Micro- Lower respiratory Flashcards by Keaton Joppru

How can diff pneumonia from bronchitis?

Need a CXR

There are no consolidation or infiltration on a bronchitis
They are very similar clinical presentation

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What are some sx of bronchitis?

Cough with some sputum
F
Chest pain

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What is the most common cause of bronchitis?

Viral

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What is bronchitis?

Inflammation of the trachea and bronchi that does not involve alveoli

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What is the prognosis of bronchitis?

self-limitation

- usually last longer than

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What if the sx’s last longer than 14 days?

With fever and purulent sputum you can give abxs

- Like erythromycin or azithromycin

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What is unique of mycoplasma pneumonoie and chlamydia pneumonie?

neither are gram + or neg

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What are the most common causes of pneumonia in adults 18-40?

Mycoplasma

C and S pneumoniae

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Where does chlamydia replicate?

within inclusion bodies

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What is the most common cause of Bronchiolitis? Identification?

RSV

typically proceeded by minor viral URI
identified by Ag testing for RSV

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Who gets bronchiolitis and why?

Less than 1 year olds

- because their developing tubes are narrow

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What is an important clinical caveat of bronchiolitis?

Need CXR to rule our pneumonia

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What are two other causes of bronchiolitis?

Parainfluenza virus

Adenovirus

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What are the phases of pertussis?

Incubation period
Paroxysmal stage
Convalescent phase

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What is the pertussis incubation stage?

AKA catarrhal stage

3-21 days
Cold sxs
notably a runny nose

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What is the paroxysmal stage?

Severe and uncontrollable coughing

Bursting blood vessels
in eyes
in brain causing seizures

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What is another name for the convalescent phase and whats important about it?

Recovery stage

Cilia of respiratory tract are damaged and take a couple weeks to recover and thus you are vulnerable for 2’ infection
takes weeks to months

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What sort of toxin does Pertussis use?

AB toxin

high levels of cAMP
high levels of mucous

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What media does pertussis grow on?

Bordet-Genour agar traditionally

2. Regan-Lowe (blood, charcoal,

What is another way to identify pertussis?

Diret fluorescent ab test

What is pertussis resistant too? ABX?

Cephalexin and penicillin

What are the sxs of influenza?

F
Cough
Runny nose 
Muscle/body ache
HA
Fatigue
V and D in children

How does influenza spread and when are adults contagious?

Air

- 1 day before sx’s and 5-7 days after sx’s

What are the antivirals used for influenza and are they efficient?

Tamiflu- oseltamivir
Relenza- zanamivir
Rapivab- peramivir

usually only shortens illness 1-2 days

What are the two envelope protein for influenza attachment?

1. Hemagglutinin (HA) | 2. Neurominidase (NA)

What is the purpose of HA?

Protein makes constant with sialic acid on cell surfaces

What is the purpose of NA?

Cleaves sialic acid from galactose which permits viral spread

What is antigenic drift?

Occurs when minor changes in ags occur due to gene mutation in influenza virus - A and B

What is antigenic shift?

Occurs when major changes in ags occur to gene ressortment in influenza virus

Which shift or drift leads to pandemics?

Shift | - usually influenza A

What is the IIV3?

Influenza vaccine that has 3 parts to it: 1. H1N1 2. H3N2 3. and B - standard and high dose

What is the quadrivalent formulation of the influneza vaccine? IIV4

Two B lineages

What is LAIV4?

Live attenuated vaccines

What are the common causes influenza leading to 2' pneumonia?

Influenza then: - S auerus - S pyogenes - H influenzae - S pneumoniae

What is pneumonia?

Inflammatory condition of the lung in which fluid fills the alveoli - cause by bodies response to pathogen

Factors to consider in clinical dx for pneumonia?

``` Age Community acquired Hospital acquired Immunocompromised Alcoholism Iv drugs use Post viral 2' infection Chronic steroids ```

What is the most common cause of pneumonia in ages 40-65?

1. S pneumoniae 2. H. Influenza 3. Legionella

What is the most common cause of pneimonia for ages >65?

1. S pneumoniae 2. Gram - rods 3. H influenzae

What is the most common cause of pneumonia in young children?

RSE | Parainfluenza virus

What is the tree for group b strep?

``` Bacteria Gram + Cocci Catalase - Beta heme Bacitracin resistant ```

What is the tree for nocardia asteriodes?

``` Bacteria Gram + Beaded filaments Weakly acid fast Obligate aerobe ```

What sort of sputum does S pneumoniae cause?

Rust colored

What sort of sputum does Pseudomonas and haemophilus and pneumococcal spp cause?

Green

What sort of sputum does Klebsiella cause?

Red current jelly

What sort of sputum does anaerobic infection cause?

foul smelling or bad tasting sputum

What are the typical sx's of TB?

- Coughing that lasts three or more weeks - Coughing up blood - Chest pain, or pain with breathing or coughing - Unintentional weight loss - Fatigue - Fever - Night sweats - Chills - Loss of appetite

What are some hints about TB?

- Acid-fast (Mycolic acid and waxy barrier) - Aerobic obligate - Bacilli - Visible growth takes 3 to 8 weeks on solid media - An estimated 10,000 organisms/mL are required for sputum smear positivity - Pulmonary cavities contain huge numbers of organisms