Chap 34-BOOK (Part 1)

Question 1

Colorful names for Acute diarrheal illness

Answer 1

Montezuma’s revenge, Delhi belly, Greek gallop, Rome runs, Aztec two-step, and back door sprint

Question 2

Alteration in a normal bowel movement characterized by an increase in the water content, volume, or frequency of stools.

Answer 2

Diarrhea

Question 3

Having more than 3 bowel per day

Answer 3

Diarrhea

Question 4

Defined as symptoms lasting less than 14 days. If symptoms last longer than 14 day

Answer 4

Acure diarrhea/Persistent diarrhea

Question 5

Diarrhea that lasts longer than 30 days,

Answer 5

Chronic diarrhea

Question 6

Noninfectious cause of diarrhea

Answer 6

Laxative use, tumor-related, malabsorption, inflammatory bowel disease, and problems with motility caused by hyperthyroidism, irritable bowel syndrome, or surgical reduction of the gut.

Question 7

Normal gastric pH

Answer 7

Lower than 4

Question 8

Motion in the small intestine

Answer 8

Peristalsis

Question 9

Colon has what immunoglobulin

Answer 9

IgA

Question 10

Number of organisms that must be ingested to cause a diarrheal illness in 50% of exposed individuals.

Answer 10

Median infectious dose (ID50)

Question 11

The absence of hydrochloric acid in gastric secretions

Answer 11

Achlorhydria

Question 12

Usually caused by enterotoxigenic Escherichia coli. This disease has a short incubation period (usually between 5 and 15 days after arrival) and normally lasts from 1 to 5 days

Answer 12

Traveller’s diarrhea

Question 13

If a diarrheal illness develops weeks after a traveler returns home, a parasitic infection such as

Answer 13

G. lamblia or E. histolytica

Question 14

If the patient is currently taking or has recently received antibiotics this organism is an important consideration

Answer 14

C. difficile

Question 15

Signs suggestive of dehydration

Answer 15

Sunken appearance to the eyes
Dry oral membranes
Loss of skin resiliency known as skin tenting
Decrease blood pressure
Increase heart rate

Question 16

Lack of fever and absence of blood or pus in the stool suggests an

Answer 16

Enterotoxin-Mediated Diarrhea

Question 17

The preformed toxin is already present in the ingested food. Because toxin can act proximally in the bowel (the small intestine), the incubation period is relatively short, usually less than 12 hour

Answer 17

Enterotoxin-Mediated Diarrhea

Question 18

Result of stool examination for Enterotoxin-Mediated Diarrhea

Answer 18

Negative for red and white blood cells

Question 19

Organism that has the largest percentage of cases of diarrhea in travelers to underdeveloped areas

Answer 19

Enterotoxigenic E. coli

Question 20

Other organisms responsible for enterotoxin-mediated disease

Answer 20

Vibrio cholerae
Staphylococcus aureus
Clostridium perfringens
Bacillus cereus.

Question 21

Culprit/source of infection can often be traced to food handlers

Answer 21

S. aureus

Question 22

Small, localized abscesses in the nail beds known

Answer 22

Paronychias

Question 23

Noninvasive parasitic invasion that produce afebrile diarrhea

Answer 23

Giardiasis, cryptosporidiosis, or infection with Cystoisospora belli

Question 24

Organism that caused diarrhea mediated by invasion of the bowel mucosal surface

Answer 24

Salmonella spp.
Campylobacter spp
Shigella spp.
some E. coli strains
Entamoeba histolytica

Question 25

Organisms that invade the bowel mucosa cause an inflammatory response, characterized by the presence of fecal leukocytes, fever and leukocytosis

Answer 25

Diarrhea Mediated by Invasion of the Bowel Mucosal Surface

Question 26

T/F: Patient may present with true dysentery syndrome, characterized by gross blood and pus in DMIBMS

Answer 26

True

Question 27

Most common invasive enteric organism that causes Diarrhea Mediated by Invasion of Full-Bowel Thickness with Lymphatic Spread

Answer 27

Salmonella Typhi and Yersinia enterocolitica.

Question 28

Incubation period for these infections (Full bowel thickness with Lymphatic spread) is about

Answer 28

1 to 3 days

Question 29

Salmonella Typhi and Yersinia enterocolitica invade the bowel wall, causing

Answer 29

bacteremia, and mesenteric lymphadenitis which can be mistaken for appendicitis

Question 30

Present in the stool for Full bowel thickness with Lymphatic spread

Answer 30

Red blood cells and fecal leukocytes

Question 31

These viruses infect cells of the villi of the small intestine, leading to epithelial atrophy and proliferation of cells with secretory capacity.

Answer 31

Rotavirus

Question 32

The most common cause of diarrhea in children younger than 5 years

Answer 32

Rotavirus

Question 33

Implicated in many illnesses, ranging from the common cold and epidemic keratoconjunctivitis (pink eye) to infectious diarrhea

Answer 33

Enteric Adenovirus

Question 34

Two adenovirus serotypes, most frequently associated with infectious diarrhea

Answer 34

Serotype 40 and 41

Question 35

Characterized by 32 cup-shaped depressions along the surface

Answer 35

Calicivirus

Question 36

Theese viruses cause an acute, self-limited diarrheal illness associated with vomiting and low- grade fever. The virus could be transmit- ted by the aerosolization of vomitus.

Answer 36

Norwalk and Sapovirus

Question 37

Small, 28-nm virus that appears as a five- or six- pointed star is the morphology at alkaline pH; suggest that an osmotic diarrhea may develop from inflammatory infiltrates in the lamina propria and intestinal villus atrophy.

Answer 37

Astrovirus

Question 38

Most common bacterial cause of gastroenteritis in the world. These organisms are developing significant resistance to antibiotics commonly used to treat diarrheal illnesses

Answer 38

C. jejuni

Question 39

Life-threatening neurologic disease, and reactive arthritis are complications of infection by C. jejuni.

Answer 39

Guillain-Barré syndrome

Question 40

often the source of the infection of C. jejuni

Answer 40

Contaminated poultry

Question 41

Preferred antibiotic for C. jejuni because of the increasing rates of fluoroquinolone resistance

Answer 41

Macrolide antibiotic

Question 42

caused by nontyphoidal Sal- monella spp. that can lead to gastroenteritis through the ingestion of contaminated meat, poultry, eggs, dairy products, and aquaculture- farmed fish and shellfish.

Answer 42

Gastroenteritis and Food poisoning

Question 43

Animal host for nontyphoidal salmonella serotyoes

Answer 43

Birds and reptiles

Question 44

causes the most severe form of enteric fever, typhoid fever.

Answer 44

Salmonella typhi

Question 45

Bacteria survive in the host immune cells, and are therefore termed

Answer 45

Intracellular pathogens

Question 46

Responsible for a diarrheal illness characterized by gross blood and pus.

Answer 46

Shigella spp. (S. sonnei , S. flexneri, S. dysenteriae, and S. boydii)

Question 47

Most easily communicable bacterial diarrheal pathogens

Answer 47

Shigella Spp.

Question 48

Shigella bacteria can produce several toxins, including the _ which can have cytotoxic, enterotoxic and neurotoxic effects

Answer 48

Shiga toxin

Question 49

Typically used as initial empiric therapy when antibiotics are required for Shigella spp.

Answer 49

Fluoroquinolones

Question 50

Produce adhesins to bind to intestinal mucosa and enterotoxins, which are heat-stable (ST) or heat-labile (LT)

Answer 50

Enterotoxigenic Escherichia coli (ETEC)

Question 51

similar to V. cholerae toxin

Answer 51

LT toxin

Question 52

Binds to guanylate cyclase, leading to increased intracellular cyclic guanosine monophosphate (cGMP) levels and active efflux of water and electrolytes from the intestinal cells

Answer 52

ST toxin

Question 53

Produce an infection similar to Shigella. Progress to an invasive-type diarrheal syndrome, with fever, abdominal cramping, and bloody stools.

Answer 53

Enteroinvasive Escherichia coli (EIEC)

Question 54

_atients can develop hemolytic-uremic syndrome (HUS), characterized by hemolytic anemia, low platelet count, and kidney failure.

Answer 54

Enterohemorrhagic Escherichia coli (EHEC)

Question 55

E. coli strain that is the principal cause of EHEC

Answer 55

O157:H7

Question 56

Referred to as the enteroadherent E. coli in some classification schemes. These organisms commonly affect children in nurseries and daycare center

Answer 56

Enteropathogenic Escherichia coli (EPEC)

Question 57

Also adhere to the intestinal surface but in a more clumped or aggregative fashion.

Answer 57

Enteroaggregative E. coli (EAEC)

Question 58

The causative agent of cholera.

Answer 58

V. cholerae

Question 59

Subunit of V. cholerae that permit attachment to the small bowel mucosa

Answer 59

B subunits

Question 60

Subunit of V. cholerae that enters the cell.

Answer 60

A subunits

Question 61

Serogroup that causes of epidemic cholera

Answer 61

Serogroups O1 and O139

Question 62

Most common virbrio spp. can have fever and evidence of fecal inflammation, sug- gesting that there is some potential for mucosal invasion

Answer 62

Vibrio parahaemolyticus

Question 63

Most virulent of all noncholera vibrios, causing an often fulminant illness characterized by sepsis and bullous skin lesions in patients with a recent ingestion of shellfish

Answer 63

V. vulnificus

Question 64

Responsible for bubonic plague

Answer 64

Yersinia enterocolitica

Question 65

Causative agent of antibiotic-associated diarrhea

Answer 65

C. difficile

Question 66

Was initially reported in patients receiving clindamycin

Answer 66

C. difficile–associated disease (CDAD)

Question 67

Epidemic strain of C. difficile that has increased virulence, which is attributed to the overexpression of toxin-encoding genes producing larger amounts of toxins, which causes a more aggressive form of the disease when compared with the nonepidemic strains.

Answer 67

BI/NAP1/027

Question 68

Mainstay therapy for C. difficile

Answer 68

Metronidazole and Vancomycin

Question 69

Best known for causing systemic disease, such as meningitis

Answer 69

L. monocytogenes

Question 70

Associated with peptic ulcer disease

Answer 70

H. pylori

Question 71

This testing is based on the organism’s high urease activity. 13C- or 14C-labeled urea will, when ingested, produce labeled CO2 in the patient’s breath if the organism is present.

Answer 71

Breath testing

Question 72

Has been associated with a watery diarrhea

Answer 72

Aeromonas spp. and P. shigelloides

Question 73

Associated with fish and shellfish, is a rare cause of gastroenteritis.

Answer 73

Edwardsiella tarda