Burkholdria

Answer 17

ceftazidime and carbapenem

Question 18

acinetobacter spp charac

Answer 18

immotile

gram negative coccobacillary

Question 19

imp member of acinetobacter

Answer 19

a. baumanii that can develop antibiotic resistance

Question 20

what infection that acinetobacter cause

Answer 20

pneumonia

Question 21

stenotrophomanos maltophilia what does and cause and how is it treated

Answer 21

pneumonia

co-trimoxazole

Question 22

what are atypical pathogens

Answer 22

intrinsically resistant to beta lactams
could not be diagnosed by conventional cultures
radiological picture is worse than the status of the patient ( walking pneumonia )

Question 23

lehionella pneumophilia is an atypical bacteria that has what charact.

Answer 23

fastidous

Question 24

is l. pneumophila a facultative intracellular

Answer 24

yes . within alveolar macrophage and epithelial cells

Question 25

how does l. pneumophila enter macrophage

Answer 25

CR3 receptor

Question 26

l. pneumophila escape intracellular killing by imhibiting phagolysosome fusion

Answer 26

true

Question 27

l. pneumophila may survive long in moist env. even in the presence of disinfectant (chlorine) or high temp

Answer 27

yes

Question 28

what can l. pneumophila do

Answer 28

legionnaires and pontiac fever

Question 29

what is legionnaires incubation period and manifestions

Answer 29

period ; 2-10 days clinical ; acute illnes after incubation and sever feautures of pneumonia extrapulmonary involvement mortality rate 15% healthy and 75 % immunocomprimised

Question 30

what is pontiac fever

Answer 30

mild flu like illness that does not involve lung

Question 31

how to diagnose l. pneumophila

Answer 31

LPS antigen in urine specific for serogroup 1 | culture needs L. cysteine , iron and BCYE and needs 3-5 days

Question 32

how to treat l. pneumophila

Answer 32

fluoroquinolones ( levofloxacin )

Question 33

copper silver ionization , superheating and hyperchlorination are used in l. pneumophila

Answer 33

true

Question 34

what do mycoplasma and ureaplasma have in common

Answer 34

inherently lack cell wall and sterols in cell membrane

Question 35

is mycoplasma pneumonia part of normal flora

Answer 35

no

Question 36

smallest free living bacteria that is strictly aerobic

Answer 36

mycoplasma pneumonia

Question 37

virulence of m. pneumonia

Answer 37

``` adhesion protein ( P1 adhesin) formation of cold agglutinins ( IgM autoab that bind to RBC surface at 4c leading to hemolysis) ```

Question 38

secondary complications of m. pneumonia

Answer 38

steven johnson syndrome , hemolysis, meningoencephalitis, arithritis

Question 39

what is the method of choice for diagnosing m. pneumonia

Answer 39

PCR

Question 40

diagnosis m. pneumonia serology

Answer 40

fourfold increase in IgG titer between acute and convalescent serum samples

Question 41

diagnosis of M. pneumonia culture

Answer 41

must contain serum to supply sterols | must contain yeast extract for nucleic acid precursor and it need 2-3 weeks

Question 42

Mycoplasma treatment

Answer 42

macrolide

Question 43

chlamydia is an obligate intracellular bacteria and is an energy and nutrient parasite

Answer 43

true

Question 44

pathogenic species of chlamydia

Answer 44

c. pneumonia c. psittaci c. trachomatis

Question 45

inside host cells chlamydia spp displays two forms within inclusions

Answer 45

``` elementary body (EB) ; infectious stage reticulate body ( RB) : forms after microbial entry when it replicates it forms EB that will be expelled out ```

Question 46

c. pneumonia features

Answer 46

no animal reservoir other than humans most cases are asymptomatic or mild sinusitis pharyngitis and pneumonia

Question 47

c. psittaci features

Answer 47

natural reservoir is birds | spread through monocyte macrophage system causing hepatospleenomegaly, pneumonia, CNS, eye and heart involvement

Question 48

c. trachomatis features

Answer 48

affect genital tract and eye cause of infant pneumonia 2-3 weeks after birth clinical course for weeks but radiological pic for months

Question 49

nucleic acid used for what and serology for what in diagnosing chlamydia

Answer 49

PCR c. trachomatis and pneumonia | serology ; psittacosis

Question 50

what is used against chlamydia

Answer 50

macrolide , tetracycline and fluoroquinolone