Microbio Final

• requirement of a quality sputum specimen/culture


  less than 10 epithelial cells

  more than 25 WBC
• lower respiratory tract barriers to infection


  mucocillary escalator

  alveolar macrophages
• is there normal flora in the lower respiratory tract?


  NO normal flora present
• bacterial diseases of LRT


  pertussis

  primary pneumonia

  atypical/walking pneumonia

  tuberculosis
• bacteria that causes pertussis(whooping cough)

  Bordetella pertussis
• gram stain of Bordetella pertussis

  gram negative coccobacillus
• stages of whooping cough disease

  catarrhal

  proximal

  convalescent
• catarrhal stage of whooping cough


  cold/flu
• proximal stage of whooping cough


  whoop cough (severe)
• convalescent stage of whooping cough

  lasts for months

  damage needs time to heal
• toxins made by bordetella pertussis


  pertussis and tracheal toxin (A)

  fialmentous hemaggultinin (B)
• how do the toxins (pertussis and filamentous) of whooping cough work?


  stop the mucocillary escalator allowing toxin to get into the lungs
• Treatment of pertussis


  antibiotics
• prevention of pertussis


  Dtap vaccine
• bacteria that causes primary pneumonia

  streptococcus pneumoniae
• gram stain of strep pneumo


  gram positive diplococci (GPDC)
• Diagnosis of strep pneumonia

  alpha hemolytic

  catalase negative

  optichin sensitive
• secondary pneumonia


  often secondary to existing infection bacterial or viral
• primary pneumonia disease characteristics

  alveoli fill with pus

  no oxygen exchange occurs

  very toxic
• virulence factor of streptococcus pneumonia


  thick and dense capsule that resists phagocytosis
• treatment for primary pneumonia


  Penicillin (antibiotic)

  can be deadly if untreated
• prevention of primary pneumonia


  1 vaccine for adults

  1 vaccine for children
• when do you suspect atypical pneumonia?

  when sputum culture is negative
• what must also be considered when the sputum culture is negative (besides walking pneumonia)?

  viruses have to be considered
• three bacterial causes of atypical pneumonia

  mycoplasma pneumoniae

  chlamydophila pneumoniae

  legionella pneumophila
• how are mycoplasma pneumo and chlamydiophila pneumo similar?


  cause the same disease (Both interstital)

  does not fill the alveoli
• why can you not treat mycoplasma pneumo or chlamydiophila pneumo with beta lactams?


  mycoplasma has no cell wall so beta lactam won't work

  treat chlamydiophila and mycoplasma the same
• disease caused by legionella pneumophila

  atypical pneumonia

  lives inside amoebas
• how does legionella pneumophila spread?

  aerosol water. AC, Misters, hospital water lines

  NO person to person spread
• what is legionella pneumophila associated with?


  associated with OUTBREAKS
• mycobacterium tuberculosis


  AFB (acid fact bacilli)

  smears pink

  infects macrophages
• bacteria that causes tuberculosis

  Mycobacterium tuberculosis
• active tuberculosis


  green and bloody sputa

  night sweats

  weight loss

  AFB smear is POSITIVE
• latent tuberculosis


  granulomas tubercles

  AFB smear NEGATIVE
• extrapulmonary tuberculosis (miliary)


  outside lungs

  tubercles in organs and tissues

  seen in AIDS and immunosuppressed

  AFB sputum smear NEGATIVE
• is there a vaccine available for tuberculosis?


  yes

  not given in the US

  not very helpful for adults (mostly given to kids)
• what will cause a positive result on the TB skin test (PPD)?


  active TB

  latent TB

  Extrapulmonary TB

  BCG vaccine

  Past exposure

  NTM exposure
• Non-tuberculous mycobacteria (NTM)


  not MTB

  non M. leprae

  AFB smear POSITIVE
• why is NTM not causes by M.leprae?


  does not cause lung infections
• when should you suspect NTM as a reason for TB?


  AIDS immunosupressed patients only