neiserrias

Question 1

Neiserrias

• Structure
• Location

Answer 1

Gram Neg DIPLOCocci

• gram neg - outer membrane present; thin cell wall peptidoglycan
• LPS - endotoxin
• N. Meningitidis has CAPSULE
• • A B C Y W135
• N. Meningitidis normal 10% NP carriage
• N. Gonorrhea is disease only; genital, sex sites

Question 2

N Meningitidis vaccine

Answer 2

Made from Polysaccaride Capsule

• A B C Y W135 - note these are Serogroups
• • B may not have

B for subcapsular antigens;

Question 3

N. Meningitidis transmission and country to note

Answer 3

Respiratory droplets;

Meningitis belt across Africa;

Question 4

Meningococcal Diseases + abit of pathophysiology

Answer 4

Think BLEEDING - hemorrhages

Hemorrhagic RASH (non blanching rash)

• PPE
• Purpura, Petechiae, Ecchymoses
• Endotoxin breaks down vessels; Sepsis; DIC, deplete clotting factors, Hemorrhage

Waterhouse-Friderichsen syndrome: haemorrhage into suprarenal glands = hemorrhagic adrenalitis

Meningitis

Question 5

Meningococcal investigation

Answer 5

BLOOD CULTURE

- CSF, throat where indicated;

Question 6

Meningococcal treatment

Answer 6

Pen G, Benzylpenicillin IV

Ceftriaxone IV/IM - CLEARS THROAT CARRIAGE;

Question 7

3 Types of Meningococcal vaccine

Sg? Given to who

Answer 7

Capsular Polysaccharide
- A C Y W135

Conjugated + Protein

B Subcapsular

No not routine in SG;

No spleen; Hajj pilgrims (at Saudi Arabia), Meningitis Belt

Question 8

So rash and GN cocci

Answer 8

Think N. Meningitidis;

Question 9

N. Gonorrhea

• Structure
• Agar
• Investigation

Answer 9

Gram Neg diplococci
Chocolate Agar; Is intracellular! CO2 enriched; selective medium; (chlamydia is IC also; but treponema is not)

Males
- Gram stain Urethra, supposed to be sterile - diagnostic

Females
- sample no point Endocervix

Nucleic Acid Test - MAINSTAY

• can swab everywhere - throat, rectal, urethral, endocervical, lower vagina for urethra; urine
• – Needs columnar epithelium hence pharynx ok vagina not okay

you say me one time 2 time ok;

Question 10

N. Gonorrhea presentations, damages

Answer 10

Male

• urethra discharge
• dysuria
• spread: prostatitis, epididymitis

Female

• infection, discharge, intermenstrual bleeding
• Salpingitis, PID;
• liver infection, FHC syndrome Fitz-Hugh-Curtis syndrome is a complication of pelvic inflammatory disease (PID)
• • FHC is Cx of PID due to perihepatic adhesions
• • both Gonorrhea and Chlamydia can cause this

Neonates

• ophthalmia neonatorum (chlamydia also can)
• • most common chlamydia

Question 11

Gonorrhea treatment and R
Vaccine?
Routine test by?

Answer 11

Azithromycin (PO)
+
Ceftriaxone (IM)

R to penicillin, and ciprofloxacin
- R cos of both PBP and Beta lactamases

NO Vaccine
Routine test by NAT urine