Chapter 19: Infectious Diseases of the Respiratory System (Pilgrim)

mechanical

Healthcare-associated pneumonia (HAP) is most commonly associated with ______ ventilation via an endotracheal or tracheostomy tube: - natural - hybrid - mechanical - pressure gradient

moist soils high in nitrogen content

Histoplasma capsulatum grows most abundantly in which type of environment? - moist soils low in nitrogen content - most soils high in nitrogen content - dry soils low in nitrogen content - dry soils high in nitrogen content

eastern/central US

Histoplasma capsulatum has the highest incidence in which region? - South Africa - western US - eastern/central US - middle east/west Asia

macrophage

In pneumonia, microorganisms avoid phagocytosis or avoid being killed inside what?

15%

Streptococcus pyogenes is carried as "normal" biota of what percentage of the population (hint: less than 20%).

anaerobic

Streptococcus pyogenes is facultatively ______ coccus in chains.

lysozyme

Streptococcus pyogenes is protected from which enzyme found in saliva?

Streptococcus pyogenes

30% of sore throats may be caused by which type of microorganism? - Haemophilus influenzae - Escherichia coli - Staphylococcus aureus - Streptococcus pneumoniae - Streptococcus pyogenes

yes

Can antibiotics the patient is already taking affect the test results for HAP?

second and third lines of defense

Complement, antimicrobial peptides, chemocytokines, macrophages (alveolar), and secretory IgA make up which line(s) of defense of the respiratory tract?

group A

Do pharyngeal swab specimens detect group A or group B streptococci?

gram positive

Is Streptococcus pyogenes gram positive or negative?

no

Is there a vaccine for pharyngitis?

Legionnaire's disease

Legionella is a less common, serious cause of which disease?

phagocytosis

M protein helps S. pyogenes resist ______ and helps with adherence.

polymicrobial

Many causes of health-care associated pneumonia are ______ in origin: - monomicrobial - polymicrobial - antimicrobial - acidophilic

children

More ______ die of pneumonia than any other infectious disease.

first line of defense

Nasal hairs, cilia, and mucus make up which line of defense of the respiratory tract?

negatives

Pharyngitis swabs have a high rate of false-______ (negatives or positives).

lungs; alveoli

Pneumonia is an inflammation of the ______ in which fluid fills the ______.

pharyngitis

Rapid diagnostic tests of pharyngeal swab specimens help identify which type of disease? - Rhinitis - acute otitis media - pharyngitis - Zoomie's syndrome

community-acquired pneumonia

Respiratory viruses are a very common cause of which type of pneumonia? - healthcare-associated pneumonia - community-acquired pneumonia - atypical pneumonia - walking pneumonia

erythrogenic

Scarlet fever produces which type of toxin that causes the lysis of RBCs?

pneumococcus

Streptococcus pneumoniae is also known as what?

injure

Streptolysins rapidly _____ cells and tissues.

true

T or F? A wide variety of microorganisms can cause pneumonia.

false

T or F? Erythrogenic toxin is in all strains of S. pyogenes.

true

T or F? Sputum and tracheal swabs are not useful for health-care associated pneumonia.

false

T or F? Streptococcus pyogenes is motile.

true

T or F? The lungs harbor a normal microbiota.

Australia

The community-acquired pneumonia, Histoplasma capsulatum, is found on all continents EXCEPT: - Africa - Australia - Europe - Asia - South America

Streptococcus pyogenes (Group A Streptococcus)

The most serious cases of pharyngitis are caused by which organism?

upper

The mouth, nose, nasal cavity, sinuses, throat/pharynx, epiglottis, and larynx make up which part of the respiratory tract?

upper and lower

The respiratory tract is divided into which two parts?

lower

The trachea, bronchi, bronchioles, and alveoli make up which part of the respiratory tract?

acute otitis media

The use of the prevnar vaccine has reduced the incidence of which disease in children? - sinusitis - rhinitis - acute otitis media - diphtheria - influenza

1%

Up to what percentage of hospitalized or institutionalized people experience pneumonia? - 5% - 1% - 32% - 25%

older adults

Vaccination for Streptococcus pneumoniae is encouraged for which age group? - infants - young children - 18 to 30 year olds - older adults

sinusitis

Various viruses, bacteria, fungi (less common), and allergies/structural abnormalities are causative agents of which disease? - pharyngitis - acute otitis media - community-acquired pneumonia - sinusitis

eustachian; fluid; bacterial

Viral infections of the upper respiratory tract cause inflammation of the ______ tubes, buildup of ______ in the middle ear, and ______ multiplication in the fluid.

mild

Viral pneumonias are generally: - severe - erythrogenic - mild - associated with a 90% mortality rate

host; antigens

Virulence is a result of the ability of surface antigens to mimic ______ proteins and possession of super______.

streptolysins and erythrogenic toxin

What are the 2 extracellular toxins of S. pyogenes? - streptolysins - lipopolysaccharides - tetanospasmin - erythrogenic toxin

Streptococcus pneumoniae and Haemophilus influenzae

What are the 2 main causative agents of acute otitis media (ear infection)? - Streptococcus pneumoniae - HPV - Haemophilus influenzae - Staphylococcus aureus

gram-negative bacteria and MRSA strains of Staphylococcus aureus

What are the 2 most frequent causes of health-care associated pneumonia? - gram-positive bacteria - gram-negative bacteria - Neisseria meningitidis - MRSA strains of Staphylococcus aureus - Cornynebacterium diphtheriae

bacitracin disc test and beta-hemolysis on blood agar

What are the 2 types of culturing for pharyngeal swab specimens? - bacitracin disc test - stab cultures - beta-hemolysis on blood agar - solid plate culture of thermophilic microorganisms

cell walls

What does Mycoplasma lack? - slime layers - spikes - cell walls - membrane

ventilator-associated pneumonia

What does the acronym VAP stand for?

Streptococcus pneumoniae

What is the leading cause of community-acquired bacterial pneumonia? - Klebsiella pneumonia - Mycoplasma pneumoniae - Chlamydophila pneumoniae - Streptococcus pneumoniae - Pseudomonas aeruginosa

30-50%

What is the mortality rate for health-care associated/ventilator-associated pneumonia? - 10-15% - 30-50% - 20-40% - 1-5%

empiric therapy

What is the term used to describe trying different antibiotics to see which ones work best? - ayurveda - homeopathy - empiric therapy - chelation therapy

atypical pneumonias

What type of pneumonias have symptoms that do not resemble those of pneumococcal or other severe pneumonias?

30-45 degree angle

When a patient has HAP, at what angle should you elevate their head to reduce aspiration of secretions? - 90 degree angle - 70-75 degree angle - 80-85 degree angle - 30-45 degree angle

deep breathing and frequent coughing

Which 2 choices are good pre-operative education points that can reduce post-operative infection rates for HAP? - shallow, fast breathing - use of cough suppresants - deep breathing - frequent coughing

penicillin and cephalexin (if allergic)

Which 2 medications are used to treat pharyngitis? - amoxicillin - clindamycin - penicillin - trimethoprim - cephalexin (if allergic)

endotracheal tube and bronchoalveolar lavage cultures

Which 2 methods for HAP are invasive, but provide better information? - endotracheal tube - Kirby-Bauer Test - turbidity test - bronchoalveolar lavage cultures - ELISA

Mycoplasma pneumoniae and Chlamydophila

Which 2 microorganisms are transmitted by aerosol droplets among people in confined to close living quarters? (ex: family, students, military). - Escherichia coli - Neisseria meningitidis - Mycoplasma pneumoniae - Hantavirus - Chlamydophila

Mycoplasma pneumoniae and Chlamydophila pneumoniae

Which 2 microorganisms cause walking pneumonia? - Streptococcus pneumoniae - Escherichia coli - Mycoplasma pneumoniae - Chlamydophila pneumoniae

capsule and slime layers

Which 2 virulence factors are associated with Streptococcus pyogenes? - capsule - your mom's puss - slime layers - obligate intracellular parasite

respiratory droplets and direct contact with mucus secretions

Which 2 ways are S. pyogenes transmitted? - people in confined living quarters - respiratory droplets - direct contact with mucus secretions - moist soils

gram positive, small, flattened, and diplococcus

Which 4 words describe pneumococcus? - gram positive - gram negative - large - small - raised - flattened - diplococcus - bacillus

hyaluronic

Which acid capsule acts as camouflage for S. pyogenes and also assists in adherence?

lack of sleep and too much sodium in diet

Which are NOT predisposing factors for Streptococcus pneumoniae (pneumococcus)? - elderly - seasonal - secondary to viral respiratory disease - lack of sleep - diabetes - chronic abuse of alcohol or narcotics - too much sodium in diet

fluoroquinolones (levaquin and ciprofloxacin)

Which broad-spectrum antibiotics are used to treat sinusitis? - amoxicillin - penicillin - fluoroquinolones (levaquin and ciprofloxacin) - doxycycline

Streptococcus pneumoniae

Which causative agent results in community-acquired pneumonia? - Staphylococcus aureus - Pseudomonas aeruginosa - Acinetobacter - Streptococcus pneumoniae

scarlet fever

Which disease has a 95% fatality rate and is characterized by a sandpaper-like rash with high fever?

pharyngitis

Which disease has the following s/sx: pain (can see suppurative exudate), inflammation of the throat, headache, fever, nausea, reddened and/or swollen mucosa.

scarlet fever

Which disease is a result of an infection of S. pyogenes infected with a bacteriophage? - acute otitis media - pneumonia - sinusitis - scarlet fever

pneumonia

Which disease is characterized by an anatomical diagnosis (chest x-ray)? - popcorn lung - respiratory alkalosis - pneumonia - salmonellosis

rheumatic fever

Which disease is due to an immunologic cross-reaction between streptococcal M proteins and the heart muscle? (also caused by S. pyogenes).

acute otitis media

Which disease treatment involves "watchful waiting", antibiotics, and tympanic membrane tubes?

Streptococcus pneumoniae

Which microorganism accounts for 40% of community-acquired bacterial pneumonia cases? - Legionella - Mycoplasma pneumoniae - Streptococcus pneumoniae - Chlamydophila pneumoniae

Streptococcus pneumoniae (pneumococcus)

Which microorganism is spade-shaped?

Escherichia coli, Pseudomonas aeruginosa, and Respiratory syncytial virus

Which of the following are NOT common normal biota of the respiratory tract? - Streptococcus pyogenes - Haemophilus influenzae - Escherichia coli - Streptococcus pneumoniae - Neisseria meningitidis -Staphylococcus aureus - Pseudomonas aeruginosa - Respiratory syncytial virus - Candida albicans

Streptococcus pyogenes

Which of the following is NOT a type of gram-negative bacteria? - Klebsiella pneumoniae - E. coli - Enterobacter - Pseudomonas aeruginosa - Streptococcus pyogenes - Acinetobacter

lower

Which part of the respiratory tract do microorganisms penetrate and survive in to cause pneumonia?

c. bronchioles

Which structure in the respiratory system is attached to the alveoli? a. epiglottis b. larynx c. bronchioles d. sinus e. bronchi

lipoteichoic acid

Which type of acid allows S. pyogenes to adhere to the pharynx?

bird/bat droppings

Which type of animal droppings is Histoplasma capsulatum associated with? - deer droppings - rat droppings - bird/bat droppings - cow droppings

erythrogenic toxin

Which type of toxin induces fever and a bright red rash? ( think "blood")

prevnar

Which vaccine is used to prevent acute otitis media? - MMR - flu vaccine - Tdap - prevnar