Gram+ Cocci and Bacilli Flashcards
All of these are properties of Staphylococci bacteria EXCEPT:
A. they are exclusively nonmotile and nonspore forming
B. they are facultative aerobes/anaerobes
C. they may be either catalase-positive or -negative but are always coagulase positive
D. they demonstrate weak to beta-hemolytic activity
E. to cause disease, they must produce both a superantigen and a cytolysin
C.
All staph are catalase-positive, which distinguishes them from steptococci. They may be either coagulase-positive (S. aureus) or coagulase-negative (other strains of staph).
Which of the following statements about S. aureus is FALSE?
A. it contains protein A, a surface antigen that binds the Fc receptor of IgG and causes an antiphagocytic effect
B. it is a multdimensional organism with differentially regulated virulence factors
C. it uses MSCRAMMS such as LPXTG for host attachment
D. it makes the superantigens TSST-1, SEB and SEC
E. SCCmec is a mobile genetic element that encodes PBP2A for methicillin resistance, which makes S. aureus much more toxic
E.
SCCmec does not make Stapholococcus bacteria more toxic; rather, more difficult treat.
Which of the following secreted staph virulence factors is incorrectly matched with its mechanism of action?
A. alpha hemolysin: homo-heptamer necrotic to human skin
B. beta hemolysin: sensitive to cold temperature
C. gamma hemolysin: hetero-octomer pore former
D. delta hemolysin: blocks nerve repolarization
E. coagulase protein: activates clotting cascade
D.
delta hemolysin acts as a surfactant to solubilize host cell membranes. Alpha hemolysin, in addition to its dermonecrotic properties also blocks nerve repolarization
This is the Staph aureus global regulator whose ultimate effect is to increase RNA synthesis and secretion of virulence factors
AgR
(This is accomplished via the staph respiratory response system and the turning off of cell adhesion proteins.)
Why have vaccines to S. aureus failed?
Antibodies formed from vaccination help the bacteria aggregate, and wall itself off from immune cells
Which of the below statements regarding S. aureus pathogenesis is FALSE?
A. S. aureus forms boils and soft tissue abscesses by walling itself off from the host immune response via cell surface virulence factors.
B. Scalded skin syndrome is a non-inflammatory illness caused by S. aureus exfoliative exotoxins.
C. S. aureus produces alpha-toxin, which typically causes wide zones of alpha-hemolysis in blood agar.
D. Strains of S. aureus that infect the mucous membranes are less inflammatory than those that infect skin, but produce more superantigen.
E. S. aureus is the number one cause of infective endocarditis.
C.
Alpha-toxin causes wide zones of beta-hemolysis in blood agar.
This illness is defined by:
- fever >102ºF
- systolic BP < 90
- macular erythroderma
- peeling of the skin
- 3 multi-organ changes
toxic shock syndrome (TSS)
What are the 3 primary superantigens produced by Staphylococcus aureus in TSS?
- TSST-1 (causes virtually all menstrual TSS and half of “other” TSS)
- SEB and SEC (staphylococcal enterotoxin - causes the other half of “other” TSS)
Which of the following coagulase-negative staph organisms is matched incorrectly with its associated disease?
A. S. hominis: occasional cause of skin infection
B. S. lugdunensis: occasional cause of infective endocarditis
C. S. epidermidis: upper respiratory infection
D. S. saprophyticus: urinary tract infections
C.
S. epidermidis is the #1 cause of blood stream infections and is not a common cause of URIs (which are most commonly associated with S. pneumoniae and H influenzae).
Note: Coagulase-negative staphylococci are normal flora microbes and only a few cause human infections, usually in immunocompromised persons.
Which of the following statements about group A strep is FALSE?
A. it is also knowns as Streptococcus pyogenes and exhibits delayed sequelae
B. it is an unencapsulated mucoid organism
C. it produces the superantigen SPEC which is the primary cause of scarlet fever
D. it has beta-hemolytic activity
E. it is bacitracin sensitive
B.
Group A strep is a highly encapsulated (hyaluronic acid capsule) mucoid organism.
What cancer is associated with infections by Streptococcus bovis?
colorectal cancer (additionally, it is an occasional cause of infective endocarditis)
Which of the following is NOT an accurate descriptor of Streptococci?
A. They are chain-forming cocci
B. They are gram negative & alpha, beta, or gamma hemolytic
C. They are catalase negative
D. They use superoxide dismutase to survive aerobically
E. They are classified into groups by their acid extractable C carbohydrate
B.
They are gram positive organisms.
some strains of streptococcal bacteria, like group A strep, display this antiphagocytic component on their cell surface
M protein
this hemolytic exotoxin is responsible for the beta-hemolytic activity of group A strep
streptolysins O (in anaerobic conditions) and S
Which of the following cell-surface virulence factors is not associated with Streptococcus pyogenes?
A. SCCmec
B. fibronectin and Fc binding proteins
C. M protein
D. C5a peptidase
E. hyaluronic acid capsule
SCCmec is a mobile genetic element of Staphylococci that confers methicilin resistance.
M protein prevents the proper deposition of complement and is antiphagocytic. C5a peptidase cleaves C5a to prevent PMN influx. The hyaluronic acid capsule mimics self and repels phagocytes with its high negative charge. Binding proteins act as adhesins, allowing bacteria to attach themselves and gain entry to host cells.
Which of the following secreted virulence factors is not associated with Streptococcus pyogenes?
A. Streptolysin S
B. Streptokinase
C. Alpha toxin
D. SPEA
E. Cysteine protease
C.
Alpha toxin is a Staphylococcus exotoxin. Streptolysins S and O cause necrotizing tissue damage and are responsible for Group A Strep’s beta-hemolytic activity. ASO titers measure antibodies as an indicator of recent infection and help diagnose rheumatic fever.
Streptokinase breaks clots down and also causes tissue damage, as does Cysteine protease. All the SPEs are superantigens that cause scarlet fever.
Which of the following group A strep acute infections is matched incorrectly?
A. pharyngitis: throat infection associated with low M protein types
B. impetigo: skin infection associated with high M protein types
C. erysipelas: mildly inflammatory skin infection with low fever
D. puerperal sepsis: sepsis without hypotension, possibly with necrotizing fascitis
C.
Erysipelas is a highly inflammatory subcutaneous infection that is normally accompanied with high fever and erythematous, well-defined, plaque-like lesions.
This is a type III hypersensitivity reaction that is part of the Group A Strep delayed sequelae, and is characterized by immune complex deposition in the kidneys, leading to hypertension, proteinuria, & hematuria
actue glomerulonephritis
This is part of the Group A Strep delayed sequelae and is characterized by the development of rose-petal shaped lesions in genetically susceptible persons
Guttate psoriasis
This is a type III hypersensitivity reaction that is part of the Group A Strep delayed sequelae, and is characterized by painful nodular lesions on arms and legs due to immune complex disease
Erythema nodosum
This is part of the Group A Strep delayed sequelae, and is characterized by the development of OCD and tic disorders following infection
PANDAS - pedatric autoimmune neuropsychiatric disorders associated with Streptococci
common histological finding associated with rheumatic fever
Aschof body “granuloma”
Which of the following about Group B Stretococci is FALSE?
A. It is also known as S. agalactiae
B. It has a hyaluronic antiphagocytic capsule which contains C5a peptidase
C. It secretes cytolysins and has beta-hemolytic activity
D. It is transmitted to fetuses and neonates from vaginally colonized mothers
E. septic neonates often do not show fever
B.
It has a polysaccharide capsule, like S. aureus.
Which of the following groups of strep is NOT beta-hemolytic?
A. Group A strep (S. pyogenes)
B. Group B strep (S. agalactiae)
C. Group C strep (S. equisimilis)
D. Group D strep (S. bovis)
E. Group G strep
D.
S. bovis has either non- or alpha-hemolytic activity. S. pneumoniae and Viridans (S. mutans, S. sanguinis), have alpha-hemolytic activity as well.
Which of the following groups of strep is the most common cause of meningitis in adults?
A. Group A strep (S. pyogenes)
B. Group B strep (S. agalactiae)
C. Group C strep (S. equisimilis)
D. Group D strep (S. bovis)
E. S. pneumoniae
E.
S. pneumoniae is also the most common cause of pneumonia, and, along with Heamophilus influenzae, the most common cause of otitis media.
Which of the following groups of strep is associated with endocarditis and colorectal cancer?
A. Group A strep (S. pyogenes)
B. Group B strep (S. agalactiae)
C. Group C strep (S. equisimilis)
D. Group D strep (S. bovis)
E. Group G strep (S. dysgalactiae)
D
Which of the following groups of strep is the most common cause of meningitis in neonates?
A. Group A strep (S. pyogenes)
B. Group B strep (S. agalactiae)
C. Group C strep (S. equisimilis)
D. Group D strep (S. bovis)
E. Group G strep (S. dysgalactiae)
B.
Meningitis in neonates is also commonly caused by E. coli, and in unvaccinated children, H. influenzae.
facultative anaerobe that is either non-hemolytic or beta hemolytic, and is capable of transferring vancomycin resistance to other gram positive cocci
Enterococci
this strain of viridans streptococci causes dental caries by demineralization of teeth due to acid production
S. mutans
Which of the following groups of bacteria is the most common cause of infective endocarditis?
A. S. pyogenes
B. S. agalactiae
C. S. aureus
D. S. pneumonia
E. S. bovis
C
S. aureus is attributed to 45% of cases of IE each year. Viridans strep causes another 35% and Enterococcus another 10%.
gram positive spore-forming rod that infects the upper respiratory tract with minimal host invation
Corynebacterium diphtheriae
Note: vaccinate with diphtheria toxoid to prevent diphtheria
Which of the following statements regarding diptheria is FALSE?
A. Low iron levels in the host cause repression of diphtheria exotoxin production.
B. Diphtheria exotoxin is is nicked into two fragments: a (B) fragment that binds host cell receptors and facilitates the internalization of the (A) fragment, which is an active enzyme.
C. Diptheria colonizes the URT and kills epithelial cells and infiltrating PMNs, creating an ulcer and pseudomembrane of necrotic exudate.
D. Heart failure is the primary cause of death in diphtheria.
E. Absorption of the diphtheria exotoxin in the blood stream leads to fever, vomiting, diarrhea and polyneuritis.
A. High iron levels function as a co-repressor of exotoxin production.
This gram-positive motile rod is beta-hemolytic and is a facultative intracellular pathogen - immunity depends on cellular mechanisms/CD8 T cells
Listeria monocytogenes
Which of the following statements about Listeria is FALSE?
A. It produces listeriolysin O to evade phagosomes
B. It survives intracellularly in PMNs, DCs, Macrophages and B cells
C. It is propelled by a flagellum and primarily affects the immunocompromised and nenonates.
D. It causes meningitis like Group B strep, but exhibits granuloma formation
E. It is spore forming
E
Which of the following statements regarding B. anthracis and B. cereus is FALSE?
A. They are both spore-forming aerobes
B. Anthracis is hemolytic while cereus is non-hemolytic
C. Anthracis has been weaponized with silica while cereus is associated with food poisoning and makes enterotoxins
D. They are both nonmotile.
E. Anthracis forms a poly-D-gamma-glutamic acid capsule while cereus is unencapsulated.
B.
This is backwards. Anthracis is non-hemolytic and cereus is beta-hemolytic.
Which of the following biosafety level ratings would a lab need to possess pathogens such as Mycobacterium tuberculosis and Yersinia pestis?
A. BSL-1
B. BSL-2
C. BSL-3
D. BSL-4
C
A BSL-3 rating means the lab has controlled access and monitored negative air flow, among other safety/containment measures.
A BSL-2 rating is required for working with S. aureus and S. pyogenes.
Which of the following statements about Bacillus anthracis is INCORRECT?
A. It is highly susceptible to all antibiotics
B. Its enzymatically active components are a pore-forming homo-heptamer with protein kinase protease activity, and an edema-causing adenylate cyclase.
C. Spores from the organism are carried to the cervical spine where they germinate and proliferate
D. Causes gram-positive shock with septicemia when ingested or breathed
E. Causes intoxication locally by direct contact
C.
After a 1-2 day incubation period, spores are carried to the mediastinum by phagocytic cells where they germinate and proliferate. Pulmonary anthrax is the most severe form of infection and is diagnosed via chest xray
What causes the mediastinal widening observed on a chest xray during pulmonary anthrax infection?
mediastinal lymph nodes become filled with the bacteria, and inflamed because of the severe immune response
