IDIS GI Inflammatory Infections of the Intestine

Question 1

Pseudomembranous colitis, look for yellowish plagues on colonoscopy

Answer 1

C. difficile

Question 2

Fulminant colitis, usually diarrhea, diffuse severe abd pain, hypoactive bowel sounds, abd distension and guarding, marked peripheral blood leukocytosis, complications: perforation and toxic megacolon

Answer 2

C. difficile

Question 3

What is the most sensitive test for detecting C. difficile?

Answer 3

PCR or glutamate dehydrogenase screen of fecal sample

Question 4

What are the 3 most common causes of invasive gastroenteritis? Other causes?

Answer 4

Campylobacter (most common overall), Shigella, Salmonella

Others: EHEC, EIEC, Yersinia enterocolitica, Entamoeba histolytica

Question 5

Which E. coli should NOT be treated with antibiotics?

Answer 5

EHEC- you will increase the risk for kidney damage

Question 6

Leading cause of bacterial diarrheal disease. Cattle, chickens, birds, and flies. Found in non-chlorinated water. Acquired from undercooked or raw meat, unpasteurized milk.

Answer 6

Campylobacteriosis

Question 7

Hard to grow, s-shaped (seagull shaped), darting motility in watery and bloody leukocyte-filled stool

Answer 7

Campylobacter jejuni

Question 8

Special test for campylobacteriosis?

Answer 8

Campy-BAP or Skirrow media

Question 9

From contaminated water sources, problem in daycare nursing homes prisons, can be spread by the 4 F’s (food, fingers, feces, flies)

Answer 9

Shigellosis

Question 10

What are the two most common Shigella species in the US?

Answer 10

S. sonnei and S. flexneri

Question 11

Nonmotile, no lactose fermentation, gram-neg rod, resistant to stomach acid

The toxin shuts down protein synthesis leading to cell death, it uses host actin to move from cell to cell

Answer 11

Shigella

Question 12

What is the special way of diagnosing shigellosis?

Answer 12

growth on S-S agar

fecal leukocytes will be present

Question 13

Motile, nonlactose fermenting rod, enteric fevers- person to person from chronic carriers

Answer 13

Salmonellosis

Question 14

6-48 hrs after ingesting contaminated food you will have nausea, abd cramps, vomiting, non-bloody diarrhea

Other Sx- fever, HA, myalgia

Answer 14

Salmonellosis

Question 15

EIEC

Answer 15

enteroinvasive E. coli

Question 16

EHEC

Answer 16

enterohemorrhagic E. coli - has shiga toxin

Question 17

Severe crampy abd pai, watery diarrhea followed by bloody diarrhea, no fever, HUS triad (acute renal failure, thrombocytopenia, microangiopathic hemolytic anemia)

Answer 17

EHEC

Question 18

Watery diarrhea that can on occasion result in dysenteric stools, little to no fever

Answer 18

EIEC

Question 19

Gram neg. rod, no lactose fermentation, urease positive, motile at 25 degrees celsius, not at 37 degrees celsius, can grow at 4 degrees but prefers 25-28 degrees celsius, Bull’s eye appearance on CIN agar

Answer 19

Yersinia enterocolitica

Question 20

Subacute onset diarrhea, occasional blood stools, abd pain RLQ, fever, nausea, vomiting, PHARYNGITIS, 12-22 days, speticemia can develop into septic shock

Answer 20

Yersinia enterocolitica

Question 21

Pseudoappendicitis, post-infectious sequelae

Answer 21

Yersinia enterocolitica

Question 22

Pathognomonic sign for this parasite-trophozoites with intracytoplasmic RBCs

Answer 22

Amebiasis (Entamoeba histolytica)

Question 23

Incubation 1-5 days, diarrhea, abd cramps, vomiting, tenesmus, stools can be watery or dysenteric

Answer 23

Amebiasis

Question 24

What creates flask-shaped ulcers?

Answer 24

amebiasis

Question 25

What has an anchovy paste appearance in aspirations of the liver?

Answer 25

amebiasis

Question 26

You will see parasite in feces, leukocytosis in peripheral blood smear, CXR will show extra-intestinal infections

Answer 26

amebiasis