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Pneumonia & Fungal Infectionsl Flashcards

1
Q

Compre typical & atypical pneumonia

A

T: rapid onset, more severe symptoms, productive cough, dense consolidation on chest X-ray
S.pneumoniae, K.pneumoniae, H.influenzae, P.aeruginosa
AT: slower onset, less severe symptoms, nonproductive cough, patchy interstitial pattern on chest X-ray
Mycoplasma pneumoniae, chlamydophilo pneumoniae, chlamydia psittaci, Legionella pneumophilia, viruses & fungi.

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2
Q

Causative agents of community vs hospital-acqiured pneumonia

A

Strept.pneumoniae - C

Gram negative bacilli, S.aureus - H

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3
Q

Typing of S.pneumoniae is by …… using …..

A

Polysaccharide capsule

Specific antisera

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4
Q

Write a short note on virulence factors of S.pneumoniae

A
  1. Capsule, antiphagocytic
  2. IgA protease
  3. Pneumolysin, membrane damaging toxin
  4. Autolysin, breaks peptide cross-linking of peptidoglycan
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5
Q

Mention sites which pneumococci can invade

A

Blood stream, pleural cavity, meninges

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6
Q

The reaction used for typing of Strept.pneumoniae

A

Quellung reaction

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7
Q

Describe the character of sputum in S.pneumoniae & K.pneumoniae

A

S: rust-coloured , from blood coughed up from the lungs
K: currant-jelly sputum, thick, tenacious, blood-tinged

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8
Q

Diagnostic specimens of S.pneumoniae & H.influenzae

A

Sputum & BAL

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9
Q

Grwoth of S.pneumoniae is inhibited by……& colonies have ……. appearnce

A

Bile & optochin

Draughtsman

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10
Q

Compare the two vaccines of S.pneumoniae

A

13-valent pneumococcal conjugate vaccine, given to immunocompromised & children under age of 5 yrs.
23-valent pneumococcal vaccine, given to individuals 65 yrs or older or 50 yrs or older if chronic disease is present.

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11
Q

Factors required by H.influenza in culture

A

Heme (factor V)

NAD (factor X)

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12
Q

Mention virulence factors of H.influenzae

A

Antiphagocytic polysaccharide capsule, pili, IgA protease.

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13
Q

Enriched medium for H.influenzae

A

Chocolate agar

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14
Q

What is satellitism?

A

H.influenzae grows well around colonies of S.aureus

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15
Q

Write a short note about H.influenzae vaccination

A

Conjugated polysaccharide capsule against type b capsular polysaccharide given between 2 and 18 months of age.

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16
Q

Name Klebsiella community acquired pneumonia

A

Friedlander’s pneumonia

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17
Q

Mention virulence factors of Klebsiella

A
  1. Huge polysaccharide capsule, antiphagocytic
  2. LPS
  3. Adhesins
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18
Q

What is the specimen of Klebsiella & pseudomonas

A

Sputum

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19
Q

Effect of Klebsiella on blood & MacConckey’s agar

A

Non hemolytic

LF

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20
Q

Klebsiella typing is done by

A

Capsular antigen

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21
Q

Pseudomonas is a major cause of …..

A

Ventilator-associated pneumonia

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22
Q

Mention predisposing factors to pseudomonas pneumonia

A

Cystic fibrosis, COPD, significant break in first-line defences e.g. endotracheal tube

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23
Q

Mention effect of pseudomonas on different culture media.

A

Nutrient agar: greenish coloration with exopigment production
Blood agar: hemolytic
MacConkey’s agar: NLF

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24
Q

ST: it is used in epidemiological studies to trace source of pseudomonas infection

A

Pyocin typing

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25
Stains for mycoplasma
Giemsa or leishman
26
Two exclusive human pathogens causing atypical pneumonia
Mycoplasma pneumoniae | Chlamydophila pneumoniae
27
MOT of mycoplasma and age group
Respiratory droplets | Young adults
28
How many serotypes of mycoplasma pneumoniae
1
29
Describe the pathogenesis of mycoplasma
Attaches & damages respiratory cilia, produces CARDS toxin which causes inflammation & airway dysfunction Respiratory mucosa is not invaded, it produces hydrogen peroxide which can cause local damage
30
First choice for lab diagnosis of mycoplasma
PCR
31
Specimen for isolation of mycoplasma
Throat swabs & sputum
32
Culture media of mycoplasma must contain
Horse serum & yeast extract
33
Pathogens treated by tetracycline
Mycoplasma & Chlamydophila & Chlamydia
34
Diseases caused by legionella pneumophilia
Legionnaire’s disease | Pontaic fever
35
Substances required for growth of Legionella
Iron & cysteine
36
Virulence factors of Legionella
``` LPS Intracellular survival (facultative) ```
37
How does legionella survive in nature
Within free-living amoeba
38
MOT of Legionella pneumophilia
Inhalation of aerosolized mist generated from contaminated water source, no person-to-person
39
Mechansim of inhibiting endosomal-lysosomal fusion
Presence within amoebic cells
40
Special feature of legionella pneumonia
Hyponatremia & renal failure
41
Specimen for legionella diagnosis
Lung aspirates, BAL, biopsies
42
GR: Sputum is not used for Legionella diagnosis
Because sputum is not produced or scanty
43
Culture medium for legionella
Buffered charcoal yeast extract
44
Mention two pneumonia-causing pathogens isolated from urine
S.pneumoniae & Legionella pneumophilia
45
How to prevent legionella?
1. Avoid stagnant water 2. Eliminate aerosols generated from water sources 3. Eradication of organism by hypercholination/superheating 4. Avoid cigarettes & alcohol
46
C/P of pontaic fever
Mild self-limited flu-like, fever, myalgia, dry cough
47
Target cells chlamydophila & MOT & assocaited morbidity
Epithelial cells of mucous membrane of lung Droplets Atherosclerosis
48
Chlamydophila geimsa stain shows ….
Inclusion bodies
49
Chlamydophila can be isolated in …..
Embryonated eggs or tissue culture
50
Causative agent of ornithosis & sources of infection
Chlamydophila psittasci | Pigeon breeders, vets & workers in pet shops & poultry slaughter houses (chicken), duck & turkey.
51
Special clinical feature of Chlamydophila psittaci
Disorientation & delirium
52
Reservoir & MOT of Q fever
Coxiella burentti in sheep, goat & cattle. | Inhalation aerosols of urine, feces, placental tissue, milk & amniotic fluid, no person-to-person
53
C/P of Q fever
Mild atypical pneumonia + hepatitis
54
MOT of B.anthacis
Inahalation of spores by workers handling infected animal hides, wool & fur. No person-to-person
55
GR: B.anthracis is a potential bioterrorism agent
1. Large quantities easily grown | 2. Spores resist destraction & can be formulated into aerosols
56
Mention virulence factors of B.antharacis
1. Antiphagocytic polypeptide capsule | 2. Anthrax toxin, consists of protective antigen (B) + edema factor or lethal factor (A), B is immunogenic.
57
Describe pathogenesis of anthrax
Inahalation of endospores follows by production of toxin which impairs respiratory function, initiates toxemia, internal haemorrhage and severe oragn damage.
58
PCR for …. Is used in anthrax infection
Tox gene
59
Describe anthrax vaccine
Cell free containing protective antigen component of anthrax toxin from avirulent strains
60
Postexposure prophylaxis of B.athracis is done by ….
Ciprofloxacine & doxycycline
61
CP of adenovirus
Pharyngitis, cough, sometimes pneumonia & acute respiratory disease
62
Specimens to diagnose adenovirus
Sputum or BAL
63
Mention the CPE of adenovirus
Grapes
64
Structure of influenza virus
-ve sense, ssRNA, with segmented genome usually 8 segments, enveloped
65
Mention structure of spikes of influenza envelope and their function.
Hemagglutinin: binds to host cell surface receptors, Ab to it neutralize infectivity & prevent disease. Agglutinates animal erythrocytes. Neuraminidase: degrades mucus protective layer & cleaves neuraminic acid to release virus progeny from infected cells. Ab against it reduce soread of virus.
66
Range of disease caused by influenza viruses
Mild tracheitis to fatal pneumonia
67
H1N1 specimens for diagnosis
Nasal or throat washings or swabs
68
MOT of H5N1
Intense exposure to chicken where the virus reaches alveoli following its aerosolization
69
What is the content of all influenza vaccines
Isolates of H1N1 & H3N2 and two B strains | It is reformulated each year
70
Compare killed and live-attenuated influenza vaccines
K: given to people at extremes of age, elderly people, immunosuppressed, healthcare personnel. Given IM, SC or ID. LA: only approved for healthy individuals, prepared from heat-sensitive strains. Given by nasal spray thus provides mucosal, humoral & cell-mediated immunity.
71
The recominant vaccine uses the gene encoding ……
The viral hemagglutinin
72
Chest X-ray of SARS
Interstitial ground glass infiltrate (atypical pneumonia)
73
SARS-1 virus binds ….. | This contributes to ……..
Angiotensin-converting enzyme -2 | Dysregulation of fluid balance that causes the edema in the alveolar space.
74
Immunological & haematological abnormalities of SARS
``` Cytokine storm (till 2 weeks) Leukopenia/thrombocytopenia ```
75
Binding site & reservoir of MERS
CD-26 | Bats
76
MOT of MERS
Direct contact or indirect contact with infected camels
77
Specimens for CMV diagnosis
BAL, peripheral blood mononuclaer cells
78
MOT of hantavirus
Virus present in various species of mice & transmitted by inhalation of aerosolised excreta of infected mouse. No human-to-huamn
79
Target cells of hantavirus
Endothelial cells of blod capillary walls
80
Explain causes of death due to hantavirus infection
Inflammatory mediators cause capillaries to leak fluid into surrounding tissue, adherenece if platelets to infected endothelium & DIC, BP drops & patients die from pneumonia & shock
81
I.P. Of Hantavirus
1 to 5 weeks
82
Describe Histoplasma capsulatum morphology
Dimporphic fungus that exists as mold in soil and as yeast in tissues.
83
MOT of Histomplasma
Inhalation of spores (microconidia) found in moist soils containing high levels of nitrogen.
84
Mention the TB resempling legion caused by fungi & its aetiology
Chronic pulmonary histoplasmosis | Due to reactivation of dormant lesion
85
Specimens for Histoplasma diagnosis
Sputum, urine, blood, BM
86
Morphology of Coccidioides
A dimorphic fungus exists as mold in soil & spherule in tissue
87
MOT of Coccidioides
Inhalation of arthroconidia when soil containing the fungus is distributed by wind or human activities.
88
Indication of Pneumocystis pneumonia
Indicator infection for aids
89
Morphological forms of pneumocystis
Trophozoites & cysts
90
Specimens for Pneumocystis diagnosis
Induced sputum, BAL, lung biopsy
91
Morphology of aspergillus
Filamentous fungus widely distributed in nature
92
Mention different effects of aspergillus
Normal: alveolar macrophages engulf and destroy conidia Atopic/asthmatic/cystic fibrosis: allergic reaction Immunocompromised: invasive disease
93
Define aspergilloma
Pre-existing lung cavities in which spores germinate & produce fungal ball
94
Mention diagnostic specimens of aspergillosis
Sputum, BAL, biopsy

Respiratory Microbiology (3 decks)

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