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Pulmonary > Test 2 Week 1 > Flashcards

Test 2 Week 1 Flashcards

1
Q

When is exposure made on a posterior-anterior view chest x ray?

A

full inspiration

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2
Q

By which route is mycoplasma pneumoniae spread by?

A

respiratory route

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3
Q

Nearly ALL anaerobes are resistant to which antibiotic class?

A

aminoglycosides

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4
Q

What’s responsible for the pathogenesis of EBV mononucleosis?

A

expansion of atypical CD8+ T cells (Downey cells)

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5
Q

What’s the endemic location for histoplasmosis?

A

Mississippi and Ohio river valleys

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6
Q

Morphology of Moraxella catarrhalis:

A

gram negative diploccoci

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7
Q

What’s the MOA of zanamivir and oseltamivir?

A

they are neuraminidase inhibitors with activity against types A and B

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8
Q

What’s the main use of ultrasound in the chest?

A

detection and characterization of pleural effusions

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9
Q

Morphology of Pneumocystis jiroveci:

A

•NOT yeast-like, but has unusual single cell forms, uninucleate sporocysts, or cysts containing up to 8 intracyst bodies.

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10
Q

By which route is Chlamydia psittaci spread by?

A

transmitted by inhalation

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11
Q

What’s the mechanism of action of Amphotericin B?

A

binds ergosterol in cell wall of fungi and induces oxygen free radicals to form pores in the membrane

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12
Q

Common causes of pneumonia in adults 18-40:

A

from first aid: -mycoplasma -chlamydia pneumoniae -strep. pneumoniae

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13
Q

morphology of actinomyces:

A

gram positive bacilli

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14
Q

What are the important characteristics of staph. aureus? (5 things)

A

-gram positive -group in grape-like clusters -catalase positive -resistant to drying -very heat resistant

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15
Q

What will the monospot test result be in CMV mononucleosis?

A

negative monospot test

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16
Q

an intestinal flora that causes lobar pneumonia in alcoholics and diabetics when aspirated

A

Klebsiella pneumonia

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17
Q

What are some side effects of amphotericin B?

A
  • fever/chills
  • hypotension
  • nephrotoxicity
  • arrhythmias
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18
Q

What’s the MOA of amantadine and rimantadine?

A

block M2 ion channel function, uncoating, and endosomal entry of influenza A

-but they are ineffective against types B and C

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19
Q

A solitary pulmonary nodule is described as a _____.

A

focal opacity < 3cm

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20
Q

____ is a unique feature of influenza A

A

antigenic shift

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21
Q

What’s the endemic location for blastomycosis?

A

states east of mississippi river and central america and around the Great Lakes

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22
Q

Common causes of pneumonia in children (1 month-18 yrs):

A

from first aid: -respiratory syncytial virus (RSV) -mycoplasma pneumoniae -chlamydia trachomatis -chlamydia pneumoniae - strep. pneumoniae

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23
Q

How does scarlet fever present?

A

scarlet rash with sandpaper-like texture and a strawberry tongue

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24
Q

How can chronic Q fever present?

A

most often presents as endocarditis

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25
Q

What is the most frequently isolated bacteria from infections caused by anaerobes?

A

bacteroides fragilis

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26
Q

What organism often causes pneumonia in immunocompromised patients?

A

Pneumocystis jiroveci (asso. w/ AIDS

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27
Q

What method is used to diagnose Legionella pneumophila infection?

A

antigen test

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28
Q

Most common cause of interstitial (atypical) pneumonia?

A

mycoplasma pneumoniae

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29
Q

Morphology of Zygomycetes (e.g. Rhizopus, Mucor, Absidia) :

A

•Typically, they grow as broad, ribbon-like hyphae that are aseptate or sparsely septate and right-angle branching in no pattern.

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30
Q

most common cause of of nosocomial infection?

A

staph aureus

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31
Q

Corynebacterium diphtheria Characteristics (4 things):

A

1) gram positive 2) slender rod (but highly pleomorphic) 3) contain metachromatic granules 4) normally found in the mouth (these cells just don’t have a lysogenic bacteriophage)

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32
Q

adenovirus characteristics:

A
  • nonenveloped
  • icosahedral symmetry
  • linear dsDNA
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33
Q

a child with Croup will show what on radiology imaging?

A

subglottic narrowing of trachea (steeple sign)

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34
Q

What’s the mechanism of action of Azoles?

A

inhibit fungal ergosterol synthesis

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35
Q

Mycoplasma pneumoniae is non-invasive. How does it adhere to tissue?

A

P1 terminal attachment factor

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36
Q

What will the monospot test result be for EBV mononucleosis?

A

+ monospot test

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37
Q

Morphology of Aspergillus species:

A

Grow as septate hyphae that are branched at 45 degree angles and form distinct conidiophore structures that do not appear in tissues, but may form in cavities.

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38
Q

What’s the major virulence factor for Streptococcus pneumoniae ?

A

it’s capsule; it has no virulence without it

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39
Q

What’s the typical treatment for TB?

A

•Isoniazid (INH) + rifampin + 2 others for 6-9 months

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40
Q

What are the paramyxoviruses we discussed?

A

–Parainfluenza (HPIV)

–Respiratory syncytial virus (RSV)

–Metapneumovirus (hMPV)

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41
Q

Which bug is responsible for most person to person pneumonia transmission?

A

strep. pneumoniae

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42
Q

What’s the endemic location for coccidiomycosis?

A

southwestern US, California

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43
Q

in regards to influenza virus, describe antigenic shift.

A

reassortment of HA and/or NA gene segments between different subtypes

-causes pandemics

•HA= hemagglutinin and NA=neuraminidase

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44
Q

Paramyxovirus family characteristics:

A
  • enveloped
  • helical capsid
  • negative sense ssRNA
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45
Q

What’s the best test available to make a histoplasmosis diagnosis?

A

DNA probe for Histoplasma rRNA

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46
Q

By which route is Legionella pneumophila spread?

A

aerosol transmission from water supplies

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47
Q

What’s the most common secondary infection in AIDS patients in the U.S.?

A

Pneumocystis pneumonia (PCP)

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48
Q

most common cause of bronchiolitis in infants

A

respiratory syncytial virus

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49
Q

What are some effective treatments for opportunistic anaerobes?

A
  • Metronidizole for obligate anaerobes
  • Imipenem
  • combo of beta lactam antibiotics + beta lactamase inhibitors
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50
Q

How can you identify Coccidioides immitis morphologically?

A

arthroconidia and spherules

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51
Q

By which route is chlamydia pneumoniae spread by?

A

respiratory route

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52
Q

barking “seal like” cough=

A

croup

most commonly caused by human parainfluenza virus (HPIV)

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53
Q

Bronchopneumonia is characterized by:

A

scattered patchy consolidation centered around bronchioles; often multifocal and bilateral

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54
Q

What gives Pseudomonas aeruginosa it’s blue coloration and grape juice smell?

A

pyocyanin

55
Q

Common causes of pneumonia in elderly (>65):

A

from first aid: -strep. pneumoniae -haemophilus influenzae -anaerobes -influenze virus -gram negative rods

56
Q

In regards to influenza virus, describe antigenic drift

A

single point mutations in HA or NA, producing new strains within a subtype

-can result in epidemics

•HA=hemagglutinin and NA=neuraminidase

57
Q

On coxiella burnetii serology, Phase II IgM and IgG would suggest ___ disease.

A

acute

58
Q

What are the most common bacterial causes of lobar pneumonia?

A

streptococcus pneumoniae (95%) and Klebsiella

59
Q

Morphology of Mycobacterium tuberculosis:

A

acid-fast bacilli (don’t stain well with gram stain)

60
Q

What’s the treatment for Coxiella burnetii infection?

A

–Doxycycline for acute disease –Chronic disease must be treated with doxycycline and hydroxychloriquine for up to 2 yrs. –If endocarditis is present, it does require surgical intervention.

61
Q

Treatment for Cryptococcus neoformans?

A

amphoteracin B

62
Q

On coxiella burnetii serology, Phase I antigens would suggest ___ disease.

A

chronic

63
Q

Legionella pneumophila is difficult to grow in the lab. What all does it require for growth?

A

cysteine, Fe2+, and charcoal yeast extract agar

64
Q

gram + cocci; form rods

A

streptococcus pyogenes (group A strep)

65
Q

How is TB spread?

A

inhalation

66
Q

Describe the vaccine for Haemophilus influenzae (Hib vaccine).

A

contains type b capsular polysaccharide conjugated to diptheria toxoid

67
Q

Of the fungi we discussed, which is a CDC select agent (possible bioterrorist agent)?

A

•Coccidio species

68
Q

What’s the Rx treatment of RSV bronchiolitis

A

ribavirin

-only for high risk infants (congenital heart defects, prematurity

69
Q

Describe morphology of Legionella pneumophila?

A

gram negative, aerobic rods

70
Q

how do Nocardia species survive intracellulary?

A

by preventing phagosome-lysosome fusion, and catalase and superoxide dismustase (SOD)

71
Q

What is used to treat histoplasmosis?

A
  • amphotericin B
  • itraconazole
  • fluconazole
72
Q

Morphology of Fusobacterium:

A

Recognized morphologically in Gram stains by presence of long, thin rods with pointed ends.

73
Q

What sequelae can follow streptococcus pyogenes infection?

A

-rheumatic fever -glomerulonephritis -scarlet fever

74
Q

How can acute Q fever present?

A

can present as pneumonia or hepatitis

75
Q

By which route is Coxiella burnetii spread?

A

spores inhaled as aerosols from cattle/sheep amniotic fluid (from first aid)

76
Q

How will an acute PE appear on CT?

A

clot sitting in CENTER of pulmonary artery, blocking further blood flow

77
Q

highly infectious and causes human Q fever

A

Coxiella burnetii

78
Q

Common causes of pneumonia in adults 40-65:

A

from first aid: -strep. pneumoniae -haemophilus influenzae -anaerobes -viruses -mycoplasma pneumoniae

79
Q

What type of hemolysis is strep. pneumoniae characterized by?

A

alpha hemolysis

80
Q

What method is used to diagnose Mycoplasma pneumoniae?

A

complement fixation serology

81
Q

most common cause of pneumonia in infants (>1month)

A

respiratory syncytial virus

82
Q

The P1 terminal attachment factor on Mycoplasma pneumoniae has a high affinity for which host receptors?

A

sialoglycoprotein or sialoglycolipid receptors

83
Q

What’s the treatment for Haemophilus influenzae​?

A

ampicillin

84
Q

Rhinovirus characteristics:

A
  • non-enveloped
  • icosahedral capsid
  • positive sense ssRNA
85
Q

lobar pneumonia is characterized by:

A

consolidation of an entire lobe of the lung

86
Q

most common cause of croup

A

human parainfluenza virus (HPIV)

87
Q

Common causes of pneumonia in neonates (0-1 month):

A

-e. coli -group b strep (strep. agalactiae)

88
Q

Mycobacterium tuberculosis survives and thrives intracellulary in which cell type?

A

alveolar macrophages

89
Q

What causes scarlet fever?

A

erythrogenic toxin carried by bacteriophage; it’s a hypersensitivity reaction to the toxin itself (the actual toxin by itself doesn’t cause the problems)

90
Q

common cause of pink eye

A

adenovirus

91
Q

Coronavirus characteristics:

A
  • enveloped
  • helical capsid
  • positive sense ssRNA
92
Q

What’s the treatment for coccidioidmycosis?

A

•Amphotericin B, itraconazole, fluconazole

93
Q

How will an older (chronic) PE appear on CT?

A

recanalized; see concentric circles around the clot

94
Q

Most common cause of pneumonia in people with COPD

A

moraxella catarrhalis

95
Q

Morphology of Acinetobacter baumannii:

A

gram negative bacilli

96
Q

most common cause of atypical pneumonia

A

Mycoplasma pneumoniae

97
Q

What are the Jones criteria for acute rheumatic fever?

A

-carditis -polyarthritis - erythema marginatum -subcutaneous nodules -sydenham chorea (in first aid, not lecture)

98
Q

How does pertussis toxin work?

A
  • uncouples G protein mediated signal transduction (increases cAMP)
    • increases respiratory secretions and mucus
    • inhibits phagocytic function and migration
99
Q

can cause a chronic granulomatous cervicofacial infection

A

actinomyces

100
Q

Morphology of pseudomonas aeruginosa:

A

gram negative bacilli

101
Q

What forms the pseudomembrane in diphtheria?

A

exudate of bacteria, inflammation, and dead cells

102
Q

Which bacteria cause pneumonia in newborns?

A

streptococcus agalactiae (group B streptococcus)

103
Q

causes pseudomembranous pharyngitis that can interfere with breathing

A

Corynebacterium diphtheriae

104
Q

What’s the treatment for Mycoplasma pneumoniae?

A

erythromycin, doxycycline

105
Q

What’s the treatment for Chlamydia psittaci ?

A

erythromycin or doxycycline

106
Q

Why don’t Mycoplasma pneumoniae show up on gram staining?

A

they don’t have a cell wall

107
Q

What’s the best test available to determine if you have a mycobacterium species present?

A

species specific DNA probes. This is important b/c you need to figure out which species you have, as some have specific antibiotic resistance profiles

108
Q

Interstitial (atypical) pneumonia is characterized by:

A

diffuse interstitial infiltrates

109
Q

What’s the treatment for Chlamydia pneumoniae?

A

erythromycin, doxycycline, levofloxacin

110
Q

Mycoplasma pneumoniae don’t have a cell wall, but what do they have that stabilizes their bacterial membrane?

A

sterols

111
Q

Describe the vaccine for Bordetella pertussis.

A

DTaP – acellular pertussis vaccine

•contains: Inactivated Pertussis toxin (PT), pertactin (adhesion molecule), FHA (adhesion molecule)

112
Q

classically results in a right lower lobe abcess

A

aspiration pneumonia

113
Q

What’s the morphology of Bordetella pertussis?

A

tiny, gram negative coccobacilli

114
Q

How is acute pulmonary embolism diagnosed?

A

CT pulmonary angiography

115
Q

What is the hallmark of pneumonia caused by strep. pneumoniae?

A

rust colored sputum (from blood in sputum)

116
Q

Morphology of Cryptococcus neoformans:

A

budding yeast cells with large capsules, visualized by india ink

117
Q

How can you identify Blastomyces dermatitidis?

A

thick walled broad based budding yeast

118
Q

1 killer of AIDS patients worldwide.

A

TB

119
Q

What about strict anaerobes makes them so sensitive to oxygen?

A

they lack superoxide dismutase (SOD) which protects cells from toxic oxygen radicals

120
Q

What type of granuloma does TB cause?

A

caseating granuloma

121
Q

Acute glomerulonephritis follows a ___ infection with strep. pyogenes.

A

skin infection (impetigo)

122
Q

What type of hemolysis is strep. pyogenes characterized by?

A

beta hemolysis

123
Q

How can you ID Histoplasma capsulatum?

A
  1. macroconidia
    1. intracellular yeast in lungs
124
Q

Morphology of Nocardia species:

A

stain poorly with gram stain, but are recognized by acid-fast staining appearing as delicate hyphae

125
Q

Morphology of Peptostreptococcus:

A

gram positive cocci

126
Q

describe the appearance of strep. pneumoniae

A

encapsulated, gram [+], diplococci

127
Q

What’s the vaccine for TB?

A

•BCG (Bacille of Calmette and Guérin)

—-Live, attenuated M. bovis

—-Do not give to immunosuppressed pt because it is live

128
Q

What’s the treatment for blastomycosis?

A

•Amphotericin B, itraconazole, fluconazole

129
Q

most frequent cause of common cold

A

rhinovirus

130
Q

What’s the treatment for Legionella pneumophila infection?

A

erythromycin or fluoroquinolones

131
Q

What cause the symptoms following Mycoplasma pneumoniae infection?

A

Sxs due to activity of mycoplasma on cells= Triggers cell to produce H2O2 and reactive O2 =Detrimental to host cell membrane and cytoplasm disruption —->Eventually leads to destruction of the cell

132
Q

Describe the morphology of Haemophilus influenzae?

A

gram negative coccobacillus

133
Q

It is important to remember that the most common causative pathogen implicated in SECONDARY bacterial pneumonia following viral infection (classically influenza) is ______.

A

staph aureus

Pulmonary (4 decks)

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