Respiratory Tract Infections 6 Flashcards
pneumococcal vaccines contains __________
capsular polysaccharide antigens
what are the virulence factors associated with strep pneumonia
- capsule
- IgA protease
- pneumolysin: targets alveolar endothelial cells by binding to cholesterol and makes pores in the cell membrane
- autolysin
- transformation: how non-pathogenic strains becomes pathogenic
pneumolysin targets _________
alveolar endothelial cells
what are the virulence factors of Klebsiella?
- thick polysaccharide capsule (CPS/K antigen)
- LPS (O antigen)
- produces enzyme carbapenamase
- pili (fimbriae): responsible for its tissue tropism
______ is responsible or the tissue tropism in Klebsiella pneumonia
- type 3 pili
______ pneumonia is seen in community acquired pneumonia
lobar
___________ pneumococcal vaccine is given to children younger than 2 years old
conjugate vaccine aka PCV13
person comes in with fever, pleuritic chest pain and signs of lung consolidation. Pathogen for his pneumonia is found to be gram positive catalase negative alpha hemolytic and optochin sensitive. what is the pathogen?
- strep pneumonia
does klebsiella ferment lactose?
YES
what are 4 typical causes of community acquired pneumonia
community acquired = bacterial
- strep. pneumonia
- Klebsiella pneumonia
- H. influenza
- Staph aureus
necrotization of lung tissue by __________ is due to _______
Klebsiella pneumonia; endotoxin (LPS)
polymicrobial infection and putrid odor to breath and sputum can be seen in _______
pneumonia caused by Klebseilla; via aspiration
what is the function of pneumolysin, a virulence factor found in ________
pneumococcal pneumonia
- targets alveolar endothelial cells by binding to the cholesterol and making pores in the cell membrane
the most common cause of atypical community acquired pneumonia is _______
mycoplasma pneumonia
rusty colored sputum is indicative of _______
pneumonia caused by strep. pneumonia
what is the function of the O antigen in Klebsiella pneumonia
- LPS that prevents ingestion b phagocytes and impedes complement (C3b) and inhibits opsonization
describe the biology of klebsiella
- gram negative bacillus with a large polysaccharide capsule that has a mucoid appearance
- non motile
- facultative anaerobe
- catalase postive
- ferments lactose
__________ is intrinsically resistant to beta lactam antibiotics
mycoplasma because it does not have a cell wall
what are 4 properties of pneumolysin
- inhibits ciliated epithelial cell activity
- cytotoxic of alveolar and endothelial cells
- causes inflammation
- ↓ PMN effectiveness
the prolonged cough seen in atypical CAP caused by mycoplasma is due to ______
inhibition of ciliary movement by P1 adhesion proteins
usually one/two lobes are involved with community acquired pneumonia
one
what are the 3 different types of pneumonia
- lobar (community acquired, bacterial)
- bronchial (hospital acquired, viral)
- interstitial (ventilator associated)
Describe the presentation of someone with pneumonia:
- fever, pleuritic chest pain with productive cough
- bronchial breath sounds heard due to consolidation
atypical pneumonia with CNS (confusion) and GI involvement is typically due to what pathogen?
- Legionella pneumophila
______ pneumonia is typically due to ventilator associated pneumonia
interstitial
outbreaks of mycoplasma pneumonia is the highest in ______
crowded institutional settings such as prisons, colleges, military, etc
mucoid appearance in their thick capsule is seen with what pathogen?
Klebsiella pneumonia
pseudomas is gram _____
negative
K antigen in ________ is associated with the ________
Klebsiella; thick polysaccharide capsule
the most common cause of otitis externa is ________
pseudomonas aeurginosa
mycoplasma attaches to the respiratory epithelial cells at the _____ and leads to
base of the cilia and leads to the activation of inflammatory mediators and produces hydrogen peroxide that disrupts the respiratory tract and damages RBC membranes
pneumonia caused by Klebsiella can lead to ______ or ______
lung abscesses or aspiration pneumonia
necrotizing pneumonia
sputum is yellow green in color and smells like grapes. what is the most likely pathogen?
pseudomonas aeurginosa
_______ pneumonia is seen in hospital acquired pneumonia
bronchial
Klebsiella is catalase _____
positive
what are the most common causes of atypical community acquired pneumonia?
- Mycoplasma pneumonia
- chlamoydophila pneumonia
- legionella pneumophila
what are some clinical features of atypical pneumonia
- symptoms are progressive and insidious
- symptoms are milder than typical pneumonia
- exertional SOB, fever with chills (lower fever than typical)
- scratchy sore throat (mycoplasma)
- confusion (elderly/legionella)
- GI symptoms (legionella)
- patient feels fine but CXR shows signs of pneumonia
what type of patients are at risk for acquiring pneumonia caused by Klebsiella?
- those with underlying conditions such as: alcoholics, diabetes, COPD, hospital acquired infections, etc
______ is a virulence factor that allows strep. pneumonia to colonize the mucosa
IgA protease
“red currant jelly” sputum is indicative of what?
pneumonia caused by Klebsiella pneumonia which is characterized by necrotization of lung tissue and is severe and destructive
describe the motility of pseudomonas
highly motile with multiple flagella (they are found in freshwater so probably helps them move in the water)
describe the biology of pseudomonas
- gram negative
- strictly aerobic
- highly motile with multiple flagella
- both beta and gamma hemolytic
- mucoid colonies on agar
- gives green color to agar
- yellow green sputum
- smells like grapes
what is the most common cause of community acquired pneumonia
strep. pneumonia
infection by pseudomonas is particularly dangerous in what type of people?
people with structural defects in body’s defenses:
- burn victims
- CF
- hospital acquired infections (ventilator acquired)
__________ causes of pneumonia is spread through physical contact and NOT through air
Klebsiella
what are the virulence factors of mycoplasma pneumonia
- P1 adhesion and accessory proteins for speicalized attachment
- production of hydrogen peroxide
- CARDS toxin (community acquired respiratory distress syndrome)
