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LC Respiratory week 4 > Microbiology 2 > Flashcards

Microbiology 2 Flashcards

1
Q

What are the host defences associated with the nasopharynx?

A

Nasal hairs
Ciliate epithelia
IgA

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2
Q

What are the host defences associated with the oropharynx?

A

Saliva
Sloughing
Cough

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3
Q

What is the common organism associated with epiglottitis?

A

Haemophilus influenzae type B (HiB)

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4
Q

What are some of the risk factors for getting epiglottitis?

A

being immunocompromised /immunosuppressed

Transmission of capsulated strain to unvaccinated host

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5
Q

How can you test which organism is causing the epiglottis?

A

Blood culture

Not throat swab due to irritating the throat and causing resp failure

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6
Q

What antibiotic do you treat epiglottitis with?

A

Ceftriaxone

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7
Q

What is Haemophilus influenza in terms of stain etc?

A

Gram negative coccobacillus

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8
Q

What are the host defences in the conducting airways? (trachea and bronchi)

A

Mucociliary escalator
Cough
AMP’s
Cellular and humoral immunity

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9
Q

How may you get infection in your conducting airways?

A

By trauma or incubation

Abnormalities with the ciliary elevator for example etc

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10
Q

What type of infections are more common in people with COPD?

A

Bacterial 50%

Viral 30%

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11
Q

Why are people with COPD more prone to infections?

A

Over time the inflammation leads to impaired cilliary clearance, effectively reduces the host’s normal defence and leads to increased susceptibility to infection. Which in turn leads to acute exacerbations of COPD. Causes of these exacerbations can be viral or bacterial, and the normal culprets are organisms we routinely associate with standard chest infections

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12
Q

What is one of the most commonly encountered organisms for COPD patients?

A

Moraxella catarrhalis. Which is a gram negative coccus

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13
Q

How would you test and treat infections in COPD?

A

Testing

  • sputum culture
  • sputum purulence
  • CXR

Treatment
- only treat if increase in sputum purulence of new CXR change or pneumonia

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14
Q

What is the specific treatment for acute exacerbation of COPD?

A
  • 1st line Amoxicillin 500 mg TDS (5 days)
  • 2nd line Doxycycline 200mg D1 > 100 mg D2-5

Aim to cover in 1st instance H. influenzae, M. catarrhalis & S. pneumoniae

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15
Q

What is Cystic Fibrosis?

A

Inherited disease leads to abnormally viscous mucous – blockages of many tubular structures including conducting airways & lungs.

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16
Q

What are the 2 organisms that you should worry about the most in terms of CF?

A

Pseudomonas aeruginosa and Burkholderia cepacia

17
Q

Is acute bronchitis viral or bacterial?

A

Viral

18
Q

Is pneumonia viral or bacterial?

A

Bacterial

19
Q

Would you usually give antibiotics for acute bronchitis?

A

Not usually

20
Q

What is whooping cough and describe some clinical features?

A 
Acute tracheobronchitis
“cold like” symptoms for two weeks
paroxysmal coughing (2 weeks)
repeated violent exhalations with severe inspiratory “whoop”, vomiting common
residual cough for month or more
21
Q

What is the causative organism for whooping cough?

A

Bordetella pertussis =

Gram negative coccobacillus

22
Q

How would you diagnose whooping cough:?

A

Bacterial culture - takes a while?
PCR - more commonly used
- however have to get the swab when the person has only been symptomatic for less than 3 weeks as after 3 weeks the test will show negative for Pertussis

23
Q

How would you treat whooping cough?

A

Treat it with antibiotics if <21 days cough

24
Q

What are the common lung infections and their organisms?

A

CAP

  • S.pneumoina, H.Infleunza
  • atypical pneumonia - mycoplasmic pneumonia etc

HAP
TB

25
Q

What is the rough pathology of CAP?

A

Organism reaches lungs > immune activation & infiltration (systemic response) > fluid & cellular build up in alveoli leads impaired gas exchange

26
Q

What are the most common causes of CAP?

A

Strep pneumonia
(viruses)
H.influenza

etc

27
Q

How would you diagnose CAP?

A

Sputum culture

Viral PCR

28
Q

What is legionella pneumonia?

A
  • It is an atypical pneumonia
  • Gram negative bacteria
  • It invades alveolar macrophages and then replicates
  • Get a flu like illness
  • transmitted by inhalation of
    water droplets
  • air conditioning, dodgy hotels etc
29
Q

How do you diagnose legionella?

A

Urinary antigen
Culture
PCR

30
Q

How do you treat legionella?

A

Levofloxacin

31
Q

How do you treat CAP mild/mod (0-2)?

antibiotic man

A

Amoxicillin (doxycycline)

32
Q

How do you treat CAP severe (3-5) if in ICU/HDU?

antibiotic man

A

Co-amoxiclav + clarithromycin (levofloxacin)

33
Q

How do yo treat HAP severe? (antibiotic man)

A

IV amoxicillin + metronidazole + gentamicin (IV Co-trimoxazole + Metronidazole +/- Gentamicin)

34
Q

How do you treat HAP non severe? (antibiotic man)

A

PO Amoxicillin + Metronidazole (PO Co-trimoxazole + Metronidazole)

35
Q

What is pneumocystis pneumonia?

A

(PCP)
One of the most frequent and severe opportunistic infections in people with weakened immune systems
- AIDS/HIV
- Immunosuppression

It is due to inhalation of fungus?

36
Q

How do you treat pneumocystis pneumonia?

A

co - trimoxaole ? check

37
Q

What is aspergillus?

A

A fungal chest infection
usually IC/IS patients

Treatment
Amphotericin B
Voriconazole
Surgery

38
Q

What is the organism in TB?

A

Mycobacterium TB

- acid alcohol fast bacilli - thick waxy coat

LC Respiratory week 4 (6 decks)

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