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39 Cards in this Set

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GRAM NEGATIVE DIPLOCOCCI

- name the 2
- Neisseria spp

- Moraxella spp.

(note: Strep. pneumoniae is GP diplococci)
GRAM NEGATIVE DIPLOCOCCI

- all Neisseria spp grow well in what media?

- all Neisseria spp. utilize what?
(NTG)

- Thayer Martin (or chocolate)

- Glucose
GRAM NEGATIVE DIPLOCOCCI

- all Moraxella spp. grow well in what media?

- all Moraxella spp. utilize what?
(MDS)

- DNAse agar

- Sucrose
NEISSERIA

- Neisseria is Positive for what 2 important enzymes in lab studies

- also has what other enzyme involved in virulence?
("CO" = 2 , so think "diplo"-COcci)
- Catalase
- Oxidase

- IgA Protease
(b/c one of the SHiN bugs)
NEISSERIA

- how do you separate N. meningitidis and N. gonorrheae?
N. meningitidis (has a CMV)

- utilizes Maltose (Ng does not)
- has a Capsule (Ng does not)
- has a Vaccine (Ng does not)
NEISSERIA MENINGITIDIS

- Neisseria Meningitidis is the 2nd MCC of?
Meningitis
in
6 mo. to 60 years
NEISSERIA MENINGITIDIS

- Nm induced Meningitis, if untreated, has what prognosis?

- can be treated with what?
- fatal if untreated

- early actions with PCN
NEISSERIA MENINGITIDIS

- what are the 3 major manifestation of symptoms with Nm?
- Meningitis

- Meningococcemia
(when meningococci enter blood)

- Waterhouse-Friderichsen Syndrome
NEISSERIA MENINGITIDIS

- define Waterhouse- Friderichsen syndrome
BILATERAL
Adrenal Hemorrhage
in the face of
Fulminant Sepsis
NEISSERIA MENINGITIDIS

- Nm endotoxin?

- Ng endotoxin?
- LPS

- LOS
NEISSERIA MENINGITIDIS

- what are the major virulence factors for Nm?
(CLAP)

- Capsule
- LPS (not LOS as in Ng)
- IgA protease
- Pili
NEISSERIA MENINGITIDIS

- what is unique about the CSF finding in bacterial meningitis?
- only Bacterial Meningitis has the Organism IN the CSF

(fungal/TB/viral don't have organism in CSF)
NEISSERIA MENINGITIDIS

- compared to other etiologies, bacterial meningitis has elevation of what immune cells?
- PMNs

(others have lymphocytes)
MENINGITIS

- MCC of Newborn meningitis (0-6mo)

- MCC of children & adult meningitis (6mo-60yrs)

- MCC of elderly meningitis (>60yrs)
- GBS
(then E. coli, then Listeria)

- S. pneumoniae
(then Nm, then HiB, then Enteroviruses or HSV)

- S. pneumoniae
(then GN rods, then Listeria)
MENINGITIS

- Treatment?

- Prophylaxis?
- PCN G

- Rifampin
(or cipro)
MENINGITIS

- Vaccine has how many capsular components?

- list the components
4 of 5

(YWCA)
- Y
- W-135
- C
- A
MENINGITIS

- since diplococci are small, how do we make the immunogens in virus much more effective?
- Conjugate to Protein
MENINGITIS

- what component of the Nm capsule is not used in vaccine?

- clinical relevance?

- why not used in vaccine?
- type B

- type B causes 50% of cases

- Type B is a polysaccharide that is NOT immunogenic
N. GONORRHOEAE

- Ng is only found where?
- ONLY in human GU tract
N. GONORRHOEAE

- MCC of?

- 2nd MC?
- Septic arthritis

- STD
N. GONORRHOEAE

- what is so unique about the septic arthritis seen in Ng?
Arthritis is:
- Monoarticular
- Migratory
- Females only
N. GONORRHOEAE

- Disseminated infection result in what Sx?
- Monoarticular Septic Arthritis

- Rash

(signs will wax & wane)
N. GONORRHOEAE

- major virulence factors?
(O-LAP)

- Opa proteins (attachment)

- LOS (not lps as in Nm)

- IgA protease

- Pili
N. GONORRHOEAE

- is usually comorbid with what dz?

- if comorbid, then the 2 are MCC of?
- Chlamydia

- PID
N. GONORRHOEAE

- causes what major Dz in males?

- Sx?
- Urethritis

(PID)
- PURULENT discharge
- Inflammation (red, swell, pain)
- Dysruia
N. GONORRHOEAE

- causes what Dz in females?
- Endocervicitis

- PID
N. GONORRHOEAE

- what are some complications seen in females?
Fitz-Hugh-Curtis Syndrome (perihepatitis)

Ophthalmia neonatorum
(also seen with chlamydia)
N. GONORRHOEAE

- how can Ng complicate into Fitz-Hugh-Curtis Syndrome?
- Direct extension of PID to the Liver capsule
N. GONORRHOEAE

- Diagnostic test in males
- Microscopy of purulent discharge

(Dx w/ evidence of PMN + GN diplococci)
N. GONORRHOEAE

- Diagnostic test in females
- Direct Fluorescent Antibody (DFA)

- Thayer-Martin Culture
GONORRHEA

- Tx for Gonorrhea?
- Ceftriaxone

(aka - Rocephin)
GONORRHEA

- Tx for Gonorrhea & the Concurrent infection with Chlamydia
Cetriaxone
&
Doxycycline

(can substitute Doxycycline with Azithromycin ($$$) or Tetracycline ($))
GONORRHEA

- Treatment of Ophthalmia Neonatorum

(either from chlamydia or gonorrhea)
Topical ==> Silver nitrate

or

PO ==> Azithromycin or Tetracycline
NEISSERIA

- Nm septicemia (or Ng bacteremia) can be predisposed if what pre-existing condition is present?
C5-C8 Deficiency
MORAXELLA CATARRHALIS

- in KIDS, very common cause of what dz?

- in ADULTS, very commonly known to do what dz?
- Otitis Media

- Upper Respiratory infection
(sinusitis, laryngitis, tracheitis)
MORAXELLA CATARRHALIS

- in CARRIERS, M. catarrhalis is found where?
- Oropharynx

&/or

- Vagina
MORAXELLA CATARRHALIS

- population group at greatest risk?
- COPD

- immunocompromised
MORAXELLA CATARRHALIS

- labs are positive for?

- agar for growth?

- utilizes what carbohydrate?
- Catalase
- Oxidase

- DNase agar

- Sucrose only
MORAXELLA CATARRHALIS

- Tx for infections?

- if allergic to DOC, then?
- Amoxicillin

- Bactin
(TMP-SMX)