question
What are the different types of pneumonia?
answer
CAP
HAP
VAP
HAP
VAP
question
What is the Gold Standard for CAP Dx?
answer
Presence of infiltrates on Chest X-ray
W/ supportive conditions
W/ supportive conditions
question
Tx for CAP outpatient
answer
No major comorbidities
No Abx in the last three months
Tx as normal
No Abx in the last three months
Tx as normal
question
What are organisms that cause CAP
answer
S. pneumonia
H. influenza
K. pneumonia
S. aureus
H. influenza
K. pneumonia
S. aureus
question
Structure of Streptococcus pneumonia
answer
Gram + cocci
Grows in pairs in short chains
Grows slow due to NO TCA cycle
Grows in pairs in short chains
Grows slow due to NO TCA cycle
question
Lab growth for Streptococcus pneumonia
answer
Grown in blood media --> supplies the catalase for organism to survive aerobically
Supplemented w/ carbon
Breakdown of heme gives a green appearance
Supplemented w/ carbon
Breakdown of heme gives a green appearance
question
Virulence factor of Streptococcus pneumonia
answer
Thick polysaccharide capsule --> 90 known serotypes
***Resists opsonization by complement
Secretory IgA protease --> cleaves secretory IgA in the mucus
***Resists opsonization by complement
Secretory IgA protease --> cleaves secretory IgA in the mucus
question
Function of the toxin pneumolysin in Streptococcus pneumonia
answer
Multiple proteins that form a pore in the membrane and causes the cell to lyse
question
What is Natural Competence in Streptococcus pneumonia
answer
bacteria can grab extracellular DNA and incorporate it into their DNA.
-Grabs ANY type of DNA in the extracellular
-Gives penicillin resistance to bacteria
-Grabs ANY type of DNA in the extracellular
-Gives penicillin resistance to bacteria
question
Pathogenesis of Streptococcus pneumonia
answer
Tissue DAMAGE
Techoic acid & petidoglycan induce alternative pathway of complement --> Pneumolysin induces classical complement
Techoic acid & petidoglycan induce alternative pathway of complement --> Pneumolysin induces classical complement
question
Pneumovax 23 is recommended for who?
answer
Adults >65 & risk factors
>65 every 5 yrs
>65 every 5 yrs
question
Prevnar 13 is recommended for who?
answer
Infants & adults >65 & at risk
question
Sxs of Pneumococcal pneumonia
answer
Severe chills
fever
cough w/ blood
fever
cough w/ blood
question
What causes bacteremia and meningitis?
answer
Pneumococcal pneumonia
question
Dx of Pneumococcal pneumonia
answer
Gram staining sputum --> not definitive
Alpha hemolytic strep culture --> oxidized Fe in heme --> green color
Alpha hemolytic strep culture --> oxidized Fe in heme --> green color
question
Structure of Haemophilus influenzae
answer
Small pleomorphic
Gram - rod
Capsule + & - strains
Lipooligosaccharides --> shorter LPS chain (LOS)
Gram - rod
Capsule + & - strains
Lipooligosaccharides --> shorter LPS chain (LOS)
question
What is the vaccine for Haemophilus influenzae
answer
Hib vaccine
four dose series --> 2,4,6, & 12-15 yrs
four dose series --> 2,4,6, & 12-15 yrs
question
Virulent factors of Haemophilus influenzae
answer
non-encapsulated strains are virulent
-Neuraminidase --> cleaves sialic acid form cell surfaces
-IgA protease --> breaks down IgA in mucus
-Neuraminidase --> cleaves sialic acid form cell surfaces
-IgA protease --> breaks down IgA in mucus
question
Dx of Haemophilus influenzae
answer
Chest X-ray --> fewer infiltrates
question
Culture of Haemophilus influenzae
answer
Chocolate agar --> preferred
Blood agar
Blood agar
question
Test for Haemophilus influenzae
answer
Latex particle agglutination test (LAT)
question
Structure of Klebsiella pneumoniae
answer
Enterobacteriaceae --> gut bacteria
Gram - rod
-thick mucoid slimy capsule
Causes pneumonia in alcoholics and DM
Gram - rod
-thick mucoid slimy capsule
Causes pneumonia in alcoholics and DM
question
Virulent factor for Klebsiella pneumoniae
answer
Polysaccharide capsule --> limits CAMP, polymixin & blocks C3b
LPS --> blocks C3b & inflammatory response
Adhesins --> bind to host receptors
LPS --> blocks C3b & inflammatory response
Adhesins --> bind to host receptors
question
Severity of Klebsiella pneumoniae
answer
Aggressive necrotizing CAP --> fatal
question
CP for Klebsiella pneumoniae
answer
ACUTE onset of high fever
Productive cough w/ thick blood tinged sputum --> Jelly like sputum (actual parts of the lungs)
Productive cough w/ thick blood tinged sputum --> Jelly like sputum (actual parts of the lungs)
question
Dx for Klebsiella pneumoniae
answer
Gram stain/culture mucoid capsule
X-ray shows cavitation
X-ray shows cavitation
question
Culturing for Klebsiella pneumoniae
answer
MacConkey Agar
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