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Gastroenteritis Flashcards

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1
Q

What is gastroenteritis simply put?

A

the bugs that cause diarrhea and vomiting; typically non-inflammatory infection of the upper small bowel or inflammatory infection of colon

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2
Q

What is diarrhea?

A

alteration in normal bowel movement characterized by increase in water content, volume, or frequency of stools (more than 3 bowel movements a day)

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3
Q

Who does diarrhea kill?

A

a leading cause of death in children worldwide

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4
Q

What can a diarrheal infection lead to?

A

malnutrition

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5
Q

What are malnourished children at highest risk for?

A

life-threatening diarrhea

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6
Q

What is the diarrheal cycle in children?

A

diarrhea leads to malnutrition which causes dehydration; each of these worsens/triggers the next

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7
Q

What problem does poor sanitation cause?

A

leads to very high risk for diarrheal infection; ex) day care and developing countries

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8
Q

WASH WHAT?

A

YOUR DAMN HANDS!!

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9
Q

What does gastric pH do?

A

helps prevent diarrheal illness due to its acidity of 1.6 as it kills ingested coliform bacteria within 30 minutes

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10
Q

What does making your normal gastric pH more basic do?

A

decreases the chances of fighting off food-borne illnesses

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11
Q

What bugs does “everyone” have in their enteric microbiome?

A

bacteroides fragilis, bacteroides spp., fusobacterium spp., enterococcus spp., and escherichia coli

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12
Q

What is the #1 obligate anaerobe in the gut?

A

bacteroides fragilis, most common spp. in gut

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13
Q

What is the #1 facultative anerobe in the gut?

A

escherichia coli

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14
Q

Why does enteric microbiome matter?

A

it keeps pathogens in check

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15
Q

What are the microbial virulence factors?

A

toxins, attachment, and invasiveness

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16
Q

What are the 3 toxins bacteria use for gastroenteritis?

A

neurotoxins, enterotoxins, and cytotoxins

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17
Q

What do neurotoxins do?

A

effect the central autonomic nervous system (ex. Clostridium botulinum)

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18
Q

How are neurotoxins ingested?

A

pre-formed toxins

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19
Q

What are enterotoxins?

A

exotoxins with a direct effect on intestinal mucosa; cause fluid secretion (diarrhea and vomiting)

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20
Q

What do enterotoxins cause?

A

alteration in metabolic activity of the intestinal epithelial cells resulting in outpouring of electrolytes and fluid

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21
Q

What kind of bugs have enterotoxins?

A

vibrio cholerae (big one), E. coli, salmonella spp., clostridium perfringens, shigella dysenteriae, bacillus cereus, and staphylococcus aureus

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22
Q

What are cytotoxins?

A

toxins that cause mucosal destruction and often result in inflammatory colitis

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23
Q

What do cytotoxins act on?

A

the colon

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24
Q

What bugs have cytotoxins?

A

shigella dysenteriae (big one), C. perfringes, V. parahemolytius, S. aureus, C. diff, campylobacter jejuni, and E. coli

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25
Do enteric pathogens only produce one toxin?
no, many of them produce multiple kinds of toxins
26
How does attachment aid pathogens?
organisms can attach to the body which destroys the cell's ability to normally secrete and absorb
27
How does invasiveness help pathogens?
not all pathogens can make their way out of the intestinal tract, but those that can cause more systematic and often dramatic symptoms
28
What is the biggest cause of food-borne illness in the US?
bacteria and viruses
29
What are the two leading causes of bacterial foodborne illness in the US?
campylobacter jejuni and salmonella spp.
30
What is norovirus?
the leading cause of ALL foodborne illness in the US
31
How is norovirus transmitted?
fecal-oral route and contaminated food
32
What is rotavirus?
most common cause of viral gastroenteritis in kids worldwide
33
How is rotavirus spread?
through the fecal oral route; typically causes diarrhea and vomiting in children
34
What can we do for rotavirus prevention?
get the rotarix vaccine
35
What does helicobacter pylori cause?
gastritis, peptic ulcer disease, and is a carcinogen (causes 75% of stomach cancers not in cardia)
36
How is H. pylori spread?
humans are primary reservoir, spread via fecal-oral route; UREASE POSITIVE
37
What is campylobacter?
most common agent of bacterial gastroenteritis in the US and worldwide
38
Where is campylobacter found?
poultry; can be found in poorly cooked chicken or raw milk
39
Where is Salmonella found?
poultry, eggs, meats, milk, and produce (think typhoid mary)
40
What spreads Shigella?
produce, fecal-oral route, STD and day-care centers
41
What is unique about Shigella?
it requires a VERY low dose to become infective (as low as 10 organisms)
42
What toxin does Shigella carry?
Shiga toxin; leads to a hemorrhages that cause bloody, mucusy, purulent diarrhea
43
Who is a reservoir for Shigella?
ONLY humans
44
EHEC/STEC E.coli is found where?
beef (especially ground meat), raw milk, and produce
45
What is STEC E. coli?
Shiga-toxin producing escherichia coli (O175:H7)
46
What does Clostridium perfringens cause?
a toxin-mediated gastroenteritis; "true food poisoning"
47
Where is Clostridium perfringens found?
raw meats and soil
48
What does Staphylococcus aureus cause?
"food POISONING"; rapidly multiplies and causes food-borne illness
49
What foods is Staphylococcus aureus realated to?
dairy and cream products; passed from food-handlers
50
What is Bacillus cereus?
"true food poisoning", produces highly resistant endospores that survive high cooking temperatures
51
What food is associated with Bacillus cereus food poisoning?
rice! But meat and vegetables can also be associated with it
52
How is Aeromonas hydrophilia passed?
contaminated water; can pass in those participating in water sports
53
Where is Vibrio parahaemolyticus found?
raw or undercooked seafood
54
What does Vibrio cholerae cause?
disease state called cholerae that is toxin mediated; "rice water stools"; sucks water out of body at severe rate
55
Where is Vibrio cholerae found?
in areas of poor sanitation via water or contaminated food
56
How do we help someone who has chloerae?
FLUID REPLACEMENT
57
How is Yersinia enterocolitica spread?
through pork, fecal-oral route, and it grows well at room temperature
58
Where is Listeria monocytogenes found?
soft cheeses, unpasteurized milk, deli meats
59
Who does Listeria monocytogenes typically affect?
pregnant women (neonates!)
60
What can cause a C. diff infection?
after antibiotics, is healthcare related
61
What can C. diff cause?
it can cause pseudomembranous colitis
62
What parasites can cause gastroenteritis?
giardia, entamoeba histolytica, cryptosporidium, and cyclospora
63
How are parasites typically transmitted?
contaminated water, contaminated food, and fecal-oral route
64
What kinds of fruits and vegetables should we be wary of?
off-season fruits and veggies
65
What is the incubation period for Bacillus cereus and Staphyloccous aureus?
causes disease within MINUTES to hours
66
What is the incubation period for Botulism and C. perfringens?
within several hours
67
What is the incubation period for Salmonella, Shigella, V. parahaemolyticus, Campylobacter, and Yersinia entercolitica?
a day or so typically
68
What is the most important piece of treatment for diarrheal infections?
fluid replacement
69
How do we make a Oral Rehydration Solution (ORS)?
6 tsp sugar + 1/2 tsp salt + 1 L clean water
70
In what diseases are antibiotics appropriate?
the are useful in H. pylori and maybe for Shigella and cholera; LIFESAVING in invasive salmonella and typhoid fever
71
In what diseases are antibiotics not always appropriate?
avoided in uncomplicated cases of non-typhoid salmonella and minimum value in V. parahaemolyticus, Y. enterocolitica and invasive E. coli
72
Where do antibiotics have NO value?
in toxin mediated "true food poisonings" such as S. aureus, B. cereus, and C. perfringens

Microbiology (26 decks)

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