Gastritis: Helicobacter pylori; Campylobacteriosis

Question 1

Gastritis refers to inflammation of the ___________

Answer 1

gastric mucosa.

Question 2

Gastritis

It is associated with nausea and upper abdominal pain; vomiting, and fever may also be present.

T/F

Answer 2

T

Question 3

Helicobacter pylori is seen on the surface of ________________ cells of patients with gastritis.

The organism is recovered from __________ material obtained _______ but not from _______.

Answer 3

gastric epithelial

gastric biopsy

endoscopically; stool

Question 4

Helicobacter pylori

H. pylori has been primarily linked to _______ infections

Helicobacter pylori’s primary habitat is the ______________

Answer 4

gastric; human gastric mucosa.

Question 5

Helicobacter pylori

Once acquired, H. pylori colonizes the _____ for a (short or long?) time and can cause a (low or high?) -grade inflammatory process, producing a (acute or chronic?) (superficial or deep?) gastritis.

Answer 5

stomach

Long

Low

chronic superficial gastritis.

Question 6

Helicobacter pylori

An _____,__________, and a common environmental source are possible routes of transmission

Answer 6

oral-oral

fecal-oral

Question 7

Helicobacter pylori

mother-to-child transmission can occur.

T/F

Answer 7

T

Research studies suggest mother-to-child transmission can occur.

Question 8

H. pylori colonizes the mucous layer of the ______ and ______ of the stomach but not the ________.

Answer 8

antrum and fundus

epithelium

Question 9

H. pylori

The organism produces _______ that hydrolyzes _________________ significantly ___easing the pH around the site of infection.

The change in pH protects the organism from the _____ environment produced by gastric secretions.

Answer 9

urease

urea-forming ammonia (NH3)

incr; acidic

Question 10

H. pylori

It also produces a protein called _______ and injects the protein into the ____________ cells.

Answer 10

CagA

gastric epithelial

Question 11

Pathogenesis of H.pylori

The CagA then affects host ___________ inducing _______ and altering ________, and interactions with neighboring cells enabling H. pylori to successfully invade the gastric epithelium.

Other possible virulence factors include:
- ________ (for colonization of mucosal surfaces, mediators of inflammation)
-________ (capable of causing damage to host cells)

Answer 11

cell gene expression

cytokine release

cell structure

adhesins; cytotoxin

Question 12

Helicobacter pylori is strongly associated with _________________________ ulcers as well as with ___________ carcinoma.

Answer 12

gastric, peptic, and duodenal

gastrointestinal

Question 13

Helicobacter pylori

The higher incidence is attributed to ___________ conditions,

Although it is not conclusively proven, _________ is said to be the likely source of many infections

Answer 13

poor sanitary

fresh groundwater

Question 14

Helicobacter pylori

long-term H. pylori infection resulting in (acute or chronic?) gastritis is an important risk factor for ______________ resulting in H. pylori being classified as a _________.

Answer 14

Chronic

gastric carcinoma

carcinogen

Question 15

Helicobacter pylori

Other species of helicobacters, (like H. ________ and H. _________) have been associated with _____________, generally in immunocompromised patients.

Answer 15

cinaedi

fennelliae

human gastroenteritis

Question 16

Campylobacter spp.

Campylobacter and Campylobacter-like

species are:

• (fermentative or non-fermentative)
• oxidase (positive or negative?)

Answer 16

fermentative

oxidase positive

Question 17

Campylobacter spp. Campylobacter and Campylobacter-like

species are:

• grown in a __________ environment.

Answer 17

microaerophilic

Question 18

Microaerophilic organisms require _______, but at a concentration ____________

_____% is normally optimal.

Answer 18

oxygen

less than that of room air

5

Question 19

Campylobacter Pylori

Primarily ________ organisms.

Cause ________ in domestic animals, such as cattle,
sheep, and swine

Answer 19

zoonotic

abortion

Question 20

Most common cause of bacterial gastroenteritis worldwide is ________________

Answer 20

Campylobacter jejuni.

Question 21

Campylobacter jejuni

Transmission of campylobacterioses has been attributed to _______ with animals and handling infected pets, such as dogs, cats, and birds, and

Answer 21

direct contact

Question 22

Campylobacter Jejunj

Indirect transmission by the consumption of _________ and __________ and improperly ———- ________.

Person to person transmission can occur

Answer 22

contaminated water and dairy products a

cooked poultry

Question 23

Some Campylobacter spp. are also sexually transmitted.

T/F

Answer 23

T

Question 24

Campylobacter jejuni

__________ in most common causes of foodborne gastrointestinal illness, behind _______________________________

Answer 24

Fourth

norvovirus, Salmonella, and Clostridium perfringens.

Question 25

Campylobacter jejuni Mostly affect ________ and ________, although all age groups are at risk.

Answer 25

infants and young adults

Question 26

In addition to C. jejuni, other Campylobacter spp. that cause gastrointestinal disease (enteric campylobacters) are C. ______ and C. _____.

Answer 26

coli Lari

Question 27

Campylobacter jejuni Several Campylobacter spp. have been implicated in human infection— C. _____, C. ______, C. _____, C. _____, C. _____, C. _____, and C. _____.

Answer 27

C. fetus, C. jejuni, C. coli, C. sputorum, C. concisus, C. curvus, and C. rectus.

Question 28

Campylobacter jejuni Patients infected with C. jejuni present with a ________ disease that begins with __________ within ____ to ______ after ingestion of the organisms. _________ and _________ often follow the initial signs.

Answer 28

diarrheal mild abdominal pain 2 to 10 days Cramps and bloody diarrhea

Question 29

Campylobacter jejuni May experience fever and chills and, rarely, nausea and vomiting. In most patients, the illness is ________ and usually resolves in ____________ Untreated patients can remain carriers for ______________.

Answer 29

self-limited 2 to 6 days. several months

Question 30

Campylobacter jejuni Other enteric Campylobacter infections (those caused by C.____ and C.____) have similar clinical manifestations.

Answer 30

coli lari

Question 31

Campylobacter jejuni Campylobacter infection plays a role in GBS (________________)

Answer 31

Guillain barre syndrome

Question 32

GBS is ____________ disorder characterized by (acute or chronic?) paralysis caused by damage to the ____________

Answer 32

an autoimmune Acute peripheral nervous system.

Question 33

Many patients with GBS test positive for antibodies to ________

Answer 33

Campylobacter

Question 34

Campylobacter Jejuni Antibodies produced during a Campylobacter infection bind to __________ found on __________. ___________ with these nerve cells in an autoimmune response may be responsible for this debilitating nerve disorder.

Answer 34

gangliosides peripheral nerves Cross-reactivity

Question 35

Laboratory Diagnosis: Specimen of campylobacter Collection and Transport _____ culture media ______ samples ______ swabs (the less preferred specimen) ____________ materials. Samples must be transported quickly to the laboratory

Answer 35

Blood stool rectal gastric biopsy

Question 36

Specimen Collection and Transport of campylobacter If a delay in processing the stool specimen is anticipated, it can be placed in a transport medium (to maintain the viability of the organisms) such as: - ________ -_______ medium - Tissue samples may also be placed in _________ broth with ____%______ and frozen at _____° C.

Answer 36

Cary-Blair Stuart Cysteine-Brucella 20; glycerol −70

Question 37

Culture Media: Campylobacter jejuni Campy-______(_________): •an enriched selective agar •Contains ______ base, 10% ______ red blood cells, and a combination of ______ (vancomycin, trimethoprim, polymyxin B, amphotericin B, and cephalothin)

Answer 37

BAP; blood agar plate Brucella agar; sheep antimicrobials

Question 38

Culture Media: Campylobacter jejuni _______ __________ medium _________ medium Medium ___

Answer 38

Campy-BAP Butzler Skirrow’s V

Question 39

Culture Media: Campylobacter jejuni Medium V (modified ______) - (contains cefoperazone, rifampin, colistin, and amphotericin B) medium can be incubated at _____° C.

Answer 39

Butzler medium 37

Question 40

Enteric Campylobacter and Helicobacter spp. require a _______ and ________ environment.

Answer 40

microaerophilic and capnophilic

Question 41

Enteric Campylobacter and Helicobacter spp. Laboratory diagnosis The ideal atmospheric environment for these organisms is a gas mixture of - ____% O2, ___% CO2, and ____% N2 for Campylobacter spp. - ____% to ____% O2 and __% to ____% CO2 for Helicobacter spp.

Answer 41

5% O2, 10% CO2, and 85% N2 for Campylobacter spp. - 5% to 10% O2 and 5% to 12% CO2 for Helicobacter spp.

Question 42

Campylobacter spp. are (straight or curved ?) (spore or non–spore?)- forming gram- _______ rods that measure approximately 0.2 to 0.9 μm × 0.5 to 5.0 μm

Answer 42

Curved non–spore negative

Question 43

Campylobacters may appear as _______, or ______ or ____________- wing shapes. They may appear as ______ in smears prepared from older cultures.

Answer 43

long spirals or ‘S’ or seagull coccobacilli

Question 44

Campylobacter : Laboratory diagnosis They exhibit a characteristic “_______” motility on ________ preparations or when visualized under _________ microscopy.

Answer 44

darting hanging drop phase contrast

Question 45

H. pylori appears similar to campylobacters, but Helicobacter has ________ flagella at one pole, unlike the _____________ of campylobacters.

Answer 45

multiple single polar flagellum

Question 46

Presumptive Identification: Colony Morphology. The typical colony morphology of C. jejuni and other enteric campylobacters are (dry or moist?) , usually (haemolytic or nonhemolytic?) Some are (round or flat ?) and raised and others may be ______.

Answer 46

moist nonhemolytic Round and raised Flat

Question 47

Laboratory mechanism Isolates from stool specimens and rectal swabs can be presumptively identified as Campylobacter spp. by: a __________-oxidase the characteristic Gram-stained microscopic morphology the characteristic motility.

Answer 47

positive

Question 48

Helicobacter infections usually are identified by culture methods. T/F

Answer 48

F nonculture

Question 49

H. pylori can be presumptively identified in a gastric biopsy specimen by testing for the presence of a ___________

Answer 49

rapid urease reaction

Question 50

H. pylori can be presumptively identified in a gastric biopsy specimen by testing for the presence of a rapid urease reaction The collected tissue sample is placed onto _________ medium and incubated at ____° C for ____ A _________ suggests the presence of H. pylori.

Answer 50

Christensen’s urea 37 2hours color change

Question 51

Helicobacter pylori Other tests include: ___________ tests Urease activity can also be detected by the _______ Fecal ______ detection Microscopic examination of stained gastric tissue DNA amplification tests (e.g., polymerase chain reaction assay).

Answer 51

Rapid urea/urease urea breath test antigen

Question 52

Laboratory diagnosis: Immunologic Assays ___________ tests are available for the rapid identification of colonies of enteric campylobacters on primary isolation media. ___________ tests in fecal samples. Specific antibodies in serum can be detected by enzymelinked immunosorbent assay or indirect immunofluorescent assay methods.

Answer 52

Latex agglutination Campylobacter antigen

Question 53

Treatment: H. pylori Triple-drug therapy: _________,_______ An alternative regimen for patients with _________ resistant strains includes: ________ and _______ and _______ or ______

Answer 53

metronidazole, a bismuth salt, and either amoxicillin or tetracycline. metronidazole omeprazole or lansoprazole amoxicillin or clarithromycin.

Question 54

Treatment: H. pylori Treatment for H. pylori infections should be administered for _______ to _______ to eradicate the infection. Relapses occur (often or rarely?)

Answer 54

7 to 14 days Often

Question 55

Treatment: Campylobacter spp. C. jejuni and C. coli are susceptible to many antimicrobial agents, including macrolides, tetracyclines, aminoglycosides, and quinolones. __________ is the drug of choice for patients with severe gastroenteritis _________ is an alternative therapeutic option.

Answer 55

Erythromycin Ciprofloxacin

Question 56

Treatment: Campylobacter spp. C. jejuni and C. coli are susceptible to many antimicrobial agents, including ———-,————-,————- and _________

Answer 56

macrolides, tetracyclines, aminoglycosides, and quinolones.