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Pulm by Minnie > SM 181a - Bacterial Infections > Flashcards

SM 181a - Bacterial Infections Flashcards

1
Q

List the different clinical manifestations of
typical vs. atypical pneumonias.

A
  • Typical
    • Abrupt onset
    • Productive cough
    • No upper respiratory symptoms
    • Frequently severe
  • Atypical
    • Gradual onset
    • Nonproductive cough
    • Upper respiratory symptoms
    • Extrapulmonary symptoms
    • Occurs in younger people
    • Usually mild
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2
Q

What are the most common bacterial causes of community-acquired pneumonia?

A
  • Streptococcus pneumoniae
  • Staphylococcus aureus
  • Haemophilus influenzae
  • Mycoplasma pneumoniae
  • Chlamydia pneumoniae
  • Legionella pneumophila
  • mixed anaerobic bacteria (aspiration pneumonia)
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3
Q

Pneumonia caused by S. pneumoniae can progress to…

A

Bacteremia

Meningitis

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4
Q

Which area of the lung is most likely to be affected by aspiration pneumonia?

A

The lung fields that aspiration gets to (dependent lung fields)

Right more likely than left

Posterior lung fields if the patient aspirated while lying on their back

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5
Q

Bordetella pertussis

Gram stain:

Size:

Shape:

Anaerobic/aerobic:

A

Gram stain: Gram negative

Size: Tiny

Shape: Coccobacilli

Anaerobic/aerobic: Strict aerobe

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6
Q

What are the most common causes of acute bronchitis/tracheitis?

A
  • Streptococcus pneumoniae
  • Haemophilus influenzae
  • Mycoplasm pneumoniae
  • Chlamydia pneumoniae
  • Bordetella pertussis
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7
Q

What toxin ADP-ribosylates EF-2?

A

Diphthera toxin

This causes cells to die and form the oropharyngeal pseudomembrane associated with diphtheria

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8
Q

How does aspiration pneumonia develop?

A

People with poor gag reflexes aspirate bacteria into their lungs

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9
Q

Who is most likely to get aspiration pneumonia?

A

People with a depressed gag reflex

  • Elderly patients
  • People who get siezures
  • Anyone who blacks out from drinking
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10
Q

What is the treatment for S. aureus?

A
  • MSSA - Nafcillin/oxacillin
  • MRSA - Vancomycin or Linezolid
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11
Q

Pseudomonas aeruginsa

Gram stain:

Shape:

Aerobic/anaerobic:

A

Gram stain: Gram-negative

Shape: Bacilli

Aerobic/anaerobic: Aerobic (oxidase positive)

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12
Q

Which bacteria are most likely to cause pharyngitis?

A
  • Streptococcus pyogenes
  • Chlamydia pneumoniae
  • Mycoplasma pneumoniae
  • Corynebacterium diphtheriae
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13
Q

How is H. influenzae transmitted?

A

Direct contact with secretions or respiratory droplets

Colonizes in the upper respiratory tract of healthy individuals

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14
Q

Which bacterial causes of pneumonia will not be detectable in gram-stained sputum specimens?

A
  • Legionella pneumophila*
  • Mycoplasma pneumoniae*
  • Chlamydia spp.*
  • Mycbacterium tuberculosis*
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15
Q

A patient with pneumonia and a really high fever (>40C/104F) and GI symptoms is most likely infected with….

A

Legionella pneumophilia

  • Atypical pneumonia
  • Water, air conditioning systems, cooling towers
  • GI symptoms
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16
Q

Nosocomial pneumonia is pneumonia that occurs ________ hours after______________

A

Nosocomial pneumonia is pneumonia that occurs >48** hours after **hospitalization (includes VAP and HAP)

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17
Q

What organism is most likely caused this patient’s pneumonia?

a. H. influenzae or S. pneumoniae
b. M. pneumoniae or C. pneumoniae

A

b. M. pneumoniae or C. pneumoniae

No lobar infiltrate

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18
Q

How is S. pneumoniae diagnosed?

A
  • Sputum sample
    • Numerous gram-positive cocci in pairs and chains
    • Many neutrophils
  • Culture
    • Alpha-hemolytic
      (incomplete hemolysis aka green on blood agar)
  • Catalase-negative
  • Optochin-susceptible
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19
Q

What cells in the body does Mycoplasma pneumoniae bind?

A

Respiratory epithelium, using protein adhesin P1

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20
Q

How can H. infleunzae be prevented?

A

Type B capsular conjugative vaccine (Hib)

Give to all infants @ 2mo

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21
Q

Describe the clinical presentation of diphtheria

A
  • Sore throat
  • Fever
  • Difficulty swallowing
  • Cough
  • Harseness
  • Rhinorrhea
  • Oropharyngeal pseudomembrane
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22
Q

Pneumonia accompanied by pharyngitis is most often caused by

A

C. pneumoniae

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23
Q

What is the treatment for Legionella pneumophila?

A

Macrolide or fluoroquinolone

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24
Q

Which bacteria are associated with ventilator-associated pneumonia?

A
  • Staphylococcus aureus
  • Enterobacteriaceae
    • (Escherichia coli, Klebsiella pneumoniae, Enterobacter spp., Serratia spp.)
  • Legionella pneumophila
  • Pseudomonas aeruginosa
  • Acinetobacter baumannii
  • mixed anaerobic bacteria (aspiration pneumonia)
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25
Where in the body does s. pneumoniae colonize?
Oropharynx and nasopharynx
26
How is S. pneumoniae treated?
Penicillin If resistant, use vancomycin
27
What clinical disease is asociated with *Bordetella pertussis?*
Whooping cough
28
What is the most life-threatening complication of *H. influenzae?*
Epiglottitis
29
Which bacteria is the most common cause of community-acquired pneumonia?
*Strep. pneumoniae*
30
Encapsulated H. influenzae primarily affects \_\_\_\_\_\_\_\_\_\_\_\_. Why?
Encapsulated H. influenzae primarily affects **_children._** We develop type-specific antibodies against the capsule antigens, so most adults have protective immunity
31
*S. Pneumoniae* can infect \_\_\_\_\_\_\_\_\_\_
*S. Pneumoniae* can infect **_humans only_**
32
\_\_\_\_\_\_\_ is the smallest organism that can be free-living in nature and self-replicating on laboratory medium.
***_Mycoplasma pneumoniae_*** is the smallest organism that can be free-living in nature and self-replicating on laboratory medium.
33
Why don’t people get the same *s. pneumoniae* infection twice?
Anibodies against the capsule are protective
34
Which enterobacteriaceae are common culprits in hospital-acquired pneumonia?
SEEK * *Serratia* spp. * *E. coli* * *Enterobacter* spp. * *Klebsiella pneumoniae*
35
How can streptococcal pneumoniae be prevented?
* Polysaccharide vaccine (Pneumovax 23) * Capsular polysaccharide conjugated to protein (Prevnar-13): works better in children Indicated for peole at risk (young, old, immunocompromised, chronic lung disease)
36
A *Mycoplasma pneumoniae* pneumonia may cause unusual manifestations such as….
* Hemolytic anemia * Neurologic abnormalities (encephalitis) * Skin rashes
37
How is pneumonia caused by Mycoplasma pneumoniae differ from pneumonia caused by *S. pneumoniae* and *H. influenzae*?
*M. pneumoniae* pneumonia... * More gradual in onset * Cough is non-productive * Chest x-ray is non lobal * More mild
38
What media should you use to grow H. influenzae?
Chocolate agar * Requires hemin and NAD * If it grows on sheep blood agar, **it is not *H. influenzae***
39
What is the treatment for *H. influenzae* infection?
* Cephalosporins, trimethoprim-sulfamethoxazole, macrolides, amoxicillin/clavulanic acid, quinolones * Penicillins not effective against beta-lactamase producing strains
40
Community-acquired pneumonia with hemolytic anemia, many neutrophils, and less severe symptoms is most likely caused by which bacteria?
*M. pneumoniae*
41
*Clamydia pneumoniae* Gram stain: Intracellular or extracellular:
Gram stain: gram negative but **does not take up gram stain** Intracellular or extracellular: **Obligate intracellular**
42
Describe the clinical presentation of s. pneumoniae infection
* Fever * Productive cough - rusty colored sputum * Pleuritic chest pain * Diminshed respiratory excursion * Abrupt onset
43
*Corynebacterium diphtheria* Gram stain: Shape:
Gram stain: **Gram positive** Shape: **Bacilli (club shape)**
44
Which bactera cause pneumonia with **lobar infiltrates** on chest x-ray?
* S. pneumoniae* * H. influenzae*
45
Which of the following is a cause of life-threatening epiglottitis? ## Footnote A. *Streptococcus pneumoniae* B. *Haemophilus influenzae* C. *Mycoplasma pneumoniae* D. *Legionella pneumophila*
B. *Haemophilus influenzae*
46
*Streptococcus pneumoniae* Gram stain: Shape: Hemolysis:
Gram stain: **Gram +** Shape: **"lancet-shpaed" diplococci** Hemolysis: **alpha-hemolytic**
47
What will you see on H. influenzae CXR?
Lobar infiltrate
48
What are the determinants of pathogenicity of *H. influenzae*?
* Polysaccharide capsule * 6 types * Antiphagocytic * We can develop protective immunity against the capsule * =\> There is a vaccine that works!
49
What will you see in a chest x-ray of somebody infected with *S. pneumoniae?*
**Lobar** infiltrates
50
What are the determinants of pathogenicity of s. pneumoniae?
* Capsule * Pneumolysin * Degrades hemoglobin * Activates complement * May form pores in human cells
51
All of the following are said to cause an atypical pneumonia EXCEPT: ## Footnote A. *Streptococcus pneumoniae* B. *Chlamydia pneumoniae* C. *Mycoplasma pneumoniae* D. *Legionella pneumophila*
A. *Streptococcus pneumoniae;*
52
Which organism causes cold hemagglutinins? 1. H. influenzae 2. S. pneumoniae 3. M. pneumoniae
c. M. pneumoniae
53
Which bacteria most likely caused this?
*Corynebacterium diptheria*
54
How does s. pneumoniae spread?
Human to human via droplets
55
Hospital acquired (HAP) pneumonia is pneumonia that occurs ________ hours after hospitalization
Hospital acquired (HAP) pneumonia is pneumonia that occurs **_\>48_** hours after hospitalization
56
Ventilator-associated pneumonia (VAP) is pneumonia that occurs ______ hours after mechanical ventilation
Ventilator-associated pneumonia (VAP) is pneumonia that occurs **_\>48_** hours after mechanical ventilation
57
Unencapsulated strains of H. influenzae can infect \_\_\_\_\_\_\_. Why?
Unencapsulated strains of H. influenzae can infect **_adults and children._** We cannot develop protective immunity if there is no capsule - no capsule = no antigens to make antibodies against
58
Which bacteria has protein adhesin P1? What does it do?
*Mycoplasma pneumoniae* Allows the bacteria to bind tightly to respiratory epithelium
59
Who gets streptococcal pneumonia?
Anyone - healthy or immunocompromised Especially people who recently had the flu
60
Enterobacteriaceae Gram stain: Shape: Anaerobic/aerobic:
Gram stain: **gram -** Shape: **rod** Anaerobic/aerobic: **facultative** **anaerobes**
61
*Haemophilus influenzae* Gram stain: Shape:
Gram stain: **gram negative** Shape: **small, gram-negative coccobacilli**

Pulm by Minnie (34 decks)

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