Inflammatory Diarrhea

Question 1

Inflamm Diarrhea

Answer 1

Loose watery stools, smaller in volume plus PMNs; usually invasive infection of LI. Mucus and Blood present, abd cramps. (Occult blood = blood that’s not visible)

Question 2

Dysentery

Answer 2

Inflammation of colon resulting in abd pain and cramps, straining stools with tenesmus. Watery diarrhea/loose stools containing PMNs, blood and mucus

Question 3

Bacterial Path

Answer 3

Bacteria enter via endocytosis by M cells found in Peyer’s patches (SI) and migrate via lamina propria or cell to cell to LI or be endocytosed via cells w/in the lymphoid aggregates in LI.

Question 4

Shigella Spp. Clin

Answer 4

Shigellosis/ Bacillary Dysentery/ Inflamm Diarrhea - large volumes diarrhea progressing to small volume with blood and tenesmus. May develop shallow intestinal ulcers. Alters Electrolyte balance

Question 5

Shigella Spp. Char

Answer 5

Gram neg rod, four groups : Sonnei, Dysenteria, Flexneri, Bovdii. S and D most prevelent

Question 6

Shigella Spp. Res

Answer 6

Humans only

Question 7

Shigella Spp. Trans

Answer 7

Fecal Oral

Question 8

Shigella Spp. RF

Answer 8

Pediatric; close quarters

Question 9

Shigella Spp. Diag

Answer 9

Hektoen agar - green colonies; lactose negative

Question 10

Shigella Spp. Toxins

Answer 10

1. ShET 1 and ShET 2 (chromosome and plasmid) = early watery diarrhea
2. S. Dys serotype produces Shiga toxin (AB) which inhibs protein synth by inact 60s ribosome subunit, synergizes with LPS to produce inflamm cytokines causing dmg to endothelium lining blood vessels. Assoc with progression to HUS

Question 11

Shigella Spp. Comp/Seq

Answer 11

HUS in children and Reactive arthritis in those with HLA-B27

Question 12

Enteroinvasive E. Coli Clin

Answer 12

Inflamm Diarrhea

Question 13

Enteroinvasive E. Coli Char

Answer 13

Gram neg rod

Question 14

Enteroinvasive E. Coli VF

Answer 14

Rearranges host cell actin for intracell mvmt and cell to cell infection

Question 15

Enteroinvasive E. Coli Res

Answer 15

Humans and Animals

Question 16

Enteroinvasive E. Coli Trans

Answer 16

Fecal-Oral

Question 17

Enteroinvasive E. Coli RF

Answer 17

Anyone; ground beef

Question 18

Enteroinvasive E. Coli Diag

Answer 18

Lactose pos, indole pos

Question 19

Salmonella Enterica spp. Clin

Answer 19

Salmonellosis = Inflamm diarrhea, small volume diarrhea and occult blood

Question 20

Salmonella Enterica spp. VF

Answer 20

1. SopE gene protein - increases cAMP

2. SopB gene protein - actin rearrangement; host cell invasion

Question 21

Salmonella Enterica spp. Res

Answer 21

Animals - poultry, dairy, reptiles

Question 22

Salmonella Enterica spp. Trans

Answer 22

Fecal Oral

Question 23

Salmonella Enterica spp. RF

Answer 23

Eggs

Question 24

Salmonella Enterica spp. Diag

Answer 24

Hektoen - black colonies via H2S, lactose neg

Question 25

Salmonella Enterica spp. Comp/Seq

Answer 25

Reactive Arthritis (HLA-B27)

Question 26

Campylobacter Jejuni Clin

Answer 26

Campylobacterosis = Inflamm Diarrhea (10+per day)

Question 27

Campylobacter Jejuni Char

Answer 27

Gram neg comma shaped rod

Question 28

Campylobacter Jejuni Res

Answer 28

Animals - poultry, pets, human carries

Question 29

Campylobacter Jejuni RF

Answer 29

young and Icomp; unpasteurized milk

Question 30

Campylobacter Jejuni Diag

Answer 30

Culture at 42C

Question 31

Campylobacter Jejuni Seq/Comp

Answer 31

``` Gullian-Barre Syndrome - ascending flaccid paralysis Reactive Arthritis (HLA-B27) ```

Question 32

Yersinia Enterocolitica Clin

Answer 32

Inflamm diarrhea +/- blood

Question 33

Yersinia Enterocolitica Char

Answer 33

gram neg rod w/ bipolar staining

Question 34

Yersinia Enterocolitica Res

Answer 34

Animals, milk, pork, pets, chitlins

Question 35

Yersinia Enterocolitica Trans

Answer 35

Fecal Oral, transfusions

Question 36

Yersinia Enterocolitica RF

Answer 36

Dairy, pork, serious disease seen primarily in children

Question 37

Yersinia Enterocolitica Diag

Answer 37

Grow at 4C

Question 38

Yersinia Enterocolitica Comp/Seq

Answer 38

1. Mesenteric lymphadentitis/pseudoappendicitis in adolescents/young adults 2. Reactive Arthritis (HLA-B27) 3. Bacteremia can occur with progression of disease or if infection is transmitted through transfusion

Question 39

Entameoba Histolytica Clin

Answer 39

Amoebiasis = Amoebic dysentery - Inflamm diarrhea with blood. Serious Disease leads to ulceration of LI (flask shaped lesions) and liver abscesses (RUQ pain)

Question 40

Entameoba Histolytica Char

Answer 40

Ameoboid protozoan

Question 41

Entameoba Histolytica Res

Answer 41

Human carriers; cysts can survive in soil and water

Question 42

Entameoba Histolytica Trans

Answer 42

Fecal Oral

Question 43

Entameoba Histolytica Diag

Answer 43

Cysts or motile trophozoites (visualized engulfed RBCs help) in stool. Followed by Elisa assay for Ag

Question 44

Entameoba Histolytica Tx

Answer 44

Amebicides