4.4

Question 1

the HACEK group cause

Answer 1

○ Causes of bacterial endocarditis
§ Not as commonly as viridans streptococci and S aureus
§ Culture negative - wont grow readily in the lab

Question 2

H

Answer 2

haemophilus aphrophilus and H paraphrophilus

Question 3

A

Answer 3

actinobacillus actinomycetemcomitans

Question 4

C

Answer 4

cardiobacterium hominis

Question 5

E

Answer 5

eikenella corrodens

Question 6

K

Answer 6

kingella kingae

Question 7

HACEK group commensals of

Answer 7

the human oropharynx

Question 8

1 species of genus pastuerella

Answer 8

pastuerella multocida

Question 9

pastuerella multocida commensal of

Answer 9

§ Part of the normal flora of the mouths of cats and dogs

Question 10

pastuerella multocida causing infection

Answer 10

§ May cause severe infection of the skin and soft tissue following a bite from cats and dogs
§ Infections may involve such as tendons, joints and bone

Question 11

1 species genus bordetella

Answer 11

bordetella pertusis

Question 12

bortedella pertusis morphology

Answer 12

§ Small gram negative coccobacillus

Question 13

cause of whooping cough

Answer 13

bordetella pertussis

Question 14

whooping cough

Answer 14

□ Potentially serious respiratory tract illness
□ Infected children, particularly those under 6 months, suffer significant morbidity from this infection
□ Highly infections
□ Transmitted by aerosol route
□ Highly fastidious and difficult to cultivate in the lab

Question 15

prior to vaccine whooping cough was seen mostly in

Answer 15

® Most cases seen in children <10

Question 16

now whooping cough is seen mostly in

Answer 16

® Most disease is seen in older primary school children and middle aged adults

Question 17

3 phases of whooping cough

Answer 17

1. catarrhal phase
2. paroxysmal phase
3. convalescent phase

Question 18

Catarrhal phase of whooping cough

Answer 18

1. Catarrhal phase - several days of mild cough and runny nose

Question 19

paroxysmal phase of whooping cough

Answer 19

2-6 weeks; persistant severe cough occuring in attacks which impair breathing, gagging and cyanosis may occur; attacks followed by desperate indrawing of breath resulting in whooping sound, vomiting may follow

Question 20

complications of paroxysmal phase of whooping cought

Answer 20

} Apnoea
} Pneumonia - primary or secondary
} Weight loss due to feeding difficulties
} Pneumothroax
} Haemorrhage - epistaxis, subconjunctival haemorrhage, subdural hematoma
} rectal prolapse
} Rib fracture
} Death

Question 21

convalescent phase of whooping cough

Answer 21

gradually decreasing cough over weeks to months

Question 22

genus brucella morphology

Answer 22

○ Gram negative coccobacilli with fastidious growth requirements

Question 23

genus brucella spread to humans by

Answer 23

○ Pathogens of animals and are spread to humans by contact with sheep, cattle, goats, pigs and sometimes dogs, their products, or consumption with infected milk or cheese

Question 24

genus brucella found in

Answer 24

○ Uncommon in developed contries

○ Problem for human and livestock in underdeveloped countries

Question 25

most common zoonosis worldwide

Answer 25

human brucellosis

Question 26

generalised features of human brucellosis

Answer 26

□ Fever 
				□ Nigh sweats 
				□ Fatigue 
				□ Muscle, joint pain, headache 
				□ Enlarged liver, spleen, lymph nodes 
				□ Depression

Question 27

localised features of human brucellosis

Answer 27

□ Joint infection 
				□ Orchitis and/or epididymitis 
				□ Various forms of lung infection 
				□ Hepatitis 
				□ Meningitis, encephalitis 
				□ Skin rashes

Question 28

human brucellosis ,ay become

Answer 28

§ May become chronic and relapsing and produce significant disability

Question 29

genus bartonella morphology

Answer 29

○ Tiny pleomorphic gram negative rods

Question 30

2 species of genus bartonella

Answer 30

henselae, quintana

Question 31

cat scratch disease caused by

Answer 31

bartonella henselae

Question 32

cat scratch disease

Answer 32

® Self limiting infection usually seen in young children
® Organism eneters the skin from a cat scratch, bite or lick
® Small red papule develops at the site of inoculation
® Regional lymph node becomes enlarged and tender
® May persist over several months

Question 33

3 diseases caused by bartonella henselae

Answer 33

cat scratch disease
bacillary angiomatosis
bacillary peliosis

Question 34

bacillilary angiomatosis seen in

Answer 34

HIV patients

Question 35

□ bacillary angiomatosis

Answer 35

® Seen in HIV infected people with advances immunosuppresion
® Vascular lesion involving skin
® Begin as small red nodules but enlarge to various forms, including raised or pedunulated friable lesions which easily bleed
® Lesions may occur occasionally in other organs

Question 36

□ Bacillary peliosis

Answer 36

® Also in HIV infected patients
® Formation of blood filled cavities within organs
® Most commonly in the liver but the spleen may be involved

Question 37

formation of blood filled cavities within organs is

Answer 37

bacillary peliosis caused by bartonella henselae

Question 38

bacillary peliosis seen in

Answer 38

HIV patients

Question 39

diseases caused by bartonella Quintana

Answer 39

trench fever

□ May cause bacillary angiomatosis or peliosis in AIDS patients

Question 40

trench fever seen in

Answer 40

® Seen in poor conditions of poor hygiene and overcrowding - trenches of WW1, homeless people, those with AIDS

Question 41

trench fever spread to the body by

Answer 41

lice

Question 42

trench fever clinical appearance

Answer 42

® Debilitating bacteraemic febrile illness which may last for days to weeks
® Endocarditis may be a complication