Diarrhea w/ or w/o Fever

Question 1

HUS can induce

Answer 1

HTN, proteinuria, chronic renal failure

Question 2

HUS is characterized by

Answer 2

hemolytic anemia, thrombocytopenia, acute renal failure

Question 3

ETEC has been lysogenized by a beta-fox phage for

Answer 3

shiga toxin

Question 4

Shiga toxin MOA

Answer 4

Cytotoxins that binds to globotriaosylceramide

Question 5

Virulence factors for STEC

Answer 5

Stx1 and Stx2, pili - for adherence

Question 6

EAEC strains w/ Stx have a high incidence of

Answer 6

HUS

Question 7

HUS is primarily associated with

Answer 7

EHEC O157:H7

Question 8

Diagnosis of EHEC

Answer 8

MacConkey w/ Sorbitol

Question 9

HUS characteristics

Answer 9

1 week after Sx onset:
microangiopathic hemolytic anemia,
thrombotic thrombocytopenia, acute renal failure and CNS symptoms which most commonly occur one week after diarrhea onset. Elevated creatinine or hematuria or proteinuria

Question 10

Symptoms of STEC/EHEC

Answer 10

Diarrhea that becomes bloody 1-3 days after onset of illness, cramps, n/v, afebrile (<50% have fever)

Question 11

Duration of STEC/EHEC

Answer 11

5-10 days

Question 12

Treatment of STEC/EHEC

Answer 12

Supportive ONLY

Question 13

Diagnosis of STEC/EHEC

Answer 13

EHEC is sorbitol (-), if grown on MacConkey’s will be white colonies; all other STEC will be pink; fecal WBC; Serotype for EHEC; ELISA; PCR

Question 14

Schistocytes

Answer 14

HUS or TTP

Question 15

HUS labs

Answer 15

schistocytes, decreased platelets, burr cells, leukocytosis
UA; hematuria, proteinuria
Labs: elevated LDH, BUN, ceatinine, CRP, total billirubin, indirect billirubin, decreased haptoglobin, hgb
Negative Coombs: rule out AI

Question 16

Characteristics of STEC

Answer 16

GNR, non-invasive, facultative anaerobe, Coliform (except EHEC)

Question 17

Characteristics of Entamoeba histolytica

Answer 17

protozoan, invasive, anaerobe, cyst/trophozoite forms

Question 18

Virulence Facotors of Entamoeba histolytica

Answer 18

adhesin, EC proteases, soluble cytotoxins (kill PMN on contact)

Question 19

Soluble cytotoxins of Entamoeba histolytica include

Answer 19

Galactose-specific lectin: mimics CD59 to inhibit the assembly of complement C8 and C9 into MAC
Cysteine proteinase: degrades C3a and C5a
Monocyte locomotion inhibition factor: inhibits monocyte migration and blocks the respiratory burst of macrophages and PMNs

Question 20

Symptoms of Entamoeba histolytica

Answer 20

diffuse abd pain, bloody diarrhea, discrete “flask-shaped” ulcers

Question 21

Complications of Entamoeba histolytica

Answer 21

liver abscess, colonic perforation, ameboma,