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PCM Exam 3 > Respiratory Tract Infections 7 > Flashcards

Respiratory Tract Infections 7 Flashcards

1
Q

what is the function of lipoarabinomannan in the pathogenesis of M. tb

A
  • helps resist lysosomal enzymes and reactive oxygen species
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2
Q

which pathogen that causes atypical pneumonia is an obligate intracellular organism?

A
  • chlamydophila pneumonia
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3
Q

at what life cycle phase is the chlamydophila pneumonia that we see as inclusion bodies on a histopathological slide?

A
  • reticulate bodies: non infectious but metabolically active
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4
Q

Describe the biology of chlamydophila pneumonia

A
  • gram NEGATIVE
  • obligate intracellular
  • biphasic life cycle: elementary bodies and reticulate bodies
  • present as inclusion bodies in the cell
  • no special risk groups
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5
Q

PPD test looks for prior exposure of tb but cannot differentiate between:

A
  • active or latent Tb or previous vaccination
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6
Q

_________ cause of atypical pneumonia is a facultative intracellular pathogen

A
  • legionella pneumophila
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7
Q

how does the elementary body of chlamydophila pneumonia survive living inside the host cell?

A

by inhibiting the fusion of the endosome and lysosome

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8
Q

______ cause of atypical pneumonia is an obligate intracellular pathogen

A
  • Chlamydophila pneumonia
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9
Q

what are some common clinical manifestations of infection by Legionella pneumophila?

A
  • one of the causes of atypical pneumonia

- look for GI and CNS symptoms along with respiratory disease PLUS: water source and hematuria

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10
Q

when treating tb, what other tests would you do?

A

check for drug resistance

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11
Q

_____________ exists as elementary bodies in the ______

A

chlamydophila pneumonia;

exists as elementary bodies outside in the environment and colonize the upper respiratory tract and move down to LRT

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12
Q

buffered charcoal yeast extract is used to culture ________

A

legionella pneumophila

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13
Q

< ____ mm of the induration in the PPD test is a negative test for everyone

A

5mm

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14
Q

what are unique features of the cell wall in mycobacterium tuberculosis?

A
  • mycolic acid: waxy coating

- lipoarabinomannan: acts like LPS and is attached to the cytoplasmic membrane

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15
Q

what are the two clinical syndromes that legionella pneumphila can cause and how can you differentiate them?

A
  • legionnaire’s disease
  • pontiac fever

pontiac fever is self limiting and does not involve the LRT

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16
Q

Describe the biology fo Mycobacterium tuberculosis

A
  • acid fast bacilli
  • aerobic
  • non spore forming
  • grows in long parallel chains: “cords” and grows very slowly
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17
Q

how does legionella survive in the cell?

A
  • inhibits fusion of lysosome and endosome (like Chlamydophia pneumonia)
18
Q

what additional symptoms to pneumonia would suspect you to think infection by legionella?

A
  • GI and CNS symptoms
  • HYPOnatremia
  • elevated hepatic transaminases
19
Q

describe the life cycle of chlamydophila pneumoniae:

A
  • endocytosed as a elementary body
  • inhibition of the endosome and phagosome fusion
  • conversion to reticulate bodies and replicates via binary fission
  • conversion back to elementary bodies
  • elementary bodies leave the cell via reverse endocytosis
20
Q

__________ bodies are infectious but NOT metabolically active

A

elementary bodies;

21
Q

what is a good way to distinguish between the different species of chlamydophila?

A

the result of the pathogen leaving the host cell:

  • C. pneumonia and C. trachomatis does not result in cell lysis
  • C. psittaci results in cell lysis
22
Q

_____ bodies are metabolically active but NON infectious

A

reticulate

23
Q

_________ on the cell membrane of mycobacterium tuberculosis gives it a waxy appearance and makes it resistant to drying

A

mycolic acid

24
Q

how does mycobacterium tuberculosis survive inside the alveolar macrophage?

A
  • prevents oxidative burst inhibits phagosome-lysosome fusion
  • resists lysosomal enzymes and reactive oxygen species
25
Q

CARDS toxin is a virulence factor of ________

A

mycoplasma pneumonia

26
Q

legionella is most commonly acquired from ______

A

contaminated water

27
Q

legionella can be cultured on ______

A

buffered charcoal yeast extract

28
Q

Ziehl- Neelsen stain is used to stain _________

A

acid fast bacilli such as Mycobacterium tuberculosis

29
Q

risks of getting pneumonia from what pathogen is high in people with lung diseases or alcoholic

A

Klebsiella

30
Q

> ____mm of the induration in the PPD test is a positive test regardless of the patient’s risk factor

A

15mm

31
Q

__________ medium is used to culture and diagnose M. tuberculosis

A
  • lowenstein- Jensen medium
  • oliec acid albumin broth

wart like colonies that go from green to blue in color

32
Q

the majority of the damage in tb is due to ______

A

host immune response to the pathogen

33
Q

how does chlamydophila pneumonia eventually leave the host cell?

A 
reverse endocytosis (same with C. trachomatis); NO HOST CELL LYSIS 
(unlike chlamydophila pstacci which will cause cell lysis )
34
Q

describe the biology of legionella

A
  • gram negative rod
  • motile (polar flagella)
  • non spore forming
  • facultative intracellular organism that lives in the alveolar macrophages
  • culture on buffered charcoal yeast extract agar
35
Q

_______ vaccine is given to kids in endemic countries for prophylactic treatment of tb

A

BCG (bacillus Calmette Guerin) which is from live attenuated M. Bovis strains

mainly used to prevent the miliary tb or tb meningitis in children

36
Q

several people have come to the doctor with symptoms such as pleuritic chest pain, SOB, cough and fever and said that they drank contaminated water. What would you use to strain this most likely pathogen? What would you culture it on?

A
  • methylamine silver stain (NOT GRAM STAIN)

- culture: buffered charcoal yeast extract

37
Q

what are some extrapulmonary manifestations of tb commonly seen in patients with HIV/AIDS

A
  • lymphadenitis
  • pott disease
  • tuberculoma (CNS)
  • meningitis
  • pericarditis
  • miliary (m. tb that is spread through blood, like sepsis of m. tb)
38
Q

resistance to TB is largely dependent on ____________

A

subset of CD4 Helper T cells that produce gamma interferon

reason why patients with HIV/AIDS and get tb, most will develop extra pulmonary infection

39
Q

the PPD test is based on a type ____ HS reaction

A

type 4; looking for prior exposure to mycobacterium tuberculosis

40
Q

the most commonly used laboratory test for diagnosis of legionella is __________

A

urinary antigen test (only looks for serogroup 1)

41
Q

what structure is responsible or the staining property of M. tuberculosis?

A

mycolic acid

PCM Exam 3 (32 decks)

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