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Year 2 Resp Exam 2 > Micro, D Kinder, Lec > Flashcards

Micro, D Kinder, Lec Flashcards

1
Q

what type of microbe is bordetella

A

gram negative coccobacilli

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2
Q

3 phases whooping cough

A

catarrhal
paroxysmal
convalescent

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3
Q

Dx whooping cough

A

nasal swabs for culture or PCR

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4
Q

Tx whooping cough

A

zpak

supportive

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5
Q

Klebsiella pneumonia is what type micrbe

A

gram - non-motile capsulate rods, faculative anaerobes

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6
Q

Currant jelly sputum is pathoneumonic for what

A

klebsiella ppneumonia

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7
Q

what type of microbe is moraxella catarrhalis

A

gram - that grow on blood or chocolate agar
diplococci
catalase and oxidase +

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8
Q

Neisseria meningitidis is what type microbe

A

gram - aerobic kidney shaped diplococci
oxidase +
ferments maltose and glucose
grows on thayer-martin media and chocolate agar!!

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9
Q

Dx and tx neisseria

A

gram stain from CSF, or PCR
CSF culture blood culture, skin culture
penicillin or 3rd generation cephalosporin

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10
Q

if left unTx neisseria m. patients have what mortality

A

70-90%

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11
Q

What microbe produces pyocyanin

A

pseudomonas

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12
Q

type of microbe that pseudomonas is

A

aerobic gram - rod
blue/green pigment
nosocomial pathogen

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13
Q

what type of infections does pseudo cause

A

HAP, CAP
otitis externa!! most common cause of this.
puncture wounds
endopthalmitis
endocarditis
UTI
skin infections, burns, ecthyma gangrenosum

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14
Q

Tx pseudomonas

A

extended spectrum penicillin and aminoglycoside combination

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15
Q

Chlamydophila psittaci is what type microbe

A

gram - obligate intracell bacteria

macrophages are principle host

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16
Q

Tx Chlamydophila psittaci

A

tetracyclines, macrolides, FQs

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17
Q

What is a very common infection in most adults and cause atypical pneumonia in children <5

A

chlamydophila penumonia

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18
Q

CXR and labs for chlamydophila pneumonia

A

pneumonitis on CXR

labs actually have normal WBC

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19
Q

Dx of chlamydophila pneumonia

A

serology

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20
Q

coxiella burnetii is what type microbe

A

gram - infects host monocytes

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21
Q

what does coxiella burnetii cuse

A

Q fever

sometimes endocarditis

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22
Q

major outbreaks of coxiella has been associated with what

A

sheep and goats

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23
Q

clinical manifestation Q fever

A

60% seroconvert wihtout disease
38% self limited disease
prolonged fever, pneumonia, hepatitis, rash
meningitis, encephalitis, peripheral neuropathy
pericarditis, myocarditis

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24
Q

what is risk of coxiella during pregnancy

A

chronic uterine infection leading to multiple spontaneous abortions

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25
Q

Dx coxiella burnetii

A

based on serology

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26
Q

Tx coxiella burnetii

A

doxy for 2 wks

doxy+hydroxychloroquine for 18-36 mo for endocarditis

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27
Q

how does hydroxychloroquine work?

A

increases pH in phagosomes

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28
Q

francisella tularensis is what type microbe

A

zoonotic
small aerobic pleomorphic gram - bacillus
rabbits squirrels and muskrats

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29
Q

clinical manifestation tularemia

A 
ulcerglandular
glandular
oculoglandula
typhoidal
oropharyngeal
pneumonic- most serious
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30
Q

Sx ulceroglandulat tularemia

A

fever
ulcer formation
sore throact
patchy infiltrates on CXR

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31
Q

glandular tularemia

A

fever, constitutional and lymphadenopathy

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32
Q

oralpharyngeal tularemia

A

oral mcous membranes of mouth
inadequately cooked game meat
pharyngeal ulcers

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33
Q

pneumonic tularemia

A

most serious
inhalation exposure
fever, dry cough, substernal chest discomfort, eribronchial infiltrates and bronchopneumonia
hilar adenopathy

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34
Q

Dx tularemia

A

serologic

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35
Q

typhoidal tularemia

A

fever only

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36
Q

Tx tularemia

A

genta or streptomycin
cipro
doxy

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37
Q

type microbe bacillus anthracis

A

spore forming gram + non motile rod that is aerobic or faculatively anaerobic
catalase +, hemolysis -
sheep agar!

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38
Q

clnical manifestation bacillus anthracis

A

mediastinal adenopathy
mediastinal widening**
pleural effusion
rapidly fatal if not Tx with multiple antibiotics and pleural drainage

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39
Q

Dx bacillus anthracis

A

blood cultures

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40
Q

tx bacillus anthracis

A

multi drug regimen

pleural drainage

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41
Q

what type of microbe is yersinia pestis

A

gram - coccobacillus, microaerophilic, nonmotile, and non spore forming
prairie dogs

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42
Q

clinical manifestations yersinia pestis (bubonic plague)

A

bubonic( nodules), septicemia, penumonic

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43
Q

septicemia from yersinia present how

A

nausea, vomiting, diarrhea
DIC
hypotension, renal failure and obtundation
ARDS

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44
Q

pneumonic plague of yersinia presents how

A

highly fatal, die in 24 hrs

respiratory distress, hemoptysis

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45
Q

Tx plague

A

strepto- pneumonic
tetracyclin- bubonic
chlorphenicol- speticemia

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46
Q

What type microbe is leptospirosis

A

spirochete with terminal hook

use dark filed microscopy

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47
Q

where in hosts does leptospirosis live

A

renal tubules

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48
Q

early clinical phase leptospirosis

A 
fever, myalgias, HA
nasuea vomiting ab pain, diarrhea
cough
muscle tenderness
conjunctival redness
49
Q

late clinical phase leptospirosos

A

thrombocytopenia
jaundice
weils disease
GI bleed

50
Q

Dx and tx lepto

A

Dx: agglutination test
Tx: doxy or penicillin

51
Q

H influenza is what type microbe

A

encapsulated gram - pleomorphic rod
aerobic or faculative
grows on chocolate agar
Factor X (hemin) and Factor V (NAD)

52
Q

common cause of meningitis in young children

A

H influenza type b

53
Q

clincal manifestations H influenza

A

meningitis
epiglottitis- children <5. high fever drooling, dysphagia, resp distress with stridor
rapid course

54
Q

Dx test for H influenza epiglottitis

A

lateral neck film

thumb sign

55
Q

pneumonia signs from H influenza

A

fever cough, lobar consolidation

56
Q

Tx H influenza

A

3rd generation cephalosporins- meningitis

57
Q

what is prophylactic Tx for unvaccinated person in contact with infected person with H influenze type b

A

rifampin

58
Q

corynebacterium diptheria is what type microbe

A

gram + bacillus, club shaped
non spore forming
aerobic

59
Q

signs resp diphteriae

A 
sore throat, malaise
thick tonsillar exudate, very sticky
exudate changes into grayish membrane
"bull neck" from cervical adenopathy
stridor
myocarditis, recurrent laryngeal nerve damage
60
Q

Tx diphteriae

A

erythromycin

antitoxin

61
Q

type microbe legionella pneumophila

A

wekaly gram - pleomorphic rod that is facultative intracellular
requires charcoal yeast extract!!

62
Q

legionella is commonly found where

A

water type reservoirs like air conditioner units

63
Q

risk factors legionella

A

smokers with high alcohol intake, immunosuppression

64
Q

signs legionaires disease

A

mental confusion
myalgias, severe HA!!! and diarrhea!!!!
fevers, malaise, cough, chilld, dyspnea, myalgias!!!! HA chest pain and diarrhea
low pulse for how high fever is

65
Q

what is pontiac fever?

caused by?

A

fever, sore throat myalgia, HA and extreme fatigue
short duration lasting on average 3 days
caused by legionella

66
Q

Dx legionella

A

Ag urine test

DFA (direct fluorescent antibody)

67
Q

Tx legniella

A

FQ, or zpak or erythromycin + rifampin for immunocompromised

68
Q

type of microbe mycoplasma pneumonia

A

smalles
no cell wall
sterol containing membrane
need cholesterol in media

69
Q

highest incidence of infection caused by mycoplasma pneumonia

A

5-20 yrs

military or dorms (like meningitis)

70
Q

resp infection from mycoplasma

A 
2-3 week incubation
fever malaise, HA cough
walking pneumonia
cough is non-productive
some progress to tracheobronchitis
bullous myringitis
71
Q

Dx and Tx mycoplasma atypical pneumonia

A

clinical Dx, positive cold agglutinins!!! (65%)
Tx: macrolides: erythromycin, zpak and clarithromycin
tetraclyines

72
Q

what type microbe is strep pneumonia

A

gram + diplococci, lancet shapet
faculative anaerobe, grows on blood agar
alpha hemolytic, optochin sensitive
lysed by bile

73
Q

risk factors for strep pneumonia

A

influenzae infection, COPD, CHF, alcoholism, asplenia

74
Q

clinical manifestations pneumonia from strep

A

shaking chills, high fever, rigors, lobar consolidation, bloody tinged sputum (rusty)!!!

75
Q

most common cause otitis media and sinusitis in children

A

strep pneumonia

76
Q

Tx strep pneumonia

A

beta lactams, macrolids or FQ

77
Q

Tx meningitis from strep pneumonia

A

3rd generation cephalosporings, vanco if penicillin R

78
Q

What type of microbe is staph aureus

A 
gram + clustered cocci
catalse, coagulae +
beta hemolytic
small yellow colonies on blood agar
ferments mannitol
79
Q

what are the 3 toxin mediated diseases from staph aureus

A

staph food poisoning
staph TSS
staph scalded skin syndrome

80
Q

clinical manifestations staph

A 
impetigo, folliculitis, furuncle, abscess
bacteremia, endocarditis
pericarditis
osteomyelitis
septic arthritis
pneumonia
81
Q

salmon colored sputum

A

staph aureus

82
Q

signs of endocarditis

A

roth spots, oslers nodes, janeway lesions and petichiae

83
Q

TSS from staph

A

secondary to TSST-1 super Ag

involvement of 3+ organ systems, desquamation of palms and soles

84
Q

what toxins are involved in scalded skin syndrome

A

exotoxin A and B

85
Q

Tx for Staph aureus

A

nafcillin/oxacillin

MRSA- vanco

86
Q

pneumocystis jirovecii microbe

A

fungus
obligate extracell parasite
silver stain
opportunistic infection HIV patients CD4 count <200

87
Q

pneumonia presentation from pneumocystic jirovecii

A

fever, nonproductive cough, SOB
CXR pathcy infiltrate with ground glass appearance, lower lobes and periphery
silver staining

88
Q

Tx pneumocystis jiroveci

A

sulfamethaxole/trimethoprim or dapsone

89
Q

Histoplasma capsulatum is what type microbe

A

dimorphic fungus in central US
faculative intracell parasite
soil, caves and abandoned buildings
Mississippi and Ohio River Valleys

90
Q

acute pulmonary histoplasma

A

asymptomatic

sometimes fevers, chills, anterioe chest pain myalgias

91
Q

chronic histoplasma infection

A

progressive often fatal

especially elderly and COPD patients

92
Q

CXR histoplasma

A

pathcy lobar or multilobar infiltrate
chronic with upper lobe infiltrates and multiple cavities, fibrosis of lower lobes
mimics TB

93
Q

Tx histoplasma capsulatum

A

antifungals

though if not severe, don’t always require Tx

94
Q

type of microbe blastomyces dermatitidis

A

thermally dimorphic fungus
broa based! budding yeast!!
inhalation

95
Q

acute pulmonary blastomyces

A

asymptomatic or CAP like
fever, malaise, nonproductive cough
CXR lobar and nodular infiltrates

96
Q

chronic pulmonary blastomyces

A

cavitary lesions and fibrosis

97
Q

Tx blastomyces

A

all patients Tx
itraconazole in mild
amphotericin B in severe

98
Q

Coccidiodes immitis is what type microbe

A

dimorphic fungi
southwest deserts
spherules that undergo septation into endospores

99
Q

clinical manifestations coccidiodes

A

asymptomatic usually
if more severe:
Sx 5-21 days post exposure
fever, weight loss, dry cough, pleuritic chest pain, arthralgias, erythema nodosum
CXR show pulm infiltrates with hilar adenopathy
cavitary pulmonary nodules

100
Q

What patients are at risk for disseminated infection cocciocdes

A

HIV, AIDS
3rd trimester pregnangy
skin, joints and bones

101
Q

Tx coccidiodes

A

amphotericin B and itraconazole

102
Q

Strongyloides stercoli is endemic where

A

warm climates worldwide

103
Q

trasmission stronglyoides

A

skin penetration of larvae rupture in alveoli then ascend and swallowed in GI tract and lay eggs which hatch in small intestine, larvae passed in feces

104
Q

pulmonary manifestations stronglyoides

A

can be severe in immunocompromised

resembles ARDS with acure onset dyspnea, hemoptysis accompanied by fever

105
Q

Tx stronglyoides

A

ivermectin

106
Q

aspergillosis microbe

A

spore like conidia that is aerosolized

isolated in basements, crawl spaces, ventilation ducts, potted plants

107
Q

invasive aspergillosis

A

immunocompromised
fever, pulm infiltrates
nodules
wedge shaped densities resembling infarcts
sinusitis
CNS abscesses, MI, GI, renal, osteomyelitis

108
Q

Dx invasive aspergillosis

A

BAL, needle aspiration, thoracoscopic biopsy or open lung biopsy

109
Q

Tx invasive aspergillois

A

antifungals like voriconazole or liposomal amphotericin B
reversal immunosuppression
surgical resection infected lesions

110
Q

chronic pulmonary aspergillosis

A

aspergilloma
ball in cavity
debris form in cavity

111
Q

Tx chronic pulmonary aspergilloma

A

limited benefit

sometimes antifungals

112
Q

Allergic bronchopulmonary aspergillosis

A

chronic asthma or CF patients
airway obstruction, eos!!, + sputum cultures, mucus plugs iwth hyphae, brown flecks in sputum
elevated IgE
upper lobe contraction, central bronchiectasis

113
Q

Tx allergic bronchopulmonary aspergillosis

A

corticosteroids and itraconazole

114
Q

cryptococcosis neoformans occurs in what patients?

what type of microbe is it?

A

immunosuppressed- HIV CD4<50
meningitis is comon presentation
capsulated yeast

115
Q

Pulmonary involvement cryptococcus?
risk factors?
Tx?

A

fever, cough ,dyspnea
risk factors: COPD, corticosteroid use and solid organ transplant
Tx: antifungals

116
Q

Dx cryptococcus

A

yeast in CSF, blood, sputum, skin lesions or other body fluids
India Ink stain!!!! visualization of budding yeast with large capsuel
latex agglutination for crytpococcal polysaccharide Ag!!!

117
Q

Tx CNS cryptococcosis

A

amphtericin B and flucytosine for 6 wks

AIDS: both for 2 weeks then fluconazole for 8 weeks and suppressive therapy after

118
Q

HACEK organisms that are common causes endocarditis

A 
Haemophilus spp
Actinobacillus
Cardiobacterium hominis
Eikenella corrodens
Kingella spp

Year 2 Resp Exam 2 (33 decks)

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