Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

S4M2 > Aniket's Fried Rice > Flashcards

Aniket's Fried Rice Flashcards

1
Q

Factors that contribute to foodborne illness outbreaks in the US

A

“Boil, peel, cook, or forget it!”

  • Inadequate handling/refrigeration
    • cook too early
    • infected person with poor hygiene
    • Not cooked through
    • Not stored well
    • Not reheated
    • Raw ingredients contaminated
  • Heat food to 165F, store at 4F!
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Treatment of foodborne illnesses

A
  • Self-limiting
  • Fluid & electrolyte replacement
  • Clostridium botulinum anti-toxin
  • Antibiotics:
    • salmonella, shigella, listeria, campylobacter, vibrio
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pathogenesis of invasive foodborne diseases

A

Inflammatory

  • Tissue invasion -> mucosa & neighboring cells destroyed
    • Cytotoxin -> destroy mucosal cells
  • Direct penetration thru distal small intestines -> bacteremia + dissemination

@ Distal small intestine, colon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pathogenesis of toxin-mediated foodborne disease

A

Non-inflammatory

  1. Toxin mediated -> no tissue invasion;
    acts on secretory mechanism to change water flow
    1. In vitro: toxin in food made my vegetative cells. (premade)
    2. In vivo: vegetative cells in food are ingested. toxin made in gut
    3. Adherence

@ proximal small intestine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Toxin-mediated vs invasive:

  1. incubation period
  2. features
  3. illness
A

Toxin-mediated:

  1. Incu: in vitro 1-6h, in vivo 8-16h
  2. Feat: uppter GI -> N&V +/- diarrhea, NO fever/chill
  3. Diarrhea: watery

Invasive

  1. Inc: 16-48h
  2. Feat: Lower GI -> abd pain + diarrhea -> BLOODY +/- mucus/pus, fever and chills
  3. Diarrhea: Inflammatory +/- bood, Dystenteric + blood
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
  1. Inflammatory Diarrhea
  2. Dysentery
  3. Stool Smear of Toxin-mediated
  4. Stool Smear of Invasive
A
  1. Inflammatory => Inflammation of colon, distal small intestine, diarrhea +/- blood
  2. Dysentery => colonic inflammation w/small volume stools + blood/pus/mucus; tenesmus
  3. Toxin-med - NO fecal WBC
  4. Invasive - YES fecal WBC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Staph aureus food poisoning

  1. S/S
  2. Duration
  3. Entry into food
  4. Food sources
A

Incubation = 1- 6h (thus, in vitro)

  1. N&V, crampy abd pain, +/- diarrhea
  2. <24h resolution
  3. From hands of infected food preps
  4. Food: prepared food, not stored well
    • eggs, ham
    • dairy
    • chicken, tuna, mayo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Staph Aureus toxin

A

SEA

  • heat stable (withstands 100C for 30m)
  • refrigeration impedes growth

Superantigen– binds to neural receptors of Upper GI to induce vomiting in brain centers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Bacillus Cereus

Forms
S/S

A

Resolution <24h:

  • Short incubation -> Emetic
  • Long incubation -> Diarrheal
  • Chinese food :(
  • abdominal cramps, N&V
  • GI tract of Animal/human -> feces -> food
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Bacillus cereus: Emetic Vs. Diarrheal

  1. Incubation
  2. Duration
  3. Toxin
  4. Path of Toxin
  5. Food Source
A

Emetic:

  1. Inc: 1-6h
  2. <24h
  3. In vitro heat stable (cereulide)
  4. Superantigen- binds 5HT receptor on vaguls -> ion channels in cell mem
  5. Fried rice

Diarrheal:

  1. Inc 8-16h
  2. <24h duration
  3. In vivo, heat labile
  4. Adenylate cyclase ↑cAMP -> ↑ fluid in Sm Int
  5. Meat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Clostridium perfringens

  1. Incubation
  2. S/S
  3. Food
  4. How it gets into you
A
  1. 6-24h inc
  2. Watery diarrhea +/- N&V
  3. Meat & Gravy
  4. GI tract of human/animal -> feces -> food
    • food prepared but vegetative cells are NOT KILLED
    • Outbreaks occur when food is prepped early and not refrigerated or cooled to room temp
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Clostridium perfringens: toxin

A

In vivo toxin

Heat labile– function as superantigens

  • *Damage brush border of small intestine**
    • alter cell membrane permeability in ileum
  • —> lose fluid & intracellular protein
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Clostridium botulinum:

  1. Incubation
  2. Toxin
  3. forms
A
  1. Incubation 18-36h
  2. In-vitro heat labile neurotoxin
    • inh ACh release @ NMJ to prevent contraction -> flaccid paralysis
  3. Forms:
    • Foodborne- most common in adults
    • Infant: floppy baby (raw honey!)- due to weak immunity
    • Inhalational: bioterrorism
    • Wound- spores in wound
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Clostridium botulinum: S/S, Dx, Tx

A

5 Ds!

  1. Dysarthria
  2. Dysphagia
  3. Dysphonia
  4. Diplopia
  5. Descending paralysis
    • Symmetric UE wekness from Eye -> arm -> leg -> respiration
  6. +/- Diarrhea (infants have constipaton)

Dx: clinical impression– promptly treat!!!

Tx: Ventilation, Botulinum-specific antitoxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Anti-Botulinum antitoxin

A

Botulinum-specific anti-toxin

arrests toxin circulating but DOESN’T improve damage already done– arrests progression of paralysis

Equine-derived heptavalent A-G for children >1yo & adults—- can cause serum sickness

Human-derived A&B (Baby B19)– children <1yo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Vibrio Cholera

  1. Characteristics
  2. S/S
  3. Incubation
  4. Serotypes
A
  1. Gram -, Ox +, comma-shaped
  2. INDIA, volumnous watery diarrhea (non-bloody), severe thirst
    • hTN, tachycardia, ↓ turgor, sunken eyes, ↑ bowel sounds, mucous flecks – Rice Water Diarrhea
  3. Incubation 16-72h
  4. >200 serotypes by LPS (O ag)
    • O1 = classic/el tor (worse)
    • O139
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Vibrio cholerae

  1. Reservoir
  2. Locations
  3. Cases in US
  4. Who needs HIgh ID to be infected
  5. Who needs Low ID to be infected
A
  1. Human colon
  2. Haiti, S.Am, India, Africa via fecally-contaminated H2O
  3. US Gulft Coast– crabs & oysters
  4. Normal gastric acidity req high infx dose
  5. Achlorhydria, Hypochlorhydria, & PPI usage req lower ID
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Vibrio cholerae: pathogenesis

A
  • Heat labile enterotoxin ↑ adenylyl cyclase -> ↑ watery diarrhea
  • Bacteriophage encodes gene tcp into bacterial cell– integrate into genome
  • tcp = toxin coregulated pilus– allows adherence
  • toxR controls toxin production in response to intestinal environment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Vibrio cholerae characteristics

A
  • abrupt onset of profuse, watery diarrhea & vomiting
    • rice water diarrhea
  • Can lead to hypovolemic shock within 4-12h of first liquid stool
    • 60% mortality untreated
20
Q

Vibrio cholerae: dx & tx

A

Dx:

  • TCBS (thiosulfate citrate bilesalt sucrose) agar
    • alkaline pH & NaCL required

Tx:

  • fluid & electrolyte replacement
  • antibiotic tx -> ↓ loss of fluid, ↓ exotoxin
  • Improve sanitation
21
Q

E. coli-related intestinal diseases:

  1. Toxin-mediated
  2. Invasive
A
  1. Toxin-mediated
    1. Enterotoxigenic e.coli (ETEC): MCC traveler’s diarrhea
    2. Enteropathogenic E.coli (EPEC): MCC neonatal nursery diarrhea
    3. Enteroaggregative E.coli (EAEC)
  2. Invasive
    1. Enterohemorrhagic (shiga-toxin producing) (EHEC)
    2. Enteroinvasive (EIEC)
22
Q

Enterotoxigenic E.coli (ETEC)

  1. S/S
  2. Incubation
  3. Duration
A
  1. Watery diarrhea (5-6/day)
    • cramping, flatulence
    • non-inflammatory (no WBCs)
    • +/- low-grade fever
  2. 24-48h incubation
  3. 3-4day resolution
23
Q

ETEC: Tx, pathogenesis

A
  1. Tx: ciprofloxacin, oral rehydration
    • +/- peptobismol (anti-motility)– use w/caution
  2. Toxins: both cause hypersecretion
    • Heat-stable toxin (ST) -> ↑ cGMP
    • Heat-labile toxin (LT) -> ↑cAMP
24
Q

Enteropathic E.coli (EPEC):

S/S

Pathogenesis

A

MCC Neonatal Nursery Outbreaks!

  1. <1yo, fever + watery diarrhea, NON-inflamm
  2. **NO TOXIN: **adhereance/superficial invasion mechanisms
    • Bundle-forming pili adhere to epithelial cell by forming attachment & effacement lesions -> disruption of normal microvilli -> malabsorption & watery diarrhea
25
***Enteroaggregative E.coli (EAEC)*** 1. Affected population 2. S/S 3. Toxin 4. IDing features
1. Children \<6yo, HIV pts 2. Persistent diarrhea + low-grade fever 3. Aggregative **adherence fimbriae** (autoagglutinate) & typical lesion-- **biofilm** 4. Inflamed microvilli tips -\> hemorrhagic necrosis of tips -\> short & round tips of villi -\> malabsorption + watery diarrhea
26
Invasive foodborne illnesses: 1. Blood 2. Blood rare
1. BLOOD * EHEC * EIEC * Campylobacter * Shigella 2. Blood RARE * C.diff * Salmonella typhi * Non-typhi Salmonella * Listeria
27
***Enterohemorrhagic/Shiga-toxin-producing E.Coli (EHEC)*** 1. Demographics 2. S/S 3. Complications 4. Tx
1. Children \<5yo, elderly: **MCC acute renal failure in children** 2. 16-72h incubation--\> abd cramping, **watery diarrhea**, **blood** in stool, ↓ urine vol 3. **Hemolytic uremic syndrome**: Renal failure, thrombocytopenia, hemolytic anemia (↑BUN, createnine) 4. Plasmaphoresis-- NO ABX! (cause release of more toxin!!)
28
***EHEC (O157:H7)*** 1. Source 2. S/S 3. Toxin
1. Cattle 2. Abd cramping, watery & bloody diarrhea **W/O FEVER** 3. Efface microvilli -\> actin polymerization - \> form pedestal - \> secrete **intimin** - \> A/E lesions (attachment to surface of host cells) - \> secrete **shiga-like toxin** (controlled by lysogenic phage) - \> inh protein synth @ **60S ribosome**
29
***EHEC (O157:H7)*** lab dx
**Sorbitol MacConkey agar**-- NON-sorbital fermenter so **colonies will be CLEAR**
30
***Enteroinvasive E.coli (EIEC)***
* Distal Small Intestine, Colon * Mucoid/bloody diarrhea * **FECAL LEUKOCYTES** * indicates DIRECT TISSUE INVASION
31
Blood smear with Schistocytes & Burr cells?????
Renal problem due to **Hemolytic Uremic Syndrome** _secondary to EHEC_
32
***Clostridium dificile***: 1. S/S 2. Toxin
1. Antibiotic therapy kills normal flora * Frequent, loose, watery stools (bloody if severe) * Febrile, Abd tenderness * **Pseudomembranous colitis** * Tenesmus, perforation 2. Toxins: * **Toxin A**: Enterotoxin that recruits neutrophils & moves into the ileum - \> cytokine release, ↑ hypersecretion of fluid (diarrhea), necrosis * **Toxin B**: depolymerization of Actin -\> cell death
33
***Clostridium dificile***: lab dx
* GOLD STANDARD* = **_Cytotoxin Assay (in vitro)_** - - but takes forevaaa * *Toxin-enzyme immunoassay** for A&B or A - - cheaper & RAPID, but ↓ sensitivity *Culture is of NO DIAGNOSTIC VALUE*
34
***C. dificile:*** tx
* Discontinue abx if possible & use **metronidazole** or **vancomycin** * Wash hands with _SOAP & WATER_ (hand sanitizers don't work on spores) * Contact isolation
35
***C. dificile :*** 1. characteristics 2. risk factors
**MCC NOCOSOMIAL DIARRHEA** 1. Anaerobic, Gram+, Sproulating Bacillus Part of normal flora 2. Risks = Ab exposure, hospitalization, **PPI use**
36
***Campylobacter jejuni*** 1. Incubation 2. S/S 3. Complications 4. Entry into food
Gram-, Ox+, curved rods 1. 6-48h inc 2. Fever, abd pain, diarrhea (\>10/day) Fecal smear = leukocytes + RBCs 3. Guillan-Barré Reactive Arthritis Hemolytic Uremic Syndrome 4. GI of animals ---- undercooked poultry, raw milk
37
***C.jejuni:*** selection in lab
Campy/Skirrow's agar - - Blood/charcoal (remove O2) - - abx (restrict normal flora) **42C** MICROaerophilic
38
***Shigella spp***: 1. Characteristics 2. Types
1. Ferment _glucose_, NOT lactose Colorless on MacConkey 2. Types: * ***Sigella Sonne***i: MCC of Shigellosis in US-- mild diarrhea @ daycare, nurseries, prisons * ***Sigella flexneri***: male homosexuals * ***Shigella dysenteriae*** 1: most severe form of shigellosis-- @developing countries
39
Which Shigellas cause dysentery?
***S. flexneri*** ***S. dysenteriae***
40
***Shigella sonnei:*** 1. Source, transmission, prevention 2. Incubation 3. S/S 4. Pathogenesis
1. ONLY IN _HUMANS_-- *hand-hand transmission* (NOT fecal-oral!). Wash your damn hands. 2. 1-3 day incubation, low ID 3. Fever, abd pain, watery diarrhea, "straining" to pass stools, "fussy" (children) 4. Invade intestinal cellls -\> lamina propria Spread via cell-cell invasion
41
**_Shiga Toxin_**
Disrupts protein synthesis @ **60S ribosome** - \> **mucosal abscess** forms as endothelial cells die - \> "squirty stools" lol
42
**_Shigellosis_** 1. Cause 2. S/S
1. *S. sonnei, S. dysenteriae* type 1 2. ↓ LRQ abd pain, fever, bloody/mucousy stool, "squirty" stools, **fecal WBCs** colonoscopy shows erythema, edema, friable ulcers
43
***Salmonella*** Types Characteristics
1. Types: * **Salmonella typhi*** --\> typhoid fever * Non-typhoid* --\> gastroenteritis 2. Colorless on MacConkey agar \*\*don't ferment lactose, but do glucose (like shigella) 3. **HE agar**-- produce H2S = black colonies
44
***Salmonella typhi*** 1. Causes what? 2. Reservoir & colonize 3. Transmission
1. Causes Typhoid Fever 2. Humans-- colonize gall bladder w/low ID 3. Fecally contaminated food/H2O
45
***Salmonella typhi:*** S/S
Gram- bacillus 1. 1-3 weeks of: Fever, Non-specific sx (headach, weakness, anorexia, high fever, **ROSE SPOTS)** * Systemic dissemination & blood- \> liver, spleen, BM --\> _rose spots_ (acute infx)
46
***Non-typhoidal Salmonella*** 1. Reservoir 2. Demographics 3. FoodSources 4. Incubation 5. S/S 6. Lab
1. ALL animals (asymptomatic) 2. Septicemia in young, geriatrics, or I/C pts 3. Eggs 4. 6-48h incubation 5. 2d-1w of gastroenteritis-- N/V, NON-bloody diarrhea 6. Leukocytes in stool smear
47
Tx of ***Non-Typhoidal Salmonella***
* Only use abx in non-septic pts who are **I/C** * 2 vaccines available * Treat **septicemia** w/abx determined by susceptibility testing

S4M2 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions