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GI II Exam 1 > Bowel Path II > Flashcards

Bowel Path II Flashcards

1
Q

most common cause of severe diarrhea in infants and young children

A

rotavirus

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2
Q

rotavirus

A

dsRNA virus
-reoviridae family

five species - A, B, C, D, E

A - most common - >90% of infections

fecal-oral transmission
-often stomach flu

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3
Q

rotavirus infection

A

easily managed
-but causes lots of death worldwide - developing countries

oral rehydration therapy and vaccines

malabsorption
-toxic protein NSP4

may also see lactose intolerance - for weeks

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4
Q

rotarix

A

vaccine for rotavirus

attenuated live virus

oral admin

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5
Q

ingestion of preformed toxins

A

rapid onset

staph food poisoning

vibrio

c perfringens

c botulinum

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6
Q

infection by toxigenic organisms

A

incubation - then diarrhea

travelers diarrhea
e coli
v cholerae
campylobacter

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7
Q

infection by enteroinvasive organisms

A

invade destroy mucosa

shigella
salmonella
campylobacter
enteroinvasive e coli

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8
Q

E. coli

A

gram negative bacilli

-colonize GI tract

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9
Q

ETEC

A

enterotoxic e coli

travelers diarrhea
food or water spread

heat labile toxin and heat stable toxin

induce chloride and water secretion

secretory diarrhea, dehydration

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10
Q

EHEC

A

E. coli 0157:H7

undercooked beef

shiga-like toxins

bloody diarrhea and HUS

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11
Q

EIEC

A

food, water, person to person

no toxins
-invade epithelial cells

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12
Q

EAEC

A

enteroaggregative e coli

adhere to epithelial

cause of diarrhea

adhere with adherence fimbrae

damage due to adherence

nonblood diarrhea - prolonged in AIDS patients

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13
Q

campylobacter

A

water or bloody diarrhea

arthritis

guillan barre syndrome

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14
Q

salmonella

A

gram negative bacilli

typhi - typhoid fever
nontyphi - enteritidis

raw or undercooked meat

few organisms required for infection

bacteria grown in phagosomes

Th17 limits to colon

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15
Q

diagnosis of salmonella

A

stool culture

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16
Q

typhoid fever

A

salmonella typhi

travel to india, mexico, phillipines, etc.

enlarged peyers patches in terminal ileum

oval ulcers - oriented along axis of ileum - may perforate**

liver - typhoid nodules

abdomen pain, bloating, nausea, vomiting, bloody diarrhea - fever and flu-like sx

blood cultures positive - more than 90% during febrile phase

rose spots - chest and abdomen

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17
Q

cholera

A

gram negative bacteria

contaminated drinking water

cholera toxin - causes disease

  • five B subunits and single A subunit
  • B goes retrograde transport to ER - A then reduced
  • A released to cytosol
  • interacts with ARF to activate and increase cAMP
  • causes chloride release to lumen
  • massive diarrhea

flagella for colonization

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18
Q

rice water stool

A

cholera

with fishy odor

dehydration, hypotension, shock

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19
Q

campylobacter jejuni

A

gram negative motile

most common enteric pathogen developed countries
-travelers diarrhea

improper cooked chickens

four virulence properties
-motility, adherence, toxin, invasion

flagella - motlie

see arthritis, erythema nodosum, guillan barre syndrome

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20
Q

most common bacterial enteritis in the world

A

campylobacter

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21
Q

shigella

A

gram negative bacilli
unencapsulated, nonmotile facultative anaerobes

watery diarrhea progres to bloody diarrhea - dysentery

resistant to acidic stomach

taken up by M cells

to left colon

diagnosis - stool culture

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22
Q

reiter syndrome

A

complication of shigella

arthritis, urethritis, conjuntivitis

HLA-B27 positive men

23
Q

pseudomembranous colitis

A

antibiotic associated
-3rd gen cephalosporins

c. difficile overgrowth and toxin production - A and B toxins

in adults - acut ediarrhea

diagnosis - C. dif in stool

eruption reminiscent of volcano

24
Q

diagnosis of c dif infection

A

presence of toxin

25
Q

volcanic eruptions

A

c dif - pseudomembranous colitis

26
Q

whipple disease

A

relapsing multisystem illness of GI tract and distant sites

weight loss, diarrhea, polyarthritis

tropheryma whipplei

40-50yo, males

tx - antibiotics

27
Q

trophermya whipplei

A

whipple disease

gram positive actinomycete

foamy macrophages with argyrophilic rods in lymph nodes

28
Q

path of whipple disease

A

malabsorptive diarrhea - impaired lymph transport

organism clogs up nodes and lymph tracts

29
Q

distended foamy macrophages

A

whipple disease

PAS positive rod shaped bacilli

and NO acid-fast staining

t. whippelii

30
Q

diarrhea, weight loss, and malabsorption

A

triad of whipple disease

31
Q

cryptosporidium

A

contaminated drinking water

travelers diarrhea

terminal ileum and right colon

intracellular at brush border

H and E stain and Ag stain

appears to sit on top of epithelial apical membrane

diagnosis - oocysts in stool

32
Q

AIDS and diarrhea

A

50% patients

cryptosporidium
CMV
MAI

33
Q

pinworms

A

enterobius vermicularis
-live in intestinal lumen - rarely cause illness

eggs deposited at night at perirectal mucosa- irritation
-itchy

diagnosis - tape to anus

34
Q

ascaris

A

small intestine roundworm
-a. lumbricoides

compromised nutritional status

SOB, fever, abdomen pain, diarrhea, malnutrition, mental changes

eggs hatch in intestines - go to lungs - coughed up and swallowed

35
Q

amebiasis

A

entamoeba histolytica
-ingestion of mature cysts

trophozites invade intestinal mucosa

cecum and ascending colon

abdomen pain, diarrhea, weight loss

acute necrotizing colitis and megacolon possible

obligate fermenters of glucose

36
Q

most common parasite infection

A

giardia

37
Q

giardia

A

g. duodenalis and g. intestinalis

asymptomatic, acute diarrhea, or chronic GI disease

malabsorption, diarrhea, abdominal pain/discomfort

38
Q

giardia morph

A

flagellated protozoans

cause decreased expression of brush border enzymes

pear shape with two nulei and line down middle

39
Q

steatorrhea

A

bulky, frothy, greasy, yellow, gray stool - with malabsorption

40
Q

ADEK

A

fat soluble vits - with malabsorption

41
Q

most common causes of malabsorption

A

celiac
pancreatic insufficiency
crohn disease

42
Q

abetalipoproteinemia

A

only see transepithelial transport defect

43
Q

altered lymph transport

A

whipple disease

44
Q

celiac disease

A

inflammatory disease
-gluten ingestion

genetic predisposition, inciting agent exposure, T cell repsonse

45
Q

gliadin

A

disease producing component of gluten

induce IL-15 expression stimulates T8 Cells

enters and stimulates T4 cells - to create B cells - make Abs

path - is CD8 cells

46
Q

class II HLA DQ2 and DQ8

A

carried by those with celiac

47
Q

celiac clinical

A

steattorhea, weight loss, abdominal pain cramping bloating, mouth ulcers, lactose intolerance, IBS

increased risk of adenocarcinoma and lymphoma

malaborption vits A, D, E, K

anemia, fatigue, megaloblastic anemia, hyperparathyroid, osteopenia, osteoporosis

48
Q

celiac disease

A

adults 30-60yo and children

diarrhea with steatorrhea

dermatitis herpetiformis

49
Q

dermatitis herpetiformis

A

extremely itchy blisters extensor surfaces of body

IgA deposition at dermal/epidermal junction

with celiac disease**

50
Q

celiac tx

A

remove from diet

51
Q

diagnosis of celiac

A

1 clinical malabsorption
2 small bowel bx - gold standard
3 response to gluten free diet

also serologic testing and HLA testing
-if IgA deficient - sero tests won’t work

52
Q

gold standard celiac diagnosis

A

small bowel biopsy
-distal duodenum/jejunum

-villous atrophy

53
Q

celiac sero tests

A

IgA tTG antibodies

also anti-endomysial antibodies - IgA EMA

54
Q

cracked mud mucosa

A

in celiac on endoscope

GI II Exam 1 (29 decks)

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