Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Bugs & Drugs > Non-Enteric Gram Negatives > Flashcards

Non-Enteric Gram Negatives Flashcards

1
Q

Neisseria meningitidis (meningococcus)

A

G- diplococcus (free and inside PMN’s)
Normal nasopharynx asymptomatic carriage
meningitis (leading cause of acute in adolescents)
NOT IN INFANTS b/c of protected abs from ma
fulminant bacteremia and sepsis –> CNS
aerosol transmission: dorms, schools, prisons, bases, planes, pilgrimages (HAJJ)
Epidemics in Africa and Asia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

H. influenzae morphology

A

G- coccobacillus

Nasopharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Sepsis, meningitis, pneumonia, cellulitis, mastoiditis, epiglottitis

A

Serotype B encapsulted H. influenzae diseases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Unencapsulated nontypable H. flu diseases

A

Mucosal infections: sinusitis, conjunctivitis, OM, bronchitis, pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Moraxella catarrhalis morph and diseases

A

G- diplococcus
nosocomial, sinusitis, OM, bronchitis & pneumonia in lung diseased, rarely sepsis/meningitis
Nasopharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Bordatella pertussis morph and disease

A

G- coccobacillus

Tracheobronchitis syndrome whooping cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Pseudomonas aeuginosa morph and diseases

A

G- rod BACILLUS
Chronic lung infection in CF pts
Acute pneumonia in the immunocompromised
Lung, skin, eye, burn/wound, blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

DIC with petechial rash progressing to purpura

A

Meningococcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Waterhouse-Friderichsen syndrome

A

Adrenal infarction/insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Sequelae in meningitis survivors

A 
cranial nerve damage (CN II, VIII)
cognitive dysfunction (seizures, learning/speech)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Vaccine for meningococcus doesn’t cover?

A

Does not cover serogroup B –> sialic acid (~K1 e. coli)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Spleen helps with clearance of?

A

Encapsulated bugs
Lots of B cells and macrophages
Also C5-9 needed for MAC formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Risk for meningococcal infection

A

Asplenia

Sickle cell disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

N. meningococcal pathogenesis

A

Capsule: serogroup A (Africa, Hajj, China)
B&C (Europe, North America)
Pili bind to nonciliated nasopharyngeal cells
LPS/endotoxin cause damage –> bloodstream invasion
“LOS” lipo-oligosaccharide
Pilin, Opa (attachment), capsule, LOS show variation, interfering with host response and enables repeat infections
IgA protease
Readily releases and takes up DNA from environment
No siderophores, rather surface proteins that bind TF/LF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which bug readily releases/takes up DNA?

A

Neisseria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Binding proteins or siderophores for Neisseria

A

Binding proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

MCV4 vaccination for whom?

A

2mo-10y at increased risk
>9mo if traveling/residing in endemic areas
Routine for ALL at 11-12 years
Booster ALL at 16
DOES NOT provide resistance against naso colonization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Tx of N. meningitidis? (3 options)

A

Penicillin (or cephalosporin)
Start broad
Chloramphenicol (low cost) avoided in the US due to marrow suppression and aplastic anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Prophylaxis for contacts of meningococcal index case (3)

A

Rifampicin or Fluoroquinolone or Cephalosporin

Achieves good levels in secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Acute meningococcal meningitis/meningococcemia tx

A

Antibiotics
Supportive
Glucocorticoid replacement
Anticoagulants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Meningococcus v. Gonococcus: similarities

A

Humans only host
Mucosal colonization
Virulence factors
Severe sequelae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Sequelae of gonococcus

A 
PID
fallopian tube scarring
infertility
ectopic preg
neonatal ocular infection
rare disseminated infection --> septic arthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

NM v GC: Host niche

A

NM: nasopharynx
GC: urogenital tract (unlike NM, GC cause disease at their colonization site)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

NM v GC: transmission

A

NM: aerosol
GC: sexual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

NM v GC: disease

A

NM: rare
GC: common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

NM v GC: capsule

A

NM: yes
GC: no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

NM v GC: vaccine

A

NM: some
GC: NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

2nd most common STI behind chlamydia

A

Gonorrhea

Generally symptomatic in MALES, not in F

29
Q

Haemophilus culture (2 RBC components)

A

Chocolate agar (will have lysed erythrocytes)
Hemin (factor X)
NAD (factor V)

30
Q

H. flu type b encapsulated

A 
G- coccobacillus (rod)
Responsible for all invasive disease
Droplet
Entry via nasopharynx --> blood --> CNS
Sepsis and meningitis
Capsule (type b polyribosyl ribitol phosphate)
Humoral immunity of utmost importance
Ages: 2mo-5y (maternal ab's until can produce own)
31
Q

Other type b H. flu infections

A

Direct extension:

Pneumonia, cellulitis (buccal, orbital), mastoiditis, epiglottitis

32
Q

Nontypable unencapsulated H. flu

A 
rarely sepsis/meningitis
nasopharyngeal colonization (80%)
also vagina
sinusitis, conj, OM (most common under S. pneumo), bronchitis, pneumonia (2nd CAP after S. pneuma)
Premature birth and neonatal infections
33
Q

Moraxella catarrhalis

A

droplets
nasopharynx in kids, reduced in adults
usually mixed in culture with H. flu and S. pneu
URI: sinusitis, OM (#3 behind above 2)
LRI: bronchitis, pneumonia in viral URI kids and COPD adults
immunocomp (CF, neutropenia, lupus, leukemia) –> sepsis, meningitis, disseminated infections
nosocomial infections (pulmonary, pediatric ICU’s)

34
Q

Bordetella pertussis

A

G- coccobacillus singly or in pairs
Fastidious, slow-grow on blood w NICOTINAMIDE
Obligate human, no environment
Aerosol
Adults have less severe disease but are MAIN reservoirs
Mucosal URI infection, rarely invasion or spread to lungs/blood

35
Q

Hib invasive disease still a problem for

A

Areas Hib vaccine not available
Pts who don’t complete vaccination schedule
Pts who don’t respond to vaccine
Rare invasive disease in those who get vaccine but don’t produce Ab’s

36
Q

H. influenzae type B in adults?

A

Not usually, even pre-vaccination due to low grade exposures and development of antibodies

37
Q

Thumb sign

A

“cherry red” epiglottitis
HiB
give Abx and dexamethasone

38
Q

Catarrhal stage

A

fever, coughing, malaise (1-2 wks)
organism replication and CAN BE CULTURED, PCR
Gram stain sputum / pharyngeal swab
Now is when bacterial products damage epithelium

39
Q

Antibiotics for which stage of pertussis?

A

Catarrhal - may lessen severity and decrease transmission

40
Q

Spasmodic/paroxysmal/toxemic/whooping stage

A

vomiting may follow
cannot recover organism now (may be present/cleared)
Abx do not help disease or prevent transmission
toxin-mediated stage: ciliary paralysis
signs continue until escalator restored

41
Q

Pt w/3 wk hx of cough, started as a cold w/low fever, discharge/cough worsened, now cough comes in spasms and followed by vomiting sometimes

A

Whooping stage

42
Q

Pathogenesis of Bordatella p: adherence

A

Adherence: filamentous hemagglutinin (FHA) binds gal residues on ciliated respiratory epithelial cells as well as CR3 molecules on phagocytes
Also pertactin, fimbrae, pili

43
Q

Pathogenesis of Bordatella p: Toxin production

A
  • Tracheal cytotoxin (TCT) - peptidogly fragment that damages epithelium via IL-1 and NO production –> ciliary stasis and cell death
  • Pertussis toxin (PTx) - secreted and on cell surface; adhesion and A/B exotoxin that disrupts cAMP regulation –> compromise of host phagocytes and lymphocytes –> dec bact clearance and secondary infections –> -LYMPHOCYTOSIS due to decreased entry into nodes
  • Adenylate cyclase - disrupts cell signaling
  • Lethal toxin
44
Q

Convalescent stage

A

gradual fading of cough

regeneration of respiratory cilia

45
Q

Pertussis complications in kids

A 
Respiratory compromise
2ndary infections
Dehydration
Seizures, encephalopathy
Malnutrition, weight loss
46
Q

Treatment of pertussis

A

Erythromycin/azith/clarith/or TMP/sulfa
ONLY IN Sx Pt with cough duration < 3 WEEKS
Prophylaxis for close contacts if w/in 3 wks

47
Q

Pertussis prevention

A

Whole cell vaccine (DPT/DTP) –> SE’s (convulsion, brain damage)
Newer acellular vaccine –> fewer SE’s but less protection
Recently, pertussis isolates are lacking PERTACTIN (key component of acellular vaccine)

48
Q

Pertussis vaccine recommendations

A

DTaP series in infants/kids
Tdap at 11-12y
Single booster in all adults regardless
Tdap for all women during EACH pregnancy

49
Q

Pseudomonas aeruginosa basic facts

A 
facultative anaerobe
flagella, oxidase +
does NOT ferment lactose
likes aerobic infection sites
BIOFILMS
Ammonia as nitrogen source
Resistant to harsh conditions
hot tubs (folliculitis, OE), antiseptic solutions, eyedrops, humidifiers, hospital equipment, CONTACT LENSES
50
Q

P. aeruginosa in the lab

A 
G- baccilus
BLUE PYOCYANIN and fluoresces
GREEN FLUORESCEIN
Wood's light for burns/wounds
SWEET GRAPE-LIKE ODOR
51
Q

Psuedomonas pathogenesis

A

Exotoxin A –> EF2 –> inhibits protein synthesis (~diptheria toxin)
Hydrolytic enzyme tissue destruction
pili, capsule
ALGINATE SLIME (mucoid strains from CF pts)
May overgrow other pathogens during abx tx

52
Q

Antibiotics for pseudomonas

A

quinolones (cipro)
beta-lactams (ceftazidime, imipenem, cefepime, meropenem, piperacillin)
Aminoglycosides (tobramycin)

53
Q

Common aerobic infection sites of pseudomonas

A 
nails, SSTI's, OE
burn/wounds, ocular (KERATITIS), bacteremia
infective endocarditis
HAP/VAP
leading COD IN CF PTs
54
Q

Ecthyma gangrenosum

A

deep ulcers via pseudomonas
neutropenic hosts MOST COMMON
hematog dissem via bacteremia, NOT A SKIN INFECTION

55
Q

Psuedomonas in CF pts

Tx

A

CFTR may be attachment site
Viscous mucus –> less PMN/abx access
Diminished phagocyte fxn
BIOFILM

chest percussion, NEBULIZED AG’s for prophylaxis

56
Q

Pseudomonas paradox

A

No problem most of the time for pts w/intact defenses

BUT rapidly progressive infection, tissue damage, and resistance

57
Q

N. meningitidis in infants?

A

no - abs from ma

58
Q

dorms, schools, prisons, bases, planes, HAJJ, africa/asia

A

N. mening (meningococcus)

59
Q

moraxella on sepsis ddx?

A

not really; rare

60
Q

chronic lung infection in CF pts bug

A

pseudomonas

61
Q

opa

A

attachment virulence factor for N. meningitidis

62
Q

What factor shows variation leading to repeat N. mening. infections?

A

LOS

63
Q

what nutrient will grow bordatella on culture?

A

nicotinamide

64
Q

B. pertussis

Peptidogly fragment that damages epithelium via IL-1 and NO production –> ciliary stasis and cell death

A

Tracheal cytotoxin (TCT)

65
Q

B. pertussis toxin:
Secreted and on cell surface; adhesion and A/B exotoxin that disrupts cAMP regulation –> compromise of host phagocytes and lymphocytes –> dec bact clearance and secondary infections –> -LYMPHOCYTOSIS due to decreased entry into nodes

A

Pertussis toxin (PTx)

66
Q

B. pertussis toxin:

disrupts cell signaling

A

Adenylate cyclase

67
Q

contact lens infection

A

pseudomonas

68
Q

Leading COD in CF pts

A

pseudomonas

Bugs & Drugs (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions