Micro - Intro Flashcards
1st and 2nd highest incidences of RTIs
Pertussis
TB
3 types of URI
- Otitis media/sinusitis 2. Pharyngitis 3. Rhinitis
80% of URI caused by:
Viruses
Common manifestation of viral URI
Ulcerated lesions/vesicles (think herpes lesion)
Common manifestation of bacterial URI
Inflammatory exudates and hemorrhages
Most common cause of otitis media/sinusitis
RSV
Most common causes of bacterial otitis media/sinusitis
S. pneumoniae, H. flu
Another name for rhinitis
Common cold
Most common cause of RHINitis
RHINOvirus
Bugs causing rhinits
Rhinovirus Adenovirus Coronavirus Paraflu Flu RSV
(T/F): Bacteria rarely cause colds
True
Another name for pharyngitis
Sore throat
70% of pharyngitis caused by (bacteria, viruses, or fungi)
Viruses
Bugs causing pharyngitis
Rhinovirus Adenovirus Coronovirus Paraflu Flu HSV Coxsackie GAS N. gonorrhea C. diptheriae
Purpose of diagnosis of URI
Identify bacteria (negative result indicates viral agent)
C. diptheriae can cause ____ if it gets into bloodstream
Acute myocarditis
Characteristics of C. diptheriae infection
Severe sore throat, high fever, pseudomembrane consisting of immune cells, necrotic tissue, and bacteria
LRIs:
- Laryngitis/croup 2. Bronchitis 3. Pneumonia 4. Influenza 5. TB
90% of laryngitis caused by (bacteria, virus, fungus):
Virus
Bugs causing laryngitis
- Adenovirus 2. Paraflu 3. Flu 4. RSV 5. H. flu 6. GAS 7. S. aureus
Mild fever, productive cough, fatigue
Bronchitis
What is another name for acute bronchitis is infants/young children? Etiology?
Whooping cough Bordetella pertussis
80% of bronchitis caused by (bacteria, virus, fungus):
Virus
Bugs causing bronchitis
Bordetella pertussis (specifically whooping cough)
H. influenza
C. pneumoniae
M. pneumoniae
Paraflu
Flu
RSV
Adenovirus
MEASLES
Use throat swab to test for which etiological agents of bronchitis?
B. pertussis Viral
Use serology to test for which etiological agents of bronchitis?
C. pneumoniae M. pneumoniae
Etiological agent of “walking pneumonia”?
M. pneumonia
Two thins unique about M. pneumoniae
Smallest organism No true cell wall
Mainly viral:
Otitis media/sinusitis Rhinitis Pharyngitis Laryngitis Bronchitis AcutecChildhood pneumonia
Mainly bacterial:
Acute adult pneumonia Chronic pneumonia TB
Deepest LRI:
Pneumonia (alveoli, interstitium)
Bugs causing acute pneumonia
S. pneumoniae te Anaerobes Candida Aspergillis Paraflu Flu RSV Adenovirus Metapneumovirus
Bugs causing chronic pneumonia:
M. TB Histo Blasto Coccidioides Nocardia
Which bug might you suspect if cause of pneumonia is aspiration?
Anaerobes
Which virus may you suspect to cause pneumonia in the young and elderly?
RSV
Bugs causing pneumonia in immunocompromised pt:
K. pneumoniae P. aeruginosa Anaerobes Candida Aspergillis
When is a pneumonia considered “atypical”?
Doesn’t follow course of pneumococcal pneumonia &/or different bug than S. pneumoniae
G+ diplococci causing pneumonia
S. pneumoniae
Most common bug causing pneumonia
S. pneumoniae
Which etiological agent often causes secondary pneumonia?
Flu (bacterial pneumonia following viral pneumonia)
Since pneumonia often causes ___, one must also get ___ along with a sputum sample
Bacteremia Blood cultures
Detection of which two etiological agents lends the most confidence that you have the source of the pneumonia?
TB and flu (the rest can be contaminants)
How do you know if sputum sample collected is good or bad?
Good = lots of immune cells = came from site of infection Bad = lots of epithelial cells = came from mouth
(T/F): Left untreated most pneumonia is fatal
True
When does the highest mortality rate associated with pneumonia occur? Implication?
First few days Treat aggressively immediately
Fever, night sweats, hemoptysis, weight loss
Recurrent TB
Sx of primary TB
Usually asymptomatic
How often does TB recur?
10%
Risk factors for TB recurrence
Immunocompromised Alcoholism Malnutrition Diabetes Men > 50 yo
What is consumption?
Fatal meningitis caused by untreated TB
4 key characteristics of TB:
- Extremely slow growing 2. IC 3. Contains mycolic acid so doesn’t gram stain 4. Bacillus (rod)
What stain is diagnostic for TB? What is being stained?
Acid-fast stain Mycolic acid
What are the disadvantages of acid-fast staining?
Low bacterial numbers Takes up to 3 weeks to grow in culture (extremely slow growing)
Fever, chills, myalgia, followed by rhinitis and cough
Influenza
Genetic characteristics of influenza virus
Segmented negative strand RNA
Consequence of segmental and RNA genome of influenza:
Prone to reassortment so high rate of mutation leads to variation in two antigenic surface proteins, hemagglutinin and neuraminidase
Key association between influenza and pneumonia
Influenza can cause a serious, often fatal pneumonia, which can also lead to secondary pneumonia
Valley fever:
Coccidioides (pneumonia in Arizona and California)
What are zoonoses?
Infx spread from non-human to human
List of zoonoses:
Hanta virus Anthrax Plaque Tularemia Q fever Brucellosis
Two zoonoses with vectors?
Plague (fleas) Tularemia (ticks)
Zoonoses common in SW US?
Plague and hanta pulmonary syndrome
Where is tularemia common?
Arkansas
Zoonoses leading to chronic infection?
Brucellosis Q fever
Zoonoses with systemic sx?
Tularemia Plague Anthrax
Respiratory disease associated with fungi?
Chronic pneumonia
Dx of fungal pneumonia
Dissolve animal tissue with KOH to ID specific morphology
Severe fungal pneumonia seen in:
Immunocompromised pt (treat aggressively at first suspicion)
Tx of viral RI
Symptomatic
Tx of influenza RI
Several Rx but amantadine has high resistance now
Tx of bacterial RI
Abx + diphtheria antitoxin
Tx of fungal RI
Azoles if healthy pt Amphotericin B if infx disseminated &/or pt is immunocompromised
Available vaccines
Pneumococcal pneumonia Influenza A & B H. influenza Pertussis TB (not in US) Adenovirus 4&7 (military use only) Anthrax (emergency personnel only)
What is adenovirus 4&7 vaccine given to military personnel?
Can cause ARDS in people in close quarters
What type of hemolysis?
What is the goopy-looking stuff?

Alpha (partial) hemolysis
Capsule
Purpose of this type of agar?

Chocolate agar plate - lyse RBC to provide Fe2+ and NAD+ to organisms
What is this?

H. flu = coccobacillus - G- “chubby rods”
What is this? Where does it live?

Legionella - found in water sources
(Really long rods characteristic of Legionella)
What organism causes this zoonotic infection?

Yersinia pestis
(“chubby safety pin appearance” due to bipolar staining)
What is this?

Anthrax
(“Box car appearance”)
What is this?

Blasto
(Budding yeasts)
What is this?

Histo
(“Tuberculate macroconidia”)
This is the etiological agent of what disease found in what region?

This is coccidio –> Valley fever in AZ/CA
(spores that cause infection once ruptured)
What is this?

Aspergillus
(A shaped)
What kind of infection caused by this? What stain needed to see it?

This is pneumocystis - causes opportunistic pneumonia
Silver stain
What is this?
Difference in A&B?

Adenovirus
A shows normal epithelial cells; B shows the cells once destroyed by adenovirus infection
What is this?

RSV
(SYNCITIAL virus; syncytium is a multinucleated giant cell)
G+ bacili
Diptheria
Anthrax
G+ cocci
Pneumococcus (S. pneumoniae)
G+ non-branching
Actinomyces (AFB -)
Nocardia (AFB +)
G- bacili
Legionella
Actinobacter
G- cocco-bacili
Francisella tularensis
Bordetella pertussis
RNA+ viruses
Rhinovirus
Coronavirus
RNA - viruses
Hantavirus
Influenza
RSV, hMPV, hPIV
DNA virus
Adenovirus
Systemic fungi
Histo
Blasto
Coccidiodomycosis
Opportunistic fungi
Aspergillus
Zygomycosis
Pneumocystis
Zoonoses
Yersinia pestis
Brucellois
Coxiella burnetti