Gramcoccobacilli

Question 1

H. influenzae was first described in 1892 by during an influenza pandemic

Answer 1

Richard Pfeiffer

Question 2

identified six capsular polysaccharides (types)

Answer 2

Pittman

Question 3

six capsular polysaccharides (types) of H. influenzae

Answer 3

a, b, c, d, e, and f

Question 4

Systemic infections in otherwise healthy children caused by this bacterial species occur throughout the world, due mostly to

Answer 4

H. influenzae type b (Hib)

Question 5

;Pittman showed that a small fraction of H. influenzae infections was caused by

Answer 5

type a (Hia) and by type f.

Question 6

The peak Hia carriage

Answer 6

was in children up to 1 year of age.

Question 7

formerly called Pfeiffer’s bacillus or Bacillus influenzae

Answer 7

Haemophilus influenzae

Question 8

is a Gram-negative, coccobacillary, facultatively anaerobic, capnophilic, pleomorphic, pathogenic bacterium of the family Pasteurellaceae.

Answer 8

Haemophilus influenzae

Question 9

occur in pairs or short chains and measures 3um to 1 um

Answer 9

Haemophilus influenzae

Question 10

A faint, refractile capsule may be demonstrated by specific ___________ reaction with type-specific antisera; Cytochrome oxidase (+), Catalase (+) & reduces Nitrates to Nitrites.

Answer 10

Quellung reaction

Question 11

Hib capsular polysaccharide confers virulence by “_______” the deeper bacterial structures such as the lipopolysaccharide from the lytic activity of complement

Answer 11

“shielding”

Question 12

can grow with or without oxygen because they can metabolise energy aerobically or anaerobically. They gather mostly at the top because aerobic respiration generates more ATP than either fermentation or anaerobic respiration ;

Answer 12

facultative anaerobes

Question 13

need oxygen because they cannot ferment or respire anaerobically. They gather at the top of the tube where the oxygen concentration is highest

Answer 13

obligate aerobes

Question 14

are poisoned by oxygen so they gather at the bottom of the tube where the oxygen concentration is lowest

Answer 14

obligate anaerobes

Question 15

need oxygen because they cant ferment or respire anaerobically. however, they are poisoned by high concentration of oxygen. They gather in the upper part of the test tube but not the very top

Answer 15

microaerophiles

Question 16

dont require oxygen as they metabolize energy anaerobically. Unlike obligate anaerobes however, they are not poisoned by oxygen. They can be found evenly spread throughout the test tube

Answer 16

aerotolerant organisms

Question 17

most virulent, composed of neutral sugar, an alcohol (ribitol), & a phosphodiester

Answer 17

types a & b

Question 18

with lesser complement resistance and low virulence, are composed of an N-acetylated amino sugar, another saccharide, and a phosphodiester.

Answer 18

types c & f

Question 19

produced by non-encapsulated organisms from the respiratory tract (sputum) or ear aspirates.

Answer 19

Small, granular (R) colony (dew-like)

Question 20

h. influenzae major colony type that Causes Meningitis, Pyarthrosis (joint disease), Cellulitis, Pneumonia, Pericarditis and acute Epiglottitis.

Answer 20

Mucoid, iridescent (S) colony

Question 21

produced by encapsulated organisms from sites of invasive disease (virulent forms)

Answer 21

Mucoid, iridescent (S) colony

Question 22

Major colony type Causes localized infection i.e., Pneumonia & Sinusitis

Answer 22

Small, granular (R) colony (dew-like)

Question 23

Major colony type Commonly associated with chronic respiratory disease, principally in adults but also in immunocompromised patients

Answer 23

Small, granular (R) colony (dew-like)

Question 24

Requires both X & V Factors; exhibits “______________________” with Staphylococcus, Neisseria, Pneumococcus and other organism capable of synthesizing the V factor

Answer 24

satellite phenomenon”

Question 25

Maximum growth occurs at 37oC & pH 7.4-7.8, aerobically.

Answer 25

h. influenzae

Question 26

H. influenzae's Maintenance can be achieved through transfer on Chocolate Agar; preservation is best accomplished by

Answer 26

lyophilization.

Question 27

Haemophilus influenzae requires for growth

Answer 27

X factor" (hemin) and "V factor" (nicotinamide adenine dinucleotide, NAD+)

Question 28

hemin)

Answer 28

X factor

Question 29

nicotinamide adenine dinucleotide, NAD+

Answer 29

V factor

Question 30

an iron-containing porphyrin molecule necessary for bacterial respiration.

Answer 30

hemin,

Question 31

coenzyme vital for cellular metabolism

Answer 31

NAD (nicotinamide adenine dinucleotide)

Question 32

grows poorly on standard blood agar but thrives on chocolate agar where red blood cells are lysed, releasing the X & V factors.

Answer 32

Hemophilus influenzae

Question 34

X factor indicates

Answer 34

hemin

Question 35

V factor indicates

Answer 35

nicotinamide-adenine-dinucleotide, NAD

Question 36

hemophilus species that (+) on both X and V factor

Answer 36

Hemophilus influenzae Hemophilus influenzae sp. aegyptius Hemophilus hemolyticus

Question 37

hemophilus species that (+) V factor and (-) X factor

Answer 37

Hemophilus parainfluenzae Hemophilus segnes Hemophilus paraprophilus Hemophilus parahemolyticus

Question 38

hemophilus that (+) X factor and (-) V factor

Answer 38

hemophilus ducreyi

Question 39

hemophilus that (-) on both X and V factor

Answer 39

Hemophilus aprophilus

Question 40

MW of Capsular polysaccharide

Answer 40

> 150,000

Question 41

The major antigenic determinant of encapsulated H. influenzae.

Answer 41

Capsular polysaccharide

Question 42

Confers type specificity on the organism and is the basis of the grouping of the organism into 6 serotypes

Answer 42

Capsular polysaccharide

Question 43

Types serotypes are of the teichoic acid type

Answer 43

a, b, c & f

Question 44

serotypes are polysaccharides

Answer 44

types d & e

Question 45

most often associated with serious disease in children.

Answer 45

Type b (Hib)

Question 46

Possesses a capsule that is a polymer of ribose and ribitol phosphate

Answer 46

Type b (Hib)

Question 47

Results in enhanced phagocytosis as well as stimulate a C’-requiring bactericidal effects

Answer 47

Type b (Hib)

Question 48

Antigenic Structures of h. influenzae

Answer 48

1. Capsular polysaccharide 2. Somatic Antigen

Question 49

in cell envelope, consists of an outer and inner membrane-containing protein and LPS antigen.

Answer 49

Somatic Antigen

Question 50

h. influenzae's Major Virulence Factors:

Answer 50

Capsule Adhesion proteins Lipooligosaccharides (LOS) Pili Outer membrane proteins (P2 Protein) IgA1 protease Phase variation

Question 51

protects Hib from host immune functions and known to play a major role for its invasiveness.

Answer 51

Capsule

Question 52

The capsular antigen of type b

Answer 52

polyribosyl ribitol phosphate (PRP)

Question 53

antiphagocytic and one of the major virulence factor of H. influenzae

Answer 53

capsule

Question 54

facilitates invasion of bloodstream and spread of infection by the hematogenous route.

Answer 54

PRP

Question 55

mediate attachment to the human epithelial cells in the airway.

Answer 55

Adhesin proteins such as HMW1 and HMW2

Question 56

play major role for the attachment of nontypeable Haemophilusinfluenzae (NTHi) to the respiratory epithelium which in turn promotes colonization and subsequent epithelial and endothelial invasion by this bacteria.

Answer 56

Adhesion proteins

Question 57

produces no exotoxins.

Answer 57

H. influenzae

Question 58

Paralysis of the ciliated respiratory epithelium thwart its mechanical clearance as a part of non-specific host defense mechanism

Answer 58

Lipooligosaccharides (LOS)

Question 59

a critical factor for defense against host complement.

Answer 59

Lipooligosaccharides (LOS)

Question 60

________ & the major outer membrane protein (P2 protein) bind sialic acid-containing moieties on epithelial cell surfaces.

Answer 60

Pili

Question 61

contribute in adhesion and invasion of host tissues.

Answer 61

Outer membrane proteins (P2 Protein)

Question 62

cleaves immunoglobulin A at the hinge region.

Answer 62

IgA1 protease

Question 63

thought to prevent agglutination at the mucosal surface and subsequent mechanical clearance of the pathogen.

Answer 63

IgA1 protease activity

Question 64

Increased levels of IgA protease activity is correlated with

Answer 64

increased invasiveness of NTHistrains in humans.

Question 65

modification of outer surface protein of the pathogen which helps the pathogen to adapt to changes in the host environment.

Answer 65

Phase variation

Question 66

Hemoglobin bind proteins

Answer 66

HgbA, HgbB, HgBC

Question 67

OapA, HMW1, HMW2

Answer 67

adhesins

Question 68

Hemophilus influenzae invasive disease occurs during the age of relative humoral immunodeficiency

Answer 68

3 months to 3 years.

Question 69

Persons with the following diseases are usually susceptible:

Answer 69

Sickle Cell Disease Agammaglobulinemia Splenectomy Treated Hodgkin’s Disease

Question 70

Haemophilus influenzae diseases include clinical syndrome of infection of the membranes that surround the brain and spinal cord

Answer 70

meningitis

Question 71

Haemophilus influenzae Invasive diseases

Answer 71

meningitis, bacteremia or sepsis, epiglottitis, pneumonia, septic arthiritis, osteomyelitis, pericarditis, cellulitis

Question 72

Haemophilus influenzae noninvasive diseases

Answer 72

bronchitis, sinusitis, otitis media

Question 73

most common cause of bacterial meningitis primarily affecting children 9 months to 4 years of age in conjunction with episodes of Otitis media

Answer 73

H. influenzae

Question 74

most serious manifestation of Hib infection.

Answer 74

Meningitis

Question 75

is an infection of the membranes covering the brain and spinal cord. This covering is called the meninges..

Answer 75

Meningitis

Question 76

involves patchy inflammation in the bronchi and surrounding lung tissue,

Answer 76

Bronchopneumonia

Question 77

affects an entire lobe of the lung with consolidation.

Answer 77

lobar pneumonia

Question 78

is an infection of the membranes covering the brain and spinal cord. This covering is called the meninges

Answer 78

Meningitis

Question 79

involves patchy inflammation in the bronchi and surrounding lung tissue

Answer 79

Bronchopneumonia

Question 80

bacterial infection of the skin caused by staphylococcus or Streptococcus

Answer 80

Cellulitis

Question 81

common among children 6-24 months of age.

Answer 81

Cellulitis

Question 82

Characterized by a raised area with a distinctive reddish blue hue, usually located on one check or less commonly, in the periorbital area.

Answer 82

Cellulitis

Question 83

The buccal and periorbital regions are most commonly involved. Fever, indurations, and tender area in the head and neck particularly in the buccal and preseptal areas characterize the condition..

Answer 83

Cellulitis

Question 84

second most common infection of H. influenzae and is a life-threatening emergency.

Answer 84

Epiglotitis

Question 85

The infected epiglottis develops ___________ and the marked edema may cause complete _____________ requiring emergency tracheostomy

Answer 85

micro-abscesses ; airway obstruction

Question 86

Severe septicemia is often present; caused by

Answer 86

Serotype B.

Question 87

occurs during septic invasion with or without systemic disease

Answer 87

Pyarthosis

Question 88

CUTE SUPPURATIVE ARTHRITIS Also k/a:

Answer 88

•Acute pyogenic arthritis •Acute septic arthritis •Acute pyarthrosis •Acute infective arthritis

Question 89

Refer to presence of pus in the joint secondary to infection of the joint.

Answer 89

septic arthritis

Question 90

septic arthritis M:F ratio

Answer 90

5:1

Question 91

The knee is the commonest joint affected.Other joints commonly affected are the hip, shoulder, elbow etc.

Answer 91

septic arthritis

Question 92

Quickest and the best method of diagnosing septic arthritis.

Answer 92

Joint aspiration

Question 93

Pyarthrosis is typically caused by a bacterial infection in the joint.

Answer 93

Infectious arthritis

Question 94

requires drainage of the joint and antibiotics, usually intravenously administered.

Answer 94

Pyarthrosis

Question 95

is also referred to as suppurative, septic or bacterial arthritis.

Answer 95

Pyarthrosis

Question 96

The infection can spread through the bone cortex and under the periosteum, potentially leading to complications like septic arthritis or soft tissue infections.

Answer 96

Septic arthritis

Question 97

is septic inflammatory bone disease – that can be due to direct trauma, surgery or infection spread by blood

Answer 97

Osteomyelitis

Question 98

reduces local perfusion, as well as function of white blood cell in bacterial elimination, bone cells activity in removal of dead infected bone and formation of a new bone (osteoclast and osteoblast activity).

Answer 98

Hypoxia

Question 99

limits antibiotics therapeutic function to penetrate pus and inactivate microorganisms.

Answer 99

hypoxia

Question 100

effectively corrects tissue hypoxia and improves blood flow and bone metabolism for faster bone healing.

Answer 100

Hyperbaric oxygen therapy

Question 101

This refers to a strain of bacteria, Hemophilus influenzae that lacks a specific polysaccharide capsule, which means that it cannot be categorized into the typical serotypes (types a-f) used to identify different strains of the bacteria. This makes it difficult to classify hence, the term “nontypeable”, and is often associated with respiratory infections like otitis media (ear infections) and sinusitis, particularly in children

Answer 101

Nontypeable Hemophilus influenzae (NTHi)

Question 102

Other diseases (caused by non-encapsulated/ non-typeable strains)

Answer 102

a.) Otitis media b.) Sinusitis c.) Chronic bronchitis d.) Pneumonia in elderly patients e.) Genital tract infections

Question 103

The complications of bacterial sinusitis are caused by local spread of infection to the nearby bone and orbit and can even extend intracranially. Bony involvement leads to osteomyelitis, with the most common sites being the maxillary and frontal bones, the latter sometimes referred to as

Answer 103

“Pott’s puffy tumor.”

Question 104

This infection typically follows some kind of nasal blockage, which causes the mucus (produced by the mucous membranes) to build up and become a breeding ground for microorg

Answer 104

sinus infection

Question 105

inflammation of the bronchial tubes,

Answer 105

Bronchitis

Question 106

The most common cause of Acute Bronchitis

Answer 106

Viral Infections

Question 107

The less common cause of Acute Bronchitis

Answer 107

Bacterial Infections

Question 108

counterstain for Gram Staining in h.influenzae

Answer 108

Carbolfuchsin

Question 109

Culture Specimen for h. influenzae

Answer 109

Blood CSF Upper & Lower Respiratory Tract specimens

Question 110

Culture Media for h. influenzae

Answer 110

CAP in 5 – 10% CO2 supplemented with 300 mg/L Bacitracin

Question 111

purpose of bacitracin for culture medium for h.influenzae

Answer 111

to reduce overgrowth of normal respiratory flora.

Question 112

Characteristic Colony (h.influenzae

Answer 112

“Translucent, moist, flat, smooth and convex with a distinct pungent,“mousy” odor; produces a more grayish-appearing (grayish brown) colony.”

Question 113

Nonhemolytic on rabbit or horse blood agar.

Answer 113

h. influenzae

Question 114

small, smooth and translucent after 24 hours

Answer 114

Non-capsulated strain

Question 115

larger and more mucoid

Answer 115

Encapsulated strain

Question 116

Cultivation of Haemophilus influenzae

Answer 116

24 hours, 37 °C in an aerobic atmosphere enriched with 5% carbon dioxide.

Question 117

is a biochemical reaction in which antibodies bind to a bacterial capsule, allowing species with a positive Quellung reaction to be visualized under a microscope.

Answer 117

Quellung reaction

Question 118

agar can be used to isolate Hemophilus because these types of blood do not contain NADase.

Answer 118

Horse and Rabbit blood agar

Question 119

H. influenzae produces a ____________ smell that can differentiate it from N. meningitidis.

Answer 119

pungent indol smell

Question 120

alternative method for determining requirements for the X and V factors

Answer 120

Porphyrin Test

Question 121

The test is based on the ability of the organism to produce enzymes that convert δ amino- levulinic acid (ALA) into porphyrin or protoporphyrin.

Answer 121

Porphyrin Test