gram positive bacilli

Question 1

bacillus anthracis virulence factors (2)

Answer 1

1. antiphagocytic protein capsule
2. tripartite toxin (oedema + lethal toxins)

Question 2

3 types of bacillus anthracis

Answer 2

1. cutaneous anthrax
2. respiratory anthrax
3. intestinal anthrax

Question 3

bacillus anthracis transmission (3)

Answer 3

skin contact
aerosol
ingestion

Question 4

bacillus anthracis treatment (2)

Answer 4

1. penicillin
2. ciprofloxacin

Question 5

bacillus cereus clinical presentations

Answer 5

rapid onset (6h): vomiting (preformed toxin)
slow onset (8-24h): diarrhoea & abdominal pain (enterotoxin formed later)

Question 6

corynebacterium diphtheriae clinical presentations (3)

Answer 6

1. pseudomembrane formation
2. inflammation resulting in bull neck
3. sore throat, malaise, fever

Question 7

corynebacterium diphtheriae treatment (2)

Answer 7

1. penicillin
2. erythromycin

Question 8

listeria monocytogenes treatment

Answer 8

empirical: ceftriaxone + ampicillin + vancomycin
definitive: gentamicin

Question 9

listeria monocytogenes drug resistance

Answer 9

resistant to cephalosporins

Question 10

nocardia asteroides clinical presentations (2)

Answer 10

1. madura’s foot
2. nocardiosis

Question 11

nocardia asteroides transmission

Answer 11

soil, dirt (opportunistic infections)

Question 12

nocardia asteroides staining

Answer 12

acid fast bacilli–> ziehl neelsen stains

Question 13

nocardia asteroides treatment

Answer 13

co-trimoxazole

Question 14

clostridium perfringens clinical presentations (4)

Answer 14

1. clostridial necrotizing enteritis (necrosis of jejunum/ileum)
2. gas gangrene (myonecrosis)
3. food poisoning (spores germinate in gut)
4. clostridial cellulitis

Question 15

clostridium perfringens transmission (2)

Answer 15

1. faecal-oral
2. direct contact

Question 16

clostridium perfringens treatment

Answer 16

penicillin + clindamycin (treats toxin)

Question 17

clostridium tetani virulence factor

Answer 17

tetanospasmin toxin

Question 18

clostridium tetani clinical presentations (4)

Answer 18

spastic paralysis:
1. lockjaw
2. risus sardonicus (grin spasm)
3. opisthotonus (arched back)
4. respiratory muscle spasms

Question 19

clostridium tetani treatment

Answer 19

Human Tetanus IG (HTIG)

Question 20

clostridium botulinum virulence

Answer 20

botulinum toxin (preformed)
found in honey–> contraindicated in babies

Question 21

clostridium botulinum clinical presentations (3)

Answer 21

flaccid paralysis
1. ptosis (drooping of upper eyelid)
2. diplopia (double vision)
3. respiratory muscles affected
infants: floppy baby syndrome

Question 22

clostridioides difficile transmission

Answer 22

precipated by antibiotic use
commensal normally, pathogen when overgrown

Question 23

clostridioides difficile clinical presentations (2)

Answer 23

CDAD
pseudomembranous colitis (PMC)

Question 24

clostridioides difficile treatment

Answer 24

STOP ANTIBIOTICS
PO vancomycin or IV/PO metronidazole

Question 25

sporing bacteria (4)

Answer 25

1. clostridium spp (perfringens, difficile, tetani, botulinum)
2. bacillus spp (anthracis, cereus)
3. nocardia asteroides
4. lactobacilli

Question 26

nonsporing gram positive
bacilli (2)

Answer 26

1. listeria monocytogenes
2. corynebacterium diphtheriae