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pneumonia organisms Flashcards

1
Q

what are the three bacteria that cause atypical pneumonia

A

mycoplasma pneumoniae
chlamydia pneumoniae
legionella pneumophila

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2
Q

strep pneumo:
gram stain
capsule and shape
appearance on culture

A 
gram positive
encapsulated diplococcus (lancet-shaped)
alpha-hemolytic=green on blood agar
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3
Q

how can strep pneumo be differentiated from:
strep viridians
staph aureus
other bacteria

A

optochin sensitive
catalase negative
quellung reaction

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4
Q

what are the three virulence factors of strep pneumo

A

capsule
IgA protease
lipoteichoic acid

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5
Q

what bacteria are implicated in aspiration pneumonia

A

strep pneumo

klebsiella

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6
Q

how does pneumonia caused by strep pneumo look on cxr

A

lobar consolidation

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7
Q

which bacteria does rusty sputum indicate

A

strep pneumo

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8
Q

how can diagnosis of strep pneumo be confirmed (2 ways)

A

gram stain and culture

rapid urinary antigen test

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9
Q

staph aureus:
gram stain
capsule

A

gram positive

encapsulated

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10
Q

how can staph aureus be differentiated from
other staphylococci
other cocci

A

coagulase positive

catalase positive

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11
Q

which bacteria are most common causes of HAP

A

staph aureus

pseudomonas

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12
Q

which bacteria are implicated in post-influenza pneumonia?

A

strep pneumo

staph aureus

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13
Q

which bacteria can cause necrotizing pneumonia and lung abscesses

A

staph aureus
klebsiella
Nocardia

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14
Q

how does infection with staph aureus appear on cxr

A

diffuse infiltrates

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15
Q

pseudomonas aeruginosa:
gram stain and shape
2 things on culture

A

gram negative
bacilli
blue-green with grape-like odor

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16
Q

how do you differentiate pseudomonas from other gram negative bacilli

A

does not ferment lactose

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17
Q

what two types of pneumonia is pseudomonas especially responsible for

A

HAP/VAP

CF patients

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18
Q

what are the virulence factors of pseudomonas and their action

A

endotoxin: causes fever and shock

exotoxin A: blocks protein synthesis

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19
Q

which pneumonia-causing bacteria is often seen in burn wound infections?

A

pseudomonas

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20
Q

klebsiella pneumoniae:
gram stain and shape
virulence factor
2 common pathology features

A

gram negative bacilli
capsule
red currant jelly sputum and necrotizing infection

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21
Q

how can klebsiella be differentiated from other gram negative rods

A

ferments lactose and incapable of growth at 10C

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22
Q

what populations are susceptible to klebsiella

A

alcoholics

malnourished

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23
Q

which bacteria is cultured on chocolate agar with factors V (NAD) and X (hematin)

A

haemophilus influenzae

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24
Q

what bacteria are implicated in exarcerbations of COPD

A

haemophilus influenzae

moraxella catarrhalis

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25
Q

haemophilus influenzae:
gram stain and shape
virulence factor

A

gram negative coccobacillary

capsule

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26
Q

which especially virulent strain of h. influenzae does the vaccine protect against

A

capsular type B

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27
Q

moraxella catarrhalis:
gram stain and shape
susceptible population

A

gram negative coccobacillary

elderly, COPD

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28
Q

which bacteria is never CAP and essentially only seen in ICU/VAP

A

acinetobacter baumanii

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29
Q

acinetobacter baumanii:
gram stain and shape
susceptible population

A

gram negative coccobacillary

patients on mechanical ventilation

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30
Q

which bacterial cause of pneumonia lacks cell wall and what does that preclude

A

mycoplasma pneumoniae
use of vancomycin, penicillins, cephalosporins, etc
and gram stain

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31
Q

what is the most common cause of pneumonia in school aged children and who else?

A

mycoplasma pneumoniae

military recruits and prisoners

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32
Q

what is the virulence factor of mycoplasma pneumoniae

A

adhesin:

binds to ciliated epithelial cells and reduces ciliary clearance

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33
Q

what are three diagnostic tests for mycoplasma pneumoniae?

A

PCR
cold agglutinins
grows on Eaton agar

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34
Q

what other organs can mycoplasma pneumoniae affect

A

cardiac and CNS (encephalitis) involvement

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35
Q

what causes atypical pneumonia in kids? older adults?

A

mycoplasma

chlamydia

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36
Q

legionella pneumophila:
gram stain and shape
virulence factors/characteristics

A

gram negative bacillus
prevent phagolysosome fusion in alveolar macrophage
cell wall endotoxin

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37
Q

what two diseases does legionella cause?

A

legionnaire’s disease: severe atypical pneumo with diarrhea, confusion
Pontiac fever: mild flu-like syndrome

38
Q

what organisms can be diagnosed using a urinary antigen test

A

strep pneumo

legionella

39
Q

how is legionella diagnosed

A

grows on charcoal yeast with iron and cystein
urine antigen test
silver stain instead of gram

40
Q

what organism commonly causes hyponatremia with pneumonia?

A

legionella

41
Q 
match the genome shape to virus:
linear ssRNA
helical linear -ssRNA, segmented
linear dsDNA
pleomorphic linear -ssRNA
A

parainfluenza and human metapneumovirus
influenza
adenovirus
RSV

42
Q 
how are the following viruses transmitted:
influenza
RSV
adenovirus
parainfluenza
A

influenza: airborne respiratory droplets
respiratory droplets and direct contact
aerosol, fecal-oral, direct contact
respiratory droplets

43
Q

describe the pathology of influenza

A

neuraminidase degrades mucus layer and infections causes necrosis of respiratory epithelium

44
Q

why does influenza cause myalgias

A

cytokine release from necrosis of respiratory epithelium

45
Q

which viruses can be diagnosed by RT-PCR

A

influenza and RSV

46
Q

what is Reye’s syndrome and which organisms and drug are implicated

A

influenza/VZV and aspirin

encephalopathy and liver degeneration following the flu

47
Q

what organism is the most important cause of pneumonia and other LRTI in infants

A

RSV

48
Q

what is the virulence factor for RSV? what is the basis for prevention using palvizumab for prevention?

A

surface spikes: cause respiratory epithelium cells to fuse forming syncytium
palvizumab: antibody against F protein, neutralizes infectivity of virus in premies

49
Q

how does RSV infection present in adults

A

mild, self-resolving URT infection

50
Q

what are two diagnostic tests for RSV

A

RT-PCR

rapid antigen test

51
Q

how does RSV present in adults

A

mild URTI

52
Q

what sometimes follows RSV pneumo in infants

A

asthma

53
Q

adenovirus commonly causes viral pneumonia in which population?

A

military recruits

54
Q

what virus can cause atypical pneumonia with diarrhea and vomiting

A

adenovirus

55
Q

what other illnesses can adenovirus cause?

A

febrile pharyngitis
conjunctivitis
hemorrhagic cystitis
gastroenteritis

56
Q

what commonly follows pneumo caused by adenovirus

A

bronchiectasis or bronchiolitis obliterans

57
Q

military recruits get vaccinated against which organism that no one else does? what serotypes are covered?

A

adenovirus

serotypes 4 and 7

58
Q

what are the virulence factors of parainfluenza virus

A

F protein
neuraminidase
hemagluttinin

59
Q

what illnesses do the 4 strains of parainfluenza cause

A

HPIV-1,2: croup
HPIV-3: croup and pneumonia and bronchiolitis
HPIV-4: common cold

60
Q

what is croup? what organisms can cause it

A

URTI with seal-like barking cough and stridor

HPIV-1,2,3, influenza, RSV, HMPV

61
Q

what is infection by human metapneumovirus often mistaken for

A

RSV, influenza, HPIV

62
Q

where is SARS endemic to and what are distinctive pathologic features?

A

east asia
leukopenia and thrombocytopenia
affects middle and lower lobes

63
Q

what is distinctive about the pathology of MERS?

A

pneumonia and ARDS with hemoptysis

AKI common

64
Q

how does histo show up under microscope?

A

macros filled with oval yeasts

65
Q

what are 2 pathologic characteristics of histo?

A

pancytopenia

mouth/GI ulcers

66
Q

what’s the most common pathologic feature of blasto? what else happens?

A

ulcerated, wart-like lesions

-bone, GU, CNS involvement

67
Q

what does blasto look like under microscope?

A

big, broad-based buds

68
Q

what does coccidioides look like under microscope?

A

spherules filled with endospores

69
Q

what is a common pathologic feature of coccidioides?

A

eosinophilia

70
Q

what are 2 common pathologic features of paracoccidioides?

A

submandibular lymphadenopathy

facial, ulcerated, nodular leasions

71
Q

how does paracoccidioides look under microscope?

A

pilot wheel configuration: multiple buds

72
Q

what are 3 common pathologic manifestations of aspergillus?

A

hemoptysis
fungus balls
allergic aspergillosis: IgE response with expectoration of brownish bronchial plugs

73
Q

how does aspergillus look under microscope?

A

septate hyphae with acute angle branching

-and radiating conidia

74
Q

what are 2 common pathologic findings in mucormycosis?

A

frontal lobe abscesses

rhinocerebral sinusitis

75
Q

what 4 conditions is mucormycosis associated with

A

immunosuppression
diabetes
iron overload
burns

76
Q

how does mucormycosis look under microscope?

A

non-septate right angle branching hyphae

77
Q

how does pneumocystis appear on microscope (2 things)?

A

alveoli filled with foamy exudate from cysts

helmet-like cysts on silver stain

78
Q

how is pneumocystis stained?

A

silver or Giemsa

79
Q

what disease does cryptococcus in immunosuppressed/AIDS

A

meningitis

80
Q

how does cryptococus appear under microscope?

A

single narrow-based bud with capsule around it

81
Q

nocardia:
gram stain
other stain for it
appearance on microscope

A

gram positive
weakly acid fast
thin branching filaments: fungal appearance

82
Q

what three diseases/pathologies is nocardia responsible for?

A
  1. PNA
  2. lung abscesses/empyema
  3. brain abscesses
83
Q

rhinovirus:
2 distinct characteristics about growth
virulence factor

A
  1. won’t replicate below 33C
  2. acid labile
    - binds ICAM-1 on epithelial cells
84
Q

what is the difference between rhinovirus and coronavirus?

A

corona can cause GI illness

85
Q

bordetella pertussis:
gram stain and structure
virulence factor
common pathologic feature

A

gram negative coccobacillus
AB toxin: increases cAMP
lymphocytosis

86
Q

3 stages of infection with pertussis

A

catarrhal: 2 weeks of mild URTI
paroxysmal: 2-3 months of whooping cough
convalescent: 1-2 weeks of reduction in cough

87
Q

corynebacterium diphtheriae:
gram stain and shape
appearance on microscope
virulence factor

A

gram positive bacillus
arranged in palisades
AB toxin: blocks EF-2/protein synthesis

88
Q

diphtheriae: 3 common pathologic features (besides pseudomembrane)

A

bull neck: cervical lymphadenopathy
cardiac toxicity
neurotoxicity

89
Q

how is diphtheria cultured and stained?

A

Loeffler medium or tellurite plate

methylene blue

90
Q

what three organisms cause otitis media and sinusitis?

A
  1. strep pneumo
  2. H flu
  3. moraxella
91
Q

what are 2 virulence factors of TB

A
  • cord factor: inhibits macro maturation, induces TNF-alpha release
  • sulfatides: inhibits phagolysosome fusion (assisted by PKnG protein)
92
Q

how is TB cultured?

A

lowenstein-jensen agar

pulm (7 decks)

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