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MICROBIOLOGY (2ND YEAR) > HAEMOPHILUS, BORDETELLAE, BRUCELLAE, FRANCISELLA, YERSINIA AND PASTEURELLA, NEISSERIA > Flashcards

HAEMOPHILUS, BORDETELLAE, BRUCELLAE, FRANCISELLA, YERSINIA AND PASTEURELLA, NEISSERIA Flashcards

1
Q

• Small, Gram-negative, pleomorphic bacteria (do not have definite shape e.g. cocci, bacilli, or coccobacilli)
• Require special media (usually containing BLOOD or its derivatives) for isolation

  • FAMILY PASTEURELLACEAE
A

HAEMOPHILUS spp.

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2
Q

the major human pathogen under Haemophilus

A

HAEMOPHILUS INFLUENZAE

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3
Q

etiologic agent of chancroid (a sexually transmitted disease)

A

HAEMOPHILUS DUCREYI

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4
Q

Aggregatibacter aphrophilus

A

(H. aphrophilus , H. paraphrophilus)

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5
Q

REQUIRES
X
V
NON HEMOLYTIC

A

Haemophilus influenzae

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6
Q

REQUIRES
X
V
HEMOLYTIC

A

Haemophilus haemolyticus

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7
Q

REQUIRES X
DO NOT REQUIRE V
NON HEMOLYTIC

A

Haemophilus ducreyi

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8
Q

• Found on the mucous membranes of the URT in humans
• Important cause of meningitis in unvaccinated children, upper & lower respiratory tract infections in children and adults

A

HAEMOPHILUS INFLUENZAE

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9
Q

COCCOBACILLARY
COCCOID BACILLI
IN PAIRS OR SHORT CHAINS
EXPRESS A CAPSULE (ANTIGEN FOR TYPING)

A

HAEMOPHILUS INFLUENZAE

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10
Q

HAEMOPHILUS MEDIUM
flat, grayish,
translucent colonies
1-2 mm diameter
after 24 hours of incubation

A

CHOCOLATE AGAR

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11
Q

H.INFLUENZAE
GROW ON sheep blood agar if with

A

STAPHYLOCOCCI COLONIES
—SATELLITE PHENOMENON
—— RELEASE NICOTINAMIDE ADENINE DINUCLEOTIDE (NAD)

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12
Q

H. INFLUENZAE
MEDIA ENHANCES GROWTH

A

IsoVitaleX
—-contains X and V

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13
Q

TEST FOR THE IDENTIFICATION OF Haemophilus INFLUENZAE

A

SATELLITISM TEST

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14
Q

acts physiologically as HEMIN
(derived from blood)

A

FACTOR X

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15
Q

invasive infections

A

H. influenzae biotypes I and II

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16
Q

polyribitol ribosephosphate (PRP)
(a sugar alcohol phosphate)

A

Type b- capsular antigen

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17
Q

test with specific antiserum immunofluorescence

A

CAPSULE SWELLING TEST

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18
Q

Most H. influenzae organisms in the normal flora of
the URT are

A

NOT encapsulated NTHi-
Non-typeable H. influenzae

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19
Q

most commonly encountered
in serious infections in humans

A

Type b H. influenzae

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20
Q

NO EXOTOXIN

A

H.INFLUENZAE

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21
Q

antiphagocytic (helps them to evade
the human’s immune system) in the absence of
specific anticapsular antibodies

A

CAPSULE

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22
Q

capsule of type b H. influenzae is the major
virulence factor

A

PRP CAPSULE
POLYRIBITOL RIBOSE PHOSPHATE

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23
Q

MORE SEVERE TYPE OF H. INFLUENZAE

A

Type b H. influenzae

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24
Q

Two most common etiologic agents of bacterial OM & acute sinusitis:

A

• H. influenzae (mostly NTHi)
• Pneumococci

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25
Q

• Encapsulated organisms may reach the bloodstream, carried to the meninges, or establish in the joints
(septic arthritis)
• Fulminating obstructive laryngotracheitis with swollen,
cherry-red epiglottis in young children (prompt
tracheostomy, intubation)
• Pneumonitis, epiglottitis may follow URTI in small
children, old & debilitated people
• Bronchitis, pneumonia in adults

A

H. INFLUENZAE

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26
Q
  • Immunologic detection of antigens in spinal fluid using commercial kits
  • Gram stain
  • Nucleic acid amplification methods. Such as the PCR.
A

H. INFLUENZAE IDENTIFICATION

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27
Q

STANDARD MEDIUMFOR H. Influenzae

A

IsoVitaleX
enriched chocolate agar

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28
Q

• Test for X factor requirement :
o Inoculum incubated with _______________ Haemophilus organisms that do not require X factor synthesize porphobilinogen, porphyrins, protoporphyrin IX and heme.

A

gama- aminolevulinic acid

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29
Q

This indicates the presence of porphyrins so if we get a red fluorescence it is not a Haemophilus influenzae.

A

Red fluorescence under UV light.

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30
Q

INFANTS may have serum antibodies transmitted from their mothers
AT WHAT AGE

A

INFANTS UNDER 3 MONTHS

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31
Q

BY AGE ____
unimmunized children have naturally acquired anti- PRP antibodies that promote complement- dependent bactericidal killing and phagocytosis.

A

By age 3-5 years

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32
Q

H.INFLUENZAE TREATMENT

A
  1. AMPICILLIN
    — but 25% produce beta lactamases
  2. CEPHALOSPORINS ( CEFOTAXIMINE IV)
  3. CARBAPENEMS
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33
Q

LATE COMPLICATIONS OF INFLUENZA MENINGITIS:

A

Localized subdural accumulation of fluid w/c requires
surgical drainage.

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34
Q

Encapsulated H. influenzae type b is transmitted
from

A

person – to- person spread
by contaminated respiratory droplets

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35
Q

3 combination vaccines that contain
Haemophilus b conjugate vaccine:

A
  1. PRP -OMP – Hep B ( Merck & Co.,Inc)
  2. Dtap – IPV / PRP -T ( Sanofi Pasteur ,Inc)
  3. MenCY / PRP-T ( GlaxoSmithKline)
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36
Q

IN H. INFLUENZAE
IMMUNIZATION STARTS

A

age of 2 months
(3 doses at 2,4,6 months)

2 doses at 2,4 months ; booster dose between 12- 18 months.:

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37
Q

Koch- Weeks bacillus

A

HAEMOPHILUS AEGYPTUS

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38
Q

PINK-EYE CONJUNCTIVITIS
MILD TYPE

Brazilian purpuric fever-fever,purpura, shock ,&
death

A

HAEMOPHILUS AEGYPTIUS

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39
Q

• Causes CHANCROID ( soft chancre)
o A sexually – transmitted disease
o Ragged ulcer on the genitalia,with Marked swelling
and tenderness
o (+) Painful enlarged regional lymph nodes

A

HAEMOPHILUS DUCREYI

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40
Q

Small G(-) rods occur in strands in the lesions

A

HAEMOPHILUS DUCREYI

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41
Q

Requires X-factor but not V factor

grow best from scrapings of the ulcer base on chocolate agar containing
1% IsoVitaleX
vancomycin

incubated at 10% CO2 at 33°C.

A

HAEMOPHILUS DUCREYI

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42
Q

treatment for HAEMOPHILUS DUCREYI

A
  1. 1g Azithromycin oral
  2. Ceftriaxone IM
  3. Oral Ciprofloxacin —- 3 days
  4. Oral Erythromycin—- 7 days

HEALING - 2 WEEKS

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43
Q
  • whooping cough (pertussis)
  • Highly communicable and
  • important pathogen of human
A

Bordetella pertussis

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44
Q
  • Bordetella bronchicanis causes diseases in animals - (kennel cough for dogs, snuffles for rabbits),
    respiratory disease & rarely bacteremia in human
A

Bordetella bronchiseptica

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45
Q

• minute gram-negative coccobacilli resembling H. influenza
• capsule is present
• small faintly-staining G (-) rods identified by immunofluorescence staining;
• non motile

—- ATTACHED TO CILIATED CELLS

A

BORDETELLA PERTUSSIS

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46
Q

Bordet-Gengou medium
Regan Lowe

A

BORDETELLA PERTUSSIS

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47
Q

CULTURE BORDETELLA PERTUSSIS

Bordet-Gengou medium

A

[potato-blood-glycerol agar] with Penicillin G
0.5mg/mL

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48
Q

CULTURE BORDETELLA PERTUSSIS

REGAN LOWE

A

[charcoal-containing medium
with
horse blood,
cefalexin
amphotericin B

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49
Q

• Strict aerobe; Oxidase & catalase (+)
• Nitrate, citrate & urea (-)
• Forms acid but not gas from lactose and glucose
• Does not require X and V factors on subculture

A

BORDETELLA PERTUSSIS

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50
Q

B. PERTUSIS
Bordetella operons
bvgA:

A

bvgA: is a transcriptional activator of the
virulence genes

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51
Q

B. PERTUSIS
Bordetella operons
bvgS:

A

responds to environmental signals

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52
Q

mediate adhesion to ciliated epithelial cells -
essential for tracheal colonization

A

Filamentous hemagglutinin and fimbriae

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53
Q
  • similar to cholera toxin
  • promotes lymphocytosis, sensitization to
    histamine and enhanced insulin secretion
  • structure that reaches the bloodstream, thus, responsible for the systemic manifestations of pertussis disease
A

Pertussis toxin

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54
Q

inhibits phagocyte function

A

Adenylate cyclase toxin (ACT)

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55
Q

regulated by the bvg system

A

Dermonecrotic toxin (DNT)
Hemolysin

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56
Q
  • inhibits DNA synthesis in ciliated cells
  • responsible for the damage of ciliated cells
  • not regulated by bvg
A

Tracheal cytotoxin

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57
Q

ANTIGENIC STRUCTURES PATHOGENESIS, PATHOLOGY:
B. pertusis
- in the cell wall important in causing damage to the
epithelial cells of the URT

A

Lipooligosaccharide

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58
Q

SURVIVES FOR ONLY BRIEF PERIODS
NO vectors
RESPIRATORY ROUTE
blood is NOT invaded

A

BORDETELLAPERTUSSIS

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59
Q

B. PERTUSIS

liberate TOXINS and substances that irritate surface cells

A

coughing and marked lymphocytosis as defense

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60
Q

IN B. PERTUSIS
necrosis of parts of the

A

epithelium
PMN infiltration
peribronchial inflammation
interstitial pneumonia

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61
Q

obstruction of the smaller bronchioles by mucous plugs results in atelectasis and diminished oxygenation of the
blood

A

——convulsions in whooping cough

Seizures and convulsions with accompanying cough
(whooping) are manifestations of B. pertussis infection.

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62
Q

B. PERTUSIS
INCUBATION PERIOD

A

2 WEEKS

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63
Q

B. PERTUSIS
STAGES
- mild coughing and sneezing
- large number of organisms are sprayed
- in droplets
- patient is higly infectious but not very ill
- resembles common colds

A

“CATARRHAL” STAGE:

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64
Q

B. PERTUSIS
STAGES
- cough develops in explosive character
- characteristic “whoop” upon inhalation
- this often results to broken ribs in children

A

“PAROXYSMAL” STAGE:

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65
Q

B pertussis is a common cause of

A

—-PROLONGED COUGH (4-6 WEEKS)
—-WBC count high 16,000 – 30,000/mL, with absolute lymphocytosis (than PMN)
—-Convalescence is slow; may take months

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66
Q

o 50% sensitivity
o Most useful in identifying B. pertussis after culture
on solid media

A

DIRECT FLUORESCENT ANTIBODY (FA) TEST

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67
Q

Most sensitive method to diagnose pertussis

A

POLYMERASE CHAIN REACTION

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68
Q

SEROLOGY
AFTER EXPOSURE TO B. PERTUSIS

A

IgA
IgG
IgM

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69
Q

B.PERTUSIS TREATMENT

during catarrhal stage promotes
elimination of the organism

A

ERYTHROMYCIN

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70
Q

PREVENTION OF B. PERTUSIS

A

PERTUSSIS VACCINE
DTaP 2,4,6, 15-18 mos, booster at 4-6 y/o
Prophylactic use of erythromycin for 5 days

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71
Q

• Obligate parasites of animals and humans
• Located INTRACELLULARLY
• Inactive metabolically

A

BRUCELLAE

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72
Q

Causes BRUCELLOSIS (Undulant fever, Malta fever)

A

BRUCELLAE

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73
Q

Characterized by acute bacteremic phase followed by a chronic stage

A

BRUCELLOSIS

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74
Q

o Cocci to rods 1.2 um in length in young cultures, short coccobacillary forms predominating
o Gram-negative, often stain irregularly o Aerobic, nonmotile, non-spore forming

A

BRUCELLA MELITENSIS

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75
Q

Small convex smooth colonies on enriched media

o Use carbohydrates but produce neither acid nor gas o Catalase and oxidase (+)
o H2S produced by many strains (black color)
o Reduce nitrates to nitrites

A

Brucella melitensis

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76
Q

Routes of infection OF B. MELITENSIS

A

○ Intestinal tract (ingestion of infected milk)
○ Mucous membranes (droplets)
○ Skin (contact with infected tissues of animals)

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77
Q

Portal of entry OF B. MELITENSIS

A

lymphatic channels
regional LN
thoracic duct
bloodstream
parenchymatous organs

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78
Q

present with granulomatous nodules- these
develop into abscesses form in lymphatic tissue, liver,
spleen, bone marrow, other parts of the RES

A

BRUCELLOSIS

79
Q

growth factor for brucella
THAT CONTAINED IN
Placentas and fetal membranes of cattle, swine, sheep and goats

A

ERYTHRITOL

80
Q

should be inoculated and
observed frequently for positive results for Brucella

A

Christensen’s urea slant

81
Q

B.MELITENSIS
SEROLOGY

A

IgM —during first week
IgG —rise about 3 weks

IgA levels parallel to IgG levels

82
Q

BRUCELLA MELITENSIS
IgG agglutinin titers above 1:80 is indicative of active infection

A

Agglutination test

83
Q

BRUCELLA MELITENSIS

● Rapid immunocapture agglutination method based on the Coombs test (detects non-agglutinating IgG & IgA Abs)

A

Brucellacapt
(Vircell, Granada, Spain)

84
Q

BRUCELLA MELITENSIS

● IgA, IgG, IgM may be detected
● Uses cytoplasmic proteins as antigens.

A

ELISA assays

85
Q

TREATMENT
BRUCELLA MELITENSIS

A
  1. TETRACYCLINE
  2. RIFAMPIN
  3. TMP-SMX
  4. AMINOGLYCOSIDES
  5. QUINOLONES
86
Q

TREATMENT
BRUCELLA MELITENSIS

—-COMBINED TREATMENT

A

tetracycline + streptomycin or gentamicin for 2-3 weeks or rifampin for 6-8 weeks

—NOT READILY ELIMINATED FROM THE HOST

87
Q

most virurlent/ pathogenic

• Transmitted to humans by biting anthropods and flies, direct contact with infected animal tissue, inhalation of aerosols, ingestion of contaminated food or water

A

FRANCISELLA TULARENSIS

88
Q

Culture: requires enriched media containing
- cysteine chocolate agar
- modified Thayer-martin agar
- buffered charcoal yeast extract (BCYE) agar
- incubated in CO2 at 35-37 degrees C for 2-5 days
o need for a biosafety level 3 when there is a need to process specimens

A

FRANCISELLA TULARENSIS

89
Q

Serology:
- Polysaccharide antigen and > 1 protein antigen/s
that cross-react with brucellae

A

FRANCISELLA TULARENSIS

90
Q

FRANCISELLA TULARENSIS
major bio groups of strains

  • produces severe illness in
    humans, ferments glycerol anf contains
    citulline ureidase
A

Jellison type A

91
Q

FRANCISELLA TULARENSIS
major bio groups of strains

  • produces milder disease in
    humans usual anti-body response consists of agglutinins developing 7-10 days after the onset of illness
A

Jellison type B

92
Q

-ULCERS
- LYMPHADENOPATHIES

A

TULAREMIA

93
Q

o Inflammatory, ulcerating papule
o regional lymph nodes enlarge and become
necrotic, sometimes draining for weeks

A

Ulceroglandular tularemia

94
Q

o Peribronchial inflammation is due to the inhalation of an infective aerosols
o Localized pneumonitis

A

Pneumonic tularemia

95
Q

o Yellowish granulomatous lesions on the eyelids
o Preauricular adenopathy

A

Oculoglandular tularemia

96
Q

o Lymphadenopathy but no ulcers

A

Glandular tularemia

97
Q

Involves the mouth and pharynx

A

Oropharyngeal tularemia

98
Q

SEPTICEMIA

o Spread of the Francisella Tularensis in the
circulation

A

Typhoidal tularemia

99
Q

Serologic studies
o Rise in agglutination titer in paired serum samples
collected 2 weeks apart
o Single serum titer of 1: 160 or a microagglutination
titer of > 1:128 highly suggestive of history and
physical findings are compatible with the diagnosis

A

FRANCISELLA TULARENSIS

100
Q

TREATMENT OF

FRANCISELLA TULARENSIS

A

• Streptomycin
• Gentamycin for 10 days- rapid improvement
• Tetracycline
• Chloramphenicol
• Ciprofloxacin
• Resistant to all beta-lactam antibiotics

101
Q

BIPOLAR STAINING
SAFETY PIN APPEARANCE

• Short, pleomorphic Gram-negative rods that often exhibit bipolar staining

A

YERSINIA

102
Q

• High mortality (40 – 100%)
• “Black Death”
• Potential use as an agent of Biowarfare

A

PLAGUE

103
Q

• Gram negative rod
• Exhibits striking bipolar staining with special stains such as
Wright, Giemsa, Wayson, or methylene blue • Nonmotile
• Grows as a facultative anaerobe on many bacteriologic media
• Growth is more rapid when agar are incubated at 28°C.
• Cefsulodin-irgasan-novobiocin (CIN) agar incubated at 25–
28°C

A

YERSINIA PESTIS

104
Q

•Colonies are typically gray to white, sometimes opaque, and are 1–1.5 mm in diameter with irregular edges; the organism does not produce hemolysis

A

YERSINIA PESTIS

105
Q

YERSINIA PESTIS
ANTIGENIC STRUCTURE

A
  1. V and W antigens
  2. Ppcp1
  3. pFra/pMT plasmid
106
Q

encoded by genes on a plasmid of approximately 70 kb (virulence) – V and W antigens yield the requirement for calcium for growth at 37 °C

A

V and W antigens

107
Q

9.5-kb plasmid that contains genes that yield plasminogen-activating protease that has temperature-dependent coagulase activity (20- 28°C, the temperature of the flea) and fibrinolytic activity (35-37 °C, the temperature of the host).

This factor is involved in the dissemination of the organism from the flea bite injection site.

A

Ppcp1

108
Q

encodes the capsular protein (fraction F1)
that is produced mainly at 37 °C and
confers antiphagocytic properties;
contains genes that encode phospholipase D
(required for organism survival in the flea midgut)

A

pFra/pMT plasmid

109
Q

have a pathogenicity island (PAI) that encodes for an iron-scavenging siderophore, yersiniabactin

A
  1. Y. pestis
  2. Y. enterolitica
110
Q

Flea feeds on a rodent infected with Y. pestis à ingested organisms multiply in the gut of the flea (+ coagulase) à block its ______

A

proventriculus

111
Q

Bacteria multiply at ______, produce the antiphagocytic proteinàresist phagocytosis

A

37°C

112
Q

often reach the bloodstream and become widely disseminated cause sepsis

A

YERSINIA PESTIS

113
Q

YERSINIA PESTIS
TYPE OF PLAGUE

MOST common clinical manifestation of Yersinia infection.
It is manifested by high fever and painful lymphadenopathy, commonly with greatly enlarged, tender nodes (buboes) in the neck, groin, or axillae.

A

Bubonic Plague

114
Q

YERSINIA PESTIS
TYPE OF PLAGUE

• This is a result of the direct inhalation of the organism into the lungs
—CLOSE AND DIRECT CONTACT, DROPLET INFECTION

A

Pneumonic Plague

115
Q

YERSINIA PESTIS
TYPE OF PLAGUE

• May be a complication of untreated Bubonic plague.
• Y. pestis multiplies intravascularly and can be seen in blood smears; sudden onset of high fever, chills, and weakness, progressing rapidly to septic shock

A

Septicemic Plague

116
Q

SMEARS
Ø Small gram-negative bacilli that appear as single cells,
as pairs or short chains in clinical material
Ø Striking bipolar appearance (safety pin shape)

A

YERSINIA PESTIS

117
Q

CULTURE
• Blood agar, chocolate, and MacConkey agar plates,
brain–heart infusion

A

YERSINIA PESTIS

118
Q

produces non-lactose-fermenting colonies
on MacConkey agar,
grows better at 25°C than at 37°C;
catalase (+);
indole, oxidase, and urease (-);
nonmotile

A

YERSINIA PESTIS

119
Q

Definite identification of cultures is best done by immunofluorescence or by lysis

A

YERSINIA PESTIS

120
Q

YERSINIA PESTIS
MORTALITY RATE:

A

50%
100% (PNEUMONIC PLAGUE)

121
Q

TREATMENT FOR YERSINIA PESTIS

A
  1. STREPTOMYCIN
  2. GENTAMICIN

ALTERNATIVES
—-DOXYCYCLINE
—-CIPROFLOXACIN
—-OTHER QUINOLONES (combination with streptomycin or gentamicin)

122
Q

does not form spores and is extremely susceptible to UV radiation (sunlight) and dessication

A

YERSINIA PESTIS

123
Q

CAPSULE +
FLAGELLA -

ALL NEGATIVE:
GAS
GRAM STAIN
H2S
HEMOLYSIS

A

YERSINIA PESTIS

124
Q

YERSINIA PESTIS
FERMENTATION OF:

GLUCOSE
MALTOSE
MANNITOL
LACTOSE
SUCROSE

A

GLUCOSE. +
MALTOSE. +
MANNITOL. +
LACTOSE. -
SUCROSE. -

125
Q

Gram-negative, nonmotile coccobacilli.
bipolar appearance on stained smears

• Aerobes or facultative anaerobes that grow readily on ordinary bacteriologic media at 37 °C
• Oxidase (+), catalase (+)

A

PASTEURELLA MULTOCIDA

126
Q

History of bites from cats and dogs.

A

PASTEURELLA MULTOCIDA

127
Q

• History of animal bite followed within hours by an acute onset of redness, swelling and pain
• Regional lymphadenopathy is variable
• Low grade fever

A

PASTEURELLA MULTOCIDA

128
Q

TREATMENT OF:
PASTEURELLA MULTOCIDA

A

DOC: PENICILLIN G
—Susceptible to most antibiotics

ALTERNATIVE:
—- TETRACYCLINE
—- FLUOROQUINOLONES

129
Q

• Gram (-) diplococci, kidney bean-shaped
• Aerobic, non-motile, non-hemolytic

A

NEISSERIA SPECIES

130
Q

TYPE OF NEISSERIA THAT
are exclusively pathogenic for humans and are typically found with or inside PMNs

A

NEISSERIA GONORRHOEAE (GONOCOCCI)
NEISSERIA MENINGITIDIS (MENINGOCOCCI)

131
Q

NO CAPSULE
+ PLASMID
GENITAL INFECTIONS
ENRICHED CHOCOLATE AGAR
+GREENISH COLOR
GLUCOS ONLY
NO VAX

A

NEISSERIA GONORRHOEAE (GONOCOCCI)

132
Q

+ POLYSACCHARIDE CAPSULE
-/RARE PLASMID
URT INFECTIONS, MENINGITIS
CHEP BLOOD AGAR
GLUCOSE AND MALTOSE
WITH VAX

A

NEISSERIA MENINGITIDIS (MENINGOCOCCI)

133
Q

SAME FOR:

NEISSERIA GONORRHOEAE (GONOCOCCI)
NEISSERIA MENINGITIDIS (MENINGOCOCCI)

A

+ PILI
+ PORINS
OKAY WITH ML AGAR

134
Q

NEISSERIA

OXIDASE + OR -

A

NEISSERIA IS
OXIDASE +

135
Q

Convex, glistening, elevated, mucoid colonies 1-5 mm in diameter.

A

N. meningitidis on BAP

136
Q

• Antigenically heterogenous and capable of changing its surface structure in vitro and in vivo to avoid host defenses

A

Neisseria gonorrhoeae (Gonococci)

137
Q

MEDIUM FOR
NEISSERIA gonorrhoeae (Gonococci)

A

MODIFIED THAYER MARTIN AGAR

138
Q

Hairlike appendages
IN NESSERIA GONORRHOEAE (GONOCOCCI)

A

PILI (FIMBRIAE)

139
Q

PILI (FIMBRIAE) M/O OF

A

PILIN PROTEINS

140
Q

Facilitates adhesion of the gonococci to host cell receptors
USEFUL METHOD OF STRAIN TYPING

A

OPA PROTEINS

141
Q

FORM PORES

A

POR PROTEINS

142
Q

ASSCOCIATED WITH POR IN THE FORMATION OF PORES IN THE CELL SURFACE

A

RMP (PROTEIN III)

143
Q

—ATTRIBUTE TO ENDOTOXIC EFECTS OF GONOCOCCAL INFECTIONS
—CAN CAUSE CILIARY LOSS AND MUCOSAL DEATH IN THE FALOPIAN TUBE
—MIMICS HUMAN CELL MEMBRANE GLYCOSPHINGOLIPIDS TO EVADE IMUNE RECOGNITION

A

LIPOOLIGOSACCHARIDE

(NO LONG O-ANTIGEN)

144
Q

Expressed when available iron supply is limited

A

FBP
FERRIC BINDING PROTEIN

145
Q

Splits and inactivates IgA1 in mucosal immunity.

A

IgA1 PROTEASE

146
Q

PATHOGENESIS OF NEISSERIA

A

ATTACKS MUCOSAL EPITHELIUM

147
Q

Single exposure: 20-30% risk for men

A

GREATER RISK FOR WOMEN (NEISSERIA)

148
Q

PROTECT AGAINST PHAGOCYTOSIS

A

GONOCOCCAL OMPS

149
Q

N.GONORRHOEAE IN MEN

A

MORE SYMPTOMATIC

150
Q

Urethritis (yellow, creamy pus and dysuria) or referred to as “Tulo” in Filipino, it can ascend and extend to epididymitis, and long-term cause urethral strictures due to fibrosis.

A

N. GONORRHOEAE IN MEN

151
Q

mucopurulent discharge in urethra and vagina, salpingitis, fibrosis, obliteration of the fallopian tubes→infertility in 20% of all infected patients.

A

IN WOMEN
N. GONORRHOEAE

152
Q

Hemorrhagic papules
and pustules on hands, forearms, feet and legs, tenosynovitis and suppurative arthritis of knees, ankles and wrists.

A

GONOCOCCAL BACTEREMIA

153
Q

• Eye infection in newborns acquired during passage through an infected birth canal wherein there is mucopurulent discharge in the eyes of the neonate.
• Rapidly progressive conjunctivitis that may result to blindness if untreated.

A

GONOCOCCAL OPTHALMIA NEONATORUM

154
Q

GONOCOCCAL OPHTHALMIA NEONATORUM
PREVENTION:

A

0.5% erythromycin ointment
or
1% tetracycline ointment
into the conjunctival sac of newborns.

155
Q

GONOCOCCAL OPHTHALMIA NEONATORUM
TREATMENT:

A

Ceftriaxone 250 mg IM single dose
+ Azithromycin 1g orally single dose,
both administered on the same day

156
Q

GONOCOCCAL OPHTHALMIA NEONATORUM
RESISTANT TO:

A

PENICILLIN G

157
Q

N. meningitidis (meningococci)
SEROGROUPS

A
  1. ABCXY
  2. W-135
158
Q

______ are the only natural hosts where
meningococci are pathogenic.

A

HUMANS

159
Q

BLOODSTREAM INFECTION CAUSED BY N.MENINGITIDIS

A

MENINGOCOCCAL BACTEREMIA

160
Q

Thrombosis of many small blood vessels with perivascular infiltration and petechial hemorrhages.

A

Fulminant meningococcemia

161
Q

FULMINANT MENINGOCOCCEMIA

High fever, hemorrhagic rash disseminated intravascular coagulation, circulatory collapse with hemorrhagic necrosis of the adrenal glands and subsequent adrenal failure

A

WATERHOUSE- FRIEDERICHSEN SYNDROME).

162
Q

the most common complication OF N.MENINGITIDIS

A

MENINGITIS

163
Q

IN GROS EXAMINATION OF N.MENINGITIDIS:

A

In gross examination, meninges are inflamed, thrombosis of blood vessels, exudation of PMN so that the brain surface is covered with thick “cheese-like” purulent exudate.

164
Q

TREATMENT OF N.MENINGITIDIS

A
  1. PENICILLIN
  2. CHLORAMPHENICOL
  3. CEFOTAXIME
  4. CEFTRIAXONE
165
Q

FLU LIKE INFECTION

A

INVASIVE MENINGOCOCCAL DISEASE (IMD)

166
Q

N. MENINGITIDIS TREATMENT:

A

PENICILLIN G

if with allergy
—-CHLORAMPHENICOL
—-3RD GENCEPHALOSPORINS

167
Q
  1. This is the transport medium used when collecting fecal
    specimen suspected of Vibrio cholerae. *
    a) Aimes
    b) Cary-Blair
    c) Buffered glycerol
    d) Any of the above may be used
A

Answer: b. Cary-Blair
Stool specimens suspected of containing Vibrio spp. should be collected and transported in Cary-Blair medium.

Buffered glycerol saline is not acceptable, because glycerol is toxic
to vibrios. Feces is preferable, but rectal swabs are acceptable
during the acute phase of diarrheal illness.

168
Q
  1. This is the characteristic appearance of Vibrios on dark-field
    microscopy. *
    a) shooting-star motility
    b) “fried-egg” appearance
    c) swarm of fish motility
    d) none is correct
A

Answer: b. shooting-star motility
The characteristic appearance of Vibrios using stool specimen on
dark-field microscopy – exhibit characteristic rapid
darting or shooting-star motility.

169
Q
  1. This test differentiates Aeromonas from Yersinia enterolitica. *
    a) Catalase test
    b) Oxidase test
    c) Beta-hemolysis
    d) Triple sugar iron
A

Answer: b. Oxidase test
Oxidase test must be performed to differentiate Aeromonas from
Yersinia Enterolitica

170
Q
  1. This test differentiates Vibrios from Aeromonas spp. *
    a) Catalase test
    b) Beta-hemolysis
    c) String test
    d) Oxidase test
A

Answer: c. String test
String test is used to differentiate Vibrio from Aeromonas spp
Both organisms are emulsified in 0.5% sodium deoxycholate,
which lyses Vibrio cells, but not those of Aeromonas spp
Vibrio cell lysis releases DNA, which can be pulled up into a string
with an inoculating loop.

171
Q
  1. When testing for Vibrios, this substance is added to TCBS agar
    which inhibits the growth of other intestinal microbiota. *
    a) Thymol blue
    b) Safranin
    c) Acridine orange
    d) Carbol fuchsin
A

Answer: a. Thymol blue
Bromothymol blue and thymol blue - pH indicators that are added
to TCBS; their high pH (8.6) inhibits the growth of other intestinal
microbiota.

172
Q
  1. This non-invasive is test is commercially available and is used
    for presumptive identification of Helicobacter. *
    a) ELISA antigen
    b) PCR immunoassay
    c) Urease test
    d) DNA amplification
A

Answer: c. Urease test
For presumptive identification of Helicobacter, UREASE test used
– a non-invasive test. Place a portion of crushed tissue biopsy
material directly into urease broth, onto commercially available
urease agar kits, or on a paper strip containing a pH indicator
A positive test is considered indicative of the organism’s presence

173
Q
  1. The incubation period of Helicobacter spp before colonies are
    observed.
    a) 1-4 days
    b) 4-7 days
    c) 1-7 days
    d) 7-10 days
A

Answer: b. 4-7 days
Colonies of Helicobacter spp. may require 4 to 7 days of incubation before small, translucent, circular colonies are observed. Culture plates should be reviewed daily for a minimum of 10 days before a negative culture is reported.

174
Q
  1. This particular species require microaerobic environment for
    incubation in order to produce gray to pink or yellow gray colonies.
    a) Aeromonas
    b) Vibrios
    c) Campylobacter
    d) Helicobacter
A

Answer: d. Campylobacter
Campylobacter have different optimum temperatures, hence two sets of selective plates should be incubated
Filtration method can also be used in conjunction with a nonselective medium to enhance recovery of Campylobacter spp A filter (0.65-mm pore-size cellulose acetate) is placed on the agar surface, and a drop of stool is placed on the filter. The plate is incubated upright. After 60 minutes at 37°C, the filter is removed
and the plates are reincubated in a microaerobic atmosphere. Take Note: Campylobacter require a microaerobic environment as previously indicated; however, not all species will grow in this environment.

175
Q
  1. Recovery of Campylobacter from stool specimens is best
    enhanced by the following media: *
    a) Modified Skirrow
    b) Campy-brucella agar base
    c) charcoal-based selective medium
    d) all may be used
A

Answer: d. All may be used
All may be used as selective media for Campylobacter spp.

176
Q
  1. This method of recovery of campylobacter from stool makes us
    of a non-selective medium PLUS a cellulose acetate filter that is
    placed on the agar surface. *
    a) Filtration method
    b) Centrifugation method
    c) Broth enrichment method
    d) none is correct
A

Answer: a. Filtration method
Filtration method can also be used in conjunction with a
nonselective medium to enhance recovery of Campylobacter
species.
A filter (0.65-mm pore-size cellulose acetate) is placed on the agar
surface, and a drop of stool is placed on the filter.
The plate is incubated upright. After 60 minutes at 37°C, the filter
is removed and the plates are re-incubated in a microaerobic
atmosphere.
The organisms are motile and capable of migrating through the
filter,
producing isolated colonies on the agar surface and effectively
removing contaminating stool microbiota.

177
Q
  1. In Gram staining Haemophilus spp, this dye is used to detect
    smaller number of organisms that may be undetectable. *
    a) carbol fuchsin
    b) Kinyoun
    c) acridine orange
    d) thymol blue
A

Answer: c. acridine orange
ACRIDINE orange is used to detect smaller numbers of
Haemophilus that may be undetectable by Gram staining. It stains
a pale pink and may be difficult to detect in the pink background of
proteinaceous material often found in clinical specimens.

178
Q
  1. Which of the following statement/s correctly describe the
    collection of specimens for Haemophilus spp? *
    a) When obtaining samples from genital ulcers, the area
    should be moistened with cotton swab dipped in
    povidone iodine.
    b) Blood cultures should be obtained if infection is highly
    suspected.
    c) Specimens may be placed at room temperature up to 4
    hours.
    d) all statements are correct
A

Answer: d. all statements are correct
In Laboratory identification of Haemophilus blood cultures should
be obtained for infections (pneumonia) and suspected infections of
other sterile body fluids (CSF). Recovery of H. ducreyi from genital
ulcer ulcer should be cleaned with sterile gauze moistened with
sterile saline (e.g., Povidone Iodine). A cotton swab moistened
with phosphate-buffered saline is then used to collect material from
the base of the ulcer, then the swab must be plated to special
selective media within 10 minutes of collection.

179
Q
  1. The optimal temperature required by H. ducreyi to achieve
    growth of colonies. *
    a) 30 deg C
    b) -30 deg C
    c) 30 deg F
    d) -30 deg F
A

Answer: a. 30 deg C
H. ducreyi grows optimally at a temperature of 33 °C.

180
Q
  1. This is a selective medium which is also used to isolate H.
    influenzae from respiratory secretions of patients with cystic
    fibrosis.
    a) horse blood agar
    b) fresh rabbit blood agar
    c) horse blood-bacitracin agar
    d) none is correct
A

Answer: c) horse blood-bacitracin agar
Horse blood–bacitracin agar- a selective medium which may be
used for isolation of H. influenzae from the respiratory secretions
of patients with cystic fibrosis
-also designed to prevent overgrowth of H. influenzae by mucoid
Pseudomonas aeruginosa.

181
Q
  1. The purpose of adding vancomycin in the selective media in
    isolating H. ducreyi is to ~ *
    a) inhibit gram-negative colonizers in the GIT
    b) inhibit gram-positive colonizers in the GIT
    c) promote aerobic growth
    d) promote anaerobic growth
A

Answer: b. inhibits gram-positive colonizers in the GIT
The vancomycin inhibits gram-positive colonizing organisms of the
in the selective media in isolating H. ducreyi.

182
Q
  1. This test is used to identify Haemophilus influenzae type B
    strains. *
    a) serotyping
    b) slide agglutination test
    c) both are correct
A

Answer: c. both are correct
In identification of H. influenzae both serotyping and slide
agglutination test.

183
Q
  1. The differentiation of Pasteurella multocida from the other
    Pasteurella spp is: *
    a) positive ornithine decarboxylase and negative urease tests
    b) negative ornithine decarboxylase and negative urease tests
    c) positive ornithine decarboxylase and positive urease
    tests
    d) negative ornithine decarboxylase and positive urease tests
A

Answer: a. positive ornithine decarboxylase and negative
urease tests
P. multocida can be differentiated from other Pasteurella spp. on
the basis of positive reactions for ornithine decarboxylase and
indole, with a negative reaction for urease.

184
Q
  1. Mode of transmission of Pasteurella infections *
    a) dog scratch
    b) cat bite
    c) animal dander
    d) animal droplet
    e) options 1 and 2 are correct
A

Answer: e. options 1 and 2 are correct
Species of Pasteurella mode of transmission to are the following:
humans by contact with infected animals, usually following bites or
scratches from cats or dogs. Respiratory tract infections may occur
through airborne transmission. Refer to the table below.

185
Q
  1. The best time to obtain cultures for Francisella is ~ *
    a) first 2 weeks of symptoms.
    b) first 4 weeks.
    c) no special requirement for collection.
    d) none is correct.
A

Answer: a. first 2 weeks of symptoms
Francisella spp are most sensitive early in the illness and
organisms may become undetectable by culture 2 weeks after the
start of paroxysms.

186
Q
  1. Indications of a possible tularemia infection are the following,
    EXCEPT: *
    a) on Gram stain, poorly staining gram-negative rods as
    single cells without distinct cell forms
    b) subcultures yielding pinpoint colonies on chocolate agar
    c) positive satellite on X and V tests
    d) prolonged incubation on chocolate agar
A

Answer: c. positive satellite on X and V tests
Indications of a possible Francisella spp.
-on gram stain, poorly staining gram-negative rods as single cells
without distinct cell forms
-subcultures yielding pinpoint colonies on chocolate agar
-requires prolonged incubation on chocolate agar

187
Q
  1. When collecting specimen for a possible Legionella infection,
    the following is used for antigen testing? *
    a) respiratory secretions
    b) urine
    c) body fluids
    d) all are correct
A

Answer: d. all are correct
Legionella specimen that can be used for testing:
-Respiratory secretions: expectorated sputum and lower
respiratory tract secretions
-Pleural fluid: has not yielded has not yielded many positive c
- Blood
- Transbronchial biopsy/aspirates
-Urine: for antigen testing

188
Q
  1. The purpose of adding charcoal into the agar plate for
    Legionella is to ~ *
    a) detoxify the medium
    b) remove carbon dioxide
    c) modify the surface tension of the medium to allow the
    organisms to proliferate easily
    d) all are correct
A

Answer: d. all are correct

189
Q
  1. The characteristic appearance of Legionella colonies. *
    a) cut-glass internal granular speckling
    b) swarming motility
    c) shooting star appearance
    d) mosaic appearance
A

Answer: a. cut-glass internal granular speckling
After incubating Legionella incubated at 35°C to 37°C in a humid
using either BCYE and buffered charcoal yeast extract agar, at 5
days, colonies are 3 to 4 mm in diameter, gray-white to -,
glistening, convex, and circular and may exhibit a cut-glass type of
internal granular speckling

190
Q
  1. Legionella species stain poorly in Gram stain if safranin or
    neutral red is used as counterstain. The substitute stain is ~ *
    a) phenol red
    b) methylene blue
    c) 0.1% fuchsin
    d) carbol fuchsin
A

Answer: c. 0.1% fuchsin
Legionella species stain poorly in the gram procedure if neutral red
or safranin is used as the counterstain.
This characteristic is related to the composition of the cell walls,
which have large amounts of branched-chain cellular fatty acids
The use of 0.1% fuchsin substituted for safranin may enhance the
organism’s visibility.

191
Q
  1. What is the best course of action when Legionella specimens
    from non-sterile sites are submitted for culture? *
    a) process just like other specimen
    b) use non selective media
    c) pre-treat the specimen to reduce the number of
    contaminating organisms
    d) all are correct
A

Answer: c. pre-treat the specimen to reduce the number of
contaminating organisms
When Legionella specimens collected are from nonsterile body
sites are submitted for culture, treatment of the specimen should
be done first to reduce the numbers of contaminating organisms.

192
Q
  1. Presumptive identification of Brucella species *
    a) catalase positive
    b) catalase negative
    c) oxidase positive
    d) oxidase negative
    e) translucent gamma-hemolytic colonies after 48H
    f) opaque beta-hemolytic colonies after 24H
A

Answer: a.catalase positive
b.oxidase positive
c.translucent gamma-hemolytic colonies after 48H
Brucella spp. are catalase and urease positive, and most strains
are oxidase positive, its colonies appear small, convex, smooth,
translucent, gamma-hemolytic, and slightly yellow and opalescent
after at least 48 hours of incubation.

193
Q
  1. These organisms are closely related to Brucella abortus and
    grow best on cell coculture systems. *
    a) Bartonella
    b) Pasteurella
    c) Legionella
    d) Francisella
A

Answer: a. Bartonella
Other non-fermentative gram-negative coccobacilli that may be
confused with Brucellae are Bordetella, Moraxella, Kingella, and
Acinetobacter spp.

194
Q
  1. Common cultivation methods for Bartonella. *
    a) direct inoculation on agar plates
    b) shell-vial centrifugation
    c) cocultivation in cell culture
A

Both shell-vial centrifugation and cocultivation in cell culture are widely used methods for isolating and culturing Bartonella species. These methods are employed because Bartonella bacteria are fastidious and may require specific conditions or host cells to grow successfully in laboratory culture.

MICROBIOLOGY (2ND YEAR) (6 decks)

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