160 Salmonella

Question 1

Salmonella serotypes that is restricted to human host

Answer 1

Salmonella typhi and salmonella paratypi

Question 2

How does Salmonella infection begin?

Answer 2

Ingestion contaminated food or water

Question 3

Best characterize regulatory system of the salmonella that trigger outer membrane so as to resist microbicidal activities

Answer 3

PhoP/PhoQ

Question 4

Hallmark feature of enteric fever

Answer 4

Fevr and abdominal pain

Question 5

Incubation period of S. Typhi

Answer 5

10-14 days. Range from 5 to 21 days

Question 6

Most prominent symptom of Salmonellosis

Answer 6

Fever 38.8 to 40. 5 Celsius. Fever 101.1 to 104.9 Fahrenheit

Question 7

Faint salmon colored blanching maculopapilar rash located on trunk and chest during the first week of Salmonellosis

Answer 7

Rose spots, present in 30% of patient and resolves in 2-5 days

Question 8

When does GI bleeding and intestinal perforation occur

Answer 8

3rd and 4th week of illness

Question 9

How does intestinal perforation and GI bleeding occur in Typhoid fever

Answer 9

Hyperplasia ulceration and necrosis of the ileocecal Peyers patches at the initial site of salmonella infiltration

Question 10

Neuropsychiatric symptoms in Typhoid fever

Answer 10

Muttering delirium, Coma vigil, Picking at bedclothes or imaginary objects

Question 11

How long is S. Typhi excreted in the feces

Answer 11

Up to 3 months

Question 12

Chronic carriage in Typhoid fever is common to what subset of people

Answer 12

Women, infants, persons with biliary abnormalities or concurrent bladder infection

Question 13

What bladder infection occurs together with S. Tyohi

Answer 13

Schistosoma haematobium

Question 14

How does S. Typhi stay in the gallbladder

Answer 14

Forming biofilms on gallstones and invading gallbladder epithelial cells

Question 15

Chronic Typhoid carriage is associated with what cancer

Answer 15

Gallbladder cancer

Question 16

What is the sensitivity of blood culture for salmonellosis

Answer 16

40-80%

Question 17

Has 80% sensitive for Typhoid fever and is not affected by 5 days of prior antibiotics

Answer 17

Bone marrow culture

Question 18

When does stool culture become positive for Typhoid fever

Answer 18

3rd week of infection in untreated patient

Question 19

Most effective class of antibiotics against salmonella

Answer 19

Fluoroquinolones: Ciprofloxacin

Question 20

Empirical treatment for enteric fever

Answer 20

Ceftriaxone, Azithromycin

Question 21

Antibiotics therapy for Typhoid fever. Fully susceptible. Optimal

Answer 21

Ciprofloxacin, Azithromycin

Question 22

Antibiotics therapy for Typhoid fever. Fully susceptible. Alternative treatment

Answer 22

Amoxicillin, Chloramphenicol, TMP SMX

Question 23

Antibiotics therapy for Typhoid fever. Multiple drug resistance. Optimal treatment

Answer 23

Ceftriaxone, Azithromycin

Question 24

Antibiotics therapy for Typhoid fever. Multiple drug resistance. Alternative treatment

Answer 24

Ciprofloxacin

Question 25

Antibiotics therapy for Typhoid fever. Quinolone resistant. Optimal treatment

Answer 25

Ceftriaxone | Azithromycin

Question 26

Antibiotics therapy for Typhoid fever. Quinolone resistant. Alternative treatment

Answer 26

High dose Ciprofloxacin 750 mg BID or 400 mg q8hrs x 10-14 days

Question 27

How long should therapy be administered in patients with continued symptoms of enteric fever

Answer 27

10 days or for 5 days after fever resolves

Question 28

How are chronic carrier of salmonella be treated

Answer 28

4 weeks of oral Ciprofloxacin or other fluoroquinolones

Question 29

What are the two commercially available vaccines? Oral? Minimum age for vaccination

Answer 29

Ty21a - - oral; at 6 years old. Vi CPS - - parenteral; at 2 years old

Question 30

Live attenuated S Typhi Vaccine. How is it administered

Answer 30

Ty21a. Day 1,3,5,7 then full 4 revaccinatiob every 5 years

Question 31

Parenteral Typhoid vaccine. Consist of purified polysaccharide from bacterial capsule. How is it given

Answer 31

Vi CPS. Single dose. Booster every 2 years

Question 32

Can cause pseudoappendicitis

Answer 32

NonTyphoidal salmonellosis

Question 33

In NTS, how Ling can the stool remain positive

Answer 33

4-5 weeks

Question 34

Commonly affected area of salmonella osteomyelitis

Answer 34

Femur, Tibia, Humerus, Lumbar

Question 35

When is salmonella osteomyelitis commonly seen in association with?

Answer 35

Sickle cell disease

Question 36

How is patient with NTS and HIV treated

Answer 36

1-2 week IV antibiotics then 4 weeks oral therapy with fluoroquinolones

Question 37

How is NTS endocarditis or arteritis treated?

Answer 37

6 weeks IV beta lactams

Question 38

Antibiotics therapy for NTS. Preemptive treatment

Answer 38

Ciprofloxacin

Question 39

Antibiotics for NTS. Severe gastroenteritis

Answer 39

Ciprofloxacin, TMP SMX, Amoxicillin, | Ceftriaxone

Question 40

Antibiotics therapy for NTS. Bacteremia

Answer 40

Ceftriaxone, Ciprofloxacin

Question 41

Antibiotics therapy for NTS. Endocarditis and arteritis

Answer 41

Ceftriaxone, Ciprofloxacin, Ampicillin

Question 42

Antibiotics therapy for NTS. Meningitis

Answer 42

Ceftriaxone, Ampicillin