05 Gm negative respiratory bacilli

• coughing: Transmitted by respiratory droplets

• red bow GI: pertussis toxin
• EF Shield: like anthrax
• Tractor: tracheal toxin

• red and blow strings: Filamentous hemagglutinin, pili used to attach to respiratory epithelium and release toxin

• bow and GI (military) in wheel chair: Pertussis toxin rirosylates Gi, disables Gi
• army camp: Pertussis toxin increases cAMP

• popcorn overflowing: Lymphocytosis due to loss of chemotaxis

• EF shield: Adenylate cyclase toxin: acts like Anthracis EF toxin, increase cAMP

• tractor cleaves grass: Tracheal toxin, peptidoglycan wall, damages ciliated cell of respiratory epithelium

• Catarrhal phase: nonspecific, 1-2 weeks, conjunctival injection, lacrimation
• whoop horn: Paroxysmal stage: Whooping cough
• Victory banner: 100 day cough: convalescent stage can last for months, 3 months

• crow: Macrolide treatment
• cell phone: DTaP vaccine has acellular Pertussis antigens

Haemophilus Influenza

• Phyllis: haemophilus
• red color: gm negative
• candy: Coccobacillary shape
• chocolate on window: Grown on chocolate agar
• 5 cent, nickle: factor V (nicotinamide) (NAD) added to chocolate agar (staph aureus with sheep blood)
• 10 c: Factor X (hematin) added to chocolate agar
• aerosol spray: Aerosol transmission
• capsule with bee: encapsulated with type B
• IgA protease

• child screaming and drooling: Epiglottitis, inflammed epiglottis, inspiratory stridor, drooling
• chocolate covered cherries, kid with icecream and cherry: Cherry red epiglottis
• stuffed ear: Otitis media
• meningitis kid: Meningitis in children
• capsule with bee: Strains with type B vaccine cause meningitis

• syringe: Vaccine for H. flu type B
• Dip: Vaccine is polysaccharide conjugated to Diphtheria toxoid
• $2.18: Vaccine for ages 2-18 months

• sickle: Increased risk of infection in sickle cell or asplenic patients

• 3 axes: Ceftriaxone for meningitis or systemic disease
• rifle: Rifampin prophylaxis for close contacts

Legionella pneumophila

• red color but silver on top: Gram negative but needs silver stain to be visualized
• piles of coal: Grown on charcoal yeast extract
• iron anchor with cysteine: Growth requires presence of iron and cysteine
• girl with ring: Oxidase positive

• pontiac fever
• legionnaire

Pontiac fever

• Legionella
• Pontiac car steaming: Pontiac fever: self limited fever and malaise

Legionnaire's disease

• sailor smoking: Legionnaires' disease more common in smokers
• coal flame: High fever >40 or >104
• confused sailor with hurt head: May present with headache and confusion
• sailor with paint all around: Pneumonia with diarrhea suggestive of Legionnaires' disease "

• sailor urinating: Urine antigen test for rapid diagnosis
• sailor wasting salt: Hyponatremia, <130
• map: X-ray shows patchy infiltrate with consolidation of one lobe

• flower: Fluoroquinolone may also be used for treatment
• crows: Macrolides for fever