Corynebacterium and Diphtheria Quiz
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Questions and Answers

Which characteristic is associated with Corynebacterium species?

  • Gram-negative cocci
  • Acid-fast bacilli
  • Spore-forming anaerobes
  • Gram-positive rods (correct)
  • What disease is caused by Corynebacterium diphtheriae?

  • Tuberculosis
  • Diphtheria (correct)
  • Listeriosis
  • Gardnerellosis
  • Besides Corynebacterium diphtheriae, which of the following genera includes a significant pathogen in the non-spore-forming Gram-positive rods group?

  • Clostridium
  • Streptococcus
  • Listeria (correct)
  • Bacillus
  • What is the typical morphology of Corynebacteria?

    <p>Club-shaped rods (B)</p> Signup and view all the answers

    What role do other Corynebacterium species (diphtheroids) commonly play in human infections?

    <p>Agents of opportunistic infections (D)</p> Signup and view all the answers

    Which of the following best describes the function of the binding (B) domain of diphtheria exotoxin?

    <p>Mediates attachment of the toxin to host cell receptors. (C)</p> Signup and view all the answers

    What is the primary mechanism by which diphtheria toxin inhibits protein synthesis in eukaryotic cells?

    <p>ADP-ribosylation of elongation factor-2 (EF-2). (C)</p> Signup and view all the answers

    A microbiologist observes purple-black granules within the cytoplasm of Corynebacterium diphtheriae cells after performing Albert’s stain. What does this observation indicate?

    <p>The cells contain metachromatic granules. (D)</p> Signup and view all the answers

    The DNA coding for diphtheria toxin is introduced into Corynebacterium diphtheriae via what mechanism?

    <p>Transduction by a temperate bacteriophage. (C)</p> Signup and view all the answers

    A patient is diagnosed with cutaneous diphtheria. What is the most likely mode of transmission?

    <p>Direct contact with a pre-existing skin lesion. (B)</p> Signup and view all the answers

    Upon microscopic examination, which morphological characteristic is NOT associated with Corynebacterium diphtheriae?

    <p>Capsule formation. (D)</p> Signup and view all the answers

    What is the significance of lysogeny in the pathogenesis of Corynebacterium diphtheriae?

    <p>Lysogeny introduces the toxin-encoding gene into the bacterial chromosome. (C)</p> Signup and view all the answers

    Which cellular component is the target of the active (A) domain of the diphtheria exotoxin?

    <p>Elongation Factor 2 (EF-2) (C)</p> Signup and view all the answers

    Why is immediate administration of diphtheria antitoxin crucial upon clinical suspicion?

    <p>Antitoxin neutralizes toxin before it irreversibly binds to cells. (A)</p> Signup and view all the answers

    What is the main purpose of antibiotics in the treatment of diphtheria?

    <p>To stop the growth of the organism, decrease toxin production, and reduce the incidence of chronic carriers. (A)</p> Signup and view all the answers

    What is the Elek test used for in the diagnosis of diphtheria?

    <p>To confirm toxin production by <em>Corynebacterium diphtheriae</em> strains. (D)</p> Signup and view all the answers

    Why is it essential to test patients for hypersensitivity before administering diphtheria antitoxin?

    <p>Because the antiserum is made in horses, and patients must be tested for hypersensitivity to avoid anaphylaxis. (B)</p> Signup and view all the answers

    What component is used in the diphtheria toxoid vaccine to provide immunity?

    <p>Inactivated diphtheria toxin treated with formaldehyde. (D)</p> Signup and view all the answers

    What finding from a Gram stain or methylene blue stain of a throat swab can be suggestive of diphtheria, but not definitive?

    <p>The presence of many tapered, pleomorphic Gram-positive rods and metachromatic granules. (B)</p> Signup and view all the answers

    How is diphtheria toxoid prepared for use in vaccines?

    <p>By treating the exotoxin with formaldehyde to inactivate the toxic effect while maintaining antigenicity. (D)</p> Signup and view all the answers

    Which of the following is NOT a recommended component of diphtheria treatment?

    <p>Surgical removal of the pseudomembrane in the throat. (A)</p> Signup and view all the answers

    What is a limitation of diphtheria immunization with the toxoid vaccine?

    <p>It prevents the disease but does not prevent nasopharyngeal carriage of the bacteria. (B)</p> Signup and view all the answers

    What is the recommended treatment for individuals presenting with symptoms of diphtheria?

    <p>Prompt administration of diphtheria antitoxin, along with a 14-day course of antibiotics. (C)</p> Signup and view all the answers

    What is the primary mechanism by which the antibody combats diphtheria exotoxin?

    <p>Interfering with the toxin's ability to bind to cell receptors, preventing cell entry. (D)</p> Signup and view all the answers

    A patient suspected of having diphtheria is awaiting lab results. Why is it crucial to initiate treatment with antitoxin before these results are available?

    <p>Delaying treatment until lab results are available may result in irreversible damage from the toxin. (C)</p> Signup and view all the answers

    What is the underlying principle of Schick's test in assessing immunity to diphtheria?

    <p>Observing the inflammatory response at the injection site of a standardized diphtheria toxin. (C)</p> Signup and view all the answers

    Which characteristic clinical manifestation of respiratory diphtheria poses an immediate life-threatening risk to the patient?

    <p>Formation of a pseudomembrane in the respiratory tract. (C)</p> Signup and view all the answers

    A patient with diphtheria presents with regurgitation of fluids through the nose. What is the most likely cause of this symptom?

    <p>Paralysis of the muscles of the soft palate and pharynx. (D)</p> Signup and view all the answers

    In addition to Loeffler’s Serum Slope Agar and Blood Agar Plates, which agar is crucial for culturing C. diphtheriae due to its diagnostic color change?

    <p>Tellurite Blood Agar. (D)</p> Signup and view all the answers

    What is the most significant difference between respiratory and cutaneous diphtheria?

    <p>Systemic symptoms are rare in cutaneous diphtheria, but potentially severe in respiratory diphtheria. (D)</p> Signup and view all the answers

    Which of the following complications of diphtheria is most likely to result in sudden death?

    <p>Myocarditis accompanied by arrhythmias. (C)</p> Signup and view all the answers

    Flashcards

    Corynebacterium diphtheriae

    A Gram-positive rod bacteria that causes diphtheria.

    Diphtheria

    A serious infection caused by Corynebacterium diphtheriae, affecting the throat and respiratory system.

    Opportunistic Infections

    Infections caused by organisms that exploit a weakened immune system.

    Coryneform bacteria

    Bacteria with similar morphology to Corynebacterium spp., often seen as diphtheroids.

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    Gram-positive Rods

    Bacteria that retain the violet stain in a Gram stain procedure, characterized by rod shape.

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    Diphtheria Pseudomembrane

    A tough, adherent, gray membrane in the throat caused by diphtheriae infection.

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    Schick’s Test

    A test to assess immune status by injecting a purified toxin; inflammation indicates no immunity.

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    Respiratory Diphtheria Symptoms

    Includes sore throat, exudative pharyngitis, fever, and formation of a pseudomembrane.

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    Airway Obstruction Complication

    Airway blockage caused by the extension of the diphtheria membrane into the larynx and trachea.

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    Myocarditis in Diphtheria

    Inflammation of the heart leading to irregular rhythms and circulatory collapse as a diphtheria complication.

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    Nerve Weakness in Diphtheria

    Paralysis, especially of cranial nerves, can occur, affecting swallowing and movement.

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    Cutaneous Diphtheria

    Causes ulcerating skin lesions covered by a gray membrane with rare systemic symptoms.

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    Laboratory Diagnosis

    Involves isolating Corynebacterium diphtheriae and demonstrating toxin production using specific culture plates.

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    Albert's Stain

    A staining technique that reveals granules in bacteria, coloring them purple-black against green cytoplasm.

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    Diphtheria Toxin

    An exotoxin produced by C. diphtheriae that inhibits protein synthesis by affecting elongation factor-2.

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    Transmissibility

    Diphtheria is transmitted through airborne droplets from asymptomatic carriers.

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    Diphtheria Pathogenesis

    The process by which diphtheria develops, relying on toxin production and invasiveness.

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    Non-motile

    Characteristic of C. diphtheriae, indicating that it does not move by itself.

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    Host Response

    The immune reaction of the host to the toxigenic C. diphtheriae invader.

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    Temperature Bacteriophage

    A bacteriophage that integrates its DNA into the host bacterium, enabling exotoxin synthesis.

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    Granules Appearance

    Rods of C. diphtheriae appear beaded due to granules of polyphosphate that stain uniquely.

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    Diphtheria Toxigenicity Tests

    Tests to determine if Corynebacterium diphtheriae produces toxins.

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    Elek Test

    An immunodiffusion assay, gold standard for confirming toxin production.

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    PCR Assay

    Molecular test for detecting toxin gene (tox) in clinical isolates.

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    Antitoxin Treatment

    Immediate administration to neutralize unbound diphtheria toxin in blood.

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    Gram Stain in Diagnosis

    Smears of throat swabs stained to identify bacterial morphology.

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    Antibiotic Role

    Inhibits growth, reduces toxin production, and lowers chronic carrier rates.

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    Booster Shots

    Additional doses of diphtheria vaccine recommended every 10 years.

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    Animal Inoculation

    In vivo test involving guinea pigs to assess toxigenicity.

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    Methylene Blue Stain

    Stain useful for revealing metachromatic granules in bacteria.

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    Study Notes

    Non-Spore-Forming Gram-Positive Rods

    • Corynebacterium diphtheriae is a non-spore-forming gram-positive rod.
    • Other important pathogens in this group include Corynebacterium diphtheriae, Listeria monocytogenes, and Gardnerella vaginalis.

    Corynebacterium diphtheriae

    • Corynebacterium diphtheriae causes Diphtheria.
    • Other Corynebacterium species (Diphtheroids) are implicated in opportunistic infections.

    Genera and Species

    • Various genera and species of Corynebacterium are listed, including toxigenic and nontoxigenic forms.

    Disease

    • Diphtheria is caused by C. diphtheriae.
    • Diphtheroids are implicated in opportunistic infections.

    Clinical Findings

    • Respiratory diphtheria has an incubation period of 2-6 days.
    • Inflammation begins in the respiratory tract, leading to sore throat, exudative pharyngitis, pseudomembrane formation, and low-grade fever.
    • Prostration and dyspnea follow, potentially leading to suffocation if not treated promptly.
    • Heart damage, visual disturbances, swallowing difficulties, and paralysis can occur but usually resolve.
    • Death may result from asphyxia or heart failure.
    • Cutaneous diphtheria results in ulcerating skin lesions covered by a gray membrane. The lesions are typically indolent and do not invade surrounding tissue.

    Transmission

    • Humans are the only natural host.
    • Transmission occurs via airborne droplets.
    • The organism can also infect the skin, especially in tropical regions or those with poor hygiene practices.

    Pathogenesis

    • Exotoxin production is essential for pathogenicity.
    • Invasiveness is also needed for the organism to establish itself.
    • Diphtheria toxin inhibits protein synthesis by ADP-ribosylation of elongation factor-2 (EF-2).
    • The toxin affects all eukaryotic cells but has no effect on analogous factors in prokaryotic cells.

    Diphtheria Exotoxin

    • The exotoxin is a single polypeptide with two functional domains.
    • The binding domain mediates toxin attachment to glycoprotein receptors on the cell membrane.
    • The active domain has enzymatic activity to cleave nicotinamide adenine dinucleotide (NAD) and transfer the remaining ADP-ribose to EF-2, thus inactivating it.
    • The DNA for the toxin is part of a temperate bacteriophage (beta phage) DNA that integrates into the bacterial chromosome during the lysogenic phase.
    • C. diphtheriae cells not lysogenized by this phage do not produce exotoxin and are nonpathogenic.

    Host Response

    • A local inflammation in the throat, with a fibrinous exudate forming a gray pseudomembrane, is a common response.
    • Antibodies neutralize exotoxin activity by blocking the binding domain from the receptors, preventing entry into the cell.

    Immune Status

    • Schick's test assesses immune status to diphtheria.
    • An intradermal injection of diphtheria toxin is used.
    • No inflammation indicates the presence of antitoxin and immunity.

    Laboratory Diagnosis

    • Diagnosis involves isolating the organism and demonstrating toxin production.
    • Throat swabs are cultured on Loeffler's Serum Slope Agar, Tellurite Blood Agar, and Blood Agar plates.
    • The presence of gray-black tellurium, reduced from a tellurium salt in the plate media, is a diagnostic indicator.
    • Toxin production can be confirmed using animal inoculation, antibody-based gel diffusion precipitin tests, PCR assays, in vivo/in vitro toxigenicity tests, and Elek tests.

    Treatment

    • Antitoxin is the treatment of choice, given immediately due to the delay in laboratory confirmation.
    • Antibiotics (penicillin G or erythromycin) are used along with antitoxin.
    • Maintenance of an open airway is crucial.
    • Treatment of bacteremia or endocarditis must be guided by antibiotic susceptibility tests.

    Prevention

    • Diphtheria is rare due to widespread childhood immunization.
    • Immunization typically uses a combination of diphtheria toxoid, tetanus toxoid, and acellular pertussis vaccine (DTaP).
    • Diphtheria toxoid is produced by treating the exotoxin with formaldehyde, inactivating its toxicity while preserving its antigenicity.
    • Boosters are recommended periodically due to immunity waning.
    • Prophylactic antibiotic treatment may be used for unimmunized contacts.

    Other Corynebacterium species

    • These organisms are often part of the normal human flora but can cause opportunistic infections in immunocompromised individuals.
    • Examples include C. jeikeium, C. urealyticum, and C. ulcerans.

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    Description

    Test your knowledge on Corynebacterium species and their associated diseases, particularly focusing on Corynebacterium diphtheriae. This quiz covers topics such as morphology, toxin mechanisms, and transmission modes. Perfect for microbiology students or professionals looking to refresh their understanding of this important pathogen.

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