MCQs: Neisseria gonorrhoeae: Answers

1) The majority of infected females are asymptomatic? T/F

True. Approxiamately 80% of females infected with Neisseria gonorrhoeae are asymptomatic. the converse is true for males where only 10% are asymptomatic.

2) Thayer-Martin Agar contains vancomycin? T/F

True. Thayer-Martin agar is a selective media used for the isolation of Neisseria gonorrhoeae. It uses a combination of Vancomycin, Colistin and Nystatin (VCN) to select out N. gonorrhoeae. Modified Thayer Martin agar uses trimethoprim in addition.

3) Natural Infection with Neisseria gonorrhoeae gives long lasting immunity to further gonococcal infection.

False: Little or no individual immunity gained from infection. Re-infection is common.

4) Neisseria gonorrhoeae grows poorly in 5% CO2? T/F

False: the presence of CO2 (2-10%) is a pre-requisite for growth of Neisseria gonorrhoeae. 

5) Neisseria gonorrhoeae usually infects squamous epithelial cells? T/F

False: N. gonorrhoeae very much has a pre-dilection for infecting columnar epithelial cells.

6) Culture for Neisseria gonorrhoeae is just as sensitive as Nucleic Acid Amplification Tests (NAATs) for the diagnosis of Neisseria gonorrhoeae from extra-genital sites? T/F

False: NAATs are more sensitive than culture for all sites for detection of N. gonorrhoeae. Specificity has historically been an issue for NAATs at extra-genital sites. This is now becoming less of an issue with newer generation molecular tests. However caution is still advised when diagnosing Neisseria gonorrhoeae from extra-genital tests with a molecular assay and confirmation with a different assay is usually still advised in this situation.

7) Neisseria Gonorrhoeae can occasionally cause Infective Endocarditis or Septic Arthritis? T/F

True: Should always be included in the differential diagnosis of both these clinical conditions and scientists should keep this possibility in mind.

8) Approximately 10% of Neisseria gonorhoeae strains are resistant to ciprofloxacin worldwide? T/F

False: More like 30%+ these days. Big increase in the last 10 years.

9) Empirical treatment is generally with penicillin? T/F

False: Penicillin resistance is 10-20% so empirical therapy these days is generally with intra-muscular ceftriaxone.

10) High level resistance to ceftriaxone has been documented in Neisseria gonorrhoeae? T/F

True: This is the big worry for the future and something which will need to be monitored very closely (see this article). There is a N. gonorrhoeae strain in Japan called H041 giving high level ceftriaxone resistance. Fortunately the strain seems to have low fitness and transmissability.

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