Science Quiz / Cardiovascular Block: Microbiology

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Can you name the answers to these questions about microbiology in the Cardiovascular Block??

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Streptococcus are (aerobic/anaerobic) gram _______ cocci in (chains/clusters), and catalase ________.
Chains' denotes _____ cocci or more strung together (according to lecture, spell out the whole number).
Lancefield grouping test: done with particles coated with antibodies against specific _________ on the cell surface.
________ Lancefield grouping tests have more clumps while ________ tests look more homogenous.
For the PYR test (PYR is a(n) _______) a positive test produces a ______ change.
Streptococcus pyogenes is Lancefield group __, bacitracin (susceptible/resistant), PYR ______, VP _______, and ____ hemolytic.
Group A Strep have virulence factors such as __ proteins and a ______ which allow them to evade phagocytes, and adhere to epithelial cells.
Name an enzyme (from the lecture) that allows GAS invasion and spread through tissue, and name a GAS toxin that causes systemic effects.
GAS pharyngitis has a (sudden/gradual) onset and is distinguished from viral pharyngitis by taking a ______ _____.
Scarlet fever is characterized by a '___ __ rash', facial flushing with ________ pallor, ________ tongue, and a high _________ count in blood.
Name the GAS clinical manifestation that affects the epidermis layer of the skin, and causes formation of vesicles --> pustules and crusts.
In an infection leading to Erysipelas, the ______ and _______ layers are affected and there is a (clear/unclear) line between the rash and normal skin.
When cellulitis is suspected, deeper infection must be excluded, eg. necrotizing fasciitis and myonecrosis which affects the _________ tissue.
Streptococcal toxic shock syndrome requires isolation of GAS, and a clinical presentation of (hypertension/hypotension) with multiorgan involvement.
'Multiorgan involvement': >2 of: coagulopathy, ____ impairment, ____ involvement, acute ________ distress syndrome, ____ tissue necrosis, erythematous ______ rash.
Strep toxic shock syndrome is toxin mediated: __________ present to many __-cells, activating a lot of them (1 out of __)
3 ways to make microbiological diagnosis: culture, _______ detection, ________.
Anti-streptolysin O is useful for diagnosis at the acute stage. True or false?
What is the first choice treatment class of drugs? There are also high rates of resistance to clindamycin and _________ in Hong Kong, especially recently.
Non-suppurative complications of GAS infection include ____ ________ ____ and post-streptococcal __________.
Acute rheumatic fever is a result of _______ damage caused by an abnormal _______ response to GAS infection.
ARF is most frequent in _______ and is a delayed sequelae of GAS ________ +/- skin infection. Its latency is usually around __ weeks.
ARF 's pathogenesis is as of yet unclear, however it is thought to have something to do with the similar structure between the streptococcal __ _______ and cardiac proteins.
A consequence of unresolved acute rheumatic fever could lead to ________ heart disease.
The criteria for acute rheumatic fever is called the _____ criteria.
Major criteria include c______, a______, S_______'s ______, subcutaneous nodule, and E_______ _________.
Minor criteria include fever, a_______, l__________, raised ____ or ____, and prolonged ____ interval.
Supportive evidence of streptococcal infection: Elevated ___-________ __ titer, and/or positive throat culture for GAS.
Treatment of ARF: antibiotics (_______), anti-inflammatory agents to relieve symptoms (a______, c_________s), or surgery in urgent situations
Prevention: elemination of risk factors, primary ___________ to prevent the first attack of ARF (antibiotic treatment of GAS pharyngitis) and secondary to prevent recurrences.
In primary prevention, penicillin or similar is used to treat GAS pharyngitis within __ days after onset, for a duration of __ days.
In secondary prevention, intramuscular penicillin is given every __-__ weeks. If no carditis, it is for __ years; if resolved carditis, for __ years, and for RHD it is lifelong.
Post-streptococcal glomerulonephritis is a delayed sequelae of GAS _________ or ________.
Latency period for post-strep GN: if throat, __-__ weeks with ____ ASO titre; if skin, __-__ weeks with ____ ASO titre.
Post-strep GN shows sudden onset of fever, hypertension, edema, etc. In children is there permanent damage usually? (Yes/No) In adults, it may progress to chronic GN.
Pathogenesis of post-strep GN: deposition of circulating ______ _______, molecular mimicry, and deposition of strep antigen in the __________.
Streptococcus agalactiae is Lancefield group __, bacitracin (susceptible/resistant), cAMP _______, and ____ hemolytic (_____ zone).
In absence of underlying disease, GBS disease usually does not affect which group of people? (___-_______ _____)
In pregnant women, GBS usually causes infection in the ______ tract, leading to bacteremia.
Streptococcus dysgalactiae is Lancefield group __, bacitracin (susceptible/resistant), PYR ______, VP _______, and ____ hemolytic.
Strep. Dysgalactiae can cause pharyngitis. Can it lead to rheumatic fever? (Yes/No)
Bacteremia due to strep. Dysgalactiae will tend to be caused by bacteria from Lancefield g____ __.
Streptococcus anginosus group can be Lancefield group A, C, F, G or none. It is bacitracin (susceptible/resistant), PYR ______, VP _______, and ____ or ____ hemolytic.
Mostly the anginosus group leads to ______ formation, which can then predispose to ________ __________.
Viridans streptococci are _____ hemolytic, and are common ____ _____. They are a common pathogen in cases of ________ ________.
Streptococcus bovis is a Lancefield group __ organism with 2 biotypes of which biotype (I/II) is common in HK. It (does/does not) ferment mannitol.
Streptococcus bovis infection is usually associated with cholangitis, the infection of the ____ _____.
Enterococci are Lancefield group __, and grow at ___ degrees, 6.5% _____ and 40% bile salt. They hydrolyze ____ ______ and are PYR ________.
Enterococci can be associated with ______ tract infection, bacteremia and infective _________, as well as other infections.
Streptococcus pneumoniae is non-groupable by Lancefield grouping. It is optochin (sensitive/resistant), and bile (soluble/insoluble).
Predisposition to strep pneumoniae: immunodeficiency, cochlear implant, or c_____ _________ ________ ______.
Prevention: 2 types of pneumococcal vaccines. PPV includes ___ types of strep pneumoniae in the vaccine. PCV is (better/worse) for children and can have __, __ or __ types.
Streptococcus suis is ____ hemolytic on horse blood and ____ hemolyic on sheep blood. Its reservoir is in _____.
Streptococcus iniae has outbreaks in ___________ farms and includes the virulence factor streptolysin __.
Name a clinical presentation of infective endocarditis (non-specific).
A damaged valve can be detected on auscultation by hearing a _______.
Classical signs of infective endocarditis include ________ hemorhhages, _______ lesions, _____ nodes and _____ spots.
Etiology of IE: native valve - bacterial. It can be staph. ______, strep. ______, Viridans Strep., and Enterococci, as well as HACEK organisms (________ gram neg. bacilli).
Name the bacteria that HACEK stands for.
Name a group of bacteria which causes early infective endocarditis in prosthetic valves.
Name the bacteria that can cause infective endocarditis through animal contact: c______ b______.
Bacteria that cause infective endocarditis must have _____ resistance, the ability to adhere to heart _____ surface or plate-fibrin ______, and resistance to host defence in ______
MSCRAMMs allow the bacteria to adhere to the valve/thrombus. For staph. Aureus examples are _______ or _______ binding protein A, while in Viridans strep it is _______.
Diagnosis for infective endocarditis is made via the modified _____'s criteria. For definite diagnosis __ major criteria, __ major and __ minor, or __ minor are needed.
Major criteria includes b_____ c_____ positive for IE, and evidence of ________ involvement.
Minor criteria include fever, predisposition, v______ phenomena, i_________ phenomena, and microbiological evidence that does not meet major criteria.
Multiple blood cultures are needed because infective endocarditis has (continuous/intermittent) bacteremia.
What group of bacteria which causes infective endocarditis is easily confused as a contaminant of the blood culture?
Cultures are drawn (before/after) starting antibiotics, and the first and last set of blood cultures should be at least __ hour(s) apart.
Usual situation: culture is incubated for __-__ days to allow even slow-growing ______ organisms to grow.
What is the single most important cause for culture negative endocarditis? (P____ a_______)
Treatment of IE is difficult because the bacteria are embedded in _______, have a reduced m_______ _______, and have a high load in v_______.
Treatment of choice for Viridans strep is (A), for Methicillin sensitive s. aureus is (B), for MRSA is (C), for enterococcus is (D). What is (A)?
What is (B)? (for methicillin sensitive s. aureus)
What is (C)? (for MRSA)
(D), for enterococcus, is a combination of a_______ and g_______.
For prosthetic valve endocarditis due to staphylococcus, r_______ is added for better penetration into biofilm.
Antibiotic prophylaxis for prevention of IE is only done for the highest risk patients due to the risk of r_______ developing.
For antibiotic prophylaxis, the dosage is such that the blood level is higher than the m______ i_______ c________ of the most probable organism.
The most common infective cause for myocarditis and pericarditis is (bacteria/viruses/fungi/parasites/prions).
Clinical features of myocarditis include heart failure and a_______, while for pericarditis it includes chest pain, pericardial r___ and cardiac t_______.
Other features are related to the underlying organism. Respiratory tract symptoms indicate infection by i_______ or a_______, and rash may indicate e_______ infection.
Myocarditis with presentation of tonsilitis can be caused by the bacteria ____________ __________.
In alphabetical order for each, name 2 types of fungi, then 3 types of parasites which may cause myocarditis and/or pericarditis.
Confirmation of myocarditis is shown by raised levels of cardiac enzymes such as CK(______ _____) and t_______. The gold standard is an e_________ b_____.
Confirmation of pericarditis is shown by a diffuse ___ ________ (on ECG), and the gold standard is a p________ b______.
To find the infective organism, a culture, swab, serology, a____ s_______ __ test or a __________ skin test can be done.
Supportive treatment for pericarditis is the usage of NSAIDs: ___ _______ ____ _________ drugs. If myocarditis is also present these are avoided.

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