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SUPER BUG - Coggle Diagram

- - - - Leukocytosis (especially PMNs)
      - Elevated Urea/creatinine
      - Elevated lactic acid
      - Elevated procalcitonin
      - Elevated CRP
      - Normal D-dimer and ferritin
- - - - Asthma
      - Heart disease
      - COPD
  - - - Organ transplant
      - Drugs (Chemotherapy - steroids)
      - HIV/AIDS
      - Incomplete vaccination
- - - - because
        
        patients are immunosuppressed
        
        Microbes are more virulent & might have antibiotic resistance
- - - - viceral pleura
      - pleural cavity
      - parietal pleura
        
        that divides by location into
        
        costal
        
        diaphragmatic
        
        cervical
        
        mediastinal
    - - consist of
        
        simple squamous epithelium
        
        subserous fascia
        
        made of
        
        loose areolar CT
    - - include
        
        costomediastinal recess
        
        costodiaphragmatic recess
  - - - is a
        
        Fibrocartilaginous tube from C6 to T4/T5
      - Anterolateral
        
        U-shaped bars of hyaline cartilage
      - Posterior
        
        Smooth muscle (trachealis)
    - - consist of
        
        primary (main) bronchi
        
        seprated into
        
        Right bronchus
        
        Wider
        
        more vertical
        
        shorter
        
        left bronchus
        
        Narrower
        
        longer
        
        horizontal
        
        Secondary bronchi
        
        Right
        
        Superior
        
        inferior
        
        middle
        
        Left
        
        Superior
        
        inferior
      - Tertiary (segmental) bronchi
        
        Supply bronchopulmonary segment
- - - - antibiotics + send patient
        home
        
        microlides
        
        or
        
        Tetracyclines
        
        e.g,
        
        Doxycycline
        
        e.g,
        
        ezithromycin
    - - admit into the ICU
        
        3rd generation cephalosporin + A/B
        
        A/B = microlides/ respiratory floroquinolone
        
        penicillin-b lactamase + A/B
    - - admit into the hospital for
        observation
        
        microlides/ tetracyclines + A/B
        
        A
        
        penicillin
        
        e.g,
        
        ampicillin
        
        B
        
        3rd generation cephalosporin
        
        e.g,
        
        ceftriaxone
  - - - respiratory fluoroquinolone
      - carbapenems
      - Amino-glycoside + microlides
      - penicillin-b lactamase
    - - Amino-glycoside OR respiratory fluoroquinolone +A/B/C
        
        B
        
        carbapenem
        
        e.g,
        
        NOT ertapenem. imipenem doripenem meropenem
        
        C
        
        3rd generation cephalosporin 4rd generation cephalosporin
        
        e.g,
        
        ceftazidime cefepime
        
        A
        
        B-lactamase inhibitor - B-lactam
        
        e.g,
        
        tazobactam -piperacillin
- - - - the dorsal respiratory group (DRG)
        
        contains
        
        inspiratory neurons
      - the ventral respiratory group (VRG)
        
        Contain
        
        both inspiratory and expiratory neurons
    - - the peripheral (arterial) chemoreceptors
        
        stimulated by
        
        1- Significantly decreased Po
        
        2- Increased H concentration
        
        3-Increased Pco
      - the central chemoreceptors
        
        stimulated by
        
        increased Pco, via associated changes in H concentration.
  - - - Severity Score estimates mortality of community-acquired pneumonia to help determine inpatient vs. outpatient treatment.
- - - - which means that
        
        removing this cause won't diminish the effect
- - - - important for
        
        Causing infection
      - includes
        
        S protein
        
        E protein
        
        M protein
        
        N protein
  - - - diagnosed by
        
        RT-PCR
        
        can detect
        
        Viral RNA
        
        Immune response
        
        looking for
        
        IgM
        
        IgG
- - - - Strep pneumonia
        
        Characteristics are
        
        Non-motile
        
        Capsule
        
        grow in pairs or chains
        
        Gram (+)
        
        Non-spore forming
        
        Catalase (-)
        
        Virulence Factors
        
        1- CPS
        
        Important for:
        
        1- Resistance to phagocytosis and antibiotics
        
        2- Adhesion
        
        3- Highly immunogenic
        
        4- protection
        
        5- Vaccine development
        
        4- CBPs
        
        PsPA
        
        bind to lactoferrin
        
        allow the growth of bacteria
        
        PspC
        
        Bind to factor H
        
        Resist complement activation
        
        3- Lyt
        
        Stationary phase
        
        Lyt A + Lyt C
        
        Bacteria cell wall autolysis
        
        release of
        
        3 more items...
        
        2- PLY
        
        Exotoxin
        
        pore forming
        
        Hemolysis activity
        
        partial hemolysis of RBCs
        
        Inhibit ciliary beating
        
        Required for transmission