Gram Pos Rods!

Question 1

Name all aerobic and anaerobic GPRs

Answer 1

Aerobic! Think AB CD

• Corynebacterium Diphtheria
• Bacillus Anthrax
• Bacillus Cereus
• NAL; Nocardia Asteroides; Lactobacilli
• • Listeria Monocytogenes (facultive anaerobe)

Anaerobic! Think clostridium lol

• Clostridium Difficile
• Clostridium Tetani
• Clostridium Botulinum
• Clostridium PERFRINGENS

Question 2

What genus has SporeS and their differences

Answer 2

CloStridium
BacilluS

• Both GPR, but bacillus is aerobic, clostridium is anaerobic

Question 3

Whats Corynebacterium diphtheria

• structure
• location
• damage
• special features

Answer 3

C. D

• Aerobic GPR
• Location: not normal flora

Diphtheria think M&N&N - diphtheria means leathery membrane

• Pseudomembrane at Neck, throat; Swelling, bull neck
• • aka Pharyngeal infection; think airway obstruction
• M&N
• • Myocarditis - arrhythmia, HF
• • Neuropathy - paralysis of limbs
• Look like Chinese characters;

Question 4

Corynebacterium Diphtheria

• treatment
• prevention, SG?
• diagnosis

Answer 4

Exotoxin mediated
- Antitoxin
AB: penicillin, erythromycin

Prevention: Vaccine for Toxoid, AB for px, contacts
YES Mandatory in SG

Diagnosis: PCR, Throat Swab can w special agar

• Clinical diagnosis already cos no time to waste
• • DONT WAIT FOR TESTS

Question 5

Corynebacterium Diphtheria toxin properties

Answer 5

Encoded by Phage

- A & B fragments, B for binding A for active

Question 6

Whats Bacillus?

Answer 6

GPR, Spore Forming, Aerobes

Question 7

Bacillus Anthracis whats so special

• damage
• structure, virulence !!!
• presentation
• lab diagnosis

Note Bacteriological Warfare as aerosol delivery, very fatal;

Answer 7

Damage: Anthrax infection amongst animals; breathe in spores, eat food or drink water that is contaminated with spores, or get spores in a cut or scrape in the skin

• PROTEIN Capsule;
• Tripartite Toxin - oedema, lethal factors; protective antigens - LOA
• Presentation as BLACK cutaneous vesicles - “anthrax”
• Entry: airway - pneumonia; swallowed - intestinal damages
• Vesicle fluid; Blood, Sputum;
• • Culture;

Question 8

Bacillus Cereus

- presentations;

Answer 8

Fried Rice;

• can be early onset, toxin already made
• slow, diarrhoea, ab pain

Question 9

Name all genus w Capsule and compare

Answer 9

• Strep Pneumonia - GP DC
• N. Meningitidis - GN DC
• • A B C Y W135
• Haemophillus Influenzae - GNR
• Bacillus Anthrax - PROTEIN Capsule + Tripartite Toxin
• • aGPR
• • NOTE Bacillus Cereus has NO CAPSULE
• Klebsiella Pneumonia!!! EBA GNR

Question 10

Listeria Monocytogenes

• location
• damage
• risk factor

Answer 10

Location: food, GIT normal

Damage, invasive

• Sepsis
• Meningitis - RF: pregnancy, fetus, neonates, IC, elderly

Question 11

Top 3 causes of neonatal meningitis

Answer 11

• GBS - Strep. agalacticae
• L MCG
• E. Coli !!!

Question 12

LMCG R ad S

Answer 12

Cephalosporin (Enterococci also)

S: Ampicillin

Question 13

Meningitis empirical therapy and why!!!

diff between R to Penicillin

Answer 13

Vancomycin - Strep. Pneumonia (R to penicillin)
Ceftriaxone - H. Influenza, N. Meningitidis

(H. Influenza also R to Penicillin) (N. Meningitidis can Penicillin but Ceftriaxone clears throat carriage)

Ampicillin - L. MCG (R to cephalosporin!)

NOTE: S. Pneumonia due to PBP changes; H. Influenzae due to Beta lactamases

Question 14

Nocardia Asteroids
Lactobacilli

1 word each ~

Answer 14

Branching filaments

Probiotic

Question 15

Note Vaccination of Diphtheria is TOXOID vaccine;

same as Tetani

• TDaP uwu

Answer 15

okie

Question 16

2 Properties of Clostridium species

Name 4 genus

Answer 16

Anaerobic GPR;
Spore forming;

C. Difficile
C. Perfringens
C. Tetani
C. Botulium

Question 17

Clostridium Perfringens

• Damage
• Location

Answer 17

GAS GANGRENE

• alpha toxin damage blood vessels, hypoxic leads to anaerobic conditions
• gas leading to crepitation, X-Ray - Radiolucent - BLACK
• myonecrosis
• LOCATION: Soil, GI, FOOD poisoning
• Diarrhoea, Necrotizing enterocolitis

Question 18

Who to prevent C. Perfringens with what?

Answer 18

Risk Factor of damaged tissues, lacking oxygen, allowing C. Perfringens to grow
- Diabetics, Amputees, Atherosclerosis

• Give PenG, Benzylpenicillin IM/IV

Question 19

Describe C. Botulinum, C. Tetani

• location
• pathophysiology
• presentations
• treatment

Answer 19

Botulinum - food

• Flaccid paralysis, Ach block at NMJ
• Needs ventilation

Tetani - GIT

• Spastic paralysis, Block off Inhibitory signals to LMN, LMN always on
• Presents as Lockjaw, risus sardonicus, stiff jaw;
• Toxoid vaccine

Question 20

C. Difficile

• damages
• treatments
• What can cause CDAD more specifically

Answer 20

CDAD associated diarrhoe
- severe is Pseudomembrane Colitis

• STOP AB
• IV Vancomycin, Metronidazole
• Tetracycline Clindamycin
• FQ Ciprofloxacin

Question 21

Singapore Vaccines Progam

• which are compulsory

Answer 21

Diptheria Toxoid, Tetanus Toxoid, Pertussis acellular
- DTaP

HiB - H. Influenzae
Strep Pneumonia - Conjugate

MMR, Polio, Hep B, BCG

• meningococcal, Chickenpox vaccines OPTIONAL
• HPV not compulsory too
• • ONLY Measles and Diphtheria compulsory

Question 22

Surprise! Name a non-sporing anaerobe and their structure
- drug to kill it; this drug also use for what

• Note most infections usually mixed w anaerobe

Answer 22

Bacteroides Fragilis - most common anaerobe

• GNRs
• Metronidazole; Also for CDAD

Question 23

How is L. MCG spread by
How is Clost. Perfringens spread by
- Tetani vs Botulinum spread

Answer 23

Food, Vertical
Food also - hence can food poisoning
Tetani GIT; Botulinum food