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MS3 - Microbiology > Respiratory infections > Flashcards

Respiratory infections Flashcards

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Biology 101 flashcards
1
Q

Neisseria meningitidis source?

A

Lives in the nose. normal commensals

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2
Q

what group of pathogens does Neisseria meningitidis belong to?

A

G neg diplococci.

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3
Q

Neisseria meningitidis causes what diseases?

A

Cause meningitis and septicaemia.

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4
Q

Haemophilus influenzae source

A

nose.

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5
Q

what group of pathogens does Haemophilus influenzae belong to?

A

G neg cocco-bacilli.

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6
Q

Haemophilus influenzae causes what diseases?

A

Cause otitis media (children) and pneumonia (adults).

  • Type b (“Hib”)– (capsulated) causes invasive disease in children including
    meningitis
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7
Q

Strep pneumonia source

A

nose

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8
Q

Strep pneumonia what group of pathogens does it belong to?

A

G pos (diplo)cocci.

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9
Q

strep pneumonia causes what diseases?

A
  • otitis media (children)
  • pneumonia (children and elderly adults)
  • invasive disease including meningitis.
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10
Q

Moraxella (Branhamella) catarrhalis source

A

nose.

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11
Q

what group of pathogens does Moraxella (Branhamella) catarrhalis belong to?

A

G neg diplococci (kidney bean shaped).

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12
Q

Moraxella (Branhamella) catarrhalis causes what diseases?

A
  • otitis media in children

- sinusitis + COPD in adults.

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13
Q

what type of abx is Cefotaxamine

A

3rd generation cephalosporins,

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14
Q

Cefotaxamine used for what types of bacteria?

A

Broad spectrum
I. especially good for Gram negatives (Neisseria, Haemophilus),

II. good for some Gram positives (Most Streptococci incl pneumococci, not Staph)

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15
Q

Cefotaxamine route of administration

A

IV

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16
Q

Cefotaxamine CSF penetration?

A

Good CSF penetration.

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17
Q

what type of abx is Amoxycillin

A

Broad spectrum penicillins.

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18
Q

Amoxycillin used for what types of bacteria?

A

Broad spectrum penicillins.

broad spectrum, activity against Gram negatives as well as positives.

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19
Q

route of administration of Amoxycillin

A

PO

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20
Q

Amoxycillin co-administrated with?

A

Can be given with betalactamase inhibitors (Clavulanic acid) to impede resistance: Coamoxyclav/Augmentin

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21
Q

Anthonisen criteria for abx for infective exacerbation of COPD?

A

Antibiotic therapy indicated if two of:

  • Increased breathlessness
  • Increased sputum volume
  • Increased sputum purulence
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22
Q

Likely pathogens for infective COPD?

A
  • 40% of acute exacerbations are viral!

- may have colonisation of the LRT with organisms normally found in the URT such as H. influenzae, M. cattarhalis.

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23
Q

Abx for infective COPD?

A

Give amoxicillin or a tetracycline

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24
Q

Influenza caused bronchitis treatment

A
  • Amantidine, rimantidine (interfere with virus uncoating and assembly)
  • Neuranimidase inhibitors: inhaled zanamivir + oral oseltamivir
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25
Q

Sputum culture useful for which pathogens?

A

TB or Legionella only

26
Q

Throat swab useful for which pathogens?

A

Influenza PCR

27
Q

BAL

A

Bronchio-alveolar lavage; optimal sample but only in severe cases since invasive

28
Q

Urine culture useful for which pathogens?

A

Legionella

S.pneumoniae

29
Q

Assessing severity of CAP

A

CURB65

30
Q

CURB65 components

A
  • Confusion (AMT of 8 or less)
  • Urea raised >7 mmol/l
  • Respiratory rate > 30 / min
  • SBP<90 mmHg +/- DBP <60 mmHg
  • 65 and over
31
Q

CURB65 interpretation in hospital

A

≥3
- Severe pneumonia (mortality 22%, admit to hospital)

= 2
- Non-severe , (mortality 9.2%, consider admission)

0 or 1
- Non-severe (mortality 1.5%, treat at home)

32
Q

CRB65 interpretation in community

A

≥ 3 Urgent Hospital admission

1 or 2 Hospital referral and assessment

0 Treat in community

33
Q

Typical pneumonia anatomical distribution

A

Often lobar

34
Q

Atypical pneumonia anatomical distribution

A

Often multisystem, multilobar

35
Q

Typical pneumonia age group

A

older patients, less nasty pathogens

36
Q

Atypical pneumonia age group

A

younger patients

37
Q

Abx for typical pneumonia?

A

Amoxicillin sensitive, Sometimes macrolide sensitive

38
Q

Abx for atypical pneumonia?

A

Amoxicillin resistant, Macrolide sensitive

39
Q

Common typical pneumonia pathogens

A

Streptococcus pneumoniae

40
Q

Common atypical pneumonia pathogens

A

Mycoplasma,
Chlamydia,
Coxiella,
Legionella

41
Q

Aspiration pneumonia cause

A

Inhalation of material (eg food);

Usually neurological problem predisposing

42
Q

Aspiration pneumonia affects which parts of the lung

A

Commonly affects posterior segment of right upper lobe

43
Q

Aspiration pneumonia complication

A

Can lead to abscess formation

44
Q

Aspiration pneumonia mx

A
  • penicillin or cephalosporin

- PLUS metronidazole

45
Q

Nosocomial pneumonia def

A

hospital acquired pneumonia

46
Q

HAP management if a patient is not already on an abx?

A

co-amoxiclav or cefuroxime

47
Q

HAP management if a patient is already on an abx?

A

cefotaxime or ceftriaxone

48
Q

Pathogens for infected bronchiectasis/cystic fibrosis

A

Staphylococcus aureus, Haemophilus influenzae, Moraxella catarrhalis and Pseudomonas aeruginosa

49
Q

RFs for TB reactivation?

A

I. HIV
II. Immunosuppressive drugs
III. Age: very young; very old
IV. Poor nutrition

50
Q

Histological findings of TB?

A

Granulomata with central caseous necrosis

51
Q

Mantoux test used instead of which test?

A

used instead of heaf test (not used anymore)

52
Q

Mantoux test procedure

A

killed MTB, mash it up, inject into skin

53
Q

Mantoux test interpretation?

A

-ive: no reaction in skin

+ive: after 3 days a rash in the injected area/necrosis

54
Q

Problems with Mantoux test

A

false +ive if BCG vaccinated (poor specificity)

false -ive if inactive TB

55
Q

IGRA test?

A

Interferon Gamma Release Assay for latent TB

56
Q

IGRA procedure

A

ESAT6 and CFP10 genes added to blood and and see how much interferon gamma they produce

57
Q

Limitation of IGRA

A

ESAT6 and CFP10 genes also present in non tuberculosis mycobacteria

58
Q

IGRA advantage over mantoux?

A

dont show a false +ive if the person had a BCG vaccine

59
Q

NICE guidelines for management of latent TB?

A

Step 1: If positive Mantoux or IGRA, then assess for active infection
Step 2: if no active, but high RFs, give either:
- 3months of isoniazid and rifampicin or
- or 6months of isoniazid

60
Q

MDR-TB

A
  • Multidrug Resistant TB

- strains of tuberculosis that are resistant to at least the two main first-line TB drugs - isoniazid and rifampicin.

61
Q

XDR-TB

A
  • Extensive Drug Resistant TB is MDR-TB that is also resistant to three or more of the six classes of second-line drugs.

MS3 - Microbiology (11 decks)

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