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micro 3 Flashcards

1
Q

typical pneumonia is caused by bacteria that

A

not intrinsically resistant to beta lactams

can be grown on lab media

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2
Q

what two MO can cause pneumonia without R/F

A

H.Influenza and S.Pneumonia

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3
Q

what are the R/F that cause pneumonia in MO

A 
Hospital admission 
old age 
aspiration 
background of lung disease 
immunocomprimise
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4
Q

important things about s.aureus

what is MRSA AND MSSA treated with

A

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

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5
Q

important things about M. catarrhalis

treatment too

A

oxidase positive and diplococcus

augmentin (clavulunic acid / amoxacillin)

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6
Q

what are enterobacterales members

A

k.pneumonia and E.coli

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7
Q

MDR organisms of enterobacterales and what is the treatment for each

A

AmpC and ESBL :temocillin and meropenem

CRE : high dose meropenem and ceftazidime/avibactam

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8
Q

pseudomonas aeroginosa imp things

A

oxidase positive
non fermenter
motile

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9
Q

virulence factors of p. aeroginosa

A 
adhesins and toxins and enzymes :
lasA and lasB Elastase 
phospholipase C 
Exotoxin A (ETA)
Exoenzyme T and S 
Alkaline protease
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10
Q

what are the diffusable pigments of p. aeroginosa

A

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

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11
Q

what are the clinical features of pseudomonas

A

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

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12
Q

why can pseudomonas be easily identified

A

positive oxidase result
pigment production
grape like odor

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13
Q

how is p. aeroginosa resistant

A

enzymatic inactivation
impermeability
efflux pumps

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14
Q

how to treat pseudomonas and MDR type

A

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

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15
Q

Burkholderia charac.

A

non fermenter
motile
gram negative bacili
oxidase negative

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16
Q

types of Burkholderia and brief explain

A

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

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17
Q

treatment option for Burkholdria

A

ceftazidime and carbapenem

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18
Q

acinetobacter spp charac

A

immotile

gram negative coccobacillary

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19
Q

imp member of acinetobacter

A

a. baumanii that can develop antibiotic resistance

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20
Q

what infection that acinetobacter cause

A

pneumonia

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21
Q

stenotrophomanos maltophilia what does and cause and how is it treated

A

pneumonia

co-trimoxazole

22
Q

what are atypical pathogens

A

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

23
Q

lehionella pneumophilia is an atypical bacteria that has what charact.

A

fastidous

24
Q

is l. pneumophila a facultative intracellular

A

yes . within alveolar macrophage and epithelial cells

25
Q

how does l. pneumophila enter macrophage

A

CR3 receptor

26
Q

l. pneumophila escape intracellular killing by imhibiting phagolysosome fusion

A

true

27
Q

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

A

yes

28
Q

what can l. pneumophila do

A

legionnaires and pontiac fever

29
Q

what is legionnaires incubation period and manifestions

A

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

30
Q

what is pontiac fever

A

mild flu like illness that does not involve lung

31
Q

how to diagnose l. pneumophila

A

LPS antigen in urine specific for serogroup 1

culture needs L. cysteine , iron and BCYE and needs 3-5 days

32
Q

how to treat l. pneumophila

A

fluoroquinolones ( levofloxacin )

33
Q

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

A

true

34
Q

what do mycoplasma and ureaplasma have in common

A

inherently lack cell wall and sterols in cell membrane

35
Q

is mycoplasma pneumonia part of normal flora

A

no

36
Q

smallest free living bacteria that is strictly aerobic

A

mycoplasma pneumonia

37
Q

virulence of m. pneumonia

A 
adhesion protein ( P1 adhesin) 
formation of cold agglutinins ( IgM autoab that bind to RBC surface at 4c leading to hemolysis)
38
Q

secondary complications of m. pneumonia

A

steven johnson syndrome , hemolysis, meningoencephalitis, arithritis

39
Q

what is the method of choice for diagnosing m. pneumonia

A

PCR

40
Q

diagnosis m. pneumonia serology

A

fourfold increase in IgG titer between acute and convalescent serum samples

41
Q

diagnosis of M. pneumonia culture

A

must contain serum to supply sterols

must contain yeast extract for nucleic acid precursor and it need 2-3 weeks

42
Q

Mycoplasma treatment

A

macrolide

43
Q

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

A

true

44
Q

pathogenic species of chlamydia

A

c. pneumonia
c. psittaci
c. trachomatis

45
Q

inside host cells chlamydia spp displays two forms within inclusions

A 
elementary body (EB) ; infectious stage 
reticulate body ( RB) : forms after microbial entry when it replicates it forms EB that will be expelled out
46
Q

c. pneumonia features

A

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

47
Q

c. psittaci features

A

natural reservoir is birds

spread through monocyte macrophage system causing hepatospleenomegaly, pneumonia, CNS, eye and heart involvement

48
Q

c. trachomatis features

A

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

49
Q

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

A

PCR c. trachomatis and pneumonia

serology ; psittacosis

50
Q

what is used against chlamydia

A

macrolide , tetracycline and fluoroquinolone

RS (13 decks)

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