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MHD Block 3:: Gram Negative Cocci and Bacilli > Neisseria > Flashcards

Neisseria Flashcards

1
Q

Characteristics of Neisseria

A

Gram Negative Diplococci (kidney bean)

LPS Endotoxin
Capsulated
Pili (Antigenic Variation)
Chocolate Agar (enriched media)
Oxidase Positive
IgA Protease
Oxidize glucose
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2
Q

What are the classification differences between N.Gonorrhea and N.Meningitidis?

A

N.Gonorrhea: No growht on blood agar, no maltose oxidation

N.Meningitidis: Growht on blood agar. Oxidize Maltose

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3
Q

Why is complement deficiency important in Neisseria disease?

A

Bactericidal activity against Neisseria requires intact complement
C5-C9 complement deficiency -> no MAC complex -> increased susceptibilty to Neisseria

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4
Q

What determines pathogenicity of Neisseria?

A

Pili
Polysaccharide Capsule: prevents phagocytosis until opsonization
LPS

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5
Q

What is the clinical result of N.Meningitidis infection?

A

Meningococcemia (sepsis): Shock, hemorrhage, purpura, adrenal hemorrhage

Meningitis: HA, AMS, petechiae

Pneumonia
Arthritis
Pericarditis
Urethritis

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6
Q

What is an immunizing event in N.Meningitidis infection?

A

REspiratory colonization in nasopharynx area -> make Ab-> gone-> immunized

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7
Q

How do we use lab tools to diagnose N.Meningitidis?

A

CSF, Blood, Skin Cultures:
Oxidase positive, oxidize glucose and maltose
Nonselective mediat (blood or chocolate)
Growth inc in CO2

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8
Q

How does a blood smear of a pt with meningococcemia look like?

A

Immature neutrophils with N.meningitidis inside the cell -> phagocytosed

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9
Q

How is N.Meningitidis treated?

A

Penicillin

Ceftriaxone

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10
Q

What is a prophylactic prevention method for N.Meningitidis?

A

Rifampin for household contacts

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11
Q

What is the vaccine for N.Meningitidis?

A

Polysaccharide containing groups other than B conjugated to Diphtheria toxoid

DOES NOT INCLUE GROUP B

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12
Q

What are the new vaccines for N.meningitidis and hwo is it given to?

A

New serogroup B vaccines to cover group B

Only given to very high risk patients

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13
Q

Who are at increased risk for meningococcal disease?

A

Children at age 11
College frehsman living in dorms
Asplenic and Sickle Cell Patients

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14
Q

What are the antigenic structures of N.Gonorrhea?

A

Pili: adherence factor
PorB : outer membrane porin protein
Opa: adherence proteins -> gives opaque appearance to colonies
Rmp: stimulate blocking antibodies

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15
Q

Which antigenic structures of N.Gonorrhea show antigenic variation?

A

Pili

Opa

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16
Q

How is N.Gonorrhea most commonly transmitted?

A

STD

17
Q

What are the reservoir for N.Gonorrhea?

A

Asymptomatic carrier patients

18
Q

What causes the innflammatory response and damage in N.Gonorrhea?

A

LOS and peptidoglycan fragments

19
Q

How does N.Gonorrhea cause PID

A

Pelvic Inflammatory Disease

LPS and fragments spread to deeper structures -> endometrial cavity -> fallopian tubes-> PID

20
Q

How does N.Gonorrhea avoid the immune system?

A 
Antigenic variation
Resist Phagocytosis: Opa/Pili
Bind Transferrin in host
IgA1 protease
Evade Ab and complement mediated killing- RMP causes blocking antibodies
21
Q

What are the most common manifestations in males with N.Gonorrhea?

A

Urethritis

Purulent Urethral Dishcarge

22
Q

What is the primary clinical disease for gonorrhea?

A

Urethritis/Cervicitis

Proctitis
Pharyngitis
Conjunctivitis

23
Q

What is unique about septic arhtritis with N.Gonorrhea?

A

Asymmetric: Only 1 knee would swell up with purulent fluid

24
Q

How is N.Gonorrhea dx in the lab?

A

Gram Stain
Cultures: Chocolate agar + CO2, Martin Lewis, Oxidase Positive, Oxidize Glucose (NO MALTOSE)
PCR:

25
Q

How is gonorrhea treated?

A

Ceftriaxone (IM injection) + Azithromycin (all single dose)
OR
Ceftriaxone + Doxycycline (5 days)

26
Q

What are the unique characteristics of N.Gonorrhea?

A 
Not capsulated
STD
Asymmetric Septic ARthritis
Chlamydia coinfection
Gram Neg Diplococci
Facultative Intracellular in PMNs
27
Q

How does N.Gonorrhea get penicillin resistance?

A

Decreased affinity for penicillin for PBPs

Plasmid mediated B-lactamase (destroys penicillin)

28
Q

What are the secondary clinical diseases of N.Gonorrhea?

A

Males: spread to urinary tract => epididymitis, prostatitis
Females: Salpingitis (damaged fallopian tube)

Arhtritis
Dermatitis: distal extremities; papulopustular

MHD Block 3:: Gram Negative Cocci and Bacilli (6 decks)

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