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Respiratory > Microbiology > Flashcards

Microbiology Flashcards

1
Q

what is an infection pathologically

A

inflammation due to a pathogen/infectious agent

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2
Q

describe colonisation

A

the presence of a microorganism, doesn’t always mean infection

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3
Q

what does colonisation mean for swap tests of infected patients

A

disease might not be caused by bugs found

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4
Q

what it a paired sera test

A

two separated blood test to show rise in antibodies

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5
Q

what determines the choice of treatment

A

when the microorganism has a cell wall (B-lactam?)

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6
Q

how are some infections prevented

A

vaccination

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7
Q

what are the conducting airways consisted of

A

trachea and bronchus

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8
Q

what are the upper resp. tract components

A

oropharynx, nasopharynx

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9
Q

what are the host defences against infection in the nasopharynx

A

nasal hairs, ciliated epithelia, IgA

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10
Q

what are the host defences against infection in the oropharynx

A

saliva, sloughing, cough

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11
Q

how does mucous prevent infection

A

traps pathogens

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12
Q

what is a rhinitis infection inflammation of?

A

the nose

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13
Q

give 3 examples of upper respiratory colonisers that are gram positive

A

alpha-haemolytic streptococci (strep. pneumoniae), beta-haemolytic streptococci (strep. pyogenes), staphylococcus aureus

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14
Q

give 2 examples of upper respiratory colonisers that are gram negative

A

haemophilus influenza, moraxella catarrhalis

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15
Q

what are the hosts defences in the conducting airways

A

mucociliary escalator, cough, AMPs (antimicrobial peptides), cellular and humoral immunity

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16
Q

describe what causes infection

A

trauma, intubation of airway, abnormalities of defence (e.g. ciliary escalator), virulent pathogen/ large inoculum

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17
Q

what causes an aspiration pneumonia

A

impaired cough reflex

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18
Q

what is acute bronchitis

A

infection and inflammation of the airway

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19
Q

what are the clinical features of acute bronchitis

A

productive cough, +/- wheeze and fever, normal chest exam and cxr,

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20
Q

what precedes acute bronchitis

A

a URT infection

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21
Q

are antibiotics made available for acute bronchitis

A

not usually indicated

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22
Q

what are 90% of acute bronchitis cases a result of

A

viruses

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23
Q

what are the clinical features of a COPD acute exacerbation

A

productive cough or acute chest illness, breathlessness, wheezing, increased sputum purulence

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24
Q

what usually causes an acute exacerbation of COPD

A

often follows viral infection or fall in temp/ increase in humidity

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25
Q

what is COPD

A

blanket term for several diseases characterised by airflow obstruction- mainly chronic bronchitis and emphysema

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26
Q

what is an exacerbation

A

acute worsening of symptoms

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27
Q

what is sputum purulence

A

its colour- green, yellow, brown

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28
Q

what pathogens cause an exacerbation

A

30% viral, 50% bacteria e.g streptococcus pneumonia, haemophilus influenzae, moraxella catarrhalis and gram negatives

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29
Q

what does the recurrent inflammation of the airways on chronic bronchitis

A

hyper production of mucous (inc, neutrophils) inhibits the ciliary escalator, blocking the airways and impairing the hosts immune response

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30
Q

what is pertussis

A

whooping cough

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31
Q

what is whooping cough

A

acute trachea-bronchitis

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32
Q

describe the symptoms of whooping cough

A

cold like for 2 weeks, paroxysmal coughing 2 weeks, repeated violent exhalations with severe inspiratory whoop, vomiting, residual cough for month or more

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33
Q

what microorganisms are responsible for pertussis

A

bordetella pertussis- gram neg cocoobacillus

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34
Q

how is bordetella pertussis diagnosed

A

bacterial culture, PCR, serology, clinical signs and symptoms

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35
Q

what is a paroxysm

A

a violent episode of something

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36
Q

how and when is pertussis treated

A

with antibiotic is <21 days cough

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37
Q

what are the three main routes of transmission

A

contact, airborne, droplets

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38
Q

describe airborne transmission

A

small, <5 microns, travel long distances and remain airborne

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39
Q

what precautions do does airborne transmission need

A

standard infection control and filtering face piece 3

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40
Q

describe droplet transmission

A

larger particles, >5 microns, fall to floor within 2m, spread via contact

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41
Q

what are the standard infection control precautions

A

hand washing, PPE, door closed, decontamination before leaving room

42
Q

when should a respirator be discard when airborne precautions are in actions

A

after leaving the room

43
Q

why are infections common in CF

A

due to the inefficient clearance of mucous and chronic colonisation

44
Q

what are some pathogens that cause infections in CF patients

A

Pseodomonas aeruginosa, burkholderia cepacia, staph. aureus, haemophilus influenza, strep pneumoniae

45
Q

what are (and arent) the host defences of the lower respiratory tract (lungs) and what

A

no ciliary escalator.
alveolar lining fluid- surfactant, Ig, complement, FFA, AMP
alveolar macrophages and neutrophils- phagocytosis, inflammatory response

46
Q

what are the clinical presentations of community acquired pneumonia

A

cough, increased sputum, chest pain, dyspnoea, fever, CXR with infiltrates

47
Q

what is the pathological mechanism behind community acquired pneumonia

A

organism reaches lungs, immune activation and infiltration (systemic response), fluid and cellular build up in alveoli leads to impaired gas exchange

48
Q

what is the most common pathogen that causes community acquired pneumonia

A

streptococcus pneumoniae

49
Q

what other pathogens can causes community acquired pneumonia

A

viruses, haemophilus influenzae, steph. aureus

50
Q

what are some risk factors for community acquired pneumonia

A

age, immunocompromised/suppressed,

smoking

51
Q

how is community acquired pneumonia diagnosed

A

sputum culture, purulence, viral PCR

52
Q

what is streptococcus pneumoniae sensitive to

A

amoxicillin, doxycycline, co-trimoxazole

53
Q

how is pneumococcal pneumonia treated

A

5 day course of amoxicillin

54
Q

what is the difference between invasive and non invasive pneumonia

A

invasive in blood stream

55
Q

what can invasive pneumonia cause in the brain

A

meningitis

56
Q

what microorganism causes typical community acquired pneumonia

A

streptococcus pnuemoniae

57
Q

what microorganisms cause atypical community acquired pneumonia

A

mycoplasma pneumoniae, legionella pneumonia, chlamydophila pneumonia, chlamydia psitacci, viruses

58
Q

how is legionella pneumonia diagnose

A

legionella unrinary antigen (detects serogroup 1 only), culture, paired serology, PCR from sputum

59
Q

how is legionella pneumonia treated

A

claythromycin, erythromycin, quinolones- levofloxacin

60
Q

is legionellla pneumonia typical or atypical

A

atypical

61
Q

how does legionella pneumonia survive in the body

A

invades macrophages and replicates

62
Q

what are the clinical symptoms of legionella pneumonia

A

flu like illness which may progress to a severe pneumonia with mental confusion, acute renal failure and GI symptoms

63
Q

what is the mortality rate of legionella pneumonia

A

5-30%

64
Q

how is legionella pneumonia transmitted

A

inhalation of contaminated water droplets

65
Q

what are the risk factors for legionella pneumonia

A

exposure to contaminated aerosolised water, impaired immunity, >55YO, diabetes, malignancy, altered immunity

66
Q

what is walking pneumonia

A

mild form of/ atypical

67
Q

what is not used to treat a walking pneumonia and why

A

amoxicillin as organism has no cell wall

68
Q

does does staphylococcus pneumonia follow

A

influenza

69
Q

describe how cadiovascular infections of staphylococcus pneumonia

A

haematogeneous spread of staphylococcus aureus

70
Q

what types of pneumonia cause relative bradycardia

A

legionella, mycoplamsa, tularaemia, chlamydia

71
Q

what organisms cause hospital acquired pneumonia

A

60% gram negative (e-coli, klebsiella spp, pseudomonas spp), CAP organisms (S. Aureus and anaerobes)

72
Q

how is HAP treated

A

IV amoxicillin (if penicillin allergic Co-trimoxazole) + metronidazole + gentamicin (+/- if pen. allergic)

73
Q

what are the non infective causes of pneumonia

A

pulmonary inflitrates with eosinophilia; parasites, brucella, endemic mycoses, psittacosis, tuberculosis

74
Q

what pathogens cause ‘classical flu’

A

influenza A and B viruses

75
Q

what pathogens cause flu like illnesses

A

parainfluenza viruses and many others

76
Q

what is haemophilus influenza and what does it do

A

bacterium, not primary cause of flu but can be secondary invader

77
Q

what is the most common cause of death in influenza epidemics

A

secondary bacterial infections

78
Q

what antivirals are used to treat flu

A

oseltamivir, zanamivir

79
Q

when should antivirals be given

A

only when patient is at risk of complications

80
Q

describe antigenic drift

A

when minor mutations in the surface proteins of the virus cause epidemics of flu

81
Q

what virus causes a flu pandemic

A

influenza A

82
Q

what other factors cause a flu pandemic

A

antigenic shift, segmented genome, animal reservoir/mixing vessel

83
Q

how is influenza detected in the lab

A

PCR of a swab (direct detection of virus) or antibody detection

84
Q

what is in a killed flu vaccine

A

inactivated virus- 2 different influenza A and 1 B + adjuvant

85
Q

how is a live vaccine administered

A

intra-nasally

86
Q

how are mycoplasma, coxiella and chlamydophila

A

all respond to tetracycline and macrolides

87
Q

what pathogens cause a typical pneumonia

A

mycoplasma, coxiella and chlamydophila psittaci

88
Q

how is an a typical pneumonia confirmed in a lab

A

serology or virus detection e.g PCR

89
Q

in which groups of people is community acquired pneumonia caused by mycoplasma pneumoniae most common

A

children and young adults

90
Q

how is community acquired mycoplasma pneumonia spread

A

person to person

91
Q

what is q fever caused by

A

coxiella burnetii

92
Q

what are the conditions caused by coxiella burnetii

A

pneumonia and pyrexia of unknown origin

93
Q

who does coxiella burnetii affect

A

sheep and goats

94
Q

what does chlamydophila psittaci cause

A

psittacosis

95
Q

how does psittacosis usually present

A

as pneumonia

96
Q

what is bronchiolitis and what is it also known as

A

inflammation of the fine bronchioles- respiratory syncytial virus

97
Q

who does RSV affect

A

infancy

98
Q

how does RSV clinical present

A

fever, coryza, cough, wheeze

99
Q

how does RSV present in severe cases

A

grunting, reduced PaO2, intercostal/ sternal indrawing

100
Q

what are the complications of bronchiolitis

A

respiratory and cardiac failure- common in premature babies or babies with pre existing resp or cardiac failure

101
Q

why is bronchiolitis so common

A

epidemics every winter, no vaccine, nosocomial spread in hospital wards

102
Q

what effect does metapneumovirus have on most children by the age of five

A

most antibody positive

Respiratory (26 decks)

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