Diptheria

Question 1

Diphtheria is a bacterial URTI

T/F

Answer 1

T

Question 2

Diphtheria

Aetiological Agent:

•________________

Answer 2

Corynebacterium diphtheriae

Question 3

Diphtheria
Characteristics

• Gram __________
• Sporulating or Non-sporulating
• Encaspulated or Non-encapsulated
• Motile or Non-motile
•coccus or bacillus

Answer 3

positive

Non-sporulating

Non-encapsulated

Non-motile

Bacillus

Question 4

Diphtheria

_______ are the only known reservoir

Answer 4

Humans

Question 5

Diphtheria

Transmission:
• Spreads via _________ and _______

•____________ is important in transmission

Answer 5

air droplets and direct contact

Asymptomatic carriage

Question 6

Diphtheria

Incubation period of _____-_____

Answer 6

2-5 days

Question 7

Morphology of diphtheria

______ shaped

________ granules giving a _______ appearance

Answer 7

Club

Metachromatic

beaded

Question 8

Morphology of diphtheria

______ lettering appearance, because the ____________ or at _______ to each other

Answer 8

Chinese

rods lie parallel

acute angles

Question 9

Morphology:

On blood agar, the diphtheria colonies are (small or large?) and ____color with ______ edges

On tellurite blood agar, it produces _____________ colonies

Answer 9

Small; gray ; irregular

brown or black

Question 10

__________ media for corynebacterium diphtheria

Answer 10

Loeffler’s serum

Question 11

Biotypes of Corynebacterium Diphtheriae

List 4

Answer 11

Gravis
Intermedius
Mitis
Belfanti

Question 12

Diphtheria Virulence factors

Diphtheria toxin
• Heat ______

• Has _________ Fragments

Answer 12

labile

A and B

Question 13

Diphtheria Virulence factors

Diphtheria toxin

Fragment A: inhibits _______________

Fragment B: binds to ______ and ___________________________ via _______________

Answer 13

polypeptide chain elongation

receptors

allows the rest of the toxin (Fragment A) to enter the cell

receptor mediated endocytosis

Question 14

Pathogenesis of Diptheria

Diphtheria toxin gets into Mucous membranes

Destroys _______ and causes _______ that leads to ______

_______+ _______+ _______+ _______ forms a __________ over the tonsils, pharynx and larynx

_______________ become enlarged.

Answer 14

membrane epithelium

inflammation; necrosis

Necrotic epithelium + Fibrin + red and white cells

grayish pseudomembrane

Regional lymph nodes

Question 15

Pathogenesis
• Toxin can also cause distant damages, particularly to;

________
___________
_________
_________
____________

Answer 15

Heart muscle
Liver
Kidneys
Adrenal Glands
Nerves (demyelination)

Question 16

• diphtheriae does not need to be toxigenic to establish localized infection but nontoxigenic strains do not yield the localized or systemic toxic effects.

Answer 16

Tf?

Question 17

Clinical Features

————
Fever
Dyspnea (due to the _________)
_______
______itis
______________

Cutaneous infection causes _________

Answer 17

Sore throat

pseudomembrane

Suffocation

Card

Motor Neuropathy

indolent ulcers

Question 18

Circulating diptheria toxin is potentially fatal

T/F

Answer 18

T

Question 19

Clinical Features of diptheria

Fever : Low or High ? grade

Answer 19

Low

Question 20

Diagnosis of Diptheria

Presumptive

Confirmation by observing ______ on Tellurite medium

______ shows toxic gene

_________

Answer 20

Brown colonies

PCR

Culture

Question 21

Diagnosis of Diptheria

Culture

_________ plate, ______ serum agar or modified _______ are preferred.

______ agar or _____ agar may also be used

______ from nose, throat or other suspected lesions are used

Answer 21

Tellurite; Loffler’s

Tinsdale medium

Blood; Pai

Swabs

Question 22

Diptheria test for Toxigenicity

_____ Test
PCR
ELISA
Immunographic strip assay

Answer 22

Elek

Question 23

Therapy for Diphtheria

_________________ is given IV before waiting for diagnosis

Antimicrobials e.g Penicillin, erythromycin inhibits bacterial growth thereby _______________

Answer 23

Diphtheria Antitoxin (DAT)

arresting toxin production

Question 24

Prevention of Diphtheria

•_________________
• Chemoprophylaxis for close contacts

Answer 24

Toxoid immunization (DPT)

Question 25

Gram stain Staining is (uniform or uneven?), ___________ appearance

Answer 25

Uneven cross-banded

Question 26

metachromatic or _______ granules

Answer 26

volutin

Question 27

Sites of infection Main - _______,_____,______ Others -_____,______

Answer 27

pharynx, larynx , nose skin, genitals

Question 28

Non toxigenic strains also cause diptheria, T/F

Answer 28

F Non toxigenic strains do not cause diptheria, but may cause other diseases e. g. endocarditis, septicaemia

Question 29

__________ on attempting to remove the pseudomembrane

Answer 29

Bleeding

Question 30

__________ enlarged to give the bull neck appearance

Answer 30

Cervical nodes

Question 31

Cervical nodes enlarged to give the ______ appearance

Answer 31

bull neck

Question 32

Clinical types - ______________ Most severe form, high mortality, sequelae

Answer 32

nasopharyngeal

Question 33

Clinical types -nasopharyngeal ________ ___________

Answer 33

Faucial Laryngeal

Question 34

Clinical types -nasopharyngeal Faucial;affects _____,_____,_____,______ Difficulty in ________, __________ lymph nodes Laryngeal secondary to ____________. _______ obstruction ; Cervical nodes present

Answer 34

tonsils, uvula, soft palate, pharynx swallowing; Enlarged neck faucial diphtheria; respiratory

Question 35

Clinical types • Anterior nasal diphtheria (mild or severe?) form toxin (more or less?) well absorbed main symptom is ______________ (Mildly or highly ?) infectious •Cutaneous diphtheria _______ or _______ ———-

Answer 35

Mild; less nasal discharge ; highly Acute or chronic ulcers

Question 36

Complications of Diphtheria Cardiovascular - _________ Neurological - _________ -______ or ______ nerves Renal – manifest as ____________ Bronchitis, _______pneumonia, otitis media.

Answer 36

myocarditis polyneuritis; cranial or peripheral albuminuria bronchopneumonia

Question 37

Complications Neurological - polyneuritis - cranial or peripheral nerves - results in ______ of ________ , _______ of fluids, _______ and ———- paralysis

Answer 37

paralysis of soft palate regurgitation diaphragmatic and limb

Question 38

Diagnosis • Treatment based on _________ and not __________

Answer 38

clinical suspicion laboratory diagnosis

Question 39

Diagnosis • Lab diagnosis is important for _________

Answer 39

epidemiology

Question 40

Laboratory diagnosis _______ stain, ______ stain, ________ stain Culture: ________ slant , ______ agar

Answer 40

Gram; Neisser’s; Albert’s Loefflers; Tellurite

Question 41

Laboratory diagnosis Biochemical tests Ferments ______ (with or without?) gas never ferments _________

Answer 41

glucose without saccharose

Question 42

Virulence test –invivo :__________ -invitro: _______ test , tissue _______ molecular biology tests

Answer 42

laboratory animal Elek culture

Question 43

Virulence test: Elek test -Most __________ -_____________ test

Answer 43

commonly used Gel diffusion precipitin

Question 44

Treatment _______ to prevent spread ________–on clinical suspicion _________ for laryngeal obstruction

Answer 44

Isolate Antitoxin Tracheostomy