Micro 7 - Diarrhea

Question 1

What does Enterohemorrhagic E.coli (EHEC)cause?

Answer 1

Bloody diarrhea and severe illness. It produces shiga-like toxin. Can lead to hemolytic uremic syndrome (HUS); anemia, thrombocytopenia, acute renal failure.

Question 2

What is the treatment for Enterohemorrhagic E.coli (EHEC)?

Answer 2

Supportive.

Question 3

What type of food is most commonly infected with enterohemorrhagic E.coli (EHEC)?

Answer 3

From infected meat.

Question 4

What is the most common serotype of Enterohemorrhagic E.coli (EHEC)?

Answer 4

O157:H7.

Question 5

What does Enterotoxigenic E.coli (ETEC) cause?

Answer 5

Watery diarrhea due to heat-labile and heat stable enterotoxins. Does not infect the intestinal wall and is the most common type of traveler’s diarrhea.

Question 6

What does Enteropathic E.coli (EPEC) cause?

Answer 6

Produces watery diarrhea, but no toxin produced; the bacteria adhere to the apical surface and flatten the villi, preventing absorption. It is common in children.

Question 7

What does Enteroinvasive E.coli (EIEC) cause?

Answer 7

Bloody diarrhea and fever die to intestinal wall invasion.

Question 8

To what other bacteria is Enteroinvasive E.coli (EIEC) related to?

Answer 8

Shigella.

Question 9

What is the treatment for Enteroinvasive E.coli (EIEC)?

Answer 9

Flouroquinolones, TMP-SMX, azithromycin.

Question 10

What does Shigella cause and why?

Answer 10

It causes watery diarrhea that turns to bloody diarrhea because it invades the intestinal mucosa, causing inflammation and necrosis.

Question 11

How is Shigella transmitted? How many of these bacteria are needed to cause disease?

Answer 11

Can spread from person to person contact and contaminated food and water. It is very virulent, only needs 10 of these to cause symptoms.

Question 12

What is the structural difference between Shigella and salmonella?

Answer 12

Shigella does not have flagella.

Question 13

How long does Shigella infection last?

Answer 13

From one to two weeks.

Question 14

Which type of Shigella is associated with Reiter syndrome?

Answer 14

Shigella flexneri.

Question 15

What does Salmonella cause?

Answer 15

Bloody diarrhea and fever. It is a non-lactose fermenter (like Shigella). The diarrhea begins 1 to 3 days later.

Question 16

What foods are associated with Salmonella infections?

Answer 16

Egg salads and poultry.

Question 17

What settings is associated with Salmonella other than foods?

Answer 17

Pet stores, especially turtles.

Question 18

What can salmonella cause in sickle cell patients?

Answer 18

Osteomyelitis because the salmonella has flagella.

Question 19

What type of reactive arthritis can salmonella cause?

Answer 19

Reiter syndrome.

Question 20

What are “rose spots” on the abdomen indicate?

Answer 20

Typhoid fever (Salmonella typhi).

Question 21

What are four special traits of Campylobacter jejuni?

Answer 21

G(-), Z-shaped, Oxidase positive, and grows in 40C.

Question 22

What does Campylobacter jejuni cause?

Answer 22

Causes bloody diarrhea, especially in children.

Question 23

What syndrome is associated with Campulobacter jejuni?

Answer 23

Guillain-Barre syndrome.

Question 24

What does Vibrio cholerae cause and why?

Answer 24

Watery diarrhea, “rice-water”; it permanently activates cAMP.

Question 25

What is the treatment for Vibrio cholerae?

Answer 25

Aggressive oral rehydration.

Question 26

What does Yersinia enterocolitica cause?

Answer 26

Bloody diarrhea and mesenteric adenitis (Can mimic appendicitis).

Question 27

What does Klebsiella pneumoniae cause?

Answer 27

Normal intestinal flora, but can cause lobar pneumonia when aspirated, especially in people with weakened immune systems. This causes red currant jelly sputum, and necrosis in the lungs. Is a major cause of UTIs.

Question 28

What does Toxin A of Clostridium difficile do?

Answer 28

Toxin A (AKA enterotoxin), Binds to the brush border of the gut, leads to intestinal fluid secretion and inflammation.

Question 29

What does Toxin B of Clostridium difficile do?

Answer 29

Toxin B (AKA cytotoxin) causes death of enterocytes by targeting its cytoskeleton. This results in pseudomembranous colitis; necrosis with exudates, fibrin, and leukocytes.

Question 30

How do we diagnose pseudomembranous colitis and what is the treatment for it?

Answer 30

We test for C.diff toxin in the stool. Treatment is Metronidazole or Vancomycin (orally).

Question 31

What type of foods are associated with Staph aureus toxin infection?

Answer 31

Meats, mayonnaise, custard and potato salad.

Question 32

What food is associated with Bacillus cereus?

Answer 32

Reheated rice.

Question 33

What foods are associated with Vibrio parahaemolyticus and vulnificus?

Answer 33

Shellfish.

Question 34

What foods are associated with Clostridium botulinum?

Answer 34

Improperly canned foods.

Question 35

What foods are associated with Clostridium perfringens?

Answer 35

Reheated meat dishes.

Question 36

What foods are associate with E.coli 0157:H7?

Answer 36

Undercooked contaminated hamburger meat.

Question 37

What organism would cause food poisoning as a result of mayonnaise sitting out too long?

Answer 37

Staph aureus.

Question 38

What organism would cause diarrhea caused by G(-) nonmotile organism that does not ferment lactose?

Answer 38

Shigella.

Question 39

What organism would cause Rice-water stools?

Answer 39

Vibrio cholerae, could be ETEC.

Question 40

What organism S-shaped organism causes diarrhea?

Answer 40

Campylobacter.

Question 41

What organism would cause diarrhea transmitted from house hold pets?

Answer 41

Yersinia enterocolitica.

Question 42

What organism would cause food poisoning resulting from reheated rice (chinese food)?

Answer 42

Bacillus cereus.

Question 43

What motile G(-) organism causes diarrhea that does not ferment lactose?

Answer 43

Salmonella.

Question 44

What is the most common cause of "traveler's diarrhea"?

Answer 44

ETEC.

Question 45

RFF: Food poisoning due to exotoxin.

Answer 45

Staph aureus and bacillus cereus.

Question 46

RFF: Osteomyelitis in sickle cell disease.

Answer 46

Salmonella.