Pneumonias CIS

Question 1

a Gram – rod that can cause both CAP and nosocomial pneumonia

Answer 1

could be klebsiella or pseudomonas

Question 2

associated with a relative bradycardia in relation to the patients fever.

Answer 2

legionella

Question 3

This organism usually associated with the inhalation of infected excrement from pigeons

Answer 3

chlamydia psitacci

Question 4

This organism is an obligate intracellular that cause pneumonia.

Answer 4

chlamydia

Question 5

an IgM autoantibody that is directed against the I antigen of red blood cells.

Answer 5

this test is cold agglutinin, for mycoplasma pneumonia (college dorms, etc.)

Question 6

Mycoplasma Pneumonia

Answer 6

Most common pneumonia in young adults.
Smallest free living organism
No cell wall – No penicillin

go with a macrolide, e.g.

Question 7

Clinical Manifestations of mycoplasma pneumonia

Answer 7

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

Question 8

Sputum specimens are yellow in nature and yield optochin sensitive organisms with a positive Quellung reaction.

Answer 8

Strep pneumo

an encapsulated organism, should vaccinate splenectomy patients

and be worried about sickle cell

Question 9

what is wool-sorter’s disease?

Answer 9

anthrax

Question 10

cave explorers get

Answer 10

histo from bats

Question 11

cat breeders get

Answer 11

toxoplasmosis

worry about preggos and HIV +

Question 12

WHat stains silver and is predisposed in AIDS patients?

Answer 12

Pneumo jirovecii

Question 13

morphology and staining of H flu

Answer 13

Gram neg coccobacillus

Question 14

neisseria gonorrhaeae staining and morphology

Answer 14

bean-shaped gram neg diplococci

Question 15

pneumo jiroveci staining and morph

Answer 15

silver stain
cup and saucer

goes well with oral thrush, immunocompromised

Question 16

Staph aureus stain and morph

Answer 16

gram + clusters

Question 17

Strep pneumo stain and morph

Answer 17

gram + encapsolated lancet-shaped diplococci

Question 18

organs typically affected by cryptococcus?

Answer 18

CNS, esp in immunocompromised

Question 19

what respiratory illness does H flu cause in children?

Answer 19

epiglottitis

see a bulge on lateral x-ray (thumb sign)

Question 20

RSV causes what in young children?

Answer 20

bronchiolitis

Question 21

corona virus causes

Answer 21

common cold, SARS, MERS

Question 22

Bactrim- what do we use it for?

Answer 22

can be used for pneumocystis prophylaxis

also used on skin infections

Question 23

Clindamycin is used to treat?

Answer 23

anaerobes

side effect: c. diff.

Question 24

erythromycin is used for?

Answer 24

atypical pneumonias

like legionella

Question 25

methicillin/ nafcillin used for?

Answer 25

gram + organisms, esp. staph if resistant, vancomycin

Question 26

erythema nodosum on the legs can be indicative of what?

Answer 26

sarcoidosis, or fungal infection among many other things.

Question 27

Gram negative bacillus that is one of the most common causes of nosocomial pneumonia

Answer 27

Pseudomonas aeroginosa causes green fluorescent sputum

Question 28

Gram negative facultative intracellular bacterium that is transmitted by flea bites

Answer 28

yersinia pestis plague

Question 29

a gram negative coccobacillary rod that, if typable is encapsulated.

Answer 29

H flu | could also be bordetella pertussis

Question 30

The most common species of fungus that would cause a “fungus ball” is?

Answer 30

Aspergillus flavus

Question 31

Someone has a positive PPD test with no symptoms. What's the best thing to do?

Answer 31

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.

Question 32

indications for a quantiferon gold test

Answer 32

BCG vaccine same indications as for a PPD or a close call on the PPD

Question 33

coxsackie virus causes, in children,

Answer 33

hand foot and mouth disease

Question 34

adenovirus causes

Answer 34

common cold

Question 35

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?

Answer 35

moraxella cattarhalis can cause ear infections in children

Question 36

drug for prophylaxis for Influenza B?

Answer 36

Oseltamivir (trade name: tamiflu)

Question 37

Ziehl Nielssen stain =

Answer 37

acid fast stain

Question 38

. Ethambutol side effects

Answer 38

difficulty with her vision and a complaint of a spinning sensation. On examination you notice vertical nystagmus.

Question 39

significance of polyurethane foam work?

Answer 39

can --> hypersensitivity pneumonitis

Question 40

Reading the PPD: 5 mm is positive in

Answer 40

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

Question 41

Reading the PPD: 1mm is positive in

Answer 41

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.)

Question 42

Reading the PPD: 15 mm or more is positive in

Answer 42

Persons with no known risk factors for TB

Question 43

Isoniazid side effects

Answer 43

peripheral neuropathy use vitamin B6 to counteract it

Question 44

india ink stain is for?

Answer 44

cryptococcus

Question 45

toxoplasmosis in an HIV pt would be seen as

Answer 45

ring-enhancing lesion on the brain

Question 46

HIV pt with diarrhea could have

Answer 46

Mycobacterium Avian complex

Question 47

most common cause of post influenza bacterial pneumonia

Answer 47

Staphylococcus aureus

Question 48

An organism without a cell wall

Answer 48

mycoplasma

Question 49

An alpha-hemolytic gram positive organism

Answer 49

streptococcus

Question 50

An aerobic gram positive bacteria that forms spores.

Answer 50

anthrax

Question 51

An intracellular pathogenic bacteria similar to rickettsia, but with genetic and physiologic differences.

Answer 51

coxiella burnetti