micro 4

Question 1

corynebacterium diphtheria charcteristics

Answer 1

catalase positive 
club shaped rods 
gram positive 
palisade like 
immotile

Question 2

corynebacterium diphtheria reservior

Answer 2

only humans

Question 3

talk about diphtheria toxin

Answer 3

encoded by tox gene introduced into bacteria by lysogenic bacteriophage which is an exotoxin made of 2 subunits
A : has a catalytic region to inhibit elongation factor EF-2
B that has receptor binding and translocation

Question 4

two main clinical presentations of diphtheria

Answer 4

respiratory and cutaneous

Question 5

respiratory diphtheria

Answer 5

exaudative pharyngitis low grade fever and sore throat
pharyngeal exaudate is firmly adherent pseudomembrane in oropharynx after a week it gets dislodged and expectorated
bull neck
systemic spread of toxin causes myocarditis and neurotoxin

Question 6

cutaneous diphtheria

Answer 6

papule that develops into chronic non healing ulcer

Question 7

lab diagnosis of diphtheria

Answer 7

culture in tellurite contain media (HOYLE and TINSDALE )

toxigenicity test by ELEK or PCR for tox gene

Question 8

most important treatment step for corynebacterium diphtheria

Answer 8

administration of antitoxin

Question 9

antibiotic for corynebacterium diphtheria

Answer 9

penicillin and erythromycin

Question 10

Bacillus anthracis charc and how is it acquired

Answer 10

gram positive , spore former

acquired by occupational exposure to herbivorous animals

Question 11

main virulence factors of Bacillus anthracis

Answer 11

toxin component ;
PA , LF and EF
polypeptide capsule

Question 12

role of each component of Bacillus anthracis toxin

Answer 12

PA ; cell binding and endocytosis
EF: increase camp
LF ; stimulate IL-1 and TNF alpha augment IR

Question 13

ANTHRAX FORMS and charac

Answer 13

cutaneous (hide porters ) : commonest and least severe, 12 days after injury a pupule forms that then forms to blister then central necrosis and hemorrhage (BLACK ISCHAR) before falling
Gastrointes. : mucosal ulceration and mesentric LAP
inhalation ( wood sorter) : symp 2 months after spore entry (mediastinal infection and mediastinal LAP)

Question 14

how is Bacillus anthracis diffrentiated from rest of Bacillus species

Answer 14

immotile
non hemolytic on sheep blood agar
medusa head

Question 15

anthrax treated by

Answer 15

ciprofloxacin and doxycycline

Question 16

bordetella pertussis charac

Answer 16

strict aerobic , gram - coccobacilli

Question 17

does bordetella pertussis have any reservoir other than humans

Answer 17

no

Question 18

pathogenicity of bordetella pertussis

Answer 18

attachment by protein adhesin ( pertactin , hemagglutinin) and fimbrie
tissue damage : dermonecrotic toxin (ischemia)
tracheal cytotoxin
systemic toxicity by pertussis toxin :
no control over adenylate cyclase cause increase in cAMP , hyperglycemia , lymphocytosis

Question 19

bordetella pertussis incubation period

Answer 19

7-10 days

Question 20

stages of bordetella pertussis clinical illness

Answer 20

• catarrhal (1-2 wks) : common cold , bacterial shedding is highest
• paroxysmal (2-4 wks) : whooping cough paroxsyms and lymphocystosis
• convalescent (3 wks) ; decreased paroxsymal intensity but complications ( pneumonia , seizures , encephalopathy)

Question 21

how to detect bordetella pertussis on culture

Answer 21

on Bordet Gingou agar or regan lowe agar

Question 22

what to do to decrease transmission and shorten disease course of bordetella pertussis

Answer 22

antibiotics within given 3 weeks of cough onset

Question 23

first line of bordetella pertussis

Answer 23

macrolide ( azithromycin)

Question 24

vaccine of bordetella pertussis

Answer 24

acellular pertussis toxoid vaccine (aP)

Question 25

when is ap toxoid vaccine given in jordanian national program

Answer 25

2,3,4 mths

booster at 18

Question 26

post exposure prophylaxis of bordetella pertussis

Answer 26

azithromycin

Question 27

actinomyces spp charac

Answer 27

gram +
branching filament
anaerobic strictly

Question 28

main specie of actinomyces

Answer 28

a. israelii

Question 29

what does a. israelii do clinically

Answer 29

actinomycosis (chronic inflam. with formation of granuloma that is supparative )
also there are abscesses that are connected by sinus tract

Question 30

the pus that is secreted by a. israelii has what granules

Answer 30

sulfur granules

yellowish masses bound by calcium phosphate

Question 31

actinomycoses forms

Answer 31

cervicofacial : poor oral hygiene
thoracic : lung abcess
abdominal: appendix and ileocecal
pelvic: with IUCD lead to tuboovarian abcess)

Question 32

actinomycosis diagnosed by

Answer 32

microscopy of sulfur granules

Question 33

DOC of actinomycosis

Answer 33

penicillin

Question 34

nocardia like what spp

Answer 34

actinomyces but it is aerobic and have a beaded appearance

Question 35

members of nocardia

Answer 35

N. asteroides and N. brasilienses

Question 36

clinical feautures of nocardia

Answer 36

bronchopulmonary disease
cutaneous : mycetoma and lymphocutaneous
brain disease

Question 37

diagnosis of nocardia culture

Answer 37

culture needs 5-10% CO2 and BCYE

Question 38

mass spectrometry and molecular methods of nocardia

Answer 38

mass spectrometry : MALDI-TOF MS

molecular : 16rRNA gene sequence

Question 39

DOC for nocardia

Answer 39

co-trimaxazole

Question 40

treatment of nocardia is prolonged

Answer 40

true ( 12 mths or more)