17-6 -- Infectious Enterocolitis

Question 1

What are the reservoirs for Vibrio Cholerae?

Answer 1

Fish and Plankton

Question 2

Transmission for Vibrio Cholerae?

Answer 2

Contaminated water

Question 3

Pathogenesis for Vibrio Cholerae?

Answer 3

• Bacteria releases Cholera Toxin
• Toxin causes CFTR channel to open
• Cl-, bicarbonate and Na+ accumulate in lumen
  = Draws water into lumen

Question 4

Symptoms of Vibrio Cholerae?

Answer 4

Rice water, fishy odor diarrhea

Question 5

The Cholera toxin causes what channel to open?

Answer 5

CFTR = Cl- allowed into lumen

Question 6

Ingestion of _____ causes Campylobacter Jejuni

Answer 6

Undercooked chicken

Unpasteurized milk and contaminated water

Question 7

Campylobacter Jejuni virulence is due to what 4 things?

Answer 7

Motility
Adherence
Toxin production
Invasion

Question 8

Campylobacter Jejuni symptoms?

Answer 8

Bloody diarrhea, Enteric fever
Reactive Arthritis, Erythema Nodosum
Guillain-Barre Syndrome

Question 9

Campylobacter Jejuni can cause Reactive Arthritis is those with what HLA?

Answer 9

HLA-B27

Question 10

What main syndrome/symptoms are seen with Campylobacter Jejuni?

Answer 10

Guillain - Barre Syndrome

= Ascending flaccid paralysis

Question 11

Guillain - Barre Syndrome = Ascending flaccid paralysis is seen with?

Answer 11

Campylobacter Jejuni

Question 12

Reservoir for Shigella and transmission type?

Answer 12

Reservoir = humans
Transmission = fecal - oral; contaminated food/water

Question 13

Where is Shigella infection common?

Answer 13

Daycares, nursing homes, low resource countries and migrant workers

Question 14

Shigella is resistant to gastric acid. What cells does it infiltrate and proliferate in?

Answer 14

M cells

Question 15

Shigella enters M cells. Where anatomically, is that often located?

Answer 15

Left colon

- M cells in dome epithelium

Question 16

Shigella causes apoptosis of?

Answer 16

Macrophages

Question 17

Symptoms of Shigella?

Answer 17

Bloody diarrhea, aphthous ulcers

- can mimic ulcerative colitis with waxing and waning diarrhea

Question 18

The severity of symptoms for Shigella is greater in?

Answer 18

Children

Question 19

In those with Shigella, what should you NOT give them?

Answer 19

Antidiarrheal - prolongs infection

Question 20

Possible complications of Shigella?

Answer 20

Megacolon (left colon)
Hemolytic Uremic Syndrome
Reactive Arthritis

Question 21

What infection can mimic ulcerative colitis with waxing and waning bloody diarrhea?

Answer 21

Shigella

Question 22

Salmonella arises from ingestion of ____ or from?

Answer 22

Ingestion of undercooked meat

From person to person

Question 23

Salmonella can occur more frequently in those with decreased?

Answer 23

Gastric acid production

Question 24

3 types of Salmonella strains and what they are common in/cause?

Answer 24

S. Paratyphi - travelers
S. typhi - typhoid fever
S. enteritidis - gastroenteritis and food poisoning

Question 25

Where can S. Paratyphi and S. Typhi colonize?

Answer 25

Gallbladder = Gallstones and chronic carrier

Question 26

Chronic carrier of S. Typhi (typhoid fever) has S. typhi colonized where?

Answer 26

Gallbladder

Question 27

If Typhoid fever disseminates via lymph and blood, what can it cause?

Answer 27

Meningitis, seizures, endocarditis, etc.

Question 28

What morphologic (3) changes are seen with Typhoid Fever?

Answer 28

Enlarged peyers patches Enlarged spleen Typhoid nodules on liver -- (macrophages replace hepatocytes)

Question 29

Skin symptoms of Typhoid Fever/Salmonella?

Answer 29

Rose spots on the skin

Question 30

Yersinia can arise from ingestion of?

Answer 30

Pork, raw milk, contaminated water

Question 31

With Yersinia, what can increase its virulence?

Answer 31

IRON

Question 32

Those with chronic forms of ____ are at greater risk for sepsis and death from Yersinia

Answer 32

= Anemia and Hemochromatosis | IRON ISSUES

Question 33

What can often be confused with Crohn Disease?

Answer 33

Yersinia

Question 34

Symptoms of Yersinia?

Answer 34

Nausea, vomiting | Pharyngitis, arthralgia and erythema nodosum

Question 35

What 3 things can increase risks of Clostridiodes Difficile overgrowth?

Answer 35

Antibiotics Increased age Hospitalizations

Question 36

What main thing does Clostridiodes Difficile cause?

Answer 36

Pseudomembranous Colitis

Question 37

What main thing does Clostridiodes Difficile cause?

Answer 37

Pseudomembranous Colitis

Question 38

Symptoms of Pseudomembranous Colitis (from C. Difficile)?

Answer 38

Fever, Leukocytosis Cramps, watery diarrhea Toxic megacolon

Question 39

What can be common in farmers with exposure to soil/animals?

Answer 39

Tropheryma Whippelli | whipple disease

Question 40

Tropheryma Whippelli involves impaired?

Answer 40

Lymph drainage

Question 41

What molecular changes are seen with Tropheryma Whippelli?

Answer 41

Foamy macrophages in SI lamina propria | -- Contain PAS (+) granules

Question 42

Foamy macrophages with PAS (+) granules are seen with?

Answer 42

Tropheryma Whippelli

Question 43

Triad of symptoms for Tropheryma Whippelli?

Answer 43

Malabsorptive diarrhea Weight loss Arthralgia

Question 44

Triad of symptoms of Tropheryma Whippelli?

Answer 44

Malabsorptive diarrhea Weight loss Arthralgia

Question 45

2 common viruses that cause gastroenteritis?

Answer 45

Norovirus | Rotavirus - common in children 6-24 months