EXAM 2 Gastroenteritis

Question 1

___ refers to the syndromes of diarrhea or vomiting that tend to involve non-inflammatory infection of the upper small bowel or inflammatory infection of the colon

Answer 1

gastroenteritis

Question 2

in many heavily populated areas, deaths from ___ exceed those from any other single cause

Answer 2

diarrheal illnesses

Question 3

___ is the leading cause of childhood death in developing countries

Answer 3

diarrheal disease

Question 4

over ___% of children born in certain parts of latin armerica die before their 5th birthday and in more than half, ___ is the major or associated cause of death

Answer 4

• 13%
• diarrhea

Question 5

the inoculum of ___ required to cause disease can be reduced 10,000 fold from 10⁸ to 10⁴ organisms by neutralizing gastric acid with 2g of ___

Answer 5

v. cholerae

sodium bicarbonate

Question 6

what are the 3 microbial virulence factor toxins involved in gasteroenteritis?

Answer 6

neurotoxins, enterotoxins, cytotoxins

Question 7

neurotoxins are usually ingested as ___ that cause enteric symptoms

Answer 7

preformed toxins

Question 8

___ have their effect on the central autonomic nervous system rather than on the intestine, per se

Answer 8

neurotoxins

Question 9

which 3 neurotoxins are involved in gastroenteritis?

Answer 9

staphylococcus aureus, bacillus, and clostridium botulinum

Question 10

___ have a direct effect on the intestinal mucosa to cause fluid secretion

Answer 10

enterotoxins

Question 11

enterotoxins cause an alteration in the metabolic activity of the ___

Answer 11

intestinal epithelial cells

Question 12

enterotoxins result in an outpouring of ___ and ___ primarily in the jejunum and upper ileum

Answer 12

electrolytes and fluid

Question 13

what are the 7 main enterotoxins involved in gastroenteritis?

Answer 13

• vibrio cholerae
• noncholera vibrio sp.
• e. coli
• salmonella sp.
• clostridium perfringens
• shigella dysenteriae
• bacillus cereus

Question 14

___ are responsible for the mucosal destruction

Answer 14

cytotoxins

Question 15

cytotoxins often result in ___ due to the mucosal destruction

Answer 15

inflammatory colitis

Question 16

cytotoxin mucosal destruction happens almost exclusively in the ___

Answer 16

colon

Question 17

inflammatory colitis as a result of cytotoxins is often referred to as ___

Answer 17

dysentery

Question 18

what are the 7 cytotoxins associated with gastroenteritis?

Answer 18

• shigella dysenteriae
• c. perfringens
• vibrio parahemolyticus
• s. aureus
• clostridium difficile
• campylobacter jejuni
• e. coli

Question 19

do many of the enteric pathogens produce more than one type of toxin?

Answer 19

yes

Question 20

what are the bacteria associated with attachment microbial virulence factors?

Answer 20

• e. coli
• giardia lamblia
• cryptosporidium
• isospora

Question 21

describe attachment microbial virulence factors

Answer 21

they destroy the ability of cells to participate in normal secretion and absorption

Question 22

what are the 6 bacteria associated with invasive microbial virulence factors?

Answer 22

• shigella sp.
• e. coli
• salmonella typhi
• salmonella cholerasuis
• vibrio sp.
• yersinia enterocolitica

Question 23

describe invasive microbial virulence factors

Answer 23

the capacity of organisms such as shigella and certain invasive strains of e. coli invade and destroy epithelial cells, primarily the colon, is responsible for the inflammatory or dysenteric diarrhea they cause

Question 24

s. aureus is often found in what 3 things?

Answer 24

meats, milk products, foodhandlers

Question 25

estimated \_\_\_% of all food-borne disease in the US is caused by bacteria and virus

Answer 25

84%

Question 26

16% of food-borne illness in the US is caused by what?

Answer 26

seafood, plant, and fungal toxins parasites

Question 27

\_\_\_ and ___ are the leading acuses of bacterial foodborne disease in the US

Answer 27

campylobacter jejuni and salmonella sp.

Question 28

c. perfringenes is often found in what 2 things?

Answer 28

meats and soil

Question 29

salmonella is found in what 5 things?

Answer 29

poultry, eggs, meats, milk, produce

Question 30

shigella is found in what 2 things?

Answer 30

produce, direct fecal/oral

Question 31

campylobacter is found in what 4 things?

Answer 31

water, raw milk, poultry, pets

Question 32

vibrio parahaemolyticus is found in what?

Answer 32

raw or undercooked seafood

Question 33

bacillus cereus is found in what 3 things?

Answer 33

rice, meat, and vegetables (dirt)

Question 34

aeromonas hydrophilia is found in what 2 things?

Answer 34

water and water sports

Question 35

vibrio cholera is found in what 2 things?

Answer 35

water and contaminated food

Question 36

SLT e. coli is found in what 3 things?

Answer 36

beef, raw milk, produce

Question 37

listeria monocytogenes is fond in what 3 things?

Answer 37

soft cheeses, unpasturized milk, deli meats

Question 38

what are 2 unusual sources of foodborne illness?

Answer 38

off-season fruits and vegetables, exotic pets

Question 39

what are the main bacteria associated with food-borne illness?

Answer 39

* staphylococcus aureus * c. perfringens * salmonella * shigella * campylobacter * vibrio parahaemolyticus * bacillus cereus * aeromonas hydrophilia * vibrio cholera * SLT e. coli * listeria monocytogenes

Question 40

\_\_\_ has an incubation period of minutes

Answer 40

hysteria reaction

Question 41

\_\_\_ have incubation periods of minutes-hours

Answer 41

* bacillus cereus * s. aureus * chemicals, heavy metals, and shellfish toxins

Question 42

\_\_\_ and ___ have incubation periods of several hours

Answer 42

* botulism * s. perfringens

Question 43

which organisms have incubations of about a day or so?

Answer 43

* salmonella * shigella * vibrio parahaemolyticus * campylobacter * yersenia enterocolitica * viruses

Question 44

what 3 organisms have incubation periods of days to weeks?

Answer 44

* c. difficile * giardia * amoeba

Question 45

of greatest importance in the treatment of microbial diarrhea, regardless of the cause or category, is \_\_\_

Answer 45

fluid replacement

Question 46

describe the standard oral fluid regimen for the treatment of gasteroenteritis

Answer 46

* 3.5g NaCl * 2.5g NaHCO3 * 1.5g KCl * 20g glucose * 1 liter of boiled water

Question 47

describe the in home fluid/electrolyte replacement for the treatment of gastroenteritis

Answer 47

* 3 tsp sugar * 3/4 tsp salt * 1/2 tsp baking soda * 1 cup orange juice * add water to make 1 quart * 2 bananas

Question 48

antibiotic treatment should be avoided in uncomplicated cases of \_\_\_

Answer 48

non-typhoid salmonella \*but, antibiotics can be lifesaving in invasive salmonella and typhoid fever

Question 49

antibiotic treatment may be used for ___ and \_\_\_

Answer 49

shigella and cholera

Question 50

\_\_\_ can eradicate carriage of c. jejuni and can shorten duration of disease

Answer 50

erythromycin

Question 51

antibiotics offer no value for \_\_\_, \_\_\_, and ___ food poisoning

Answer 51

staph, b. cereus, and c. perfringens

Question 52

antibiotics probably have minimal vause in what 3 organisms?

Answer 52

v. parahaemolyticus, y. enterocolitica, and invasive e. coli

Question 53

what is a potential contraindication for the use of antibiotics in the treatment of gastroenteritis?

Answer 53

patients with SLT e. coli and HUS

Question 54

what are the 3 microbial virulence factors?

Answer 54

toxins, attachment, and invasiveness

Question 55

what are the two normal enteric microflora

Answer 55

* anaerobe - bacteroides fragilis * facultative - e. coli

Question 56

at the normal gastric pH (\<4), over 99.9% of the ingested coliform bacteria are killed within ___ minutes

Answer 56

30

Question 57

what are the host factors for gastroenteritis?

Answer 57

* host species, genotype, and age * personal hygiene * gastric aciditiy and other physical barriers * intestinal motility * enteric microflora * specific immunity - phagocytic, humoral, cell-mediated * nonspecific protective factors and human milk * intestinal receptors

Question 58

gastrointestinal illnessin the US ranges from ___ to ___ illnesses per person per year

Answer 58

1-1.5

Question 59

\_\_\_ is a common result of gastroenteritis

Answer 59

dehydration

Question 60

can malnutrition cause diarrhea?

Answer 60

yes