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GI- Upper Flashcards

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1
Q

What breaks down breast milk for digestion

A

Bifidobacterium

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2
Q

What is needed to digest formula

A

Lactobacilli

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3
Q

Normal flora of the mouth

A 
Strtococcus 
Neisseria
Actinomyces
Veillonella 
Lactobacillus 
Yeast
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4
Q

What kind of bacteria is found in stomach

A

Sterile
Streptococcus
Staphylococcus
Lactobacillus

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5
Q

What predisposes you to H pylori

A

Gastritis

Peptic ulcers

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6
Q

Do you find bacteria in the small intestine

A

No

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7
Q

Bacteria in duodenum

A

Aerobic streptococci
Staphylococci
Lactobacilli
Yeast

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8
Q

What bacteria do you find at LI

A

Anaerobic

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9
Q

Which part of the Digestive system has the most amt of bacteria

A

LI 10^10-10^12

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10
Q

What is Allogenic

A

Factors outside the ecosystem affecting the microbrial composition of GI flora

Diet 
Age
Georgraphic location 
Antibiotics 
Surgery
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11
Q

How does diet change flora of GI

A

Vegetarians have lower bacteroides, higher enterococci

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12
Q

How does antibiotics change flora of GI

A

Makes you susceptible to c. difficile

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13
Q

What is autogenic

A

Factors affecting GI from within the ecosystem
Environment
Activities of microorganisms

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14
Q

At risk groups of lower GI infections

A

CHildren <5
Elderly
Immunocompromised

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15
Q

Food hazards

A 
Microbial contamination 
Naturally occurring toxicants 
Environment contaminants 
Nutritional problems 
Pesticides 
Food additives
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16
Q

What are the routinely screened bacteria from stool samples

A

Campylobacter
Salmonella
Shigella
STECs (if stool is bloody)

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17
Q

What is the highest contamination for GI infections

A

Norwalk virus

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18
Q

What is food poisoning

A 
Toxin in food- short incubation period 
Toxemia 
C. Botulinum 
S. Aureus
B. Cereus
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19
Q

What is food associated infections

A

Consumption of food containing organism

Longer incubation period since organisms need to colonize first

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20
Q

Enteritis

A

Inflammation of intestinal mucosa

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21
Q

Gastro enteritis

A

Inflammation of stomach and intestinal linings

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22
Q

Colitis

A

Inflammation of LI

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23
Q

Enterocolitis

A

Inflammation of small and large intestine

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24
Q

Dysentery

A

Inflammation of GI tract and blood and pus in faeces

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25
Acute Diarrhea
Resolves in 2 weeks | Infectious agents
26
Chronic diarrhea
``` Persistent Lasts longer than 4 weeks Need to know what meds taken Possible syndrome Parasite ```
27
What is the cause of non inflammatory gastroenteritis
Food poisoning
28
What are the infectious causes of gastroenteritis
``` S. Aureus B. Cereus C. Botulinum Wild mushroom Ciguatera Scrombroid Shellfish ```
29
What are the sx of food borne infections
Non inflammatory diarrhea | Inflammatory diarrhea
30
What the the pathogens of inflammatory diarrhea
``` Shigella EIEC Salmonella Campylobactor V. Vulnificus V. Parahaemolyticus Yersinia STEC C. Difficile ```
31
What are the pathogens of non inflammatory diarrhea
``` ETEC EPEC V. Cholerae C. Perfringens B. Cereus Rotavirus Norovirus Adenovirus Astrovirus C.difficile ```
32
Which pathogen is not food borne
c difficile
33
General sx of toxemia
Rapid onset No fever/faecal leukocytes Affects CNS and sometimes CNS and Intestines
34
Characteristics of S. Aureus
Aerobic Coagulase/catalase + Heat stable enterotoxin production
35
Is S. aureus found naturally in humans
yes
36
What are the toxins released by s. aureus
Exotoxins (8) | A&D typically implicated
37
What are the sx from s. aureus
Neurological (Vomiting) Enteric (Diarrhea) Self limiting recovery 24-48 hours
38
Is adenylate cyclase stimulated by s. aureus
No
39
Foods at risk for s. aureus
``` Meat Bakery foods Dairy produce Fruit Veg Salad ```
40
What causes the spread of s. aureus
poor food handling
41
When is highest incidence of s aureus
summer | Winter holiday periods
42
S. aureus confirmation test
Coagulase test
43
Bacillus cereus characteristics
``` Gram + Rods Aerobic Spore former Emetic toxin and enterotoxin ```
44
How does bacillus cereus spread
Air
45
How does b. cereus look under blood agar
Wrinkly
46
Baby sx to botulism
``` constipation Lethargy Suck/gag reflex diminish Head control lost Infant becomes flaccid ```
47
Tx for botulism
Antitoxin hepatavalent | Baby- immune globulin
48
Mushroom toxin characteristics
Short acting- wild mushrooms | Long acting- uncultivated mushrooms (amantia toxin)
49
Mycotoxigenic fungi characteristics
Aflatoxin Contamination of nuts Causes: acute necrosis, cirrhosis, carcinoma of liver
50
Ciguatera poisoning characteristics
Caribbean tropical fish Large predatory reef fish Acute GI sx- Watery diarrhea Neurological sx- paresthesia, temp reversal
51
Scromboid poisoning
Non allergic histamine Tuna mahi mahi bluefin metallic taste
52
Shell fish poisoning
Brevetoxin
53
Paralytic shellfish poisoning
Dinoflagellate algae Saxitoxin Muscular in coordination
54
What does ecoli activate via its toxins
``` Heat Labile (LT)- adenylate cyclase Heat stable (ST)- gunylate cyclase ```
55
Action of E coli toxin
B binding subunit adheres to GM1 receptor of epithillia cells. Allows for subunit A entrance. Entry of A activates G proteins of adenylate cyclase... hyper secretion of electrolytes and water
56
What is a way to contract c. perfringens
Not well cooked pig | Papua new guinea
57
WHat type of c perfringens is food borne
Type A
58
What is the toxin from c. perfringens called?
CPE
59
WHat are the parasitic causes of diarrhea
Cryptosporidium Cyclospora Entamoeba Giardia
60
CHaracteristics of Rotavirus
11 segments | ds RNA
61
What are the important serotypes of rotavirus
G1-G4
62
Epidemiology of rotavirus
ages 4-5 Asia, africa, latin america Developed countries- winter Less developed countries- summer
63
What causes rotavirus
unsafe water
64
When are kids asymptomatic from rota virus
5 years and older | 6months and younger
65
Pathogenesis of rotavirus
Fecal oral Replication on epithelial cells of SMALL intestine peaks in 8 days
66
Histopath of rotavirus
Shortening and blunting of villi
67
Clinical sx of rota
Sudden watery diarrhea
68
Complications from rota
Extreme dehydration (more severe than cholera)
69
Detection of rota
Latex agglutination | EIA
70
Sapovirus is mostly seen in this population (norovirus)
Elderly | in Winter
71
What is the main sx of sapovirus (norovirus)
vomiting
72
Transmission of noro virus
fecal oral | Spares large intestine (no faecal leukocytes)
73
How long does noro last
24-60 hours
74
Best way to detect noro in stool
RT-qPCR
75
Adenovirus characteristics
Icosahedral ds DNA 40/41 serotype, Group F
76
Target of adenovirus in GI
Small intestine
77
Epi of adeno
Children less than 5 | Diarrhea w/ w.o vomiting
78
Astrovirus characteristics
non enveloped star shaped Scotland + RNA
79
Hepatitis A transmission
Fecal oral Non enveloped ss + RNA
80
Hep E
Non enveloped icoshedral Endemic in India
81
Inflammation Diarhea overview
Food associated invasion of intestines Sx- bloody diarrhea Toxin: enterotoxin/ cytotoxin
82
Shigella groups
A-D | A is the most severe
83
What are the virulence factors for Shigella
``` Endotoxin (O toxin) Exotoxin: Neurotoxin causes coma meningismus NAD glycohydrolase (destroys NAD in cells- cell death) ```
84
Main sx of shigellosis sonnei
Watery diarrhea
85
Main sx of shigellosis flexneri
Stool mucus
86
Shigella pathogenesis
Invades distal ileum and colon through specialized epithelial cells (M cells) that overlie mucosal lymphoid follicles → escapes endocytic vesicle → replicates intracellularly, spreads cell-to-cell
87
Action of shiga toxin
cytotoxin- inhibit protein synthesis Enterotoxin: produces diarrhea Exotoxin: inhibit sugar aa absorption in SI Neurotoxin effects
88
Epi shigella sonnei
Children <5
89
Epi shigella flexneri
Homosexuals
90
Transmission of shigella
Food Fingers Flies Feces
91
Diagnosis of shigella
MacConkey agar S-S agar Stool is watery to bloody
92
General characteristics of shigella
``` Gram - No fermentation lactose No utilization of citric acid No H2S production No gas from glucose ```
93
Which shigella produces H2S
Shigella flexneri
94
Which is more infective shiga and enteroinvasive
Enteroinvasive Ecoli only 10 organisms needed for infection
95
Enteroinvasive E coli pathogenesis
Invasion in LI Enters via endocytosis Inhibits protein synthesis Dead wbc, rbcs, mucosal cells in stool
96
3 types of clinical sx of salmonella
Gastroenteritis (s. typhimurium, s. enteritidis, s. newport) Septicemia (s. cholerasuis) Enteric Typhoid fever
97
Review chart in ipad for Salmonella (bookmarked) | Enteroinvasive vs septic vs typhoid
book mark
98
Where does Salmonella replicate
pyers patches
99
Where does salmonella infect
Columnar epithelial cells of the small intestine
100
What is most at risk for carrying enterocolitis
poultry
101
Highest incidence of salmonella
Serotype enteritidis
102
What besides food carries salmonella
reptiles
103
Enteric fever characteristics
Only found in travelers from asia mexico india | S. typhi
104
What is one weird fruit that carries salmonella typhi
Mamey fruit pulp
105
Diagnosis of salmonella
Macconkey agar
106
General characteristics of salmonella
``` Motile Gram - rod No fermentation lactose H2S production Gas from glucose serotype ```
107
Clinical diagnosis of salmonella
Hx of travel Rose colored spots on abdomen Examine blood for absece of eosinophils Positive widal reaction
108
Characteristics of campylobacter
``` Gram - non sporing microaerophilic Does not ferment CH2O Catalase + ```
109
Epi of campylobacter compared to h pylori
Campylobacter- Spike in summer | H pylori same level each season
110
What is the #1 food borne disease
Campylobacter
111
Pathogenesis of campylobacter
Invasion Toxin: Endo/entero (watery diarrhea) Cytotoxin: Verotoxin similar to shiga
112
Clinical sx of campylobacter
sx after 3-5 days of ingestion Profuse diarrhea sometimes Green Fever Prostration
113
Campylobacter lab
Culture: Spreading, grey color Catalase/oxidase definitive diagnosis Microscopy: gram- (presumptive diagnosis)
114
Characteristics of yersinia
Psychrotroph- facultative psychrophile | common in children < 7
115
What is the toxin released by yersinia
ST enterotoxin | Increases cGMP
116
How long does yersinia last
14-21 days
117
What is a complication related to yersinia
Reactive arthritis | Induced polyclonal T cell stimulation (toxin)
118
Lab diagnosis of yersinia
MacConkey look for pinpoints | Specialized media for yersinia
119
General characterisitc of non cholera vibrio
Not agglutinated Halophilic organisms Coastal waters
120
Vibrio parahaemolyticus
Eat raw seafood look out for sushi Watery diarrhea
121
Vibrio vulnificus
Diarrhea INfection of cuts Skin lesions
122
Diagnosis of non vibrios
Screen stool for oxidase TCBS agar Sucrose: differentiating agent Sucrose - : v. parahaemolyticus, v. vulnificus
123
Pathogenesis of EAEC
1. Initial adherence to intestinal mucosa (fimbriae) 2. enhanced mucus production- biofilm 3. cytotoxin production - damage to intestinal cells
124
Prognosis of EHEC
Life threatening Haemorrhagic colitis Uremic syndrome: renal failure
125
Toxin for EHEC
Phage encoded cytotoxin verotoxin VT1: biochem structure similar to shiga toxin VT2: B toxin bound to receptor allows for subunit A into cell. Activates 28 rna
126
Pathogenesis of EHEC
No invasion | Attaches via fimbrae
127
Diagnosis of e coli
``` Pink colonies on mac conkey agar Sortibol macconkey agar ETEC ELISA DNA probe ```
128
What are the antibiotics associated with C diff
ampicillin Cephalosporins clindamycin Amoxicillin
129
Toxins in C diff
Toxin A: Enterotoxin | Toxin B: cytotoxin
130
Clinical sx of c diff
Varies watery diarrhea non bloody hyposlcumineia, leukocytosis
131
Diagnosis of c diff
presence of pseudomembrane
132
Tx of c diff
Discontinue antibiotics | Tx w/ vancomycin, metronidazole
133
Gastric cancer w. H. Pylori seen with
Low acid production | Pan gastritis
134
Peptic ulcer w. h. pylori seen with
high acid production | antral predominant gastritis
135
What allows for h. pylori to survive at low pH
Urease
136
Virulence factor for H. pylori
cagPAI | VacA cytoxin
137
Non invasive tests for h pylori
Breath (rapid presumptive) | Serology (definitive)
138
Invasive tests for h pylori
Urease (rapid presumptive) Culture (definitive) Histo (definitive)
139
Tx for h pylori
Triple/quadruple therapy
140
Gastrointestinal abscess pathogenesis general
Reduced O2 tension/ oxidation reduction potential Impaired blood supply Provides anaerobic environment
141
Common cause of peritonitis
Primary: e coli, tb, n. gonorrhoeae, c. thrachomatis secondary: Spillage of bacteria from GI into peritoneal cavity
142
Common cause of diverticulitis
bacteroides | Ecoli enterococci
143
Common cause of pancreatic absces
``` e coli Klebsiella Enterobacter enterococci streptococci ```
144
Diagnosis of abscess
location of pain WBC count imagining
145
Treatment of abscess
improve vascular perfusion eliminate source of infection Aspirate infected exudate Treat complications
146
Anaerobes are resistant to what
penicillins cephalosporins Amino glycosides
147
Non toxic b. fargils promotes what
Mucosal health
148
Toxic b fragilis causes what
inflammatory diarrhea coloniziation | Toxins 1-3

Micro (14 decks)

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