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HDID Block 2 > Neisseria > Flashcards

Neisseria Flashcards

1
Q

Presentation of N meningitidis

A

headache, fever, vomiting,

meningeal signs (neck stiffness, photophobia)

petechial rash

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2
Q

A petechial rash with meningococcemia suggests thrombocytopenia which can progress to ___

Other complications include hypotension and adrenal hemorrhage, both leading to __

A

A petechial rash with meningococcemia suggests thrombocytopenia which can progress to DIC

Other complications include hypotension and adrenal hemorrhage, both leading to shock

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3
Q

Which bug causes the rash below?

A

N meningitidis

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4
Q

Chronic meningococcemia can lead to___ (less serious N meningitidis infection)

A

Chronic meningococcemia can lead to arthritis/dermatitis syndrome (less serious N meningitidis infection)

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5
Q

Neisseria associate with (ciliated/non-ciliated) cells of the ciliated epithelial layer

A

Neisseria associate with non-ciliated cells of the ciliated epithelial layer

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6
Q

Pathogenesis of N meningitidis

A

passage thru mucosal epithelium (first in nasopharynx) >> survival in bloodstream >> crossing of blood brain barrier >> multiplication in subarachnoid space

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7
Q

Survival of N meningitidis in the bloodstream is mediated by the __ and __ from transferrin

A

Survival of N meningitidis in the bloodstream is mediated by the capsule (anti-phagocytic and protects from complement) and iron acquisition from transferrin

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8
Q

Virulence factors of Neisseria meningitidis

A

Polysaccharide capsule

Pili

Lipo-oligosaccharide

Factor H binding protein

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9
Q

N meningitidis capsule serogroups that cause disease are ___

Which ones cause disease in the developing vs developed world?

Serogroup B contributes the most to virulence because ___

A

A more common in developing world, B and C more common in developed countries

Type B = polysialic acid (sialic acid present on host cell membranes so this is a type of molecular mimicry)

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10
Q

What is the function of Pili in N meningitidis?

A

Attachement to resp epithelium (also binds CD46 - complement regulatory protein)

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11
Q

Role of LOS in N meningitidis

A

Potent endotoxin (mediates inflammatory response)

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12
Q

Dx of Neisseria meningitidis

A

Gram stain of CSF specimen

culture from blood or CSF specimen

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13
Q

Rx of N meningitidis

Prophylaxis for close contacts?

A

Ceftriaxone (no more penicillin b/c resistance)

3rd generation cephalosporins (remember the meningitis space helmet on general Taz’s head in Sketchy. One to know: ceftriaxone (3 axes))

Rifampin (#rifampin rifle)

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14
Q

Neisserica vaccine types: (describe what they’re made of)

Menomune (MSPV4)

Menactra (MCV4)

Menjugate

A

MPSV4 or Menomune - A, C, Y, W135 serotypes

MCV4 or Menactra - A, C, Y, W135 conjugated to diphtheria toxoid

Menjugate - C conjugated to diphtheria toxoid

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15
Q

New vaccines for serogroup B: (what’s in them)

Bexsero

Trumenba

A

Bexsero has 3 Neisserial antigens + outer membrane protein vesicles

Trumenba has 2 factor H binding protein variants

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16
Q

__ is a gram neg coccobacillus member of the Neisseria family that causes infectious arthritisin children (normal oropharyngeal flora, esp in kids)

A

Kingella kingae

17
Q

Dx of Kingella

Rx of Kingella infection

A

Dx: blood culture vials (grows poorly on agar)

Rx: Ampicillin or Ceftriaxone

18
Q

N gonorrhoeae presentation in males

A

Urethritis: purulent urethral discharge and dysuria

19
Q

N gonorrhoeae presentation in females

A

cervical/vaginal discharge; dysuria and abdominal pain

ascending infection leading to salpingitis (infection of fallopian tubes), ovarian abscesses, and pelvic inflammatory disease

20
Q

Other infections ass’d with Neisseria include __ (affects musculoskeletal system) and ___ (affects babies born to infected moms)

A

Arthritis

Conjunctivitis

21
Q

N gonorrhoeae pathogenesis

A

Bug initially adheres to the epithelial cells of the UG tract >> intimate attachment >> invasion of cells

Doesn’t go into bloodstream generally, and doesn’t cross blood brain barrier

Bug also enters and LIVES INSIDE neutrophils (PMNs) hence ass’n with WBCs

22
Q

N gonorrheae virulence factors

A

Pili - promote adherence to epithelial cells (PilE – major subunit of the pilus; PilC – adhesion on the tip of the pilus)

Opa (PII) - adherence to epithelial cells and neutrophils; suppresses lymphocyte functions

LOS - binds to asialoglycoprotein receptor on sperm and urethral epithelium

Iron binding proteins

23
Q

Mechanisms of protection from immune response of N gonorrhea

A

Antigenic and phase variation

(alter pili proteins/express different variations; sialylation of LOS mediated by gonococcal sialyltransferase (Lst) using host serum component)

24
Q

Rx for N gonorrheae

A

Ceftriaxone + azithromycin (assume co-infection with Chlamydia)

25
Q

Mechanism of N gonorrheae drug resistance

A

Efflux pump

HDID Block 2 (28 decks)

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