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Bacterial infections of the GI Tract Flashcards

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1
Q

H/o frequent vomiting early in the course of a GI tract disease indicates what usually?

A

Viral infection

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2
Q

High fever, lack of vomiting, abdominal pain with bowel movements, and the presence of gross blood and mucus in the stool suggest what type of cause?

A

Bacterial

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3
Q

What is the bacteria that is associated with improperly canned food?

A

Clostridium botulinum

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4
Q

Aerobic or anaerobic? Gram positive or negative? Cocci or bacillus? Spores? : Clostridium botulinum

A

Anaerobic
Gram positive
Rod
Spores

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5
Q

What is the MOA of botulinum toxin?

A

Inhibit the release of Ach from synaptic vesicles

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6
Q

Exotoxin or endotoxin: botulinum

A

Exotoxin

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7
Q

What are the ssx of botulinumism?

A

Descending weakness and paralysis
Dysphagia
Diplopia

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8
Q

Is the botulinum toxin heat stable or labile?

A

Will denature at 100 C for 15 minutes

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9
Q

What is the treatment for botulinum intoxication? What is the prognosis?

A

IV antitoxin (horse antibodies). This only binds to active toxin however, and thus it is a slow recovery

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10
Q

Aerobic or anaerobic? Gram positive or negative? Cocci or bacillus? Spores? : Clostridium difficile

A

Anaerobic
Gram Positive
Spore forming
Rod

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11
Q

What is the most common nosocomial cause of diarrhea?

A

Clostridium difficile

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12
Q

What abx is the most common cause of C.diff infections?

A

Cephaolsporins

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13
Q

True or false: C.diff does not invade intestinal tissue

A

True (well, rarely anyway)

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14
Q

What is the MOA of the exotoxin that C.diff produces?

A

Exotoxins A and B are enzymes that glycosylate a G protein involved in actin polymerization

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15
Q

What are the gross features of pseudomembranous colitis caused by C.diff?

A

White-yellow plaques

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16
Q

Is C.diff diarrhea bloody?

A

No

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17
Q

What is the treatment for C.diff?

A

Oral Metronidazole or vancomycin

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18
Q

Aerobic or anaerobic? Gram positive or negative? Cocci or bacillus? Spores? Lactose fermenter?: Shigella dysenteriae

A

Gram negative enteric rods

Non-lactose fermenting

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19
Q

What is McConkey agar used for? What are the results?

A

Tests for lactose fermentation

Color change = lactose fermenter

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20
Q

How do you differentiate Salmonella from Shigella?

A

Shigella:

  1. Produce no gas from fermentation
  2. Do NOT produce H2S gas
  3. They are non-motile
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21
Q

What type of diarrhea does shigella produce: bloody or not? Why?

A

Bloody– invasion of the intestinal epithelium causes blood and pus to form

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22
Q

What is the MOA of shigella? (does it produce a toxin? Does it invade cell walls)?

A

Produce a toxin and invade intestinal cell walls

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23
Q

What is the MOA of shigella toxin?

A

binds to ribosomes and halts transcription

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24
Q

What is the treatment for shigellosis?

A

IVF and lytes

If severe, fluoroquinolones (e.g. cipro)

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25
Aerobic or anaerobic? Gram positive or negative? Cocci or bacillus? Motile? Lactose fermentation?: Salmonella?
Gram negative rods NO lactose fermentation Produce H2S Motile
26
What are the two species of Salmonella that cause few GI symptoms?
S. Typhimurium | S. Enteritidis
27
What are the three types of Salmonella infections?
Enterocolitis Enteric fever Enteritidis
28
Which bacteria are not susceptible to HCl?
Shigella** | Campylobacter jejuni
29
Are S. Typhi or S. Enteritidis invasive?
If they cause disease, yes
30
Where does S.Typhi bacteria typically multiply? What can this lead to?
Peyer's patches | Bacteremia d/t dispersion
31
What are the ssx of salmonella (besides Typhi)?
N/v Abdominal pain Diarrhea wwo blood
32
What are the symptoms of S.Typhi infection?
ILI Splenomegaly **Rose spots on the abdomen**
33
Rose spots on the abdomen in the setting of enterocolitis = ?
S. Typhi infection
34
What is the treatment for Salmonellosis?
Supportive | Ceftriaxone if severe
35
What organ typically holds Salmonella Typhi, and is the cause for the carrier state?
gallbladder
36
How do you differentiate E.Coli from salmonella dn shigella?
E.coli will ferment lactose
37
What happen with E.coli on MacConkey agar? What does this mean?
Turns the agar purple, meaning it ferments lactose
38
What is the gram stain, morphology, lactose fementation results, for E.coli? Aerobic or anaerobic?
Gram negative rod Facultative anaerobe Ferments lactose
39
What are the three antigens that E. Coli has?
O (in the cell wall) H (flagella) K (capsule)
40
What is the disease that enterotoxigenic E.Coli causes (ETEC)? MOA?
Traveler's (watery) diarrhea cholera-like toxin and local adherence
41
What is the disease that Enteroinvasive E.Coli causes (EIEC)? MOA?
Bloody diarrhea | Enters the intestinal epithelium, and destroys cells
42
What is the disease that Enteropathogenic E.Coli causes (EPEC)? MOA?
Watery diarrhea in infants. Adhere to intestinal wall and cause loss of microvilli
43
What is the disease that Enterohemorrhagic E.Coli causes (EHEC)? MOA?
Bloody diarrhea Produce shiga-like toxin
44
What is the cause of hemolytic uremic syndrome? What is this?
EHEC Hemolysis followed by renal failure
45
What is the treatment for diarrhea caused by E.coli? What is the one strain that should not be given abx for? Why?
Supportive EHEC d/t possibility to develop massive shia-like toxin release
46
Rice water stool = ?
Cholera
47
What is the gram stain and morphology of Vibrio Cholera?
Curved, gram negative rod
48
What is the MOA of Cholera (generally)?
Adherence to intestinal GI mucosa via pili (but no visible damage) Cholera toxin
49
What is the MOA of cholera toxin?
AB protein that activates Gs, activating adenylate cyclase, and causing Cl channels to open and pump out Cl/water
50
How does the body overcome a cholera infection?
Shedding of the intestinal cell wall
51
What is the most common source of cholera infections?
Contaminated water or foods fertilized with human feces
52
What is the treatment for cholera?
Supportive
53
What is the gram stain and morphology of Campylobacter jejuni? Aerobic or anaerobic?
Curved, gram negative or Microaerophilic
54
What are the ssx of campylobacter jejuni infection?
fever, n/v/ diarrhea and abdominal cramps
55
How do you diagnose Campylobacter Jejuni?
Stool culture in micoaerophilic conditions
56
What is the treatment for campylobacter?
Supportive or erythromycin/cipro if severe
57
What is the gram stain and morphology of helicobacter pylori? Aerobic?
Short, spiral, gram negative microaerophilic
58
What is the enzymes that allows H.Pylori to survive in the low pH of the stomach?
Urease
59
What is the route of transmission for H.pylori?
Fecal-oral route
60
How do you distinguish between H.Pylori and Campylobacter?
H.pylori has urease
61
What is the treatment for H.pylori?
PPI Tetracycline Clarithromycin
62
Why is there no fever with botulinumism?
Toxin is the causative agent, not bacteria
63
Will boiling of foods prevent botulinumism? Why or why not?
No-- spores
64
What are the histological characteristics of C.Botulinum?
Gram negative Rods with spores at the end
65
What is the way to distinguish between diarrhea from other bacteria, and diarrhea caused by C.diff?
Toxins in the stool
66
What is the severe adverse reaction with Fluoroquinolones?
Tendon rupture/tendinitis
67
Match the MOA with the E.coli strain: 1. Enterotoxin delivery 2. Actin bundle pedestal formation 3. Shiga toxin delivery 4. Dissemination
1. ETEC 2. EPEC 3. EIEC 4. EHEC
68
What is the serotype of EHEC that causes diarrhea?
0157:H7
69
What is the major complication with EHEC?
Hemolytic uremic syndrome with abx use
70
Will heating food prevent cholera?
Yes-- cholera toxin will denature
71
What is the odd thing about H.Pylori's shape?
Multiple sheathed polar flagella Corkscrew shape

Gastrointestinal (42 decks)

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