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Pulmonology Exam > Respiratory Pathogens > Flashcards

Respiratory Pathogens Flashcards

1
Q

community acquired respiratory pathogens

A

-strep pneumoniae
-haemophilus influenza
-moraxella catarrhalis
-legionella pneumonphilia
-bordetella pertussis
-corynebacterium diphtheriae

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2
Q

hospital-acquired (nosocomial) respiratory pathogens

A

-legionella pneumophilia
-pseudomonas aeruginosa

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3
Q

division point - community vs hospital acquired

A

in hospital > 72 hrs, it is hospital acquired

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4
Q

upper respiratory tract infections (URIs)

A

-strep pneumonia
-haemophilus influenza
-moraxella cararrhalis
-corynebacterium diphtheriae

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5
Q

lower respiratory tract infections (LRIs)

A

-strep pneumoniae
-haemophilus influenza
-bordetella pertussis
-legionella pneumophilia
-pseudomonas aeruginosa

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6
Q

community acquired pneumonia - overview

A

*common
*risk factors include respiratory tract disease, smoking, alcohol abuse, comorbidities, immunodeficiency, and acid reducing drugs

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7
Q

which 3 community-acquired pneumonias typically follow viral infection (like flu or covid)

A
  1. strep pneumoniae
  2. strep pyogenes
  3. staph aureus
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8
Q

where does the majority of community-acquired pneumonia come from

A

aspiration of upper airway bacteria (90%)
*only 10% from hematogenous pneumonia

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9
Q

streptococcus pneumoniae - morphology

A

*encapsulated gram positive coccus
*Lancet-shaped diplococci
*ALPHA hemolytic (due to pneumolysin)

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10
Q

strep pneumoniae - virulence factors

A

ANTIPHAGOCYTIC POLYSACCHARIDE CAPSULE
*protein adhesions, IgA protease, pneumolysin
*techoic acid
*phosphorylcholine

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11
Q

strep pneumonia - pathophysiology

A

-acquired by inhalation of droplet nuclei or direct contact
-spreads to lungs through microaspiration

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12
Q

strep pneumoniae - main host defense

A

serospecific antibodies

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13
Q

what is the most common / severe infection for people who had a splenectomy

A

strep pneumoniae

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14
Q

strep pneumoniae - clinical infection

A

*lobar pneumonia (rust-colored sputum)
*sinusitis
*otitis media
*MENINGITIS

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15
Q

strep pneumonia - diagnosis

A

-gram stain of sputum (lancet-shaped diplococci; gram +)
-culture of sputum or sterile body fluid

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16
Q

haemophilus influenza

A

*gram negative coccobacilli
*requires CHOCOLATE agar
*factor X and V required for growth

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17
Q

what agar is necessary to grow haemophilus influenza

A

chocolate agar

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18
Q

what factors are necessary for haemophilus influenza

A

factor X and V

19
Q

what is the most virulent strain of haemophilus influenza

A

strain B

20
Q

haemophilus influenza - virulence factors

A

*antiphagocytic polysaccharide capsule (polyribitol phosphate - PRP)
*PILI
-lipooligosaccharide
-IgA proteases
-beta lactamases

21
Q

what is the main host defense against haemophilus influenza

A

serospecific antibodies

22
Q

haemophilus influenza - clinical infection

A

*lobar pneumonia
*sinusitis
*otitis media
*MENINGITIS
*EPIGLOTTITIS
*conjunctivitis

23
Q

haemophilus influenza - diagnosis

A

*gram stain or culture (chocolate agar)
*PCR of CSF or blood

24
Q

moracella catarrhalis

A

*gram negative coccobacillus
*looks like haemophilus influenza
*less virulent that haemophilus influenza

25
Q

legionella pneumophilia

A

*gram negative rod
*requires cysteine for growth (BCYE agar)
*serogroup 1 is the most important
*can cause community and hospital acquired pneumonia

26
Q

legionella pneumophilia - virulence factors

A

*LPS/lipid A (endotoxin)
*facultative INTRACELLULAR bacteria (not killed by ROS or phagocytosis)

27
Q

legionella pneumophilia - pathophysiology

A

*acquired by inhalation of droplets from an infected AEROSOL (water droplets in environment)
*cooling towers, showers, spas, whirlpools, fountains, grocery store and flower show misters
*able to survive in hot water tanks

28
Q

legionella pneumophilia - clinical infection

A

*severe pneumonia
*systemic inflammatory response can be quite severe, causing septic shock
*high fatality rate

29
Q

legionella pneumophilia - pontiac fever

A

*much less severe, influenza-like illness
*host response causes the majority of symptoms

30
Q

legionella pneumophilia - risk factors

A

-older age
-lung disease
-kidney, liver, or heart disease
-immunocompromised
-cigarette smoking
-alcohol abuse

31
Q

legionella pneumophilia - diagnosis

A

*detection of serogroup 1 specific lipopolysaccharide antigens in URINE (using ELISA testing)

32
Q

legionella pneumophilia - prevention

A

-monitor water sources through periodic culturing
-hyperchlorination or superheating of water
-discontinuing or shutting off problematic water features

33
Q

pseudomonas aeruginosa

A

*gram negative rods
*GREEN PIGMENT
*musty GRAPE ODOR
*found in most, warm environmental soils, plant materials, and water

34
Q

pseudomonas aeruginosa - virulence factors

A

**ALGINATE (helps biofilms)
*EXOTOXIN A (kills host cells)
*virulence genes controlled by quorum sensing

35
Q

pseudomonas aeruginosa - pathophysiology

A

*inhalation of droplets from infected aerosol or other environmental source
*introduced to lung through microaspiration
*can also go into skin
*colonization extremely common in hospitalized and very ill people (including IV drug users)

36
Q

pseudomonas aeruginosa - clinical presentations

A

-pneumonia
-UTIs
-hot tub folliculitis

37
Q

bordetella pertussis (whooping cough)

A

*gram negative coccobacilli
*many nutritional requirements

38
Q

bordetella pertussis - virulence factors

A
  1. attachment:
    *fimbriae
    *FHA
    *pertussis toxin - ciliary paralysis
  2. evasion of phagocytosis
    *adenylate cyclase toxin (inhibits cAMP)
39
Q

bordetella pertussis - pathogenesis

A

*inhalation and subsequent adherence to ciliated respiratory epithelial cells
*local tissue damage and loss of protective respiratory cells
*COUGH
*VERY CONTAGIOUS

40
Q

bordetella pertussis - 3 phases of clinical manifestation

A
  1. catarrhal (1-2 weeks): upper airway
  2. paroxysmal (2-3 months): lower airway
  3. convalescent (1-2 weeks): recovery
41
Q

bordetella pertussis - clinical manifestations during paroxysmal phase

A

*coughing paroxysms
*inspiratory “whoop”
*post-tussive emesis (coughing to the point of throwing up)**
*LYMPHOCYTOSIS is a clue

42
Q

prevention of bordetella pertussis

A

*vaccination of children
*macrolide prophylaxis

43
Q

diagnosis of bordetella pertussis

A

PCR of nasopharyngeal swab or aspirate (“gold standard”)

Pulmonology Exam (36 decks)

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