Cross: NON-inflammatory Diarrhea

Question 1

causes on Non-Inflammatory D

Answer 1

“EEEVVVSB”

ETEC
EPEC
EAEC
Vibrio cholera
Vibrio parahemolyticus
Vibro vulnificus
Staph aureus
Bacillus cereus

Question 2

define NI diarrhea

Answer 2

no cells in stool
watery
LARGER volume
afebrile
SMALL INTESTINE affected

Question 3

major cause of traveler’s D

Answer 3

ETEC
also C jejuni
rarely EAEC

Question 4

ETEC pathogenesis

1-5 days course of watery D

Answer 4

LT and ST
LT=similar to cholera-inc cAMp-inc Cl-secretion from crypts=Na+ and H2O collow=water D
ST=activated cGMPcl secretion-watery D

Question 5

cGMP activation=water D

Answer 5

=heat stabile toxin

Question 6

cAMP activation=watery D

Answer 6

=heat labile toxin

Question 7

Profuse watery D, Vomitting and dehydration in developing countries= children <6 mos to 2 years old

Answer 7

EPEC

Question 8

pathogenesis of EPEC

Answer 8

LEE PAI like EHEC

attachement and effacing through pedastal like strcutures stick it to GI mucosa
NO SHIGA TOXIN PRODUCED-unlike EHEC

Question 9

does EPEC make a shiga toxin

Answer 9

HELL NAW-but it does enter mucosa with LEE like EHEC

Question 10

EAEC pathogensis

Answer 10

NOT UNDERSTOOD

*affects children, HIV pt.’s travellers D

Question 11

neonatal menigitis

Answer 11

E. coli- encapsulated strains (K1 antigen)

Question 12

90% of UTI (more commonly in females)

Answer 12

UPEC
virulence factors incldue
P fimbriae (PAP pilli) and a capsule (K1 antigen)

Question 13

curved comma shaped GNR-polar flagella

-motile, oxidase positive,

Answer 13

vibrio sp.

Question 14

oxidase positive

Answer 14

vibrio

Question 15

environment for cholera

Answer 15

warm months
salt water-SE asia and Africa, SAmerica
-after natural disasters-fecally contaminated water
5-10 million cases annually

Question 16

main animal reservoir for vibrio cholera

Answer 16

shellfish-raw oysters

Question 17

serogroups responsible for epidemic and pandemic cholera

Answer 17

O1 and O139

Question 18

O1 serogroup divided into

Answer 18

• e1 tor

- classic

Question 19

cholera pathogen

Answer 19

> High IDose-cant handle stomach acid
-colonizes small bowel-by the help of mucinase enzyme-dissolves glycoprotein over brush border=leads to adherence
secretes cholera toxin (an A/B toxin)-

Question 20

5B (binding) subunit of cholera AB toxin….

Answer 20

binds ganglioside R on surface of enterocyte

Question 21

1A (active( subunit of cholera AB toxin…

Answer 21

ADP ribosylation of Gs protein-overactive AC-inc. cAMP-loss of CL–>Na+==>H20
=WATERY D

Question 22

clinical course for cholera

mortality rate if untreated is 40%

Answer 22

water D=up to 20 L per day “rice water stools”
-high pathogen load in stools-smells like fish
no abdominal pain usually
-no cells in stool

eventually loss of electrolytes= renal failure and cardiac failure
HCO3 loss=acidosis and hypokalemia

Question 23

dx of cholera

Answer 23

clnical mostlt

-TCBS, TTGA, MacConkey agar

Question 24

tx of cholera

Answer 24

>AGGRESIVE FLUID REPLETION
>TETRACYCLINE
ERYTHROMYCIN
AZITHROMYCIN
CIPRO
VACCINE AVAILABLE

Question 25

RAW OYSTERS

Answer 25

VIBRIO-ESP PARAHEMOLYTICUS

Question 26

BACTEREMIA CAN BE SEEN WITH PARAHEMOLYTICUS IF ALSO UNDERLYING

Answer 26

LIVER DISEASE | OTHERWISE ITS LIKE A 3 DAYS COURSE AND NOT AS SEVERE AS CHOLERA

Question 27

HAND INFECTION IN ANY WAY DEALING WITH SALT WATER | recreation, oyster shucker-fisherman

Answer 27

VIBRIO PARAHEMOLYTICUS can cause cellulitis if DM, or liver disease

Question 28

tx of parahemolyticus

Answer 28

fluid repletion | doxycycline

Question 29

main manifestation is diarrhea and severe skin and soft tissue infections

Answer 29

vibrio vulnificus

Question 30

shelfish handers who sustiain hand injusries are at risk

Answer 30

virbio vulnificus

Question 31

tc for vulnificus

Answer 31

doxy cefotaxime recephin

Question 32

most common foodborne illness in japan

Answer 32

vibrio vulnificus

Question 33

spore forming GPB can survive in the envrionment for a while sustain extremes of temp

Answer 33

bacillus cereus

Question 34

REHREATED FRIED RICE DAIRY SPICES BEAN SPROUTS

Answer 34

B CEREUS

Question 35

emetic type food poisoning

Answer 35

B cereus

Question 36

b cereus diarrheal syndrome

Answer 36

caused by diarrheal toxin | 8-16 hours after ingestion-vomiting uncommon-resolves in 24 horus

Question 37

b cereus emetic syndrome caused by

Answer 37

cerulide toxin-heat stable

Question 38

b cereus emetic syndrome reheated fried rice

Answer 38

1-5 hours after ingestion (preformed)-> Abdominal cramps N/V, D in 1/3 of pt.'s, resolves in 24 hrs

Question 39

S aureus found in

Answer 39

``` potato salad at a picnic meats eggs dairy produce *when left at room temp *cross contam by food handler ```

Question 40

pathogenesis of SA food poisoning

Answer 40

acts as a superantigen within the GI tract=stimulates release fo IL1 and IL2 *within 1-6 hours N/V abdominal cramps typically done in 24 hours

Question 41

preformed toxins

Answer 41

SA and B cereus

Question 42

abundant in soil and freshwater

Answer 42

Bacillus cereus