Clinical Bacteriology II

Question 1

botulism

Answer 1

clostridium botulinum
heat labile toxin - inhibit ACh release - at NMJ
flaccid paralysis
floppy baby

canned food and honey (kids)

Question 2

honey in kids

Answer 2

botulism - spore ingestion

floppy baby

Question 3

canned food in adults

Answer 3

botulism - preformed toxin ingestion

flaccid paralysis

Question 4

tx botulism

Answer 4

antitoxin

Question 5

gas gangrene

Answer 5

clostridium perfringes

alpha toxin - mynecorsis and hemolysis

Question 6

pseudomembranous colitis

Answer 6

clostridum dificile infection

two toxins
A - bind brush border of gut
B - cytoskeletal disruption - actin depolymer - pseudomembranous formation

Question 7

secondary to antibiotic use

Answer 7

C. dif

Question 8

tx of C. dif

Answer 8

metrondiazole

oral vancomycin

Question 9

anthrax

Answer 9

bacillus anthracis

gram positive spore forming rod

Question 10

polypeptide capsule bacteria

Answer 10

only one - bacillus anthracis - D-glutamate

Question 11

cutaneous anthrax

Answer 11

painless papule surrounded by vesicle - ulcer with black eschar

bacillus anthracis

Question 12

pulmonary anthrax

Answer 12

inhale spores
-flu-like sx - rapid progress to fever, pulmonary hemorrhage, mediastinitis, shock

death

Question 13

nausea and vomit after eating rice

Answer 13

bacillus cereus

nausea and vomiting 1-5 hours - preformed toxin cereulid

diarrhea watery, nonbloody, within 8-18 hours

Question 14

cereulide

Answer 14

preformed toxin bacillus cereus

Question 15

rocket tails

Answer 15

actin polymer - with listeria monocytogenes

-allow intracellular movement and cell to cell spread

Question 16

listeria monocytogenes

Answer 16

facultative intracellular

unpasteurized dairy, cold deli meat, transplacental, vaginal during birth

Question 17

meningitis with listeria

Answer 17

infant, immunocompromised, elderly

tx - ampicillin

Question 18

actinomyces class

Answer 18

long branch filament
gram positive anaerobe
not acid fast
normal oral flora

oral facial abscess drain through sinus tracts - yellow sulfur granules

tx - PCN

Question 19

nocardia class

Answer 19

long branching filament
gram positive aerobe
acid fast
found in soil

pulm infection in immunocompromised
cutaneous infection after trauma - immunocompetent

tx - sulfonamides

Question 20

tx of actinomyces

Answer 20

PCN

Question 21

tx of nocardia

Answer 21

sulfonamides

Question 22

ghon complex

Answer 22

primary TB
-lower to mid zones of lung

also see hilar nodes with primary TB

heals - by fibrosis

Question 23

secondary TB

Answer 23

fibrocaseous cavitary lesion - upper lung lobe

Question 24

pott disease

Answer 24

TB to vertebral body

Question 25

miliary TB

Answer 25

disseminated - severe bacteremia often to death

Question 26

tuberculosis

Answer 26

mycobacterium tuberculosis

Question 27

mycobacterium avium intracellulare

Answer 27

disseminated non-TB disease in AIDS pt CD4

Question 28

prophylactic tx for mycobacterium avium intracellulare

Answer 28

CD4

Question 29

hand infection aquarium handler

Answer 29

mycobacterium marinum

Question 30

hansen disease

Answer 30

leprosy mycobaterium leprae acid fast - likes cool temps - infect skin and superficial nerves

Question 31

armadillo

Answer 31

leprosy

Question 32

2 forms of leprosy

Answer 32

1 - lepromatous - skin, leonine lion like facis - is communicable -Th2 response 2 - tuberculoid - hairless skin plaque -Th1 response

Question 33

tx of leprosy

Answer 33

dapsone and rifampin - tuberculoid form | clofazimine added - lepromatous form

Question 34

campylobacter jejuni class

Answer 34

gram negative oxidase positive comma shaped grow at 42C

Question 35

vibrio cholera class

Answer 35

gram negative oxidase positive comma shaped grow in alkaline media

Question 36

h. pylori class

Answer 36

gram negative oxidase positive comma shaped produce urea

Question 37

neisseria meningitidis class

Answer 37

gram negative diplococci | maltose fermenter

Question 38

meisseria gonorrhea class

Answer 38

gram negative diplococci | maltose nonfermenter

Question 39

maltose

Answer 39

determine neisseria meningitidis - maltose fermenter gonorrhea - maltose nonfermenter

Question 40

h flu class

Answer 40

gram negative coccoid rod

Question 41

pasteurella class

Answer 41

gram negative coccoid rod

Question 42

brucella class

Answer 42

gram negative coccoid rod

Question 43

bordetella pertussis class

Answer 43

gram negative coccoid rod

Question 44

pseudomonas class

Answer 44

gram negative rod lactose nonfermenter oxidase positive

Question 45

klebsiella class

Answer 45

gram negative rod | lactose fermenter - fast

Question 46

E. coli class

Answer 46

gram negative rod | lactose fermenter - fast

Question 47

salmonella class

Answer 47

gram negative rod lactose nonfermenter oxidase negative produce H2S

Question 48

proteus class

Answer 48

gram negative rod lactose nonfermenter oxidase negative produce H2S

Question 49

yersinia class

Answer 49

gram negative rod lactose nonfermenter oxidase negative produce H2S

Question 50

shigella class

Answer 50

gram negative rod lactose nonfermenter oxidase negative no H2S production

Question 51

tx of gonorrhea

Answer 51

ceftriaxone and azithromycin or doxycycline - for chlamydial coinfection

Question 52

tx of neonatal conjunctivitis

Answer 52

often with gonococci infection eyedrops - erythromycin drops

Question 53

tx of meningococcus

Answer 53

ceftriaxone or PCN G

Question 54

maltose fermenation

Answer 54

neisseria meningitidis

Question 55

waterhouse friedrichson syndrome

Answer 55

neisseria meningitidis

Question 56

fitz hugh curtis syndrome

Answer 56

neisseria gonorrhea

Question 57

h flu

Answer 57

IgA protease

Question 58

chocolate agar

Answer 58

culture h. flu | -factor V and X

Question 59

cherry red epiglottitis in children

Answer 59

h. flu

Question 60

tx mucosal infection of h. flu

Answer 60

amoxicillin +/- clavulanate

Question 61

tx meningitis with h. flu

Answer 61

ceftriaxone rifampin prophylaxis - close contacts

Question 62

disease with h. flu

Answer 62

epiglottitis meningitis otitis media pneumonia