Bacterial GI 2

Question 1

When you suspect shigella and you want to send specimens to the lab, what must you do?

Answer 1

Get the sample on a plate Quickly!

Question 2

What is the reservoir of C.diff in nosocomial outbreaks?

Answer 2

Asymptomatic carriers of c. Diff

Question 3

Is salmonella incidence increasing or decreasing?

Answer 3

Increasing

Question 4

Will you be sick for a long time after consuming the toxins of staphylococcus, B. Cereus, or C. Perfringens?

Answer 4

No, these are short duration, since no additional growth of the organism or production of the toxin will occur

Question 5

How long after eating food infected by the heat stable preformed toxin of staphylococcus will you start having N/V, diarrhea, cramps and acute salivation?

Answer 5

1-6 hours…fast!

Question 6

Which strain of salmonella leads to food poisoning?

Answer 6

Salmonella typhimurium

Question 7

What kinds of symptoms will you have if you ingest the preformed toxin of bacillus cereus?

Answer 7

Beautiful projectile vomiting only 1-5 hours after eating the contaminated food

🍚

Question 8

Is salmonella normal gut flora?

Answer 8

It is in birds and other animals!!!

Question 9

Is the infectious dose of shigella high or low?

Answer 9

Very low, don’t need much

Question 10

Do state authorities keep track of serotypes of salmonella

Answer 10

Yes

Question 11

Is it possible to have disease with colonization of staph?

Answer 11

Yes, because just ingestion of the heat stable preformed toxin in foods will cause disease

Question 12

Which patients need special care for salmonella poisoning?

Answer 12

AIDS patients

Question 13

Are the eggs you buy at Safeway pasteurized?

Answer 13

Yes

Question 14

What is an example of a physician-induced disease?

Answer 14

C. Diff causing pseudomembranous colitis

Question 15

How do you treat shigella?

Answer 15

Fluid replacement

Antibiotics might help shorten the course and eliminate carriers, but there are lots of resistant strains

Question 16

Is c.diff part of the normal flora?

Answer 16

It is in about 10% of people who are asymptomatic !

Question 17

What are the 4 species of shigella and which two are most prevalent in the US

Answer 17

Group A- S. dysentariae-WORST ONE HUS CAUSING

Group B- S. flexneri

Group C- S. boydii

Group D- S. sonnei

Flexneri and sonnei are most common in US

(I don’t know if we need to know this)

Question 18

Can you detect the staph toxin in foods?

Answer 18

No, there is nothing off about the smell/taste/appearance

Question 19

How is shigella spread?

Answer 19

Person to person

Question 20

Does shigella cause a fever?

Answer 20

Yes

Question 21

What organism causes problems when you cook meat inadequately to kill spores, then leave it out, allowing the spores to germinate?

Answer 21

Clostridium perfringens

Question 22

Will antibiotics help you if you have staphylococcal food poisoning/.

Answer 22

No. This is an intoxication from Enterotoxin A

Question 23

What should you suspect if you see blood, mucus, PMNs and RBCs in someone’s feces?

Answer 23

Shigella

Question 24

Is staphylococcal food poisoning directly communicable from person to person?

Answer 24

No

Question 25

What are some complications of shigella?

Answer 25

Reiters syndrome in HLA-B27 people Hemolytic Uremic syndrome (HUS) if you have Shigella dysentariae since it produces shiga toxin

Question 26

What kind of a sample is ideal to send to the lab if you suspect shigella?

Answer 26

Blood-tinged flecks of mucus

Question 27

When do we see the most salmonella infections?

Answer 27

Summer and fall

Question 28

How do you diagnose salmonella?

Answer 28

Culture a sample of the food that made them sick Stool sample Blood cultures Fluorescent Antibody tests allow for serological confirmation

Question 29

What should you be very suspicious of if someone starts hardcore vomiting 1-5 hours after eating?

Answer 29

Bacillus cereus

Question 30

What is the source of staphylococcus toxin in foods?

Answer 30

Humans

Question 31

What food is associated with staphylococcal food poisoning

Answer 31

Custard-filled baked goods | Also canned foods, processed meats, potato salad

Question 32

What are the two forms of bacillus cereus disease?

Answer 32

1. Emetic form- preformed toxin is ingested | 2. Diarrheal form- ingestion of large numbers of vegetative cells

Question 33

How do you treat salmonella?

Answer 33

Supportive care, fluid/electrolytes AIDS patients get a little extra love

Question 34

How do humans get salmonella?

Answer 34

Food contamination

Question 35

What kind of symptoms will you get with shigella?

Answer 35

Ranges from moderate diarrhea to severe dysentery Starts with fever, cramps, vomiting, and watery diarrhea, and then can progress to dysentery in severe forms: blood, mucus, and PMNs in stools

Question 36

What is the 2nd leading cause of food borne disease?

Answer 36

Staphylococcus

Question 37

What is the best way to prevent shigella

Answer 37

Hand washing. Especially kids

Question 38

How do you get clostridium perfringens?

Answer 38

Grossly contaminated meat/poultry that was left out after cooking that wasn’t enough to destroy spores!

Question 39

What is the difference between shiga toxin and shiga-like toxin?

Answer 39

They are biochemically identical

Question 40

Do we see shigella in regions with modern plumbing and good sanitation?

Answer 40

Yes

Question 41

What organism is associated with eating spores in rice?

Answer 41

Bacillus cereus

Question 42

Which microbe might get passed to you from your pet dog, cat, or turtle?

Answer 42

Salmonella

Question 43

How do you prevent bacillus cereus?

Answer 43

Promptly refrigerating all grain foods after cooking

Question 44

What is the specific preformed heat-stable toxin produced by staphylococcus that makes you vomit and shit

Answer 44

Enterotoxin A | Tolerates boiling for 30 minutes!

Question 45

Do you need a high or low dose to get clostridium perfringens?

Answer 45

High dose

Question 46

Does C.diff always cause pseudomembranous colitis?

Answer 46

No it may just cause diarrhea/cramping or it can cause a severe colitis, but without a pseudomembrane

Question 47

How long does clostridium perfringens type A illness last?

Answer 47

Complete recovery in one day

Question 48

Since our eggs are pasteurized, does that mean that the yolk is sterile and safe to eat raw?

Answer 48

No, since the chicken may be infected by salmonella, and it will get in there before it even lays the egg

Question 49

Why do we see more salmonella these days?

Answer 49

Food processing changes-large scale facilities increase risk of massive common source outbreaks Changing consumer preferences for fresh food items, including salad ingredients (tomatoes) has led to mosre cases by cross contamination by consumers or at the factory by equipment or water supplies with poop in them Changes in animal husbandry

Question 50

What is a predisposing factor to C.diff infection?

Answer 50

Disruption of normal gut flora

Question 51

What is the reservoir for shigella?

Answer 51

Humans

Question 52

What is the “pseudomembrane” in PMC?

Answer 52

An elevated yellowish plaque over inflamed mucosa. Its a fibrin mesh of necrotic cells, PMNs, monocytes, and RBCs