CCOM Micro Exam 3 helps – Flashcards

Unlock all answers in this set

Unlock answers
question
23 serotypes account for _______% of __________ infection
answer
90% of Pneumococcal
question
Gr+ lancet-shaped diplococci
answer
Strep pneumo
question
Single bout of rigors
answer
Strep Pneumo
question
Strep Pneumo virulence factors
answer
Capsule - Pneumolysin
question
Strep Pneumo CXR
answer
Atypical: generally patchy
question
Optochin Sensitive?
answer
Strep Pneumo
question
Positive Quelling
answer
Strep Pneumo
question
Bile (or deoxycholate) soluble
answer
Strep Pneumo
question
When does Strep pneumo become invasive?
answer
A: In children <5 with severe illness such as
-Cancer
-Renal Disease
-Splenectomy
-Transplant
question
Catalase Positive
answer
Staph (NOT Strep)
question
Coagulase +
answer
Staph aureus
question
What is Staph aureus' aerotolerence?
answer
Facultative Anaerobe
question
Q: Agent of most soft tissue infections?
answer
A: Staph aureus
question
Infection of Staph aureus is due to ________
answer
contact
question
If 2 BCX are + for _________, PT has a ___% risk of _______ (with ___% mortality if present).
answer
If 2 BCX are + for Staph aureus, PT has a 50% risk of ACUTE INFECTIOUS ENDOCARDITIS (with 100% mortality if present).
question
Best prevention for SA transmission?
answer
Chlorhexadine soap
question
Pneumonia presentation with Staph aureus?
answer
Necrotizing
question
blue-green pigment
answer
Pseudomonas aeruginosa (Ps. aeruginosa)
question
Fruity odor
answer
Pseudomonas aeruginosa (Ps. aeruginosa)
question
How typical is pneumonia from fruity organism?
answer
Unlikely.
question
Normal reservoir for Pseudomonas aeruginosa (Ps. aeruginosa)?
answer
Ubiquitous
question
**Mortality of Pseudomonas aeruginosa (Ps. aeruginosa) pneumonia?
answer
Highest mortality (just of necrotizing pneumonias?)
question
Pseudomonas aeruginosa (Ps. aeruginosa) morphology
answer
GNR, motile, capsule possible,
question
Pseudomonas aeruginosa (Ps. aeruginosa) respiration
answer
fermentor, facultative anaerobe
question
What is Pyoverdin?
answer
Green pigment from Pseudomonas aeruginosa (Ps. aeruginosa)
question
What is Pyocyanin?
answer
Blue pigment from Pseudomonas aeruginosa (Ps. aeruginosa)
question
Function of Pyoverdin and Pyocyanin? (incl. sp.)
answer
Iron sequestration for Pseudomonas aeruginosa (Ps. aeruginosa)
question
Produced by Pseudomonas aeruginosa (Ps. aeruginosa):
answer

1) Pyoverdin - Iron (fluorescent)

2) Pyocyanin - Iron 3) Exotoxin A (AKA Exoenzyme A) - ADP-Ribosyltransferase action 4) Proteases/Elastases 5) Slime Layer

question
ADP-Ribosyltransferase is present in which 2 compounds?
answer
Diphtheria Toxin, &
Exotoxin A (Pseudomonas aeruginosa)
question
Biofilm formers include:
answer
1) Pseudomonas aeruginosa (Ps. aeruginosa)
2) ?
question
Presentation of P. aeruginosa pneumonia?
answer
Rapidly fulminant consolidation - high mortality
question
Describe Pseudomonas aeruginosa resistance patterns
answer
Ceftazidine-resistance common (MDR)
Resistance includes:
-Ceftazidime & Cefepime
-cipro
-imipenem
-piperacillin
Susceptibility: TOBRA (Aminoglycosides)
question
K. pneumoniae lab diagnosis
answer
GNR, Fac. Anaerobe with capsule, Oxidase negative, Mucoid colony morpholgy
question
K. pneumoniae risk factors?
answer
Usually HAP - 50% immunocompromised PTs Comorbidities include: -Diabetics with UTI -Bacteremia/Meningitis in neonates -Liver abscesses + meningitis or ophthalmitis
question
Does Kleb pneumoniae have a capsule?
answer
Yes - Polysaccharide (causes mucoid appearance of colonies)
question
Opportunistic pathogens
answer
1) K. pneumoniae
2) MTB
3) Nocardia
question
Most virulent K. pneumoniae capsules?
answer
K1 & K2
question
# of different K. pneumoniae capsules?
answer
72
question
Current jelly appearance?
answer
K. pneumoniae
question
Abscess formers:
answer
1) K. pneumoniae
question
Agents of Chronic Pneumonia
answer
1) K. pneumoniae
question
Respiratory Isolation recommended
answer
1) P. aeruginosa
2) K. pneumoniae
question
** Describe K. pneumoniae resistance patterns
answer
Panresistant (CRKP)
-Cefepime & Imipenem?
question
K. pneumoniae mortality
answer
Pneumonia: 50%
Bacteremia: 100%
question
Acinetobacter (A. baumanii) Lab diagnosis
answer
GNCB (appear diplococci), non-motile, aerobic, Oxidase negative, Fermentation negative
question
Pneumonia presentation of Acinetobacter (A. baumanii)
answer
CAP & HAP (VAP!)
Infections also include Endocarditis, Meningitis, Peridontitis, Osteomyelitis, Endophthalmitis, UTIs, Skin infections, wound infections.
question
Describe resistance patterns of Acinetobacter (A. baumanii)
answer
Easily acquire resistance genes.
---------
>1/3 are resistant
Carbapenems are the effective Tx
question
H. influenzae (Type B) lab diagnosis
answer
Small GNR, fastidious (CO2 on chocolate), oxidase positive(+),
question
Typical presentation with Hib?
answer
Tracheitis, AECB, AECOPD
Pneumonia after viral infection
question
H. influenzae (Type B) is where?
answer
Initially on mucosal surfaces, but may become invasive.
question
Treatment of HiB
answer
Cephalosporins or
Bactrim
question
Vaccine-preventable Bugs
answer

HiB

Strep Pneumo

question
L. pneumophilia laboratory diagnosis
answer
AEROBIC, GNR
question
Facultative intracellular organisms:
answer
1) L. pneumophilia
question
Predisposing factors for L. pneumophilia
answer
1) Age
2) alcohol abuse
3) Heart disease
4) smoker
5) chronic disease
6) Age
7) Immunosuppression
question
Reservoir for L. pneumophilia
answer
Water systems
question
Walking pneumonia can be caused by
answer
M. pneumoniae, U. urealyticum,
question
Smallest cellular organism?
answer
M. pneumoniae
question
M. pneumoniae lab diagnosis
answer
fastidious, requiring long incubation
question
Transmission of M. pneumoniae
answer
Direct contact and inhalation of aerosols
question
How infectious is M. pneumoniae?
answer
Not very. Usually only infecting closed populations under stress.
question
Predominance of Mono/Macroph indicates what?
answer
M. pneumoniae
question
Lab incubation of M. pneumoniae takes ____.
answer
2 weeks
question
Dx of M. pneumoniae based on _____?
answer
1) CXR
2) Cx (special medium)
3) Serology (DFA/IFA/"Cold aggultinins")
question
What should M. pneumoniae be treated with?
answer
1) Macrolides ("-mycin") 2) Tetracycline 3) Quinolones
question
__-__% of sexually mature women are colonized with ____________.
answer
40-80%, with U. urealyticum&parvum
question
Children typically infected with U. urealyticum&parvum by which means?
answer
Vertical transmission
question
What disease process results in children infected with U. urealyticum&parvum
answer
Bronchiolitis
ARDS
question
How does U. urealyticum&parvum typically present?
answer
Coughing and wheezing child of infected mother
question
Cx site for U. urealyticum&parvum?
answer
Mom: Vaginal (or from urine)
Child: Throat
question
Tx for U. urealyticum&parvum?
answer
Clarithromycin
question
Lab diagnosis of Chlamydia pneumoniae?
answer
(small GNR) - slow growing in cell Cx.
question
How does Chlamydia normally present?
answer
Cervicitis
question
What is an Elementary body?
answer
The infectious particle of a Chlamydia infection
question
What is a reticulate body?
answer
The Replicative particle of a Chlamydia infection.
Obligate intracellular particle.
question
How long is the incubation period for Chlamydia?
answer
4 weeks
question
Chlamydia trachomatis by vertical infection causes:
answer
Pneumonia and Conjunctivitis (or just one)
question
TWAR
answer
Taiwan associated Respiratory Disease
(Chlamydia pneumoniae)
question
What is MIF?
answer
Micro-Immuno-Fluorescence
question
Systems that can be complicated by Chlamydia
answer
CNS
Joints
Asthma
Heart
question
Tx of Chlamydia?
answer
Macrolides (-mycin)
question
Chronic necrotizing pneumonia is most often from which type of respiratory organism?
answer
facultative anaerobes
question
Most common neoplastic pneumonia?
answer
Primary squamous carcinoma
question
Signs of Chronic necrotizing pneumonia?
answer
Prolonged onset, fever, chills, night sweats,
Anorexia, weight loss, pleuritic chest pain
Solitary cavitating lesion on CXR
question
MTB organism
answer
Fac intracellular pathogen
Obligate AEROBE
question
MTB Transmission
answer
Human to human (only host/reservoir)
question
Virulence factors of MTB
answer
1) Mycolic acids
2) Cord factor (Trehalose dimycolate)
question
What causes TB from MTB?
answer
Immunosuppression is commonly the trigger to activate latent infections.
question
Where will MTB replicate after inhalation (as dusts/aerosols)?
answer
Often lungs, but anywhere where oxygen is present (usually within the macrophages)
question
What causes the lesion in pulmonary TB?
answer
CMI response
question
How is latent TB diagnosed?
answer
Dx by ppd or quantiferon test.
question
What response is a positive PPD?
answer
DTH w/ induration
question
Will quantiferon be positive with BCG vaccine? Why or why not?
answer
No. Quantiferon tests for proteins only made by MTB, not by BCG.
question
Fastest way to conclusively detect MTB in lab?
answer
PCR
question
Tx for TB?
answer
Isoniazid
Rifampin
Pyrazinamide
Ethambutol
question
reservoir of Actinomyces israelii?
answer
Human mouth & GI
Female repro
question
Lab diagnosis of Actinomyces israelii
answer
Branching, filamentous Gram Positive or variable,
Facultative Anaerobe (ANACx)
question
Risk for Actinomyces israelii pneumonia?
answer
Male, Tobacco and alcohol use,
Poor oral hygiene, oral trauma
question
How does Actinomyces israelii get to pathogenic sites?
answer
hematogenous spread
question
How does Actinomyces israelii pneumonia present?
answer
Abscesses with sinus tracts and sulfur crystals.
(Can also infect skin, bones, lower GI, brain, other organs)
question
Tx of Actinomyces israelii?
answer
Penicillin
question
How does Nocardia asteroides stain?
answer
Filamentous appearance, variable AFB/Gram positive
question
Life cycle of Nocardia asteroides
answer
Opportunistic, facultative intracellular bacteria.
question
How is Nocardia asteroides transmitted?
answer
NOT person to person
Environmental source + CMI supression
question
Which factors increase risk of Nocardia asteroides infections?
answer
CMI Suppression
Lymphoma
Other pulmonary problems
Males affected most
question
How is Nocardia asteroides spread?
answer
First by environment
Second by hematogenous spread
question
How does Nocardia asteroides present?
answer
Purulent lesions WITHOUT GRANULOMA formation
Nodular masses
Can be acute to chronic
Can infect other tissues (ie skin)
question
Tx of Nocardia asteroides?
answer
Bactrim or Cephalosporins
question
Reservoir of Non-TB Mycobacteria?
answer
Environment & Animals
(NF to some degree)
question
Common strains of Non-TB Mycobacteria?
answer
M. kansasii
M. fortuitum
MAC
question
Length of latency of Non-TB Mycobacteria
answer
No latency or reactivation
question
diagnosing PT's Non-TB Mycobacteria
answer
weak PPD test positive.
question
Tx of Non-TB Mycobacteria?
answer
Depends on senstivities
Get an explanation on any task
Get unstuck with the help of our AI assistant in seconds
New