Respiratory Infections 2

Question 1

What are the two most common pathogens causing health care associated pneumonia?

Answer 1

Methicillin resistant staph aureus and PA

Question 2

What are the 4 most common pathogens causing hospital acquired pneumonia?

Answer 2

Gram positive cocci staph aureus and strep pneumonia and gram negative enterococci and Pseudomonas species.

Question 3

What type of hospital patients are at high risk for acquiring pneumonia while in the hospital?

Answer 3

Patients on long term antibiotics, catheters, immunosuppressed and especially on a ventilator

Question 4

What are the most common pathogens causing pneumonia in neonates?

Answer 4

Group b strep, gram negative bacilli, listeria

Question 5

What is the main virus causing pneumonia in babies older than 1 month? What are the 4 bacterial pathogens causing pneumonia in babies older than 1 month?

Answer 5

Respiratory syncytial virus.

Strep pneumonia, h influenza, m catarrhalis, and s. Aureus

Question 6

What umbrella virus is RSV under and what other 3 viruses are also under this umbrella?

Answer 6

Paramyxoviruses.

RSV, hMPV, parainfluenza, and measles.

Question 7

What are 5 clinical symptoms of RSV?

Answer 7

Cough, wheezing, dyspnea, tachypnea, and cyanosis.

Question 8

How does RSV get down into the lower respiratory tract?

Answer 8

The virus attacks the epithelium of the nose and other parts of the respiratory tract. The cells are eventually sloughed off with the virus and aspirated and sent down the respiratory tract.

Question 9

What are the 5 stages of measles infection?

Answer 9

Exposure, incubation, prodrome, koplicks spots, and rash.

Question 10

What are the 4 symptoms of measles prodrome?

Answer 10

High fever, rhinitis and cough, conjunctivitis and photophobia.

Question 11

What are koplicks spots?

Answer 11

Red raised lesion with white-blue centers.

Question 12

How does the rash proceed in measles?

Answer 12

Head to toe.

Question 13

Histologically, what is the difference between pneumonia caused by bacteria and pneumonia caused by virus?

Answer 13

Bacterial is in the alveolar spaces and viral is in the intersititum

Question 14

What are 5 clinical presenting symptoms that are different for bacteria vs. virus? Fever? Epidemics? What is heard on lung exam? Appearance on CXR? Onset speed?

Answer 14

Bacteria
Abrupt
Fever
Crackles on lung exam
Lobar appearance
Not associated with epidemics

Viral
Gradual
No fever
Wheezes on lung exam
Diffuse infiltrate
Epidemics are common

Question 15

What are the two top pathogens causing lung abscess and abscesses are complications of what?

Answer 15

Complication of pneumonia.

Staph aureus and klebsiella pneumonia.

Question 16

What are the different pathogenesis causing the abscess? 4 things.

Answer 16

Aspiration of infected material, lung infection already, septic embolism, and tumor.

Question 17

What are two histo features of TB?

Answer 17

Caseating granulomatous and ghon complex

Question 18

Describe Ghon complex?

Answer 18

Lesion consisting of a calcified focus of infection and an associated lymph node.

Question 19

How do we define chronic pneumonia?

Answer 19

Pneumonia lasting for months in an immunocompromised individual

Question 20

What are the top family of pathogens causing chronic pneumonia and what are specific examples of each?

Answer 20

Bacterial, like TB.

Fungal, like histoplasma, blastomycosis, and coccidiomycosis.

Question 21

What two regions is there an endemic of histoplasma

Answer 21

Midwest and Caribbean

Question 22

What type of response do we get to a histo infection and what do we see on chest x ray

Answer 22

Granulomatous response.

Coin lesions on X-ray

Question 23

What host cell is the target of histo infection and what morph feature is typical of histo

Answer 23

Macrophages.

Pumpkin seed morphology

Question 24

Where are most infections with blastomyces

Answer 24

Southeast and central us

Question 25

What are the three main types of blasto infection

Answer 25

Pulmonary, cutaneous , and disseminated

Question 26

What part of the lungs is most commonly involved with histo, how does the pathogen divide, and what type of response does the infection yield

Answer 26

Upper lobes, broad based budding, granulomatous response

Question 27

Where are most infections of cocci

Answer 27

Southwestern, western us and Mexico

Question 28

What type of response and reaction do people yield when infected by cocci

Answer 28

They yield a delayed type hypersensitivity. They yield a granulomatous response with eosinophils

Question 29

What type of reaction is super imposed when a person is infected by cocci?

Answer 29

A pyogenic reaction because the fungus ruptures to release the endospores

Question 30

What are the 4 most common bacterial agents causing pneumonia in an immunocompromised patient

Answer 30

Pa, Tb, legionella, and listeria mono

Question 31

What are are the two viruses causing pneumonia in the immunocompromise patients

Answer 31

CMV and herpes

Question 32

What are the 4 fungi causing pneumonia in the immunocompromised patient

Answer 32

P jiroveci, Candida, Aspergillus and cryptococcus

Question 33

What are the 3 most common pathogens causing pulmonary infections in hiv patients

Answer 33

Strep pneumonia, staph aureus and h influenza

Question 34

What 2 families of pathogens do we see infection aids patients above 200 cd count. What pathogen infects when cd count drops below 200. What 3 pathogens infect less than 50.

Answer 34

Bacterial and Tb
Pneumocystis
CMV, fungi, and Mac

Question 35

What does the p jiroveci yeast look look on histo.

Answer 35

Cup shaped

Question 36

What stain do we use for Mac and what does the pathogen look like

Answer 36

Acid fast stain. Thin red forms