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Pathology > 4 GI infectious disease > Flashcards

4 GI infectious disease Flashcards

0
Q

virulence factors for E. coli

A
  1. LPS
  2. Pili= adhesion
  3. K antigen= capsule
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1
Q

lactose fermenter

A

E. coli

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2
Q

it your using MacConkeys agar what are you looking for?

A 
lactose fermenters
#1= E. coli
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3
Q

what is another growth media you can use to determine if its E. coli

A

EMB agar= eosin methylene blue
green sheen= lactose fermenting E. coli
pink= enterobacter

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4
Q

what are the 2 E. colis that you seen in bloody diarrhea

A
  1. EHEC= entero-hemorrhagic E. coli

2. EIEC= entero-invasive E. coli

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5
Q

what toxins do you see with EHEC

A

shiga toxin 1 and 2

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6
Q

what organism do you think of when you hear H2S production

A

Salmonella

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7
Q

what organisms cause bloody diarrhea?

A

gram - rods

  1. E. coli
  2. Salmonella
  3. Shigella
  4. yersinia enterocolitica
  5. cam-pylobacter jejuni
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8
Q

what media can you use to determine if the blood diarrhea is due to salmonella or shigella

A

Hektoen-enteric agar

Salmonella–> produces H2S which will precipitate black on Hektoen-enteric agar

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9
Q

this gram - rod that results in bloody diarrhea can be cultured on Cefsulodin-Irgasan Novobiocin (CIN) agar, what is the organism

A

yersinisa entero-colitica–> see bulls eye on agar (deep red center with transparent margins)

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10
Q

how can you differentiate bloody diarrhea from yersinia colitica vs cam-pylobacter jejuni?

A

culture at different temps

yersinia enterocolitica–> motile @ 25C
cam-pylobacter jejuni–> motile @ 42C

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11
Q

What 2 diseases are associated with salmonella

A 
1. S. typhi
	rose spots
	abd pain, fever and chills
	have erosion of Peyers patches
2. enterocolitis/gastroenteritis
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12
Q

What 2 diseases does Yersinia enterocolitica mimic

A

its enterocolitis mimics

1. Crohn's disease
2. appendicitis
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13
Q

what is special about the shape of cam-pylobacter jejuni

A

its a gram - rod, with a comma shape

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14
Q

if you hear 10 or more bloody stools a day you should think

A

gastroenteritis due to cam-pylobacter jejuni

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15
Q

an infection with cam-pylobacter jejuni can cause

A

Guillan-Barre syndrome

=due to immune response to the foreign antigen mistargeting host nerve tissue via molecular mimicry

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16
Q

what is the main gram - bacteria associated with watery diarrhea

A

Vibrio cholera= enteric

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17
Q

what are the 2 protozoas associated with watery diarrhea

A
  1. Giardia lamblia

2. Cryptosporidium parvum= stain + for acid fast

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18
Q

what are the 2 viruses associated with watery diarrhea

A
  1. rotavirus, ROTA= right out the anus

2. Norwalk virus

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19
Q

what is the main virulence factor for vibrio cholera (=gram - curved rod)

A

cholera A-B toxin–> which increases cAMP and cause the watery diarrhea

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20
Q

what agar can you use to identify vibrio cholera

A

TCBS= thiosulfate citrate bile salt sucrose

alkaline

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21
Q

if you hear a patient say they have specs of mucus in their poop you might think

A

rice water stools= Vibrio cholera

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22
Q

pt presents with “i suddenly started shitting water out my ass that smelled somethin foul and had alot of white spec in it you might think”

A

sudden onset of foul-smelling watery fatty stools= Giardia lamblia

23
Q

if a patient have watery diarrhea comes back with + acid fast organisms–>

A

Cryptosporidium parvum

seen more in immunocompromised (AIDS)

24
Q

how long does diarrhea from cryptosporidium last

A

see 1-2 weeks after exposure

lasts 5 days

25
Q

whats the incubation time for giardia lamblia

A

10 days

26
Q

MOA of rotavirus

A

shortens microvilli, which

1. decreases absorption
2. decreases enzymatic function
27
Q

how long does rotavirus (dsDNA) incubate

A

1-3 days

28
Q

whats important about the Norwalk virus?

A

it only takes a small dose for infection

29
Q

MOA of Norwalk virus

A

damages brush borders, which

blocks/decreases absorption

30
Q

what else is special about Norwalk virus

A

immunity to the Norwalk virus is short lived, which means youll see recurrent infection

incubation= 24-48 hrs
can resolve in 12-60hrs

31
Q

whats a difference bt rotavirus and Norwalk virus

A

norwalk is ssRNA rotavirus is dsRNA

32
Q

what 3 organisms could you see from food poisoning

A
  1. clostridium botulism
  2. staph aureus
  3. bacillus cereus
33
Q

which 2 food poisoning organisms are gram + spore formers

A
  1. clostrium botulism= anaerobe

2. bacillis cereus= aerobe

34
Q

MOA of clostridium botulism

A

A-B toxin is absorbed by the gut and carried to the peripheral nerves where is prevents release of ACH at the synapse
which results in flaccid paralysis

35
Q

symptoms of clostridium botulism

A

1-3 days after you ingest toxin–>

1. weakness
2. blurred vision
3. fixed dilated pupils
4. Flaccid paralysis

FLOPPY BABY SYNDROME

36
Q

what is the toxin for food poisoning due to staph aureus

A

enterotoxin= heat stable toxin

37
Q

symptoms of food poisoning due to staph aureus

A

self limiting= 5-24 hrs

  1. nausea
  2. vomiting
  3. diarrhea
38
Q

where do you see bacillus cereus

A

reheated rice at chinese restaurants

39
Q

MOA of bacillus cereus

A

enterotoxin that is
1. heat stable/emetic form–> seen in fried rice
short incubation (1-6 hr)
lasts <24 hr
2. heat labile/diarrheal form
+ cAMP system in intestinal epithelial cells (similar to vibrio cholera from cholera A-B toxin, which increases cAMP)
get profuse watery diarrhea

40
Q

which bacillus cereus enterotoxin causes a true infection

A

the heat labile/diarrhea form

41
Q

which 2 types of hepatitis are NOT associated with chronic liver disease

A
  1. HAV
  2. HEV

vowels–> not associated with chronic liver disease

42
Q

MOA of HAV

A

can get in water–> travels to intestines
replicates in the liver
gets shed in bile
and released in poop

43
Q

incubation time of HAV

A

2-4 wks

and shed HAV before and after jaundice

44
Q

which hepititis can cause infection of HDV

A

HBV

45
Q

MOA of HBV

A

get release of HBsAg (surface antigen), which gets into the serum
virus replicates and incubates for 75 days= LONG TIME
get increased HBsAg in the liver–> which causes elimination of hepatocytes
+ CMI and inflamm–> CHRONIC HEPATITIS

46
Q

which types of hepatitis cause CHRONIC HEPATITIS

A
  1. HBV

2. HCV

47
Q

how can the HBV vaccine be blocked

A

if you already have high levels of HBsAg in you serum it will block the Hep B vaccine

48
Q

what else do you see with HBV

A

immune complexes= type 3 hypersensitivity

–> vasculitis and rash

49
Q

who is most likely to have HCV

A
  1. HIV + pts

2. IV drug users

50
Q

use of what can increase liver damage in pts with HCV

A
  1. EtOH
  2. some medication
  3. other forms of hepatitis
51
Q

How can you diagnose HCV

A
  1. ELISA for anti-HCV

2. RT-PCR

52
Q

which hepatitis causes a selective increase in morbidity in pregnant women?

A

HEV

53
Q

HEV is due to

A

Flavivirus in the blood

not fully understood

54
Q

liver damage in HAV may be due to…

A

T cell mediated immunity

55
Q

when you thing HBV think

A

HBsAG–> ground glass hepatocytes

56
Q

MOA of hepatitis

A

virus injures or kills hepatocytes, which leads to
inflammatory response–> further injury to hepatocytes
antibodies attack viral antigen, which leads to
destruction of infected cells
–> edema and swelling–> cap. collapse–> decreased
blood flow–> hypoxia and scarring

Pathology (6 decks)

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