Pneumonias CIS Flashcards
a Gram – rod that can cause both CAP and nosocomial pneumonia
could be klebsiella or pseudomonas
associated with a relative bradycardia in relation to the patients fever.
legionella
This organism usually associated with the inhalation of infected excrement from pigeons
chlamydia psitacci
This organism is an obligate intracellular that cause pneumonia.
chlamydia
an IgM autoantibody that is directed against the I antigen of red blood cells.
this test is cold agglutinin, for mycoplasma pneumonia (college dorms, etc.)
Mycoplasma Pneumonia
Most common pneumonia in young adults.
Smallest free living organism
No cell wall – No penicillin
go with a macrolide, e.g.
Clinical Manifestations of mycoplasma pneumonia
Respiratory tract
- Pharyngitis, laryngitis, acute bronchitis, bronchopneumonia
Skin and mucosa
- Maculopapular and vesicular exanthema, urticarial, purpura, erythema nodosum, erythema multiforme, Stevens-Johnson syndrome
Central Nervous System
- Meningitis, meningoencephalitis, acute psychosis, cerebritis, Guillain-Barre syndrome
Parenchymatous organs
- Pancreatitis, diabetes mellitus, non-specific reactive hepatitis, subacute thyroiditis
Miscellaneous
- Hemolytic anemia, pericarditis, thromboembolism
Sputum specimens are yellow in nature and yield optochin sensitive organisms with a positive Quellung reaction.
Strep pneumo
an encapsulated organism, should vaccinate splenectomy patients
and be worried about sickle cell
what is wool-sorter’s disease?
anthrax
cave explorers get
histo from bats
cat breeders get
toxoplasmosis
worry about preggos and HIV +
WHat stains silver and is predisposed in AIDS patients?
Pneumo jirovecii
morphology and staining of H flu
Gram neg coccobacillus
neisseria gonorrhaeae staining and morphology
bean-shaped gram neg diplococci
pneumo jiroveci staining and morph
silver stain
cup and saucer
goes well with oral thrush, immunocompromised
Staph aureus stain and morph
gram + clusters
Strep pneumo stain and morph
gram + encapsolated lancet-shaped diplococci
organs typically affected by cryptococcus?
CNS, esp in immunocompromised
what respiratory illness does H flu cause in children?
epiglottitis
see a bulge on lateral x-ray (thumb sign)
RSV causes what in young children?
bronchiolitis
corona virus causes
common cold, SARS, MERS
Bactrim- what do we use it for?
can be used for pneumocystis prophylaxis
also used on skin infections
Clindamycin is used to treat?
anaerobes
side effect: c. diff.
erythromycin is used for?
atypical pneumonias
like legionella
methicillin/ nafcillin used for?
gram + organisms, esp. staph
if resistant, vancomycin
erythema nodosum on the legs can be indicative of what?
sarcoidosis, or fungal infection among many other things.
Gram negative bacillus that is one of the most common causes of nosocomial pneumonia
Pseudomonas aeroginosa
causes green fluorescent sputum
Gram negative facultative intracellular bacterium that is transmitted by flea bites
yersinia pestis
plague
a gram negative coccobacillary rod that, if typable is encapsulated.
H flu
could also be bordetella pertussis
The most common species of fungus that would cause a “fungus ball” is?
Aspergillus flavus
Someone has a positive PPD test with no symptoms. What’s the best thing to do?
INH for 9 months (isoniazid)
active TB would be INH, rifampin, ethambutol, and pyrozytamide for 2 months followed by just 2 of those.
if the redness extends a long way but the edema does not, it’s a negative test.
indications for a quantiferon gold test
BCG vaccine
same indications as for a PPD
or a close call on the PPD
coxsackie virus causes, in children,
hand foot and mouth disease
adenovirus causes
common cold
70 year old man presents with a lobar pneumonia on chest x-ray. Sputum gram stain shows a gram negative diplococci.
What is the most likely pathogen?
moraxella cattarhalis
can cause ear infections in children
drug for prophylaxis for Influenza B?
Oseltamivir (trade name: tamiflu)
Ziehl Nielssen stain =
acid fast stain
. Ethambutol side effects
difficulty with her vision and a complaint of a spinning sensation.
On examination you notice vertical nystagmus.
significance of polyurethane foam work?
can –> hypersensitivity pneumonitis
Reading the PPD: 5 mm is positive in
HIV positive person
Recent close contacts of TB case
Persons with nodular or fibrotic changes on chest x-ray consistent with old healed TB
Patients with organ transplants and other immunosuppressed patients
Reading the PPD: 1mm is positive in
Recent arrivals (less than 5 years) from endemic countries
Injection drug users
Residents and employees of high risk congregate settings (e.g. prisons, nursing homes, hospitals, homeless shelters, etc.).
Mycobacteriology lab personnel
Persons with clinical conditions that place them at high risk (e.g. diabetics, prolonged steroid therapy, leukemia, end-stage renal dx, chronic malabsorption syndromes, low body weight, etc.)
Reading the PPD: 15 mm or more is positive in
Persons with no known risk factors for TB
Isoniazid side effects
peripheral neuropathy
use vitamin B6 to counteract it
india ink stain is for?
cryptococcus
toxoplasmosis in an HIV pt would be seen as
ring-enhancing lesion on the brain
HIV pt with diarrhea could have
Mycobacterium Avian complex
most common cause of post influenza bacterial pneumonia
Staphylococcus aureus
An organism without a cell wall
mycoplasma
An alpha-hemolytic gram positive organism
streptococcus
An aerobic gram positive bacteria that forms spores.
anthrax
An intracellular pathogenic bacteria similar to rickettsia, but with genetic and physiologic differences.
coxiella burnetti
