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GI INFECTIONS Flashcards

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1
Q
A

D. The presence of linear esophageal ulcers with a yellow exudate

B. indicative of HSV

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2
Q
A

A. Remove the catheter

Common fomite for Candida

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3
Q
A

C. S. pneumoniae capsular polysaccharide

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4
Q

What antiviral can cause obstructive crystalline nephropathy and AKI?

A

Acyclovir/valacyclovir

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5
Q

Common complications of C. diptherae

A

-Facial numbness
-Arrhythmia
-Airway obstruction

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6
Q
A
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7
Q

Tx for C. diptherae

A

-Diptherae antitoxin
-Erythromycin

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8
Q
A

C. Human adenovirus

Coxsackie A - Nake virus with + ssRNA genome

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9
Q

Which diagnostic test would most likely result in a diagnosis of Whipple’s disease?

A

Duodenal biopsy

Tropheryma whipplei cannot be lab cultured

Subsequent PCR to ID Tropheryma whipplei

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10
Q

Test for Helicobacter pylori infection would be most appropriate for determining treatment success:

A

Stool antigen test

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11
Q

A 50-yr old male has been having chronic arthralgias and arthritis for many years without relief despite many attempts at diagnoses and treatments. Now the patient is losing weight and has chronic diarrhea with signs of malnutrition. Which of the following bacteria is most likely the etiologic agent of these symptoms?

A

Tropheryma whipplei

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12
Q

A 60-yr old male was diagnosed with IBS a few years ago and is also being treated for GERD. He is now experiencing significant abdominal distention, bloating and pain. What test would be the best and least invasive for detection of bacterial overgrowth in the small intestines?

A

The detection of hydrogen in the breath

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13
Q

What virulence factor of Helicobacter pylori affords the bacterium the ability to survive the severity of stomach acids?

A

Urease

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14
Q

55 y/o female presents with hematamesis, BP 96/60, HR 108.

What diagnostic test should be performed?

A

Esophogaduodenoscopy (EGD)

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15
Q
A

A. Serum H. pylori antibody test

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16
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17
Q

Somatostatin ______ enterochromaffin like cells

A

Somatostatin inhibits enterochromaffin like cells

Increase in somatostatin decreases gastric, which decreases HCl

enterochromaffin like cells secrete histamine, which activates parietal cells to secrete HCl

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18
Q
A

C. Decreased somatostatin input from D cells

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19
Q

Corpus-predominant atrophic gastritis caused by H. pylori can lead to?

A

Gastric adenocarcinoma

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20
Q

Nonatrophic gastritis caused by H. pylori can lead to?

A

MALT lymphoma

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21
Q
A

B. Gastritis, duodenal ulcer, gastric ulcer, MALT tumor, adenocarcinoma of the stomach

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22
Q
A

D. Decreases recurrence rate by greater than 50%

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23
Q
A

B. Are low-grade B-cell lymphoma

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24
Q
A

C. Atrophic gastritis - gastric metaplasia - adenocarcinoma

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25
What bacteria produces a double-zone (bull's eye) beta hemolysis?
*Clostridium perfringens*
26
How does C. jejuni cause Guillain-Barre syndrome?
Ab developed to O:19 LPS cross react to glycosphingolipids on neural tissues | Destruction of Schwann cells
27
Characteristics of *C. jejuni*
* Gram (-) ribbon-shaped bacteria * Oxidase (+) * Catalase (+) * Micro-aerophilic * Thermophilic
28
MOA of Shiga-like toxin
Shiga toxins are (a A/B toxin that blocks protein synthesis Subunit B - binds globtriaosylceramide (surface receptor found in high conc. on renal endothelial and intestinal villus cells) Subunit A1fragment binds to the 28S ribosomal subunit and inhibits protein synthesis
29
Unlike other E. coli, O157 is unable to ferment what?
Sorbitol
30
Which shiga-like toxin is associated with HUS?
Stx-2 produced by EHEC ## Footnote EHEC strains that express both Shiga toxins and attaching and effacing activity (i.e. adhesion) are more pathogenic.
31
What bacteria produces shiga toxin?
*Shigella dysenteriae*
32
Shiga toxin produced by S. dysenteriae MOA
Inhibits protein synthesis by cleaving the 60S ribosomal subunit
33
About 3-hours following a family picnic with fried chicken, potato salad, green beans, and lemon pie, a 30 yr old female has nausea and vomiting and feels terrible. Which of the following bacteria is most likely responsible for this illness?
*Staphylococcus aureus*
34
Should Abx be used in EHEC infection?
No ## Footnote Antibiotic treatment in these cases can increase the risk of hemolytic uremic syndrome (HUS), a serious complication associated with EHEC infections. Therefore, supportive care is the recommended management approach for these patients.
35
A. *Bacillus cerues*
36
D. This condition is the most common cause of acute renal failure in children
37
What is the only microaerophilic/thermophilic pathogenic bacteria that causes GI sxs?
*Campylobacter jejuni*
38
What growth medium can be used to help ID EHEC?
Sorbitol MAC - EHEC does not ferment sorbitol (appears colorless on SMAC)
39
A. Binds to the 60S.... D. Binds to the 28S ribosomal subunit (part of the 60S ribosomal subunit) and prevents protein synthesis
40
A and C (SS = Salmonella/Shigella agar - Salmonella produces black colonies)
41
A. Intestinal enterocytes B. M-cells
42
How is Shigellosis primarily transmitted?
Human-to-human and contaminated water
43
What bacteria is associated with "actin comets"
Shigella and Listeria ## Footnote Also Rikettsia Rickettsi
44
C. Is aerobic (*C. perfringens* is anaerobic)
45
D. It produces a double zone hemolysis
46
Upon steroid use for asthma-like symptoms or when someone has hyper-infection from auto-infections, which parasite may cause a skin rash of larva moving through the skin?
*Strongyloides stercoralis*
47
In tape worm infections, what is the most common means by which one can self-diagnose?
the discovery of **proglottids** in the stool
48
A patient with round worm intestinal infections should be treated with what drug?
Albendazole ## Footnote The action of praziquantel is specific to trematodes and cestodes; nematodes (including filariae) are not affected.
49
*Ancylostoma duodenale*
50
*Trichuris trichiura*
51
Humans with adult *Taenia solium* worms in the GI tract acquired them how?
Ingestion of improperly cooked pork
52
*Ascaris lumbricoides*
53
Which of the following is associated with fecal/oral transmission? a) *Necator americanus* b) *Enterobius vermicularis* c) *Ancylostoma duodenale* d) *Strongyloides stercoralis*
*Enterobius vermicularis*
54
How does *Enterobius vermicularis* reinfect host?
Reinfection can occur by hatched larva entering the anus
55
How is *Taenia solium* transmitted in cysticercosis?
Eggs are ingested fecal/orally human-to-human ## Footnote - Humans with T.s. tapeworms often have eggs on their exteriors (under finger nails, between fingers and toes) despite good hygiene. - Approximately 20-25% of persons with adult worms have some form of cysticercosis. - Immunity to onchospheres may be the reason why numbers are this low.
56
A. *Ascaris lubmricoides* | ~25% world population (not very common in US) infected
57
C. Muscle encystment ## Footnote Insomnia and teeth grinding are also sxs
58
Mnemonic for parasite transmission
59
Which parasite causes "wandering worms"
60
C. *Strongyloides stercoralis* ## Footnote Secondary bacterial infection can occur with parasites that penetrate the skin
61
A. *Strongyloides stercoralis* | Roundworm
62
D. The hookworm
63
C. *Trichuris trichiura* | The whipworm ## Footnote Does not penetrate into tissues
64
C. *Trichuris trichiura* | The whipworm
65
A. Enterobius & Strongyloides | Pinworm = Enterobius
66
D. *Taenia solium* | *Taenia saginata* is "beef tapeworm"
67
D. *Listeria*
68
D. *Listeria monocytogenes* & *Streptococcus agalactiae* ## Footnote Can also perform catalase test to differentiate (Listeria = cat +, *S. agalactiae* = cat-)
69
C. 3rd trimester | Immunocompromised host
70
C/D - both surgery and needle aspiration | Preoperative Tx w/ albendazole ## Footnote Larger cyst - removal Small cyst - aspiration
71
D. Granuloma
72
A. Lakes, ponds, rivers
73
C. Gall bladder
74
What is the most common CC of S. typhi infection?
Fever | Debilitating, sustained high fever (can last 4-8 wks.)
75
Why is there a late response in stool Ag during the course of infection w/ *S. typhi*?
76
What hepatitis virus requires co-infection with Hep B to repilicate and produce viral progeny?
Hep D
77
Which hepatitis virus is most likely to evade host T-cell mediated responses?
Hep C
78
There is an outbreak of hepatitis associated with consumption of raw oysters. Which is the MOST LIKELY etiologic agent of this outbreak?
Hep A
79
You suspect a patient has hepatitis C virus (HCV) infection. Testing patient serum for which target is BEST used to confirm that the patient is currently HCV infected?
HCV RNA RT-PCR
80
A patient from Nashville, TN develops hepatocellular carcinoma. Which virus is the MOST LIKELY etiologic agent of this disease?
Hep C
81
eutralizing antibody to which protein will MOST LIKELY prevent hepatitis D virus replication?
HBs
82
Hepatitis E virus infection has a greatly increased risk of causing fulminant hepatitis in which specific patient population?
Pregnant women
83
A patient with chronic hepatitis B virus infection is put on anti-viral drug therapy. Their viral load decreases but they develop liver swelling and steatosis (fatty liver). Which class of anti-viral drugs is MOST LIKELY responsible for the observed liver pathology?
Nucleoside/tide reverse transcriptase inhibitors (NRTIs) ## Footnote Associated w/ myelosuppression, lactic acidosis, and **hepatomegaly w/ steatosis**
84
A 26 year old woman comes into the JCMC emergency room presenting with vomiting, jaundice and fever. Her symptoms started suddenly 4 days ago. The patient has no history of travel outside the US in the last 6 months. Given this information, which virus is the MOST LIKELY etiologic agent
85
A combination of vaccine and anti-viral human immune globulin is used for post-exposure prophylaxis for which virus?
HBV ## Footnote Post-exposure Prophylaxis (PEP) for perinatal, natal, sexual, or needle stick exposure is composed of the HBV vaccine and HBIG; see above. PEP should be administered within 12 hours of birth (for perinatal exposure) or within 24 hours after other exposure (if possible)
86
(T/F) The Hepatitis A and hepatitis B vaccines can cause hepatitis in severely immunosuppressed individuals
False ## Footnote Hep A vaccine - inactive virus Hep B vaccine - subunit HBV vaccine is composed of recombinant HBsAg
87
D. Hepatitis B
88
B. HBsAg +; HBeAg +; anti-HBc IgM -; anti-HBc + ## Footnote 90% of those in acute phase Hep B infection (answer choice A) will clear virus w/o Tx
89
Tx of choice for CMV infection:
Ganciclovir
90
NS4a inhibitor used to Tx Hep C
Pibrentasvir
91
Which hepatitis virus can be Tx'd with ribavirin and PEG-INF-alpha
Hep C | (Old-school Tx, low efficacy ~40% remission)
92
What RTI can be used to Tx both HIV and Hep B
Tonofavir
93
First-line Tx against Hep C
Glecapredvir + pibrentasvir ## Footnote Glecapredvir - contraindicated in decompensated liver disease
94
B. Vaccinate all exposed, seronegative children ## Footnote HAV is extermely contagious (fecal-oral transmission)

M1 GI (4 decks)

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