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MICI module 1 > RTI > Flashcards

RTI Flashcards

1
Q

What are some examples of RTI specimens

A 
Sputum
Bronchial washing
Nasopharyngeal swabs
Exceetions from ventilators
Sinus aspirates 
Tympanicentesis
Throat swabs
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2
Q

What would be considered a poor quality specimen?

A

Oropharingeal contamination

Many squamous cells and no neutrophils

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3
Q

What are atypical pathogens

A

Mycoplasma pneunoniae
Chlamydia pneumoniae
Legionella pneumoniae

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4
Q

What is the correct name for whooping cough

A

B. Pertussis

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5
Q

What pathogen is commonly associated with a high pneumonia infuced mortality

A

Streptococcus pneumoniae

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6
Q

Define pneumonia

A

An inflammatory condition of the lungs primarily affecting the alveoli (air sacs)

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7
Q

What are typical signs of pneumonia

A

Fever, cough, chest pain, shortness of breath

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8
Q

Why are throat swabs a bad idea when testing for pneumonia

A

S. Pneumoniae colonizes in the throats of 5-10% of adults and 20-40% of children, can lead to pneumonia infection if swabbed

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9
Q

Describe S.pneumoniae

A

Most common bacterial cause of RTIs, small gram positibe diplococci
Alpha hemolytic

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10
Q

True or false: s. Pneumoniae is bile soluble

A

True

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11
Q

What is the most important virulance factor of S. Pneumoniae

A

The capsule; aids in escape from phagocytic cells

Aids in adherance which is essential for colonization

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12
Q

What is pneumolysin

A

Type of hemolysin
Destroys epithelial cells
Activate classical complement pathway
Suppress oxidative burst by phagocytic cells

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13
Q

Describe pneumovax

A

A carbohydrate vaccine
Protexrs against 23 serotypes
Infants and elderly do not respond well to carbohydrate vaccines

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14
Q

What is prevnar

A

Conjugate vaccine

Indicated for use in infants and adults

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15
Q

What are indications of pneumonia vaccine use?

A 
Advanced age
HIV/AIDS
Alcoholism 
Diabetes
Lymphoma
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16
Q

What are potential treatments for S.pneumoniae?

A

Penecilins, cephalosporins, macrolides, fluroquinolones, vancomycin

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17
Q

Define COPD

A

Chronic obstructive pulmonary disease
An unbrella twem for progressive lung diseases
Characterized by increasing breathlessness

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18
Q

Describe H.influenzae

A

Most common cause of AE COPD
small gram NEGATIVE BACILLI
Require x&v factors for growth
Will only grow on chocolate agar

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19
Q

If RBC is liced what does that mean?

A

More nutritious, x&v available

H. Influenzae will culture here

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20
Q

What are effective treatments for H.influenzae

A

2nd/3rd generation cephalosporins
Newer macrolides
Fluroquinolones (not for kids!)
Amoxicillin-clavulanate very effective

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21
Q

Describe moraxella cartarrhalis

A

Small gram negative cocco-bacilli

90% of strains resistant to ampicillin and amoxicillin with the exception of tmp/smx

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22
Q

Describe legionella pneumophilla

A 
1st described in legionare convention in philly
Gram NEGATIVE BACILLI
Widespread environment 
Wide spectrum of illness 
Intracellular organism
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23
Q

Desceibe legionella pneumophilia staining

A

Faintly staining and easy to miss on gram stain

Required BCYE agar to be seen

24
Q

How is legionella lab diagnosed

A

Cultures and urinary AG most effective in lab diagnosing

25
How is legionella treated?
Predictably susceptible to fluroquinolones | Macrolides are an excellent alternative
26
Describe bordetella pertussis
Causative agent of pertussis Small gram NEGATIVE cocci-bacilli Strictly aerobic and fastidious Requires growth on media containing blood, charcoal or startch
27
What are the 3 stages of pertussis
Catarrhal stage Paroxysmal stage Convalescent stage
28
Describe catarrhal stage
Very contagious | Sneezing runny nose mild cough low grade fever
29
Describe paroxysmal stage
Cough, whoop present, posttussive vomiting
30
Describe convalescent stage
Symptoms gradually resolve | Risk of secondary infection
31
How is pertussis diagnosed
PCR
32
How is pertussis treated
Macrolides
33
Describe bacterial pharyngitis
Caused by S. Pyrogenes Gram postibe, catalase negative beta haemolytic Group A
34
How is bacterial pharyngitis treated?
Penicillin/amoxicillin | Because it is beta haemolytic it is ALWAYS susceptible to penicillin
35
Why do we treat bacterial pharyngitis
Eradication Prevention of complications 10 days to treat so wait for the lab results, no need to treat empirically
36
Describe aracnobacterium
Pharyngitis in teens and young adults Invasive disease can occur but it is rare May respond poorly to penecillin but the disease is self limiting
37
What makes Mycoplasma pneumoniae atypical
No cell wall | Betalactams do not work here
38
What makes chlamydia pneumoniae atypical
Cell wall but no peptidoglycan
39
What makes legionella pneumophilia atypical?
Intracellular
40
Describe mycoplasma
Smallest free living bacteria Requires sterol for growth as there js cholesterol in the membrane Lacks a cell wall Facultative anaerobes
41
Describe chlamydia pneumoniae
Unique cell wall structure is considered a virulence factor Inhibits phagysosome fusion in phagocytes Resembles gram negative bacteria Lacks peptidoglycan in its cell wall, not a true bacterial cell wall
42
Why wont betalactams work on chlamydia pneumoniae cells
Lacks peptidoglycan
43
Describe chlamydia pneumoniae life cycle
Biphasic EB (elementary bodies) ineffective form, attach to susceptible host RB (reticulate bodies) divide by binary fission, reorganize to EB
44
Describe mycobacteria
Aerobic, non spore forming bacilli Cell walls contain long chain fatty acids (mycolic acid) which make them acid fast Grow exceedingly slow
45
Whag makes mycobacteria acid fast
Long chain fatty acids known as mycolic acid
46
Desceibe ziehl neelsen stain
Used to identify acid fast organisms Slide is flooded with CARBOL FUCHIN which is the heated to dry Flooded with alcohol and counterstained blue Acid fast organism retain carbol fuchin due to mycolic acids in the cell wall
47
What are the mycobacterial classifications
Tuberculosis complex And Non tuberculosis (atypical) mycobacteria
48
How does mutation occur in M.tuberculosis
Resistance can only occur through chromosomal mutation | Mutation rate for individual genes varies between and within genes
49
Describe TB transmission
Spread by airborne droplets Nuclei droplets generated when a person with tb speaks, coughs or sneezes Infective dose <10 bacilli Very small infectibe dose
50
What are clinical clues for TB
Fever Night sweats Weight loss Focal symptoms
51
What are some clues for diagnosis of tb
History of tb Immuno compromised Exposure history (travel, close contact)
52
Describe lab identification for pulmonary tb
``` First morning sputum for 3 days Bronchial washing Bronchoalveolar lavage Gastric washings Pleural fluid ```
53
Desceibe lab identification specimens for extra pulmonary tb
First morning whole urine for 3 days Pus or tissue Liver/bone marrow biopsy CSF in meningitis
54
Describe lab identification of tb
Must be done in level three lab Fluorescent stain, mark where lit up then restain with acid fast and compare Pcr also used and molecular probes
55
What is the treatmenr for TB
Must use drug combinations to delay emergence of drug resistance Patients become non infective after 2-3 weeks of chemotherapy
56
Why is the treatment period for tb long?
Long doubling time of tubercle bacilli Metabolically inactive bacilli are not killed by drugs Caseous material interferes with drug action

MICI module 1 (4 decks)

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