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CRRAB II Week 7 > PBL 7 - Pneumonia Diagnosis and Treatment > Flashcards

PBL 7 - Pneumonia Diagnosis and Treatment Flashcards

1
Q

Typical presentation of Moraxella Catarrhalis:

A

Typical Pneumonia/Bronchopneumonia: sudden onset, productive cough, consolidation

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2
Q

What is the second most common cause of bacterial pneumonia in patients with COPD behind HiB?

A

Moraxella Catarrhalis

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3
Q

How do you diagnose Moraxella Catarrhalis?

A
  • Hydrolyzes tributyrin
  • Produces DNase
  • Reduces nitrite to nitrate
  • Does NOT ferment sugars
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4
Q

How should you treat Moraxella Catarrhalis?

A
  • Amoxicillin-Clavulanate
  • Cephalosporins
  • TMP-SMX
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5
Q

What is the clinical presentation of Strep. pneumo?

A

Lobar pneumonia (CAP)

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6
Q

What is the most common cause of community acquired pneumonia (CAP) and secondary pneumonia?

A

Strep. pneumo.

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7
Q

How do you diagnose Strep pneumo.?

A
  • Gram +
  • Diplococci
  • Catalase (-)
  • Susceptible to optochin (OVRPS)
  • Quellung Reaction (Ig binds to capsule)
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8
Q

What is important to remember about treatment of Strep. pneumo.?

A

Treatment is MANDATORY.

-Use Penicillin G (G= IV, IM)

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9
Q

How can you prevent Strep. pneumo.?

A

Pneumovax with capsular polysaccharides

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10
Q

What is the most common cause of secondary pneumonia and pneumonia superimposed on COPD?

A

Haemophilus Influenza Type B

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11
Q

How do you diagnose Haemophilus Influenza Type B?

A
  • Gram (-)
  • Requries Hemin (Factor X) and NAD (Factor V) on Chocolate Agar
  • Immunofluorescence
  • Positive Quellung test
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12
Q

What should you use for treatment of Haemophilus Influenzae Type B?

A

Cephalosporin (Ceftriaxone)

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13
Q

What should you use for prevention of HiB?

A
  • HIB vaccine (capsular polysaccharide)

- Rifampin prophylaxis for close contact

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14
Q

What does Respiratory Syncytial Virus (RSV) cause?

A

Kids pneumonia

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15
Q

How do you diagnose RSV?

A
  • Detection of virus in respiratory secretions

- Serology

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16
Q

How should you treat RSV pneumonia?

A
  • Supportive

- Ribavirin in severe cases

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17
Q

What is Ribavirin?

A

Guanosine analog to stop vRNA synthesis (Nucleoside inhibitor)

18
Q

How do you prevent RSV pneumonia?

A

Synagis (F antigen vaccine)

19
Q

What type of pneumonia does Streptococcus agalactiae cause?

A

(GROUP B STREP)

-Neonatal penumonia -within days after birth

20
Q

How do you diagnose Streptococcus agalactiae?

A
  • Gram (+)
  • Beta-hemolytic
  • Bacitracin resistant
21
Q

How do you treat Streptococcus agalactiae?

A

Penicillin G

22
Q

What is Mycoplasma Pneumoniae also known as?

A

Atypical Pneumonia/Walking Pneumonia

23
Q

What symptoms are associated with Mycoplasma Pneumoniae?

A

Gradual onset, non-productive cough, interstitial pneumonia

24
Q

How do you diagnose Mycoplasma Pneumoniae?

A
  • Presence of cold hemagglutinin
  • No cell wall = NO gram stain
  • Fried egg appearance
  • Serology
25
Q

What are the best drugs used to treat Mycoplasma Pneumoniae?

A
  • Erythromycin

- Tetracycline

26
Q

What are the signs of Chlamydia Pneumoniae?

A

-Atypical Pneumonia: gradual onset, non-productive cough, interstitial CXR

27
Q

How do you diagnose Chlamydia Pneumoniae?

A
  • Giemsa stain to visualize intracytoplasmic inclusions

- Serology

28
Q

How should you treat Chlamydia Pneumoniae?

A

Doxycycline

29
Q

What is the second most common cause of secondary pneumonia?

A

Staph. aureus

30
Q

What does Staph aureus show?

A

Pneumonia with cavitations

31
Q

How do you diagnose Staph. aureus?

A

Gram (+)
Catalase (+)
Coagulase (+)

32
Q

What should you use to treat Staph. aureus?

A
  • Penicillinase-resistant penicillins

- Vancomycin

33
Q

In what populations do you usually see Legionella pneumophila?

A

CAP in elderly smokers (“Legion smokers”)

34
Q

What type of pneumonia and symptoms does Legionella pneumophila cause?

A
  • Gradual onset
  • Non-productive cough
  • Interstitial CXR
35
Q

What do you use to Diagnose Legionella pneumophila?

A
  • Gram stain sucks; use silver stain
  • Culture on Charcoal yeast extract with iron and cysteine
  • Urinary antigen detected by radioimmunoassay
36
Q

What should you use to treat Legionella Pneumophila?

A

Erythromycin

37
Q

What is Pneumocystis Jirovecii known for?

A

Fungal opportunistic infection in AIDS.

-Pneumonia

38
Q

How do you diagnose Pneumocystis Jirovecii?

A
  • Silver stain of sputum
  • Bronchoalveolar lavage or lung Bx
  • Cysts forming dark oval bodies
39
Q

How should you treat Pneumocystis Jirovecii?

A
  • TMP-SMX

- Pentamidine

40
Q

What is Nocardia Asteroides associated with?

A

Pneumonia (chronic steroid use/immunocompromised)

41
Q

How do you make a diagnosis of Nocardia Asteroides?

A
  • Gram (+)
  • Aerobic
  • Beaded filaments
  • Weakly acid fast
42
Q

What drug should you use to treat Nocardia Asteroides?

A

TMP-SMX

CRRAB II Week 7 (8 decks)

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