Chapter 18 The Gram-Positive and Gram-Negative Cocci of Medical Importance
___ pneumonia is an infection involving whole segments of the lungs, which may lead to consolidation and plugging of the alveoli and extreme difficulty in breathing.
Lobar
Signs and symptoms of gonorrhea in males include ______. Multiple select question. Urethritis Yellowish discharge Painful urination Cervicitis or vaginitis
Urethritis Yellowish discharge Painful urination
Which of the following is not a method of preventing group A infections in hospitals? Multiple choice question. Isolation of patients with group A strep infections Vaccination of all admitted patients Use of high-level precautions for handling infectious secretions Preventing carriers of S. pyogenes from working with some groups of patients.
Vaccination of all admitted patients
Select all that apply What are the signs and symptoms of meningococcemia? Multiple select question. Vascular damage Hemorrhage Petechiae Bulbar lesions Excessive sweating Low grade fever
Vascular damage Hemorrhage Petechiae
When levels of magnesium ions ______, levels of toxic shock syndrome toxin produced by S. aureus ______.
decrease increase
Patients who should receive the Pneumovax vaccine include ______.
diabetics patients with sickle-cell anemia patients with congestive heart failure elderly patients
S. pneumoniae in respiratory droplets that land on fomites will ______.
die quickly, preventing transmission
S. pyogenes is usually transmitted through respiratory ____ or through direct ____.
droplet contact
The transmission route of N. meningitidis is through close contact with respiratory
droplets secretions
Due to Pelvic Inflammatory Disease (PID), scar tissue can form in the fallopian tubes and can cause ______.
ectopic pregnancies sterility
Select all that apply What are possible complications of PID in women? Multiple select question. ectopic pregnancies tubal infertility mixed anaerobic infections scarring in the fallopian tubes milky or yellow discharge
ectopic pregnancies tubal infertility mixed anaerobic infections scarring in the fallopian tubes
Select all that apply Signs and symptoms of gonococcal ophthalmia neonatorum include ______. Multiple select question. edema in the eye intense inflammation pharyngitis or tonsillitis
edema in the eye intense inflammation
Select all that apply Infections caused by S. epidermidis include ______. Multiple select question. endocarditis bacteremia scalded skin syndrome urinary tract infections
endocarditis bacteremia urinary tract infections
Signs and symptoms of subacute____ include fever, heart murmur, weight ___ and anemia.
endocarditis loss
Select all that apply Which of the following are virulence factors of S. aureus? Multiple select question. enterotoxins streptokinase leukocidins hemolysins
enterotoxins leukocidins hemolysins
Staphylococcus aureus produces , which can cause symptoms of cramping, nausea, vomiting, and diarrhea, appearing in 2 to 6 hours.
enterotoxins or enterotoxin
S. aureus can frequently be isolated from fomites in the ____.
environment, hospital, or clinic
Local infections caused by S. pyogenes include ______. Multiple select question. erysipelas impetigo pharyngitis scarlet fever (scarlatina)
erysipelas impetigo pharyngitis
The major extracellular toxins produced by S. pyogenes include streptolysin O, streptolysin S, and ____ toxin.
erythrogenic
The means by which S. pneumoniae gains access to the chamber of the middle ear is through the ___ ___
eustachian tube
Which factor associated with S. aureus gives rise to staphylococcal scalded skin syndrome? Multiple choice question. hyaluronidase leukocidin hemolysin toxic shock syndrome toxin exfoliative toxin
exfoliative toxin
As the pneumococcus traces a pathway down the respiratory tree, it provokes intense inflammation and ____ formation, leading to blocking of the bronchioles and alveoli by a solidification called ____.
exudate consolidation
Select all that apply Signs and symptoms that may be caused by gonorrhea include ______. Multiple select question. eye infections in newborns herpetic keratitis sterility in females only urethritis in males PID in females
eye infections in newborns urethritis in males PID in females
The intestinal inhabitant, Enterococcus , causes infections involving the urinary tract, wounds, blood, the endocardium, the appendix, and other intestinal structures.
faecalis
Select all that apply Which of the following are signs and symptoms of meningococcal meningitis? Multiple select question. fever urethritis stiff neck headache salpingitis
fever stiff neck headache
Which are the main virulence factors of N. gonorrhoeae?
fimbriae
The main virulence factors of N. gonorrhoeae are the ____, which play a role in adherence and preventing ____ by host cells.
fimbriae phagocytosis
Systemic staph infections usually have a _____ pattern, with a local cutaneous infection leading to systemic infection via the ____.
focal bloodstream
S. aureus invades the skin through wounds, hair , or skin .
follicles glands
What is the name for a mild, superficial inflammation of the hair follicles? Multiple choice question. folliculitis abscess impetigo
folliculitis
Transmission of S. pyogenes is through ______. Multiple select question. fomites respiratory droplets direct contact food and water
fomites respiratory droplets direct contact
The proximity of the ____and ___ tract systems in females increases the possibility that both systems can be infected during sexual intercourse.
genital urinary
In the presence of sugar, S. oralis, S. gordonii, and S. mutans produce slime layers made of ____ polymers that adhere to____ surfaces, leading to plaque formation and tooth decay.
glucose teeth
Multi-drug resistant strains of S. aureus have become common in ____ and therefore strains must be checked for antimicrobial susceptibility.
hospital
S. pyogenes does not provoke an immune response from its human host due to the presence______ acid, which is chemically identical to that found in host tissues.
hyaluronic
Infection with pneumococcal pneumonia confers ___ to reinfection with the same strain.
immunity
Coagulase-negative staphylococci cause nosocomial and opportunistic infections in ____ patients.
immunocompromised
A skin condition marked by burning, itching papules that break and form a highly contagious yellow crust, often occurring among schoolchildren, is called streptococcal____ .
impetigo
The ____ response that occurs when pneumococci infect the lungs is marked by the release of ____ into the lungs.
inflammatory fluids
When pneumococci infect the lungs, the immune system responds with an overwhelming ______.
inflammatory response
Neisseria are residents of ______. Multiple select question. skin and hair fresh water environments mucous membranes of animals mucous membranes of humans
mucous membranes of animals mucous membranes of humans
Asymptomatic carriers of S. aureus most often carry the bacteria in the anterior ___
nares, nasopharynx, or nostrils
Humans act as the reservoir for N. meningitidis because 3%-30% of the adult population carries the bacteria in their ______.
nasopharynx
Most people in the general population have a _______ immunity to meningococci.
natural
The streptococcal infection ____ ____begins at the skin and leads to deeper infection of the muscle, resulting in the sloughing off of tissue. Listen to the complete question
necrotizing fascitis
The species is responsible for causing gonococcal ophthalmia neonatorum.
neisseria gonorrhoeae
Characteristics of the Neisseria genus of bacteria include ______. Multiple select question. obligate anaerobes nonmotile lancet-shaped cocci fastidious mostly strict parasites bean-shaped cocci gram-negative endospore-formers
nonmotile fastidious mostly strict parasites bean-shaped cocci gram-negative
The best methods of minimizing _____ infection by staphylococci amongst hospital patients include meticulous hand washing and adequate cleansing of surgical incisions and burns.
noscomial
What is the name of a bone infection that occurs when S. aureus establishes itself in the highly vascular metaphyses of a variety of bones? Multiple choice question. Osteoporosis Toxic shock syndrome Osteomyelitis Staphylococcal scalded skin syndrome Folliculitis
osteomyelitis
Select all that apply To presumptively identify the pathogenic Neisseria, specimens should be streaked on chocolate or modified Thayer-Martin agar and incubated in a high carbon dioxide atmosphere. What tests should then be performed on the isolated colonies? Multiple select question. sugar fermentation oxidase gram stain catalase
oxidase gram stain
Multidrug-resistant strains of enterococci are emerging as serious nosocomial opportunists especially the ___-____ ____(VRE).
vancomycin resistant enterococci
The major ___ factor of S. pneumoniae is its large capsule.
virulence
Prevention of group B streptococcal infection in neonates is usually through screening of ____women, followed by antibiotic treatment during labor.
pregnant
Which of the following are functions of the fimbriae of N. gonorrhoeae? Multiple select question. transmission of drug resistance preventing phagocytosis adherence
preventing phagocytosis adherence
Select all that apply Which of the following are contributing factors to the pathogenicity of N. gonorrhoeae? Multiple select question. sex pili promoting attachment of cocci to each other protease cleaving IgA on mucosal surfaces surface molecules attachment to other cocci and to tissue surfaces fimbriae promoting attachment to other cocci and to tissue surfaces lipase damaging cell membranes of the host
protease cleaving IgA on mucosal surfaces surface molecules attachment to other cocci and to tissue surfaces fimbriae promoting attachment to other cocci and to tissue surfaces
Pyogenic cocci cause development of ______.
pus
Pyogenic infections of the skin caused by S. pyogenes include impetigo, which is also known as ____, as well as the more invasive skin infection called ___.
pyoderma erysipelas
Select all that apply Pyogenic infections of the skin caused by S. pyogenes include ______. Multiple select question. pharyngitis pyoderma tonsillitis erysipelas
pyoderma erysipelas
S. ______, S. agalactiae, viridans streptococci, S. pneumoniae, and E. _____ are the species of streptococci and enterococci most often associated with human disease.
pyogenes faecalis
Women who suspect they have a ____ tract infection should seek diagnosis and treatment as soon as possible to lower the risk of developing PID.
reproductive
The typical transmission route of N. meningitidis is through ______.
respiratory secretions respiratory droplets
A delayed inflammatory condition of the joints, heart, and subcutaneous tissues is known as .
rheumatic fever
Select all that apply Which of the following are types of infections caused by S. agalactiae? Multiple select question. skin infections wound infections neonatal infections endocarditis rheumatic fever
skin infections wound infections neonatal infections endocarditis
Patient specimens that are useful in diagnosing pneumococcal infections include ______. Multiple select question. spinal fluid urine sputum pleural fluid throat swab blood
spinal fluid sputum pleural fluid blood
A condition seen in children with S. aureus infections of the umbilical stump or eyes showing skin blistering and extensive desquamation of the epidermis is called ______. Multiple choice question. methicillin-resistant staphylococcal aureus syndrome staphylococcal scalded skin syndrome bullous impetigo bacterial meningitis toxic shock syndrome
staphylococcal scalded skin syndrome (SSSS)
Which of the following is not a virulence factor of S. aureus? Multiple choice question. lipase hemolysins streptokinase leukocidins coagulase
steptokinase
When growing in liquid culture ____, generally have a spherical shape arranged in long ____.
streptococci chain
The most important complication caused by viridans streptococci is ____ ____.
subacute endocarditis
Select all that apply Which patient groups are most susceptible to pneumococcal disease? Multiple select question. the immunocompromised the elderly middle aged adults young children those weakened by viral infections
the immunocompromised the elderly young children those weakened by viral infections
Signs and symptoms of pharyngitis include pain and swelling in the ____, reddened _____, swollen ____, and sometimes white packets on the walls of the throat.
throat mucosa tonsil
Disease caused by toxin being produced in the body is known as ____ whereas disease from toxin ingested via food is known as a food ___.
toxemia intoxication
The symptoms seen in ____ ____ syndrome include fever, vomiting and rash; also potentially fatal complications involving the liver, kidneys, nervous system.
toxic shock
Women who suspect they have a reproductive tract infection should seek diagnosis and _____ as soon as possible to ____ the risk of developing PID.
treatment lower
The signs and symptoms of meningococcal meningitis include all of the following except ______. Multiple choice question. fever urethritis photophobia vomiting convulsions
urethritis
Typical signs and symptoms of gonorrhea include ___ in males, eye infections in ___, and pelvic inflammatory disease in women.
urethritis neonates
True or false: Colonization with S. aureus invariably leads to clinical symptoms.
False.
True or false: A toxemia occurs when food containing a toxin is ingested.
False. Ingestion of food containing a toxin is a foodborne intoxication.
True or false: S. aureus exhibits fewer virulence factors than S. epidermidis.
False. S. aureus produce more virulence factors than other pathogen
Select all that apply Which groups of beta-hemolytic, bacitracin-resistant streptococci are found in the human respiratory tract and are responsible for disseminated infections in immunocompromised patients? Multiple select question. Group C (S. equisimilis) Group D (E. faecalis) Group A (S. pyogenes) Group B (S. agalactiae) Group G (S. equisimilis)
Group C (S. equisimilis) Group G (S. equisimilis)
Which groups of beta-hemolytic streptococci are resistant to bacitracin?
Group D (E. faecalis) Group C/G (S. equisimilis) Group B (S. agalactiae)
Which of the following are methods of preventing group A infections in hospitals?
High-level precautions must be practiced in handling infectious secretions Patients with group A strep infections should be isolated Carriers of S. pyogenes must be kept from working with some groups of patients
Select all that apply Which circumstances predispose an individual to infection with S.aureus? Multiple select question. Immunodeficiency states Good hygiene and nutrition Diabetes mellitus Tissue injury
Immunodeficiency states Diabetes mellitus Tissue injury
Select all that apply Why is the number of gonorrhea infections reported in the US is probably much lower than the actual number of cases? Multiple select question. Many cases are asymptomatic. Individuals do not seek treatment due to the stigma of a sexually transmitted disease. Diagnosis of gonorrhea is unreliable and time-consuming. It is not a notifiable disease so no one keeps track for the number of cases.
Many cases are asymptomatic. Individuals do not seek treatment due to the stigma of a sexually transmitted disease.
A sample of beta-hemolytic streptococci is Bacitracin-resistant and CAMP factor positive would be placed in which of the following groups?
Group B (S. agalactiae)
Which of the following are correct about treating staphylococcal infections? Multiple select question. Abscesses must be perforated and cleaned before they respond to antibiotic treatment Systemic infections require oral or injected drugs, usually over an extended period of time Systemic infections can be treated by a short course of antibiotics
Abscesses must be perforated and cleaned before they respond to antibiotic treatment Systemic infections require oral or injected drugs, usually over an extended period of time
Staphylococci are gram-______ facultative anaerobes with ______ cells arranged primarily in irregular clusters.
positive, spherical
Which species has become a significant source of infections of military personnel with traumatic injuries due to its primary targets of wounds and burns and the challenges of providing medial care under combat conditions? Multiple choice question. Acinetobacter baumannii Neisseria meningitidis Streptococcus pyogenes Moraxella (Branhamella) catarrhalis
Acinetobacter baumannii
Select all that apply Which of the following are long-term sequelae of S. pyogenes? Multiple select question. Necrotizing fasciitis Acute glomerulonephritis Rheumatic fever Bullous impetigo
Acute glomerulonephritis Rheumatic fever
What does S. pyogenes produce when it invades the skin or the throat? Multiple choice question. An inflammatory primary lesion An inflammatory secondary lesion mucus
An inflammatory primary lesion
Select all that apply Which two types of antibodies can provide long-term protection against streptococcal group A infections? Multiple select question. Antibodies against exfoliative toxin Antibodies against streptolysin O and streptolysin S Antibodies against a strain-specific M-protein Neutralizing antitoxin against the erythrogenic toxin Antibodies against coagulase
Antibodies against a strain-specific M-protein Neutralizing antitoxin against the erythrogenic toxin
____ and Acinetobacter are morphologically and biochemically similar to the Neisseria, and are therefore included in the same ___.
Blank 1: Moraxella Blank 2: Family
The vaccine ___ (used to prevent pneumonia) is indicated for patients and ____ patients at particularly high risk, including those with sickle-cell anemia, lack of a spleen, congestive heart failure, lung disease, diabetes, and kidney disease.
Blank 1: Pneumovax Blank 2: elderly or older
____ is the pneumococcal vaccine recommended for children, whereas ____ is the vaccine for adults.
Blank 1: Prevnar, PCV13, or Prevnar 13 Blank 2: Pneumovax, Pneumovax 23, or PPSV23
Morexella (Branhamella) ____ causes ____ infections in immunocompromised individuals.
Blank 1: catarrhalis Blank 2: opportunistic
Possible complications of PID in women include scarring in the tubes, ectopic pregnancies, and mixed infections.
Blank 1: fallopian Blank 2: anaerobic
Important virulence factors of N. meningitidis include the _____ (LPS) in the cell wall, polysaccharide ___, adhesive ___, and IgA ___.
Blank 1: lipopolysaccharide or endotoxin Blank 2: capsule Blank 3: fimbriae Blank 4: protease
Course of pneumococcal infection in the lungs
1. Load of bacterial cells is aspirated into the lungs 2. Pneumococci multiply, provoking inflammation and exudate formation 3. Exudate formation blocks bronchioles and alveoli by consolidation
The Neisseria genus of bacteria includes organisms which are fastidious, nonmotile gram- ____ kidney bean-shaped ____ that are ___ or microaerophilc.
Blank 1: negative Blank 2: cocci or coccus Blank 3: aerobic or aerobes
Put the following in order from most common cause of meningitis in adults to the least common: Instructions
1. streptococcus pneumoniae 2. Neisseria meningitidis 3. Streptococcus agalactiae
Put the events in order from the beginning of meningococcal infection to the end result, putting the first event at the top. Instructions
1. Bacteria spread to roof of nasal cavity 2. Bacteria enter the bloodstream 3. Bacteria escape into the cerebrospinal fluid 4. Bacteria infect meninges and cause disease
Gonorrhea is asymptomatic in % of males and % of females, which increases the persistence and spread of N. gonorrhoeae.
10 50
What is the infectious dose of gonorrhea?
100 to 1000 colony-forming units
The presence of Gram- diplococci in neutrophils from urethral, vaginal, cervical, or eye is highly diagnostic for gonorrhea.
Blank 1: negative Blank 2: exudates or exudate
How many different groups of streptococci did Rebecca Lancefield identify? Multiple choice question. 2 10 20
20
The optimal growth temperature for S. aureus is degrees ____ Celsius. (Give a number)
37
The group most likely to be affected by skin or pharyngeal infections caused by S. pyogenes includes children from __ to ___ years of age.
5 to 15
5% to % of all people carry S. pneumoniae as normal ____ in the nasopharynx.
50% microbiota
Streptococcus pyogenes belongs to which group of streptococci? Multiple choice question. B C A
A
Acinetobacter baumannii has become a significant pathogen in ____ and community-based infections due to its ability to survive for months on ___ such as sinks, respiratory equipment, and catheters.
Blank 1: nosocomial Blank 2: fomites
What do all cutaneous lesions of Staphylococcus aureus have in common? Multiple choice question. All are carbuncles. All are due to inflammation of hair follicles. All are skin abscesses.
All are skin abscesses
Select all that apply Strains of MRSA are generally resistant to which of the following antibiotics? Multiple select question. Cephalosporins Gentamicin Vancomycin Methicillin
Cephalosporins Gentamicin Methicillin
Select all that apply General characteristics of streptococci include which of the following? Multiple select question. Arranged in long, beadlike chains Spherical shape Arranged in irregular clusters Facultative anaerobes
Arranged in long, beadlike chains Spherical shape Facultative anaerobes
Select all that apply Which of the following can result from extragenital gonococcal infections occurring in adults? Multiple select question. Arthritis Conjunctivitis Proctitis Pharyngitis Pneumonia
Arthritis Conjunctivitis Proctitis Pharyngitis
Select all that apply Which preventive measures are currently used to minimize healthcare-associated staphylococcal infections? Multiple select question. Barring S. aureus positive workers from delivery rooms and nurseries Treating workers with combinations of antimicrobic drugs Treating all patients with combinations of antimicrobic drugs Vaccinating patients prior to their entry into a hospital
Barring S. aureus positive workers from delivery rooms and nurseries Treating workers with combinations of antimicrobic drugs
Groups ____and ____ streptococci are common microbiota of domestic animals but can be isolated from the human upper respiratory tract and occasionally cause pharyngitis imitating Group A streptococci.
C G
Which of the following tests is often used to distinguish S. aureus from other staphylococcal species? Multiple choice question. Gram staining reaction Coagulase test Sugar fermentation tests Growth on mannitol salt agar Catalase test
Coagulase test
Select all that apply The later signs/symptoms of pneumonia include ______. Multiple select question. Cyanosis Vomiting Cough Clear sputum Nasal discharge Discolored sputum Difficulty breathing Chest pain
Cyanosis Cough Discolored sputum Difficulty breathing Chest pain
True or false: Only pathogenic Neisseria species can be present in infectious fluids.
False Reason: Normal, nonpathogenic Neisseria species can be present in infectious fluids and must be differentiated from true pathogens.
What is the result of invasive gonorrhea infection in males? Multiple choice question. Damage to the ducts carrying sperm can create scar tissue and blockage, leading to possible infertility Nothing occurs as gonorrhea infection in males is not invasive Damage to the testes can lead to inflammation and infertility in males.
Damage to the ducts carrying sperm can create scar tissue and blockage, leading to possible infertility
Which of the following are species of the enterococci that are found as normal colonists in the human large intestine? Multiple select question. E. faecium E. faecalis E. agalactiae E. durans
E. faecium E. faecalis E. durans
Which group is likely to have natural immunity to the meningococcus and have a lower risk for meningococcal infection?
Elderly individuals
____ released from the cell wall of N. meningitidis has potent pathological effects on the host.
Endotoxin or Lipopolysaccharide
True or false: Streptococci are generally resistant to environmental factors such as drying, heat, disinfection, and drugs.
False Streptococci are generally susceptible
What is the first step in the infectious process of N. gonorrhoeae? Multiple choice question. Attachment by fimbriae to epithelial surface Entry through genital or other portal of entry Invasion of underlying connective tissue
Entry through genital or other portal of entry
_______ is produced by Group A beta-hemolytic streptococci, causing the rash and severe fever characteristic of scarlet fever.
Erythrogenic toxin
The meningococcus attaches to the nasopharynx with
FIMBRIAE
True or false: Prevention of rheumatic fever or acute glomerulonephritis is through vaccination.
False
True or false: Most Neisseriaceae are primary human pathogens, while a few are commensals of humans.
False Most Neisseriaceae are primary human pathogens, while few are commensals of human
True or false: Fomites are a common source of infection in gonorrhea because N. gonorrhoeae survives for long periods of time on inanimate surfaces.
False Reason: Fomites are not a common source of infection in gonorrhoeae because the gonococci can only survive 1 to 2 hours on fomites.
True or false: Viridans streptococci cause disease when ingested in food or water.
False enter the body through the bloodstream due to dental or surgical manipulation
Which can be causes of Pelvic Inflammatory Disease (PID)? Multiple select question. Gonococcal infection spreading to the upper reproductive structures such as the fallopian tubes Chlamydia infection of the female reproductive tract Gonococcal infection spreading to the lower reproductive structures such as the vagina
Gonococcal infection spreading to the upper reproductive structures such as the fallopian tubes Chlamydia infection of the female reproductive tract
Select all that apply Which of the following statements about Gonorrhea are correct? Multiple select question. Gonorrhea can be spread to humans from animals as a zoonosis. Gonorrhea is among the top five sexually transmitted diseases. Incidence of gonorrhea is probably higher than reported due to asymptomatic infections. Gonorrhea is strictly a human pathogen
Gonorrhea is among the top five sexually transmitted diseases. Incidence of gonorrhea is probably higher than reported due to asymptomatic infections. Gonorrhea is strictly a human pathogen
____ are the most significant reservoir for S. pyogenes.
Humans
Gram-positive and gram-negative cocci are prevalent members of the normal flora of the ______. intestine nervous system skin oral cavity
Intestine Skin Oral Cavity
Select all that apply What possible roles does coagulase play in the disease process? Multiple select question. It may cause the blistering seen in most staphylococcal infections. It may help in the evasion of host defenses by the deposition of fibrin around the staphylococcal cells. It may promote adherence to host tissues. It may assist in the secretion of an antiphagocytic capsule. It may digest the glue that binds cells together in tissues.
It may help in the evasion of host defenses by the deposition of fibrin around the staphylococcal cells. It may promote adherence to host tissues.
Select all that apply Which of the following are serious sequelae of gonococcal eye infections? Multiple select question. Pelvic inflammatory disease Meningitis Keratitis Ophthalmia neonatorum Blindness
Keratitis Ophthalmia neonatorum Blindness
The _____ classification system for streptococci is based on the present ____ on the cell wall of different species.
Lancefield carbohydrates
Select all that apply Diseases caused by S. pneumoniae include which of the following? Multiple select question. Meningitis Pneumonia Tonsillitis Otitis media Pharyngitis
Meningitis Pneumonia Otitis media
The family Neisseriaceae includes the genera Neisseria, Branhamella, and
Moraxella
Select all that apply The two pathogenic members of the Neisseria genus include which of the following? Multiple select question. B. catarrhalis N. gonorrhoeae N. subflava N. meningitidis
N. gonorrhoeae N. meningitidis
What are the leading causes of PID? Multiple select question. N. gonorrhoeae infections Chlamydia infections N. meningitidis infections
N. gonorrhoeae infections Chlamydia infections
Because nonpathogenic ____ species can be found in the human body in infectious fluid, they must be differentiated from true pathogens in order to diagnose diseases like meningitis and gonorrhea.
Neisseria
Which gram-negative organism is positive for oxidase but does not ferment maltose and does not grow on nutrient agar?
Neisseria gonorrhoeae
Most individuals have a natural immunity to the meningococcus, ____ ____. which is indicated by the low infection rate of this pathogen.
Neisseria meningitidis
Which gram-negative organism would test positive for oxidase and be able to ferment maltose but not sucrose or lactose?
Neisseria meningitidis
Select all that apply Carriers of S. aureus harbor the bacteria in the ______. Multiple select question. Ureter Nostrils Skin Mouth Nasopharynx Intestine Stomach
Nostrils Skin Nasopharynx Intestine
What occurs when gonorrhea infection ascends from the vagina and cervix to the uterus and fallopian tubes?
Pelvic inflammatory disease (PID)
S. pneumoniae infection can occur through which of the following? Multiple select question. Fresh water sources Respiratory droplets Fomites Endogenous flora
Respiratory droplets endogenous flora
___ ____ is a throat infection usually caused by S. pyogenes that also produces a bright red rash on the skin and a high fever.
Scarlet fever
The majority of otitis media cases are caused by
Streptococcus pneumoniae
Which of the following causes of pneumonia matches this description: small, gram-positive lancet-shaped cells arranged in pairs and short chains? Multiple choice question. Legionella pneumophila Mycoplasma pneumoniae Histoplasma capsulatum Streptococcus pneumoniae Pneumocystitis jiroveci
Streptococcus pneumoniae
______ are common inhabitants of the skin and mucous membranes.
Staphylococci
The four most common genera of infectious cocci are
Staphylococcus Streptococcus Neisseria Enterococcus
Which of the following species uses coagulase to cause plasma clotting? Multiple choice question. Candida albicans Staphylococcus epidermidis Alpha-hemolytic streptococcus Micrococcus luteus Staphylococcus aureus
Staphylococcus aureus
Select all that apply The virulence factors of S. pyogenes include ______. Multiple select question. Streptolysin O Catalase Tissue-digesting enzymes M protein Streptolysin S Toxic shock toxin
Streptolysin O Tissue-digesting enzymes M protein Streptolysin S
Signs and symptoms of otitis media include which of the following? Multiple select question. Temporary deafness Inflammation of the pharynx Painful headaches Painful earaches
Temporary deafness Painful earaches
What happens when an individual is colonized with S. aureus? Multiple choice question. The individual always presents with clinical symptoms The individual usually does not display any signs or symptoms
The individual usually does not display any signs or symptoms
Why is antimicrobial susceptibility testing of Staphylococcus species essential? Multiple choice question. Antimicrobial susceptibility testing is not needed for treating staphylococci Antimicrobial susceptibility testing is best practice for all infections The staphylococci are notorious in their acquisition of resistance to new drugs.
The staphylococci are notorious in their acquisition of resistance to new drugs.
Why are Moraxella and Acinetobacter included in the same family as Neisseria? Multiple select question. These genera cause similar diseases These genera are morphologically similar These general are biochemically similar
These genera are morphologically similar These general are biochemically similar
Which of the following are true about systemic staph infections? Multiple select question. They spread via the bloodstream They spread from local cutaneous infections They have a focal pattern They begin by infecting an internal organ
They spread via the bloodstream They spread from local cutaneous infections They have a focal pattern
Select all that apply Which of the following are disorders caused by toxin production of S. aureus? Multiple select question. Toxic shock syndrome Food intoxication Scalded skin syndrome Osteomyelitis
Toxic shock syndrome Food intoxication Scalded skin syndrome
What is the best method to prevent rheumatic fever or acute glomerulonephritis?
Treat the preceding infection
True or false: Isolates of S. aureus can be resistant to multiple antibiotics.
True
True or false: Prevention of gonorrhea in infants is partly done by physicians, who screen pregnant women for gonorrhea.
True
True or false: S. aureus can be found in most environments frequented by humans.
True
True or false: Before antibiotics were developed, diseases caused by S. pyogenes (such as rheumatic fever and puerperal sepsis) were significant causes of mortality.
True These diseases were often fatal before antibiotics came into use
True or false: Infection with pneumococcal pneumonia confers immunity to reinfection with the same strain.
True immunity does not occur after the first infection
Inflammation of a single hair follicle or sebaceous gland can progress into a large, red, and extremely tender abscess or pustule called ______.
a furuncle
Select all that apply Signs and symptoms of PID include ______. Multiple select question. abdominal pain urethral exudate fever tenderness
abdominal pain fever tenderness
A local staphylococcal infection often manifests as an inflamed, fibrous lesion enclosing a core of pus called a(n) .
abscess
To treat staphylococcal infections, ______ must first be perforated and cleaned before they respond to antibiotic treatment, while ____ (throughout the body) infections require oral or injected drugs, usually over an extended period of time.
abscesses systemic
Inflammation of the kidney glomerulus and tubular epithelia due to S. pyogenes is known as ___ ____ .
acute glomerulonephritis
-hemolysis helps differentiate the pneumococcus from the beta-hemolytic streptococci.
alpha
The viridans streptococci are ____-hemolytic streptococci found in the ____ cavity.
alpha oral
Prior to the advent of ____, S. pyogenes was a significant cause of human infection and death.
antibiotics
Select all that apply Immunity to meningococci develops naturally through the production of ______. Multiple select question. antibodies against membrane antigens antibodies against capsular polysaccharides antibodies against proteins in fimbriae neutralizing antibodies against toxins
antibodies against membrane antigens antibodies against capsular polysaccharides
Hospital workers who carry S. aureus nasally may be barred from nurseries and other high-risk areas; carriers may be treated with a combination of .
antimicrobic drug
A significant number of gonorrhea infections are ____ , which leads to many cases not being reported to health authorities.
asymptomatic
Because many cases of gonococcal infection are ______ in women (and a small percentage of men), tracking sexual partners of identified individuals is critical in preventing complications.
asymptomatic
In hospital settings, the most common source of staphylococci are visitors or hospital personnel who are ____ ____ and therefore are unaware they carry staphylococci. Listen to the complete question
asymptomatic carriers
The most common source of staphylococci in hospital settings is ______.
asymptomatic carriers
Amongst the species of staphylococci that are important human pathogens, the most significant pathogen is Staphylococcus ____.
aureus
Staphylococcus _______, Staphylococcus _____ and S. saprophyticus are human commensals and can be pathogenic.
aureus epidermis, capitis, or hominis
Repeated blood samples that are positive for ___ are highly suggestive of endocarditis.
bacteremia
Repeated blood samples that are positive for ____ are highly suggestive of endocarditis.
bacteremia
S. pyogenes is ___-hemolytic on blood agar and bacitracin-, characteristics used to place this organism in Lancefield Group A. Listen to the complete question
beta sensitive
Which of the following are characteristics of S. pyogenes? Multiple select question. beta-hemolytic alpha-hemolytic bacitracin-resistant bacitracin-sensitive
beta-hemolytic bacitracin-sensitive
Foreign objects can support _____ production by the staphylococci, increasing the risk of infections in patients who have catheters, shunts, or other prosthetic devices.
biofilm
E. faecalis causes infections involving ______. Multiple select question. blood the upper respiratory tract wounds intestine the urinary tract skin
blood wounds intestine the urinary tract
Endocarditis is diagnosed through ______. Multiple choice question. PCR analysis gram stain blood culture throat culture
blood culture
S. aureus produces _____, a blood cell toxin that can cause disruption of red blood cell ____.
hemolysin membranes
Natural immunity to meningococci is due to the development of antibodies against ___ polysaccharides in Groups A and C and against membrane ____ in Group B.
capsule antigens
A _____ is a deeper lesion caused when a cluster of furuncles aggregates into one large mass.
carbuncle
Select all that apply The best methods of minimizing nosocomial infection by staphylococci are ______. Multiple select question. careful hand washing attention to indwelling catheters screening of visitors proper disposal of infectious dressings adequate cleansing of incisions
careful hand washing attention to indwelling catheters proper disposal of infectious dressings adequate cleansing of incisions
Fill in the blanks to complete the sentence. Infants born to gonococcus ____ are at risk of infection with gonorrhea during the birth process.
carriers
The _____ test can be used to distinguish streptococci from staphylococci.
catalase
The chemotherapeutic agent used to treat meningococcal meningitis is usually a third generation cephalosporin such as ____.
ceftriaxone
Which of the following accurately describe the appearance of S. pneumoniae in a gram stain of sputum? Multiple select question. cells arranged in pairs or short chains gram positive cells gram variable cells small, lancet-shaped cells cells arranged in clusters
cells arranged in pairs or short chains gram positive cells small, lancet-shaped cells
Which is the chemotherapeutic agent of choice for meningococcal meningitis?
cephalosporin
N. meningitidis is usually associated with epidemic .
cerebrospinal meningitis
Some of the signs and symptoms of pneumonia include severe ____ pain, cough, and the production of ____ sputum.
chest bloody
Specimens from suspected Neisseria infections should be streaked on ____ or modified Thayer-Martin (MTM) agar and incubated in a high carbon dioxide atmosphere.
chocolate
The main function of the enzyme _______ is to clot plasma and blood. Multiple choice question. catalse lipase urease coagulase
coagulase
Gram-positive and gram-negative _____ are among the most significant infectious agents of humans.
cocci
______ acquired MRSA is most often acquired outside of the hospital setting.
community
CA-MRSA stands for _____ - acquired methicillin ____ Staphylococcus aureus.
community resistant
The common name for Neisseria gonorrhoeae is the
gonococcus
is a sexually transmitted disease caused by a member of the Neisseria that has been known since ancient times. Listen to the complete question
gonorrhea
Select all that apply Which of the following are characteristics of Staphylococcus species? Multiple select question. gram-positive lack spores sensitive to a variety of environmental extremes may be encapsulated catalase positive lack flagella
gram-positive lack spores may be encapsulated catalase positive lack flagella
______ of female gonorrhea cases display a mucopurulent or bloody vaginal discharge.
half
Which is a toxin produced by S. aureus that can cause disruption of red blood cell membranes? Multiple choice question. lipase leukocidin hemolysin
hemolysin
When sputum is gram stained, S. pneumoniae will appear as small, ____-shaped gram- ____cells arranged in pairs or short chains.
lancet positive
The exotoxin ____ is produced by S. aureus and damages the cell membranes of neutrophils and macrophages, causing them to lyse.
leukocidin
S. aureus can cause ______.
localized and systemic disease
The overall incidence of CA-MRSA is ____ than that of hospital MRSA.
lower or less
Ultra-absorbent tampons bind _____ ions causing S. aureus to produce much greater levels of the ____ involved in toxic shock syndrome.
magnesium toxin or exotoxin
Bacterial ______ constitutes a medical emergency, and must be diagnosed as quickly as possible due to the rapidity of the disease and the potential for a fatal outcome.
meningitis
Extragenital gonococcal bacteremia can lead to gonococci causing damage to the joints and skin, as well as rare cases of _____ in the brain and ____ 1in the heart.
meningitis endocarditis
Petechiae, necrosis of tissues and extremities, and high fever are all signs and symptoms of ______.
meningococcemia
When the meningococcus enters the bloodstream and begins to multiply in the host, causing severe vascular disease, it is known as ______.
meningococcemia
Select all that apply What are the most serious complications of meningococcal infection? Multiple select question. stiff neck meningococcemia brain infection pharyngitis
meningococcemia brain infection
Neisseria meningitidis is commonly known as the
meningococcus
The vaccine used to prevent meningococcal meningitis in persons older than 55 is known as .
menomune, MPSV4, or Menactra
The acronym MRSA refers to strains resistant to ____ and VRSA refers to strains resistant to _____.
methicillin vancomycin
Acronyms such as MRSA and VRSA indicate resistance to which two antibiotics? Multiple choice question. methicillin and penicillin V metronidazole and vancomycin methicillin and valacyclovir methicillin and vancomycin metronidazole and valacyclovir
methicillin and vancomycin
MRSA stands for ____ ____ Staphylococcus aureus.
methicillin-resistant
In animals and humans, Neisseria are found as resident microflora in the
mucous membranes
The main signs and symptoms of pharyngitis include ______. Multiple select question. leukocytosis pain and swelling of throat swollen tonsils high long-lasting fever reddened mucosa in throat
pain and swelling of throat swollen tonsils reddened mucosa in throat
Pneumococcal meningitis has historically been treated with some form of
penicillin
Effective treatment of enterococcal infections usually requires combined chemotherapy using which two agents? Multiple select question. penicillin gentamicin chloramphenicol tetracycline
penicillin gentamicin
The main drug used to treat group B streptococcal infections, as used in cases of neonatal S. agalactiae meningitis, is ______.
penicillin G
Some isolates of S. aureus show multiple resistance to antibiotics; some produce ______, which is used by the bacteria to inactivate some beta-lactam antibiotics. Multiple choice question. penicillinase oxidase catalase ampicillinase
penicillinase
The antibiotic of choice for pharyngitis caused by S. pyogenes is .
penicllin V
Individuals most at risk for meningococcal infection include Multiple select question. people exposed during outbreaks military recruits students children age 2 or older elderly individuals
people exposed during outbreaks military recruits students children age 2 or older
Minute hemorrhagic spots appearing in the skin on the trunk and appendages are known as ______ and these serve as a sign of meningococcemia.
petechiae
Which of the following host defenses is considered the most effective in combating S. aureus infection? Multiple choice question. phagocytic response B cell response antibody production
phagocytic response
Strep throat is more accurately referred to as streptococcal _____.
pharyngitis
Types of infections caused by members of the viridans streptococci include all of the following except ______. Multiple choice question. subacute endocarditis meningitis bacteremia pharyngitis
pharyngitis
Pyogenic infections of the throat caused by S. pyogenes include ______.
pharyngitis tonsillitis
Select all that apply S. pyogenes gains a foothold in the host, usually when defenses are lowered, through the ______. Multiple select question. pharynx genital tract skin
pharynx skin
The most common type of bacterial meningitis in adults is ____ meningitis.
pneumococcal
The common name for Streptococcus pneumoniae is the _____.
pneumococcus
Mucus containing a load of bacterial cells being aspirated into the lungs of susceptible patients who have lowered defenses can lead to .
pneumonia
Which of the following are symptoms seen in early-onset S. agalactiae infection in neonates? Multiple select question. pneumonia meningitis sepsis
pneumonia sepsis
S. aureus is a coagulase - _______ staphylococcus.
positive
Using microscopic characteristics, it is observed that Staphylococci are gram- _____cocci and form irregular _____.
positive clusters
Major complications that can occur if gonorrhea infection ascends from the vagina and cervix to the uterus and fallopian tubes are ______. Multiple select question. glomerulonephritis pharyngitis salpingitis tubal infertility pelvic inflammatory disease
salpingitis tubal infertility pelvic inflammatory disease
Select all that apply Where is CA-MRSA most often transmitted? Multiple select question. surgical wards schools prisons gyms
schools prisons gyms
Symptoms of late-onset neonatal meningitis caused by S. agalactiae include ______. Multiple select question. seizures sepsis pneumonia fever vomiting
seizures fever vomiting
In infants infected with S. agalactiae, ____ and ____ can develop a few days after birth and may result in high mortality rates.
sepsis pneumonia
Select all that apply Which of the following are caused by N. meningitidis? Multiple select question. rheumatic fever shock glomerulonephritis vascular damage clotting disorders
shock vascular damage clotting disorders
Children under 2 years old are more susceptible to otitis media because they have a___ eustachian tube than adults.
shorter
Select all that apply The universal precaution to prevent gonococcal eye infections in neonates is the instillation of ______ into the conjunctival sac: Multiple select question. silver nitrate antiseptics antibiotics vaccination of neonate
silver nitrate antiseptics antibiotics
The habitat of S. epidermidis is usually the ___ and ___ membranes.
skin mucous