7 - Gram Negative Bacilli

b. Ability to form spores

Gram positive bacilli are classified based on this characteristic

a. Ability to form capsules
b. Ability to form spores
c. Ability to form biofilms
d. Ability to form flagella

• Bacillus spp.

• Clostridium spp.

📌Mneamonic: “BC”

Spore - Forming Gram Negative Bacilli [2]

• Corynebacterium spp.

• Listeria spp.

• Erysipelothrix xpp.

• Actinomyces spp.

• Nocardia spp.

• Propionibacterium spp.

📌Mnemonic: “CLEAN P”

Non - Spore Forming Gram Negative Bacilli [6]

c. B. thuringiensis

[Spore-forming]

BEQ: Bacillus spp. used for agricultural pest control

a. B. anthracis
b. B. cereus
c. B. thuringiensis
d. B. subtilis

d. B. anthracis

[Spore-forming]

Identification:

• Box car shaped bacteria

• Capsule (D-glutamic acid instead of polysaccharide)

• Not motile

a. B. thuringiensis
b. B. cereus
c. B. subtilis
d. B. anthracis

c. D-glutamic acid

[Spore-forming]

Capsule of B. anthracis is made of this instead of polysaccharide

a. D-alanine
b. D-galactose
c. D-glutamic acid
d. D-mannose

b. Exotoxin

[Spore-forming]

Virulence factor of B. anthracis

a. Endotoxin
b. Exotoxin
c. Hemolysin
d. Superantigen

• Protective factor

• Edema factor

• Lethal factor

[Spore-forming]

Components of the exotoxin of B. anthracis

a. Necrotic factor, edema factor, lethal factor
b. Cytotoxic factor, edema factor, lethal factor
c. Protective factor, necrotic factor, lethal factor
d. Protective factor, edema factor, lethal factor

c. Zoonotic

[Spore-forming]

Anthrax is this type of infection

a. Nosocomial
b. Vector-borne
c. Zoonotic
d. Anthroponosis

b. Malignant pustule

[Spore-forming]

Cutaneous anthrax is also known as

a. Woolsorter's disease
b. Malignant pustule
c. Black lung disease
d. Farmer's lung

c. Woolsorter's disease

[Spore-forming]

Pulmonary anthrax is also known as

a. Malignant pustule
b. Farmer's lung
c. Woolsorter's disease
d. Black lung disease

d. GI Anthrax

[Spore-forming]

Anthrax type that is rare

a. Pulmonary Anthrax
b. Cutaneous Anthrax
c. Systemic Anthrax
d. GI Anthrax

b. Category A

[Spore-forming]

B. anthracis belongs to this bioterrorism category because it causes public panic

a. Category B
b. Category A
c. Category C
d. Category D

• Ciprofloxacin

• Doxycycline

[Spore-forming]

Drugs of choice for B. anthracis

a. Vancomycin and Clindamycin

b. Ampicillin and Gentamicin

c. Ciprofloxacin and Doxycycline

d. Penicillin G and Metronidazole

c. Bacillus cereus

[Spore-forming]

• This organism lacks a capsule and is motile

• This organism is associated with reheated rice

a. Bacillus anthracis

b. Clostridium perfringens

c. Bacillus cereus

d. Listeria monocytogenes

d. Heat-stable enterotoxin

[Spore-forming]

Toxin produced by B. cereus from reheated rice

a. Endotoxin
b. Heat-labile enterotoxin
c. Superantigen
d. Heat-stable enterotoxin

• Diarrhea

• Vomiting

[Spore-forming]

Clinical manifestations caused by B. cereus heat-stable enterotoxin

a. Nausea and constipation
b. Fever and chills
c. Diarrhea and vomiting
d. Rash and pruritus

b. Chinese Fried Rice Syndrome

[Spore-forming]

Syndrome associated with B. cereus infection from reheated rice

a. Rice Water Syndrome
b. Chinese Fried Rice Syndrome
c. Reheated Rice Syndrome
d. Fried Rice Poisoning Syndrome

• Hydration

• Vancomycin

• Clindamycin

[Spore-forming]

Treatment for B. cereus [3]

c. Soil

[Spore-forming]

Reservoir of C. perfringens

a. Colon
b. Nasopharynx
c. Soil
d. Skin

a. Neuropathy in Type 2 DM leading to impaired sensation

[Spore-forming]

Risk factor for C. perfringens infection.

a. Neuropathy in Type 2 DM leading to impaired sensation
b. Hypertension
c. Hyperlipidemia
d. Asthma

c. Alpha toxin

[Spore-forming]

Virulence factor of C. perfringens

a. Endotoxin
b. Superantigen
c. Alpha toxin
d. Beta toxin

d. Gas gangrene

[Spore-forming]

Alpha toxin of C. perfringens causes ______

a. Pseudomembranous colitis
b. Woolsorter's disease
c. Malignant pustule
d. Gas gangrene

d. Gas gangrene

[Spore-forming]

Also known as “diabetic foot"

a. Pseudomembranous colitis
b. Woolsorter's disease
c. Malignant pustule
d. Gas gangrene

• Penicillin G

• Hyperbaric O₂

[Spore-forming]

Treatment for C. perfringens

a. Ciprofloxacin and Doxycycline

b. Ampicillin and Gentamicin

c. Penicillin G and Hyperbaric O₂

d. Vancomycin and Metronidazole

c. Amputation

[Spore-forming]

Worst case scenario management for C. perfringens infection

a. Hyperbaric O₂
b. Penicillin G
c. Amputation
d. Ciprofloxacin

b. C. difficile

[Spore-forming]

Causative agent of pseudomembranous colitis

a. C. botulinum
b. C. difficile
c. C. tetani
d. C. perfringens

c. Colon

[Spore-forming]

Reservoir of C. difficile

a. Soil
b. Skin
c. Colon
d. Nasopharynx

d. Chronic antibiotic use

[Spore-forming]

Risk factor for C. difficile infection

a. Chronic steroid use
b. Chronic NSAID use
c. Chronic antifungal use
d. Chronic antibiotic use

• Cephalosporin

• Clindamycin

• Ciprofloxacin

[Spore-forming]

Antibiotics that serve as risk factors for C. difficile infection

a. Penicillin, Ampicillin, Gentamicin
b. Cephalosporin, Clindamycin, Ciprofloxacin
c. Tetracycline, Erythromycin, Azithromycin
d. Vancomycin, Metronidazole, Doxycycline

d. Pseudomembrane

[Spore-forming]

Long usage of Cephalosporin, Clindamycin, Ciprofloxacin antibiotics kills normal flora, allowing C. difficile to proliferate and produce this structure

a. Biofilm
b. Capsule
c. Spore
d. Pseudomembrane

d. Toxin A

[Spore-forming]

Toxin produced by C. difficile that causes colitis

a. Beta toxin
b. Toxin B
c. Alpha toxin
d. Toxin A

• Stop the antibiotic

• Vancomycin (oral) - most preferred

• Metronidazole

• Fecal transplant (50% efficacy)

[Spore-forming]

Treatment for C. difficile infection

a. Ciprofloxacin, Doxycycline, Hydration
b. Ampicillin, Gentamicin, Fecal transplant
c. Penicillin G, Hyperbaric O₂, Amputation
d. Stop the antibiotic, Vancomycin (oral), Metronidazole, Fecal transplant

a. C. tetani

[Spore-forming]

Identification:

• Lollipop shape bacteria

• Drumstick shape bacteria

• Tennis racket shape bacteria

a. C. tetani

b. C. perfringens

c. C. botulinum

d. C. difficile

b. Soil

[Spore-forming]

Reservoir of C. tetani

a. Colon
b. Soil
c. Nasopharynx
d. Skin

b. Wound

[Spore-forming]

Risk factor for C. tetani infection

a. Chronic antibiotic use
b. Wound
c. Type 2 DM
d. Immunocompromised state

c. Tetanospasmin

[Spore-forming]

Neurotoxin produced by C. tetani

a. Alpha toxin
b. Tetanolysin
c. Tetanospasmin
d. Botulinum toxin

c. Inhibits GABA

[Spore-forming]

Mechanism of action of tetanospasmin

a. Inhibits acetylcholine release

b. Inhibits norepinephrine release

c. Inhibits GABA

d. Blocks sodium channels

b. Spastic paralysis

[Spore-forming]

Result of tetanospasmin inhibiting GABA

a. Flaccid paralysis
b. Spastic paralysis
c. Sensory paralysis
d. Autonomic paralysis

• (+) Abdominal rigidity

• (+) Trismus (Lock jaw)

• (+) Opisthotonos (Arching of the back)

[Spore-forming]

Clinical manifestation of C. tetani [3]

c. Risus sardonicus

[Spore-forming]

Clinical manifestation of C. tetani referring to sardonic smile

a. Trismus
b. Opisthotonos
c. Risus sardonicus
d. Abdominal rigidity

• Anti-tetanus serum (ATS)

• Tetanus toxoid

• Diazepam

• Metronidazole

[Spore-forming]

Treatment for C. tetani [4]

c. Antitetanus serum

[Spore-forming]

Treatment for C. tetani providing artificial passive immediate protection

a. Tetanus toxoid
b. DPT vaccine
c. Antitetanus serum
d. Diazepam

d. Tetanus toxoid

[Spore-forming]

Treatment for C. tetani providing artificial active long term protection

a. Antitetanus serum
b. Diazepam
c. Metronidazole
d. Tetanus toxoid

b. Diazepam

[Spore-forming]

Treatment for spasm caused by C. tetani

a. Metronidazole
b. Diazepam
c. Antitetanus serum
d. Tetanus toxoid

c. DPT

[Spore-forming]

Prevention vaccine for C. tetani:

• For High risk, higher case

• For kids

a. Tdap

b. Tetanus toxoid

c. DPT

d. Antitetanus serum

d. Tdap

[Spore-forming]

Prevention vaccine for C. tetani:

• For lower case, low risk

• For adults

a. DPT
b. Antitetanus serum
c. Tetanus toxoid
d. Tdap

d. Tetanus toxoid

[Spore-forming]

Recommended vaccine for pregnant women because birth location is unknown, leading to wound exposure and tetanus risk

a. DPT
b. Tdap
c. Antitetanus serum
d. Tetanus toxoid

• Canned goods

• Contaminated honey

[Spore-forming]

Risk factor for C. botulinum infection

a. Reheated rice, contaminated water
b. Wound exposure to soil
c. Canned goods, contaminated honey
d. Chronic antibiotic use

d. Botulinum toxin

[Spore-forming]

Neurotoxin produced by C. botulinum

a. Tetanospasmin
b. Tetanolysin
c. Alpha toxin
d. Botulinum toxin

c. Inhibits Ach

[Spore-forming]

Mechanism of action of botulinum toxin

a. Inhibits GABA
b. Blocks sodium channels
c. Inhibits Ach
d. Inhibits norepinephrine release

d. Flaccid paralysis

[Spore-forming]

Result of botulinum toxin inhibiting Ach

a. Spastic paralysis
b. Autonomic paralysis
c. Sensory paralysis
d. Flaccid paralysis

• Antitoxin

• Airway support

[Spore-forming]

Treatment for C. botulinum infection

a. Penicillin G, Hyperbaric O₂
b. Antitoxin, Airway support
c. Vancomycin, Metronidazole
d. Antitetanus serum, Diazepam

d. Prevention of wrinkles (Botox)

[Spore-forming]

Clinical application of botulinum toxin aside from its role as a neurotoxin

a. Treatment for spasm

b. Treatment for paralysis

c. Prevention of infection

d. Prevention of wrinkles

c. Palisade "chinese character"

[Nonspore- forming]

BEQ: ID of Corynebacterium diphtheriae based on its arrangement

a. Box car shaped
b. Lollipop, drumstick, tennis racket
c. Palisade "chinese character"
d. Diplococci

b. Metachromatic granules

[Nonspore- forming]

Unique granules found in Corynebacterium diphtheriae

a. Lipid granules
b. Metachromatic granules
c. Sulfur granules
d. Volutin granules

c. Loeffler's agar

[Nonspore- forming]

Culture medium used for Corynebacterium diphtheriae

a. MacConkey agar
b. Blood agar
c. Loeffler's agar
d. Chocolate agar

c. Elek test

[Nonspore- forming]

Test used to determine toxigenicity of Corynebacterium diphtheriae

a. Schick test
b. Dick test
c. Elek test
d. Widal test

d. Schick test

[Nonspore- forming]

Test used to determine susceptibility to Corynebacterium diphtheriae

a. Elek test
b. Dick test
c. Widal test
d. Schick test

c. Droplet

[Nonspore- forming]

Route of transmission of Corynebacterium diphtheriae

a. Fecal-oral
b. Direct contact
c. Droplet
d. Vector-borne

b. Cytotoxin

[Nonspore- forming]

The toxin of Corynebacterium diphtheriae is a:

a. Endotoxin

b. Cytotoxin

c. Neurotoxin

d. Enterotoxin

c. Inhibit protein synthesis elongation faction 2

[Nonspore- forming]

Mechanism of action of Toxin A of Corynebacterium diphtheriae

a. Inhibit GABA
b. Inhibit Ach
c. Inhibit protein synthesis elongation faction 2
d. Inhibit DNA replication

c. Pharyngeal diphtheria (with dyspnea and bullneck)

[Nonspore- forming]

The exotoxin of Corynebacterium diphtheriae causes cell death leading to the formation of a pseudomembrane in the throat, which is characteristic of:

a. Gas gangrene
b. Pseudomembranous colitis
c. Pharyngeal diphtheria (with dyspnea and bullneck)
d. Malignant pustule

• Antitoxin (passive)

• Pen G

• Erythromycin if allergic to Pen G

• Airway support

[Nonspore- forming]

Treatment for Corynebacterium diphtheriae

a. Antitoxin (passive), Pen G, Erythromycin if allergic to Pen G, Airway support
b. Antitetanus serum, Diazepam, Metronidazole
c. Ciprofloxacin, Doxycycline, Airway support
d. Vancomycin, Clindamycin, Airway support

b. Erythromycin

[Nonspore- forming]

Treatment for Corynebacterium diphtheriae if allergic to Penicillin G.

a. Doxycycline

b. Erythromycin

c. Ciprofloxacin

d. Vancomycin

• DPT (toxoid)

• Tdap

[Nonspore- forming]

Prevention vaccines for Corynebacterium diphtheriae

a. DPT only

b. Tdap only

c. DPT, Tdap

d. BCG, DPT

a. Diphtheria, Pertussis, Tetanus

[Nonspore- forming]

DPT (toxoid) and Tdap are vaccines used for the prevention of:

a. Diphtheria, Pertussis, Tetanus

b. Diphtheria, Polio, Tetanus

c. Diphtheria, Pertussis, Polio

d. Diphtheria, Tetanus, Hepatitis B

d. Tumbling motility

[Nonspore- forming]

Unique motility characteristic of Listeria monocytogenes

a. Gliding motility

b. Swarming motility

c. Darting motility

d. Tumbling motility

b. Able to grow at low temperatures and survive phagocytosis

[Nonspore- forming]

Unique characteristic of Listeria monocytogenes regarding temperature and phagocytosis

a. Able to grow at high temperatures and survive phagocytosis

b. Able to grow at low temperatures and survive phagocytosis

c. Unable to grow at low temperatures and resist phagocytosis

d. Unable to grow at high temperatures and survive phagocytosis

d. Endotoxin

[Nonspore- forming]

Toxin possessed by Listeria monocytogenes

a. Alpha toxin

b. Exotoxin

c. Superantigen

d. Endotoxin

c. Sepsis and meningitis in neonates and elderly

[Nonspore- forming]

Watch out for complications of Listeria monocytogenes infection

a. Gas gangrene and sepsis

b. Pneumonia and bacteremia

c. Sepsis and meningitis in neonates and elderly

d. Pseudomembranous colitis and meningitis

• No; cephalosporins

• Yes; ampicillin and co-trimoxazole

[Nonspore- forming]

Treatment for Listeria monocytogenes

a. Vancomycin and Metronidazole
b. No cephalosporins; Yes ampicillin and co-trimoxazole
c. Ciprofloxacin and Doxycycline
d. Penicillin G and Erythromycin

c. Occupational pathogen

[Nonspore- forming]

Erysipelothrix chusiopathiae is classified as this type of pathogen

a. Nosocomial pathogen
b. Opportunistic pathogen
c. Occupational pathogen
d. Vector-borne pathogen

b. Fish handlers (mangingisda or nagtitinda)

[Nonspore- forming]

Population at risk for Erysipelothrix chusiopathiae infection

a. Healthcare workers and immunocompromised
b. Fish handlers (mangingisda or nagtitinda)
c. Farmers and agricultural workers
d. Veterinarians and animal handlers

c. Swelling but no pus

[Nonspore- forming]

Clinical manifestation of Erysipelothrix chusiopathiae infection

a. Swelling with pus formation
b. Gas gangrene with bullneck
c. Swelling but no pus
d. Pseudomembrane with dyspnea

d. Whale finger / seal finger

• Swelling but no pus

[Nonspore- forming]

Watch out for complications of Erysipelothrix chusiopathiae infection

a. Seal finger / whale finger
b. Malignant pustule
c. Diabetic foot
d. Whale finger / seal finger

c. Penicillin

[Nonspore- forming]

Treatment for Erysipelothrix chusiopathiae

a. Ampicillin and co-trimoxazole
b. Ciprofloxacin and Doxycycline
c. Penicillin
d. Vancomycin and Metronidazole

a. Actinomyces israelii

[Nonspore- forming]

Aerobe

a. Actinomyces israelii

b. Nocardia asteroides

b. Nocardia asteroides

[Nonspore- forming]

Anaerobe

a. Actinomyces israelii

b. Nocardia asteroides

b. Acid fast

[Nonspore- forming]

Staining characteristic of Nocardia asteroides.
a. Gram-positive only
b. Acid fast
c. Gram-negative only
d. Non-staining

c. Soil

[Nonspore- forming]

Environment where Actinomyces israelii is found.
a. Water
b. Normal flora
c. Soil
d. Air

c. Normal flora

[Nonspore- forming]

Nocardia asteroides is part of:
a. Transient flora
b. Pathogenic flora
c. Normal flora
d. Opportunistic flora

d. False mycetoma

[Nonspore- forming]

Disease caused by Actinomyces israelii.
a. True mycetoma
b. Atypical pneumonia
c. Acne vulgaris
d. False mycetoma

d. Co-trimoxazole

[Nonspore- forming]

Treatment for Nocardia asteroides.
a. Penicillin and amputation
b. Clindamycin
c. Doxycycline
d. Co-trimoxazole

b. Madura foot

[Nonspore- forming]

______is the historical medical term for a true mycetoma

a. Seal finger

b. Madura foot

c. Whale finger

d. Erysipeloid

d. Sulfur granules

[Nonspore- forming]

Characteristic granules found in false mycetoma caused by Actinomyces israelii.
a. Yellow granules
b. Red granules
c. White granules
d. Sulfur granules

• Penicillin

• Amputation

[Nonspore- forming]

Treatment for Actinomyces israelii.
a. Co-trimoxazole
b. Clindamycin and doxycycline
c. Penicillin and amputation
d. Metronidazole

d. Fungal

[Nonspore- forming]

True mycetoma is caused by:
a. Bacteria
b. Virus
c. Protozoa
d. Fungal

c. Bacteria

[Nonspore- forming]

False mycetoma is caused by:
a. Fungal
b. Protozoa
c. Bacteria
d. Virus

c. Aerotolerant anaerobe

[Nonspore- forming]

Identification of Propionibacterium acnes.
a. Obligate aerobe
b. Facultative anaerobe
c. Aerotolerant anaerobe
d. Microaerophile

d. Lipase

[Nonspore- forming]

Enzyme produced by Propionibacterium acnes that initiates acne vulgaris pathogenesis.
a. Protease
b. Coagulase
c. Transpeptidase
d. Lipase

b. Lipase → lipid → sebum → FA → increased inflammation → acne vulgaris

[Nonspore- forming]

Correct pathogenesis of Propionibacterium acnes leading to acne vulgaris.
a. Lipase → sebum → FA → decreased inflammation
b. Lipase → lipid → sebum → FA → increased inflammation → acne vulgaris
c. Lipase → pimple → FA → inflammation
d. Lipase → cytokine → inflammation → acne

• Clindamycin

• Doxycycline

[Nonspore- forming]

Treatment for Propionibacterium acnes.
a. Penicillin and amputation
b. Co-trimoxazole
c. Clindamycin and doxycycline
d. Metronidazole

c. Testosterone

[Nonspore- forming]

Hormone in females that causes increased acne through hyperandrogenism.
a. Estrogen
b. Progesterone
c. Testosterone
d. Cortisol

b. Testosterone

[Nonspore- forming]

Hormone in males that causes increased acne.
a. Estrogen
b. Testosterone
c. Cortisol
d. Progesterone

a. Oily → FA → pimple

[Nonspore- forming]

Pathway of oily skin leading to pimple formation.
a. Oily → FA → pimple
b. Oily → sebum → FA → pimple
c. Oily → inflammation → pimple
d. Oily → lipase → pimple

• Hyperandrogenism

• Irregular period

• Cyst in ovary

📌NOTE: Only 2 is needed to diagnose it

[Nonspore- forming]

Criteria needed to diagnose PCOS [3]