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Microbiology > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Enterovirus D68 Features

A

Transmission: respiratory and GI secretions
Underlying condition: asthma
ROS: mild to severe resp illness including pneumonia
Complication: linked to flaccid paralysis

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2
Q

Moraxella catarrhalis Features

A

G-ve diplococcus, strict aerobe
Oxidase: positive
Motility: non-motile
Penicilin resistant: produce B-lactamases
*mostly colonize URT in children but also in pt’s w/ COPD

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3
Q

Haemophilus influenzae Features

A

Pleomorphic, needs factors X (hemin) and V (NAD) for growth

  • encapsulated
  • IgA protease
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4
Q

Chlamydophila pneumoniae Features

A

Transmission: droplets

Clinical syndrome: atypical pneumonia and bronchitis

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5
Q

Legionnaires Dz

A

Water source, atypical pneumonia, CNS sx’s (confusion/HA), GI sx’s (N/V/D), hematuria

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6
Q

Pneumocystis jirovecii Features

A

CM component: cholesterol instead of ergosterol
CW: contains chitin and glutan
Risk: CD4 count < 200

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7
Q

Klebsiella pneumoniae Features

A 
G-ve bacillus, non-motile
Oxidase negative -
Catalase positive +
Ferments lactose
Encapsulated
Facultative anaerobes
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8
Q

Klebsiella pneumoniae Bronchopneumonia

A

ROS: thick, bright red gelatinous sputum (“currant jelly” sputum), typical pneumonia w/ many abscesses
Risk: pt’s w/ chronic lung dz or alcoholism

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9
Q

Histoplasmosis

A

ROS: fever, cough, CP
Course: severity depends on infectious dose and pt’s health status, high intensity exposure will cause sx’s in most pt’s
Diagnosis: silver stain, thick blood smear w/ Giemsa stain

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10
Q

Intubated pt is at risk for what?

A

Typical HAP caused by Pseudomonas or Klebsiella

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11
Q

Post-streptococcal Glomerulonephritis

A

Type III Hypersensitivity, immune complexes of Abs against S. pyogenes serotypes M12 and M14 circulate w/ the ag and block small diameter blood vessels

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12
Q

Pneumocystis Pneumonia (PCP)

A

Organism: Pneumocystis jirovecii
ROS: atypical pneumonia w/ interstitial mononuclear infiltrates (predominantly plasma cells)
*most common serious opportunistic infection in HIV pt’s

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13
Q

Corynebacterium Features

A

G+ve rods, non-spore forming, aerobic

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14
Q

Legionella pneumophila Features

A

Facultative intracellular (in alveolar macrophages) causes atypical pneumonia
Transmission: aerosols from water sources
Diagnosis: urine ag test (for serogroup 1), silver stain, BYCE agar

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15
Q

Chlamydophila psittaci Features

A

Clinical syndrome: atypical pneumonia (Ornithosis)
Exposure: parrot/bird (feces)
-Obligate intracellular-
Infectious form: elementary bodies (EBs)
Noninfectious form: reticulate bodies (RBs)

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16
Q

M-protein

A

Destroys C3 convertase, thus no C3b is produced and pt cannot opsonize
*Strep pyogenes (GAS)

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17
Q

Cryptococcus neoformans Pathogenesis

A

Capsule: anti-phagocytic, provides the most virulence, down regulates immune response
- oxidizes catecholamines to prevent phagocytic oxidative damage

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18
Q

Blastomyces dermatitidis Features

A

Dimorphic (mold in the cold, yeast in the heat)
Tissue form: large yeast w/ broad-based buds and thick CW
Exposure: decaying organic matter (soil)
Geography: NC and SC

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19
Q

Rhinovirus Features (common cold)

A

4 viral capsid protein: VP1, VP2, VP3, VP4
Acid labile: yes (can’t survive in GIT)
Incubation: 48-72 hours
Transmission: 2h - 7d
Complication: can exacerbate COPD and asthma

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20
Q

Respiratory Diphtheria

A

ROS: sudden onset of educative pharyngitis, sore throat, fever, malaise
Course: thick pseudomembrane dev over pharynx, can cause resp obstruction
Complications: carditis and neuro sx’s (recurrent laryngeal n. palsy)

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21
Q

Calcifying lesions in the lung?

A

Fungi tend to cause dystrophic calcification in the lung because the indigestible complex carbohydrates that make up their CW

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22
Q

Aspergillus infections

A

Allergic aspergillosis: exacerbates asthma and CF
Invasive aspergillosis: risk is immunocompromise, can disseminate
Aspergilloma: formation of fungus ball in preexisting cavitations likely caused by TB or lung abscesses

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23
Q

Strep Pneumoniae

A

ROS: rusty sputum
Seasonality: winter/early spring
Pneumolysin: damage to epithelium by messing w/ membrane stability, it suppresses PMN chemotaxis and produces H2O2 to inhibit respiratory burst

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24
Q

Influenza Virus Features

A

Nucleocapsid: 8 segments of -ssRNA (8 for A and B; 7 for type C)
Subtypes: A is further classified by subtype on basis of hemagglutinin and neuraminidase
Hemagglutinin (H/HA): 18 types total
Neuraminidase (N/NA): 11 types total
Replication: in nucleus, virions bud from plasma membrane

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25
Q

Bordatella Pertussis Diagnosis

A

Bordet-Gengou medium
NO cotton swab, NO throat swab
*acellular FhA and pertussis toxin in the DTaP vaccine

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26
Q

Most common cause of CAP?

A

Streptococcus pneumoniae

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27
Q

Moraxella catarrhalis Diagnosis

A

Blood and chocolate agar (round, opaque colonies), hockey puck sign, colonies take pink color after 48 hours
(To differentiate from Neisseria):
DNase: positive
Nitrate reduction: positive

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28
Q

Aspergillis fumigatus Features

A

Monomorphic (bc opportunistic)
- filamentous fungus w/ septate hyphae branching dicothotomously at acute angles
Exposure: decaying matter, air, soil

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29
Q

Chlamydophila psittaci Virulence

A 
CW: no PG, has LPS with weak endotoxicity, major outer membrane protein (MOMP) is major virulence factor
Elementary Bodies (EBs): attach to microvilli and penetrate into cell, the outer membrane of EBs inhibits fusion to the lysosomes 
Reticulate Bodies (RBs): divide to become smaller EBs again and then lyse the cell
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30
Q

Moraxella catarrhalis Infections

A

Acute exacerbation of COPD in elderly, pneumonia, bacteremia, periorbital cellulitis, conjunctivitis

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31
Q

Rhinovirus Pathogenesis (common cold)

A

Receptors: ICAM-1 and LDL-R
Transmissible due to stability in environment (naked), grows at 33-35C so ideal for upper RT infection, af drift so high # of serotypes

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32
Q

Moraxella catarrhalis Pathogenesis (otitis media)

A

Colonization of nasopharynx then migrates to middle ear through Eustachian tube, migration usually precipitated by viral URI

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33
Q

Pseudomonas aeruginosa Risk

A

CF pt’s risk of dev pneumonia, burn pt’s (blue green pus), neutropenic pt’s

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34
Q

Haemophilus influenza Culture and Dx

A

Coagulase: negative
Catalase: positive
Culture: requires chocolate agar w/ factor X (hemin) and factor V (NAD)

35
Q

Melioidosis Clinical Features

A

Incubation: about 9d
ROS: pneumonia in adults, localized skin infection in children
Diagnosis: Ashdown’s agar (shows corn flower head morphology)

36
Q

Moraxella catarrhalis Pathogenesis Characteristics

A

Adherence to resp epithelium, intracellular invasion, complement resistance, biofilm formation, induction of inflammation, acts as co-pathogen

37
Q

Mycoplasma pneumoniae Virulence

A

P1 protein: used for tropism to attach to cilia and microvilli of bronchial epithelium causing stasis of cilia
Community Acquired Respiratory Distress Syndrome (CARDS) Toxin: leads to cytotoxic effect and causes persistent cough
Produces H2O2: causes tissue destruction and damage to RBC membranes

38
Q

Cryptococcus neoformans Features

A

Monomorphic (bc its opportunistic), encapsulated, urease +ve

Transmission: bird droppings (soil)

39
Q

Lysozyme

A

.

40
Q

Streptococcus pyogenes (Group A)

A
  • Beta hemolytic
  • Bacitracin sensitive
  • patechiae on palate
41
Q

Haemophilus influenza Pathogenesis

A

Pili, and non-pilus adhesions
LPS: impairs ciliary function, endotoxin
Capsule: antiphagocytic and composed of polyribose ribitol phosphate (PRP)
IgA proteases: >30 different proteases identified

42
Q

Adenovirus Pathogenesis (common cold)

A

Receptor: CAR (coxackie adenovirus receptor) cell surface glycoproteins belonging to IgG superfamily
Fiber protein: enables attachment to host cell
Inclusion: basophilic intranuclear inclusion bodies

43
Q

Corynebacterium diphtheriae Epidemiology

A

Vaccine: DTaP it is the D for diphtheria toxoid

<10 cases/yr in US

44
Q

IgA

A

Protective toward viral infections of upper respiratory tract

45
Q

Moraxella catarrhalis Pathogenesis (COPD exacerbation)

A

Altered mucociliary function, airway colonization and infection, triggered by acquisition of new strains

46
Q

Lactoferrin

A

Limits availability of iron for growth of bacteria

47
Q

Coronavirus Pathogenesis (common cold)

A

Envelope spikes (peplomer): bind to host cell
Hemagglutinin: RBC agglutination
*nucleoprotein, matrix glycoproteins

48
Q

Corynebacterium diphtheriae Pathogenesis

A

Virulence factor: diphtheriae exotoxin
Non-invasive: does not enter into bloodstream
Affect: local and systemic sx’s, inflammation and formation of pseudomembrane, damage to organs

49
Q

SARS Features

A

ROS: h/o fever + 1 or > sx of LRTI (dyspnea, cough, etc)
Diagnostics: Abs by ELISA, or viral DNA by RT-PCR
Reservoir: bats
Intermediate host: civet cats
Incubation: 2-10d
Peak shedding: 6-11d post start of illness

50
Q

Hemophilia influenzae Features

A

Most common cause of epiglottitis, can cause otitis media, pneumonia and meningitis
Pleomorphism, G-ve, coccobacillus, facultative anaerobe, normal component of upper RT flora

51
Q

Streptococcus Features

A 
G+ve cocci, in pairs or chains, mostly facultative anaerobes, catalase negative
Capsule: hyaluronic acid
Hemolytic: seen on blood agar
Lancefield grouping: 21 serologic groups
M protein: 80 serotypes
Dx: PCR, RFLP, DNA sequencing
52
Q

MERS Features

A

Animal Host: Arabian camels
Evaluation: done 14 days after possible exposure
ROS: fever w/ or w/o chills, cough, dyspnea, hemoptysis, sore throat, GI sx’s, abnml CXR
Comorbidities: DM, HTN, chronic cardiac or kidney dz
Dx: rRT-PCR, serology

53
Q

Coronavirus Features (common cold)

A

Capsid: spike protein on envelope (important ag protein)
Incubation: 2-5d
Transmission: via respiratory droplets (3 hours)
*MERS and SARS

54
Q

Mycoplasma pneumoniae Features

A

Does not Gram stain, has sterols in CM
Transmission: droplets
#1 cause of atypical pneumonia (CAP) <40yo
Diagnosis: > or = to 4 fold increase or decrease in Ab titer, or IgM cold agglutinins
*intrinsically resistant to B-lactams bc lack CW

55
Q

SARS Clinical Course

A

Prodrome: 3-7d, temp >38C, malaise, HA< myalgia, no URT sx’s usually
Respiratory phase: non-productive cough, dyspnea, resp failure
CXR: pneumonia by 7-10d
Labs: lymphopenia
Dx: serology, RT-PCR

56
Q

Cocciioides immitis Features

A

Dimorphic
Tissue form: large round double-walled “spherules” (20-150 microns) containing uninucleate endospores
Geography: desert/dry areas so SW of US and NW Mexico
- spherules: protect it from phagocytosis
*most virulent of all human mycotic pathogens

57
Q

Corynebacterium diphtheriae Features

A

Gray-to-black colonies of dub shaped G+ve rods arranged in V or L shape
Granules: aka volutin produced on Loeffler coat serum medium stain metachromatically

58
Q

Pseudomonas aeruginosa Features

A

Most commonly causes Otitis Externa, strict/obligate aerobe, common cause of atypical pneumonia
Pigment: blue green
MDR

59
Q

Hantavirus Pulmonary Syndrome (HPS) Features

A

Transmission: rodent urine/droppings/saliva via airborne transmission most commonly
Seasonality: fall/winter when it gets cold and mice come inside

60
Q

Flu Sx’s in Adults

A 
Rapid onset after 1-4 day incubation
Sudden malaise and HA lasting few hrs
Abrupt raise in fever, chills, myalgia, loss of appetite and nonproductive cough (can last 3-8 days)
Recovery: complete in 7-10 days
Contagious: end of day 1 for next 7 days
61
Q

Klebsiella pneumoniae Virulence

A
  • Large capsule
  • Pili: type 3 strains have pili that mediate attachment for tropism and for biofilm formation
  • Endotoxins prevents phagocytosis and blocks C3b
62
Q

HPS Pathogenesis

A

Increase in capillary permeability that results from endothelial damage caused by host immune response to viral ag
- widespead exudate caused by the permeability

63
Q

Influenza Nomenclature

A

Type/Host of origin/Geographic origin/Strain #/year of isolation/Subtype of HA and NA
E.g. - A/Avian/Hong King/03/68 (H3N3)

64
Q

Adenovirus Features (common cold)

A

Capsid: naked icos w/ fiber VAP for tropism
Acid labile: no (it can survive in GIT)
Incubation: 4-8d
Transmission: 7d-3mo
Vaccine: approved only for military recruits
ROS: URI, hemorrhagic cystitis, conjunctivitis

65
Q

Bordatella pertussis Virulence

A

Pili: filamentous hemagglutinin (FHA) mediates attachment to ciliated epithelium
Pertussis toxin: ADP-ribosylates Gi keeping high levels of intracellular cAMP will shut down chemokine receptors and pt will develop hypoglycemia due to increased insulin secretion

66
Q

Legionella pneumophila Virulence

A

Inhibits fusion of phagosome w/ lysosome, pore-forming toxin kills macrophages
Exudate: alveoli filled w/ fibrin, PMNs, macrophages and RBCs
*most damage caused by host immune response

67
Q

HPS Clinical Features

A

Prodromal (3-5d): nonspecific sx’s fever, HA, V/D, myalgia
Cardiopulmonary (24-48h): dyspnea, dry cough, pulmonary edema (pink frothy sputum) circulatory collapse
Covalescent: significant dieresis, improvement/recovery
Diagnosis: RT-PCR for viral RNA, ELISA for IgM and IgG Abs against Hantavitus

68
Q

Pontiac Fever

A

Organism: Legionella
Patient: immunocompetent
ROS: mild flu-like sx’s
*self-limiting (so it resolves after about 1 wk)

69
Q

Melioidosis

A

Aka Whitemore’s Dz
Organism: Burkholderia pseudomallei
Geography: SE Asia and Australia
- G-ve rod, motile, aerobic
- Facultative intracellular, non spore forming
Transmission: broken skin w/ exposure to soil and fresh water

70
Q

Hemophilia influenzae Epiglottitis

A

ROS: enlarged epiglottis shows the “thumb sign” on X-ray, aryepiglottic folds thickening

71
Q

IgA Protease carriers

A 
NASH:
Neisseria
(IgA protease)
Strep pneumo
H. influenzae
*the enzyme cleaves IgA at the hinge region
72
Q

H. Influenzae Clinical Syndromes

A

EMOP:

  • epiglottitis (thumb sign on X-ray)
  • meningitis
  • otitis media
  • pneumonia
73
Q

Histoplasmosis capsulatum biopsy finding

A

Yeasts packed inside alveolar macrophages

74
Q

Ornithosis Clinical Features

A

ROS: constitutional (fever, HA, chills, myalgia) nonproductive cough and consolidation
*Look for prominent systemic involvement (CNS - encephalitis, GI - N/V/D, other - hepatosplenomegaly)
Diagnosis: serology

75
Q

Coccidioidomycosis

A

ROS: self-limited flu-like illness, in immunocompromised can disseminate
Seasonality: late summer, early fall

76
Q

C. neoformans Pneumonia

A

ROS: atypical pneumonia
Diagnosis: India Ink stain, latex particle agglutination

77
Q

Pseudomonas aeruginosa Virulence

A

Huge capsule (slime layer)
Exotoxins A: ADP-ribosylates eEF-2 target is the liver
Elastase: destroys bv walls

78
Q

Hantavirus Features

A

RNA, lipid envelope w/ 2 major glycoproteins (for attachment)
Sin Nombre Virus (SNV) - commonest cause of Hantavirus Pulmonary Syndrome (HPS)
Geography: west of MS river

79
Q

Blastomycosis

A

ROS: productive cough, CP, fever; also skin lesions on exposed skin
Investigation: KOH

80
Q

Histoplasma capsulatum

A

Dimorphic, facultative intracellular Tissue form: yeasts w/ halos in phagocytes
Environment form: septate hyphae w/ microconidia and tubercular macroconidia
Geography: MS and OH river valleys
Exposure: bat roost or chicken coops (soil w/ increased Nitrogen content)

81
Q

Ornithosis Course

A

Spreads to RES producing necrosis, seeded in lung through blood causing lymphocytic inflammation in alveoli
ROS: edema, thickening of alveolar wall, infiltration of macrophages, necrosis and occasional hemorrhages

82
Q

Cutaneous Diphtheria

A

ROS: papule dev on skin and progresses to non-healing ulcer, systemic sx’s can dev

83
Q

Mycoplasma pneumoniae Atypical Pneumonia

A

Most common form of atypical pneumonia in young adults

Microbiology (14 decks)

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