Micro Resp Bugs

Question 1

AIDS, transplantation, immunosuppression, C
CXR: patchy infiltrates; Silver Stain: organism seen
What is the organism cause?
Seen in premature infants
What is the morphology? VF? Tx?

Answer 1

Pneumocystis jurovecii
Hat shaped cyst collapsed
Obligate extracellular
VF: destroys type 1/2 & pneumocytes
Tx: sulfa

Question 2

Transplantation, immunosuppressive
CXR: patchy infiltrates
Silver stain: NO
Organisms seen owls eyes
Dx?
Cause?
Morph?
Tx?

Answer 2

Esophagitis
CMV
DNA Env
Antiviral: Gancyclovir, Foscarnet

Question 3

CXR; Hilar lymphadenopathy, calcified nodules
TNF-alpha inhibitors, AIDS, Immunocompromised, skin and body manifestation
What is the morph? Cause? Tx?

Answer 3

Morph: yeast w/n macrophage—>Histoplasma
Morph: spherules, infective form: arthrospores——>Coccidiodis
Tx: anitfungal Azoles, Amp B

Question 4

CXR; Hilar lymphadenopathy, calcified nodules
TNF-alpha inhibitors, AIDS, Immunocompromised, skin and body manifestation
What is the morph? Cause? Tx?

Answer 4

Morph: broad based bud—-> blastomyces

Question 5

CXR; Hilar lymphadenopathy, calcified nodules
TNF-alpha inhibitors, AIDS, Immunocompromised, skin and body manifestation. Pt on VAP
What is the morph? Cause? Tx?

Answer 5

Pseudomonas, Burkholderia, ESKAPE

Question 6

CXR; Hilar lymphadenopathy, calcified nodules
TNF-alpha inhibitors, AIDS, Immunocompromised, skin and body manifestation. Orbital pain, swelling, draining pus
What is the morph? Cause? Tx?

Answer 6

Neutropenia
DKA
Zygomycetes
Aspergillosis
Morph: Aseptate hyphae
VF: angioinvasive neurotropic
Antifungal: Azole, Amphotericin

Question 7

A 26 y/o male has dry hacking cough, no severe systemic s/sx
CKR: patchy infiltrates. What is the culprit name, underlying risk factors for complication? Morph? VF? Tx?

Answer 7

Walking pneumonia/atypical —>mycoplasma pneumonia
SCD, Hemolytic anemia, Reynauds, SGS, erythema Multi forme
Morph: wall less
VF: destroy cilia denudation of resp epithelium
Tx: macrolide/doxycycline no cell wall acting

Question 8

A 75 y/o woman comes in with sudden onset of chills and productive cough. CXR: lobar consolidation(middle and lower) what is the culprit/risk factors/morph/VF/Tx?

Answer 8

S pneumoniae
Age, smoking, alcoholism, antecedent viral infection, splenectomy
Morph: Gram + diplo,alpha hemolytic on blood agar
VF: polysaccharide capsule, pneumolysisn, IgA protease
Tx:cell wall acting-Fluroqunolone/Macrolide
Vaccine-23PCV, Conjugate V

Question 9

85 y/o man comes in with non productive cough, diarrhea, confusion, hyponatremia. CXR: patchy infiltrates lobar consolidation. What is the culprit/RF/Morph/VF/Tx?

Answer 9

Legionella
Age, smoker, alcoholism, environmental exposure to fresh watet
Morph: Gram - cysteine iron BYCE
VF:intracellular, inhibition of phagolysosomal fusion
Tx: macrolides

Question 10

A 5 y/o boy comes in with sore throat fever and exudate with a rash. Who is the culprit/morph/VF?

Answer 10

GAS—-> S pyogenes
Morph:SPE toxin(lysogenic phage)
M protein
Hyaluronic acid capsule

Question 11

A 18 y/o boy comes in with sore throat fever and exudate with a rash. Who is the culprit/morph/VF?

Answer 11

EBV/CMV/HIV/Toxplasma/N gonorrhea
Morph: EBV/CMV—->DNA Env
Target: B cells HIV: CD4
VF: nonspecific proliferation of B cells destroyer of B cells by CD8 and NK cells(atypical T)

Question 12

A non immunized 5 y/o boy comes in with sore throat fever and exudate with gray/white on the posterior of his throat when scrapped it bleeds. Who is the culprit/morph/VF?

Answer 12

C. Diphtheriae
Morph: Gram + rods pleomorphic club shaped
VF: exotoxin inhibiting EF-2 cytotoxic, cardiotoxin, neurotoxin

Question 13

A 5 y/o boy comes in with sore throat fever and exudate with redden eyes after a summer camp trip to the public swimming pool with his camp buddies. Who is the culprit/morph/VF?

Answer 13

Adenovirus
Morph: DNA naked
VF: virus spikes Penton fibers

Question 14

A 5 y/o boy comes in with sore throat fever and exudate with child is crying and pulling on ear and has no appetite mom says. Who is the culprit/morph/VF?

Answer 14

Otitis externa
Pseudonmonas aeruginosa
S aureus
Candida species
Morph: Gram negative rod, oxidase positive, green pigment
VF: exotoxin EF-2 inhibitor Elastase

Question 15

A child comes in with his mom to ER with cough, fever, rhinitis and subglottal swelling. Who is the culprit/morph/VF?

Answer 15

Croup——->Parainfluenza virus
Morph: ss-ve RNA virus Env
HN spikes F protein
VF: fusion protein leads to giant cell formation

Question 16

A non immunized child comes in with his mom to ER with cough, fever, rhinitis and epiglottal swelling,drooling. Who is the culprit/morph/VF?

Answer 16

Hib/S aureus/S pyogenes
Morph:Gram -, pleomorphic cocco bacilli X and V factor
VF: capsule w/PRP

Question 17

A child comes in with his mom to ER with cough, fever, rhinitis and paroxysmal cough. Who is the culprit/morph/VF?

Answer 17

Bordetella pertussis
Morph: Gram - cocco bacilli—->regan Lowe medium
VF: destroys cilia filamentous hemagglutinin
Tracheal cytotoxin
Ardently Cyclase(lymphocytosis)

Question 18

A child comes in with his mom to ER with cough, fever, rhinitis and Inspiratory and expiratory wheeze and blueish. Who is the culprit/morph/VF?

Answer 18

RSV-infant
Morph: ss-ve RNA Env/G protein/F protein
VF: Fusion protein leads to gain cell formation
Tx: Palivizumab