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COM MOD 2.2 Bacteria 1 > Chapter 1.8 Neisseria > Flashcards

Chapter 1.8 Neisseria Flashcards

1
Q

What is the only pathogenic gram-negative cocci?

A

Neisseria

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2
Q

What is the shape of Neisseria?

A

Diplococci and each coccus is shaped like a kidney bean with their concave sides facing each other

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3
Q

What are the 2 species of Neisseria that cause disease in humans?

A

Neisseria meningitidis and Neisseria gonorrhoeae

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4
Q

What type of meningitis is associated with Neisseria meningitidis?

A

Central nervous system irritation-meningitis (meningocococcus)

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5
Q

What dose Neisseria gonorrhoeae cause?

A

Sexually transmitted disease (STD) gonorrhea

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6
Q

What disease other then meningitis does Neisseria meningitidis cause?

A

Life threatening sepsis (meningococemia)

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7
Q

What are the virulence factors of Neisseria meningitidis?

A

Polysaccharide capsule, endotoxin (LPS), IgA1 protease, iron extraction from transferrin

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8
Q

What is the function of endotoxin (LPS) in Neisseria meningitidis?

A

Cause blood vessel destruction (hemorrhage) to look like petechiae and sepsis

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9
Q

What makes someone a carrier of Neiserria meningitidis?

A

When the Neisseria becomes part of the normal flora of the nasopharynx and they are asymptomatic

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10
Q

What are the high risk groups for Neisseria meningitidis?

A

Infants from 6 months to 2 years and army recruits

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11
Q

Why are infants from 6 mo. - 2 years susceptible to meningococcal infections?

A

Up until then they were protected by mothers antibodies and haven’t made their own yet

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12
Q

Why are army recruits susceptible to invasive meningococcal invasion from Neisseria?

A

Since they are in such close quarters, each army recruit an be a carrier of a certain strain of meningococcus that the other army recruit’ immune system has never encountered

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13
Q

How does Neisseria meningitidis spread?

A

Via respiratory secretions and lives asymptomatic ally in the nasopharynx

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14
Q

What is the classic clue to an invasive meningococcal infection?

A

Appearance of petechial rash from release of endotoxin and vascular necrosis of skin

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15
Q

What is meningooccemia?

A

Intravascular invasion of Neisseria meningitidis in the bloodstream

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16
Q

What is the clinical presentation of meningococcemia?

A

Spiking fevers, chills, arthralgia, muscle pains, and petechial rash

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17
Q

What is arthralgia?

A

Joint pain

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18
Q

What is fulminant meningococcemia?

A

septic shock from bilateral hemorrhage into the adrenal glands that causes adrenal insufficency
*also called Waterhouse-Friderichsen syndrome

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19
Q

What is the clinical presentation of fulminant meningococcemia?

A

Abrupt onset of hypotension and tachycardia
Rapidly enlarging petechial skin lesion
DIC and coma may occur
Death occurs in 6-8 hours

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20
Q

What is the most common form of meningocococcal disease?

A

Meningitis in infants

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21
Q

What is the clinical presentation of an infant with meningitis?

A

Nonspecific findings of infection- fever, visiting, irritability, and lethargy
Anterior Fontainebleau may be present

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22
Q

What is the clinical presentation of a slightly older child with meningitis?

A

Stiff neck and positive Kernig’s and Brudzinski’s sign

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23
Q

What tests are done to diagnose meningitis?

A

Gram stain

Culture from blood, CSF, or petechial scraping

24
Q

What agar does Neisseria grow best?

A

Chocolate agar- blood agar that has been heated

25
Q

What is the classic medium for culturing Neisseria?

A

Thayer-Martin VCN media- chocolate agar with antibiotics
*Neisseria is the only bacteria that can grow in this
V- vancomycin
C- colistin
N- nystatin

26
Q

What an kill all gram-positive organisms?

A

Vancomycin

27
Q

What can kill all gram-negative organisms except Neisseria?

A

Colistin (polymyxin)

28
Q

What can eliminate fungi?

A

Nystatin

29
Q

How to culturally differentiate between the 2 Neisseria strains?

A

Neisseria meningitidis can produce acid from metabolism while Neisseria gonorrhoeae cannot

30
Q

What is another name for Neisseria gonorrhoeae?

A

Gonococcus

31
Q

What is the first sexually transmitted disease? What is the second?

A
  1. Chlamydia

2. Gonorrhoeae

32
Q

What are the virulence factors of Neisseria gonorrhoeae?

A

Pili, protein II

33
Q

What is the function of pili in Neisseria gonorrhoeae?

A

Protect bacteria from antibodies
Adhere to host cell allowing disease to occur
Prevent phagocytosis

34
Q

How does Neisseria gonorrhoeae occur in men?

A

Men who have unprotected sex with an infected person

35
Q

What is the mechanism of Neisseria gonorrhoeae in men?

A

Neisseria penetrates mucous membrane or urethra, causing inflammation (urethritis)

36
Q

What is the clinical presentation of a man with Neisseria gonorrhoeae?

A

Painful urination

Purulent urethral dish argue (pus from tip of penis)

37
Q

How is Neisseria gonorrhoeae occur in women?

A

Sexual transmission from infected person

38
Q

What is the clinical presentation of a woman with Neisseria gonorrhoeae?

A 
Painful burning on urination
Purulent discharge from urethra
Dyspareunia- pain with intercourse
Lower abdominal discomfort 
*more likely asymptomatic
39
Q

What is the clinical presentation of the cervix in a woman with Neisseria gonorrhoeae?

A

Reddened and friable with purulent exudate

40
Q

What can a gonococcal infection of the cervix progress to?

A

Pelvic inflammatory disease (PID)

41
Q

What is pelvic inflammatory disease?

A

Infection of the uterus (endometritis) , Fallopian tubes (salpingitis), and or/ovaries (oophoritis)

42
Q

What is the clinical presentation of a woman with PID?

A

Fever, lower abdominal pain, abnormal menstrual bleeding, and cervical motion tenderness

43
Q

What is the significance of an intrauterine device (IUD) in gonococcal infection?

A

Increases the risk of a cervical gonococcal infection that can progress to PID

44
Q

What are the complications of PID from gonorrhoeae?

A

Sterility- increased risk from scarring of Fallopian tubes preventing sperm from reaching egg
Ectopic pregnancy- increased risk from scarring of fallopian tube and inflammation
Abscesses- can develop in Fallopian tube, ovaries, or peritoneum
Peritonitis- bacterial spread from ovaries and Fallopian tube and infect peritoneal fluid
Peri-hepatitis- infection of the capsule around the liver

45
Q

What is the patient presentation of peri-hepatitis caused from Neisseria gonorrhoeae?

A

Right upper quadrant pain and tenderness

*also called Fitz-Hugh-Curtis syndrome

46
Q

What are 2 gonococcal diseases that can occur in both men and women?

A

Gonococcal bacteremia and septic arthritis

47
Q

What causes gonococcal bacteremia?

A

When Neisseria gonorrhoeae invades the bloodstream

48
Q

What is the clinical presentation of gonococcal bacteremia?

A

Fever, joint pains, skin lesions

49
Q

What is the clinical presentation of septic arthritis from Neisseria gonorrhoeae?

A

Acute onset of fever
Pain and swelling of 1 or 2 joints
Progressive destruction of joint

50
Q

What tests are done for septic arthritis from Neisseria gonorrhoeae?

A

Synovial fluid exam- high WBCs

Gram stain and culture of synovial fluid- gram-negative diplococci within the WBCs

51
Q

What is the most common kind of septic arthritis in young, sexually active individuals?

A

Gonococcal arthritis

52
Q

How is Neisseria gonorrhoeae transmitted in infants?

A

From pregnant woman to her child during deliver

53
Q

What is the clinical presentation of an infant who got Neisseria gonorrhoeae from delivery?

A

Ophthalmia neonatorum- eye infection that occurs on 1st or 2nd day of life
Damages cornea- causing blindness

54
Q

What is the best way to diagnose Neiserria gonorrhoeae?

A

Gram stain and culture on Thyer-Martin VCN medium

Gram stain will show diplococci within WBCs

55
Q

What disease can be caused by branhamella catarrhalis?

A

Otitis media, sinusitis, bronchitis, and pneumonia

56
Q

What are the characteristics of branhamella catarrhalis?

A

Formerly called Neisseria catarrhalis

Is part of the normal respiratory flora

COM MOD 2.2 Bacteria 1 (12 decks)

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