Micro - Systems (Pneumonia & Meningitis)

Question 1

What are 2 common causes of pneumonia in neonates (<4 wk)?

Answer 1

(1) Group B streptococci (2) E. coli

Question 2

What are 5 common causes of pneumonia in children (4 wk-18 yr)? Of these, which is most associated with infants-3 yr age range? Which is most associated with school-aged children?

Answer 2

(1) Viruses (RSV) (2) Mycoplasma (3) C. trachomatis (infants-3 yr) (4) C. pneumoniae (school-aged children) (5) S. pneumoniae; Think: “Runts May Cough Chunky Sputum”

Question 3

What are 3 common causes of pneumonia in adults (18-40 yr)?

Answer 3

(1) Mycoplasma (2) C. pneumoniae (3) S. pneumoniae

Question 4

What are 5 common causes of pneumonia in adults (40-65 yr)?

Answer 4

(1) S. pneumoniae (2) H. influenzae (3) Anaerobes (4) Viruses (5) Mycoplasma

Question 5

What are 5 common causes of pneumonia in elderly?

Answer 5

(1) S. pneumoniae (2) Influenza virus (3) Anaerobes (4) H. influenzae (5) Gram-negative rods

Question 6

What are 3 common causes of pneumonia in alcoholics and/or IV drug users?

Answer 6

(1) S. pneumoniae (2) Klebsiella (3) Staphylococcus

Question 7

What is the most common cause of pneumonia in aspiration?

Answer 7

Anaerobes

Question 8

What are 3 common causes of atypical pneumonia?

Answer 8

(1) Mycoplasma (2) Legionella (3) Chlamydia

Question 9

What are 3 common causes of pneumonia in cystic fibrosis patients?

Answer 9

(1) Pseudomonas (2) S. aureus (3) S. pneumoniae

Question 10

What are 5 common causes of pneumonia in the immunocompromised? Which of these is particularly associated with HIV?

Answer 10

(1) Staphylococcus (2) Enteric gram-negative rods (3) Fungi (4) Viruses (5) P. jirovecii (with HIV)

Question 11

What are 3 common causes of nosocomial (hospital-acquired) pneumonia?

Answer 11

(1) Staphylococcus (2) Pseudomonas (3) other enteric gram-negative rods

Question 12

What are 3 common causes of postviral pneumonia?

Answer 12

(1) Staphylococcus (2) H. influenzae (3) S. pneumoniae

Question 13

What are 3 common causes of meningitis in newborns (0-6 mo)?

Answer 13

(1) Group B streptococci (2) E. coli (3) Listeria

Question 14

What are 4 common causes of meningitis in children (6 mo - 6 yr)?

Answer 14

(1) S. pneumoniae (2) N. meningitidis (3) H. influenzae type B (4) Enteroviruses

Question 15

What are 4 common causes of meningitis in people aged 6-60 years old? Of these, which is the #1 cause of meningitis in teens?

Answer 15

(1) S. pneumoniae (2) N. meningitidis (#1 in teens) (3) Enteroviruses (4) HSV

Question 16

What are 3 common causes of meningitis in the elderly (60 yr+)?

Answer 16

(1) S. pneumoniae (2) Gram-negative rods (3) Listeria

Question 17

For bacterial meningitis, what 2 drugs should be given empirically? What other drug may need to be added, and in what context?

Answer 17

Give ceftriaxone and vancomycin empirically (add ampicillin if Listeria is suspected)

Question 18

What are 5 viral causes of meningitis?

Answer 18

Viral causes of meningitis - (1) Enteroviruses (esp. coxackievirus) (2) HSV-2 (HSV-1 = encephalitis) (3) HIV (4) West Nile virus (5) VZV

Question 19

Of the enteroviruses, which is especially associated with meningitis?

Answer 19

Coxsackievirus

Question 20

What is a main difference in infection due to HSV-1 versus HSV-2?

Answer 20

HSV-1 = encephalitis, HSV-2 = meningitis

Question 21

In HIV patients, what are 4 common causes of meningitis?

Answer 21

In HIV - (1) Cryptococcus (2) CMV (3) Toxoplasmosis (brain abscess) (4) JC virus (PML)

Question 22

Again, what are the 4 common causes of meningitis in HIV patients? Which of these causes brain abscess? Which of these is associated with PML?

Answer 22

In HIV - (1) Cryptococcus (2) CMV (3) Toxoplasmosis (brain abscess) (4) JC virus (PML)

Question 23

How has the incidence of H. influenzae meningitis changed, and why? In what patient population are such cases usually seen today?

Answer 23

Incidence of H. influenzae meningitis has decreased greatly with introduction of the conjugate H. influenzae vaccine in last 10-15 years.; Today, cases are usually seen in unimmunized children

Question 24

What is the CSF finding of opening pressure in each of the following kinds of meningitis: (1) Bacterial (2) Fungal/TB (3) Viral?

Answer 24

(1) Increased (2) Increased (3) Normal/Increased

Question 25

What is the CSF finding of cell type in each of the following kinds of meningitis: (1) Bacterial (2) Fungal/TB (3) Viral?

Answer 25

(1) Increased PMNs (2) Increased lymphocytes (3) Increased lymphocytes

Question 26

What is the CSF finding of protein in each of the following kinds of meningitis: (1) Bacterial (2) Fungal/TB (3) Viral?

Answer 26

(1) Increased (2) Increased (3) Normal/Increased

Question 27

What is the CSF finding of sugar in each of the following kinds of meningitis: (1) Bacterial (2) Fungal/TB (3) Viral?

Answer 27

(1) Decreased (2) Decreased (3) Normal