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Gastrointestinal System > EXAM #1: BACTERIAL INFECTIONS OF THE GI TRACT > Flashcards

EXAM #1: BACTERIAL INFECTIONS OF THE GI TRACT Flashcards

1
Q

What are the symptoms of Botulism poisoning?

A

1) Dizziness
2) Dry mouth
3) Blurred vision
4) Abd. sx
5) Progressive paralysis

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2
Q

What causes Botulism?

A

Improperly canned (non-acidic food)

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3
Q

When do the symptoms of Botulism start?

A

12-36 hours after ingestion

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4
Q

Is fever present in Botulinism?

A

No–only ingested toxin, NOT whole pathogen

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5
Q

What organism causes Botulinism?

A

C. botulinum

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6
Q

List the characteristics of C. botulismsm.

A

Gram positive
Spore forming
Rod-shaped
Anaerobic

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7
Q

What kind of toxin is the C. botulinum toxin?

A

A-B Bacterial toxin

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8
Q

What is the MOA of the C. Botulinum toxin?

A

1) B portion attaches to receptors on motor nerve endings
2) A portion enters nerve cell
3) Toxin blocks release of ACh

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9
Q

What causes Floppy Baby Syndrome?

A

C. Botulinum spore ingestion

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10
Q

What are the symptoms of Floppy Baby Syndrome?

A

Constipation followed by generalized paralysis

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11
Q

Where are C. botulinum spores and toxins identifiable in Floppy Baby Syndrome?

A

Feces

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12
Q

How is Botulsim treated?

A

Antitoxin administration

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13
Q

What is a major adverse effect of Botulism antitoxin administration?

A

Serum sickness

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14
Q

What are the characteristics of Clostridium difficile?

A

Gram positive
Spore forming
Rod-shaped
Anaerobic

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15
Q

What does Clostridium difficile cause?

A

Antibiotic associated pseudomembranous colitis

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16
Q

What is the most common cause of nosocomial diarrhea?

A

Clostridium difficile

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17
Q

How is Clostridium difficile transmitted?

A

Fecal-oral

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18
Q

What antibiotic was the first abx to cause pseudomembranous colitis?

A

Clindamycin

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19
Q

What are the most common causes of pseudomembranous colitis today?

A

2nd and 3rd generation cephalosporins (only b/c they are the most frequently used)

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20
Q

What are pseudomembranes?

A

white-yellow plaques on the colonic mucosa

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21
Q

What is a severe complication of Clostridium difficile infection?

A

Toxic megacolon

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22
Q

How do you tell the difference between adverse diarrhea with abx administration vs. Clostridium difficile?

A

Clostridium difficile toxin present in the stool

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23
Q

How is Clostridium difficile treated?

A

1) Withdraw antibiotic
2) Oral metronidazole* or vancomycin
3) Fluid replacement

*Preferred

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24
Q

What is Shigellosis?

A

Dysentery i.e. bloody diarrhea

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25
Q

List the characteristics of Shigella dysenteriae.

A

Gram negative
Rods
Non-lactose fermenting

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26
Q

How does Shigella dysenteriae appear on MacConkey agar?

A

Colorless b/c non-lactose fermenting

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27
Q

How is Shigella dysenteriae distinguished from Salmonella?

A

1) Do NOT produce H2S
2) Non-glucose fermenting
3) Non-motile

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28
Q

What infective dose is required for Shigella dysenteriae infection? How does this compare to Salmonella?

A

Shigella dysenteriae= low

Salmonella= high

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29
Q

What type of diarrhea is seen with Shigella dysenteriae?

A

Bloody diarrhea

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30
Q

What is the typical symptom progression in Shigella dysenteriae infection?

A

1) Fever, abdominal cramping and diarrhea
- Watery diarrhea at first
- Bloody/ mucousy diarrhea

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31
Q

What strain of Shigella causes a much milder disease than Shigella dysenteriae?

A

Shigella sonnei

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32
Q

What strain of Shigella is most common in the US?

A

Shigella sonnei

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33
Q

What is the drug of choice to treat Shigella dysenteriae?

A

A fluoroquinolone i.e. Ciprofloxacin

34
Q

What is the drug of choice for Shigella dysenteriae in kids?

A

TMP-SMX

35
Q

What drugs are contraindicated in Shigella dysenteriae?

A

Antiperistaltic drugs

36
Q

Why are Fluoroquinolones NOT used in kids?

A

Increased risk of tendinitis and tendon rupture, especially in kids

37
Q

List the different infections caused by Salmonella species.

A

1) Enterocolitis
2) Typhoid fever
3) Septicemia
4) Osteomyelitis

38
Q

List the characteristics of Salmonella.

A

Gram negative rod
Non-lactose ferm.
Produce H2S

39
Q

What antigens are associated with Salmonella?

A 
O= LPS 
H= Flagella 
K= Capsule
40
Q

What is the species of Salmonella most responsible for entercolitis?

A

Salmonella typhimurium

41
Q

What is the important host defense against Salmonella typhimurium ?

A

Gastric acid

42
Q

What does gastrectomy and use of antacids do to the infectious dose of Salmonella typhimurium ?

A

Lowers it

43
Q

What disease is caused by Salmonella typhi?

A

Typhoid Fever

44
Q

Where does Salmonella typhi replicate?

A

Mononuclear phagocytes of the Peyer’s Patches

45
Q

After Salmonella typhi enters the GI tract, where does it go?

A

1) Liver
2) Gallbladder
3) Spleen

Organism likes the gallbladder and can develop a carrier state there*

46
Q

What is the typical course of Salmonella in a healthy individual?

A

Non-bloody diarrhea that does NOT require medical care

47
Q

What patient populations are at risk of life-threatening Salmonella infection?

A

1) Kids

2) Elderly

48
Q

What are the symptoms of Typhoid Fever?

A

1) Flu-like symptoms
2) Fever/ constipation
3) Bactermeia
4) Rose-spots

49
Q

How is Salmonella Enterocolitis treated?

A

Fluid and electrolyte replacement

50
Q

When are antibiotics indicated in Salmonella Enterocolitis?

A

Only in those at risk for septicemia

51
Q

What drugs should be used to treat Salmonella enteric fever, septicemia, severe enterocolitis?

A

Ceftriaxone or ciprofolaxcin

52
Q

What surgical procedure may be required to abolish the carrier state of Salmonella?

A

Cholecystectomy

53
Q

List the characteristics of E. Coli species.

A

Gram negative rod
Ferments lactose
Facultative anaerobe

54
Q

What is the most common cause of traveler’s diarrhea?

A

E. coli

55
Q

What is ETEC?

A

Enterotoxigenic E. Coli

56
Q

What specific strain of E. coli is responsible for traveler’s diarrhea?

A

ETEC

57
Q

What is the MOA of the ETEC toxin? What symptom does this toxin cause?

A

ETEC toxin is similar to the cholera toxin and causes a WATERY DIARRHEA

58
Q

What type of diarrhea is seen in ETEC?

A

Non-bloody

59
Q

What is EIEC?

A

Enteroinvasive E. coli

60
Q

What type of diarrhea is seen in EIEC?

A

Blood and pus in feces

61
Q

What is EPEC?

A

Enteropathogenic E. coli

62
Q

What does EPEC cause?

A

Chronic diarrhea in infants

63
Q

What type of diarrhea is seen with EPEC?

A

Watery diarrhea containing mucous

64
Q

What is EHEC?

A

Enterohemorrhagic E. coli

65
Q

What toxins are seen in EHEC?

A

Shiga-Like Toxins 1 and 2 i.e. “SLT-I and SLT-II”

66
Q

What are the symptoms of EHEC infection?

A

Severe disease with bloody diarrhea

67
Q

What is an adverse effect of EHEC infection?

A

HUS

68
Q

What is HUS?

A

Hemolyticuremic Syndrome characterized by:

1) Microangiopathic hemolytic anemia
2) Thrombocytopenia
3) Acute kidney injury

This is the leading cause of acute renal failure in children worldwide*

69
Q

What antibiotics should be given to infants with E. coli infection?

A

Gentamycin

Polymyxin

70
Q

How is traveler’s diarrhea treated?

A

Bismuth preparations

71
Q

What type of diarrhea is “pathogmneomonic” for Cholera?

A

“Rice-water stool” i.e. severe watery diarrhea

72
Q

Are neutrophils present in the stool of patients with Cholera?

A

NO

73
Q

What are the characteristics of Vibrio cholerae?

A
  • Curved gram negative rod
  • Tolerates strong alkaline conditions
  • Tolerates high salt concentrations
74
Q

What is the MOA of the Cholera toxin?

A
  • Heat-labile
  • AB subunit protein
  • B-binds to receptors on microvilli
  • A-activates adenylate cyclase (increases cAMP)
75
Q

How is Cholera treated?

A

Rapid replacement of fluids and electrolytes

76
Q

What are the characteristics of Campylobacter jejuni?

A
  • Curved gram negative rod

- Microaerophilic

77
Q

How are severe Campylobacter jejuni infections treated?

A

Erythromycin or ciprofloxacin

78
Q

What disease is caused by H. pylori?

A

Infectious gastritis

79
Q

What are the characteristics of H. pylori?

A

Gram negative
Microaerophilic
Short/ spiral shaped
Polar flagella

80
Q

What allows H. pylori to survive in that acidic environment of the stomach?

A

Urease enzyme that creates an alkaline microenvironment

81
Q

How is H. pylori diagnosed?

A

Urea breath test

Gastrointestinal System (42 decks)

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