.microbio E1: 2 Neisseria, Bacterialstds, Myc

Front 1

Neisseria has two species. Name em and the diseases they cause.

Back 1

N. meningitidis (the meningococcus) --> causes meningitis

N. gonorrhoeae
(gonococcal infection) --> causes gonorrhea

Front 2

What is the gram staining and match the morphology of each: cocci arranged in pairs to resemble kidney beans, rods, curved spiral-rods

A. Camplyobacter jejuni
B. Enterobacteriaceae family
C. Vibrionaceae family
D. Neisseria genus

Back 2

A. Camplyobacter jejuni : GI Pathogen. Gram - , curved spiral rods
B. Enterobacteriaceae family: GI Pathogen. Gram - , rods
C. Vibrionaceae family: GI Pathogen. Gram - , rods
D. Neisseria genus - Gram - cocci arranged into kidney bean shape

Front 3

One of the two Neisseria species is slightly bigger than the other in size and has a polysaccharide capsule, resulting in a smooth, mucoid colony. Which one?

Back 3

N. meningitidis
(the meningococcus)

Front 4

One of the two Neisseria species is frequently seen within polymorphonuclear leukocytes (PMNs) in clinical specimen while the other is in a general intracellular location which prevents killing by serum and macrophages. Which is which?

Back 4

N. meningitidis in PMNs ;
N. gonorrhoeae general intracellular

Front 5

N. gonorrhoeae is commonly unsymptomatic in about half of females. Infection can spread up the urogenital tract and cause _____ which in turn causes endometritis, saplingitis, tubo-overian abscess, pelvic peritonitis. Consistent lower abdominal pain common in this condition, esp after menses.

Back 5

PID, or pelvic inflammatory disease

Front 6

Which organism has receptors for iron sources that facilitate iron acquisition from host iron-binding proteins. Esp transferrin (found in serum) and lactoferrin (found on muscosal secretions)?

A. Chlamydiae pneumoniae
B. Chlamydiae. trachomatis
C. N. gonorrhoeae
D. N. meningitidis

Back 6

C. N. gonorrhoeae

Front 7

True or False:

Both the Neisseria species exclusively infect humans.

Back 7

TRUE!

For N. meningitidis, transmission is by airborne droplets facilitated by close contact (household, barracks, prisons)

For N. gonorrhoeae , transmission is through sexual contact or perinatally

Front 8

N. meningitidis has three states of infection. Name them and describe them.

Back 8

1) Carrier state: asymptomatic nasopharyngeal colonizaiton of newly infected or previously infected bu twith recent upper respiratory infection
2) Local infection: all characterized by purulent discharge
Pharyngitis: sore throat
Pneumonia: symptoms of cough, chest pain, recent viral respiratory infeciton, often due to serogroup Y
Urethritis: purulent urethral discharge and history of orogenital sexual contact
3) System infections:
acute purulent meningitis: fever, headache, altered mental status, stiff neck, malaise and vomiting. Lumbar puncture reveals cloudy CSF.
Fulminant meningococcemia: sudden onset rapid course, fever, coma, intravascular coagulation, circulatory collapse (shock), cyanosis, gangrene, hemorrhage into skina dn mucous membranes, adrenal insufficiency with bilateral destruction of adrenal glands

Front 9

Match the drug(s) to the respective Neiserria species they treat.

A. Cephalosporins
B. Macrolides
C. IM ceftriaxone or other 3rd gen cephalosporin
D. Penicillin G
E. doxyclycline or z-pack

Back 9

N. meningitidis : treat with Penicillin G or Cephalosporins.

N. gonorrhoeae : 3rd gen. cephalosporin, and since chlamydia trachomatis infection is common with gonorrhoeae, doxycycline or z-pack is also added to treatment plan

Front 10

One of the two Neisseria species have a LOT of antibiotic resistance while the other does not. Which is which?

Back 10

N. gonorrhoeae has a LOT (is penicillin resistant, tetracylcine resistant and has other things in general like more efflux pumps);
N. meningitidis has no resistance to antbx

Front 11

Which of the following are so small they were once thought to be viruses?

A. Chlamydiae
B. Enterobacteriaceae family
C. Neisseria
D. Vibroionaceae family

Back 11

A. Chlamydiae

Front 12

Which exists morphologically in two forms: RB and EB? Which form is infectious?


A. Chlamydiae
B. Enterobacteriaceae family
C. Neisseria
D. Vibroionaceae family

Back 12

A. Chlamydiae

The elementary body (EB) is the infectious form; the reticular body (RB) is the noninfectious replicative form.

Front 13

Chlamydiae trachomatis causes several (4) disease/ conditions. Name them and describe them.

Back 13

*trachoma : inflammation and follicle formation that involves entire conjunctiva. Conjunctivae can become scarred and eyelids turn inward, leading to abrasiona dn ulceration, cornea scarring nad interfernece with tear flow which can all furtherh cause secondary bacterial infections
*urogenital infections: In men, most infections are symptomatic and clinical manifestations include urethral discharge, dysuria (painful difficult urination) and pyuria (presence of pus in urine). In women: most infections are asymptomatic thoguh clinical manifestations include cervicitis, endometritis, urethritis, salpingitis, perihepititis. Can result in PID. Pretty much same as N.gonorrheae genital infection.
*inclusion conjunctivitis: mucopurulent discharge, keratitis, corneal infiltrates, some corneal scarring.
*lymphagranuloma venereum: Primary lesion at site of infection is a painless papule or ulcer that heals rapidly. Second stage is inflammation adn swellign of lymph nodes draining the site of infection- usually inguinal nodes. Painful, fluctuant buboes (swollen lymph nodes) can rupture. Systemic manifestation includes feve, chills, anorexia, headache, myalgias.

Front 14

[ N. gonorrhoeae / N. meningitidis ] is carried in the nasopharynx as a commensal but its infection can be life-threatening ; [ N. gonorrhoeae / N. meningitidis ] is rarely fatal but is ALWAYS considered a pathogen because it is not commensal.

Back 14

N. meningitidis ; N. gonorrhoeae

Front 15

True or False:
Neisseria species are all Gram negative cocci arranged in pairs resembling kidney beans

Back 15

TRUE. GRAM NEGATIVE! KIDNEY BEANS!

Front 16

What virulence factor is responsible for N. meningitidis tissue damage?

A. alpha toxin (lechtinase)
B. lipooligosaccharide (LOS)
C. Toxin A and Toxin B
D. IgA1 protease

Back 16

B. lipooligosaccharide (LOS)

alpha toxin is from anaerobe Clostridium perfringens. Toxins A and Toxins B are from anaerobe Clostridium difficile. IgA1protease is from N. meningitidis itself but that is responsible for allowing the meningococcus to evade local immune response by cleaving IgA.

Front 17

Match each organism to the group it commonly attacks.
Neisseria meningitidids, Streptococcus pneumoniae, Streptoccocus agalactiae (Group B), Haemophilus influenzae


1. neonates to 3 months
2. children 6 months to 5 years
3. infants- 5 y/o and young adults
4. very young and very old

Back 17

1. *Streptoccocus agalactiae (Group B):
neonates to 3 months
2. Haemophilus influenzae:
children 6 months to 5 years though less common due to Hib vaccine
3. Neisseria meningitidids:
infants- 5 y/o and young adults
4. Streptococcus pneumoniae:
very young and very old

Front 18

True or False:
Chlamydiae genus has an intracellular growth requirement component to its lifecycle.

Back 18

TRUE. Chlamydiae have EB and RB forms.

Front 19

True or False:
Neisseria meningitidis is the only cause of epidemic meningitis.

Back 19

True

Front 20

True or False:
Neisseria meningitidis is one of the leading causes for endemic meningitis, particularly meningitis in children 6 months to 5 years.

Back 20

Partial truth so overall FALSE!

N. meningitidis IS one of the leading causes for endemic meningitis, but the age group it is for is infants- 5 years and young adults.

Front 21

Match the N. meningitidis serogroup to its description:
A, B, C, Y

1. associated with pneumonia
2. commonly causes epidemic meningitis in developing countries
3. is cause of endemic meningitis in developed countries

Back 21

1. Y is associated with pneumonia
2. A commonly causes epidemic meningitis in developing countries
3. B & C cause endemic meningitis in developed countries

Front 22

Describe the clinical manifestations of N. meningitidis. (3 states/stages)

Back 22

1) Carrier state: asymptomatic nasopharyngeal colonizaiton of newly infected or previously infected bu twith recent upper respiratory infection
2) Local infection: all characterized by purulent discharge
Pharyngitis: sore throat
Pneumonia: symptoms of cough, chest pain, recent viral respiratory infeciton, often due to serogroup Y
Urethritis: purulent urethral discharge and history of orogenital sexual contact
3) System infections:
acute purulent meningitis: fever, headache, altered mental status, stiff neck, malaise and vomiting. Lumbar puncture reveals cloudy CSF.
Fulminant meningococcemia: sudden onset rapid course, fever, coma, intravascular coagulation, circulatory collapse (shock), cyanosis, gangrene, hemorrhage into skina dn mucous membranes, adrenal insufficiency with bilateral destruction of adrenal glands

Front 23

True or False:
Recurrent meningococcal and gonococcal infections occur as a result of complement deficiencies.

Back 23

True.

Front 24

Laboratory diagnosis of N. meningitidis can be done with non-selective media like ____________ but moreso is done with selective media _________ or _________.

Back 24

Non-selective: chocolate agar

Selective: Modified Thayer-Martin agar (MTM) or New York City agar (NYC). It is important to plate specimens collected from complicated niches onto selective media.

Front 25

Upon which scenario is it appropriate to begin treatment for N. meningitidis infection?

A. positive antigen detection test (latex agglutination, coagglutination) or DNA detection by PCR in absence of a positive sterile site culture in setting of clinical illness consistent with meningococcal disease
B. requires cultivation of N.meningitis from normally sterile body fluid like blood or CSF. From chocolate agar or selective media (when taken from complicated niches) like MTM or NYC agar.
C. Gram-negative diplococci identified by Gram stain of any sterile fluid.

Back 25

C. SUSPECTED CASE stage: Gram-negative diplococci identified by Gram stain of any sterile fluid.

The other two are a confirmed case (would want to start treatment before getting there) and the other is probable (need a bit more info).

Front 26

What disease/ condition does this describe and what organism causes it?

" inflammation and follicle formation that involves entire conjunctiva. Conjunctivae can become scarred and eyelids turn inward, leading to abrasiona dn ulceration, cornea scarring nad interfernece with tear flow which can all furtherh cause secondary bacterial infections"

Back 26

Trachoma, caused by Chlamydiae trachomatis.

Front 27

What is the disease/ condition known as Donavonosis which pathogen listed below causes it?

A. Atopobium vaginae
B. Gardnerella vaginalis
C. Klebsiella granulomatis
D. Chlamydiae trachomatis

Back 27

C. Klebsiella granulomatis

Following sexual contact, 1 wk to 3 months until PAINLESS granulomatous lesions appear. Lesions are beefy, red in appearance and bleed easily. If infection spreads, local lymph nodes can become enlarged. Early on can resemble chancroid and later on can resemble LGV (Lymphagranuloma venereum, caused by C.trachomatis).

Front 28

This organism is endemic in India, Central Australia and South Africa. Risk groups: sexually active persons who have recently traveled to endemic areas. Men afflicted more commonly.

A. Chlamydiae trachomatis
B. Klebsiella granulomatis
C. Atopobium vaginae

Back 28

B. Klebsiella granulomatis

Front 29

For which organism, when inspecting under a microscope for diagnosis, would you see "GNIDS" - Gram negative intracellular diplococci?

A. N. gonorrhoeae
B. C. trachomatis
C. Klebsiella granulomatis

Back 29

A. Neisseria gonorrhoeae

Front 30

For which organism would you stain scrapings from border of lesion with Giemsa or Wright's stain. Dark staining bodies are evident within MONOCYTES (not PMNs or neutrophils!).

A. Chlamydiae trachomatis
B. Klebsiella granulomatis
C. Atopobium vaginae

Back 30

B. Klebsiella granulomatis

Front 31

What condition does this describe: Following sexual contact, 1 wk to 3 months until painless granulomatous lesions appear. Lesions are beefy, red in appearance and bleed easily. If infection spreads, local lymph nodes can become enlarged. Early on can resemble chancroid and later on can resemble LGV (lymphagranuloma venereum).

A. A. Chlamydiae trachomatis
B. Klebsiella granulomatis
C. Atopobium vaginae

Back 31

B. Klebsiella granulomatis

Front 32

For which organism, when inspecting under a microscope for diagnosis, would you see the presence of "clue cells" and absence of Lactobacilli?

A. Chlamydiae trachomatis
B. Klebsiella granulomatis
C. Atopobium vaginae

Back 32

Anything that yields or is associated with Bacterial Vaginosis:
C. Atopobium vaginae

and if given the option, Gardnerella vaginalis

Front 33

True or False:
Mycoplasma have noteably thick peptidoglycan that serves as an anti-phagocytic virulence factor.

Back 33

FALSE. mycoplasma do not have any peptidoglycan at all! Their colonies look like "fried eggs" and they are pleomorphic and very small as microorganisms go.

Front 34

What are the best drugs for treatment of any mycoplasma?

A. Sulfonamide and Macrolides
B. Tetracycline and erythromycin
C. Z-pack and fluoroquinolone

Back 34

B. Tetracycline and erythromycin

Front 35

Which is the MCC of atypical pneumonia?

A. Bordatella pertusiss
B. Chlaymideae pneumoniae
C. Klebsiella pneumoniae
D. Legionella pneumophila
E. Mycoplasma pneumoniae

Back 35

E. Mycoplasma pneumoniae


B. Chlaymideae pneumoniae also yields walking pneumonia, but not MCC.

C. Klebsiella pneumoniae is MCC of nosocomial pneumonia

D. Legionella pneumophila oportunistic pathogen leads to severe toxic pneumonia. Should be considered in anyone presenting with sever progressive pneumonia.

Front 36

Non-gonococcal urethritis is NOT a potential disease of which of the following?

A. Atopobium vaginae
B. Chlamydiae trachomatis
C. Mycoplasma genitalium
D. Ureaplasma urealyticum

Back 36

A. Atopobium vaginae

Front 37

What condition does the following describe and what organisms is it caused by? "Abnormal, foul-smelling vaginal discharge that is white or gray. Pain during urination, itching. Absence of inflammatory signs. Increased vaginal pH since natural flora are wiped out."

Back 37

Bacterial vaginosis, caused by Atopobium vaginae and associated with but not caused by Gardnerella vaginalis.

Treatment: Clindamycin or metronidazole (though note that if caused by Atopobium vaginae, use only clidamycin as it is resistant to metronidozole)

Front 38

What condition does the presence of "clue cells" and absence of Lactobacilli and a "Fishy" odor after addition of base (Whiff test) diagnostically confirm?

A. Bacterial vaginosis
B. Chlamydia
C. Donovanosis
D. Gonorrhea
E. Non-gonococcal urethritis

Back 38

A. Bacterial vaginosis

Front 39

What condition is described: Following sexual contact, 1 wk to 3 months until painless granulomatous lesions appear. Lesions are beefy, red in appearance and bleed easily.

A. Bacterial vaginosis
B. Chlamydia
C. Donovanosis
D. Gonorrhea
E. Non-gonococcal urethritis

Back 39

C. Donovanosis

Treatment: Doxycycline for at least 3 weeks or until ALL lesions have heald. Relapses can occur. Bactrim can also be used.

Front 40

What condition is described with this diagnostic workup: Stain scrapings from border of lesion with Giemsa or Wright's stain. Dark staining bodies are evident within MONOCYTES (not PMNs or neutrophils!).

A. Bacterial vaginosis
B. Chlamydia
C. Donovanosis
D. Gonorrhea
E. Non-gonococcal urethritis

Back 40

C. Donovanosis

Treatment: Doxycycline for at least 3 weeks or until ALL lesions have heald. Relapses can occur. Bactrim can also be used.