Term
| What causes most cases of diarrhea? |
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Definition
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Term
| Bacterial pathogens have been isolated in 1-6% of cases of diarrhea. Name the top 4 in order. |
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Definition
| 1) Campylobacter 2) Salmonella 3) Shigella 4) E. Coli |
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Term
| What is the top cause of foodborne illness? |
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Definition
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Term
| What is the most common bacterial pathogen in food? Tx is complicated by the emergence of ___________ resistance. |
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Definition
| Campylobacter jejuni, fluoroquinolone |
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Term
| What toxin causes watery diarrhea by acting directly on secretory mechanisms in the intestinal mucosa? Name 3 pathogens that produce this toxin. |
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Definition
| Enterotoxin. Vibrio cholera, ETEC, Clostridium perfringens. |
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Term
| What toxin causes destruction of mucosal cells and is associated with inflammatory diarrhea. Name 2 pathogens that produce it. |
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Definition
| Cytotoxin. Shigella and EHEC. |
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Term
| What toxin acts directly on the CNS or PNS? Name 2 pathogens. |
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Definition
| Neurotoxin. S. aureus and Bacillus cereus. |
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Term
| What is the inoculum size of shigella and Enterohemmorhagic E. Coli (EHEC)? |
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Definition
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Term
| Name 2 bacteria w/ an inoculum size of <1000 organisms? |
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Definition
| Salmonella typhi and Campylobacter jejuni |
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Term
| What 2 organisms have an inoculum size of 10,000 to 100,000,000 organisms? |
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Definition
| vibrio cholera and Salmonella (nontyphoidal) |
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Term
| What toxin results in destruction of intestinal cells and villi, decreasing intestinal absorption? |
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Definition
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Term
| What toxin is heat stable and increases peristalsis through sympathetic activation resulting in intense vomiting? |
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Definition
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Term
| There is increased frequency of ______________ among pts w/ h/o gastric bypass? |
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Definition
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Term
| Name 4 host defenses against pathogens that cause food-borne illness. |
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Definition
| 1) Normal flora 2) Gastric acid 3) Gastric motility 4) Immunity |
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Term
| If a pt presents w/ watery diarrhea, what 5 bacteria could be responsible? What mechanism of infection is it and what part of the GI tract is affected? |
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Definition
| Vibrio cholera, ETEC, Clostridium perfringens, Bacillus cereus, and S. aureus. Non-inflammatory (enterotoxin). Proximal small bowel. |
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Term
| If a pt presents w/ bloody diarrhea, what 4 bacteria could be responsible? What mechanism is used? What part of the GI tract is affected? |
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Definition
| Shigella, Salmonella (nontyphoidal), C. jejuni, EHEC. Inflammatory (invasion or cytotoxin). Colon or distal small bowel. |
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Term
| If a pt presents with enteric fever, what bacteria could be responsible? What mechanism is used? What part of the GI tract is affected? |
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Definition
| Salmonella typhi. Penetrating systemic infection. Distal small bowel. |
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Term
| Which V. cholera are associated w/ disease? |
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Definition
| Only those carrying 01 and 0139 antigens. |
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Term
| Where does V. cholera live? How is it transmitted? |
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Definition
| Aquatic environments attaching to algae or crustacean shells. Through contaminated food and water. |
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Term
| What is the tx for V. cholera infection? |
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Definition
| IV followed by oral rehydration (GLUC and lytes). Doxycycline. |
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Term
| What is Shigella a member of? |
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Definition
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Term
| What serotype produces Shiga toxin? |
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Definition
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Term
| How is Shigella spread? What part of GI anatomy does shigella affect? |
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Definition
| Person to person. Intestinal mucosa. |
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Term
| S. dysenteriae may result in a more serious diarrhea w/ risk of Hemolytic Uremic Syndrome (HUS). What is this condition? |
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Definition
| Disease chac. by hemolytic anemia, ARF (uremia), and thrombocytopenia (low platelets) usually preceded by diarrhea. |
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Term
| Describe the disease progression with an infection of shigella. |
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Definition
| Abd pain, watery diarrhea, cramping, and fever. Fever resolves in a few days followed by urgency, tenesmus, and bloody mucoid stools lasting for 7 days. |
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Term
| what bacteria is responsible for "traveler's" diarrhea? |
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Definition
| Entero-toxigenic E. coli (ETEC) |
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Term
| What bacteria causes shigella-like dysentery? |
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Definition
| Entero invasive E. coli (EIEC) |
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Term
| What E. coli is responsible for hemorrhagic colitis and which strain of this type is associated w/ HUS in children? |
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Definition
| Entero-hemorrhagic (EHEC), E. coli 0157:H7 |
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Term
| What E. coli is responsible for "traveler's" diarrhea in Mexico and N. Africa? |
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Definition
| Entero-adherent E. coli (EAEC) |
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Term
| Which strains of salmonella are strictly human pathogens? |
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Definition
| S. typhi and S. paratyphi |
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Term
| Which strains of salmonella infect animals and are therfore transmitted to human through contaminated food? |
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Definition
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Term
| Describe sx of gastroenteritis w/ infection of nontyphoidal salmonella. |
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Definition
| N/V/D 6-48hrs /p ingestion, fever, abd cramping, self-limited (3-7 days) |
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Term
| What types of pts does bacteremia from nontyphoidal salmonella typically affect? How is it different from typhoidal salmonella? |
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Definition
| AIDS/immunocompromised. More rapid, lacks rose spots and leukppenia. |
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Term
| Name 3 manifestations of tissue invasion/localized infections from nontyphoidal salmonella. |
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Definition
| 1) Osteomyelitis 2) Septic arthritis 3) Cholecystitis |
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Term
| Describe sx of enteric fever. Which strains of salmonella cause it? |
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Definition
| Fever, rose spots, hepatosplenomegaly. S. typhi and S. paratyphi |
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Term
| Name 5 possible complications of enteric fever d/t salmonella. |
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Definition
| Death, intestinal perforation, endocarditis, abscess, relapse |
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Term
| A pt w/ dry mouth, decreased sweat and urine may have what degree of dehydration? |
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Definition
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Term
| A pt w/ orthostasis, skin tenting, and sunken eyes may have what degree of dehydration? |
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Definition
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Term
| Name 4 signs that occur in a pt with severe dehydration. |
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Definition
| 1) Hypotension 2) Tachycardia 3) Confusion 4) Shock |
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Term
| Name 5 tests that can be performed on stool samples to help determine a cause of diarrhea. |
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Definition
| 1) Fecal leukocytes 2) Bacterial culture 3) C. diff toxin 4) Shiga toxin 5) Ova and parasites |
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Term
| When would you consider empiric Abx tx for diarrhea, if it is inflammatory or non-inflammatory? |
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Definition
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Term
| What tx should be added if a pt has HUS d/t EHEC infxn? |
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Definition
| Plasmaphoresis for thrombocytopenia |
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Term
| What med is used to tx enteric fever and shigellosis? |
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Definition
| Ciprofloxacin or levofloxacin |
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Term
| Name 2 vaccines to prevent food-borne illness. |
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Definition
| 1) S. typhi vaccine to Vi antigen 2) oral cholera vaccine (Dukoral) |
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Term
| What bacteria causes N/V X 1 d and is associated with rice and meats? |
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Definition
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Term
| What bacteria N/V X 1-2d and is associated with meat, eggs, potatoes and salads? |
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Definition
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Term
| What are the sx, duration, and foods associated with bacillus cereus? |
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Definition
| 10-16h, cramps, diarrhea X 1-2 days, meat and stew |
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Term
| What bacteria causes diarrhea, vomiting, cramps X 1-2d and is associated with meats, poultry and gravy? |
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Definition
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Term
| What bacteria is associated with canned goods and cheese sauce? What are the sx? |
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Definition
| Clostridium botulism. V/D, blurred vision, and weakness |
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Term
| What bacteria is associated w/ soft cheese, milk, and deli foods? What are the sx? |
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Definition
| Listeria monocytogenes. Fever, myalgia, N/D |
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Term
| what bacteria can be spread from person-to-person or in contaminated food? What are the sx? |
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Definition
| Shigella. Cramps, fever, diarrhea |
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Term
| What bacteria causes diarrhea, fever, and cramps X 4-7days? What foods is it associated with? |
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Definition
| Salmonella, poultry, milk, cheese, fruit |
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Term
| What bacteria causes severe bloody diarrhea X 5-10d? Foods? |
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Definition
| EHEC, beef, milk, raw fruits and veg. |
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Term
| What are the sx of, duration, and foods associated with campylobacter jejuni? |
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Definition
| Diarrhea, cramps, fever X 2-10d. Poultry, milk, and water |
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Term
| What does fever or tenesmus suggest w/ diarrhea suggest? |
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Definition
| Inflammatory proctocolitis |
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Term
| What does diarrhea w/ blood, especially w/o fecal leukocytes suggest? |
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Definition
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Term
| What should be considered w/ ingestion of inadequately cooked seafood? |
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Definition
| Vibrio or norwalk-like viruses |
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Term
| What should be considered w/ diarrhea > 10d with wt loss? |
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Definition
| giardiasis, cyclosporiasis, or cryptosporidiosis |
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