Gastrointestinal Infections Flashcards
Botulism Campylobacter jejuni Shigellosis Salmonellosis Typhoid Fever Cholera (139 cards)
1
Q
Botulism Reportable/ Notifiable in Texas?
A
Call immediately (special number)
2
Q
Campylobacter jejuni (Campylobacteriosis)
A
One week report
3
Q
Shigellosis
A
One week report
4
Q
Typhoid Fever
A
One week report
5
Q
Cholera
A
Within one workday report
6
Q
What causes Botulism?
A
Clostridium botulinum
7
Q
What is Botulism named afterwards?
A
latin word sausage: botulus
8
Q
Where do you found botulism?
A
spore-forming bacillus found in soil
9
Q
What are the four types of botulism that causes human disease?
A
A, B, C, F
10
Q
What organism can be weaponized?
A
Botulism
11
Q
What organism is used for comestic use?
A
Clostridium botulinum
12
Q
What does botulin toxin block?
A
acetylcholine (irreversible!)
13
Q
What is the most common form of Botulism in the U.S. and the world?
A
Infant botulism
14
Q
What form of botulism can come from IV drug use?
A
wound botulism
15
Q
What form of botulism can come from home canned vegetables?
A
food- borne botulism
16
Q
What is the first presenting symptom of botulism ingestion?
A
Constipation
17
Q
What are 3 characteristic signs of botulism?
A
- Fix dilated pupils
- Ptosis
- Cranial nerve palsies w/ impairment of extra-ocular muscles
18
Q
What causes death in botulism poisoning?
A
Respiratory failure
19
Q
T/F Most cases of infant botulism have NO history of honey exposure?
A
True
20
Q
What is the definitive diagnosis for Clostridium botulinum?
A
isolating it in the stool
21
Q
What is the biggest differential for botulism?
A
Myasthenia gravis
22
Q
What is the most important thing for diagnosing botulism?
A
High Index of Suspicion!
23
Q
What medical treatments are used for adult and child botulism?
A
BIG- IV and BabyBIG ( botulism immune globulin)
24
Q
How many hours do you have for treating botulism?
A
24 hours
25
What are to treatments used for botulism?
- Immunoglobulin IV
| - Intubation and mechanical ventilation
26
When are antibiotics used in the treatment of botulism?
ONLY in wound botulism (along with antitoxin)
27
T/F there is a vaccine for botulism?
False
28
How long does acute diarrhea last?
< 2weeks
29
How long does chronic diarrhea last?
> 2weeks
30
What is mild diarrhea last?
< 3 stools per day
31
What is moderate diarrhea?
> 4 stools per day w/ local symptoms ( abdominal cramps, nausea, tenesmus)
32
What is severe diarrhea?
>4 stools per day w/ systemic symptoms (fever, chills, dehydration)
33
Pt experiences vomiting after 1-6 hrs after food consumption, what type of food poisoning do they have?
preformed toxin induced
34
Pt experiences diarrhea after 8-16 hours after eating, what type of food poisoning do they have?
organism is in the food induced (organism then produces toxin)
35
What is the definitive diagnosis for infectious diarrhea?
stool culture
36
What is the symptom for infectious diarrhea?
Watery or blood or lots of mucus stool
37
What is the treatment for infectious diarrhea?
Symptomatic therapy- rehydration
38
What is the leading cause of acute diarrhea worldwide?
Campylobacter enteritis
39
Who dies due to campylobacter jejuni?
elderly or others with comorbid conditions
40
Where does the biggest consumption of campylobacter jejuni come from?
Chicken consumption (48%)
41
Where does the second largest consumption fo campylobacter jejuni come from?
Unknown (24%)
42
What are the symptoms of campylobacter enteritis?
- frequently bloody diarrhea
- abdominal pain
- periumbilical cramping
- fever
- nausea (common)
43
T/F Campylobacter enteritis is self limited?
True
44
How long does campylobacter enteritis last?
~ 7 days
45
Who is a chronic carriage of campylobacter enteritis?
immunocompromised
46
What is the treatment for campylobacter enteritis?
Treatment not required in mild, self-limited infection
- ONLY proper hydration
- Correction of electrolyte balance
47
What are 3 unique manifestations of campylobacter enteritis?
- Pseudoappendicitis
- Colitis
- Lymphoma
48
What two complications seen in late onset of c. enteritis?
- Reactive arthritis
| - Guillain- Barre Syndrome
49
Cholecystitis and Septic pseudoaneurysm is a acute or chronic complication of C. enteritis?
Acute
50
What is the gold standard for diagnosing C. enteritis?
Stool culture (only if necessary)
51
Which medication do you not give in C. enteritis?
anti-motility agents
52
When do you use antibiotics for C. enteritis?
pts with severe disease or risk for severe disease
53
What are risk for severe disease in C. enteritis?
- elderly
- pregnant
- immunocompromised
54
What is the antibiotic of choice for C. enteritis?
azithromycin
55
What is the common cause of bacterial diarrhea worldwide?
Shigella species
56
Where does Shigella spread commonly occur?
predominately institutions (day care, custodial institutions)
57
What is the less common source of contamination for Shigella?
Food or drinking water
58
What does Shigella predominately infect?
lower gastrointestinal tract
59
What is a complication of Shigella?
- Proctitis or rectal prolapse
| - Toxic megacolon
60
What is the definitive diagnosis of Shigella?
Stool culture
61
What symptom can be seen in Shigella?
Frequent, small volume, bloody stools
62
What is the treatment for Shigella?
-Fluid hydration
63
Imodium
a intestinal anti-motility drug to avoid in Shigella
64
What are two cons of using antibiotics for Shigella?
- Increasing antimicrobial resistance of Shigella species
| - Antibiotic therapy is not essential since infection clears spontaneously
65
What are two pros of using antibiotics for Shigella?
- Antibiotics decrease the duration of fever, diarrhea by about two days
- Shortening the duration- reduce the risk of spread
66
What are two fluroquinolones used for Shigella?
-Levofloxacin
-Ciprofloxacin
(Azithromycin)
67
What causes salmonellosis
Salmonella enterica
68
What are the three serotypes isolated from salmonellosis?
- typhi
- typhimurium
- choleraesuis
69
What are the three patterns of infection of Salmonellosis?
- Enteric Fever (typhoid fever)
- Acute enterocolitis
- "Septicemic" type
70
What causes enteric fever (typhoid fever)?
Salmonella typhi
71
What causes acute enterocolitis?
typhimurium
72
What causes "septicemic" type?
choleraeusis
73
What is salmonellosis transmitted?
orally (contaminated food/drink)
74
Whom is Typhoid fever common?
children and young adults
75
What is the biggest cause of typhoid fever?
poor access to sanitation
76
Who has the most likelihood of contracting typhoid fever?
travelers to countries where typhoid fever is endemic
77
Where can typhoid fever be found?
impoverished areas
78
Which region has the most infections in returning travelers?
South Central Asia
79
What symptoms are experienced during the Prodromal stage of typhoid fever?
- Increasing malaise
- Headache
- Cough
- Sore throat
80
When does fever ascend in a stepwise fashion in Typhoid fever?
Prodromal stage
81
Where is pea soup diarrhea seen?
typhoid fever
82
Which illness reaches a plateau in 7-10 days?
typhoid fever
83
What appears commonly during the second week of disease for typhoid fever?
rash (rose spots)
84
What is found on the trunk, is a pink papule 2-3 mm in diameter, and fades on pressure?
rash rose spot
85
How long does it take for rash rose spots to disappear?
3-4 days
86
Where is typhoid fever usually found in?
women
87
What occurs during the stage of chronic carriage in typhoid mary?
excretion of organism in stool or urine
88
What is chronic carriage in the urine associated with?
defect in the urinary tract
89
Who is Typhoid Mary?
Mary Mallon (New York)
90
What causes 75% of deaths of Typhoid fever?
complications of untreated cases
91
What are two dangerous complications of Typhoid?
- Intestinal hemorrhage
| - Intestinal perforation
92
T/F immunization is available for typhoid?
True (not always effective)
93
What is critical in typhoid fever?
good sanitation
94
What is the most sensitivity available diagnostic tool for typhoid?
Bone marrow culture
95
When is bone marrow culture used?
in suspected disease that is unresponsive to antibiotic therapy
96
What is the biggest thing to consider in typhoid disease diagnosis?
Travel history
97
What is the first line treatment for typhoid?
Fluoroquinolones
98
What are 4 possible treatments for typhoid?
- Fluoroquinolone
- Chloramphenicol
- Ampicillin
- Ciprofloxacin
99
What medication is used in chronic carrier state of typhoid?
- Ampicillin plus probenecid
| - Ciprofloxacin
100
What is the most common form of salmonellosis?
acute enterocolitis
101
What is the incubation period for salmonella gastroenteritis?
8-48 hrs
102
What is the diagnosis for salmonella gastroenteritis?
stool culture
103
What is the treatment for salmonella gastroenteritis?
self limiting (symptomatic care only)
104
What antibiotic is used for immunocomprised patients with salmonella gastroenteritis?
Fluoroquinolone
105
Which disease has prolonged or recurrent fevers?
Salmonella Bacteremia
106
What is a complication of Salmonella Bacteremia?
Endovascular infection
107
Where is mycotic abdominal aortic aneurysms is found?
Salmonella Bacteremia
108
What is the treatment of Salmonella Bacteremia?
Fluoroquinolone (plus drainage any abscesses)
109
What causes Cholera?
Vibrio cholerae (gram -) TOXIN
110
How is cholera transmitted?
contaminated food and water
111
What causes acute secretory diarrheal illness?
Cholera
112
What are 3 things that happen within 24 hrs of cholerae infection?
- Profound fluid loss
- Electrolyte losses in the stool
- Rapid development of hypovolemic shock
113
Inadequate access to clean water sources?
Vibrio cholerae
114
Which disease has the highest number of deaths related to diarrhea?
Vibrio cholerae
115
Rice water stools?
cholera
116
Vomiting frequently with watery emesis?
cholera
117
Fishy odor stools?
cholera
118
Sunken eyes, dry mouth, cold clammy skin, decreased skin turgor?
cholera
119
What is the definitive diagnosis for cholera?
stool culture
120
Hypokalemia, hyponatremia or hypocalcemia, and acidosis is seen in what disease?
Cholera
121
What is the treatment for cholera?
aggressive volume repletion (orally or IV)
122
WHO recommends what in children with cholera?
Zinc (20mg daily
123
What reduces the duration of symptomatic cholera by 1.5 days and limit life threatening dehydration?
Antibiotics
124
What antibiotic is used in adults with cholera?
doxycycline or tetracycline
125
What antibiotic is used in children with cholera?
azithromycin
126
What antibiotic is used in pregnancy with cholera?
azithromycin or erythromycin
127
T/F there is a vaccine for cholera?
True
128
What are the vaccines for cholera?
Dukoral and Shanchol/ mORCVAX
129
T/F 95% of infant botulism occurs in infants younger than 6 months?
True
130
What is associated with botulism?
Honey
131
Where is food-borne botulism often come from?
home canned foods
132
How is food borne botulism treated?
equine botulinum antitoxin and supportive care
133
What section of the colon does Shigella infect?
rectosigmoid colon
134
What is the most common identified food-borne illness in the U.S.?
Salmonella
135
What is the most common cause of traveler's diarrhea?
Salmonella
136
What is the 1st most common bacteria isolated from diarrheal stool samples in the U.S.?
Campylobacter
137
What is the 2nd most common bacteria isolated from diarrheal stool samples in the U.S.?
Salmonella
138
What is the peak frequency months of Salmonella?
July to November
139
What are synonymphs for typhoid fever?
```
typhoid
typhus abdominalis
enteric fever
nervous fever
slow fever
```
