other gram positives

Question 1

draw the algorith for gram positive bacteria

Question 2

what do all clostridium have in common ?

Answer 2

all form spores
all are obligate anaerobes
all form toxins

Question 3

what are the obligate intracellular anaerobes ?

Answer 3

rickettsia
chlamydia
coxiella
clostridiu,

Question 4

who are the pore forming bacteria ?

Answer 4

ABC
autoclave to kill bacillus and clostridium

Question 5

where is clostridium tetani found and how do they enter the body ?

Answer 5

spores are found in the soil
enter through penetrating injuries , as with walking barefoot

Question 6

what is the toxin of tetanus and what does it do ?

Answer 6

tetansopasmin
retrograde axonal transport to CNS
blocks glycine and GABA release by inhibitory neurons
attacks renshaw cells
causes spastic paralysis

Question 7

what are the classic spasm of tetanus ?

Answer 7

lock jaw
risus sardonicus ( permanent smile)

Question 8

what is the treatment of tetanus?

Answer 8

debriement of the wound
metronidazole
tetanus immunoglobulin
benzos or neuromuscular blockers

Question 9

what is in the vaccination for tetanus ?

Answer 9

the toxoids

Question 10

what is so special about botulinum spores ?

Answer 10

produce heat labile toxins that damages SNARE proteins

Question 11

what is the mechanism of botulinium toxin ?

Answer 11

Forms a heat labile toxin that cleaves SNARe protein that then
blocks the release of ACH so no muscle contraction
leads to flaccid paralysis

Question 12

where is the DNA for c botulinium usually found ?

Answer 12

found in many different variants
carried by bacteriophages

Question 13

what are the three types of botulinium and what are their features ?

Answer 13

food - usually in adults , from canned undercooked food
infant - ingestion of spores , grow in intestines , associated with honey, floppy baby syndrome
wound - infection

Question 14

what are the symptoms of botulism ?

Answer 14

usually ocurs after 12-48 hours of ingestion
5D symptoms :
diplopia
dysphagia
dysphonia
descending flaccid paralysis
NO SENSORY DEFECITS

Question 15

what is the treatment of botulism ?

Answer 15

antitoxin
supportive care

Question 16

where is clostridiu perferinges found ?

Answer 16

widespread in soil

Question 17

what are the effects of infection by c perferinges ?

Answer 17

causes gas gangrene - clostridial myonecrosis

Question 18

what is the toxin associated with clostridium perferinges ?

Answer 18

alpha toxin
causes hemolysis of muscles
it is a phospholipase that acts on lecithin and degrades it in the cell membrane

Question 19

what bis the presentation of food poisoning in association with c perferinges ?

Answer 19

1- it happens after the ingestion of the spores in association with undercooked meats
2- late onset with watery diarrhea because the ingestion of spores makes the presentation late

Question 20

what is the classic clinical scenario associated with c difficile infection ?

Answer 20

ingestion of the spores are not harmful
colonic flora prevents the overgrowth
the environment only becomes favourable after antibiotic administration

Question 21

what bacteria is associated with antibiotic associated colitis ?

Answer 21

c difficile

Question 22

what are the toxins associated with c difficile ?

Answer 22

toxin a - enterotoxin causes watery diarrhea
toxin b - cytotoxin causes cell necrosis and fibrin deposition
toxin b is more potent

Question 23

what is the mechanism of action associated with the toxins made by c difficile ?

Answer 23

both toxins bind to GI cells and are internalized
destroy the cytoskeleton of GI cells and form a pseudomembrane

Question 24

massive watery diarrhea and history of ab therapy ?

Answer 24

suspect c difficile

Question 25

how is a diagnosis of c difficile made ?

Answer 25

stool detection of toxin a or b

Question 26

what is the treatment for c difficile ?

Answer 26

metronidazole ORAL vancomycin

Question 27

what is the toxin associated with diphtheria annd what is the associated mechanism ?

Answer 27

diphtheria exotoxin not part of bacterial genoe carried by b prophage inactivates EF2 by ADP ribosylation

Question 28

what is the shape of corynebacterium features ?

Answer 28

club shaped gram positive rods Chinese character distribution

Question 29

what are the media used for c diptheria ?

Answer 29

loefflers media or tinsdale

Question 30

what test is used for the diagnosis of diphtheria ?

Answer 30

elek test for diagnosis and toxin detection

Question 31

what are the symptoms of diptheria ?

Answer 31

gray white membrane in the back of the throat lymphadenopathy fever sore throat

Question 32

what is the treatment for acute infection of diphtheria ?

Answer 32

penicillin diphtheria anti toxin ( passive immunization) diphtheria toxoid ( active immunization )

Question 33

how is a lab diagnosis of diptheria made ?

Answer 33

based on gram positive rods with metachromatic granules and positive elek test for toxin

Question 34

what is the unique moving mechanism of listeria ?

Answer 34

tumbling motility moves from cell to cell to avoid extracellular responses it polymerizes actin in cells to move " actin rockets"

Question 34

what is the virulence of diptheria toxin ?

Answer 34

encoded by B prophage that allows of ADP ribosylation of elongation factor 2

Question 35

what type of patients are most likley to get listeria ?

Answer 35

in people with poor cell mediated immunity in adults who consume undercooked meats unpasteurized cheese or milk likes cold temperatures

Question 36

what are the three clinical pictutes associated with listeria ?

Answer 36

gastroenteritis - self limited meningitis - elderly or newborns infection in pregnancy - usually in 3rd trimester

Question 37

what happens if a pregnant mother infects her foetus with listeria ?

Answer 37

newborn gets granulomatosis infantiseptica severe in utero infection most babies will be still born

Question 38

what is distinctive in the placenta with babies that develop granulomatosis infantiseptica ?

Answer 38

chorioamnionitis villitis abscess formation

Question 39

what are the two types of bacillus ?

Answer 39

bacillus anthrax baciilus cereus

Question 40

which is the only bacteria with a polypeptide capsule ?

Answer 40

bacillus anthrax and contains d-glutamate most are polysacchrides

Question 41

what type of workers are more at risk of bacillus anthrax ?

Answer 41

farm workers

Question 42

what are the toxins associated nwith bacillus anthrax ?

Answer 42

protective factor edema factor- acts as adenyl cyclase and increases cAMP lethal factor-inhibits MAP kinase, allows for macrophage apoptosis

Question 43

what is the cutaneous disease of anthrax ?

Answer 43

painless black ulcer forms edema surrounds the black ulcer from edema factor

Question 44

what is the clinical picture associated with the pulmonary disease of anthrax ?

Answer 44

woolsorters disease , caused by the inhalation of spores fluu symptoms then eventually may cause pulm hge

Question 45

what is the classic finding on chest x ray of people with wool sorters disease ?

Answer 45

wide mediastinum

Question 46

what is the classic scenario associated with bacillus cereus ?

Answer 46

classically in undercooked or reheated rice cause by ingesting the enterotoxin reheated rice syndrome

Question 47

what are the two types bacillus cereus disease ?

Answer 47

emetic type - rice dished direct ingestion of toxin diarrheal type - caused by several enerotoxins , heat labile toxins

Question 48

what gram positive bacteria is normally found in both the oral flora and in the female genital tract ?

Answer 48

actinomyces

Question 49

what is the shape of actinomycen ?

Answer 49

long filaments resembling fungi

Question 50

what is the classic disease presentation associated with actinomyces ?

Answer 50

head and neck abscess

Question 51

if there is an IUD associated infection what is the most likely causative organism ?

Answer 51

actinomyces

Question 52

dental work , or orofacial truma followed by a mass on the face ?

Answer 52

associated with actinomyces

Question 53

what colour is associated with actinomyces ?

Answer 53

yellow sulfur granules

Question 54

what is the only bacteria that is acid fast that isnt mycobacterium ?

Answer 54

nocardia

Question 55

what are the urease positive organisms ?

Answer 55

Pee CHUNKS proteus cryptococcus H pylori Ureaplasma Nocardia Klebsiella S epidermidis

Question 56

what are the 2 illnesses associated with nocardia ?

Answer 56

pneumonia because they are obligate aerobes skin infections

Question 57

how does the skin infection happen in nocardia ?

Answer 57

invades the skin during gardening or farming

Question 58

what is the drug of choice when treating nocardia ?

Answer 58

TMP-SMX which is sulphonamide

Question 59

what are the lab indications of recent strep pyogens infection ?

Answer 59

ASO titre anti-DNase B antibodies

Question 60

what is medusa head an indication of ?

Answer 60

bacillus anthrax

Question 61

what disease mimics nocardia ?

Answer 61

TB but with a negative PPD

Question 62

what is the treatment of actinomycen ?

Answer 62

penicillin

Question 63

what can cause PID in association with IUDs ?

Answer 63

actinomycen

Question 64

how can clostridium perferinges be associated with colonic malignancies ?

Answer 64

most commonly caused by clostridium septicum