Pulm - Infectious Disease

Question 1

What is pneumonia?

Answer 1

Infection of the lung parenchyma

Question 2

What are the three main pattern types seen on CXR in patients with pneumonia?

Answer 2

Lobar;

bronchopneumonia;

interstitial

Question 3

What are the two most common causes of lobar pneumonia?

(Give percentages for the two.)

Answer 3

S. pneumoniae (95%);

Klebsiella pneumoniae (5%)

Question 4

Bronchopneumonia is typically ____focal and ___lateral.

Answer 4

Bronchopneumonia is typically multifocal and bilateral.

Question 5

Which type of pneumonia is characterized by relatively mild upper respiratory symptoms?

Answer 5

Interstitial

(atypical)

Question 6

Aspiration pneumonia is typically caused by which organisms?

(Give a few examples.)

Answer 6

Anaerobic bacteria

(e.g. Bacteroides, Fusobacterium, Peptococcus)

(from the oropharynx)

Question 7

What is the most common cause of community-acquired pneumonia?

Answer 7

S. pneumoniae

Question 8

What are the two most common causes of secondary pneumonia?

Answer 8

1. S. pneumoniae
2. S. aureus

Question 9

Which causal organism associated with secondary pneumonia is often complicated by abcess and/or empyema formation?

Answer 9

S. aureus

Question 10

What is a common cause of pneumonia in patients with cystic fibrosis?

Answer 10

Pseudomonas aeruginosa

Question 11

Klebsiella pneumoniae is associated with pneumonia following what?

Answer 11

Aspiration of enteric flora

Question 12

Name an organism associated with both secondary pneumonia and also pneumonia superimposed on COPD.

Answer 12

Haemophilus influenzae

Question 13

Name two organisms associated with both community-acquired pneumonia and also pneumonia superimposed on COPD.

Answer 13

Moraxella catarrhalis;

Legionella pneumophila

Question 14

What are the two most common causes of atypical pneumonia?

Answer 14

1. Mycoplasma pneumoniae
2. Chlamydia pneumoniae

Question 15

What is the most common cause of atypical pneumonia in children?

Answer 15

RSV

Question 16

What is a common cause of atypical pneumonia in immunosuppressed patients (e.g. in patients posttransplant)?

Answer 16

CMV

Question 17

S. aureus and H. influenzae are both associated with secondary pneumonia superimposed on pneumonia caused by what?

Answer 17

Influenzavirus

Question 18

Name a few common causes of bronchopneumonia.

Answer 18

H. influenzae;

S. aureus;

• Legionella pneumonia*;
• Moraxella catarrhalis*

Question 19

What is a zoonotic cause of atypical pneumonia associated with high fevers?

Answer 19

Coxiella burnetti

(‘Q fever’)

Question 20

Epiglottitis is most commonly caused by what?

Answer 20

H. influenzae

Question 21

Bronchitis is mostly of _______ etiology.

Answer 21

Bronchitis is mostly of viral etiology.

Question 22

Pneumonia is mostly of _______ etiology.

Answer 22

Pneumonia is mostly of bacterial etiology.

Question 23

Hospital-acquired pneumonia is almost always a(n) ________ (typical/atypical) ________ (bacterial/viral) pneumonia.

Answer 23

Hospital-acquired pneumonia is almost always a typical bacterial pneumonia.

Question 24

Ventilator-acquired pneumonias put one at risk for what two organisms in particular?

Answer 24

Legionella spp.;

Pseudomonas spp.

Question 25

Which Mycobacteria spp. is associated with cytic fibrosis?

Answer 25

M. abcessus

Question 26

What are the most common two non-TB Mycobacteria spp.?

Answer 26

M. Kansasii;

MAC (if AIDS is suspected)

Question 27

Which virus of the Paramyxoviridae family causes acute upper and lower respiratory tract infections in all age groups?

Answer 27

Human metapneumovirus

Question 28

Which Pseudomonas virulence factor promotes adherence to respiratory epithelium and interferes with effective phagocytosis and antibody- or complement-mediated killing?

Answer 28

Alginate

Question 29

Do Pseudomonas spp. form biofilms?

Answer 29

Yes.

Question 30

Alginate expression in Pseudomonas is almost exclusively seen in patients with what diease?

Answer 30

Cystic fibrosis

Question 31

Describe M. catarrhalis in terms of its microbiology.

Answer 31

(HIGH clinical significance)

Gram-negative diplococcus; oxidase-positive

Question 32

True/False.

M. catarrhalis is highly penicillin-sensitive.

Answer 32

True/False.

M. catarrhalis is often penicillin-resistant.

Question 33

What pathogen is only very likely to be seen in a diabetic patient with pneumonia who recently traveled to SE Asia or Northern Australia?

Answer 33

Burkholderia pseudomallei

Question 34

Which Burkholderia spp. can cause chronic, necrotizing pneumonia in CF patients?

Answer 34

Burkholderia cepacian