Fungal
Viral
Bacterial
IC
Pediatric
100
Name 3 dimorphic fungi.
Histo, Blasto, Coccio
100
What kind of virus is influenza?
Negative-sense RNA enveloped
100
A drunk pledge from a nearby college is brought to the hospital unresponsive. What bacterial pneumonia are they most likely to contract?
Klebsiella and other anaerobic bacteria
100
Strongyloides is an opportunistic infection in what pts?
chronic steroid use pts
100
What virus does this baby have?
Parainfluenza (Croup), most likely 1
200
Azole mechanism of action inhibits _____ of lanosterol by binding cytochrome P450.
C-14-alpha demethylation
200
This virus is common amongst children and military recruits. Disseminated disease can result in hemorrhagic cystitis and conjunctivitis.
Adenovirus
200
Pt presents to pediatric clinic with pneumonia with purulent sputum. This patient did not receive his influenza vaccine and within the past month there has been a flu outbreak in his school. What 2 pathogens are most likely causing his current pneumonia?
Strep pneumonia and S. aureus
200
A patient with chronic granulomatous disease comes into the clinic and is diagnosed with pneumonia. What is one characteristic of pathogens that this pt is susceptible to?
catalase + pathogens
200
Premature baby is at high risk for developing RSV. What prophylaxis should be given?
Palivizumab
300
Blastomyces spreads hematogenously. What organs does that usually affect?
skin, bone, prostate, CNS
300
This acid-labile virus attaches to ____ to enter epithelial cells and contains many serotypes and thrives in what temperatures?
ICAM-1 and cooler temperatures (33 degrees)
*in reference to Rhinovirus*
300
What are the five ways of acquiring pneumonia?
Inhalation, Aspiration, bypassing protective mechanisms, hematogenous spread, direct spread.
300
What is the difference between Histo and Blasto transmission?
Blasto is not more prevelant (but more severe) in IC, whereas Histo is both more prevelant and severe in IC hosts.
300
A third trimester pregnant woman has acutely contracted VZV. What treatment should be given to prevent transition to newborn?
Acyclovir IV before birth
400
Majority of “sporadic infections” result from inhalation of _____.
Aerosolized microconidia.
400
This virus has 3 serotypes, 2 of which are seasonal and 1 is more severe and year-round.
What is this virus? Which serotypes are which?
Parainfluenza 1 and 2 are seasonal
PIV 3 is year-round and more severe (annual epidemics)
400
A patient is on a ventilator and acquires pneumonia. What are the two pharmaceutical treatments given?
Vancomycin and 3rd generation cephalosporin
400
Pt with anklyosing spondylitis comes in seeking treatment for autoimmune disease. She is prescribed a TNF-alpha inhibitor. What precautionary measures should the doctor make?
Testing for TB or HepB
400
This virus is common in young healthy infants, has an incubation period of 5-6 days, no vaccine, and treated with supportive care.
Human metapneumovirus
500
A 69 year old man who received a lung transplant three months ago comes in with severe shortness of breath, headaches, and small skin lesions on his arms. A tissue histology slide is taken and the following image is seen below. Due to indications of severe disseminated disease the attending doctor prescribes a drug to aggressively attack the responsible pathogen. Later that same week the patient begins experiencing painful urination, fevers, and significant hypokalemia and hypomagnesemia. What is the pathogen responsible for her infection and what is the drug the doctor likely prescribed?
Aspergillus and Amphotericin B
500
An elderly patient died from an acute viral pneumonia. At autopsy, these images were obtained. Explain these findings?
Pneumonia has 4 stages. Congestion, red hepatization, grey hepatization, then resolution. The red hepatization phase has exudate with fibrin, RBC, WBC, and bacteria.
500
A 73 year old female, with a history of 100 pack-years smoking cigarettes, presents to the clinic with a recent production of sputum, cough and severe dyspnea. She has had pulmonary function testing done in the past and has a low FEV1/FVC ratio. A sputum culture is taken and the bacteria that grow are able to produce beta-lactamase. The causal pathogen is non-encapsulated and is also known to cause acute otitis media. What is the gram stain and oxygen requirement of the likely causal pathogen?
Aerobic gram - diplococci (Moraxella)
500
A 35 year old male who has HIV and a CD4+ <150 enters the clinic with a history of 3-4 weeks of dry cough, dyspnea, and fever. A X-ray scan is taken and the results are shown below. As a result the doctor prescribes an antifungal drug treatment to help eliminate the causal pathogen. One day following the administration of this drug there is significant elimination of the pathogen, however, the patient begins experiencing hypoxemia and feels unwell. The doctor urgently prescribes a class of drugs to assist the patient. What class of drugs did the doctor prescribe and why?
Glucocorticosteroids should be administered in pts with hypoxemia to tamper the residual inflammatory response from PJP
500
In order of prevalence, what are the 4 most common causes of pediatric pneumonia viruses?
RSV, PIV type 3, hMPV (human metapneumovirus), influenza A