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GI II > Ch. 17 Pathology: Infectious Enterocolitis > Flashcards

Ch. 17 Pathology: Infectious Enterocolitis Flashcards

1
Q

what is cholera?

A

disease caused by vibrio cholerae (gram-negative rod)

transmitted through contaminated drinking water

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2
Q

what is the pathogenesis of cholera?

A

cholera toxin binds epithelial cell GM1 ganglioside

results in the opening of CFTR

cAMP inhibits the absorption of sodium and chloride

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3
Q

what is the clinical presentation of cholera?

A

massive amounts of “rice-water” diarrhea with fishy-odor
dehydration
electrolyte imbalance

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4
Q

what is campylobacter enterocolitis?

A

caused by campylobacter jejuni

the most common enteric pathogen in developed countries

cause of travel’s diarrhea

undercooked chicken, unpasteurized milk and contaminated water

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5
Q

What is the clinical presentation of campylobacter enterocolitis?

A

watery or bloody diarrhea

enteric fever with bacteria proliferation

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6
Q

people with HLA-B27 are prone to develop what symptom when infected with C. jejuni?

A

reactive arthritis

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7
Q

What CNS complication is associated with C. jejuni infection?

A

Guillain-Barre syndrome: ascending demyelinating polyneuropathy

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8
Q

what skin manifestation can occur with C. jejuni infection?

A

Erythema nodosum

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9
Q

what is shigellosis?

A

enteric infection caused by Shigella bacteria

common throughout daycares, migrant workers, and nursing homes

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10
Q

what is the pathogenesis of shigella?

A

predominately affects the left colon and ileum

organize within M cells overlying Peyer patches causing ulceration

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11
Q

what is the clinical presentation of shigella?

A

1 week incubation period

watery diarrhea that progresses to dysentery

fever and abdominal pain

mimics new onset ulcerative colitis

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12
Q

what should NOT be given to patients infected with shigella?

A

anti-diarrheals

*delays bacterial clearance

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13
Q

what are some complications associated with shigella?

A

reactive arthropathy
hemolytic-uremic syndrome
toxic megacolon

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14
Q

What are the two subtypes of salmonella?

A

typhoidal and non-typhoidal

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15
Q

what is non-typhoidal salmonella?

A

caused by S. enteritidis

food poisoning by ingestion of contaminated food

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16
Q

what is the clinical presentation of non-typhoidal salmonella?

A

clinically indistinguishable from other enteric pathogens

watery diarrhea or dysentery

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17
Q

what is typhoidal salmonella?

A

caused by S. typhi or S. paratyphi
*Americans are vaccinated against S. typhi

an enteric disease that also manifests with flu-like symptoms

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18
Q

what is the pathogenesis of thyphoid fever?

A

S. typhi are able to survive gastric acid and are taken up by M cells within Peyer patches of the terminal ileum

Peyer patches ulcerate

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19
Q

what is the clinical presentation of typhoid fever?

A 
anorexia
abdominal pain (may mimic appendicitis)
bloating
nausea and vomiting
blood diarrhea
rose spots on chest and abdomen

*short asymptomatic phase followed by bacteremia and flu-like symptoms

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20
Q

what are the hallmarks of disseminated S. typhi?

A

enlarged spleen with pale red pulp, follicular markings, and phagocyte hyperplasia

liver contains macrophage aggregates called typhoid nodules

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21
Q

What comlications can occur with disseminated S. typhi?

A 
encephalopathy
meningitis
seizures
endocarditis
myocarditis
pneumonia
cholecystitis
22
Q

colonization of what organ is associated with a chronic carrier state of S. typhi?

A

Gallbladder

*can cause gallstones also

23
Q

who is at risk for disseminated S. typhi?

A 
Cancer
Immunosuppresion
EtOH
CV disease
Sickle cell disease
Hemolytic anemia
24
Q

what are sickle cell patients susceptible to developing when infected with salmonella?

A

salmonella osteomyelitis

25
Q

what are the 3 species of yersinia?

A

Y. enterocolitica
Y. pseudotuberculosis
Y. pestis

26
Q

what is the pathogenesis of yersinia?

A

invade and colonize within M cells of Peyer patches within ileum causing ulceration

also invade appendix and right colon

can mimic crohn disease and/or appendicitis

27
Q

what enhances yersinia virulence and stimulates systemic dissemination?

A

iron

*people with certain anemias or hemochromatosis are at increased risk for sepsis

28
Q

what is enterotoxic E. coli?

A

principle cause of traveler’s diarrhea due to contaminated food or water

29
Q

what is enteropathic E. coli?

A

worldwide cause of endemic diarrhea

30
Q

what is enterohemorrhagic E. coli?

A

E. coli O157:H7 and non-O157:H7 serotypes

*inadequately cooked beef

31
Q

what is enteroinvasive E. coli?

A

bacteriologically similar to Shigella

transmitted via food, water, or person-to-person contact

32
Q

what is enteroaggregative E. coli?

A

unique “stacked brick” morphology when bound to epithelial cells

33
Q

what is pseudomembranous colitis?

A

antibiotic-associated colitis due to disruption of the normal colonic microbiota

allows overgrowth of C. diff

34
Q

what is the clinical presentation of pseudomembranous colitis?

A

fever
leukocytosis
abdominal pain/cramping
watery diarrhea (may be occult blood +)

protein loss and dehydration!

35
Q

what is the potentially fatal complication of pseudomembranous colitis?

A

toxic megacolon

36
Q

what is whipple disease?

A

rare, multivisceral chronic disease described as intestinal lipodystrophy

associated with farmers and other occupations with soil or animal exposure

37
Q

what is the clinical presentation of whipple disease?

A

TRIAD:
diarrhea
weight loss
arthralgia

38
Q

what is the morphologic hallmark of whipple disease?

A

dense accumulation of distended, foamy macrophages in the small intestine lamina propria

macrophages are periodic acid-Schiff (PAS) +

39
Q

what is the most common cause of gastroenteritis outbreaks?

A

norovirus

usually occurs in schools, hospitals, nursing homes and cruise ships

40
Q

what age group is most susceptible to rotavirus infection?

A

6-24 month old babies

*breast milk provides immunity until 6 months old

41
Q

ascaris lumbricoides

A

nematode parasite

larvae are ingested and migrate to the lungs

larvae are coughed up and swallowed where they mature in the GI tract

42
Q

strongyloides

A

nematode parasite

reside in soil and can penetrate broken skin

migrate to GI tract

43
Q

intestinal hookworm

A

larvae penetrate the skin and travel to lungs

larvae will migrate up the trachea and are subsequently swallowed

mature worms attach to duodenal mucosa

*can cause anemia and hemorrhage

44
Q

enterobius vermicularis

A

pinworms!

ingested and travel to the external anus where they lay eggs

itchy butthole

45
Q

schistosoma spp.

A

found in water and penetrate skin

eggs become trapped within mesenteric veins and cause obstruction

46
Q

taenia spp.

A

“pork tapeworms”

ingested by eating raw or undercooked pork

larvae attach to the intestinal mucosa and feeds on intestinal contents

*can cause B12 deficiency

47
Q

Diphyllobothriid spp.

A

“fish tapeworms”

ingested by eating infested fish

larvae attach to the intestinal mucosa and feeds on intestinal contents

*can cause B12 deficiency

48
Q

Entamoeba histolytica

A

causes amebiasis

reside within the colon but can travel to liver, lungs, or brain via bloodstream

49
Q

giardia lamblia

A

flagellated protozoan

the most common parasitic pathogen in humans

spreads by infested water or food washed with infested water

*typically found in streams and lakes

50
Q

cryptosporidium

A

spread via infected water supply

attaches to brush boarder

GI II (16 decks)

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