| Question |
Answer |
| bacterial pharyngitis |
group a beta strep, most common |
| bacterial pharyngitis symptoms |
fever, pain, swollen glands, exudate on tonsils/pharynx. diff swallowing, no cough |
| bacterial pharyngitis collection |
swab tonsillar area/posterior pharynx. avoid tongue + other surfaces. get exudate, |
| bacterial pharyngitis diagnosis |
culture: blood, sxt. non-culture: rapid enzyme immunoassays, if pos = group A(highly specific) fairly sensitve(follow neg with cultrue) |
| Trench mouth |
Vincent's angina. inflamed bleeding gums |
| Trench mouth gram stain |
spirochete + fusiforms |
| pharyngitis viral |
rhinovirus, adenovirus, RSV, influenza |
| barriers to infection |
nasal hair, ciliated mucosal cells, coughing, normal flora, phagocytes |
| uncommon pharyngitis cause |
Corynebacterium diptheriae-when no DPT vaccine |
| sinusitis bacteria |
S. pneumoniae, H. influenzae, S. pyo. Moraxella catarrhalis(children), S. aureus |
| sinusitis virus |
rhinovirus, parainfluenza, influenza |
| sinusitis diagnosis |
CT, MRI, culture aspirate of direct sinus puncture(rare), culture secretions(unreliable) treated empirically(symptoms) |
| otitis media pathogens |
Strep pneumoniae, Haemophilus influenza |
| otitis media complications |
damage to tympanic membrane, hearing loss, meningitis(spread to CNS-close proximity) |
| otitis media diagnosis |
empirical antibiotic treatment |
| otitis media culture |
not usually done, blood, chocolate(H.influenza) |
| Epiglottitis pathogen |
Haemophilus influenzae type b |
| epiglottitis |
rapid, edema causing airway obstruction |
| epiglottis diagnosis |
gram stain-"intracellular very small pleomorphic coccobacillus white cells" |
| epiglottis diagnosis |
chocolate agar, capnophile 5-10% CO2 |
| pertussis |
Bordetella pertussis + parapertussis, "whooping cough" |
| bacterial bronchitis |
secondary infection following viral. |
| bacterial bronchitis most common pathogens |
Strep pneumoniae, H. influenzae |
| bacterial bronchitis uncommon causes |
mycoplasma, chlamydophila, bordetella |
| bronchitis diagnosis |
viral cultrues not in uncomplicated cases, 2ndary bact. pneumonia-culture sputum |
| CA pneumonia |
1. RSV(children) 2. Parainfluenza 3. Bacterial |
| CA pneumonia bacteria adults |
S. pneumoniae(adults),mycoplasma pneumoniae(young adults) H.influenzae type b, |
| CA pneumonia bacteria neonates |
group B strep, Chlamydia trachomatis |
| CA pneumonia bacteria |
S aureus, Legionella pneumophila |
| bacterial pneumonia symptoms |
rapid onset, chills, fever, productive cough (purulent, blood tinged) high WBC |
| viral pneumonia symptoms |
slower onset, less sputum |
| HA pneumonia |
Pseudomonas aeruginosa, MRSA |
| HA pneumonia risks |
unconscious patients, intuvation of airway, immunosuppressed |
| pneumonia diagnosis |
gram stain (WBC + squamous) culture sputum - blood, chocolate, EMB/MacConkey |
| good gram stain |
more than 25 polys, less than 10 epis |
| poor gram stain |
more than 25 epis, don't culture |
| aspiration pneumonia - at risk |
elderly, immumosuppressed, periodontal disease, altered lung defense(smoke, lung disease) |
| Empyema |
thick fluid in plerual space, bacterial |
| Chronic pneumonia |
TB, NTM, fungal |
| Pneumocystis jiroveci |
carinii, LRT infection in immumosuppressed |
| sputum specimen |
most common, least relevant, normla flora |
| Thoracentesis |
aspirates pleural fluid, excellent=pneumonia |
| bronchial washing |
sterile saline instilled into bronchial tree |
| BAL Bronchoalveolar lavage |
deeper, diagnosis - pneumocystis, fungi, TB/ snip tissue |
| better specimens |
thoracentesis, bronchial washing, BAL - surgery needs to be done, not routine |
Ch.18 LTI-MA 509
