03 Gm negative cocci

  • pink handcuff: Gram negative diplococci
  • blue ring: Oxidase positive
  • ferments glucose. Meningiditis also ferments maltose

  • Vice City Private Investigator: Growth on VPN agar
  • Thayer Martin: Alternate name for VPN agar
  • Chocolate bar: Growth on chocolate agar

The commonly used antibiotics are vancomycin to inhibit gram-positive bacteria, colistin (i.e. polymyxin) to inhibit gram-negative bacteria (commensal Neisseria species but not N. meningitidis or N. gonorrhoeae), nystatin to inhibit yeast, and trimethoprim to inhibit the Proteus species.

  • Mac: Patients with C5-C9 deficiency are unable to form MAC complex, leading to increased infections
  • 5-9PM: C5-C9 deficiency

  • chains: Pili demonstrate antigenic variation. Fimbriae
  • card: IgA protease - cleaves IgA at hinge region

Neisseria Meningiditis

  • Dorm room: Easily spread in close quarters like college dorms
  • Communist flag: Sickle cell and asplenic patients at higher risk of infection

  • Malt liquor: Ferments maltose in addition to glucose. Compare with neisseria gonorrhea
  • plastic bags on floor: Polysaccharide capsule inhibits phagocytosis

  • Q tip: Colonizes nasopharynx first. Transmitted by respiratory secretions.

  • Syringe, A, C, D: Vaccine contains polysaccharide capsule
  • No syringe: Type B capsule not included in vaccine

  • Envelope burning: LOS envelope proteins cause inflammatory response
  • Water leaking: Inflammation leads to leaky capillaries
  • Electric circuit: Capillary leakage can lead to hypovolemia and shock
  • Underwear with red dots: Characteristic petechial rash indicates thrombocytopenia
  • Wet floor spots: Petechial rash from thrombocytopenia. Risk of DIC
  • Petechial rash from thrombocytopenia. Risk of DIC
  • Water house: Waterhouse-Friderichsen syndrome, characterized by hemorrhage of adrenals (adrenal insufficiency, low bp, shock, DIC)

  • Ceftriaxone treatment
  • Rifampin prophylaxis in close contacts

Neisseria Gonorrhea

  • Red pillows in white chairs: Gram negative diplococci, facultative intracellular in PMNs
  • Broken glass: not encapsulated

  • chandelier: Causes Pelvic Inflammatory Disease in females
  • white on table: Characteristic white purulent discharge
  • Band name: Fitz Hugh Curtis Syndrome: spread of PID into peritoneum
  • violin: Violin string adhesions form to capsule of liver
  • covering baby's eyes: Early onset conjunctivitis in newborns
  • cracked knee: Asymmetric arthritis, commonly in knee

  • Ceftriaxone treatment
  • clam: Chlamydia coinfection, doxycyclinen and macrolide

  • woman at bar: Sexually Transmitted Infection (the sexual tension is palpable)