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CRRAB II > Lower Respiratory Infections > Flashcards

Lower Respiratory Infections Flashcards

1
Q

Opsonizing Ig in alveoli?

A

IgG

**facilitates ingestion by macrophages

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2
Q

Only real way to differentiate between bronchitis and pneumonia?

A

infiltrates or consolidation on CXR

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3
Q

Most common cause of bronchiolitis?

A

RSV

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4
Q

Age where clinical sx of bronchiolitis develop?

A

infants and young children only

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5
Q

Diagnostic test for RSV?

A

nasal washing + antigen test

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6
Q

Respigram?

A

Ig reactive with RSV

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7
Q

palivizumab

A

humanized monoclonal Ab reactive with RSV

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8
Q

Mild type of influenza virus?

A

C

**almost everyone develops immunity by age 15

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9
Q

Infectious period for adults with influenza virus?

A

one day before onset of sx –> 5 days after sx onset

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10
Q

Sx to differentiate influenza virus from common cold?

A

high fever

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11
Q

Characteristic to differentiate influenza from atypical PNA?

A

rapid onset

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12
Q

Test for influenza?

A

rRT-PCR

real time reverse transcriptase PCR

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13
Q

Whooping cough bug?

A

Bordetella pertusis

Gram -

cocco-bacillus

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14
Q

Bordetella pertussis

Gram ?

shape ?

A

Gram -

cocco-bacillus

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15
Q

Tissue damaging VF of B pertusis?

A

AB-toxin

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16
Q

Atteachment VF of B. pertusis?

A

filamentous hemagglutinin

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17
Q

age for most severe pertusis?

A
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18
Q

Culture medium for B. pertusis?

A

Bordet-Gengou

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19
Q

Unusual WBC finding in pertusis?

A

lymphocytosis (vs high PMNs of other bacterial infx)

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20
Q

Tx for pertusis?

A

erythromycin

**not effective after ~2 weeks

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21
Q

Most common cause of CAP?

A

Strep pneumoniae

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22
Q

Three major bacterial causes of atypical PNA?

A

Mycoplasma

Chlamydia

Legionella

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23
Q

Viral cause of PNA in immunocompromised?

A

CMV

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24
Q

PNA age group:

Strep agalactiae

E. coli

A

neonates

birth - 6 weeks

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25
Q

PNA age group:

RSV

Mycoplasma pneumoniae

Chlamydia pneumoniae

Strep pneumoniae

A

6 weeks - 18 years

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26
Q

PNA age group:

Mycoplasma pneumoniae

Chlamydia pneumoniae

Strep pneumoniae

A

18 - 40 years

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27
Q

PNA age group:

Strep pneumoniae

Haemophilus influenzae

Anaerobes

Viruses

A

40 - 65 years

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28
Q

PNA age group:

Strep pneumoniae

Viruses

Anaerobes

Haemophilus influenzae

Gram (-) rods

A

> /= 65 yo

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29
Q

Most common HAP causes?

A

Gram (-) rods

S. aureus

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30
Q

Most common PNA in immunocompromised:

A

G - rods

Strep pneumo

fungi

filamentous bacteria

P. jiroveci

viruses

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31
Q

PNA causes in alcoholics:

A

Strep pneumo

Klebsiella pneumoniae

anaerobes

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32
Q

PNA in IV drug use:

A

S. aureus

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33
Q

PNA in post viral secondary infx:

A

S. aureus

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34
Q

PNA in chronic steroid use:

A

Nocardia

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35
Q

rhinovirus binds to?

A

ICAM-1 on resp epithelial cells

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36
Q

parainfluenza virus VF forming multinucleated giant cells?

A

F surface protein

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37
Q

croup

A

parainfluenza virus

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38
Q

Influenza virus types with 8 segments of RNA?

A

A and B

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39
Q

Influenza types with no animal reservoir?

A

B and C

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40
Q

What is required for antigenic SHIFT?

A

animal/human reservoir with simultaneous infx from two different strains of influenza

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41
Q

Influenza virus capable of genetic DRIFT and SHIFT:

A

A

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42
Q

Test for influenza?

A

rapid antigen test on nasopharyngeal swab

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43
Q

What is detected on influenza rapid antigen swab?

A

HA type via RBC agglutination

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44
Q

myocarditis

A

Coxackie B

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45
Q

herpangia, hand-foot-mouth disease

A

Coxackie A

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46
Q

Potential vector for gene therapy

A

Adenovirus

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47
Q

Three viruses that utilize hemagglutinin for binding:

A

influenza

parainfluenza

adenovirus

48
Q

viral conjunctivitis

A

adenovirus

49
Q

hemorrhagic cystitis

A

adenovirus

50
Q

S. pyogenes

? hemolytic

bacitracin ?

ASO

Ab present?

A

Beta-hemolytic

bacitracin sensitive

ASO +

anti-streptolysin O

51
Q

Second most common cause of PNA in pts w COPD?

A

Moraxella catarrhalis

52
Q

Most common cause of PNA in pts w COPD?

A

non-typeable H. influenzae

53
Q

attachment VF for M. catarrhalis:

A

pili

54
Q

M. catarrhalis

Gram ?

VF for inflammatory response

A

gram -

endotoxin

55
Q

Tx for M. catarrhalis?

A

amoxicillin-clavulanate

2nd linde: 2nd/3rd gen cephalosporin

56
Q

whooping cough bug

A

Bordetella pertusis

57
Q

B. pertussis VF’s for:

attachment?

impairs phagocytosis?

A

filamentous hemagglutinin

AB toxin –> increased cAMP

58
Q

Bordet-Gengou

A

B. pertusis

59
Q

Strep pneumo VFs for:

evading phagocytosis ?

A

capsule

IgA protease

60
Q

S. pneumo

Optochin ?

? hemolytic

A

suceptible to optochin

alpha-hemolytic

61
Q

Difference between H. influenzae type B and non-typeable:

A

HiB is encapsulated –> invasive

NTHi not encapsulated –> local infx

62
Q

X factor and V factor on chocolate agar?

A

H. influenzae

63
Q

H. influenzae

Gram ?

A

negative

64
Q

Tx of H. influenzae?

A

3rd gen ceph

65
Q

prophylaxis for close contacts of H. influenzae?

A

rifampin

66
Q

RSV attachment VF:

A

G surface protein

67
Q

Tx of severe RSV?

A

ribavirin

68
Q

Most common cause of meningitis in newborns?

A

Strep agalactiae

69
Q

Gram +

neonatal pneumonia

A

Strep agalactiae

beta-hemolytic

bacitracin resistant

70
Q

“walking pneumonia”

A

Mycoplasma pneumoniae

71
Q

Cold hemagglutinin

fried egg appearance

pneumonia in young person living in a dorm or similar

how would you treat it?

A

Mycoplasma pneumoniae

Erythromycin or tetracycline (no cell wall so no beta lactams)

72
Q

intracytoplasmic inclusions on Giemsa stain

A

Chlamydia pneumoniae

73
Q

Tx for Chlamydia pneumoniae?

A

Doxycycline

74
Q

Most likely patient for C. pneumoniae infx?

A

young adult

75
Q

S. aureus VFs for host defense evasion?

A

protein A

coagulase

hemolysins

leukocidins

76
Q

S. aureus VFs for deeper systemic invasion?

A

hylauronidase

staphlokinase

lipase

77
Q

Gram + cocci in clusters

A

S. aureus

78
Q

Naturally inhabits water reservoirs

A

Legionella pneumophila

79
Q

Silver stain positive

charcoal yeast extract

proliferates inside macrophages

A

Legionella pneumophila

80
Q

pneumonia in pt with CD4 under 200?

silver stain positive

A

PCP pneumocyctic pneumonia

Pneumocytis jiroveci

81
Q

beaded, filamentous growth in immunocompromised

can acid fast stain and look like TB

A

Nocardia asteroides

82
Q

Forms caseous granulomas and PNA w cavitations +/- abcesses in kidney/brain

Gram +

aerobic

beaded filaments

A

Nocardia asteroides

83
Q

Age group where S. pneumo is less likely cause of PNA?

A

neonates

birth - 6 weeks

84
Q

Age where you might start seeing H. influenzae as a more common cause of PNA?

A

> 40

85
Q

Age group less likely to have viral PNA?

A

18 - 40

86
Q

anti-HA Abs on serology?

A

Parainfluenza virus

87
Q

Influenza C has ___ segments in RNA.

A

7

88
Q

Cytokines contributing to Influenza disease process?

A

IL-1

IFN-gamma

89
Q

SS (+) Nonsegmented

non enveloped

icosahedral

A

Rhinovirus

90
Q

Helical

enveloped

SS (-)

non segmented

A

Parainfluenza virus

91
Q

Helical

enveloped

SS (-)

nonsegmented

F-protein –> multinucleated giant cells

A

RSV

92
Q

Icosahedral

nonenveloped

SS (+) non segmented

Enterovirus

A

Coxackie A and B

93
Q

DNA

Icosahedral

nonenveloped

liner DS genome

A

Adenovirus

94
Q

Helical

Enveloped

SS (-) segmented 
(class V)

orthomyxoviridae

A

Influenza virus A B C

95
Q

Two bacterial causes of conjuntivitis:

A

H. influenza

S. pneumo

96
Q

Two bacterial causes of bronchitis that are not gram + or -:

A

Mycoplasma pneumoniae

Chlamydia pneumonia

97
Q

Most common causes of “atypical PNA”

A

Mycoplasma

Chlamydia

Legionella

viral

98
Q

Obligate intracellular bug that causes PNA and requires host ATP for energy?

A

Chlamydia

99
Q

Inclusion body replication?

A

Chlamydia

100
Q

Most common cause of bronchiolitis:

A

RSV

101
Q

Age group you’re thinking about with RSV?

A

young

**almost everyone becomes immune after early life exposure

102
Q

What does “catarrhal stage” refer to?

A

post incubation (3-21 days) stage of pertussis

lasts 1-2 weeks

103
Q

What does “paroxysmal stage” refer to?

A

B. pertusis w/ severe and uncontrollable coughing

104
Q

Regan-Lowe medium?

A

B. pertusiss

105
Q

What won’t work to treat pertusiss?

A

cephalexin/penicillin

106
Q

G - rods that could cause HAP?

A

Klebsiella

Pseudomonas?

E. coli?

107
Q

Current Jelly sputum?

A

Klebsiella

108
Q

Two bugs with positive silver stain?

A

Legionella

P. jiroveci

109
Q

charcoal yeast

A

Legionella

110
Q

hydrolyzes tributyrin

A

M. catarrhalis

111
Q

four ways to Dx M catarahlis

A

hydrolyzes tributyrin

produces DNase

reduces Nitrite to Nitrate

does NOT ferment sugars

112
Q

presence of cold hemagluttinin

A

Mycoplasma

113
Q

fried egg

A

Mycoplasma

114
Q

cysts forming dark oval bodies

A

P. jiroveci

115
Q

Tx for Nocardia

A

TMP SMX

CRRAB II (28 decks)

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