Gram Negative Cocci

Question 1

Neisseria
Gram ——
shape??
oxidase —- (+/-?)

Answer 1

• Gram negative
• diplococci
• oxidase +

Question 2

which neisseria can metabolize glucose

Answer 2

• Neisseria gonorrhea
• Neisseria meningiditis

Question 3

which neisseria can metabolize glucose and maltose

Answer 3

• N. meningiditis

Question 4

T or F
Neisseria can grow in sheep blood agar

Answer 4

F
Neisseria cannot grow in sheep blood agar

Question 5

T or F
Neisseria can grow in chocolate agar

Answer 5

T

Question 6

T or F
VPN is selective for neisseria (Thayer martin agar)

Answer 6

T

Question 7

what is an essential host defense mechanism against neisseria infections?

Answer 7

MAC (C5-C9)

Question 8

what is the major virulence factor of neisseria

Answer 8

Pilli

Question 9

Virulence factors of neisseria

Answer 9

• pilli
• IgA protease (inactivates IgA)
• LOS (lipooligosaccharide)
• Opa proteins

Question 10

—- is the second cause of acute bacterial meningitis (#1 is strep pneumoniae)

Answer 10

N.meningiditis

Question 11

Pili in N.meningiditis promotes —– colonization

Answer 11

nasopharyngeal

Question 12

T or F
N.meningiditis has a protective capsule

Answer 12

T

Question 13

N.meningiditis spreads via

Answer 13

Respiratory droplets

Question 14

N. meninigiditis bacteria enters the body through the ——

Answer 14

Nasopharynx

Question 15

Outbreaks of N. meningiditis are prominent in places like

Answer 15

military quarters and dorms

Question 16

N.meningiditis spreads via —– spread

Answer 16

hematogenous

Question 17

Once in the blood stream, N.meningiditis causes a pro-inflammatory generated by ——

Answer 17

LOS (lipooligosaccharide)

Question 18

what causes massive inflammatory response in N.meningiditis

Answer 18

LOS blebs

Question 19

The inflammatory response caused by LOS blebs leads to

Answer 19

vascular injury

Question 20

Leaky vasculars caused by LOS blebs causes —–

Answer 20

shock

Question 21

—– is a strong indicator of thrombocytopenia

Answer 21

Petechial rash

Question 22

If a small petechiae is evolving to a large purpura, this is a sign of

Answer 22

DIC (immediate attention is needed)

Question 23

what is a syndrome caused by N.meningiditis in the adrenal glands which can extenuate shock

Answer 23

Waterhouse friedrichsen syndrome

Question 24

signs of shock due to N.meningiditis

Answer 24

• hypoglycemia
• hyponatremia
• Hyperkalemia

Question 25

S and S of N. meningiditis

Answer 25

- febrile - flu like symptoms - Intense myalgias - Strep like pharyngitis - Petechial rash which can progress to purpura (strong indicator of DIC) - septic shock

Question 26

Presentation of acute bacterial meningitis caused by N.meningiditis

Answer 26

- neck stiffness - fever - headache

Question 27

As patients recover from N.meningidiits, they can have immune complex mediated complications such as

Answer 27

- arthritis - pericarditis - vasculitis

Question 28

Treatment of N. meningiditis

Answer 28

- ceftriaxone - penicillin - chloramphenicol (if allergic to penicillin and other beta lactams)

Question 29

drug used for N.meningidits post exposure prophylaxis

Answer 29

- Rifampin - ceftriaxone - ciprofloxacin

Question 30

T or F There are vaccines for N. meningitidits

Answer 30

T

Question 31

Neisseria gonorrhea is a ---- intracellular

Answer 31

Facultative

Question 32

T or F Neisseria gonorrhea is not encapsulated

Answer 32

T

Question 33

T or F N.gonorrhea is an STI

Answer 33

T

Question 34

New borns can get N. gonorrhea through the -----

Answer 34

vaginal canal

Question 35

N.gonorrhea to infants that contract it through the vaginal canal can cause

Answer 35

Severe eye infection and blindness

Question 36

Clinical features of N.gonorrhea in males

Answer 36

- Asymptomatic and symptomatic Urethritis - Prostatitis - Orchitis

Question 37

clinical features of N.gonorrhea in females

Answer 37

- mucopurulent cervicitis - Intermenstrual bleeding - Salpingitis - Fitz hugh curtis syndrome (spread to liver and peritoneum) - Purulent arthritis

Question 38

Disseminated Gonococcal infection can present as

Answer 38

- Polyarthralgia (involves the knees, ankles, wrists) - Tenosynovitis (affects tendons) - dermatitis

Question 39

N.gonorrhea in infants can present as

Answer 39

Ophthalmia neonatorum

Question 40

N.gonorrhea in infants causing eye infection can be prevented by

Answer 40

Applying erythromycin ointment to baby's eyes

Question 41

Preferred testing for N.gonorrhea

Answer 41

NAAT

Question 42

Treatment for N.gonorrhea

Answer 42

Ceftriaxone

Question 43

T or F You need to cover for chlamydia when treating N.gonorrhea

Answer 43

T

Question 44

What do you use to cover chlamydia when treating N.gonorrhea

Answer 44

Doxycycline or macrolide like azithromycin

Question 45

Moraxella catarrhalis Gram----- shape?? oxidase ----- Aerobe or anaerobe?

Answer 45

Gram negative diplococcus oxidase positive Aerobe

Question 46

Moraxella catarrhalis normally takes up residence in the -------

Answer 46

Nasopharynx

Question 47

M.catarrhalis can form ----- that helps it resist antibiotics

Answer 47

Biofilm

Question 48

T or F M.catarrhalis produces beta lactamase

Answer 48

T

Question 49

M.catarrhalis has a positive hockey puck sign, what does that mean?

Answer 49

colonies slide easy across the agar like a hockey puck on ice it is unique to M.catarrhalis

Question 50

M.catarrhalis is a common cause of ----- in children

Answer 50

Otitis media

Question 51

bacterial sinusitis is commonly caused by

Answer 51

M.catarrhalis

Question 52

T or F M.catarrhalis can cause COPD exacerbations

Answer 52

T

Question 53

Treatment of M.catarrhalis

Answer 53

- Cephalosporins - Amoxicillin-clavulante - TMP-SMX - FQ