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Flashcards in GI 2 Deck (36):
1

types of toxin released from bacillus cereus

emetic toxin and enterotoxin
ST (heat stable) neurotoxin

2

habitat for bacillus cereus

air, soil, water, and dust

3

incriminated food for bacillus cereus

rice and pulses (beans and lentils)

4

incubation period and duration period of b. cereus

incubation is 2-3 hours
and it lasts for 6-24 hrs

5

how do you differentiate staph aureus and b. cereus

the incriminating food, the toxins released, habitat found in

6

how does one isolate and identify b. cereus

non selective medium: blood agar
(sometimes + polymyxin suppresses gram neg bacteria)

7

toxins released by clostridium botulinum

exotoxin and neurotoxin (A, B, C1, C2, D, E, F, G)

8

what is c. botulinum susceptible to

penicillin

9

habitat that c. botulinum is found in

soil (fertilized animal excreta), lower GI tract humans and animals

10

incriminated food of c. botulinum

home canning, meats, vegetables, fish, fruits, and condiments

major concern food processor and consumers

11

most potent c. botulinum toxin

toxin A --> kills humans

12

what happens with muscles with c. botulinum toxin

muscle will not contract and will remain in its relaxed state -- flaccid paralysis

13

c. botulinum toxins found in human, ones found in US, ones found in Europe

humans - A, B, C and rarely F
US - A then B and E
Europe - B (rarely A)

14

symptoms of c. botulinum

nausea, vomiting, abdominal pain, diarrhea
GI disturbances in some patients
serious disease can be fatal within 24 hours

15

how do you diagnose c. botulinum

REPORTABLE DISEASE

presumptive diagnosis: presence of rapidly descending paralysis and history of home canned and fermented food

confirmative diagnosis: toxin in serum/feces or incriminating food (mouse toxin neutralization test)

16

differential diagnosis for c. botulinum

guillian barre - ascending paralysis with elevated CSF protein

myasthenia gravis - descending paralysis occurring with increased activity and positive response to edrophonium

other microbial food poisoning and gastroenteritis: no cranial nerve involvement

chemical and non microbial food poisoning: symptoms occur within minutes

17

what is infant botulism

not food poisoning

ingestion of spores of c. botulinum --> spore germination in GI tract --> vegetative cells --> replicate and release toxin

18

what are symptoms of infant botulism

illness and constipation --> lethargy, sleep more than normal, suck and gag reflex diminish, dysphagia (with drooling) --> head control lost and infant becomes flaccid

19

severe symptom with infant botulism

respiratory arrest

20

diagnosis of infant botulism

toxin in feces

21

treatment of botulism

Botulism Antitoxin Heptavalent (A, B, C, D, E, F, G)-(Equine)

Supportive measures: maintain respiration

Baby Botulism Immune Globulin (BIG-IV) for A & B toxins

22

toxin in long acting mushroom

amantia

23

incubation period for long acting mushroom and symptoms

4-8 hrs
diarrhea, abdominal cramps, can be fatal

24

toxin in short acting mushroom

Museinol, Muscarine, Psilocybin, Coprius artemetaris, Ibotenic acid

25

incubation period for short acting mushroom and symptoms

less than 2 hours
vomiting diarrhea

26

what are mycotoxigenic fungi toxins

mycotoxin: 2ndary metabolites -- aspergillus, fusarium, penicillium

aflatoxin: aspergillus flavus and a. parasiticus

27

foods responsible for mycotoxigenic fungi toxins

tree nuts, peanuts, oilseeds (corn and cotton)

28

complications of mycotoxigenic fungi toxins

acute necrosis, cirrhosis, and carcinoma (liver)

29

toxin in ciguatera poisoning

Dinoflagellates: Gambierdiscus toxicus: Ciguatoxin

30

types of sea creatures involved in ciguatera poisoning

Large predatory reef fish: barracuda, grouper and amberjacks

31

symptoms of ciguatera poisoning

3-6 hrs after ingestion

big thing: hot/cold temp reversal and watery diarrhea

watery diarrhea, nausea, abdominal pain
circumoral, and extremity paresthesia, severe pruritus, hot/cold temp reversal

32

bacteria involved in scombroid poisoning

Stenotrophomonas maltophilia, M. morganii

33

what do the bacteria in scombroid poisoning do

turn histadine --> histamine which is a scrombotoxin

34

types of sea creatures involved in scombroid poisoning

Scrombridae Fish: tuna, mahi-mahi, marlin and bluefin

35

first symptom in scombroid poisoning

metallic taste in mouth

36

other symptoms of scombroid poisoning

watery diarrhea, nausea, dizziness, urticaria (rash), facial flushing, generalised pruritus, paresthesias