4. Haemophilus Flashcards

1
Q

HINF is normal in —– and pathogenic in ——

A

upper resp tract
lower resp tract

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2
Q

HINF clinical significance (8)

A

meningitis (<6 yo)
sinusitis
otitis media
pneumonia
bronchitis
epiglottitis
pinkeye
systemic infection

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3
Q

HINF CO2 requirement

A

3-5% CO2

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4
Q

distingushed from Haemophilus species by the fact that it grows on SBA

A

A. aphrophilus

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5
Q

HINF ALA

A

negative

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6
Q

HINF quad results

A

X - neg
V - neg
XV - pos
HBA - no hemolysis

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7
Q

Haemophilus species with a B-lactamase

A

HINF
HAEG

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8
Q

HINF has developed —— resistance through CAT enzyme

A

chloramphenicol

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9
Q

used to tx HINF

A

ceftriaxone
cefotaxime

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10
Q

HAEG clinical significance (3)

A

conjunctivitis
Brazilian purpuric fever
pinkeye

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11
Q

HAEG can take —– days to grow

A

5

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12
Q

HAEG ALA

A

negative

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13
Q

HAEG quad results

A

X - neg
V - neg
XV - pos
HBA - no hemolysis

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14
Q

HHAEM ALA

A

negative

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15
Q

HHAEM quad results

A

X- neg
V - neg
XV - pos
HBA - hemolysis

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16
Q

HPINF normal location

A

oropharynx
URT

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17
Q

HPINF clinical significance

A

endocarditis
epiglottitis
sinusitis
otitis media
bronchitis

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18
Q

HPINF ALA

A

positive

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19
Q

HPINF quad results

A

X - neg
V - pos
XV - pos
HBA - no hemolysis

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20
Q

Is HPINF or HPHAEM more common in the URT as normal flora?

A

HPINF

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21
Q

HPHAEM is a rare cause of…

A

endocarditis

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22
Q

HPHAEM ALA

A

positive

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23
Q

HPHAEM quad results

A

X - neg
V - pos
XV - pos
HBA - hemolysis

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24
Q

Haemophilus species whose presence is always pathogenic

A

H. ducreyi

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25
Q

Haemophilus GS

A

GNCB
pleiomorphic

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26
Q

unique HDUC arrangement

A

school of fish

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27
Q

HDUC incubation requirement

A

5-7% CO2
up to 10 days

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28
Q

HDUC ALA

A

Negative – but not respiratory so you shouldn’t do it. Could mis-ID as HINF or HHAEM.

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29
Q

HDUC quad results

A

X - pos
V - neg
XV - pos
HBA - no hemolysis

30
Q

AAPH normal flora site

A

mouth

31
Q

AAPH clinical signifcance

A

endocarditis after break in oral mucosa, oral piercing, etc

32
Q

AAPH CO2 requirement

A

5-10% CO2

33
Q

AAPH ALA

A

Positive – but not respiratory so you shouldn’t do it. Could mis-ID as HPHAEM or HPINF.

34
Q

about —% of HINF meningitis cases are GS CSF positive

A

85

35
Q

factor X name

A

hemin

36
Q

factor V name

A

nicotinamide adenine dinucleotide (NAD)

37
Q

which factors does AAPH require?

A

Only factor X, and only on initial isolation.

38
Q

which factor can diffuse from intact RBCs, and which is only present after lysis

A

Factor X can diffuse (SBA and CHOC)
Factor V available after lysis (CHOC)

39
Q

3 ways bacteria can get factor V from the medium

A
  • gentle heating, CHOC
  • SAUR or yeast producing it directly
  • SAUR’s beta hemolysis liberating it from RBCs
40
Q

2 purposes of heating sheep’s blood for the CHOC

A
  • lysis RBCs, releasing NAD
  • destroys the NADases in the blood
41
Q

Haemophilus will grow in —- broth

A

thioglycolate

42
Q

Haemophilus make up —% of NURF

A

10

43
Q

endotoxin of Haemophilus

A

LPS

44
Q

HINF’s pathogenicity largely depends on whether it has…

A

a capsule or not

45
Q

HINF capsule serotypes and the worst one

A

a, b, c, d, and f
B is the worst

46
Q

—– test was used to determine HINF serotype, but is now rarely used becasue….

A

latex agglutination
HiB vaxx largely eliminated serotype B

47
Q

long name for ALA

A

delta-aminolevulinic acid

48
Q

used to determine an organism’s ability to make factor X

A

ALA test

49
Q

screen HINF for ——- production

A

B-lactamase

50
Q

How did HINF get its name?

A

They blamed it for the 1890 flu epidemic even though it was actually caused by a virus :(

51
Q

Meningitis due to HINF usually occurs in what pop?

A

unvaccinated or incompletely vaccinated kids

52
Q

HINF meningitis mortality

A

5-10%

53
Q

1/3 of HINF meningitis survivors have….

A

neurological problems

54
Q

meningitis prophylactic drug

A

rifampin

55
Q

epiglottitis common population

A

2 to 7 years old
males 20-30 years old

56
Q

ideal sample for a culture for epiglottitis

A

blood

must establish airway (trach) before taking sample from epiglottis

57
Q

3 most common causes of otitis media

A

SPNE
HINF
MCAT

58
Q

HINF has no clinical significance if isolated from a —— culture

A

throat

59
Q

What causes petechiae, purpura in Brazilian purpuric fever?

A

LPS of organism causes capillaries/vessels to leak

60
Q

Least virulent Haemophilus

A

HHAEM

61
Q

Haemophilus with—– in the name make their own factor X.

A

para

62
Q
A

H. ducreyi
(school of fish)

63
Q

Plating HDUC

A

Mueller-Hinton + various other types, often at patient bedside
very fastidious

64
Q

Ideal for IDing HDUC

A

molecular methods (fastitious)

65
Q

Requires X factor only

A

HDUC

66
Q

HDUC sx

A
  • Painful genital lesions that turn into purulent ulcers
  • Tender inguinal (groin) lymphadenopathy
  • Chancroid lesions
67
Q

HDUC endemic in…

A

Latin/South America
Africa
East and Southeast Asia
India

68
Q

Spell AAPH

A

Aggregatibacter aphrophilus

69
Q

Doesn’t require either X or V factor, eventually

A

AAPH

70
Q

Mueller-Hinton agar nutrients

A

none
(why it’s used to test for X and V requirement)

71
Q

Intermediate products of heme production that give a red fluorescence under UV

A

Porphyrins and protoporphyrins