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RHS > L11- RTI III > Flashcards

L11- RTI III Flashcards

1
Q

Streptococcus properties:

  • Gram(+/-)
  • (cocci/rods)
  • catalase(+/-), but does contain (4)
  • (non-/motile)
  • most species are (obligate aerobes / obligate anaerobes / facultative anaerobes)
A

Gram+ cocci, catalase- but has Superoxide Dismutase (=> aerotolerant), non-motile, facultative anaerobes

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2
Q

Strep. spp. are divided into groups through (1) agar, but are classified by (2)

A

1- blood agar (sheep) => α β γ

2- polysaccharide Ag in cell wall => Lancefield groupings

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3
Q

GAS polysaccharide capsule is made out of…..

A

hyaluronic acid

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4
Q

S. pneumoniae capsule has the (1) property which is used for (2)

A

1- quellung reaction: swollen capsule in presence of antiserum
2- serotyping S. pneumoniae

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5
Q

S. pyogenes:

  • blood agar result is (1), it is due to presence of (2)
  • (3) is an important sensitivity/resistance property
  • (4) is an additional and notable positive test result
A

1- β-hemolytic
2- Streptolysin S
3- Bacitracin sensitivity
4- PYR+ (pyrolidonyl arylamidase hydrolysis of L-pyrolidonyl-β-naphthylamide)

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6
Q

S. pneumoniae:

  • blood agar result is (1)
  • (2) is an important sensitivity/resistance property
A

1- α-hemolytic

2- optochin sensitive

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7
Q

S. pyogenes:

  • pyogen = (1), because of (2) in the bacterium
  • (3) reservoir
  • (4) transmission
A

1- induces pus formation
2- leukocidin
3- human throat
4- direct contact, respiratory droplets

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8
Q

list the syndromes caused by S. pyogenes

A
  • pharyngitis (strep throat)
  • skin infections (impetigo, etc)
  • soft tissue infections
  • rheumatic fever
  • glomerulonephritis
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9
Q

what properties of Strep. spp. contributed to the varying virulence factors between species

A
  • transduction-mediated gene transfer (bacteriophages)

- transformation (DNA uptake from environment)

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10
Q

S. pyogenes / GAS virulence factors:

  • (1) and (2) are cell wall carbohydrate and protein respectively (indicate if they are for group/type)
  • (3) for phagocytosis evasion
  • (4) adherence / invasion
  • (5) toxins
A

1- A antigen (group specific- same for all GAS)
2- M protein (type specific- serotype)

3- capsule, C5a peptide + (M/M-like proteins, F protein, Lipoteichoic acid)
4- M proteins, F protein, Lipoteichoic acid
5- Streptolysin S (RBCs), Streptolysin O (WBCs) + (SPE/strep. pyrogenic exotoxins, DNAse)

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11
Q

describe the Sxs of GAS / Strep. pharyngitis

A

(suppurative GAS disease)

  • inflamed pharynx with exudates
  • anterior cervical lymphadenopathy
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12
Q

describe the Sxs of Scarlet Fever

A

(suppurative GAS disease)
-via GAS, sequela to Pharyngitis

  • diffuse erythematous rash: starts on trunk/chest –> moves to extremities
  • strawberry tongue
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13
Q

what are two non-suppurative diseases stemming from GAS

A
  • Rheumatic Fever: type II sensitivity rxn

- Acute Glomerulonephritis:

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14
Q

Rheumatic Fevers is caused by (1), proceeding (2). It results from a (3) type reaction. It is described symptomatically with the following: (4).

A

1- GAS
2- Strep. pharyngitis (2-4 wks)
3- type II hypersensitivity
4- endocarditis, polyarthritis, subcutaneous nodules, chorea (JONES criteria)

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15
Q

Acute Glomerulonephritis can result after (1) infection of the (2). It presents symptomatically with (3).

A

1- GAS
2- pharyngitis (7-10 days) or impetigo (3 wks)
3- edema, HTN, hematuria, proteinuria

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16
Q

Corynebacterium properties:

  • Gram(+/-)
  • (cocci/rods)
  • (non-/spore forming)
  • (aerobic/anaerobic)
  • (5) color and shape appearance on slide
A

Gram+ rods, non-spore forming, aerobic

5:

  • gray-to-black colonies
  • shape is pleomorphic called ‘club-shaped’ / V/L shaped / ‘chinese letter arrangement’ —- this is due to snapping cell division (incomplete membrane separation)
17
Q

The main corynebacterium species that cause infection is (1), while many other species are (2)

A

1- C. diphtheriae

2- non-pathogenic members of flora in pharynx, nasopharynx, skin

18
Q

C. diphtheriae appears as (1) color in slides due to (2) produced on (3) mediums after staining the sample metachromatically.

A

1- gray-to-black
2- granules / volutin
3- Loeffler’s coagulated serum medium

19
Q

The most critical virulence factor that may be present in C. diphtheriae is…..

A

(toxin producing strains)
-β-prophage carries genes for toxin (lysogeny, β-corynephage)

Note- phage from toxin-diphtheria infected Pt can infect / transmit to non-toxin diphtheria infected Pt
**Mobile gene elements

20
Q

Respiratory Diphtheria:

  • (1) regular Sxs
  • (2) hallmark Sxs, include what it can lead too
  • (3) severe manifestations
A

1- (sudden onset) exudative pharyngitis, sore throat, fever, malaise, dysphagia

2- i) thick pseudomembrane (dead cells / bacteria) –> can possibly cause respiratory obstruction; ii) bull neck appearance

3- myocarditis, recurrent laryngeal nerve palsy

21
Q

Cutaneous Diphtheria clinical presentation

A
  • papule on skin progresses to healing ulcer

- systemic signs can develop

22
Q

C. diphtheria can be dangerous in (1) areas because of (2)

A

1- endemic in some subtropical and tropical countries (+ underdeveloped countries with poor health infrastructure)

2- diphtheria toxoid vaccine is apart of DTaP

23
Q

C. diphtheria is a unique organism because it is not (1) to yield systemic symptoms, instead (2) will cause systemic manifestations. (2) can be acquired in C. diphtheria via (3). (2) will specifically cause (4) and (5).

A

1- non-invasive, does not enter bloodstream
2- diphtheria exotoxin
3- bacteriophage (lysogenic conversion)
4- inflammation and formation of pseudomembrane
5- damage to organs

24
Q

list the medias for C. diphtheria

A
  • Cysteine-Tellurite blood agar (CTBA)
  • Tinsdale medium
  • Colistin-nalidixic agar (CAN)
25
Q

what are the characteristics needed for Dx of C. diphtheria infection

A

(culture on selective media)
-characteristic grey-to-black colonies with brown halo

1) tellurite reductase +, cystinase +
2) urease -, pyrazinamidase -
3) toxingenicity test: ELEK, PCR

26
Q

describe the ELEK test and what it is used for

A

Test for toxigenicity, specifically for C. diphtheria

1) incubation culture with a streak of known non-toxigenic strain and unknown, suspected toxigenic strain
2) place filter paper with anti-toxin
3)
- Pos (toxigenic): lines of precipitin (area of no growth)
- Neg (non-toxigenic): grows the same as the known non-toxigenic strain

27
Q

______ are common squeal of infection

A
  • sinusitis

- acute otitis media (AOM)

28
Q

Sinusitis and AOM are mostly caused by (1) pathogens, including (2).

The second most common pathogens are (3) including (4).

A

1- viruses
2- rhinovirus, adenovirus, coronavirus (same as rhinitis)

3- bacteria
4- Strep. pneumoniae, Haemophilus influenza, Moraxella catarrhalis

29
Q

describe the Sxs of sinusitis

A

(inflammation of any of the four pairs of sinuses)

  • bad breath / loss of smell
  • fatigue, fever, HA
  • pressure-like pain with facial tenderness + pain behind eyes, toothache
  • nasal congestion and discharge
  • cough (worse at night)
  • sore throat, postnasal drip
30
Q

AOM Sxs:

(1) common Sxs
(2) describe the TM
(3) neonatal Sxs

A

1- fever, ear pain (ear tugging), hearing loss, ear stuffiness
2- (tympanic membrane) immobile, inflamed, perforated and or bulging of TM, ear discharge
3- irritability, feeding difficulties

31
Q

list the syndromes caused by Haemophilus influenzae

A

otitis media, sinusitis, pneumonia, epiglottitis, meningitis, COPD acute exacerbation

32
Q

(1) is the most common cause of epiglottitis, which is described as (2). (3) are other epiglottitis associated microbes.

A

1- haemophilus influenzae
2- epiglottic and supraglottic swelling / inflammation
3- C. diphtheria, N. meningitis

Note- 90% of epiglottitis is caused by bacteria

33
Q

Haemophilus influenzae:

  • (small/large)
  • (2) shape [cocci/bacillus]
  • Gram(+/-)
  • coagulase(+/-)
  • catalase(+/-)
A 
small 
Gram- 
coccobacilli with pleomorphic shape (shape is able to change / is variable)
coagulase-
catalase+
34
Q

describe the 2 types of Haemophilus influenzae

A

Non-Typeable / Non-Encapsulated:

  • colonizes in URT of children / adults
  • causes otits media, sinusitis, COPD exacerbations

Typeable / Capsulated:

  • serotyped a –> f
  • type b has invasive disease, Hib does have a vaccine
  • other types are apart of normal microbiota
35
Q

Haemophilus influenzae virulence factors:

  • (1) and (2) are for adhesion
  • (3) makes up capsule
  • (4) is a toxin
  • (5) is a useful protease
A

1- pili
2- non-pilus adhesins: P-2 outer membrane protein
3- PRP (polyribose ribitol phosphate)
4- LPS endotoxin impairs ciliary function
5- IgA proteases, >30 types

36
Q

describe the requirements for Haemophilus influenzae culture (and the appearance)

A

chocolate agar (heated blood agar) with the following factors:

  • X growth factor: acts as **hemin
  • V growth factor: **NAD (nicotinamide adenine dinnucleotide)

**colonies appear large, round, opaque

37
Q

Haemophilus influenzae Epiglottitis clinical features / common Sxs

A

fever, sore throat, dys-/odyno-phagia, stridor, restlessness, drooling, hoarseness, muffled voice, tripod position

38
Q

describe tripod position sign in Haemophilus influenzae Epiglottitis

A

trunk leaning forward
neck hyper-extended
chin thrust forward

39
Q

describe radiological evidence for Haemophilus influenzae Epiglottitis

A

enlarged epiglottis = ‘thumb sign’

aryepiglottic folds thickening

RHS (35 decks)

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