DIARRHEA-DO NOT STUDY NOW

Question 1

Acute infectious diarrhea typically consists of what symptoms, lasting how long?

Answer 1

Consists of an increased frequency of bowel movements of 3 or more times a day and at least 200g of stool per day lasting LESS than 14 days.

Question 2

Generally, how does one come in contact with the pathogen(s) or microbial toxin causing acute infectious diarrhea?

Answer 2

Must be ingested.

-This is why socioeconomic conditions that result in crowding, poor sanitation and contaminated water lead to an increased risk of diarrheal illnesses.

Question 3

What are the reasons why the small bowel NORMALLY stays free of pathogenic microorganisms (although not sterile)?

Answer 3

1. Low pH in the stomach
2. Rapid transit time of the small bowel
3. Antibody and innate host defense molecules produced by cells in the lamina propria of the small bowel.

These are adequate to keep the jejunum and proximal ileum free of pathogenic organisms.

Question 4

People with what disease are at increase risk for acute diarrheal disease?

Answer 4

People with decreased gastric acidity.

Question 5

What two ways allow a pathogenic microorganism to pass through the hostile environment of the stomach?

Answer 5

1. They are acid resistant (Shigella)

2. They are ingested with food and are therefore partially protected in the neutralized environment.

Question 6

How to organisms get into the small bowl and cause trouble?

Answer 6

In the small bowel, organisms either colonize or they invade the local mucosa or they pass through to colonize and invade the mucosa of the terminal ileum or colon.

Question 7

Which organisms typically use “colonization” as means to get to the small bowel and cause trouble?

Answer 7

Vibrio Cholerae, Escherichia Coli.

Question 8

Which organisms typically use the “invade” tactic to mess up ones small bowel?

Answer 8

rotavirus, noroviruses.

Question 9

What main factor does the book state allows microorganisms to multiply preferentially and cause BIG trouble and nasty diarrhea.

Answer 9

The ability of the colonic enteropathogens to invade intestinal mucosa.

Question 10

When you think you’re friends are joking, but you’re pants are brown and soaking….

Answer 10

That’s Diarrhea, diarrhea

Question 11

Microbes can cause diarrhea INDIRECTLY through elaboration of one of three class of microbial toxins. Name these 3 toxins.

Answer 11

1. Secretory enterotoxins
2. Cytotoxins
3. Neurotoxins

Question 12

T/F: Patients infected with secretory-induced toxin typically have a fever with other major systemic symptoms.

Answer 12

FALSE:

These patients SELDOM have a fever or other major systemic symptoms, and there is little or NO inflammatory response.

Question 13

What is the mechanism of action for secretory-induced toxins?

Answer 13

After multiplying to large numbers, the bacteria produce enterotoxins that bind to mucosal cells, causing HYPERSECRETION or isotonic fluid at a rate that OVERWHELMS the reabsorptive capacity of the colon.

TYPICALLY diarrhea is WATERY.

Question 14

In a patient with secretory induced toxins causing diarrhea, what are the predictable outcomes one might see in labs?

Answer 14

Rapid loss of diarrheal fluid results in saline depletion, base-deficit acidosis and K+ deficiency.