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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
Q

How is legionella treated?

A

Predictably susceptible to fluroquinolones

Macrolides are an excellent alternative

26
Q

Describe bordetella pertussis

A

Causative agent of pertussis
Small gram NEGATIVE cocci-bacilli
Strictly aerobic and fastidious
Requires growth on media containing blood, charcoal or startch

27
Q

What are the 3 stages of pertussis

A

Catarrhal stage
Paroxysmal stage
Convalescent stage

28
Q

Describe catarrhal stage

A

Very contagious

Sneezing runny nose mild cough low grade fever

29
Q

Describe paroxysmal stage

A

Cough, whoop present, posttussive vomiting

30
Q

Describe convalescent stage

A

Symptoms gradually resolve

Risk of secondary infection

31
Q

How is pertussis diagnosed

A

PCR

32
Q

How is pertussis treated

A

Macrolides

33
Q

Describe bacterial pharyngitis

A

Caused by S. Pyrogenes
Gram postibe, catalase negative beta haemolytic
Group A

34
Q

How is bacterial pharyngitis treated?

A

Penicillin/amoxicillin

Because it is beta haemolytic it is ALWAYS susceptible to penicillin

35
Q

Why do we treat bacterial pharyngitis

A

Eradication
Prevention of complications
10 days to treat so wait for the lab results, no need to treat empirically

36
Q

Describe aracnobacterium

A

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
Q

What makes Mycoplasma pneumoniae atypical

A

No cell wall

Betalactams do not work here

38
Q

What makes chlamydia pneumoniae atypical

A

Cell wall but no peptidoglycan

39
Q

What makes legionella pneumophilia atypical?

A

Intracellular

40
Q

Describe mycoplasma

A

Smallest free living bacteria
Requires sterol for growth as there js cholesterol in the membrane
Lacks a cell wall
Facultative anaerobes

41
Q

Describe chlamydia pneumoniae

A

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
Q

Why wont betalactams work on chlamydia pneumoniae cells

A

Lacks peptidoglycan

43
Q

Describe chlamydia pneumoniae life cycle

A

Biphasic
EB (elementary bodies) ineffective form, attach to susceptible host
RB (reticulate bodies) divide by binary fission, reorganize to EB

44
Q

Describe mycobacteria

A

Aerobic, non spore forming bacilli
Cell walls contain long chain fatty acids (mycolic acid) which make them acid fast
Grow exceedingly slow

45
Q

Whag makes mycobacteria acid fast

A

Long chain fatty acids known as mycolic acid

46
Q

Desceibe ziehl neelsen stain

A

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
Q

What are the mycobacterial classifications

A

Tuberculosis complex
And
Non tuberculosis (atypical) mycobacteria

48
Q

How does mutation occur in M.tuberculosis

A

Resistance can only occur through chromosomal mutation

Mutation rate for individual genes varies between and within genes

49
Q

Describe TB transmission

A

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
Q

What are clinical clues for TB

A

Fever
Night sweats
Weight loss
Focal symptoms

51
Q

What are some clues for diagnosis of tb

A

History of tb
Immuno compromised
Exposure history (travel, close contact)

52
Q

Describe lab identification for pulmonary tb

A 
First morning sputum for 3 days
Bronchial washing
Bronchoalveolar lavage
Gastric washings
Pleural fluid
53
Q

Desceibe lab identification specimens for extra pulmonary tb

A

First morning whole urine for 3 days
Pus or tissue
Liver/bone marrow biopsy
CSF in meningitis

54
Q

Describe lab identification of tb

A

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
Q

What is the treatmenr for TB

A

Must use drug combinations to delay emergence of drug resistance
Patients become non infective after 2-3 weeks of chemotherapy

56
Q

Why is the treatment period for tb long?

A

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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