Bacteria: Gram-Positive Flashcards

1
Q

Streptococci vs. Staphylococci

Which would be lined up like a strip in a gram stain?

Which would be lined up in clusters in a gram stain?

A

Which would be lined up like a strip in a gram stain?

Streptococci

Which would be lined up in clusters in a gram stain?

Staphylococci

Strep sounds like strip

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2
Q

In order to determine the identity of the gram positive bacterium. The tech wraps a wire containing H2O2 is rubbed across the slide containing a colony of gram positive bacteria. The tech notes the formation of bubbles on the slide. What is the most likely bacterium present on the slide?

A. Streptocci due to its superoxide dimutase activity

B. Streptococci due to its catalase activity

C. Staphylococci due to its superoxide dimutase activity

D. Staphylococci due to its catalase activity

A

Staphylococci due to its catalase activity

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3
Q

Streptococci can be classified into 3 groups based on their ability to lyse RBCs. They go alpha-, beta-, and gamma- hemolytic strep. For the image below, indicate which group has been plated for 1-3.

A
  1. alpha-hemolytic strep
  2. beta-hemolytic strep
  3. gamma-hemolytic strep

NOTE: gamma-hemolytic strep is also called non-hemolytic step

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4
Q

Which of the following is a major virulence factor found in the cell wall of Group A beta-hemolytic streptococci that inhibits complement activation and protects it from phagocytosis?

A. C carbohydrate

B. M protein

C. Streptolysin S

D. Streptolysin O

E. Pyrogenic exotoxin

A

M protein

NOTE:

We defend against M protein by forming Ab against M protein that bind and opsonizing the cell wall

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5
Q

Which of the following is an enzyme that destroys RBCs and WBCs, and it’s antigenicity allows us to test for Abs we produce against it to confirm recent infection by Group A beta-hemolytic strep? Bonus: Which enzyme does the same thing but is NOT antigenic?

A. M protein

B. Streptolysin S

C. Streptolysin O

D. Pyrogenic exotoxin

E. B and C

A

Streptolysin O

Steptolysin S is not antigenic, but is hemolytic

NOTE:

ASO is the test used to find anti-streptolysin O Abs in our system

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6
Q

Pyrogenic exotoxin is only found in a few strains of Group A beta-hemolytic strep that upon invasion of the enzyme produces what disease?

Pyrogenic exotoxin also is a superantigen that leads to the superstimulation of T cells which produce a cytokine overload that leads to what syndrome?

A

Pyrogenic exotoxin is only found in a few strains of Group A beta-hemolytic strep that upon invasion of the enzyme produces what disease?

Scarlett Fever

fire burns scarplet like a fire that a pyro might start

Pyrogenic exotoxin also is a superantigen that leads to the superstimulation of T cells which produce a cytokine overload that leads to what syndrome?

Toxic Shock Syndrome

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7
Q

Local invasion and exotoxin release by Group A beta-hemolytic strep causes 4 types of disease, EXCEPt which of the following that is caused by delayed Ab-mediated disease?

A. Streptoccocal pharyngitis and skin infections

B. Streptoccocal pharyngitis and Scarlet fever

C. Rheumatic fever and Glomerulonephritis

D. Toxic Shock syndrome and Scarlett fever

A

Rheumatic fever and Glomerulonephritis

NOTe:

technically called acute post-streptococcal glomerulonephritis

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8
Q

What are the 4 disease associated with local invasion and exotoxin release by Streptoccocus Pyogenes?

What are the 2 diseases associated with delayed Ab-mediated diseases caused by Streptoccocus Pyogenes?

A

What are the 4 disease associated with local invasion and exotoxin release by Streptoccocus Pyogenes?

Pharyngitis, Skin infections, Scarlet fever, Toxic Shock syndrome

What are the 2 diseases associated with delayed Ab-mediated diseases caused by Streptoccocus Pyogenes?

Rheumatic fever

Acute post-strep Glomerulonephritis

When Strep Pyrogenes get PSST they come back later and like an acute punch to the kidneys cause a fever room.

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9
Q

What is the genus and species name of Group A Beta-hemolytic streptococci?

A. Streptococcus agalactiae

B. Streptococcus pyogenes

C. Enterococci or Non-enterococci

D. Viridians group streptoccocus

A

Streptococcus pyogenes

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10
Q

Rheumatic fever is a delayed-Antibody mediated disease caused by an infection of Strep Pyogenes when which of the following goes untreated?

A. Necrotizing facitis

B. Pharyngitis

C. Pyroderma

D. Erypspelas

A

Pharyngitis

NOTE:

Rheumatic fever does not show up after skin infections

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11
Q

Erythema marginatum is a rash that spreads out from the center and is 1/6 major manifestations of what disease caused by Strep Pyogenes?

A

Rheumatic fever

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12
Q

What is the genus and species name of Group B strep, which is also a B-hemolytic strep?

A. Streptococcus agalactiae

B. Streptococcus pyogenes

C. Enterococci or Non-enterococci

D. Viridians group streptoccocus

A

Streptococcus agalactiae

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13
Q

Strep Agalactiae is also called Group B strep, and we can use the “B” in Group B to remeber BABY. Why is it good to remember BABY?

What are the 3 common diseases Group B strep is associated with?

A

Strep Agalactiae is also called Group B strep, and we can use the “B” in Group B to remeber BABY. Why is it good to remember BABY?

Babies are the common group affected

What are the 3 common diseases Group B strep is associated with?

Neonatal Meningitis, Pnumonia, and Sepsis

Group B strep makes baby MaPS

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14
Q

Group B strep (strep agalactiae), Listeria, and E. Coli are the 3 most common pathogens associated with what disease?

A. Meningitis in neonates and infants <3 months

B. Pneumonia in neonates and infants <3 months

C. Sepsis in neonates and infants <3 months

D. All of the above

A

Meningitis in neonates and infants <3 months

NOTE:

in adults, the most common pathogens for meningitis are Neisseria meningitides and Haemophilus influenzae

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15
Q

All of the following are classic signs of meningitis seen in neonates infected by Strep Agalactiae, EXCEPT?

A. Fever

B. Stiff neck

C. Vomiting and poor feeding

D. Irritability

A

Stiff neck

NOTE:

Stiff neck is a symptom seen in adults, NOT neonates which instead have non-specific signs like A, C, and D

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16
Q

T/F: Streptococcus agalactiae can cause bacteremia and sepsis in pregnant and secondary infection of the fetus results in still birth or spontaneous abortion in about 80% of cases

A

False;

True in 30% of cases

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17
Q

Viridians group streptococcus represents about 30% of the culturable bacteria of the gingiva, tongue, salvia and dental plaque; and is indigenous to which of the following locations?

A. Heart

B. Brain

C. Lungs

D. GI tract

A

GI tract

NOTE:

Viridians group are the normal human flora of the GI tract frequently found in the nasopharynx and gingival crevices

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18
Q

Viridians Group Strep is associated with what 3 main types of infection?

A

Dental infection

Endocarditis

Abscesses

Viridians sound like verde which means green. Think of green foliage between the teeth, that can fly off and enter the blood stream to deposit on your heart to cause infection.

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19
Q

Finding which of the following Viridians Group Strep subspecies in a blood culture liekly indicates an abscess hiding in an organ, and should be ImMEDIately ASsessed by a CT scan with contrast?

A. S. Anginosus and S. multans

B. S. Intermedius and S. multans

C. S. Anginosus and S. Intermedius

D. S. salivarius and S. criceti

E. None of the above

A

S. Anginosus and S. Intermedius

Viridian AI: Investigate Abscesses

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20
Q

T/F: Viridians Group of Strep causes “subacute” bacterial endocarditis (SBE), while Staphylococcus causes acute infective endocarditis

A

True

NOTE:

Strep -> endocarditis: slow developing low grade fever, fatigue, anemia, murmurs

Staph –> endocarditis: rapid onset of high fever, chilld, valve destruction

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21
Q

Which of the following groups of streptocci that we’ve been over can be alpha or gamma hemolytic?

A. Group A

B. Group B

C. Viridian

D. Group D

A

Group D

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22
Q

Which of the following is unique to enterococci (faecalis and faecium), members of Group D strep?

A. Grow well in 40% NaCl and 6.5% bile

B. Grow well in 40% bile and 6.5% NaCl

C. Grow well in 4% bile and 65% NaCl

D. Grow poorly in 40% NaCl and 6.5% bile

A

Grow well in 40% bile and 6.5% NaCl

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23
Q

Enterococci (faecalis and faecium) are common infecting agents associated with the development of what 3 infections?

A

Biliary tract infection

UTI

Subacute bacterial endocarditis (SBE)

Enterococci are D-listers that have to take the BUS

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24
Q

Which of the following is true of Enterococci (faecalis and faecium)?

A. Use of infectious disease specialist is not necessary when treating Enterococci as they are not known to be very anti-biotic resistant yet

B. Enterococci are significantly more virulent than Strep Pyogenes

C. Enterococci are the 2nd and 3rd most common cause of hospital acquired (nosocomial) infection

D. All the above are true

E. All the above are false

A

Enterococci are the 2nd and 3rd most common cause of hospital acquired (nosocomial) infection

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25
Q

S. bovis vs. S. equinous:

Which of these non-enterococci of Group D strep, is most like enterococci as it is good at growing in 40% bile (NOT 6.5% NaCl), lives in the GI and causes similar disease?

Bacteremia with which is found to have a remarkable association with colon cancer?

A

S. bovis

S. bovis

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26
Q

Streptococcus pneumoniae is also referred to as pneumococcus. Pneumococcus is the major cause of what 2 diseases in adults?

Pneumococcus is the major cause of what disease in children?

A

It is the major cause of what 2 diseases in adults?

Bacterial Pneumonia

Bacterial Menigitis

Pneumococcus is the major cause of what disease in children?

Otitis media

  • A child with Strep pneumoniae has an ear infection, that his parents can treat in the PM*
  • Pnemococcus is to Parents what group B streptococcus is to Babies”*
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27
Q

Which of the following is the major virulence factor of Streptococcus Pneumoniae (Pneumococcus), which allows it protection from phagocytosis? Bonus: is this factor antigenic?

A. M protein

B. C carbohydrate

C. Polysaccharide capsule

D. Bile resistance

A

Polysaccharide capsule

yes; polysaccharide capsule is antigenic

NOTE about it’s antigenicity and immunity:

there are 84 different capsuel types, so surviving infection only results in immunity against 1 capsule type.

basically you can get infected by pneumoccocus 84 times should the pathogen have a different capsule

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28
Q

Which 2 of the following streptococcal groups is alpha-hemolytic only, and thus only able to partially lyse RBCs and produce a greenish area around the colony?

A. Group A

B. Group B

C. Viridian group

D. Group D

E. Streptoccus Pneumoniae

A

Viridian group

Streptoccus Pneumoniae

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29
Q

What are the two lab tests used to identify pneumococcus?

If a disc coated in optochin is placed on an agar dish, between Viridian group and Pneumococcus, which of these is LEAST likely to grow?

A

What are the two lab tests used to identify pneumococcus?

Quelleng reaction

Optochin Sensitivity

If a disc coated in optochin is placed on an agar dish, between Viridian group and Pneumococcus, which of these is LEAST likely to grow?

Pneumococcus

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30
Q

What pathogen is the most common cause of pneumonia in adults?

This same pathogen is the most common cause of what disease in children?

A

What pathogen is the most common cause of pneumonia in adults?

Pneumococcus (Streptococcus Pneumoniae)

This same pathogen is the most common cause of what disease in children?

Otitis Media

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31
Q

Pneumovax is a vaccine that has 23 of the most common capsular polysaccharides and is given to those who’s infection of pneumococcal pneumonia would be the most lethal. All of the following are included in this group EXCEPT?

A. AIDS patients

B. Asplenic people (people without spleens)

C. Immunocompromised individuals

D. Elderly

E. Children

A

Children

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32
Q

What are the 3 major pathogenic species of Staphylococcus?

A

Aureus

Epidermis

Saprophyticus

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33
Q

Which of the following species of Staphylococcus is beta-hemolytic and produces a gold pigment when plated on sheep blood agar?

A. Staph aureus

B. Staph epidermidis

C. Staph saprophyticus

A

Staph aureus

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34
Q

The lab sends a report that the clustered, gram positive cocci have been confirmed to be coagulase negative. To you this means the pathogen could be any of the following EXCEPT?

A. Staph saprophyticus

B. Staph epidermidis

C. Staph aureus

A

Staph aureus

NOTE:

  • Staph aureus is coagulase positive
  • Coagulase activates prothrombin to promote blood clot formation
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35
Q

Which of the following is true of staphylococcus?

A. All species are coagulase negative

B. All species are coagulase negative

C. All species are catalase positive

D. All species are catalase negative

A

C. All species are catalase positive

NOTE:

All species of Staph are catalase positive and should bubble when plated against H2O2

36
Q

Which of the following proteins from staphylococcus aureus binds the Fc portion of IgG to not only permit it protection from phagocytosis, but also opsonization?

A. Leukocidins

B. Coagulase

C. Hemolysins

D. Penicillinase

E. Novel Penicillin binding protein (transpeptidase)

F. Protein A

G. Protein M

A

Protein A

37
Q

Which of the following proteins allows fibrin formation around Staph Aureus to allow it protection from phagocytosis?

A. Coagulase

B. Catalase

C. Fibrinogen

D. Penicillinase

A

Coagulase

38
Q

Which aureus protein would likely be most useful for specifically targeting leukocytes?

A. Hemolysins

B. Leukocidins

C. Penicillinase

D. Transpeptidase

A

Leukocidins

NOTE:

Hemolysin targets macrophages, platelets, neutrophils, and RBCs, while leukocidins tagets WBCs

39
Q

Which of the following proteins of Staph aureus is the most vulnerable to penicillin?

A. Penicillinase

B. Transpeptidase

C. Protein A

D. All of the above

A

Transpeptidase

Transpeptidase is also called novel penicillin binding protein and is needed for the formation of staph aureus’s peptidoglycan cell wall, BUT get’s inhibited by penicillin

NOTE:

Penicillinase is the enzyme that inactivates penicillin

40
Q

All of the following proteins are utilized by Staph aureus to tunnel through tissues, EXCEPT which of the following that is not part of its arsenal?

A. Hyaluronidase

B. Staphylokinase

C. Peptidase

D. Proteases

E. Lipases

A

Peptidase

41
Q

Which protein most directly contributes to Staph aureus ability to colonize sebaceous glands?

A. Hyaluronidase

B. Staphylokinase

C. Proteases

D. Lipases

A

Lipases

Lipase degrades fats and oils

42
Q

Which protein most directly contributes to Staph aureus ability to lyse fibrin clots?

A. Hyaluronidase

B. Staphylokinase

C. Proteases

D. Lipases

A

Staphylokinase

NOTE:

Very similar to streptokinase

43
Q

Which of the following exotoxins of Staph Aureus is a superantigen, analogous to pyrogenic toxin of Group A beta-hemolytic strep (S. pyrogene), and causes a massive T cell response by binding to MHC class II on APCs?

A. Enterotoxin

B. TSST-1

C. Exfoliatin

D. None such thing exists

A

TSST-1

NOTE:

TSST-1 is a potent stimulator of TNFa, IL-1 and also enhances susceptibility to endotoxins

44
Q

All of the following is true of Staphylococcal Scalded Skin Syndrome, EXCEPT?

A. Caused by production of exfoliative toxin A and B

B. Usually affects neonates with local infection of a recently served umbilicus and older children with a skin infection

C. Drug allergies have a similar presentation and thus must be ruled out

D. Healing is slow and the mortality rate is high

A

D. Healing is slow and the mortality rate is high

Healing is rapid and the mortality rate is low

45
Q

T/F: When treating TSS antibiotics can prevent for exotoxin production, but it is not curative and thus clinical symptoms will persist

A

True

46
Q

Staph aureus is the most common pathogen to cause septic arthritis for which of the following age groups?

A. Neonate and pediatric

B. Pediatric and young adult

C. Pediatric and adults over 50

D. Pediatric and adults under 50

A

C. Pediatric and adults over 50

47
Q

Effusions and empyema (pus in the pleural space) is often seen in pneumonia caused by what pathogen?

A. Staph Aureus

B. Pneumococcus

A

Staph Aureus

48
Q

Minor skin infections are most exclusively caused by what two pathogens that are clinically impossible to differentiate for this infection and are often both involved?

A. Staph epidermidis and Staph Aureus

B. Staph aureus and Strep Pyogenes

C. Strep Pyogenes and Staph saprophyticus

D. Strep Pyogenes and Group D Strep

A

B. Staph aureus and Strep Pyogenes

NOTE:

In an outpatient setting it is often treated with clindamycin

49
Q

Which of the following is true of both MRSA and CA-MRSA?

A. Both can be acquired in and outside of the hospital

B. Vancomycin is the most useful antibiotic to treat both forms

C. Both pass their resistance via mobile genetic elements called transposons

D. Both utilize Panton-Valentine Leukocidin (PVL)

E. All of the above is correct

F. All but C is correct

G. A and C are correct

H. B and D are correct

A

G. A and C are correct

A. Both can be acquired in and outside of the hospital

C. Both pass their resistance via mobile genetic elements called transposons

50
Q

What are the 3 diseases caused by exotoxin release from Staph aureus?

What are the 6 out of 11 diseases that you decided to memorize caused by direct organ invasion by Staph Aureus?

A

What are the 3 diseases caused by exotoxin release from Staph aureus?

Gastroenteritis, TSS, Scalded Skin Syndrome

What are the 6 out of 11 diseases that you decided to memorize caused by direct organ invasion by Staph Aureus?

Skin infection, Meningitis, Septic arthitis, Osteomyelitis, Acute Endocarditis, Pneumonia

Mneumonic:

Tss! I scalded my skin on the golden staph that it made me nauseous. I need to put SoMe SOAP on it directly before I get staph.

51
Q

Staphylococcus epidermidis is part of the normal flora on our skin, but its ability to form a biofilm, or an extracellular polysaccharide scaffold, gives it the ability to adhere to certain structures. What are those structures that it often causes infections through?

A

Prosthetic devices

Intravenous catheters

Foley urine catheters

52
Q

Staphylococcus saprophyticus is the leading cause of what type of infection, second only to E. coli?

A

UTIs in sexually active young women

Weird mneumonic time:

Young sexually active women like to “phyt” and “cus”, and as punishment they get UTIs

53
Q

Bacillus vs. Clostridium:

Which gram-positive spore-forming rod is aerobic?

A

Bacillus

Bacic people come off like air-heads

54
Q

Between: Bacillus anthracis and Bacillus cereus

Which of the following bacterium is the only one with a capsule composed of protein, specifically poly-Dglutamic acid?

Which of the following bacterium is motile, non-encapsulated, and resitant to penicillin?

A

Which of the following bacterium is the only one with a capsule composed of protein, specifically poly-Dglutamic acid?

Bacillus anthracis

Which of the following bacterium is motile, non-encapsulated, and resitant to penicillin?

Bacillus cereus

55
Q

Germination and release of the encoded virulence factors encoded on Bacillus anthracis pXO1 and pXO2, is regulated by an increase in which of the following?

A. [CO2]

B. Temperature to 37 C

C. Serum proteins

D. All of the above

E. None of the above

A

All of the above

56
Q

Which of the following animals is least likely to become infected by bacillus anthracis?

A. Sheep

B. Cow

C. Bulls

D. Wild Dog

A

Wild Dog

NOTE:

predominantyl infects herbivores

57
Q

What is the most common route of entry for Bacillus anthracis?

A. Lungs

B. GI

C. Cutaneous

D. None of the above

A

Cutaneous

58
Q

Why is the painless, necrotic lesion with a rim of edema caused by Cutaneous anthrax infection called a malignant pustule?

A. It can cause rapid death

B. It often allows entry of severe pathogens that lead to loss of appendage and eventually death

C. It has the ability to continue to proliferate and enter the blood stream where it can cause death

D. None of the above

A

It has the ability to continue to proliferate and enter the blood stream where it can cause death

59
Q

Which of the following disease associated with Bacillus anthracis most often ersults in death, and is most fortunatly rare?

A. Cutaneous anthrax

B. Pulmonary anthrax

C. GI anthrax

D. None of the above

A

GI anthrax

NOTE:

Pulmonary anthrax leads to mediastinal widening and pleural effusion

Cutaneous anthrax leads to malignant pustules that 85-90% of the time spontaneously ersolve

60
Q

What plasmid encodes the exotoxins of Bacillus anthracis?

What are the 3 exotoxins encoded by this plasmid?

What plasmid encodes the genes necessary to produce the poly-glutamyl capsule that protects the vegetative bacillus anthracis against phagocytosis?

What plasmid is necessary for the bacillus anthracis virulence?

A

What plasmid encodes the exotoxins of Bacillus anthracis?

pXO1

What are the 3 exotoxins encoded by this plasmid?

PA (protective antigen)

EF (edema factor)

LF (lethal factor)

anthrax comes off PELts

What plasmid encodes the genes necessary to produce the poly-glutamyl capsule that protects the vegetative bacillus anthracis against phagocytosis?

pXO2

What plasmid is necessary for the bacillus anthracis virulence?

Both

61
Q

Bacillus anthracis plasmid, pXO1, encodes three virulence factors that are non-toxic when seperate, but together contribute to the systemic effects of anthrax. Which of these factors is used in the vaccine to help at risk people be protected against anthrax?

A. PA

B. EF

C. LF

D. All of the above

A

PA

protective antigen

NOTE:

PA allows entry of edema factor to enter phagocytic cells

62
Q

Bacillus anthracis plasmid, pXO1, encodes three virulence factors that are non-toxic when seperate, but together contribute to the systemic effects of anthrax. Which of these factors is a calmodulin-dependent adenylate cyclase that increases cAMP production that impairs neutrophil function?

A. PA

B. EF

C. LF

D. All of the above

A

EF

edema factor

63
Q

Lethal factor is a virulence factor of Bacillus anthracis that is a zinc metalloprotease that inactivates protein kinase and causes the macrophage to release what 2 factors that contribute to death in anthrax?

A. TNF-a and TGF-B

B. IL-1B and TNF-a

C. TNF-a and TNF-B

D. IL-6 and IL-2

A

IL-1B and TNF-a

64
Q

In what 3 ways is Bacillus cereus different from Bacillus anthracis?

A
  1. motile
  2. non-encapsultated
  3. resistant to penicillin
65
Q

Bacillus cereus releases two exotoxins that cause two different types of food poisoning. Which of the following would there be limited diarrhea, but severe nausea and vomiting?

A. a heat-labile toxin

B. a heat-stable toxin

A

B. a heat-stable toxin

Stable people don’t shit everywhere

66
Q

Bacillus cereus releases two exotoxins that cause two different types of food poisoning. Which of the following is most similar to cholera and E. coli’s enterotoxins that cause nasea, abdominal pain and diarrhea that lasts 12-24 hours?

A. a heat-labile toxin

B. a heat-stable toxin

A

A. a heat-labile toxin

Stable people don’t shit everywhere, and Bacillus cereus could get labiled as a cholera or E. coli immitator

67
Q

Is Clostridium most likely to grow in an aerobic or anaerobic culture?

A

Anaerobic

68
Q

Which of the following is true of clostridium botulinum?

A. Infected adults ingested the clostridium botulinum spores and infants ingested the neurotoxin

B. Infected adults respiratory muscle weakness is one of the most significant symptoms, and infected infants become floppy from flaccid paralysis as their most significant symptom

C. Infants often develop diplopia, dysphagia and respiratory muscle weakness

D. All the above are correct

A

B. Infected adults respiratory muscle weakness is one of the most significant symptoms, and infected infants become floppy from flaccid paralysis as their most significant symptom

NOTE: To make them all correct

  • Flip option A
  • Substitute adults for infants for option C
69
Q

From the wound of entry, Clostridium tetani releases its exotoxin that causes sustain contraction of muscles called tetany. What is the name of this released exotoxin?

A. Tetanoclaspin

B. Tetanokinase

C. Tetanoplasmin

D. Tetanospasmin

A

D. Tetanospasmin

70
Q

Which of the following would likely result in the symptoms you see in patients with Clostridium botulinum?

A. Preventing the release of GABA and Glycine from Renshaw cell interneurons

B. Promoting release of GABA and glycine from Renshaw cell interneurons

C. Blocking release of Ach from the presynaptic neurons of ANS or motor end plate

D. Promoting the release of Ach from the presynaptic neurons of ANS or motor end plate

A

C. Blocking release of Ach from the presynaptic neurons of ANS or motor end plate

this leads to flaccid paralysis as muscle cannot be stimulated to contract properly

71
Q

Which of the following would likely result in the symptoms you see in patients with Clostridium tetani?

A. Preventing the release of GABA and Glycine from Renshaw cell interneurons

B. Promoting release of GABA and glycine from Renshaw cell interneurons

C. Blocking release of Ach from the presynaptic neurons of ANS or motor end plate

D. Promoting the release of Ach from the presynaptic neurons of ANS or motor end plate

A

A. Preventing the release of GABA and Glycine from Renshaw cell interneurons

The toxin tetanospasmin inhibits renshaw cell internueorns, which normally release inhibitory neurone GABA and glycine to signal that muscle contractions need to chill. The lack of cool-it signalling is wat leads to the tetany seen in Tetanus

72
Q

Which of the following anaerobic species of clostridium is reffered to as gas gangrene that can cause 3 different types of infection upon wound exposure?

A. Clostridium botulinum

B. Clostridium tetani

C. Clostridium perfringens

D. Clostridium difficile

A

Clostridium perfringens

73
Q

Which of the following anaerobic species of clostridium is associated with red-inflamed mucosa and areas of white exudate called pseudomembranes on the surface of the large intestines?

A. Clostridium botulinum

B. Clostridium tetani

C. Clostridium perfringens

D. Clostridium difficile

A

D. Clostridium difficile

74
Q

Clostridial myonecrosis is the destruction of adjacent muscles where a thin, black exudate is produced. Clostridial myonecrosis is an infection associated with what species?

A. Clostridium botulinum

B. Clostridium tetani

C. Clostridium perfringens

D. Clostridium difficile

A

Clostridium perfringens

75
Q

What are the 3 infection classes that are caused by exposure to Clostridium perfringens?

A
  1. Cellulitis
  2. Clostridium myonecrosis
  3. Diarrheal illness
76
Q

Clostridium difficile is the pathogen responsible for Anti-body associated pseudomembranes colitis (diarrhea), which is caused when anti-biotics wipe out the normal flora and difficile is left to superinfect the colon. When clostridium difficile grows it releases 2 exotoxins that carry out different effects. Which of the following is cytotoxic to cells of the colon? Bonus: Which one causes diarrhea?

A. Toxin A

B. Toxin B

A

Toxin B

Toxin A causes diarrhea

NOTE:

Preferred method of testing for Clostridium difficile is PCR testing for Toxin A and B

77
Q

Listeria and Corynebacterium predominantly infect which age group with a few exceptions?

A. Neonate

B. Pediatric

C. Young adult

D. Adults over 50

A

Pediatric

78
Q

Corynebacterium diptheria colonizes the pharynx and produces a greyish pseudomembrane made of fibrin, leukocytes, necrotic epithelial cells, and from there it releases toxins into the blood stream that specifically damage what cells by blocking protein synsthesis?

A. Neural and Heart cells

B. Heart and Intestinal cells

C. Kidney and Heart cells

D. Neural and Kidney cells

A

Neural and Heart cells

79
Q

When testing for diptheriae you should utilize a culture plated on what agar, complete with what medium?

A

Potassium Tellurite agar

Loeffler’s coagulated blood serum

When dealing with Corneybacterium diphtheriae to diagnose you should TELL yoUR InTErn not to LOAF around”

80
Q

T/F: Much like Group A beta-hemolytic streptoccocus and the pyogene that produces scarlett fever, not all Corneybacterium diptheriae have the exotoxin and must first be lysogenized by a bacteriophage that contains the plasmid encoding the exotoxin

A

True

81
Q

Treatment of a pediatric patient with suspected infection of Corneybacterium diptheria occurs in which of the following orders?

A. DPT vaccine > Penicillin or erythromycin > Antitoxin administration

B. Antitoxin administration > Penicillin or erythromycin administration > DPT vaccine

C. Antitoxin administration > DPT vaccine > Penicillin or erythromycin administration

D. None of the above

A

B. Antitoxin administration > Penicillin or erythromycin administration > DPT vaccine

82
Q

Like Mycobacterium Tuberculosus, Rhodococcus equi (corynebacterium equi) may stain acid fast and produce a necrotizing pneumonia. However, the presentation of necrotizing pneumonia caused by Rhodococcus is present in which of the following ways that is not seen in Mycobacterium Tuberculosis?

A. Upper lung cavities without air-fluid levels

B. Upper lung cavties with air-fluid levels

C. Lower lung cavities without air-fluid levels

D. Lower lung cavities with air-fluid levels

A

B. Upper lung cavties with air-fluid levels

NOTE:

Mycobacterium Tuberculosis has upper lung cavities but air-fluid levels are rarely seen

83
Q

Listeria is a cause of meningitis in what categories of epople? (4)

A

Pregnant women

Fetus and neonates

Elderly

Immunocompromised

PINE flavored listerine is gross

84
Q

In people over 50, which of the following pathogens is the SECOND most common cause of meningitis?

A. Pneumococcus

B. Listeria

C. Neisseria

D. Cholera

A

Listeria

85
Q

Listeria monocytogenes are considered Faculative Intracellular Organisms because they are able to live for long periods of time inside phagocytes. Our ability to get rid of Listeria monocytogenes is most directly based on the strength of what portion of our immune system?

A. Humoral immunity

B. Innate immuntity

C. Passive immunity

D. Cell-mediate immunity

A

Cell-mediate immunity

NOTE:

Listeria is targeted and destroyed by cell mediated immunity, and it is why people with weak cell-mediated immunity are most infected by Listeria.

  • pregnant women in the 3rd trimester where cell mediated immunity is decreased
  • neonates who do not developed cell-mediated immunity
  • elderly with weakened cell-mediated immunity
  • AIDS patients with compromised cell-mediated immunity
  • people on corticosteroids who’s medication inherently supresses the immune system