M5 PART 6

Question 1

• aerobic (5% – 10%), Gram-negative
• non-motile diplococcus
• Kidney bean shaped
• Culture: Sheep blood agar, chocolate agar

Answer 1

NEISSERIAE

Question 2

NEISSERIAE

oxygen requirement

Answer 2

aerobic

Question 3

NEISSERIAE

motility

Answer 3

nonmotile

Question 4

NEISSERIAE

shape

Answer 4

kidney bean shaped

Question 5

NEISSERIAE

culture media

Answer 5

sheep blood agar, chocolate agar

Question 6

Neisseria gonorrhoeae

POE

Answer 6

genital tract

Question 7

Neisseria gonorrhoeae

maltose formation

Answer 7

negative

Question 8

Neisseria gonorrhoeae

β-lactamase production

Answer 8

some

Question 9

Neisseria gonorrhoeae

vaccine

Answer 9

no

Question 10

Neisseria meningitidis

POE

Answer 10

respiratory tract

Question 11

Neisseria meningitidis

maltose formation

Answer 11

positive

Question 12

Neisseria meningitidis

β-lactamase production

Answer 12

none

Question 13

Neisseria meningitidis

vaccine

Answer 13

yes

Question 14

NEISSERIAE GONORRHOEAE | ANTIGENIC STRUCTURE

• they enhance adhesion to host cells & resistance to phagocytosis
• important to establish a disease

Answer 14

PILI (FIMBRIAE)

Question 15

NEISSERIAE GONORRHOEAE | ANTIGENIC STRUCTURE

• it forms pores in the surface
• Prevent fusion of phagosome with lysosome

Answer 15

POR PROTEIN

Question 16

NEISSERIAE GONORRHOEAE | ANTIGENIC STRUCTURE

adhesion and migration of the bacteria

Answer 16

OPA (OPACITY) PROTEIN

Question 17

NEISSERIAE GONORRHOEAE | ANTIGENIC STRUCTURE

• reduction modifiable protein
• It associates with Por protein

Answer 17

Rmp (protein III)

Question 18

NEISSERIAE GONORRHOEAE | ANTIGENIC STRUCTURE

• has endotoxin
• fewer sugar

Answer 18

LIPOOLIGOSACCHARIDES (LOS)

Question 19

NEISSERIAE GONORRHOEAE | PATHOGENESIS & CLINICAL FINDINGS

Gonococci attack ____ of the GUT, eye, rectum, and throat

Answer 19

mucus membrane

Question 20

NEISSERIAE GONORRHOEAE | PATHOGENESIS & CLINICAL FINDINGS

Gonococci attack mucus membrane of the GUT, eye, rectum, and throat

Answer 20

chronic inflammation
fibrosis

Question 21

NEISSERIAE GONORRHOEAE | PATHOGENESIS & CLINICAL FINDINGS

GONORRHEA:
urethritis, with yellow, creamy pus, and painful urination

Answer 21

MEN

Question 22

NEISSERIAE GONORRHOEAE | PATHOGENESIS & CLINICAL FINDINGS

GONORRHEA:
primary infection is in the endocervix and extends to the urethra and vagina, giving rise to mucopurulent discharge; half of the women are asymptomatic carriers

Answer 22

WOMEN

Question 23

NEISSERIAE GONORRHOEAE | PATHOGENESIS & CLINICAL FINDINGS

local gonorrheal infection in women

Answer 23

gonorrhea

Question 24

NEISSERIAE GONORRHOEAE | PATHOGENESIS & CLINICAL FINDINGS

ascending gonorrheal infection in women

Answer 24

PELVIC INFLAMMATORY DISEASE (PID)

Question 25

# **NEISSERIAE GONORRHOEAE** | PATHOGENESIS & CLINICAL FINDINGS * **salpingitis** (frequent complication in women when the infection **ascends to the uterine tube**) * May lead to **ectopic pregnancy** * **Infertility** may occur in **20%** of the women with gonococcal salpingitis

Answer 25

PELVIC INFLAMMATORY DISEASE (PID)

Question 26

# **NEISSERIAE GONORRHOEAE** | PATHOGENESIS & CLINICAL FINDINGS * **Skin lesions** (especially hemorrhagic papules and pustules) on the **hands**, **forearms**, **feet**, and **legs** * **Tenosynovitis** and **suppurative arthritis**, usually of the **knees**, **ankles**, and **wrists**

Answer 26

Gonococcal bacteremia

Question 27

# **NEISSERIAE GONORRHOEAE** | PATHOGENESIS & CLINICAL FINDINGS * Gonococcal ophthalmia neonatorum, an **infection of the eye in newborns** * can be passed to newborns via **vaginal delivery**

Answer 27

NEONATAL INFECTIONS

Question 28

# **NEISSERIAE GONORRHOEAE** | PATHOGENESIS & CLINICAL FINDINGS infection of the eye in **newborns**

Answer 28

Gonococcal ophthalmia neonatorum

Question 29

# **NEISSERIAE GONORRHOEAE** | TREATMENT DOC: **uncomplicated** genital or rectal infections

Answer 29

ceftriaxone IM azithromycin

Question 30

# **NEISSERIAE GONORRHOEAE** | TREATMENT Patient with **azithromycin allergy**

Answer 30

DOXYCYCLINE

Question 31

# **NEISSERIAE GONORRHOEAE** | PATHOGENESIS & CLINICAL FINDINGS **prevention** of neonatal infections

Answer 31

instillation of **erythromycin ointment**

Question 32

# **NEISSERIAE MENINGITIDIS** | ANTIGENIC STRUCTURES serogroup A, B, QC, X, Y

Answer 32

capsular polysaccharide

Question 33

# **NEISSERIAE MENINGITIDIS** | ANTIGENIC STRUCTURES for **humans**

Answer 33

W-135

Question 34

# **NEISSERIAE MENINGITIDIS** | ANTIGENIC STRUCTURES outer membrane

Answer 34

proteins & LPS

Question 35

# **NEISSERIAE MENINGITIDIS** | PATHOGENESIS POE

Answer 35

respiratory tract

Question 36

# **NEISSERIAE MENINGITIDIS** | ANTIGENIC STRUCTURES what makes it unique

Answer 36

N-acetyl-mannosamine

Question 37

# **NEISSERIAE MENINGITIDIS** | PATHOGENESIS Nasopharynx → bloodstream

Answer 37

meningococcal bacteremia

Question 38

# **NEISSERIAE MENINGITIDIS** | PATHOGENESIS “**Flu-like**” infection

Answer 38

invasive meningococcal disease (MID)

Question 39

# **NEISSERIAE MENINGITIDIS** | CLINICAL FINDIGNS **intense headache**, vomiting, photophobia, confusion, and stiff neck → **COMA**; common complication of meningococcal bacteria in age **2 to 18** years old

Answer 39

MENINGITIS

Question 40

# **NEISSERIAE MENINGITIDIS** | CLINICAL FINDIGNS * **High fever** and **rash** * **Waterhouse-Friderichsen syndrome** * Disseminated **intravascular coagulation** (DIC) → **circulatory collapse** and **adrenal insufficiency**

Answer 40

MENINGOCOCCEMIA (sepsis)

Question 41

# **NEISSERIAE MENINGITIDIS** | CLINICAL FINDIGNS most severe

Answer 41

Waterhouse-Friderichsen syndrome

Question 42

# **NEISSERIAE MENINGITIDIS** | TREATMENT DOC

Answer 42

PENICILLIN G

Question 43

# **NEISSERIAE MENINGITIDIS** | TREATMENT ALTERNATIVES

Answer 43

chloramphenicol cefotaxime ceftriaxone