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Respiratory II > Pneumonia > Flashcards

Pneumonia Flashcards

1
Q

Common cause of lobar pneumonia

A

Strep pneumoniae

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2
Q

Reason for increased risk of pneumonia post influenza

A

Disruption of respiratory epithelium and ciliary dysfunction

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3
Q

Common causes of atypical pneumonia

A

Mycoplasma pneumoniae
Chlamydophila pneumonia
Viral

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4
Q

Timeframe for chronic pneumonia

A

Symptoms for 3 wks or more

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5
Q

CXR findings in typical pneumonia

A

Consolidation

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6
Q

CXR findings in atypical pneumonia

A

Patchy interstitial infiltrates

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7
Q

CXR findings in chronic pneumonia

A

Coin lesions

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8
Q

Localized collection of neutrophils/pus and necrotic pulmonary parenchyma

A

Lung abscess

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9
Q

Gram positive diplococci with a polysaccharide capsule. Causes typical pneumonia

A

Strep pneumoniae

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10
Q

Virulence factors of strep pneumoniae

A

Pneumolysin
IgA protease
Teichoic acid
Polysaccharide capsule
Phosphorylcholine

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11
Q

Cytokines increased by pneumolysin virulence factor of Strep pneumoniae

A

TNF
IL-1

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12
Q

Virulence factor of Strep pneumoniae that inhibits alternate complement pathway

A

Teichoic acid

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13
Q

Virulence factor of Strep pneumoniae that binds to platelet activating factor receptors on endothelial cells, leukocytes, and tissue cells to facilitate entry into cells

A

Phosphorylcholine

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14
Q

Gram positive diplococci that is optochin sensitive with alpha hemolysis on blood agar. It is bile soluble and activates autolysin.

A

Strep pneumoniae

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15
Q

Treatment options for strep pneumoniae

A

Third gen cephalosporin
Levoflox
Gariflox
Vancomycin
Penicillin if sensitive

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16
Q

Vaccine types for Strep pneumoniae

A

23 valent pneumococcal polysaccharide vaccine
Pneumococcal conjugate vaccine –> 12, 15, or 20

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17
Q

What is pneumococcal conjugate vaccine conjugated to?

A

Diphtheria toxoid

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18
Q

Gram negative rods that cause atypical pneumonia. Not transmitted person to person

A

Legionella pneumophila

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19
Q

Risk factors for legionella

A

> 50 yo
Smokers and COPD
Alcoholics
Immunocompromised

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20
Q

Main target of legionella in the human host

A

Macrophage

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21
Q

Negative on gram stain. Positive silver stain and DFA. Cultured on BYCE with cysteine and iron agar. Obligate or facultative IC pathogen

A

Legionella

22
Q

Cytokines released by triggering of macrophage by legionella

A

TH1
IFN-gamma
IL-2

23
Q

Function of type 1 interferon release in infection with legionella

A

Reduce replication and reduce iron required by bacteria

24
Q

Signs of severe legionella infection

A

Respiratory failure
Bilateral pneumonia
Rapidly worsening pulmonary infiltrates
Neurologic symptoms

25
Treatments for legionella
Azithromycin Fluoroquinolones
26
Common viral causes of atypical pneumonia
Influenza RSV Parainfluenza
27
Bacteria with peptidoglycan bound cell membrane containing sterols that requires cholesterol --> grows on fried egg colonies. To small to show up on gram stain
Mycoplasma pneumonia
28
Cause of ciliostasis in M pneumonia
Respiratory epithelial damage due to hydrogen peroxide
29
Complications of M pneumonia
Hemolytic anemia Stevens Johnson syndrome Raynaud's phenomenon
30
Hypersensitivity type of Stevens Johnson syndrome
Type IV hypersensitivity
31
Increases risk of hemolysis in M pneumonia
Sickle cell disease
32
Treatments for M pneumonia
Erythromycin Tetracyclines --> doxy
33
Prophylaxis for M pneumonia used in households with high-risk pt
Macrolide or doxycycline
34
TWAR agent
Chlamydophila pneumonia
35
Obligate IC organism that uses host ATP. Causes atypical pneumonia. May also infect and grow in smooth muscle cells, endothelial cells, coronary A, and macrophages
Chlamydophila pneumoniae
36
Metabolically inert form of Chlamydophila pneumoniae
Elementary body
37
Metabolically active form of Chlamydophila pneumoniae
Reticulate body
38
Methods used to identify inclusions of Chlamydophila pneumoniae
Giemsa stain Immunofluorescence
39
Foreign material will localize to this portion of the lungs if the pt is sitting or standing
Posterior-basal segment of R lower lobe
40
Foreign material will localize to this portion of the lungs if the pt is supine
Superior segment of R lower lobe
41
Most common segment affected in aspiration pneumoniae
Superior segment of R lower lobe
42
Foreign material will localize to this portion of the lungs if the pt is on the R lateral decubitus
R middle lobe or posterior segment of R upper lobe
43
Common causal organisms of lung abscess in community acquired aspiration pneumonia
Oral anaerobes Strep pneumonia Klebsiella pneumonia
44
Oral anaerobes that can cause lung abscess in aspiration pneumonia
Prevotella Bacteroides Peptostreptococcus Fusobacterium
45
Capsulated gram negative bacteria that ferments lactose. Forms colonies on MacConkey Agar and MAC. Possible causal organism of lung abscess in aspiration pneumonia
Klebsiella pneumoniae
46
Common causes of lung abscess in hospital acquired aspiration pneumonia
Oral anaerobes Hospital gram negative enterics S aureus
47
Complications of aspiration pneumonia
Lung abscess Empyema
48
Common causal organisms in post-influenza pneumonia
S aureus Strep pneumonia H influenzae
49
Complication of post-influenza pneumonia
Empyema
50
Hallmark of post-influenza pneumonia
Abscess
51
Treatments for post-influenza pneumonia
Vancomycin Linezolid Clindamycin
52

Respiratory II (17 decks)

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