Gram-Negative Cocci Flashcards

1
Q

the 3 Gram-neg cocci?

A

Neisseria meningitidis; Neisseria gonorrhoeae; Moraxella catarrhalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

N meningitidis, vir factors?

A

GNC; capsulated; LOS – endotoxin; antigenic variation (fimbriae and opa)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

diff btwn N meningitidis and gonorrhoeae?

A

N meningitidis encapsulated (A/ B/ C/ Y/ W135)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

conj vacc for N mening

A

not for B only, so A/C/Y/W135 – quadrivalent vacc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how does grp B N mening vacc work?

A

not via capsular Ag; subcapsular peptides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

N mening; epid?

A

nasopharyngeal carr ~10%; transm = resp drops; outbreaks = institutions/close contact/mening belt in Africa; meningococcal disease most common in young children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

meningococcal disease most common in adults?

A

F

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what can commonly cause bac mening in young children?

A

N mening; Hib; Spn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

meningococcal rash; desc

A

initially macular but progresses; hemorrhagic rash (petechiae, purpura, ecchymoses)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Tumbler test; desc

A

+ve if rash does not blanch upon pressure; significant of meningcoccal inf

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

why does nonblanching rash occurs in meningococcal inf?

A

its not due to dilated blood vessels (which blanch upon pressure); its due to rupturing and bleeding of the small blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

rashes can be hard to see on a dark-skinned patient. where can rashes better be seen on such pts?

A

at the conjunctiva, eg conjunctival petechiae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

meningococcal disease; desc?

A

fulminant meningococcemia; meningitis (or can be both)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

desc Waterhouse-Friderischen

A

hemorrhagic adrenalitis (due to hemorrhage into the adrenal glands) that usually occurs secondary to severe meningococcal infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Dx of meningococcal?

A

Always blood culture; location as indicated (eg, CSF, throat, other sites). but molecular Dx increasingly impt

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Tx meningococcal

A

benzylpeni – R still v uncommon but dont clear nasophar carr; cetriaxone – clears nasophar carr

rmb surgical debridement

17
Q

high risk pts for mening?

A

asplenic or pts w/ hematologic diseases; certain travellers (eg, Hajj pilgrims, mening belt); local outbreaks (must perform prophyl for close contacts)

18
Q

meningo vacc

A

polysacc (not so good infant – rmb infants most vuln)

conj vacc (ie polysacc + prot) = quadrivalent (A/C/Y/W135) or monovalent (country specific)

subcapsular protein-based = grp B vacc (eg, 4CMenB)

19
Q

ABx as chemoprophyl for meningo?

A

rifamipicin, ciprofloxacin, ceftriaxone + vacc

20
Q

mening inf rarer complics?

A

pneumonia; pericard; endocard; conjuctiv; arthri

21
Q

gonorrhea in males SS?

A

urethritis – discharge, dysuria, local SS (eg epididymitis)

22
Q

Dx of male gonorrhea?

A

Gram stain!!! GNC, intracell, diplococci

23
Q

recurr gonorrhea can lead to____?

A

urethral strictures

24
Q

gonorrhea female inf can cause?

A

endocerv inf (SS = vag disch/ dysuria/ intermenstr bleeds); salpingitis (PID); Fitz-Hugh-Curtis (perihepatitis)

25
pyosalpinx can be observed in____?
acute salpingitis
26
why Gram stain less helpful for Dx in female gonorrhea?
backgroud has many other bacteria!!
27
which medium recover N gonorrhoeae?
modified Thayer-Martin medium (5% choc sheep blood w/ ABx)
28
gonorrhea can lead to? (for all ppl)
throat inf (usually asymp); proctitis; conjuncitivitis (think of ophthalmia neonatorum!!); dissem gonococcal inf; gonococcal arthri
29
female gonococcal-inf pts usually ________?
asymp at first -- carriage & reservoir
30
Dx for gonorrhea in general?
NAT using urine samples, throat and rectal swabs, male = urethral, female = endocervical/ LVS Gram strain for clean sites (eg, male urethra, joint fluid) culture -- in co2 enrinched medium (rmb charcoal transport medium!!)
31
Tx gonorrhea??
ceftriaxone IM 500mg
32
which to avoid for Tx of gonorrhea?
unless proven to be sus, penicillin & ciprofloxacin; increasing res to azithromycin as well (taken off first line agents in 2020)
33
what can M catarrhalis cause??
opportunistic chest infs (gen in ppl w/ comorbs)
34
Tx of M catarrhalis inf?
Coamoxiclav usually effective