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Gastrointestinal System > EXAM #1: BACTERIAL INFECTIONS OF THE GI TRACT > Flashcards

EXAM #1: BACTERIAL INFECTIONS OF THE GI TRACT Flashcards

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1
Q

What are the symptoms of Botulism poisoning?

A

1) Dizziness
2) Dry mouth
3) Blurred vision
4) Abd. sx
5) Progressive paralysis

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2
Q

What causes Botulism?

A

Improperly canned (non-acidic food)

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3
Q

When do the symptoms of Botulism start?

A

12-36 hours after ingestion

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4
Q

Is fever present in Botulinism?

A

No–only ingested toxin, NOT whole pathogen

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5
Q

What organism causes Botulinism?

A

C. botulinum

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6
Q

List the characteristics of C. botulismsm.

A

Gram positive
Spore forming
Rod-shaped
Anaerobic

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7
Q

What kind of toxin is the C. botulinum toxin?

A

A-B Bacterial toxin

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8
Q

What is the MOA of the C. Botulinum toxin?

A

1) B portion attaches to receptors on motor nerve endings
2) A portion enters nerve cell
3) Toxin blocks release of ACh

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9
Q

What causes Floppy Baby Syndrome?

A

C. Botulinum spore ingestion

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10
Q

What are the symptoms of Floppy Baby Syndrome?

A

Constipation followed by generalized paralysis

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11
Q

Where are C. botulinum spores and toxins identifiable in Floppy Baby Syndrome?

A

Feces

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12
Q

How is Botulsim treated?

A

Antitoxin administration

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13
Q

What is a major adverse effect of Botulism antitoxin administration?

A

Serum sickness

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14
Q

What are the characteristics of Clostridium difficile?

A

Gram positive
Spore forming
Rod-shaped
Anaerobic

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15
Q

What does Clostridium difficile cause?

A

Antibiotic associated pseudomembranous colitis

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16
Q

What is the most common cause of nosocomial diarrhea?

A

Clostridium difficile

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17
Q

How is Clostridium difficile transmitted?

A

Fecal-oral

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18
Q

What antibiotic was the first abx to cause pseudomembranous colitis?

A

Clindamycin

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19
Q

What are the most common causes of pseudomembranous colitis today?

A

2nd and 3rd generation cephalosporins (only b/c they are the most frequently used)

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20
Q

What are pseudomembranes?

A

white-yellow plaques on the colonic mucosa

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21
Q

What is a severe complication of Clostridium difficile infection?

A

Toxic megacolon

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22
Q

How do you tell the difference between adverse diarrhea with abx administration vs. Clostridium difficile?

A

Clostridium difficile toxin present in the stool

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23
Q

How is Clostridium difficile treated?

A

1) Withdraw antibiotic
2) Oral metronidazole* or vancomycin
3) Fluid replacement

*Preferred

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24
Q

What is Shigellosis?

A

Dysentery i.e. bloody diarrhea

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25
List the characteristics of Shigella dysenteriae.
Gram negative Rods Non-lactose fermenting
26
How does Shigella dysenteriae appear on MacConkey agar?
Colorless b/c non-lactose fermenting
27
How is Shigella dysenteriae distinguished from Salmonella?
1) Do NOT produce H2S 2) Non-glucose fermenting 3) Non-motile
28
What infective dose is required for Shigella dysenteriae infection? How does this compare to Salmonella?
Shigella dysenteriae= low Salmonella= high
29
What type of diarrhea is seen with Shigella dysenteriae?
Bloody diarrhea
30
What is the typical symptom progression in Shigella dysenteriae infection?
1) Fever, abdominal cramping and diarrhea - Watery diarrhea at first - Bloody/ mucousy diarrhea
31
What strain of Shigella causes a much milder disease than Shigella dysenteriae?
Shigella sonnei
32
What strain of Shigella is most common in the US?
Shigella sonnei
33
What is the drug of choice to treat Shigella dysenteriae?
A fluoroquinolone i.e. Ciprofloxacin
34
What is the drug of choice for Shigella dysenteriae in kids?
TMP-SMX
35
What drugs are contraindicated in Shigella dysenteriae?
Antiperistaltic drugs
36
Why are Fluoroquinolones NOT used in kids?
Increased risk of tendinitis and tendon rupture, especially in kids
37
List the different infections caused by Salmonella species.
1) Enterocolitis 2) Typhoid fever 3) Septicemia 4) Osteomyelitis
38
List the characteristics of Salmonella.
Gram negative rod Non-lactose ferm. Produce H2S
39
What antigens are associated with Salmonella?
``` O= LPS H= Flagella K= Capsule ```
40
What is the species of Salmonella most responsible for entercolitis?
Salmonella typhimurium
41
What is the important host defense against Salmonella typhimurium ?
Gastric acid
42
What does gastrectomy and use of antacids do to the infectious dose of Salmonella typhimurium ?
Lowers it
43
What disease is caused by Salmonella typhi?
Typhoid Fever
44
Where does Salmonella typhi replicate?
Mononuclear phagocytes of the Peyer's Patches
45
After Salmonella typhi enters the GI tract, where does it go?
1) Liver 2) Gallbladder 3) Spleen ****Organism likes the gallbladder and can develop a carrier state there*****
46
What is the typical course of Salmonella in a healthy individual?
Non-bloody diarrhea that does NOT require medical care
47
What patient populations are at risk of life-threatening Salmonella infection?
1) Kids | 2) Elderly
48
What are the symptoms of Typhoid Fever?
1) Flu-like symptoms 2) Fever/ constipation 3) Bactermeia 4) Rose-spots
49
How is Salmonella Enterocolitis treated?
Fluid and electrolyte replacement
50
When are antibiotics indicated in Salmonella Enterocolitis?
Only in those at risk for septicemia
51
What drugs should be used to treat Salmonella enteric fever, septicemia, severe enterocolitis?
Ceftriaxone or ciprofolaxcin
52
What surgical procedure may be required to abolish the carrier state of Salmonella?
Cholecystectomy
53
List the characteristics of E. Coli species.
Gram negative rod Ferments lactose Facultative anaerobe
54
What is the most common cause of traveler's diarrhea?
E. coli
55
What is ETEC?
Enterotoxigenic E. Coli
56
What specific strain of E. coli is responsible for traveler's diarrhea?
ETEC
57
What is the MOA of the ETEC toxin? What symptom does this toxin cause?
ETEC toxin is similar to the cholera toxin and causes a WATERY DIARRHEA
58
What type of diarrhea is seen in ETEC?
Non-bloody
59
What is EIEC?
Enteroinvasive E. coli
60
What type of diarrhea is seen in EIEC?
Blood and pus in feces
61
What is EPEC?
Enteropathogenic E. coli
62
What does EPEC cause?
Chronic diarrhea in infants
63
What type of diarrhea is seen with EPEC?
Watery diarrhea containing mucous
64
What is EHEC?
Enterohemorrhagic E. coli
65
What toxins are seen in EHEC?
Shiga-Like Toxins 1 and 2 i.e. "SLT-I and SLT-II"
66
What are the symptoms of EHEC infection?
Severe disease with bloody diarrhea
67
What is an adverse effect of EHEC infection?
HUS
68
What is HUS?
Hemolyticuremic Syndrome characterized by: 1) Microangiopathic hemolytic anemia 2) Thrombocytopenia 3) Acute kidney injury ****This is the leading cause of acute renal failure in children worldwide*****
69
What antibiotics should be given to infants with E. coli infection?
Gentamycin | Polymyxin
70
How is traveler's diarrhea treated?
Bismuth preparations
71
What type of diarrhea is "pathogmneomonic" for Cholera?
"Rice-water stool" i.e. severe watery diarrhea
72
Are neutrophils present in the stool of patients with Cholera?
NO
73
What are the characteristics of Vibrio cholerae?
- Curved gram negative rod - Tolerates strong alkaline conditions - Tolerates high salt concentrations
74
What is the MOA of the Cholera toxin?
- Heat-labile - AB subunit protein - B-binds to receptors on microvilli - A-activates adenylate cyclase (increases cAMP)
75
How is Cholera treated?
Rapid replacement of fluids and electrolytes
76
What are the characteristics of Campylobacter jejuni?
- Curved gram negative rod | - Microaerophilic
77
How are severe Campylobacter jejuni infections treated?
Erythromycin or ciprofloxacin
78
What disease is caused by H. pylori?
Infectious gastritis
79
What are the characteristics of H. pylori?
Gram negative Microaerophilic Short/ spiral shaped Polar flagella
80
What allows H. pylori to survive in that acidic environment of the stomach?
Urease enzyme that creates an alkaline microenvironment
81
How is H. pylori diagnosed?
Urea breath test

Gastrointestinal System (42 decks)

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