Entero 3

Question 1

All vibrios are

Answer 1

curved, gram neg rods, all can grwo on bile salts agar in vitro (selective for SALT TOLERANCE)

Question 2

Cholera has caused;

for epidemics there is

Answer 2

epidemics and pandemics throughout history, with best preventatives being hygiene (food and water purification);
modestly-effective vaccine

Question 3

Cholera reservoirs are

Answer 3

humans and ocean microbial communities, primarily Indian ocean but now seen in Gulf of Mexico;
“planktonic” ocean form is source of genetic diversity

Question 4

Cholera pathogenesis:

Answer 4

fecal-oral transmission, poor survival in stomach acid, so requires high infectious dose, colonizes epi of interior surface (lumen) of small intestine with mucinase and toxin-coregulated pilus (TCP), secretes Choleragen exotoxin enterotoxin, AB subunit signal transduction alterer that can lead to massive watery diarrhea (rice water stool), both IC and interstitial

Question 5

Choleragen gene carried by

Answer 5

lysogenic bacteriophage CTX; O1 and O139 Ags are markers for infection by CTX (non-CTX V cholerae strains cause sporadic mild disease)

Question 6

Cholera bacteremia is;

interstitial dehydration diagnosed by

Answer 6

rare, most morbidity and mortality from dehydration and electrolyte imbalance (acidosis, loss of K);
skin-tenting pinch test, treated with IV Lacted Ringer Solution (not just saline - acidosis)

Question 7

What can help deal with Cholerae or parahaemolyticus?

Answer 7

Rehydration most important, but short course of doxycycline helps shorten the course

Question 8

Non-cholera vibrio infections associated with; reservoir is;

complicating factors are

Answer 8

gastroenteritis (usually self-limited) and rapid progression cellulitis (life-threatening) from eating or handling raw shellfish;
ocean water that means they are halophiles;
liver or kidney disease, immunodeficiency, iron overload

Question 9

Diagnose cellulitis by

Answer 9

exam (rapid progression, HEMORRHAGIC BULLAE, seawater-exposed injury), proceed with immediate aggressive surgical care; later, do gram stain and culture, and treat with dual antibiotics!!

BRS GAS

Question 10

Campylobacter are;
reservoir from;
colonizes both;
complications follow;
diagnose by;
treat with

Answer 10

gram neg rods, microaerophilic, ubiquitous;
animals, causes diarrhea, some autoimmune complications;
intestines, destructive IC infection, bloody diarrhea;
bacteremia: Guillain-Barre, reactive arthritis, HUS, meningitis, vascular infection;
microaerophilic culture, gram stain of fecal smear, sigmoidoscopy;
rehydration, add antibiotics if high fever or predisposed to complications (immunosuppressed, pediatric, worsening)

Question 11

H pylori is related to;
predisposes to;
diagnose by;
treat with

Answer 11

campylobacter, colonizes stomach, expresses urease, irritates stomach lining, attracts massive inflamm infiltrate, destroys local cells, leads to peptic uler;
gastric cancer and MALT lymphoma, and infection much more common than symptoms;
scope, urea breath and/or PCR, biopsy;
combined antibiotics and PPI’s