EXAM 2 Gastroenteritis Flashcards
___ refers to the syndromes of diarrhea or vomiting that tend to involve non-inflammatory infection of the upper small bowel or inflammatory infection of the colon
gastroenteritis
in many heavily populated areas, deaths from ___ exceed those from any other single cause
diarrheal illnesses
___ is the leading cause of childhood death in developing countries
diarrheal disease
over ___% of children born in certain parts of latin armerica die before their 5th birthday and in more than half, ___ is the major or associated cause of death
- 13%
- diarrhea
the inoculum of ___ required to cause disease can be reduced 10,000 fold from 108 to 104 organisms by neutralizing gastric acid with 2g of ___
v. cholerae
sodium bicarbonate
what are the 3 microbial virulence factor toxins involved in gasteroenteritis?
neurotoxins, enterotoxins, cytotoxins
neurotoxins are usually ingested as ___ that cause enteric symptoms
preformed toxins
___ have their effect on the central autonomic nervous system rather than on the intestine, per se
neurotoxins
which 3 neurotoxins are involved in gastroenteritis?
staphylococcus aureus, bacillus, and clostridium botulinum
___ have a direct effect on the intestinal mucosa to cause fluid secretion
enterotoxins
enterotoxins cause an alteration in the metabolic activity of the ___
intestinal epithelial cells
enterotoxins result in an outpouring of ___ and ___ primarily in the jejunum and upper ileum
electrolytes and fluid
what are the 7 main enterotoxins involved in gastroenteritis?
- vibrio cholerae
- noncholera vibrio sp.
- e. coli
- salmonella sp.
- clostridium perfringens
- shigella dysenteriae
- bacillus cereus
___ are responsible for the mucosal destruction
cytotoxins
cytotoxins often result in ___ due to the mucosal destruction
inflammatory colitis
cytotoxin mucosal destruction happens almost exclusively in the ___
colon
inflammatory colitis as a result of cytotoxins is often referred to as ___
dysentery
what are the 7 cytotoxins associated with gastroenteritis?
- shigella dysenteriae
- c. perfringens
- vibrio parahemolyticus
- s. aureus
- clostridium difficile
- campylobacter jejuni
- e. coli
do many of the enteric pathogens produce more than one type of toxin?
yes
what are the bacteria associated with attachment microbial virulence factors?
- e. coli
- giardia lamblia
- cryptosporidium
- isospora
describe attachment microbial virulence factors
they destroy the ability of cells to participate in normal secretion and absorption
what are the 6 bacteria associated with invasive microbial virulence factors?
- shigella sp.
- e. coli
- salmonella typhi
- salmonella cholerasuis
- vibrio sp.
- yersinia enterocolitica
describe invasive microbial virulence factors
the capacity of organisms such as shigella and certain invasive strains of e. coli invade and destroy epithelial cells, primarily the colon, is responsible for the inflammatory or dysenteric diarrhea they cause
s. aureus is often found in what 3 things?
meats, milk products, foodhandlers
estimated ___% of all food-borne disease in the US is caused by bacteria and virus
84%
16% of food-borne illness in the US is caused by what?
seafood, plant, and fungal toxins
parasites
___ and ___ are the leading acuses of bacterial foodborne disease in the US
campylobacter jejuni and salmonella sp.
c. perfringenes is often found in what 2 things?
meats and soil
salmonella is found in what 5 things?
poultry, eggs, meats, milk, produce
shigella is found in what 2 things?
produce, direct fecal/oral
campylobacter is found in what 4 things?
water, raw milk, poultry, pets
vibrio parahaemolyticus is found in what?
raw or undercooked seafood
bacillus cereus is found in what 3 things?
rice, meat, and vegetables (dirt)
aeromonas hydrophilia is found in what 2 things?
water and water sports
vibrio cholera is found in what 2 things?
water and contaminated food
SLT e. coli is found in what 3 things?
beef, raw milk, produce
listeria monocytogenes is fond in what 3 things?
soft cheeses, unpasturized milk, deli meats
what are 2 unusual sources of foodborne illness?
off-season fruits and vegetables, exotic pets
what are the main bacteria associated with food-borne illness?
- staphylococcus aureus
- c. perfringens
- salmonella
- shigella
- campylobacter
- vibrio parahaemolyticus
- bacillus cereus
- aeromonas hydrophilia
- vibrio cholera
- SLT e. coli
- listeria monocytogenes
___ has an incubation period of minutes
hysteria reaction
___ have incubation periods of minutes-hours
- bacillus cereus
- s. aureus
- chemicals, heavy metals, and shellfish toxins
___ and ___ have incubation periods of several hours
- botulism
- s. perfringens
which organisms have incubations of about a day or so?
- salmonella
- shigella
- vibrio parahaemolyticus
- campylobacter
- yersenia enterocolitica
- viruses
what 3 organisms have incubation periods of days to weeks?
- c. difficile
- giardia
- amoeba
of greatest importance in the treatment of microbial diarrhea, regardless of the cause or category, is ___
fluid replacement
describe the standard oral fluid regimen for the treatment of gasteroenteritis
- 3.5g NaCl
- 2.5g NaHCO3
- 1.5g KCl
- 20g glucose
- 1 liter of boiled water
describe the in home fluid/electrolyte replacement for the treatment of gastroenteritis
- 3 tsp sugar
- 3/4 tsp salt
- 1/2 tsp baking soda
- 1 cup orange juice
- add water to make 1 quart
- 2 bananas
antibiotic treatment should be avoided in uncomplicated cases of ___
non-typhoid salmonella
*but, antibiotics can be lifesaving in invasive salmonella and typhoid fever
antibiotic treatment may be used for ___ and ___
shigella and cholera
___ can eradicate carriage of c. jejuni and can shorten duration of disease
erythromycin
antibiotics offer no value for ___, ___, and ___ food poisoning
staph, b. cereus, and c. perfringens
antibiotics probably have minimal vause in what 3 organisms?
v. parahaemolyticus, y. enterocolitica, and invasive e. coli
what is a potential contraindication for the use of antibiotics in the treatment of gastroenteritis?
patients with SLT e. coli and HUS
what are the 3 microbial virulence factors?
toxins, attachment, and invasiveness
what are the two normal enteric microflora
- anaerobe - bacteroides fragilis
- facultative - e. coli
at the normal gastric pH (<4), over 99.9% of the ingested coliform bacteria are killed within ___ minutes
30
what are the host factors for gastroenteritis?
- host species, genotype, and age
- personal hygiene
- gastric aciditiy and other physical barriers
- intestinal motility
- enteric microflora
- specific immunity - phagocytic, humoral, cell-mediated
- nonspecific protective factors and human milk
- intestinal receptors
gastrointestinal illnessin the US ranges from ___ to ___ illnesses per person per year
1-1.5
___ is a common result of gastroenteritis
dehydration
can malnutrition cause diarrhea?
yes
