Exam 2 Gram Positive Bacilli Flashcards
(133 cards)
1
Q
Gram positive spore forming bacilli
A
- Clostridium
- Bacillus
2
Q
Gram positive branching bacteria
A
- Nocardia
- Actinomyces
3
Q
Anaerobic non-spore forming rods: example?
A
Lactobacillus
4
Q
Sporulation is common in ______ bacteria
A
gram positive
5
Q
Prior to forming spores, bacteria are found in ____ state
A
Vegetative (non-spore, growing)
6
Q
Bacteria will form spores in response to:
A
Adverse conditions
7
Q
To form spore, what happens in bacteria?
A
- asymmetric cell division
- partitioning of chromosome into an internal spore (endospore)
8
Q
How many endospores can a bacterium create?
A
1 per bacterium
9
Q
Spore can germinate under what conditions?
A
Anaerobic
10
Q
True or false: spore is contained within cell’s plasma membrane
A
False - they become “free” because rest of cell dies off, leaving behind the spore by itself
11
Q
A
Clostridia (spoons)
- Spores form at the end of the cell
12
Q
Clostridia is found deep in the soil, which means they are:
A
Obligate anaerobes
13
Q
Clostridium will form spores in what kind of conditions?
A
Nutrient-limiting conditions
14
Q
Clostridium spores are resistant to:
A
- dryness
- heat (boiling)
- many chemical disinfectants
“indestructable”
15
Q
Clostridium spores germinate and may produce toxins under what conditions?
A
Anaerobic conditions (deep in soil; human tissues)
16
Q
Clostridium contains a ____ toxin, which enters into cells by:
A
AB toxin; either endocytosis to bring in whole complex or only A enters through cytoplasmic membrane
17
Q
What does A stand for in AB toxin?
A
Active
18
Q
What does B stand for in AB toxin?
A
Binding
19
Q
What bacteria causes tetanus?
A
Clostridium tetani
20
Q
Where are Clostridium tetani spores found?
A
Ubiquitous in soil, animals/human feces
21
Q
How does Clostridium tetani colonize tissue?
A
Wounds contaminated with feces or soil, usually by penetrating trauma (ex. nail puncturing through skin/deep tissues)
22
Q
Neonatal tetanus can occur via:
A
unclean deliveries and cord care practices that can infect the umbilical cord
23
Q
Clostridium tetani incubation time
A
3-21 days
24
Q
What toxin does Clostridium tetani produce?
A
Tetanospasmin (potent neurotoxin)
25
True or false: many toxins are responsible for tetanus symptoms
False - only tetanospasmin is responsible for all symptoms
26
Tetanus toxin structure
AB structure
27
How does tetanus toxin travel to the CNS?
Via bloodstream or along nerves toward the spine
28
What does tetanospasmin do?
- Destroys proteins that regulate release of inhibitory neurotransmitters
- Enhanced and continuous involuntary muscle contraction
- Unregulated excitatory activity leads to spastic paralysis
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Trismus
Lockjaw
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Risus sardonicus
Sardonic smile, causes difficulty swallowing
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Opisthotonos
Muscle rigidity and spasms
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Spastic paralysis can lead to:
- trismus
- risus sardonicus
- opisthotonos
- seizures
- arrhythmias
- respiratory arrest --> death
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How to prevent and treat Clostridium tetani
- vaccination
- debridement, clean wound
- antitoxin
- supportive care, sedation
34
True or false: Tetanus has no immunity
True - so toxic that not much bacteria is needed to produce symptoms, but is not enough to produce antibodies. Cannot build immunity to it or you'd already be dead
35
What is found in the tetanus vaccine?
Inactivated tetanus toxin; given with diphtheria and pertussis vaccines (DTaP/Tdap)
36
DTaP is given to:
Young children (high dose of everything)
37
Tdap is given to:
preteens (11-12 years old) and adults (every 10 years)
38
_____ is always given as a high dose in vaccines
Tetanus
39
Clostridium botulinum causes:
- botulism
- infant botulism
- wound botulism
40
What is botulism?
Life threatening paralytic illness - muscles become relaxed and don't work
41
C. botulinum spores are:
Ubiquitous - on surface of vegetables used for **home canning, preserves, fermented food**
42
True or false: C. botulinum spores can survive boiling but are killed by autoclaving
True
43
How many toxins does C. botulinum have?
7 (A-G)
44
C. botulinum toxin structure
AB structure
45
C. botulinum toxin is a:
Neurotoxin
46
What does C. botulinum toxin do?
**Prevents release of acetyl choline** from motor neuron, stops muscle contraction - leads to flaccid paralysis
47
True or false: C. botulinum can be inactivated by boiling for 10 min
True but may not kill spores
48
_____ has potential for bioterrorism
C. botulinum (1g of toxin can kill 1 million people)
49
Foodborne botulism is caused by which toxins?
Toxins A and B
50
Foodborne botulism onset
18-38 hours; ranges 2 hours - 8 days
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Symptoms reported for foodborne botulism
Headaches, dizziness, descending flaccid paralysis
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Descending flaccid paralysis symptoms
1. **diplopia** (double vision)
2. difficulty swallowing and speaking, unable to move lips or tongue
3. progressive difficulty breathing --> death
Also bilateral descending muscle weakness
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Diagnosis for foodborne botulism
Toxin in feces or contaminated food
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True or false: foodborne botulism is an acute illness
False - long lasting, takes months or years to recover
55
Ptosis
Drooping eyelid
56
If someone has botulism, what signs can you see from their eyes?
Ptosis, fixed dilated pupils
57
What is the most common botulism in the US
Infant botulism
58
Infant botulism affects infants ____ weeks of age
3-20
59
How is infant botulism acquired?
Spores may be ingested with food, honey is the only known risk factor
60
Wound botulism occurs in:
Almost exclusively injection drug users associated with black tar heroin
61
Treatment of botulism
**- antitoxin** to bound remaining circulating toxin (has to be done before symptoms appear)
- **supportive therapy** (ventilation)
62
Where is antitoxin available for botulism
Health department has to contact CDC - it is so rare, not on hand at hospital
63
Botulism prevention
- **proper sterilization in canning** (home canning major disease source)
- toxin can be deactivated by **heat**
64
Where is botox derived from
C. botulinum toxin (BoTox)
Diluted VERY well
65
What is botox used for
Rid frown lines, crow's feet, etc.; can treat migraines, muscular, bowel, gland disorders
Temporarily paralyzes the muscle. Toxicity is due to overdosing
66
____ may administer botox in a majority of US states
Dentists - can treat TMD or for cosmetic purposes
67
C. perfringens causes what kind of infections?
Soft tissue or intestinal infections
68
C. perfringens soft tissue infections
1. gas gangrene and myonecrosis
2. anaerobic cellulitis
69
C. perfringens example of intestinal infection
Food poisoning
70
There are several types of gangrene, which are:
- dry gangrene
- wet gangrene
- gas gangrene
71
Dry gangrene is caused by:
Ischemia (inadequate blood supply to organs) as a result of atherosclerosis, diabetes, frost bite
72
Wet gangrene is caused by:
Ischemia and infection (by many bacteria types)
Low blood supply but infection on top of that (lots of pus)
73
Gas gangrene is caused by:
C. perfringens - infection deep in tissues, causes gas buildup
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Which C. perfringens toxins cause gas gangrene
- **Alpha**
- Epsilon
75
C. perfringens alpha toxin causes:
- Phospholipid destruction
- lyses RBC, WBC, platelets
- tissue destruction
- renal failure
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C. perfringens Epsilon toxin causes formation of ____ and is implicated in ___
membrane pore; multiple sclerosis
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What does Gas gangrene look like in histology
Large gas bubbles in muscle tissue (fermentation)
78
Gas gangrene treatment
- debridement
- high dose penicillin can sometimes work
- **hyperbaric oxygen** (because the bacteria is anaerobic)
79
True or false: Anti-toxin is ineffective in C. perfringens
True - toxin is already bound/inside cell
80
C. perfringens enterotoxin causes:
food poisoning - **alters membrane permeability** of small intestine epithelium
81
C. perfringens enterotoxin may act like
Superantigen
82
C. perfringens enterotoxin is inactivated by:
Heat (heat labile)
83
C. perfringens food poisoning is commonly associated with:
chicken/poultry (improper cooling of cooked meat)
84
C. perfringens food poisoning symptoms
Watery diarrhea, abdominal pain
85
True or false: C. perfringens food poisoning is self limiting, meaning you don't generally die from it or require treatment
True
86
Antibiotic-associated colitis is associated with what bacteria?
Clostridium difficile
87
C. difficile causes what disease?
Antimicrobial-induced (pseudomembranous)
enterocolitis
88
C. difficile infection is associated with:
Broad spectrum antibiotics - normal flora is decreased and allows opportunistic infection
89
What toxins does C. difficile produce?
Enterotoxin, cytotoxin
| toxic to cells, necrosis of villi
90
In C. difficile infection, ____ forms on the large intestine
Pseudomembrane
91
C. difficile associated pseudomembrane is made up of:
inflammatory cells, fibrin, bacteria
92
C. difficile enterocolitis symptoms
**Watery diarrhea**, leukocytosis, fever, abdominal pain
93
Diagnosis of C. difficile enterocolitis
stool culture, toxin in feces by PCR
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Treatment for C. difficile enterocolitis
- discontinue current antimicrobial therapy
- fecal microbiota transplantation (poorly regulated but high success rate 90%)
- preventative measure: take probiotics
95
Bacillus anthracis classification
gram positive, spore-forming rods
96
B. anthracis metabolism
Obligate aerobes
97
Anthrax toxin structure
AB toxin with 2 alternate A subunits
- Edema factor (EF)
- lethal factor (LF)
Has Protective antigen (PA) that binds to cell, is equivalent to B subunit
98
Anthrax edema factor causes:
swelling, trapping of fluids
99
Anthrax lethal factor causes:
cell death, hypoxia
100
B. anthracis forms of infection
1. cutaneous anthrax
2. Gastrointestinal anthrax
3. pulmonary anthrax
101
Symptoms of cutaneous anthrax
Ulceration, eschar formation, lymphadenopathy
102
GI anthrax symptoms
Ulceration of oropharynx, esophagus, intestine; severe gastroenteritis
103
Pulmonary anthrax is also known as
Cattle and sheep "wool sorter's disease"
104
Symptoms of pulmonary anthrax
Severe/fatal pneumonia, fever, lymphadenopathy of mediastinal lymph nodes
105
Bacteremia, meningitis, shock, and death can result from which form of anthrax?
Pulmonary anthrax
106
Eschar definition
dark scab, dead tissue sloughs off
107
Oropharyngeal anthrax is marked by formation of:
Pseudomembrane overlying ulcers
108
Telltale sign of inhalation anthrax
Widening mediastinum (membrane separating the lungs)
109
From inhalation anthrax, dissemination of ____ can be seen in blood
Gram positive rods
110
Bacillus anthracis treatment
**Ciprofloxacin** - military grade anthrax is resistant to penicillin and other antibiotics so cannot use those
111
B. anthracis has potential for ______
bioterrorism
112
What event occurred in 2011 regarding anthrax?
Biowarfare - 22 people infected, all got some kind of disease (half inhalation, half cutaneous) - 5 died, making it a 45% death rate
33,000 people given prophylactic abx
113
Nocardia is a ______
pulmonary opportunist (infect those that are immune deficient)
114
Which bacteria stains weakly gram positive and also has mycolic acid in its cell wall?
Nocardia
115
Nocardia causes what kinds of infection?
Traumatic **skin** lesion infection, abscess formation (can occur in mouth), hematogenous dissemination to the brain
116
Actinomyces is found where?
Normal oral flora on teeth/tonsillar crypts
117
____ is associated with root surface caries
Actinomyces
118
Which bacteria forms slow growing, "molar" colonies?
Actinomyces
119
Actinomycosis is primarily caused by:
A. israelii and A. viscosus
120
Actinomycosis disease symptoms
- acute or chronic **abscesses**
- draining sinuses with **sulfur granules**
- **cervicofacial (lumpy jaw)** in over half of all infections
121
Actinomycosis treatment
Surgery, penicillin
122
Cervicofacial actinomycosis commonly occurs at:
Angle of mandible
123
Trauma in the form of injury, perio pocket, nonvital tooth, extraction socket, and an infected tonsil increase the risk of aquiring:
Cervicofacial actinomycosis
124
Which teeth are often involved in cervicofacial actinomycosis?
Mandibular first molars and anterior maxillary teeth
125
True or false: cervicofacial actinomycosis is reported to be very painful
False - pain often minimal
126
Sulfur granules are associated with:
Actinomycosis (colonies look like tiny molars)
127
Which gram positive bacilli species does not form spores?
Lactobacillus
128
Where is lactobacilli found?
Normal flora of the mouth, GI tract, vagina
129
Lactobacilli produces _____ and is tolerant of ____
Lactic acid; acid
130
Lactobacilli is involved in _____ progression
Caries
131
True or false: lactobacilli can be ingested via fermented foods and food supplements
True
132
Normal vaginal smear should show some lactobacilli - why is this important?
Keeps vaginal environment slightly acidic to prevent other infections (like yeast infection)
133
Bacillus anthracis major virulence factors
toxin and capsule
