Cross Anerobes and H pylori

Question 1

anaerobes affecting the GI tract

Answer 1

Bacteroides fragilis
prevotella
Clostridium:
perfringens 
tetani
botulinum
difficile

Question 2

major phyla of anaerobes contributing to gut microbiome

Answer 2

Clostridia
Bacteroides
also in oral cavity
femal Genital tract
soil/spores

Question 3

anaerobes lack (2)
anaerobes\_\_\_\_

Answer 3

SOD
catalase-thus cant deal with oxygen

they stink-organic acid end products of metabolism

Question 4

anaerobic infections are often _____

Answer 4

poly microbial
MIXED ANAEROBIC AND FACULTATIVE AEROBIC BACTERIA
-IN ABCESSES-USUALLY REFLECT THE NORMAL FLORA IN THAT SITE

Question 5

INTRA ABDominal infections, abcesses, paritonitis-from break in mucosal surface during Sx or trauma

Answer 5

Bacteroides fragilis

Question 6

decubitus ulcer

Answer 6

Bacteroides fragilis

Question 7

found in 25% of lung abceses

Answer 7

b fragilis

otherwise it is below the diaphragm

Question 8

tx of b fragilis

Answer 8

RESISTANT TO PENICILLIN

-SUSCEPTIBLE TO METRO, CARBAPENEMS, BETA LACTAM+BLINHIBITOR

Question 9

PELVIC OR PER-RECTAL ABCESSES

Answer 9

B FRAGILIS

Question 10

GRAM NEGATIVE COCCOBACILLUS

OPPORTUNISTIC PATHOGEN-IN NASAL AND ORAL CAVITIES

Answer 10

PREVOTELLA

A MEMBER OF BACTEROIDES

Question 11

CAUSES ORAL/PERIDONTAL ABCESSES
CHRONIC OTITIS
SINUSITIS
PULMONART ABCESSES/EMPYEMAS

Answer 11

PREVOTELLA

Question 12

GRAM POSITIVE SPORE FORMING RODS

*only anaerobe spore formers-thus resistant to harsh environment

Answer 12

clostridum sp.

colon and soil as spores

Question 13

pathogenesis of clostridia

Answer 13

exotoxins secreted in hydrolytic enzymes

Question 14

GAS gangrene

large box car GPR

Answer 14

C perfringens
ALPHA TOXIN
*3 rd leading cause of foodborne illness in US??

Question 15

cases gas gangrene

Answer 15

ALPHA TOXIN

Question 16

protal of entry is a wound site (nail) or skin popping druggies

Answer 16

C tetani

Question 17

c tetani pathogenesis

Answer 17

Tetanus toxin (tetanospasmin AB toxin)-enter NMJ-transported by motor neurons to ganglia
-bind irreversibly inhibiting GABA and SNARE-disinhibition of neurons that modulate excitatoryimplulses =increased msucle tone

Question 18

trismus- 
risus sardonicus
painful spasms
tonic paralysis
autonomic instability
arched back and respiratory failure

Answer 18

c tetani- disinhibition of excitatory neurons

Question 19

tx of tetanus

Answer 19

debridement
Human Tetanus Immunglobulin-neutralize
Ab’s universally given-metro, penicillin
always give the vaccine immediately after dx

Question 20

home canned fruits and veggies and fish, bioterror, iatrogenic, wound

Answer 20

c. botulinum-AB toxin

Question 21

carpets or raw honey

Answer 21

infantile botulism

Question 22

moa for botulism-mot potent toxin we have

Answer 22

cleaves snares–no exocytosis of ACH-flaccid parlysis

Question 23

foodborne botulism

Answer 23

Spores are resistant to heat, germinate after cooking and release toxin
Subsequent heating will inactivate the toxin (heat-labile)

Question 24

accute symettirc descending parlaysis

Answer 24

botulism
N/Dry mouth/Dysphagia/ Blurred vison (ACH deficiet)
possible death by respiratory failure

Question 25

Tx of GI botulism

Answer 25

Mechanical vent -HORSE ANTI-toxin if over 1 year old -hBIG-IVNO if less than 1 year AB's-would just spread the toxin

Question 26

flobby baby syndrome :Constipation followed by weakness, feeding difficulties, descending global hypotonia, drooling, anorexia, irritability, weak cry

Answer 26

infantile botulism | infection first then intoxication with the toxin

Question 27

tx of wound botulism

Answer 27

ab's- penicillin, or metro

Question 28

H pylori is responsible for

Answer 28

95% of duodenal ulcers 70% gastric ulcers *associated with adenocarcinomas and lymphomas

Question 29

spread of H pylori

Answer 29

fecal oral and human to human

Question 30

virulence factors for H pylori

Answer 30

``` Slender, curved gram negative rods Motile with polar flagella Microaerophilic VacA: vaculolating cytotoxin PAI encoding Type III secretion system Cag: rearranges cytoskeleton Urease-ammonia damages epitheliam cell-also bings up local H+ making microenvironment alkaline ```

Question 31

ulcers for h pyori are due to

Answer 31

VacA CagA Host immune response

Question 32

tx of h pylori

Answer 32

1. PPI, clarith, amoxicillin 2. PPI, clarith, metro 3. PPI or H2RA, Bismuth, metro, tetracycline

Question 33

dx of H pylori

Answer 33

Endoscopy with biopsy and culture Stool antigen Urea breath test Serology