Pulm-micro Test Questions – Flashcards
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| Normal Flora of the URT |
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| Diptheriods, H. influenzae, Moraxella, Coag (-) Staph, Staph aureus, Pneumococci |
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| Most common causes of Pharyngitis |
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| Adenovirus, Rhinovirus, Group A Strep |
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| Most common cause of Otitis Media |
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| S. pneumoniae, Non-typable H. influenzae, Moraxella |
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| Presentation of Otitis Media |
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| Inflamed Typanic membrane with purulent fluid behind |
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| Presentation of Pharyngitis |
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| Pain while swallowing with an inflamed pharynx |
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| Morphology of Moraxella |
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| Small Gram (-) coccibacillus, cocci, bacili |
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| Lab Diagnosis of Moraxella |
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| Oxidase (+), Non-Carb Fermenter, Blood Agar culturable |
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| Diseases caused by Moraxella |
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| Otitis Media, Sinitis Brochisis, Pneumonia, Conjunctivitis in Elderly or Compromised |
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| Treatment of Moraxella |
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| Non-Beta Lactam Antibiotics |
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| Morphology of Haemophillus influenzae |
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| Small Pleomorphic Gram (-) Bacillococci, Bacilli |
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| Lab Growth of H. influenzae |
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| Satellite Colonies on Blood Agar Cocolate agar with Factor V and X (NAD and Hematin Respectively) |
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| Virulence factors for H. influenzae |
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| Capsule, IgA Protease, Endotoxin, Membrane adhesive proteins |
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| Diseases causes by H. influenzae |
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| Otitis Media, Epiglotitus, Pneumonia Meningitis, Arthritis, Cellulitis |
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| Lab Diagnosis of H. influenzae |
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| PRP Latex Agglutination Site swab cultured on Chocolate agar |
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| Immunity to H. influenzae |
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| Anti-PRP Antibody |
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| Non-Typeable H. influenzae diseases |
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| Sinitus, Otitis Media, Pneumonia, Bronchitis |
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| What is H. influenzae Type B Antigen |
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| Polyribose-Ribitol Phosphate |
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| Haemophillus influenzae Treatment |
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| Ampicillin first is sensitive, then Cephalosporins 35% are B-Lactam and AMP resistant |
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| Epidemiology of H. influenzae |
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| Nontypable: 60-90% Normal flora Typable: 5-0.5% Carriers |
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| Prevention of H. influenzae |
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| PRP conjugated to CRM197 Diptheria Protein immunization at 2,4,6 11-15 mths, 4-6 yrs, 11-18 yrs |
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| Morphology of Streptococcus pyogenes |
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| Gram(+) Cocci in Chains, Catalase(-), B-hemolytic, Group A Antigen, Bacitracin Sensitive |
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| Epidemiology of Group A Strep |
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| 30% of Anterior Nasals, <10yrs, Winter |
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| Strep pyogenes Transmission |
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| Droplet Infection |
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| Virulence Factors for Streptococcus Pyogenes and Role |
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| Streptolysin O and S M-Protein- binds keratin Streptokinase, Streptodornase, Hyluronidase Capsule with Hyluronic Acid SPE A,B,C- Delayed Hypersensitivity, Superantigen-> IL-1, TNF-alpha |
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| Primary Infections Presentation of Strep Pyogenes |
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| White Exudate in Pharynx with enlarged tonsils and anterior cervical lymph nodes |
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| Presentation of Post-Strep Rheumatic fever |
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| Type II Hypersensitivity: Carditis, Chorea, Erythema Marginatum, Subcutaneous Nodules, Polyarthritis, Fever, high ESD/CRP, Prolonged PR, Arthia |
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| Presentation of Post-Strep Glomerulonephritis |
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| Type III Hypersensitivity: Hematuria, Hypertension, Facial Edema |
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| Acquirement of SPE A and C |
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| Lysogenic Phage |
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| Lab Diagnosis of Strep pyogenes |
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| Sreptozyme Gram(+), B-hemolytic, Group A, Catalase(-) Bacitracin Sensitive, CAMP(-) |
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| Mechanism of Immunity to Strep pyogenes |
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| Ig to M-Protein |
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| Treatment for Strep pyogenes |
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| Pencillin or Erythomycin if allegic to Penicillin |
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| Symptoms of Scarlet Fever |
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| Sandpaper Rash, Strawberry Tongue |
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| Cause of Scarlet Fever |
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| SPE A,B,C |
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| Distinguishing Group A from group B strep |
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| Bacitracin Sensitive is A |
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| How are Otitis Media Infections made |
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| URT mostly in Children |
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| What Strep pyogenes sequelle can be prevented with antibiotics |
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| Rheumatic Fever |
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| Morphology of Bordetella pertussis |
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| Gram (-) Coccobacillus, Strict Aerobe |
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| Growth of B. pertussis |
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| Charcoal or Bordet-Gengou Agar |
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| Virulence Factors of B. pertussis and Mechanism |
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Pertussis Toxin-ADP-Ribosylation of Gs Tracheal Endotoxn Invasive Adenylate Cyclase Filamentinous Hemmaglutinin Hemolysin, Dermonecrotic Heat-labile toxin |
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| Disease Stages of Pertussis and Timing |
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| Catarrheal: Rhinorrea, Sinitis (1-2 wks) Paroxysmal Cough: Inspiratory Whoop from narrow glottis, Lymphocytosis (wks 2-3) Convelescent: Symtom Fade (wks 3-4) |
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| Lab Diagnosis of Pertussis |
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| Culture Immunoflorescence PCR |
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| Immunity to Pertussis |
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| sIgA, but doesn't last a lifetime |
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| Empidemiology of Pertussis |
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| Infants and Children, Only Humans |
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| Prevention of Pertussis |
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| Vaccine @ 2,4,6, 11-15 mths, 4-6 yrs, 11-18 yrs |
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| Hallmark of Pertussis Infection |
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| Lymphocytosis |
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| Hallmark of Pertussis Infection |
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| Lymphocytosis |
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| Morphology of Corynebacterium diptheriae |
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| Gram (+) rod, non-spore forming, aerobe Chinese Letter, Palisading Arrangement, Metachromatic Granules in Methylene Blue |
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| Virulence Factors of Diptheriae |
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| Diptheria Toxin-EF-2 ADP-Ribosylation |
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| Important points about diptheria toxin |
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| Beta phage carrying DtxR represses gene if Fe is present |
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Presentation of a diptheria patient |
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1)Pseudomembranous plaque that bleeds when scratched, Bull Neck, Systemic Effects 2)Skin ulceration with dirty gray base 3)Mild Pharyngitis if diptheriod |
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Lab Dx of Cornebacterium diptheria |
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Clinical Diagnosis Culture: K;Tellurite/Tinsdale Agar Biochemical Testing Tissue Culture |
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| Immunity to diptheria |
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| Neutralizing Ig to Diptheria Toxin |
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| Treatement of Diptheria |
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Passive Equine Immunity against DT Macrolides TX: Penicillin, Erythromycin |
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| Epidemiology of Pertussis |
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| Human only |
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| Prevention of Diptheria |
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| Toxoid 2,4,6,11-15mths,4-6yrs,11-18yrs |
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| Why is Diptheria diagnosis reliant on clinical eveluation |
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| Few organisms to culture and asymptomatic onset |
