CNS Infx: Parasites, Botulism, Tetanus

Question 1

What two clostridium spp release neurotoxins?

Answer 1

tetani, botulinum

Question 2

Clostridium species are ______ anaerobes

Answer 2

obligate anaerobes

Question 3

The important clostridium species are Gram_______ with what morphology?

Answer 3

G+ Bacilli

Question 4

What confers resistance in the environment for clostridium species?

Answer 4

spore formation

Question 5

Production of ______ are important for disease progression with clostridium infx.

Answer 5

exotoxins

Question 6

This is a G+ Bacillus w. terminal spores and a tennis-racket appearance…

Answer 6

Tetanus

Question 7

What mediates toxin production of clostridium tetani?

Answer 7

plasmid mediated

Question 8

What allows the entry of tetanus spores into the body?

Answer 8

trauma

Question 9

Describe the spread of c. tetani after infx manifests

Answer 9

localized at site (no bacteremia)

Question 10

If infx remains local with tetani, how does it cause systemic sxs?

Answer 10

production and release of tetanospasmin via neuron transmission

Question 11

what are the three clinical forms of tetanus?

Answer 11

generalized, localized, cephalic

Question 12

Which type of clinical tetanus?

• uncommon
• muscle spasm confined to injured area
• immunocompromised

Answer 12

localized

Question 13

Which type of clinical tetanus?

• lesions on head/face/ear infx
• only affects facial muscles
• rarest

Answer 13

cephalic

Question 14

Which type of clinical tetanus?

• MC
• exposure via broken skin
• infant infx via umbilical stump

Answer 14

generalized

Question 15

What are three physical signs of tetanus?

Answer 15

trismus (lockjaw)
risus sardonicus (grimace)
arching of back

Question 16

What serious manifestations can cause death with tetanus infection?

Answer 16

respiratory and cardiac complications

Question 17

Isolation of c. tetani is often (Pos or neg) for what reason?

Answer 17

negative (requires anaerobic culture)

Question 18

What is more reliable for diagnosing tetanus than laboratory methods?

Answer 18

clinical findings

Question 19

DTaP and Td has decreased tetanus in the US. It works by neutralizing…

Answer 19

tetanus toxin (tetanospasmin)

Question 20

Tetanus booster is recommended q…

Answer 20

10 yers

Question 21

4 doses of DTaP are given beginning at what age?

Answer 21

6 weeks

Question 22

what must be included with abx when treating tetanus?

Answer 22

antitoxin (human tetanus immune globulin)

Question 23

What pathogen has the following characteristics?

• subterminal spores
• distended shape
• heat resistant

Answer 23

C. botulinum

Question 24

What is the MC cause of botulism?

Answer 24

contaminated food

Question 25

What are the 8 serologically distinct botulinum toxins?

Answer 25

A-H, X

Question 26

Which botulinum toxins are involved in human disease and used for medical/commercial use as botox?

Answer 26

A,B

Question 27

Which botulinum toxins are less common causes of human disease?

Answer 27

E, F

Question 28

Which botulinum toxins cause animal disease?

Answer 28

CDG

Question 29

Botulinum neurotoxin is different from tetanus in that the toxin producing gene is found where? what does this mean?

Answer 29

on the chromosome, not plasmid all C. botulinum will have toxin producing ability

Question 30

What clinical manifestation of botulism infection is different from tetanus?

Answer 30

flaccid paralysis via blocked ACh release

Question 31

This type of botulinum toxin lacks an anti-toxin and is considered the most deadly substance ever found...

Answer 31

Type H

Question 32

What are the three clinical types of botulism infection?

Answer 32

infant, foodborne, wound

Question 33

Ingestion of spores can cause infant botulism for those < 6mo. What is a common mechanism for this?

Answer 33

honey ingestion

Question 34

What type of wounds can allow c. botulinum?

Answer 34

deep wounds to anaerobic environment, IVDU

Question 35

Does botulism infection cause fever?

Answer 35

no

Question 36

What type of botulism results in neuroparalytic illness after entry by bacteria into tissue

Answer 36

wound botulism

Question 37

What type of botulism results from toxin ingestion in substances that contain the bacteria, resulting in GI disturbance and eventual neuroparalysis

Answer 37

food poisoning

Question 38

This type of botulism results from germination of spores and bacteria and release of neurotoxin to cause systemic effects.

Answer 38

infant botulism

Question 39

what is a probable cause of SIDS?

Answer 39

infant botulism

Question 40

Confirmation of botulism is related to_____

Answer 40

toxin presence in fecal samples

Question 41

Are abx recommended for botulism tx?

Answer 41

no