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True/False: Strep pneumo is normal microbiota
True
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True/False: nontypeable H. influenzae is normal microbiota
True
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What is the leading agent causing epiglottitis?
Hib
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What are the symptoms of epiglottitis?
- Dysphagia
- Dysphonia
- Drooling
- Distress
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What are the 4D’s and what do they refer to?
- Refers to symptoms of epiglottitis
- Dysphagia, dysphonia, drooling, distress
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True/False: epiglottitis is a medical emergency
True
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What would epiglottitis look like on exam and how is it diagnosed?
- Inflamed throat, swollen/stiff/beefy red epiglottis
- Diagnosed with “thumbprint” like neck on radiographs
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How is epiglottitis treated?
Intubation and abx
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Which is the most common cause of pneumonia?
Streptococcus pneumoniae
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How do strep pneumo enter the lower respiratory tract?
- inhalation aersol
- Aspiration from oropharynx – most common route for hospital-acquired PNA
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True/False: bacterial pneumonia more often result in chronic pneumonia
False; fungal and mycobacterium result in chornic, bacterial pneumonia are acute
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What are the most common community-acquired pneumonia etiologies?
- S. pneumoniae
- H. influenzae
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What are some of the common etiologies for hospital-acquired pneumonia?
- MRSA
- Pseudomonas
- Acinetobacter,
- MDR Enterobacteriaceae
- CMV
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Is person-to-person transmission a CAP or HAP?
CAP (community acquired)
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Is animal or environment exposure pneumonia a CAP or HAP?
CAP (community acquired)
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What are signs and symptoms of typical pneumonia?
- Rapid onset
- Severe symptoms: productive cough
- CXR with solid consolidations
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What are signs and symptoms for atypical pneumonia?
- Slower onset
- Less severe sxs: nonproductive cough
- CXR with patchy interstitial pattern
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What is the most common etiology of typical pneumonia?
Streptococcus pneumoniae
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What is the most common etiology of atypical pneumonia?
Mycoplasma pneumoniae
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List three bacterial agents causing typical pneumonia:
- Strep pneumo
- Hib
- Nontypeable H. influenzae
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True/False: S pnuemo has hallmark symptom of rust-colored sputum
True
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List 4 bacterial agents of atypical pneumonia:
- Mycoplasma pneumoniae
- Chlamydophila pneumoniae
- Chlamydophila psittaci
- Legionella pneumophila
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Which bacterial agent has the hallmark symptom of bilateral interstitial pneumonia and severe headache?
Chlamydophila psittaci
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Which bacterial agent has the hallmark sx of tracheobronchitis that leads to hacking cough for weeks?
Mycoplasma pneumoniae
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True/False: Myocobacterium is a bacterial agent of atypical acute pneumonia
False. Mycobacterium is an agent of chronic pna, mycoplasma is the one that is an atypical PNA agent
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Which bacterial agent causing predominant GI symptoms and confusion in atypical pneumonia?
Legionella pneumonphila
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True/False: bacterial pneumonia usually has elevated lymphocytes with a left shift
False; elevated white count with left shit, not lymphocytes. (Lymphocytosis is only seen with B pertussis infections)
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What is the gram stain of streptococcus pneumoniae?
Gr +
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Is S. pneumoniae alpha or beta hemolysis?
Alpha
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Is S pnuemo catalase positive or negative?
Negative
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What is S. pneumo’s Oxygen metabolism?
Facultative anaerobes
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Which type of agar does S pnuemo grow on?
Blood agar
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Is S penumo sensitive to optochin?
Yes
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Is S pnuemo sensitive in bile?
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True/False: S pnuemo is soluble in bile i.e. the tube becomes clear
True
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True/False: S pnuemo is optochin negative
False; it is optochin positive
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True/False: S pnuemo does not have a capusule
False; it does have a capsule (polysaccharide)
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True/false: S pneumo is found in soil and water
False; it has a human reservoir and part of our normal microbiota
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True/False: S pneumo is catalast positive
False; it is catalase negative
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True/False: S pneumo is gamma hemolytic
False; it is alpha hemolytic
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True/False: S pneumo is alpha hemolytic
True
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What does it mean that S pneumo is naturally competent for transformation?
It can take up naked DNA from its environment therefore have more abx resistance
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What are virulence factors for S pneumo?
- Adhesins
- Polysaccharide capsule
- IgA 1 protease
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What is IgA1?
An important mucosal antibody
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What is IgA1 protease?
A virulence factor for mucosal pathogens like S. pnuemo, N. gonorrhea and H. influenzae to clip IgA1
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What does the mnemonic “nice strip of ham” mean?
Pathogens that produce IgA1 : Neisseria, Strep pneumoniae, H. influenzae
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True/False: S pneumo produces a toxin called pneumolysin
True
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S pneumo has a positive or negative Quellung, and what does that look like?
Positive; has enlarged/swollen capsule, so looks like an extra circle encircling the dot
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Will S pneumo grow in the presences of optochin?
No, it will not grow with optochin
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True/False: S pneumo “respects the boundary”, and will not extend beyond labor boundaries
True
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Is S pneumo vaccine preventable?
Yes
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What is the Gram stain for myoplasma
Ha. Trick question! There is none because they are wall less
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True/False: Mycoplasma are not visualized on gram stain
True
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True/False: mycoplasma are circular shape
False; they are pleomorphic as they don’t have any walls
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True/False: mycoplasma pneumoniae have a human reservoir and normal microbiota in respiratory tract
False; they ARE human reservoir, yes. But they are not normal microbiota
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What does mycoplasma’s cell membrane contain?
Sterol
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True/False: Mycoplasma does not have cell wall so it is resistant to penicillin and cephalosporin
True
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True/False: mycoplasma stains poorly
True
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True/False: because M pneumoniae is a respiratory pathogen, it is aerobic
True
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What are symptoms of M. pneumoniae infection?
Persistent/ hacking cough
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What is a major virulence factor of M. pneumo?
P1 adhesin – concentrated in attachment tip structure
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How is M pneumo diagnosed?
Cold aggultinins
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True/False: Chlamydophila and Chlamydia are interchangeable names
Nope, fake news. The are distinct genus
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What is the gram stain of Chlamydophila?
Gram negative
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True/False: Chlamydophila are obligate intracellular
True
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The life cycle of Chlamydophila and Chlamydia alternates between ________ form and ______ form.
Elementary body; reticulate body
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What form of Chlamydophila is the one that initially gets taken up by host cell?
Elementary body
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What is elementary body?
Small, rigid, metabolically inactive, infectious form of Chlamydophila life cycle
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Where in the host cell does elementary body begin to differentiate into reticulate body? (life cycle of Chlamydia, Chlamydophila)
Phagosome
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What is reticulate body? (life cycle of Chlamydia, Chlamydophila)
Larger, noninfectious, actively replicating
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C. pnuemoniae is a/an ______ pathogen (host)
Animal, human
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C. psittaci is a _____ pathogen (host)
Bird
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How is C. pneumo transmitted?
Human to human transmission via respiratory secretions
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How is C penumoniae and C psittaci diagnosed?
Serology, PCR
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How is C. psittaci transmitted?
Bird to human via aerosolized bird secretions, excretions
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What are some sympstoms of C. psittaci?
Severe headache, diarrhea
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Is there a vaccine for strep pyogenes?
No
-
Is there a vaccine for N gonorrhea?
No
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Is there a vaccine for C diphtheriae?
Yes
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Is there a vaccine for S pnuemo?
Yes
-
Is there a vaccine for Hib?
Yes
-
Is there a vaccine for nontypeable H influenzae?
No
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Is there a vaccine for M pneumo?
No
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Is there a vaccine for C. pneumo?
No
-
Is there a vaccine for c psittaci?
No
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Is there a vaccine for Legionella pneumo?
No
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Is there a vaccine for B anthracis?
Yes
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Is there a vaccine for B pertussis?
Yes
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Which bacterial agents of PNA/respiratory tract infection are vaccine-preventable?
- C diphtheriae
- S pneumo
- Hib
- B anthracis
- B pertussis
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