Basic Pneumonia Associations

Question 1

Strep Pneumo

Answer 1

most common CAP

most common lobar pneumonia

Question 2

Klebsiella

Answer 2

enteric so in those w/ inc risk of aspiration (alcoholics, malnourished, DM)

mucoid wall comes out in sputum (currant jelly sputum)

Question 3

Staph Aureus

Answer 3

most common secondary pneumonia

rare hematogenous spread if IV drug user endocarditis

Question 4

Pseudomonas

Answer 4

CF, bronchiectasis

Catalase-pos so if neutropenia

1st mo post-transplant

recent abx, recent ICU stay

Question 5

H Flu/ M catarrhalis

Answer 5

on top of COPD (exacerbation)

H flu = gram neg rods on chocolate agar

Question 6

Legionella

Answer 6

water source (outbreaks)

intracellular

silver stain b/c so small it will not show up on gram stain

also seen on top of COPD

inhibit phag-lysosome fusion by remodeling vesicle to look like rough ER

Question 7

Mycoplasma and Chlamydiphilia

Answer 7

• Mycoplasma - young adults; no cell wall so no gram stain; can cause hemolytic anemia; mild symp (may have dry cough)
• Chlamydophilia - also young adults; mild symp (may have sore throat/hoarseness)

Question 8

RSV

CMV

Flu

Adenovirus

Answer 8

• RSV- infants and elderly
• CMV - transplant
• Flu - inc risk of secondary infection
• Adenovirus (military and start of school)

Question 9

Coxicella burnetii

Answer 9

• in cattle placenta and given to cattle by tics (farmers and vets); high fever (Q fever)

Question 10

Tb

Answer 10

CHRONIC pneumonia

Weight loss, night sweats in AIDS reactivation

Acid-fast stain

Jail, foreign, homeless

Primary - subpleural Ghon complex of fibrosis and calcification

Secondary - caseating necrosis at apex

Question 11

Coccidio

Histoplasmosis

Chlamydia psittacii

Cryptococcus

Answer 11

• SW US - coccidio
• Ohio River Valley/ bird dander - histoplasmosis
• Sick birds - chlamydia psittacii
• Immunosuppressed - cryptococcus