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GI II Exam 1 > Bowel Path II > Flashcards

Bowel Path II Flashcards

1
Q

most common cause of severe diarrhea in infants and young children

A

rotavirus

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2
Q

rotavirus

A

dsRNA virus
-reoviridae family

five species - A, B, C, D, E

A - most common - >90% of infections

fecal-oral transmission
-often stomach flu

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3
Q

rotavirus infection

A

easily managed
-but causes lots of death worldwide - developing countries

oral rehydration therapy and vaccines

malabsorption
-toxic protein NSP4

may also see lactose intolerance - for weeks

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4
Q

rotarix

A

vaccine for rotavirus

attenuated live virus

oral admin

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5
Q

ingestion of preformed toxins

A

rapid onset

staph food poisoning

vibrio

c perfringens

c botulinum

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6
Q

infection by toxigenic organisms

A

incubation - then diarrhea

travelers diarrhea
e coli
v cholerae
campylobacter

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7
Q

infection by enteroinvasive organisms

A

invade destroy mucosa

shigella
salmonella
campylobacter
enteroinvasive e coli

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8
Q

E. coli

A

gram negative bacilli

-colonize GI tract

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9
Q

ETEC

A

enterotoxic e coli

travelers diarrhea
food or water spread

heat labile toxin and heat stable toxin

induce chloride and water secretion

secretory diarrhea, dehydration

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10
Q

EHEC

A

E. coli 0157:H7

undercooked beef

shiga-like toxins

bloody diarrhea and HUS

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11
Q

EIEC

A

food, water, person to person

no toxins
-invade epithelial cells

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12
Q

EAEC

A

enteroaggregative e coli

adhere to epithelial

cause of diarrhea

adhere with adherence fimbrae

damage due to adherence

nonblood diarrhea - prolonged in AIDS patients

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13
Q

campylobacter

A

water or bloody diarrhea

arthritis

guillan barre syndrome

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14
Q

salmonella

A

gram negative bacilli

typhi - typhoid fever
nontyphi - enteritidis

raw or undercooked meat

few organisms required for infection

bacteria grown in phagosomes

Th17 limits to colon

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15
Q

diagnosis of salmonella

A

stool culture

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16
Q

typhoid fever

A

salmonella typhi

travel to india, mexico, phillipines, etc.

enlarged peyers patches in terminal ileum

oval ulcers - oriented along axis of ileum - may perforate**

liver - typhoid nodules

abdomen pain, bloating, nausea, vomiting, bloody diarrhea - fever and flu-like sx

blood cultures positive - more than 90% during febrile phase

rose spots - chest and abdomen

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17
Q

cholera

A

gram negative bacteria

contaminated drinking water

cholera toxin - causes disease

  • five B subunits and single A subunit
  • B goes retrograde transport to ER - A then reduced
  • A released to cytosol
  • interacts with ARF to activate and increase cAMP
  • causes chloride release to lumen
  • massive diarrhea

flagella for colonization

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18
Q

rice water stool

A

cholera

with fishy odor

dehydration, hypotension, shock

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19
Q

campylobacter jejuni

A

gram negative motile

most common enteric pathogen developed countries
-travelers diarrhea

improper cooked chickens

four virulence properties
-motility, adherence, toxin, invasion

flagella - motlie

see arthritis, erythema nodosum, guillan barre syndrome

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20
Q

most common bacterial enteritis in the world

A

campylobacter

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21
Q

shigella

A

gram negative bacilli
unencapsulated, nonmotile facultative anaerobes

watery diarrhea progres to bloody diarrhea - dysentery

resistant to acidic stomach

taken up by M cells

to left colon

diagnosis - stool culture

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22
Q

reiter syndrome

A

complication of shigella

arthritis, urethritis, conjuntivitis

HLA-B27 positive men

23
Q

pseudomembranous colitis

A

antibiotic associated
-3rd gen cephalosporins

c. difficile overgrowth and toxin production - A and B toxins

in adults - acut ediarrhea

diagnosis - C. dif in stool

eruption reminiscent of volcano

24
Q

diagnosis of c dif infection

A

presence of toxin

25
volcanic eruptions
c dif - pseudomembranous colitis
26
whipple disease
relapsing multisystem illness of GI tract and distant sites weight loss, diarrhea, polyarthritis tropheryma whipplei 40-50yo, males tx - antibiotics
27
trophermya whipplei
whipple disease gram positive actinomycete foamy macrophages with argyrophilic rods in lymph nodes
28
path of whipple disease
malabsorptive diarrhea - impaired lymph transport organism clogs up nodes and lymph tracts
29
distended foamy macrophages
whipple disease PAS positive rod shaped bacilli and NO acid-fast staining t. whippelii
30
diarrhea, weight loss, and malabsorption
triad of whipple disease
31
cryptosporidium
contaminated drinking water travelers diarrhea terminal ileum and right colon intracellular at brush border H and E stain and Ag stain appears to sit on top of epithelial apical membrane diagnosis - oocysts in stool
32
AIDS and diarrhea
50% patients cryptosporidium CMV MAI
33
pinworms
enterobius vermicularis -live in intestinal lumen - rarely cause illness eggs deposited at night at perirectal mucosa- irritation -itchy diagnosis - tape to anus
34
ascaris
small intestine roundworm -a. lumbricoides compromised nutritional status SOB, fever, abdomen pain, diarrhea, malnutrition, mental changes eggs hatch in intestines - go to lungs - coughed up and swallowed
35
amebiasis
entamoeba histolytica -ingestion of mature cysts trophozites invade intestinal mucosa cecum and ascending colon abdomen pain, diarrhea, weight loss acute necrotizing colitis and megacolon possible obligate fermenters of glucose
36
most common parasite infection
giardia
37
giardia
g. duodenalis and g. intestinalis asymptomatic, acute diarrhea, or chronic GI disease malabsorption, diarrhea, abdominal pain/discomfort
38
giardia morph
flagellated protozoans cause decreased expression of brush border enzymes pear shape with two nulei and line down middle
39
steatorrhea
bulky, frothy, greasy, yellow, gray stool - with malabsorption
40
ADEK
fat soluble vits - with malabsorption
41
most common causes of malabsorption
celiac pancreatic insufficiency crohn disease
42
abetalipoproteinemia
only see transepithelial transport defect
43
altered lymph transport
whipple disease
44
celiac disease
inflammatory disease -gluten ingestion genetic predisposition, inciting agent exposure, T cell repsonse
45
gliadin
disease producing component of gluten induce IL-15 expression stimulates T8 Cells enters and stimulates T4 cells - to create B cells - make Abs path - is CD8 cells
46
class II HLA DQ2 and DQ8
carried by those with celiac
47
celiac clinical
steattorhea, weight loss, abdominal pain cramping bloating, mouth ulcers, lactose intolerance, IBS increased risk of adenocarcinoma and lymphoma malaborption vits A, D, E, K anemia, fatigue, megaloblastic anemia, hyperparathyroid, osteopenia, osteoporosis
48
celiac disease
adults 30-60yo and children diarrhea with steatorrhea dermatitis herpetiformis
49
dermatitis herpetiformis
extremely itchy blisters extensor surfaces of body IgA deposition at dermal/epidermal junction with celiac disease**
50
celiac tx
remove from diet
51
diagnosis of celiac
1 clinical malabsorption 2 small bowel bx - gold standard 3 response to gluten free diet also serologic testing and HLA testing -if IgA deficient - sero tests won't work
52
gold standard celiac diagnosis
small bowel biopsy -distal duodenum/jejunum -villous atrophy
53
celiac sero tests
IgA tTG antibodies also anti-endomysial antibodies - IgA EMA
54
cracked mud mucosa
in celiac on endoscope

GI II Exam 1 (29 decks)

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