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Respiratory Microbiology > Pneumonia & Fungal Infectionsl > Flashcards

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
Q

Stains for mycoplasma

A

Giemsa or leishman

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26
Q

Two exclusive human pathogens causing atypical pneumonia

A

Mycoplasma pneumoniae

Chlamydophila pneumoniae

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27
Q

MOT of mycoplasma and age group

A

Respiratory droplets

Young adults

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28
Q

How many serotypes of mycoplasma pneumoniae

A

1

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29
Q

Describe the pathogenesis of mycoplasma

A

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

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30
Q

First choice for lab diagnosis of mycoplasma

A

PCR

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31
Q

Specimen for isolation of mycoplasma

A

Throat swabs & sputum

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32
Q

Culture media of mycoplasma must contain

A

Horse serum & yeast extract

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33
Q

Pathogens treated by tetracycline

A

Mycoplasma & Chlamydophila & Chlamydia

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34
Q

Diseases caused by legionella pneumophilia

A

Legionnaire’s disease

Pontaic fever

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35
Q

Substances required for growth of Legionella

A

Iron & cysteine

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36
Q

Virulence factors of Legionella

A 
LPS
Intracellular survival (facultative)
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37
Q

How does legionella survive in nature

A

Within free-living amoeba

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38
Q

MOT of Legionella pneumophilia

A

Inhalation of aerosolized mist generated from contaminated water source, no person-to-person

39
Q

Mechansim of inhibiting endosomal-lysosomal fusion

A

Presence within amoebic cells

40
Q

Special feature of legionella pneumonia

A

Hyponatremia & renal failure

41
Q

Specimen for legionella diagnosis

A

Lung aspirates, BAL, biopsies

42
Q

GR: Sputum is not used for Legionella diagnosis

A

Because sputum is not produced or scanty

43
Q

Culture medium for legionella

A

Buffered charcoal yeast extract

44
Q

Mention two pneumonia-causing pathogens isolated from urine

A

S.pneumoniae & Legionella pneumophilia

45
Q

How to prevent legionella?

A
  1. Avoid stagnant water
  2. Eliminate aerosols generated from water sources
  3. Eradication of organism by hypercholination/superheating
  4. Avoid cigarettes & alcohol
46
Q

C/P of pontaic fever

A

Mild self-limited flu-like, fever, myalgia, dry cough

47
Q

Target cells chlamydophila & MOT & assocaited morbidity

A

Epithelial cells of mucous membrane of lung
Droplets
Atherosclerosis

48
Q

Chlamydophila geimsa stain shows ….

A

Inclusion bodies

49
Q

Chlamydophila can be isolated in …..

A

Embryonated eggs or tissue culture

50
Q

Causative agent of ornithosis & sources of infection

A

Chlamydophila psittasci

Pigeon breeders, vets & workers in pet shops & poultry slaughter houses (chicken), duck & turkey.

51
Q

Special clinical feature of Chlamydophila psittaci

A

Disorientation & delirium

52
Q

Reservoir & MOT of Q fever

A

Coxiella burentti in sheep, goat & cattle.

Inhalation aerosols of urine, feces, placental tissue, milk & amniotic fluid, no person-to-person

53
Q

C/P of Q fever

A

Mild atypical pneumonia + hepatitis

54
Q

MOT of B.anthacis

A

Inahalation of spores by workers handling infected animal hides, wool & fur.
No person-to-person

55
Q

GR: B.anthracis is a potential bioterrorism agent

A
  1. Large quantities easily grown

2. Spores resist destraction & can be formulated into aerosols

56
Q

Mention virulence factors of B.antharacis

A
  1. Antiphagocytic polypeptide capsule

2. Anthrax toxin, consists of protective antigen (B) + edema factor or lethal factor (A), B is immunogenic.

57
Q

Describe pathogenesis of anthrax

A

Inahalation of endospores follows by production of toxin which impairs respiratory function, initiates toxemia, internal haemorrhage and severe oragn damage.

58
Q

PCR for …. Is used in anthrax infection

A

Tox gene

59
Q

Describe anthrax vaccine

A

Cell free containing protective antigen component of anthrax toxin from avirulent strains

60
Q

Postexposure prophylaxis of B.athracis is done by ….

A

Ciprofloxacine & doxycycline

61
Q

CP of adenovirus

A

Pharyngitis, cough, sometimes pneumonia & acute respiratory disease

62
Q

Specimens to diagnose adenovirus

A

Sputum or BAL

63
Q

Mention the CPE of adenovirus

A

Grapes

64
Q

Structure of influenza virus

A

-ve sense, ssRNA, with segmented genome usually 8 segments, enveloped

65
Q

Mention structure of spikes of influenza envelope and their function.

A

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
Q

Range of disease caused by influenza viruses

A

Mild tracheitis to fatal pneumonia

67
Q

H1N1 specimens for diagnosis

A

Nasal or throat washings or swabs

68
Q

MOT of H5N1

A

Intense exposure to chicken where the virus reaches alveoli following its aerosolization

69
Q

What is the content of all influenza vaccines

A

Isolates of H1N1 & H3N2 and two B strains

It is reformulated each year

70
Q

Compare killed and live-attenuated influenza vaccines

A

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
Q

The recominant vaccine uses the gene encoding ……

A

The viral hemagglutinin

72
Q

Chest X-ray of SARS

A

Interstitial ground glass infiltrate (atypical pneumonia)

73
Q

SARS-1 virus binds …..

This contributes to ……..

A

Angiotensin-converting enzyme -2

Dysregulation of fluid balance that causes the edema in the alveolar space.

74
Q

Immunological & haematological abnormalities of SARS

A 
Cytokine storm (till 2 weeks)
Leukopenia/thrombocytopenia
75
Q

Binding site & reservoir of MERS

A

CD-26

Bats

76
Q

MOT of MERS

A

Direct contact or indirect contact with infected camels

77
Q

Specimens for CMV diagnosis

A

BAL, peripheral blood mononuclaer cells

78
Q

MOT of hantavirus

A

Virus present in various species of mice & transmitted by inhalation of aerosolised excreta of infected mouse. No human-to-huamn

79
Q

Target cells of hantavirus

A

Endothelial cells of blod capillary walls

80
Q

Explain causes of death due to hantavirus infection

A

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
Q

I.P. Of Hantavirus

A

1 to 5 weeks

82
Q

Describe Histoplasma capsulatum morphology

A

Dimporphic fungus that exists as mold in soil and as yeast in tissues.

83
Q

MOT of Histomplasma

A

Inhalation of spores (microconidia) found in moist soils containing high levels of nitrogen.

84
Q

Mention the TB resempling legion caused by fungi & its aetiology

A

Chronic pulmonary histoplasmosis

Due to reactivation of dormant lesion

85
Q

Specimens for Histoplasma diagnosis

A

Sputum, urine, blood, BM

86
Q

Morphology of Coccidioides

A

A dimorphic fungus exists as mold in soil & spherule in tissue

87
Q

MOT of Coccidioides

A

Inhalation of arthroconidia when soil containing the fungus is distributed by wind or human activities.

88
Q

Indication of Pneumocystis pneumonia

A

Indicator infection for aids

89
Q

Morphological forms of pneumocystis

A

Trophozoites & cysts

90
Q

Specimens for Pneumocystis diagnosis

A

Induced sputum, BAL, lung biopsy

91
Q

Morphology of aspergillus

A

Filamentous fungus widely distributed in nature

92
Q

Mention different effects of aspergillus

A

Normal: alveolar macrophages engulf and destroy conidia
Atopic/asthmatic/cystic fibrosis: allergic reaction
Immunocompromised: invasive disease

93
Q

Define aspergilloma

A

Pre-existing lung cavities in which spores germinate & produce fungal ball

94
Q

Mention diagnostic specimens of aspergillosis

A

Sputum, BAL, biopsy

Respiratory Microbiology (3 decks)

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