1. Anatomy
    2. 1. Thoracic cage
    2. Respiratory muscles and Movements
    3. External Nose and Nasal cavity
    4. Paranasal Air Sinuses
    5. Pharynx
    6. Larynx
    7. Trachea
    8. Brochopulmonary segments
    9. Pleura
    10. Lung
    11. Diaphragm
    12. Histology (Epiglottis, Trachea and Lungs)
  2. Biochemistry
    3. 13. Metabolism in the Lungs
    14. Synthesis of Surfactant system in Lungs
    15. Hyaline Membrane Disease (Infant Respiratory Distress Syndrome)
    16. Gaseous Transport and Haemoglobin
    17. Ion Electrolyte Balance
    18. Henderson Hasselbalch Equation
    19. Anion Gap (AG)
    20. Biological Oxidation
    21. Electrolyte Transport Chain
  3. Microbiology
    4. 22. Streptococcus pyogenes
    23. Corynebacterium diphtheria
    24. Streptococcus pneumonia
    25. Haemophilus influenzae
    26. Pseudomonas aeruginosa
    27. Microbacterium tuberculosis
    28. Bordetella pertussis
    29. Whooping cough
    30. Viruses
    31. Orthomyxo viruses
    32. Paramyxoviruses
    33. Respiratory Syncytial Virus (RSV)
    34. Adenovirus
    35. Rhinovirus
    36. Severe Acute Respiratory Syndrome (SARS)
    37. Histoplasma Capsulatum
    38. Aspergillus
    39. Cryptococcus neoformans
    40. Pneumocystis carinii
    41. Parasites
    42. Paragonimus westermani
  4. Pathology
    5. 43. Atelectasis
    44. Tuberculosis
    45. Chronic Obstructive Pulmonary Disease
    46. Emphysema
    47. Bronchial Asthma
    48. Bronchiectasis
    49. Acute Respiratory Distress Syndrome
    50. Hyaline Membrane Disease
    51. Pneumonia
    52. Pneumoconiosis
    53. Bronchogenic Carcinoma
    54. Pleural Lesions
  5. Pharmacology
    6. 55. Antitussives, Expectorants and Mucolytics or Therapy of Cough
    56. Drugs used in Bronchial Asthema
    57. Nasal Decongestants and Cold remedies or Therapy of Allergic Rhinitis
    58. Chemotherapy of Tuberculosis
  6. Physiology
    7. 59. Mechanism and Mechanics of Breathing
    60. Regulation of Respiration
    61. Pulmonary circulation
    62. Pulmonary Gas exchange
    63. Gas transport and Exchange
    64. Lung compliance
    65. Pulmonary Function Tests
    66. Spirometry
    67. Applied Respiratory Physiology
    68. Abnormal Breathing
    69. Artificial Respiration
    70. Lung Defense Mechanism
Microbiology
24. Streptococcus pneumonia
Features
S. pneumoniae
Viridans streptococci
Arrangement
Gram +ve cocci in pairs
Gram +ve cocci in long chains
Morphology
Lanceolate shaped
Round/ Oval
Capsule
Present
Absent
On blood agar
Draughtsman or Carrom coin colony
Minute colony
Bile solubility
Soluble
Insoluble
Inulin fermentation
Fermenter
Non-fermenter
Optochin sensitivity
Sensitive
Resistant
VIRULENCE FACTORS
C-carbohydrate antigen
Capsular polysaccharide
Pneumolysin
Autolysin
Pneumococcal surface proteins (Psp)
  1. PspA
  2. PspC
Pneumococcal surface adhesin A (PsaA)
IgA protease
Neuraminidase
LABORATORY DIAGNOSIS
Specimen collection
  1. Sputum
  2. CSF
  3. Pleural fluid
  4. Other sterile body fluids
  5. Aspiration of sinus material
  6. Ear discharge/ aspirate
Direct smear microscopy
Gram staining
  1. Gram +ve cocci in pair
  2. Lanceolate or flame-shaped
  3. 1 μm
  4. Surrounded by clear halo (due to capsule)
Antigen detection
Latex agglutination test
It detects capsular antigens
Immunochromatographic test (ICT)
It detects C-antigens
Culture
Culture medium
Basal media
No growth as it is fastidious organism.
Enriched media
24 hours incubation at 37°C in presence of 5-10% CO2.
Blood agar
Colony
Initial
Small dome shaped
Prolonged incubation
Draughtsman-shaped or Carrom coin-shaped appearance
Hemolysis
α-hemolysis
Chocolate agar
Greenish discoloration
Selective media
Crystal violet blood agar
Culture smear microscopy
Gram stain
  1. Gram +ve cocci in pair
  2. Lanceolate or flame-shaped
  3. 1 μm
  4. Surrounded by clear halo (due to capsule)
Hanging drops
Non-motile cocci
Identification
Biochemical tests
Catase test
-ve
Bile solubility
Soluble
Optochin sensitivity testing
Sensitive to optochin disk and produce wider zone of inhibtion.
Inulin fermentation
Ferments inulin
Automation tests
VITEK
MALDI-TOF
Typing
  1. Quellung or Neufeld reaction
Molecular methods
Real time PCR
Multiplex PCR
Antimicrobial Susceptibility Test (AST)
Disk diffusion test
Muller Hinton blood agar
Muller Hinton
Automated MIC detection method
Microbroth dilution
VITEK