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Nervous Bacterial Infections Flashcards

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1
Q

Which neuro are nationally reportable infections

A

Tetanus Botulism Neisseria Meningitis Listeria Monocytogenes

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2
Q

normal biota of nervous stem:

A

None

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3
Q

Tetanus caused by

A

clostridium Tetani Gram + rod spore forming obligate anaerobe*

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4
Q

symptoms of Tetanus

A

Spastic Paralysis*** lock jaw- inability to open mouth due master muscle spasm nuchal rigidity and dysphagia

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5
Q

Risus sardonicus seen:

A

in tentanus scornful smile due to facial muscle involvement

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6
Q

morphological description of tetanus

A

non encapsulated rod with spores located at one end of rod TURKEY LEG? TENNIS RACKET

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7
Q

what do tetanus spores need to germinate?

A

anaerobic conditions: wounds that have low oxidation reduction potential ( DEAD tissue)

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8
Q

toxin that tents spores produce on germination

A

tetanolysin: hemolysin with no path activity TETANOSPAMIN: one of the MOST potent toxins known – blocks release of inhibitory neurotransmitter (GABA) : so muscles do NOT relax

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9
Q

can tetanospamin toxin be tx?

A

once the toxin binds to neurons it CANNOT be neutralized with antitoxin - recovery requires sprouting of new nerves– takes 2-4 m (go back to normal)

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10
Q

clinical types of tetanus

A

generalized- at wound and spread to lymphatics localized- persistent rigidity at muscle group close to injury cephalic- head injury/ otitis neonatal

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11
Q

Tetanus neonatorum caused by

A

infection of unhealed umbilical stump: cut with contaminated instrument major cause of infant mortality in undeveloped countries poor prognosis

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12
Q

tet to diagnose tetanus

A

spatula test - touch oropharynx to elicit gag reflex (-) - with tetanus: reflex spasm of masseter and they will BITE the spatula difficult to culture c. tetani

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13
Q

Tx for tetanus

A

supportive therapy debridement to get rid of dead tissue immediate tc w human tetanus immune globulin – to lessen course of tetanus

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14
Q

antibiotic for tetanus*

A

metronidazole

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15
Q

vaccination for tetanus

A

DTaP < 7 2 4 6 15-18 (Diptheria, tetanus, acelular pertussis) tdap > 7 years old adults Td every 10 years

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16
Q

preggo women vaccination tentanus

A

single dose of Tdap every pregnancy

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17
Q

what if you’ve never been vaccinated for tetanus

A

Tdap and then td 4 weeks later and td every 10 years

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18
Q

tetanus PEP dirty v clean

A

admonished tetanus toxoid (Td) vaccine if vaccine history is unknown or if records show less than 3 tetanus immunizations clean wound: > 10 y administer vaccine dirty wound > 5 y

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19
Q

bacteria that cause botulism

A

Clostridium botulism* clostridium butycurum Clostridium baraati

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20
Q

morphology of botulism bacteria

A

Gram+ rods spore forming grow in low oxygen conditions

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21
Q

human botulism caused by which serotypes?

A

A [most potent one] B E (main ones) and F

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22
Q

is botulism nationally reportable

A

YES

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23
Q

forms of botulism

A

food infant wound- into blood stream adult intestinal toxemia- rare iatrogenic

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24
Q

food botulism

A

ingesting pre formed toxin symptoms 18-36 h public health emergency

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25
infant botulism
caused by consuming spores of botulism bacteria which then germinate and release the toxin (kiddos don't have healthy gut flora that prevents clostridium from setting up shop)
26
iatrogenic botulism
accidental overdose
27
classic symptoms of botulism
flaccid muscle paralysis\* double vision blurred vision drooping eye lids slurred speech difficulty swallowing muscle weakness
28
botulism symptoms in baby
floppy baby syndrome lethargic, feed poorly constipated poor muscle tone diminished suck and gag reflexes
29
infant botulism can be caused by\*
going children HONEY \< 12 months don't give it to them also in soil and dust
30
food borne botulism caused by prevented by
HOME canned goods-- with foods that have low acid content: asparagus, green beans corn strict hygienic procedures boil food for 10 min to ensure safety
31
pathogenesis of botulism
Neurotoxin A: hella potent bind to receptors at NMJ - blocks Ach from leaving the cell leading to flaccid muscle paralysis can descend leading to respiratory problems-- and then you die
32
lab diagnosis of botulism Special culture:
difficult bc it can appear as many other diseases culture on egg yolk agar\* to demonstrate LIPASE activity
33
tx of botulism antibiotics:
ventilator antitoxin surgican debridement NO ANTIBIOTICS: lyses vegetative cell causing release of more toxins you use botulism immune globulin -- Baby BiG
34
normal amount of WBC in meninges
0-5 (meninges-- pia dura and archnoid) meningitis occurs in an inflammation of the CSF in subarachnoid space
35
classic triad of bacterial meningitis
fever (\>100.4) nuchal rigidity change in mental status: like lethargic or unresponsive to stimuli also severe and generalized headache could be presence of one or all the findings
36
tests for nuchal rigidity
brudnizki- flex hops when trying to flex neck kernig- inability to extend knee when hip is flexed
37
normal CSF levels\*
protein 15-45 glucose 45-85 WBC 0-5
38
bacterial meningitis CSF levels
protein \> 100 glucose \< 45 (lack of permeability of meninges prevents glucose from being transported) WBC 200-2,000
39
Viral meningitis CSF levels
protein \< 100 glucose: 45-85 WBC \< 500
40
tx bacterial meningitis
START them antibiotics even if csf abnormalities are not diagnostic if you suspect it
41
meningitis: gram + diplococci gram - diplococci:
gram + diplococci: Pneumococci gram - diplococci: Meningococci
42
meningitis Haemophilus influenza morphology
small pleomorphic gram negative cocobacilli
43
Meningitis Listeria morphology
gram + rods and cocobacili
44
which is the common cause of community acquired bacterial meningitis in both children and adults\*\>
Neisseria meningitiis 2nD most common in adults
45
is N. mengitidis nationally reportable:
yes
46
strains of n meningitis that cause disease
ENCAPsulated strains
47
pathogenesis of n memingitis
fimbriae- attachment and colonization capsules inhibit phagocytosis IGA protease- lipooligosaccharide: HIGHLY toxic-- causes vascular damage and circulatory collapse
48
classic clinical features of meningococcal disease late in disease
hemorrhage rash meiningismus: severe headache, neck stiffness, photophobia impaired consciousness
49
how does n. meningitis enter body
respiratory tract
50
rash in n meningitis
Petechiae\* palpable purpura: non blanching, raised felt on palpation maculopapular rash that is NOT pruritic ( unlike rubella)
51
waterhouse Friderichen syndrome
found in n. meningitis disease large petechial hemorrhage on skin and mucous membranes fever septic shock
52
severe complication of n memingitidis
purpura fulminans - painful indurated well demarcated purple paupers with erythematous bordrs can progress to necrosis formation
53
diagnosis/ morphology of n. meningitis\*
Gram - COFFEE BEAN SHAPED DIPLOCOCCI intra/ extracellular in PMN cells
54
which media is selective for only NEISSERIA
Thayer martin\*
55
biochemical testing for Strep Pneumoniae
Another cause of bacterial meningitis (1) Gram + cocci - Catalase negative - A hemolysis in blood agar - Optochin sensitive\*
56
biochemical tests/ morphology for H influenza
Gram - small pleomorphic cocobacilli Oxidase + we are the ONLY host for H influenza
57
antibiotic for n meningitis\*
Penicillin G 3rd generation cephalosporin
58
PEP v PrEP tx for n meningitis
PrEP: pneumococcal conjugate vaccine PEP: No
59
most common causes of bacterial meningitis in adolescents
N meningitis Strep pneumoniae
60
who's at risk for Hib
children and adults that have an underlying medical condition
61
risk factors for Hib meningitis:
day care attendance in children \< 2 y
62
what does H influenza need to grow?
factor X and factor V
63
seasonal variation of incidence of HIB meningitis
temperate cliname 1st- June 2nd october september
64
3 most common causes of nosocomial infections
1. E coli 2. Staph 3. Enterococcus\*
65
Morphological features for enterococcus
Gram + cocci catalase negative usually a hemolysis (similar to streptococci pneumonia)
66
Test for Enterococcus\* they have the ability to do what \*
Rapid biochemical test- gives a colored product they can hydrolyze PYR ( pyrrolidonyl beta naphtylamide--\*- also leucine aminopeptidase
67
is enterococcus optochin Sensitive
NO\*\*\*\*\*
68
ways to differentiate pneumonia from enterococcus
Strep pneumonia is sensitive to Optochin, Enterococcus is optochin RESISTANT Strep pneumonia is - for PYR test Enterococcus is + for PYR test ( rapid biochemical test)
69
Tx for enterococcus\*
Linezolid and quinupristin/ dalfopristin
70
is Listeria a torch pathogen
YES
71
how is listeria transmitted
Tipically a food borne organism\*
72
what is the most common clinical manifestation of listeria
diarrhea (can also cause bacteremia and meningitis
73
morphology of Listeria
gram + rod non spore forming b hemolytic (w blue green sheen on blood agar)
74
what is characteristic about listeria\*
tumbling motility when viewed with light microscopy
75
in a CNS infection what is indicative of listeria\*
FOCAL neurologic deficits - ( like weakness in one arm possible)
76
how is diagnosis of listeria made transmission? is it normal flora ?
by culture of organism from blood/ such or other sterile body fluid transmission from person to person does not occur listeria is NOT found on us
77
what is Streptococcus agalactia known for\>? aka
best known cause of postpartum infection and neonatal sepsis - in adults is uncommon unless they have some abnormalities Group B strep
78
what is characteristic of GBS (streptococcus Agalagtica)\*
Gram + coccus that forms glistening gray white colonies w narrow zone of b hemolysis
79
Ecoli Strain K1
gram - rod OHK antigens used to determine serotypes

Microbio (7 decks)

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