13. Acute Diarrhea- Non-inflammatory-2

Question 1

A 32 year old woman goes on a family reunion on a Royal Caribbean cruise 3 days in she is vomiting and has immense diarrhea. She find out many of the other passengers on the ship are ill as well. She goes to the ship doctor who say “ yeah looks like a break out of that Caliciviridae family virus hit the boat” and tell her to rest and hydrate. What is true of causal agent?

A. Produces transient lesions in the large intestine
B.Shortens microvilli and widened intercellular spaces
C. Decreases intestinal enzyme activity
D. Stains with Ziehl-Neelsen stain
E. Replaces columnar epithelium at the villus tips with irregular cuboidal

RFA

Answer 1

Ans. B Norovirus produces transient lesions of the intestinal mucosa which on EM shows microvilli that are shortened and widened intercellular spaces

A . Norovirus spares the large intestine.

C. Describes Astroviruses

D. Cryptosporidium

E. Describes Rotavirus

Question 2

A 4 year old boy in Africa is brought to the doctor due to a 2 week history of non bloody diarrhea. Labs are done showing a non enveloped ds RNA virus that replication primarily in the villous epithelium of the SI. What virulence factor allows the causal agent to attach to cellular receptors?

A. VP4
B. VP7
C. ST
D. LT
E. CFA

RFA

Answer 2

Ans. A VP4- the described infectious agent is Rotavirus “P” antigen allows for attachment to cellular receptors

B. VP7- G antigen glycoprotein causes the different serogroups of Rotavirus

C. ST- is neurotoxin found in Bacillus cereus and ETEC activates guanylate cyclases

D. LT- activates adenylate cyclase found on ETEC

E. CFA- colonization factor antigens allows ETEC to attach by fimbriae

Question 3

A 24 year old male presents with complains of non-bloody, non-mucoid diarrhea that has been consistent for the past 3 months. His CD4 count is 90cells/uL. A stool sample is obtained and oocyts are visible under light microscopy and stain acid fast. What is the Dx? (MG)

A. Norovirus
B. Adenovirus
C. Cyrptosporidium
D. Cyclospora
E. Vibro cholerae

Answer 3

C. Cyrptosporidium

NOTE: Cyclospora also stains acid fast. However this pt has AIDS so cryptosporidium is much more likely

Question 4

A 5 year old boy is brought to the physician by his parents after developing unrelenting diarrhea for the past 10 days. His mom is a dumbass so he has not received any of the childhood vaccinations. Serology reveals a virus. It is found to have VP7 and VP4 virulence factors. What complication is he most at risk for? (MG)

A. Sepsis
B. Pulmonary infiltration
C. Cardiac arrhythmia
D. Intussusception of the bowel

Answer 4

D. Intussusception of the bowel

Dx is Rotavirus… there is a vaccine for it