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Respiratory > Microbiology (Respiratory) > Flashcards

Microbiology (Respiratory) Flashcards

1
Q

What should the infection control precautions for influenza include?

A

Aerosol protection for aerosol generated procedures only e.g. intubation/extubation, CPR, bronchoscopy, surgery and post mortem procedures, dental procedures, ventilation, induction of sputum.

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2
Q

When is primary influenzal pneumonia seen most and who can it effect?

A

Pandemic years, young adults (high mortality).

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3
Q

When is secondary bacterial pneumonia seen and who does it affect most?

A

Epidemic and pandemic years, more common in infants, elderly/debilitated, pre-existing disease and pregnant women.

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4
Q

What may influenza in pregnancy be associated with?

A

Perinatal mortality, prematurity, smaller neonatal size and lower birth weight.

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5
Q

What are potential complications of influenza?

A

Primary influenzal pneumonia, secondary bacterial pneumonia, bronchitis and otitis media.

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6
Q

What is the symptomatic therapy for influenza?

A

Bed rest, fluids, paracetamol.

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7
Q

What are the antivirals for influenza?

A

Oseltamivir, zanamivir.

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8
Q

What influenza strain is involved in pandemics?

A

A

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9
Q

How would you test for influenza?

A

PCR from nasopharyngeal swabs or throat swabs.

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10
Q

What might other labs use to test for influenza?

A

Immunofluorescence, antigen detection, virus culture.

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11
Q

How is the killed vaccine for flu produced?

A

Virus grown in hen eggs or cell culture then inactivated and combined with adjuvant, currently contains 2 different infleunza A and 1 B virus.

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12
Q

Who is the live attenuated vaccine offered to and how is it administered?

A

All primary school children, administered intranasally.

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13
Q

What are mycoplasma pneumonia, coxiella burnetii and chlamydia (all bacteria) all microbiological causes of?

A

Community acquired pneumonia.

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14
Q

How is pneumonia caused by mycoplasma pneumonia, coxiella burnetii and chlamydia treated?

A

All respond to tetracycline and macrolide e.g. clarithromycin.

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15
Q

What is pneumonia caused by mycoplasma pneumonia, coxiella burnetii and chlamydia sometimes known as?

A

Atypical pneumonia.

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16
Q

How would you confirm what of mycoplasma pneumonia, coxiella burnetii and chlamydia was causing a pneumonia?

A

By serology: send acute and convalescent bloods to lab in gold top vacutainer. By virus detection: PCR, currently used only for mycoplasma in Tayside.

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17
Q

What type of pneumonia is a common cause, children and young adults have highest incidences and there is a person to person spread?

A

Mycoplasma pneumoniae.

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18
Q

What 2 diseases does coxiella burnetii cause?

A

Pneumonia or pyrexia of unknown origin (Q fever).

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19
Q

What animals can people contract coxiella burnetii from?

A

Sheep and goats.

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20
Q

What is a complication of coxiella burnetii?

A

Culture negative endocarditis.

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21
Q

What does chlamydia/chlamydophila psittaci cause (usually presents as a pneumonia) and what is it caught from?

A

Pet birds.

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22
Q

What are the symptoms of bronchiolitis and what happens in severe cases?

A

1st or 2nd year of life, fever, coryza (common cold), cough, wheeze. Severe cases: grunting, decrease in PaO2, intercostal/sternal indrawing.

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23
Q

When can respiratory and cardiac failure occur in bronchiolitis?

A

Prematurity, pre-existing respiratory and cardiac disease.

24
Q

What is the aetiology of bronchiolitis?

A

Up to 80% of cases due to RSV.

25
Q

How can the lab confirm the aetiology of bronchiolitis?

A

By PCR on throat or pernasal swabs.

26
Q

What infection control measures are used in hospitals for bronchiolitis?

A

Cohort nursing, handwashing, gowns, gloves.

27
Q

What virus is the second most common cause of bronchiolitis in children?

A

Metapneumovirus.

28
Q

What types of pneumonia does chlamydia trachomatis cause and how can it be diagnosed?

A

Infantile pneumonia (it is an STI), diagnosed by PCR on urine of mother or pernasal/throat swabs of child.

29
Q

Describe what a respiratory infection with chlamydophila pneumoniae is like.

A

Person to person, mostly mild TRI, may be picked up by test for psittacosis.

30
Q

Where is the middle east respiratory syndrome coronavirus (MERS CoV) most prevalent and what animal reservoir does it use?

A

Saudi Arabia, dromedary camels.

31
Q

What are the URT defences?

A

Nasopharynx: nasal hairs, ciliated epithelia, IgA. Oropharynx: saliva, sloughing (separation of dead from living tissue), cough.

32
Q

What are the gram positive and gram negative URT colonisers?

A

Gram positive: alpha-haemolytic streptococci e.g. strep pneumoniae. Beta-haemolytic: streptocooci e.g. strep pyogenes. Staph aureus.
Gram negatives: haemophilus influenzae, moraxella catarrhalis.

33
Q

What are the conducting airway defences?

A

Mucociliary escalator, cough, AMPs, cellular and humoral immunity.

34
Q

What are the symptoms of whooping cough (pertussis)?

A

Acute trachea-bronchitis, cold like symptoms for 2 weeks, paroxysmal coughing (2 weeks), repeated violent exhalations with severe inspiratory whoop, vomiting common, residual cough for month or more.

35
Q

What microbe causes whooping cough?

A

Bordetella pertussis (gm-ve coccobacillus, exclusively human pathogen, vaccine preventable).

36
Q

How would you diagnose pertussis?

A

Culture, PCR, serology (paired sera, used to check if antibodies increase over time)

37
Q

What treatment is there for pertussis?

A

Antibiotics if less than 21 days cough.

38
Q

What are the 3 main routes of transmission for respiratory infections?

A

Contact, airborne, droplet.

39
Q

What size of particles are more likely to be airborne or droplet?

A

Airborne: <5 microns. Droplet: >5 microns.

40
Q

Give examples of diseases that are airborne.

A

MDR TB, some viruses, RTI undergoing aerosol generating procedures.

41
Q

What infection control measures are required for airborne diseases?

A

Require standard infection control precautions and a filtering face piece.

42
Q

What infection control measures are required for droplets?

A

Ideally in a single room.

43
Q

What are the lung defences against infection?

A

Normally relatively sterile, no ciliary escalator, alveolar lining fluid (surfactant, Ig, complement, FFA, AMP), alveolar macrophages and neutrophils.

44
Q

How would you test if a pneumonia is caused by strep pneumoniae?

A

Gram stain sputum (pus cells and gram positive), culture on blood agar produced alpha haemolysis.

45
Q

What is invasive pneumococcal disease?

A

Pneumonia with spread to the bloodstream, can cause meningitis.

46
Q

What is non-invasive pneumococcal disease?

A

Pneumonia without spread to bloodstream, can cause URT infection, sinus infection, ear infection.

47
Q

What are the different types of pneumonia?

A

Acute or chronic, typical (strep pneumo), atypical (complain of non-pulmonary symptoms), hospital acquired pneumonia (including ventilator associated pneumonia), aspiration pneumonia, pneumonia in the immunosuppressed/special populations.

48
Q

How would you diagnose legionella pneumonia?

A

Legionella urinary antigen (detects serogroup 1 only), culture, paired serology, now PCR available direct from sputum.

49
Q

What treatment would you give for legionella pneumonia?

A

Clarythromycin, erythromycin, quinolones e.g. levofloxacin (only use quinolones in as few cases as possible as high risk c. diff).

50
Q

Describe legionella.

A

Common environmental gm-ve bacteria (unusual cell wall structure), obligate intracellular organism (resides within water amoeba which provides nutrients and protection, invades alveolar macrophages).

51
Q

What are the clinical symptoms and signs of legionella?

A

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

52
Q

How does legionella spread?

A

No person-to-person spread, transmitted by inhalation of contaminated water droplets.

53
Q

Why does amoxicillin not work on walking pneumonia and what rashes are caused by walking pneumonia?

A

Organism has no cell wall, bullseyes.

54
Q

When is staph pneumonia more likely?

A

Post infleunza (though strep still more common), haematogeneous spread of staph aureus from people who inject IV drugs.

55
Q

Why is staph aureus pneumonia particularly bad?

A

PVL toxin is produced by staph aureus

56
Q

What types of pneumonia does bradycardia occur in and how many beats are lowered per degree rise in temperature?

A

Legionella, mycoplasma, tularaemia, chlamydia.

Respiratory (30 decks)

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