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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
Q

Treatments for legionella

A

Azithromycin
Fluoroquinolones

26
Q

Common viral causes of atypical pneumonia

A

Influenza
RSV
Parainfluenza

27
Q

Bacteria with peptidoglycan bound cell membrane containing sterols that requires cholesterol –> grows on fried egg colonies. To small to show up on gram stain

A

Mycoplasma pneumonia

28
Q

Cause of ciliostasis in M pneumonia

A

Respiratory epithelial damage due to hydrogen peroxide

29
Q

Complications of M pneumonia

A

Hemolytic anemia
Stevens Johnson syndrome
Raynaud’s phenomenon

30
Q

Hypersensitivity type of Stevens Johnson syndrome

A

Type IV hypersensitivity

31
Q

Increases risk of hemolysis in M pneumonia

A

Sickle cell disease

32
Q

Treatments for M pneumonia

A

Erythromycin
Tetracyclines –> doxy

33
Q

Prophylaxis for M pneumonia used in households with high-risk pt

A

Macrolide or doxycycline

34
Q

TWAR agent

A

Chlamydophila pneumonia

35
Q

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

A

Chlamydophila pneumoniae

36
Q

Metabolically inert form of Chlamydophila pneumoniae

A

Elementary body

37
Q

Metabolically active form of Chlamydophila pneumoniae

A

Reticulate body

38
Q

Methods used to identify inclusions of Chlamydophila pneumoniae

A

Giemsa stain
Immunofluorescence

39
Q

Foreign material will localize to this portion of the lungs if the pt is sitting or standing

A

Posterior-basal segment of R lower lobe

40
Q

Foreign material will localize to this portion of the lungs if the pt is supine

A

Superior segment of R lower lobe

41
Q

Most common segment affected in aspiration pneumoniae

A

Superior segment of R lower lobe

42
Q

Foreign material will localize to this portion of the lungs if the pt is on the R lateral decubitus

A

R middle lobe or posterior segment of R upper lobe

43
Q

Common causal organisms of lung abscess in community acquired aspiration pneumonia

A

Oral anaerobes
Strep pneumonia
Klebsiella pneumonia

44
Q

Oral anaerobes that can cause lung abscess in aspiration pneumonia

A

Prevotella
Bacteroides
Peptostreptococcus
Fusobacterium

45
Q

Capsulated gram negative bacteria that ferments lactose. Forms colonies on MacConkey Agar and MAC. Possible causal organism of lung abscess in aspiration pneumonia

A

Klebsiella pneumoniae

46
Q

Common causes of lung abscess in hospital acquired aspiration pneumonia

A

Oral anaerobes
Hospital gram negative enterics
S aureus

47
Q

Complications of aspiration pneumonia

A

Lung abscess
Empyema

48
Q

Common causal organisms in post-influenza pneumonia

A

S aureus
Strep pneumonia
H influenzae

49
Q

Complication of post-influenza pneumonia

A

Empyema

50
Q

Hallmark of post-influenza pneumonia

A

Abscess

51
Q

Treatments for post-influenza pneumonia

A

Vancomycin
Linezolid
Clindamycin

52
Q
A

Respiratory II (17 decks)

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