Microbiology - RTIs Flashcards

1
Q

What is pneumonia, some symptoms and investigations?

A

Inflammation of lung alveoli

  • Sx: Fever, cough, SOB, pleuritic chest pain
  • Ix: CXR, CURB-65, sputum cultures, atypical screen
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2
Q

What is the general treatment for pneumonia?

A

Supportive (O2, fluids etc.)
- Abx (guided by CURB-65)

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3
Q

What are some examples of a lower respiratory tract infection (LRTI)?

A
  • Pneumonia
  • Bronchitis
  • Empyema
  • Abscess
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4
Q

What is bronchitis, what are its causes, investigations and treatment?

A

Inflammation of medium-sized airways, mostly in smokers

  • Viral/bacterial cause
  • CXR: No changes
  • Tx: Bronchodilation, chest physio +/- Abx
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5
Q

How is hospital-acquired pneumonia defined?

A

After >48hrs of hospital admission

  • Usually intubated + ventilated
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6
Q

What are soem common pathogens of hospital acquired pnuemonia?

A
  • Staphylococcus. aureus
  • Klebsiella
  • Pseudomonas
  • Haemophilus
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7
Q

What is the most common cause of hospital acquired pneumonia?

A

Pseudomonas aeruginosa

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8
Q

What are some basic features of typical pneumonia?

A
  • Classic signs + symptoms
  • Classic CXR changes (e.g. consolidation)
  • Responds to penicillin Abx
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9
Q

What are some basic features of an atypical pneumonia?

A
  • No/atypical signs + symptoms
  • Not in keeping with CXR
  • Doesn’t respond to penicillin Abx (no cell wall) - responds well to macrolides
  • ?Extra-pulmonary features
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10
Q

What are some typical pneumonia causative pathogens?

A
  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Moraxella catarrhalis
  • Staphylococcus aureus
  • Klebsiella pnuemoniae
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11
Q

What are some buzzwords of streptococcus pneumoniae, its microscope findings and which type of pneumonia is it associated with?

A
  • Most common
  • Rusty-coloured sputum
  • +ve diplococci

CAP

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12
Q

What are some buzzwords of haemophilus influenzae, its microscope findings and which type of pneumonia is it associated with?

A
  • A/w COPD/smoking
  • Cavitating lesion
  • -ve cocco-bacilli

CAP

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13
Q

What are some buzzwords of Moraxella catarrhalis, its microscope findings and which type of pneumonia is it associated with?

A
  • A/w smoking
  • -ve Cocci

CAP

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14
Q

What are some buzzwords of staphylococcus aureus, its microscope findings and which type of pneumonia is it associated with?

A
  • A/w recent viral infection (post-influenza)
  • Cavitation on CXR
  • +ve cocci
  • Grape-bunch clusters

HAP

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15
Q

What are some buzzwords of Klebsiella pneumoniae, its microscope findings and which type of pneumonia is it associated with?

A
  • Alcoholic, elderly, haemoptysis, aspiration (stroke)
  • Cavitating lesions
  • -ve rod, enterobacter

HAP

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16
Q

What are some atypical pneumonia pathogens?

A
  • Legionella pneumophilia
  • Mycoplasma pneumoniae
  • Chlamydia pneumoniae
  • Chlamydia psittaci
  • Coxiella burnetti
17
Q

What is the general treatment for atypical pneumonias?

A

Clarythromycin

18
Q

What are some buzzwords associated with legionella pneumophilia?

A
  • Travel
  • Air conditioning
  • Water towers
  • Hepatitis
  • Hyponatraemia
  • Lymphopaenia
19
Q

What are some buzzwords associated with Mycoplasma pneumoniae?

A
  • Transverse myelitis
  • University students/boarding schools
  • Dry cough
  • Arthralia
  • Cold agglutinin test/AIHA
  • Erythema multiforme
20
Q

What are some buzzwords associated with chlamydia pneumoniae?

A

?Asthma patients

21
Q

What are some buzzwords associated with chlamydia psittaci?

A
  • Birds
  • Dry cough
22
Q

What are some buzzwords associated with coxiella burnetti?

A
  • Farm animals
23
Q

How is aspiration pneumonia caused and what is its treatment?

A
  • Unsafe swallow
  • Anaerobes from gut flora
  • Tx: Metronidazole + Tazocin
24
Q

What RTI is associated with HIV, its features, buzzwords and treatment?

A

P. jiroveci / PCP

  • Ground glass shadowing (bat-wing)
  • Silver stain
  • Honeycombing + cystic appearance on CT
  • Dry cough + desaturation
  • Co-trimoxazole
25
What RTI pathogens are associated with a splenectomy?
NHS (encapsulated organisms) - N. meningitidis - H. influenzae - S. pneumoniae
26
What RTI pathogens are associated with cystic fibrosis?
- Pseudomonas aeruginosa - Burkholderia cepacia
27
What RTI pathogen is associated with neutropenia, its features, buzzwords and treatment?
Aspergillus - Blood-streaked sputum - Halo sign - Amphotericin B
28
What is the treatment of CAP?
- Calculate CURB-65 score 0-1 (Mild): - Amoxicillin PO 5/7 - 2nd line/pen alergy: Macrolide PO 5/7 - OPD Tx 2 (Moderate): - Amoxicillin PO 5-7/7 + Clarithromycin PO 5-7/7 - ?Admission 3-5 (Severe): - Co-amoxiclav IV 7/7 + Clarythromycin IV 7/7 - Admit +/- ?ITU
29
What are the elements of the CURB-65 score?
1 point each: - Confusion - Urea >7 - RR > 30 - BP < 90/69 - >=65yrs
30
What is the treatment of HAP?
Dependent on Trust guidelines - Ciprofloxacin + Vancomycin - IF Severe: Tazocin + Vancomycin
31
What is seen on a covid CXR + it's treatment?
- Ground-glas shadowing - Tx: Dexamethasone
32
What Abx is given for pneumonia if MRSA is confirmed?
Vancomycin
33
What Abx is given for pneumonia if Psuedomonas is confirmed?
Tazocin (piperacillin + tazobactam)