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CPR Part II > Pneumonias > Flashcards

Pneumonias Flashcards

1
Q

Typical Pneumonia, Causes

A

*Strep. pneumoniae
Staph. aureus
Haemophilus influenzae
Gm– enterics

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2
Q

Atypical Pneumonia, Causes

A 
*Mycoplasma pneumoniae
Chlamydophila pneumoniae/psittaci
Bordetella pertussis
Legionella pneumophila
Coxiella burnetii
Viruses - parainfluenza, adenovirus, EBV, RSV (neonates)
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3
Q

Streptococcus Pneumoniae - Characteristics

A

Gm+ cocci, often diplococci
catalase –
alpha-hemolytic (green hemolysis)
bile/optochin sensitive/soluble

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4
Q

Streptococcus Pneumoniae - Virulence

A

capsule prevents depositions of C3b on surface

~90 serotypes, anti-capsular Ab provide serotype specific immunity. Type 3 serotype is the most common cause of disease.

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5
Q

Streptococcus Pneumoniae - Clinical Presentation

A

Pneumonia
Otitis Media
Meningitis
Complications - abscesses, hearing loss, neurologic problems and learning disabilities.

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6
Q

Streptococcus Pneumoniae - Vaccine

A

PCV13 (13-valent, conjugated)

PPSV23 (23-valent, polysaccharide only)

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7
Q

Mycoplasma Pneumoniae - Pathogenesis

A

Tight adhesion (via P1 adhesin) disturbs function of cilia but no cell invasion. CARDS toxin causes cell vacuolation and deterioration of cilia. Immune response causes disease.

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8
Q

Mycoplasma Pneumoniae - Characteristics, Detection

A

no cell wall, small
“fried-egg” colonies; culture not recommended
test for cold agglutinins (nonspecific)

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9
Q

Chlamydia - Characteristics, Pathogenesis

A

obligate intracellular pathogen

causes both cytopathic and immune responses

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10
Q

Chlamydophila Pneumonia

A

diagnose via serology; culture not recommended

present in > 60% of adults

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11
Q

Chlamydia psittaci

A

zoonotic infection - parrot fever, spontaneous abortion in sheep; transmitted to humans via direct contact or aerosolization of feces; clinical - confusion/altered mental state

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12
Q

Bordetella Pertussis

A

short Gm– rod

whooping cough, resembles pneumonia

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13
Q

Legionella - Characteristics

A

Gm– but difficult to gram stain
culture in buffered charcoal yeast extract agar + IRON
sequestered in macrophages (coiling phagocytosis)

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14
Q

Legionella - Environmental Source

A

iron-rich soil and water (natural and domestic)
water towers, indoor fountains, etc
tolerates temp up to 65C and chlorination
survive in amebas (coiling phagocytosis)

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15
Q

Legionella - Clinical Presentation

A

Legionnaire’s Disease
-acute ATYPICAL or TYPICAL pneumonia w/ GI SYMPTOMS; occurs in elderly persons with underlying disease
Pontiac Fever
-influenza-like disease; self-limiting more mild form of disease in healthier individuals

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16
Q

Pseudomonas Aeruginosa - Characteristics

A

flagellated Gm– bacilli, oxidase +, strict aerobe

artificial grape-like smell

17
Q

Pseudomonas Aeruginosa - Environmental Source

A

ubiquitous in the environment; soil and water

fresh fruits and vegetables; whirlpools, sinks, respiratory therapy equipment, hospitals/nosocomial

18
Q

Pseudomonas Aeruginosa - Virulence

A

LPS (septic shock), capsule (impedes clearance), toxins, biofilm formation.

19
Q

Pseudomonas Aeruginosa - Clinical Presentation

A

healthy persons - folliculitis, swimmer’s ear

immunocompromised - pneumonia (esp. in cystic fibrosis, ASPIRATION PNEUMONIA), nosocomial infections

20
Q

Legionella - Virulence

A

survival in macrophages, LPS, biofilm formation

21
Q

Patient presents w/ pneumonia. Lab has trouble w/ gram stain. What organism(s) can this be? If applicable, what further tests would you run?

A 
Legionella pneumophila (Gm– but difficult to stain)
Mycoplasma pneumoniae (no cell wall) - test for cold agglutinins
22
Q

How are endemic mycoses acquired?

A

inhalation of SPORES, typically aerosolized from disturbed soil

23
Q

Histoplasma capsulatum

Histoplasmosis

A

dimorphic fungi, intracellular (macrophages), thin wall
soil + bird/bat feces in Ohio/Mississippi river valleys
caseating granulomas + calcification, consider TB?
pulmonary, mediastinal, disseminated disease

24
Q

Blastomyces dermatitidis

Blastomycosis

A

dimorphic fungi, thick wall + broad-base budding
soil of south central US, dogs particularly susceptible
pulmonary, skin, bone, and GU disease

25
Q

Coccidioides immitis

Coccidioidomycosis

A 
dimorphic fungi
arthroconidia mold -> yeast spherule w/ endospores
pulmonary disease (persists in cavities); eosinophilia 25% of cases
26
Q

Paracoccidioidomycosis

A

pilot-wheel budding
Central/South America
pulmonary and disseminated, chronic mucocutaneous ulcers

CPR Part II (5 decks)

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