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Gastroenterology exam 2 > Typhoid Fever, Typhus, and Yellow fever > Flashcards

Typhoid Fever, Typhus, and Yellow fever Flashcards

1
Q

What are the common manifestations of Typhus and Typhoid?

A

sustained high fever, skin rashes, delirium

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2
Q

What microorganisms cause Typhus and Typhoid fever (enteric fever)

A

Typhus - Rickettsia

Typhoid - Salmonella

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3
Q

What is the Sx difference between Typhus and Typhoid?

A

Typhus - rash is much more abundant and DONT BLANCH

Typhoid - rash “rosy spots” are pink and BLANCHES

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4
Q

What demographic dues Typhoid fever usually occur in?

A

mostly among travelers

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5
Q

What are 4 defining characteristics of Salmonella? (cause of enteric fever)

A
  1. Enterobacteriaceae
  2. Gram negative bacilli
  3. peritrichous
  4. facultative anaerobe
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6
Q

How is Salmonella serovars classified?

A

O, H, K antigens
O antigen = outer membrane
H antigen = flagella antigen
S. Typhi - strain that causes typhoid fever

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7
Q

Wheer are salmonelloses usually localized? who are the usual hosts?

A

Most are located in GI EXCEPT for enteric fever

Salmonella are zoonotic EXCEPT: S. Typhi, S. Paratyphi

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8
Q

How is typhoid fever transmitted?

A

Fecal-Oral
Patients and long-term convalescent carriers shed bacteria in FECES and/or URINE

humans = only host

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9
Q

What is the pathophysiology of Typhoid fever?

A
  1. Bacteria penetrate PEYER’s PATCHES - replicate in macrophages
  2. Intestinal lymph nodes ->mesenteric lymph nodes -> thoracic duct = systemic infection
  3. Multiply in organswith macrophages (liver, spleen, bone, marrow)
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10
Q

What is the most important lymphocyte against Salmonella enterica?

A

TH1 - produces INF-gamma to enhance the bacteriocidal capacity of macrophages

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11
Q

what is the incubation period of typhoid fever, what are Sx?

A

Incubates 10-14 days
Sx: first week = flu-like Sx
1. Faint, sparse, blancing, pnik macules on abdomen and chest first few days

  1. Prolonged fever (4-6 weeks)
  2. Splenomegaly, hepatomegaly
  3. Leukopenia in adults
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12
Q

What are complications of typhoid fever?

A
  1. intestinal hemorrhage/perforation
  2. Encephalopathy
  3. Mycarditis
  4. Intravascular coagulation
  5. Osteomyelitis, meningitis, endocarditis
  6. Chronic carriers usually have CHOLELITHIASIS
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13
Q

How is Typhoid fever diagnosed?

A

Culture blood, feces, urine:

  1. Salmonella grows on McConkey agar
    - –Salmonella = CANT ferment lactose = WHITE spots
    - –e. Coli = ferments lactose = RED spots
  2. TSI tube - salmonella produces H2S = BLACK in tsi tube
  3. Widal test - detects antiO and antiH
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14
Q

What are some common characteristics of all enterobacteriaceae

A
  1. negative for cytochrome C oxidase,
  2. reduce nitrate to nitrite
  3. ferment glucose
  4. facultative
  5. peritrichous
  6. immotile, Gram neg bacillus
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15
Q

What 3 microoganisms are lactose fermenters?

A

Escherichia
Enterobacter
Klebsiella

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16
Q

Which 3 microorganisms are Lactose-non-fermenters

A

Salmonella
Shigella
Proteus

17
Q

What substance is produced by e coli?

A

indole

18
Q

What substance is produced by Salmonella?

A

H2S

19
Q

Which organism is positive for urease?

A

Protease

20
Q

What test is used to differentiate between Enterobacteriaceae from other species?

A

Oxidase test

Enterobes are oxidase negative

21
Q

What is the treatment and prevention of Typhoid fever?

A

Tx:

  1. Fluoroquinolones
  2. third gen cephalosporins
22
Q

Why is chlorampenicol good for enteric fever (S. typhi?)

A

it can diffuse into cells to kill the intracellular bacteria

23
Q

What family is Yellow fever in?

A

Flaviviridae

24
Q

What are 4 characteristics of flaviviridae?

A
  1. Enveloped
  2. icosahedral capsid
  3. +ve sense ssRNA
  4. Spread by Aedes aegypti from human to human
25
Q

What is the incubation period of flaviviridae and where does it infect in the body?

A

3-6 days

infects: vascular endothelium and liver

26
Q

What are four initial symptoms of Yellow fever (flaviviridae)

A
  1. fever
    2, headache
  2. myalgia
  3. arthralgia (knees)
27
Q

What are more serious Sx that yellow fever can progress to?

A

Liver damage
Hemorrhage (deficiency of clotting factors from liver)
Shock
Proteinuria, tubular necrosis, acute renal failure

28
Q

What two diseases is Yellow fever similar too? how do you differentiate?

A

similar to Dengue and Leptospirosis

differentiate with jaundice

29
Q

What are characteristics of Vibrio Cholera?

A
  1. Gram negative vibrio
  2. monotrichous
  3. reservoir = asymptomatic carriers
30
Q

What is the pathogenesic characteristics of cholera?

A
  1. non-invasive
  2. phage-coded cholera toxin (enterotoxin)
  3. Dehydration/electrolyte loss (hypokalemia)
  4. Metabolic acidosis

(resembles a ETEC infection)

31
Q

What is the main treatment of cholera?

A

IV rehydration

32
Q

What causes endogenous C. Difficile to overgrow? (4) what kind of organism is it?

A

anaerobic

  1. Clindamycin
  2. Fluoroquinolones
  3. penicillins
  4. cephalosporins
33
Q

What toxins are produced by C. diff? What are Sx?

A

entertoxin (A) and cytotoxin (B)
—toxin B gene is identified for Dx by PCR

watery diarrhea + ab cramping

34
Q

What is Tx for C. Diff?

A

Vancomycin + Metronidazole
Colectomy
Fecal microbiota transplantation

35
Q

What are characteristics of the agent causing Mumps?

A
  1. paramyxovirus
  2. Negative sense ssRNA
  3. Helical nucleocapsid
  4. enveloped
  5. glycoproteins = HN and F
36
Q

How is mumps transmitted and what the disease progression?

A

Droplet transmission
pathogenesis:
URT - lymph nodes - viremia - multiple glands - enters saliva and urine

Parotid gland is a primary target (diffuse swelling)

37
Q

What are some complications of Mumps

A

Orchitis (may cause infertility)

Pancreatitis, meningitis (less common)

38
Q

How is Typhus and Rocky Mountain Spotted Fever treated?

A

Tetracyclines

Gastroenterology exam 2 (19 decks)

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