Micro: LRT infection

Question 1

Criteria for Chronic Bronchitis.

Answer 1

Cough with excessive mucous production for at least 3 months within a 2 year period.

Question 2

How can you exclude Acute bronchitis from pneumonia on H and P?

Answer 2

Low grade fever with bronchitis

or no fever at all

Question 3

3 routes of entry into the lungs for bacteria to cause pneumonia.

Answer 3

1. Aspiration of Normal Flora
2. Hematogenous Spread from another site
3. Inhalation of Aerosols

Question 4

1 cause of typical pneumonia.

Answer 4

Strep pneumo

Question 5

Major virulence factor of Strep pneumo.

Answer 5

Capsule

also uses IgA protease, pneumolysin, adhesins

Question 6

What kind of operation predisposes patients to acquire a Strep pneumo infection?

Answer 6

Splenectomy

Question 7

Best Tx for Strep pneumo infection.

Answer 7

Ampicillin or Erythromycin

Question 8

Virulence Factor for Klebsiella p.

Answer 8

Capsule

Question 9

What groups are at risk for Klebsiella infection leading to pneumonia?

Answer 9

Alcoholics

IC, hospitalized, ventilator

Question 10

Tx for Klebsiella

Answer 10

Gentamicin, Cipro

Question 11

What is Klebsiella’s form of antibiotic resistance?

Answer 11

Carbapenamase (only present in some strains)

-this enzyme hydrolyzes carbapenam, a large component of the beta lactam ring

Question 12

Plate used to diagnose Haemophilus influenza.

Answer 12

Chocolate agar

• Factor V (NAD)
• Factor X (hemin: iron-containing porin)

Question 13

Salmon Pink sputum.

Answer 13

Staph aureus pneumonia

Question 14

Presentation of Atypical pneumonia

Answer 14

Non-productive cough

-fever, headache, myalgia, nausea, diarrhea
organisms don’t gram stain well or at all

Question 15

Cause of walking pneumonia.

Answer 15

Mycoplasma pneumoniae

Question 16

Virulence factors of Mycoplasma.

Answer 16

Capsule

Adhesins: will bind cilia and destroy them

Question 17

Rapid test to detect Mycoplasma infection.

Answer 17

Cold Agglutinins
(There is actually a disease called Cold Agglutinin Disease, it's autoimmune and patients make IgM autoantibodies against RBCs that agglutinate at lower temperatures.  The Mycoplasma antigens have epitomes very similar to RBCs and the body makes IgMs that will recognize Mycoplasma and RBCs simulating the actual disease) just FYI

Question 18

Describe the pathogenesis of Chlamydophila pneumonia.

Answer 18

Obligate Intracellular with 2 stages
1. Elementary body: the infectious form that enters host cells

2. Reticulate Body: metabolically active form that replicates within the host cell

The reticulate body must convert back to an elementary body before it lyses the cells and searches for other host cells

Question 19

Tx for mycoplasma.

Answer 19

Macrolides or Doxycycline

Question 20

Tx for Chlamydophila p.

Answer 20

Macrolides or Doxycycline

Question 21

Pneumonia from handling birds.

Answer 21

Chlamydophila psittaci

Question 22

Source of Legionella pneumophila.

Answer 22

Water cooling towers, air conditioners
-intracellular and resides inside amoebas
(once humans are infected it invades alveolar macrophages)

Question 23

Lab plate used to diagnose Legionella

Answer 23

Buffered Charcoal Yeast agar

-requires iron and cysteine

Question 24

Most common population to acquire a Pseudomonas infection in the lungs.

Answer 24

CF patients

Question 25

What should you suspect if a patient presents coughing up lots of smelly sputum?

Answer 25

Anaerobe infection

-Bacteroides sp. or Fusobacterium sp.

Question 26

Tx for anaerobe lung infection.

Answer 26

Metronidazole

2-4 months

Question 27

Unique characteristic of Bacillus anthracis and its major virulence factor.

Answer 27

Polyglutamic Acid Capsule

VF: anthrax toxin

Question 28

Bipolar or safety pin staining.

Answer 28

Yersinia pestis (plague)

Question 29

Tx for Y. pestis

Answer 29

Immediate

• Stretomycin or
• Tetracycline or
• Chloramphenicol

and Isolate them

Question 30

Unpasteurized milk from cattle, goats, or sheep

Answer 30

Coxiella burnetii (Q fever)

Question 31

Rabbits

Answer 31

Francisella tularensis

-causes ulceroglandular disease

Question 32

Treatment for Tularemia

Answer 32

Streptomycin